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Sample records for extremely complicated factors

  1. Complications of extremity vascular injuries in conflict.

    Science.gov (United States)

    Brown, Kate V; Ramasamy, Arul; Tai, Nigel; MacLeod, Judith; Midwinter, Mark; Clasper, Jon C

    2009-04-01

    The extremities remain the most common sites of wounding in conflict, are associated with a significant incidence of vascular trauma, and have a high complication rate (infection, secondary amputation, and graft thrombosis). The purpose of this study was to study the complication rate after extremity vascular injury. In particular, the aim was to analyze whether this was influenced by the presence or absence of a bony injury. A prospectively maintained trauma registry was retrospectively reviewed for all UK military casualties with extremity injuries (Abbreviated Injury Score >1) December 8, 2003 to May 12, 2008. Demographics and the details of their vascular injuries, management, and outcome were documented using the trauma audit and medical notes. Thirty-four patients (34%)--37 limbs (30%)--had sustained a total of 38 vascular injuries. Twenty-eight limbs (22.6%) had an associated fracture, 9 (7.3%) did not. Twenty-nine limbs (23.4%) required immediate revascularization to preserve their limb: 16 limbs (13%) underwent an initial Damage Control procedure, and 13 limbs (10.5%) underwent Definitive Surgery. Overall, there were 25 limbs (20.2%) with complications. Twenty-two were in the 28 limbs with open fractures, 3 were in the 9 limbs without a fracture (p vascular trauma if there is an associated fracture, probably due to higher energy transfer and greater tissue damage.

  2. Clinical Characteristics and Risk Factor Analysis for Lower-Extremity Amputations in Diabetic Patients With Foot Ulcer Complicated by Necrotizing Fasciitis.

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    Chen, I-Wen; Yang, Hui-Mei; Chiu, Cheng-Hsun; Yeh, Jiun-Ting; Huang, Chung-Huei; Huang, Yu-Yao

    2015-11-01

    Patients with diabetes are at a higher risk of having diabetic foot ulcers (DFUs) or necrotizing fasciitis (NF). The present study aims to examine the clinical characteristics and associated risk factors for lower-extremity amputation (LEA) in patients with DFU complicated by NF.We retrospectively reviewed patients treated at a major diabetic foot center in Taiwan between 2009 and 2014. Of the 2265 cases 110 had lower-extremity NF. Limb preservation outcomes were classified as major LEA, minor LEA, or limb-preserved. Clinical characteristics, laboratory data, and bacterial culture results were collected for analysis.Of the 110 patients with NF, 100 had concomitant DFUs (NF with DFU) and the remaining 10 had no DFU (NF without DFU). None of the NF patients without DFU died nor had their leg amputated. Two NF patients with DFU died of complications. The amputation rate in the surviving 98 NF patients with DFU was 72.4% (46.9% minor LEA and 25.5% major LEA). Seventy percent of the NF patients without DFU had monomicrobial infections (60% with Streptococcus species), and 81.4% NF patients with DFU had polymicrobial infections. Anaerobic organisms were identified in 66% of the NF patients with DFU. Multinomial logistic regression analysis revealed an association between high-grade Wagner wound classification (Wagner 4 and Wagner 5) and LEA (adjusted odds ratio [aOR] = 21.856, 95% confidence interval [95% CI] = 1.625-203.947, P = 0.02 and aOR = 20.094, 95% CI = 1.968-205.216, P = 0.01 for major and minor LEA, respectively) for NF patients with DFU. In addition, a lower serum albumin level was associated with major LEA (OR = 0.066, P = 0.002).In summary, once DFUs were complicated by NF, the risk of amputation increased. Empirical treatment for NF patients with DFU should cover polymicrobial infections, including anaerobic organisms. The high-grade wound classification and low serum albumin level were associated with LEA.

  3. [Complications in reconstructive procedures on arteries in the lower extremities].

    Science.gov (United States)

    Radak, D; Rosato, E; Cyba-Altunbay, S

    1990-01-01

    During a year (1987/88) a study was performed at he Clinic of Thoracal and Vascular Surgery, supervised by Prof. dr J. Vollmar. Analysis of all cases with complications after reconstruction of the lower limbs arteries necessitating reoperation was performed. There were 56 patients in all. They were retrospectively analysed for establishing risk factors, clinical stage (by Fonstine), and time lapse from the surgery to the occurrence of complications. There were 12(21,4%), 23 (41,1%) and 21 (37,5%) of immediate, early and late complications, respectively. The following causes of complications following reconstruction of the lower limbs arteries were recorded: graft trombosis (41,1%), pseudoaneurism of anastomosis (17,8%), progressive arteriosclerosis (12,7%), proximally or distally to the operated segment. The following reoperations were applied: graft prolongation due to distal occlusion (35,7%), desobstruction of the graft and patch plasty (21,2%), partial or total replacement of the graft (17,9%), correction of the supplying vascular tree (7,1%). More than one reoperation were performed in 22 cases (39,2%) and amputation of the limb was necessitated in 4 (7,1%) cases.

  4. Lower extremity lipedema, upper extremity lipodystrophy and severe calcinosis complicating juvenile dermatomyositis.

    Science.gov (United States)

    Pavlov-Dolijanovic, Slavica R; Vujasinovic Stupar, Nada Z; Gavrilov, Nikola; Seric, Srdjan

    2014-11-01

    Juvenile dermatomyositis (JDM) is a rare but complex and potentially life-threatening autoimmune disease of childhood. Significant proportions of patients have residual weakness, muscle atrophy, joint contractures, and calcinosis. Recently, new clinical findings, such as lipodystrophy accompanied with increased fat deposition in certain areas, have been reported. So far, it is not known whether the redistribution of body fat may be the type of lipedema of lower extremity. We describe a 39-year-old woman who was diagnosed with JDM at the age of 7. Later she developed symmetrical lipodystrophy of upper extremities and symmetrical lipedema of lower extremities (making 2 and 58.3 % of total body fat mass, respectively), with multiple calcified nodules in the subcutaneous tissues. These nodules gradually increased in size despite therapy. Capillaroscopy findings showed scleroderma-like abnormalities. ANA and anti-U1RNP antibodies were positive. Similar cases with simultaneous occurrence of the lipedema of lower extremities, lipodystrophy of upper extremities, and severe calcinosis complicating JDM have not been published so far. We showed that the calcinosis and lipodystrophy were associated with short duration of active disease. Also, we display case that raises the question whether it is possible overlapping autoimmune diseases revealed during follow-up.

  5. Perioperative complications of orthopedic surgery for lower extremity in patients with cerebral palsy.

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    Lee, Seung Yeol; Sohn, Hye-Min; Chung, Chin Youb; Do, Sang-Hwan; Lee, Kyoung Min; Kwon, Soon-Sun; Sung, Ki Hyuk; Lee, Sun Hyung; Park, Moon Seok

    2015-04-01

    Because complications are more common in patients with cerebral palsy (CP), surgeons and anesthesiologists must be aware of perioperative morbidity and be prepared to recognize and treat perioperative complications. This study aimed to determine the incidence of and risk factors for perioperative complications of orthopedic surgery on the lower extremities in patients with CP. We reviewed the medical records of consecutive CP patients undergoing orthopedic surgery. Medical history, anesthesia emergence time, intraoperative body temperature, heart rate, blood pressure, immediate postoperative complications, Gross Motor Function Classification System (GMFCS) level, Cormack-Lehane classification, and American Society of Anesthesiologists physical status classification were analyzed. A total of 868 patients was included. Mean age at first surgery was 11.8 (7.6) yr. The incidences of intraoperative hypothermia, absolute hypotension, and absolute bradycardia were 26.2%, 4.4%, and 20.0%, respectively. Twenty (2.3%) patients had major complications, and 35 (4.0%) patients had minor complications postoperatively. The incidences of intraoperative hypothermia, absolute hypotension, and major postoperative complications were significantly higher in patients at GMFCS levels IV and V compared with patients at GMFCS levels I to III (PGMFCS level, patient age, hip reconstructive surgery, and history of pneumonia are associated with adverse effects on intraoperative body temperature, the cardiovascular system, and immediate postoperative complications.

  6. Risk Factors for Wound Complications Following Abdominoplasty

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    Samir K. Jabaiti

    2009-01-01

    Full Text Available Problem Statement: Abdominoplasty has become an increasingly popular procedure. Risk factors affecting wound complications of abdominoplasty are not adequately defined in literature. Identification of these risk factors is crucial for better patient’s selection and counseling. The objectives of this study were to determine wound complication rate following abdominoplasty and to examine the relationship of a set of possible risk factors with the incidence of complications. Approach: We studied 116 patients (107 women and 9 men who underwent abdominoplasty at Jordan University Hospital, between June 1997 and June 2007. Data were collected from patients’ medical records and analyzed to determine types and rates of surgical wound complications. Fourteen possible risk factors were investigated using logistic regression analysis to evaluate their relationship with the occurrence of wound complications. Risk factors examined were: age, sex, body mass index, parity number, smoking history, history of diabetes mellitus, previous gastroplasty for morbid obesity, previous abdominal surgical scars, type of abdominoplasty, plication of recti, hernia repair, operative time and operative blood loss. Results: A total of 29 patients (two males and 27 females (25% had wound complications. The most common complication was seroma. It was encountered in 15 cases (12.9%. Six patients (5.2% had wound infection. Partial skin necrosis was encountered in four cases (3.4 %. Two patients (1.7% developed wound dehiscence and two patients (1.7% had hematoma. The only factors significantly increased the complication rate were: increased body mass index (p = 0.002 and history of smoking (p = 0.004. Conclusions and Recommendations: This study confirms the adverse effect of overweight and cigarette smoking on the incidence of wound complication rate following abdominoplasty. We recommend that overweight patients and smokers undergoing abdominoplasty should be adequately

  7. Factors predictive of complicated appendicitis in children.

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    Pham, Xuan-Binh D; Sullins, Veronica F; Kim, Dennis Y; Range, Blake; Kaji, Amy H; de Virgilio, Christian M; Lee, Steven L

    2016-11-01

    The ability to predict whether a child has complicated appendicitis at initial presentation may influence clinical management. However, whether complicated appendicitis is associated with prehospital or inhospital factors is not clear. We also investigate whether hyponatremia may be a novel prehospital factor associated with complicated appendicitis. A retrospective review of all pediatric patients (≤12 y) with appendicitis treated with appendectomy from 2000 to 2013 was performed. The main outcome measure was intraoperative confirmation of gangrenous or perforated appendicitis. A multivariable analysis was performed, and the main predictors of interest were age 24 h, leukocytosis (white blood cell count >12 × 10(3)/mL), hyponatremia (sodium ≤135 mEq/L), and time from admission to appendectomy. Of 392 patients, 179 (46%) had complicated appendicitis at the time of operation. Univariate analysis demonstrated that patients with complicated appendicitis were younger, had a longer duration of symptoms, higher white blood cell count, and lower sodium levels than patients with noncomplicated appendicitis. Multivariable analysis confirmed that symptom duration >24 h (odds ratio [OR] = 5.5, 95% confidence interval [CI] = 3.5-8.9, P appendicitis. Increased time from admission to appendectomy was not a predictor of complicated appendicitis (OR = 0.8, 95% CI = 0.5-1.2, P = 0.2). Prehospital factors can predict complicated appendicitis in children with suspected appendicitis. Hyponatremia is a novel marker associated with complicated appendicitis. Delaying appendectomy does not increase the risk of complicated appendicitis once intravenous antibiotics are administered. This information may help guide resource/personnel allocation, timing of appendectomy, and decision for nonoperative management of appendicitis in children. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Incidence of delayed complications following percutaneous CT-guided biopsy of bone and soft tissue lesions of the spine and extremities: A 2-year prospective study and analysis of risk factors

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    Huang, Ambrose J.; Rosenthal, Daniel I. [Massachusetts General Hospital, Boston, MA (United States); Halpern, Elkan F. [Massachusetts General Hospital, Institute of Technology Assessment, Boston, MA (United States)

    2013-01-15

    To prospectively evaluate the incidence of delayed complications (bleeding, pain, infection) following CT-guided biopsies of bone or soft tissue lesions and to identify risk factors that predispose to their occurrence. All adults presenting for CT-guided biopsy of a bone or soft tissue lesion were eligible for the study. Risk factors considered included patient gender and age, bone versus soft tissue, lesion location, lesion depth, anticoagulation, conscious sedation, coaxial biopsy technique, bleeding during the biopsy, dressing type and duration of placement, final diagnosis, needle gauge, number of passes, and number of days to follow-up. Outcomes measured included fever, pain, bruising/hematoma formation, and swelling and were collected by a follow-up phone call within 14 days of the biopsy. Fisher's exact test, the Wald Chi-square test, and univariate, multivariate, and stepwise logistic regression were performed to evaluate the influence of the risk factors on the outcomes. A total of 386 patients participated in the study. The rates of post-biopsy fever, pain, bruising, and swelling were 1.0, 16.1, 15.6, and 9.6 %, respectively. Anticoagulants were identified as a risk factor for fever. Increasing patient age was identified as a risk factor for pain. Female gender and lesion location were identified as risk factors for bruising. Increasing patient age and lesion location were identified as risk factors for swelling. Patient age, female gender, and lesion location are risk factors for delayed minor complications following CT-guided biopsy of a bone or soft tissue lesion. There were no major complications. None of the complications in this series altered patient management. (orig.)

  9. Risk factors for development of complication following peripherally inserted central

    OpenAIRE

    Hakan Aydın; Gülsen Korfalı; Suna Gören; Esra Mercanoğlu Efe; Bachri Ramadan Moustafa; Tolga Yazıcı

    2014-01-01

    Objectives: Peripherally inserted central venous catheters (PICCs) are inserted into central veins through the upper extremity veins. In this retrospective study, we aimed to evaluate PICC procedures, related complications, their causes and factors influencing the success of the procedure during anaesthesia Methods: ‘Central Venous Catheterization Forms’ filled out for 850 patients in whom a PICC was inserted by residents during general anaesthesia between November 2009 and March 2013 in t...

  10. PERIPHERAL BLOCK ANESTHESIA OF UPPER EXTREMITY AND ITS COMPLICATIONS

    OpenAIRE

    Tapar, Hakan; SÜREN, Mustafa; Kaya, Ziya; Arıcı, Semih; Karaman, Serkan; Kahveci, Mürsel

    2012-01-01

    Successful peripheral blocks and selection of appropriate technique according to surgery is possible with a good knowledge of anatomy. Regional peripheral block anesthesia of upper extremity which applied by single injection to plexus brachialis is the most recommended method of anesthesia in daily surgical procedures. The most important advantages of peripheral nerve blocks which are type of regional anesthesia according to general anesthesia and central blocks are less effect to...

  11. Risk Factors of Early Complications of Tracheostomy at Kenyatta ...

    African Journals Online (AJOL)

    Risk Factors of Early Complications of Tracheostomy at Kenyatta National Hospital. ... Journal Home > Vol 17, No 1 (2012) >. Log in or ... The aim of this study was to identify risk factors that contribute to complications following tracheostomies.

  12. Long-term complications of snake bites to the upper extremity.

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    Cowin, D J; Wright, T; Cowin, J A

    1998-01-01

    The purpose of this study was to determine long-term complications of upper-extremity snake envenomations. The records of 73 patients, who were seen for snake bites were obtained; 46 of these patients had bites to the upper extremity, and 27 had bites to the lower extremity. These patients were graded according to the severity of the bite. The snakes involved were eastern diamondback rattlesnake, coral snake, pigmy rattlesnake, water moccasin, and unknown. Fourteen of the 46 patients receiving upper extremity bites were examined by a hand surgeon and an occupational hand therapist 1 to 3.2 years after their bite. Subjective pain data, range-of-motion, intrinsic, extrinsic, finger-flexion tightness, grip strength, pinch strength and objective sensory data were collected. Four patients had continued pain and tissue atrophy at the bite site. There were no long-term sequelae from a missed compartment syndrome.

  13. Risk factors for development of complication following peripherally inserted central

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    Hakan Aydın

    2014-03-01

    Full Text Available Objectives: Peripherally inserted central venous catheters (PICCs are inserted into central veins through the upper extremity veins. In this retrospective study, we aimed to evaluate PICC procedures, related complications, their causes and factors influencing the success of the procedure during anaesthesia Methods: ‘Central Venous Catheterization Forms’ filled out for 850 patients in whom a PICC was inserted by residents during general anaesthesia between November 2009 and March 2013 in the operating room of Uludag University Medical Faculty Hospital were retrospectively analysed. Results: A total of 1174 procedures were evaluated. The most preferred vein for the first attempt was the right basilic vein (32.7%. Difficulty (more than two attempts with the PICC procedure was correlated with the patient’s age (p30 kg/m² (p<0.05, resident with less than 4 years of training (p=0.001, number of PICC attempts ≥2 (p<0.001, more than one resident involved in the catheterization procedure (p<0.001 and previous failed PICC procedures (p<0.001. Conclusion: We conclude that catheterization should be performed under the surveillance of a staff keeping in mind the risks of complications. In the case of failure following 2 attempts, the procedure should be handed over to a more experienced staff member. J Clin Exp Invest 2014; 5 (1: 29-35

  14. Risk factors of severe ischemic biliary complications after liver transplantation

    Institute of Scientific and Technical Information of China (English)

    Ming-FengWang; Zhong-Kui Jin; Da-Zhi Chen; Xian-Liang Li; Xin Zhao; Hua Fan

    2011-01-01

    BACKGROUND: Ischemia-related biliary tract complications remain high after orthotopic liver transplantation. Severe ischemic biliary complications often involve the hepatic duct bifurcation and left hepatic duct, resulting finally in obstructive jaundice. Prevention and management of such complications remain a challenge for transplant surgeons. METHODS: All 160 patients were followed up for at least 180 days after transplantation. One-way analysis of variance (ANOVA) and comparative univariate analysis were made using 3 groups (no complications; mild complications;severe complications), to analyze risk factors associated with biliary complications. Multiple logistic regression and linear regression analysis were used to analyze independent risk factors for severe ischemic biliary complications, after excluding other confounding factors. RESULTS: By ANOVA and comparative univariate analysis, the risk factors associated with biliary complications were preoperative bilirubin level (P=0.007) and T-tube stenting of the anastomosis (P=0.016). Multiple logistic regression analysis showed that the use of T-tube and preoperative serum bilirubin were not independent risk factors for severe ischemic biliary complications after orthotopic liver transplantation. Chi-square analysis indicated that in the incidence of severe ischemic biliary lesions, bile duct second warm ischemic time longer than 60 minutes was a significant risk factor. Linear regression demonstrated a negative correlation between cold preservation time and warm ischemia time. CONCLUSIONS: Preoperative serum bilirubin level and the use of T-tube stenting of the anastomosis were independent risk factors for biliary complications after liver transplantation, but not for severe ischemic biliary complications. The second warm ischemia time of bile duct longer than 60 minutes and prolonged bile duct second warm ischemia time combined with cold preservation time were significant risk factors for severe

  15. Colopleural fistula caused by aspergillus: an extremely rare complication after lung resection—case report

    OpenAIRE

    Hayashi, Akio; Susaki, Yoshiyuki; Ose, Naoko; Takeuchi, Yukiyasu; Maeda, Hajime

    2016-01-01

    A colopleural fistula is a rare condition reported to be caused by Crohn’s disease, a malignant tumor of the gastrointestinal tract, and other clinical conditions. Some studies have noted that a sub-diaphragmatic abscess, usually organized following abdominal surgery, may play some role in the formation of this type of fistula. Therefore, a colopleural fistula is a complication very rarely encountered by thoracic surgeons after lung resection. We experienced an extremely rare case of colopleu...

  16. Urethral protrusion of the abdominal catheter of ventriculoperitoneal shunt: Case report of extremely rare complication

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    Ugur Yazar

    2012-01-01

    Full Text Available Hydrocephalus in its various forms constitutes one of the major problems in pediatric neurosurgical practice. The placement of a ventriculoperitoneal (VP shunt is the most common form of treatment for hydrocephalus, so that all neurosurgeons struggle with shunt malfunctions and their complications. Well-known complications are connected with the use of the valve systems (malfunction, infectious, overdrainage, secondary craniosynostosis, etc.. We report an unusual case of protruding abdominal catheter from the urethra. This girl had received a VP shunt for hydrocephalus following surgery of posterior fossa medulloblastoma 4 years ago. After admission, the entire system was removed, antibiotic treatment was administered for 2 weeks, and a new VP shunt was placed. The postoperative course was uneventful. This complication is extremely rare.

  17. Patient factors may predict anastomotic complications after rectal cancer surgery

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    Dana M. Hayden

    2015-03-01

    Conclusion: Our study identifies preoperative anemia as possible risk factor for anastomotic leak and neoadjuvant chemoradiation may lead to increased risk of complications overall. Further prospective studies will help to elucidate these findings as well as identify amenable factors that may decrease risk of anastomotic complications after rectal cancer surgery.

  18. Green teeth are a late complication of prolonged conjugated hyperbilirubinemia in extremely low birth weight infants.

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    Battineni, Sireesha; Clarke, Paul

    2012-01-01

    Eruption of green, discolored teeth affecting the primary dentition has been described in association with congenital viral infection, sepsis, hemolytic jaundice, and cholestasis. The purpose of this paper was to present the cases of 3 extremely low birth weight preterm infants who were noted to have green teeth at the corrected ages of 10 to 12 months. All had a history of prolonged conjugated hyperbilirubinemia during their time in neonatal intensive care. For infants with prolonged conjugated hyperbilirubinemia, extreme preterm birth and/or extremely low birth weight may be additional risk factors predisposing to the eruption of green teeth in later infancy.

  19. ADAPTIVE CHEMOREFLECTORY MECHANISMS RESPONDING TO EXTREME FACTORS

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    S. G. Krivoschekov

    2014-01-01

    Full Text Available An analysis of adaptive chemoreflectory mechanisms responding of extreme factors opens prospects for understanding of a role of a phenotype in this process, and also for search of new methods of the forecast and diagnostics. We analysed individual-typological variability of hypoxic tolerance and muscular working capacity at healthy people with various kinds of habitual sports activity. It is established, that formatting of new neuro-visceral interactions which occurs under the influence of individual training process, is reflected in reactivity of cardiovascular and respiratory systems in response to hypoxia. Adaptive strategy produces changes in systemic response to hypoxia which correlates with aerobic work capacity and EEG activity of a brain at sportsmen of different specializations. Individually-typological characteristics of sportsmen (typology of nervous system also mediate EEG response to hypoxia, but they can be modified by the influence of phenotypic adaptive mechanisms (aerobic, anaerobic or mixed type of individual training process. The obtained results testify, that sports loadings forms specific adjustment of mechanisms of chemoreflectory regulation of cardiovascular and respiratory systems.

  20. SIZE AND SHAPE FACTOR EXTREMES OF SPHEROIDS

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    Daniel Hlubinka

    2011-05-01

    Full Text Available In the paper we consider random prolate (oblate spheroids and their random profiles. The limiting distribution of the extremal characteristics of the spheroids is related to the limiting distribution of the corresponding extremal characteristics of the profiles. The difference between the analysis of the prolate and oblate spheroids is discussed. We propose the possible application of the theoretical results.

  1. Complications of Sclerotherapy with Sclerosing Foam in Lower Extremity Varicose Veins

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    Hossein Hemmati

    2015-01-01

    Full Text Available Background: Using sclerotherapy with foam has caused a great change in treatment of varicose veins. Although, it is more than a century that it is being used, no exact and comprehensive knowledge of its complications has been published yet with regard to the existing facilities in Iran. Materials and Methods: In this cross-sectional study, Patients with varicose veins of lower extremity referred to cardiology clinic of Razi hospital, Rasht were included in the study after doppler sonography and in case of presence of varicose veins with more than 2 mm diameter in lower extremities without inadequacy of saphenofemoral and saphenopopliteal valve. They then underwent sclerosing with foam treatment. The total number of patients was 156 who were examined 2 weeks and 3 months after sclerotherapy in terms of complications such as pain, pigmentation, recurrence, phlebitis, deep vein thrombosis and skin necrosis. Results: Out of 156 patients, 47 were men and 109 women whose mean±SD age was 46.5±12.2 years. Two weeks after sclerotherapy, pain in 95 patients (65.1%, pigmentation in 79 patients (53.4%, recurrence in 5 patients (3.4%, necrosis in 8 patients (5.5% and no phlebitis was witnessed. Three months after sclerotherapy, pain in 10 patients (6.8%, pigmentation in 52 patients (35.1%, recurrence in 13 patients (8.8% and phlebitis in 13 patients (8.8% were seen; however, necrosis was not observed Conclusion: Sclerotherapy with foam is an effective, safe and inexpensive method for treatment of varicose veins of lower extremities. Thus, in case of a careful selection of patients and conduction in an equipped center, few complications will be seen.

  2. Risk factors for medical complications of acute hemorrhagic stroke

    Institute of Scientific and Technical Information of China (English)

    Jangala Mohan Sidhartha; Aravinda Reddy Purma; Nagaswaram Krupa Sagar; Marri Prabhu Teja; Meda Venkata subbaiah; Muniswami Purushothaman

    2015-01-01

    Objective: To assess the risk factors leading to medical complications of hemorrhagic stroke. Methods: We conducted an observational study in neurology, emergency and general medicine wards at a tertiary care teaching hospital in Kadapa. We recruited hemorrhagic stroke patients, and excluded the patients have evidence of trauma or brain tumor as the cause of hemorrhage. We observed the subjects throughout their hospital stay to assess the risk factors and complications. Results: During period of 12 months, 288 subjects included in the study, 89% of them identified at least 1 prespecified risk factor for their admission in hospital and 75% of them experienced at least 1 prespecified complication during their stay in hospital. Around 47% of subjects deceased, among which 64% were females. Conclusions: Our study has assessed that hypertension followed by diabetes mellitus are the major risk factors for medical complications of hemorrhagic stroke. Female mortality rate was more when compared to males.

  3. Factors that can minimize bleeding complications after renal biopsy

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    Zhu, M. S.; J. Z. Chen; A.P. Xu

    2014-01-01

    Renal biopsy is a very important diagnostic tool in the evaluation of renal diseases. However, bleeding remains to be one of the most serious complications in this procedure. Many new techniques have been improved to make it safer. The risk factors and predictors of bleeding after percutaneous renal biopsy have been extensively reported in many literatures, and generally speaking, the common risk factors for renal biopsy complications focus on hypertension, high serum creatinine, bleeding dia...

  4. Cesarean delivery in Finland: maternal complications and obstetric risk factors.

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    Pallasmaa, Nanneli; Ekblad, Ulla; Aitokallio-Tallberg, Ansa; Uotila, Jukka; Raudaskoski, Tytti; Ulander, Veli-Matti; Hurme, Saija

    2010-07-01

    To assess the rate of maternal complications related to cesarean section (CS) and to compare morbidity between elective, emergency and crash-emergency CS. To establish risk factors associated with maternal CS morbidity. A prospective multicenter cohort study. Twelve delivery units in Finland. Women delivering by CS (n = 2,496) during a 6 months period in the study hospitals. Data on pregnant women, CS, and maternal recovery during the hospital stay was collected prospectively on report forms. The complication rates by different CSs were calculated, and factors associated with morbidity were analyzed by odds ratios (OR). Maternal complication rates in different types of CS. The association of risk factors with morbidity. About 27% of women delivering by CS had complications; 10% had severe complications. The complication rate was higher in emergency CS than in elective CS, and highest in crash-emergency CS. Significant independent risk factors for maternal morbidity were emergency CS and crash-emergency CS compared to elective CS (OR 1.8; 95% confidence interval (CI) 1.5-2.2), pre-eclampsia (OR 1.5; CI 1.1-2.0), maternal obesity (OR 1.4; CI 1.1-1.8) and maternal increasing age (OR 1.1; CI 1.03-1.2 per each 5 years). Maternal complications are frequent in CS, and although performing CS electively reduces the occurrence of complications, the frequency is still high. The complication rate depends on the degree of emergency, and increases with maternal obesity, older age and pre-eclampsia.

  5. Disgust is a factor in extreme prejudice.

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    Taylor, Kathleen

    2007-09-01

    Understanding intergroup prejudice is a dominant research focus for social psychology. Prejudice is usually conceptualized as a continuum of positive/negative affect, but this has limitations. It neither reflects people's ability to maintain simultaneous positive and negative stereotypes of others nor explains extreme prejudice (bigotry). Some researchers have proposed multidimensional models of prejudice in which different negative emotions are evoked depending on the situation. Extending this to bigotry raises the question of which emotions are most relevant. Therefore, this study looked at 'anti-group' texts--writings which promote extreme intergroup hostility--and analysed the frequency of emotive language. Findings suggest that bigotry may be distinguished by high levels of disgust.

  6. Secondary abdominal compartment syndrome after complicated traumatic lower extremity vascular injuries.

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    Macedo, F I B; Sciarretta, J D; Otero, C A; Ruiz, G; Ebler, D J; Pizano, L R; Namias, N

    2016-04-01

    Secondary abdominal compartment syndrome (ACS) can occur in trauma patients without abdominal injuries. Surgical management of patients presenting with secondary ACS after isolated traumatic lower extremity vascular injury (LEVI) continues to evolve, and associated outcomes remain unknown. From January 2006 to September 2011, 191 adult trauma patients presented to the Ryder Trauma Center, an urban level I trauma center in Miami, Florida with traumatic LEVIs. Among them 10 (5.2 %) patients were diagnosed with secondary ACS. Variables collected included age, gender, mechanism of injury, and clinical status at presentation. Surgical data included vessel injury, technical aspects of repair, associated complications, and outcomes. Mean age was 37.4 ± 18.0 years (range 16-66 years), and the majority of patients were males (8 patients, 80 %). There were 7 (70 %) penetrating injuries (5 gunshot wounds and 2 stab wounds), and 3 blunt injuries with mean Injury Severity Score (ISS) 21.9 ± 14.3 (range 9-50). Surgical management of LEVIs included ligation (4 patients, 40 %), primary repair (1 patient, 10 %), reverse saphenous vein graft (2 patients, 20 %), and PTFE interposition grafting (3 patients, 30 %). The overall mortality rate in this series was 60 %. The association between secondary ACS and lower extremity vascular injuries carries high morbidity and mortality rates. Further research efforts should focus at identifying parameters to accurately determine resuscitation goals, and therefore, prevent such a devastating condition.

  7. Hepatitis A complicated with acute renal failure and high hepatocyte growth factor: A case report.

    Science.gov (United States)

    Oe, Shinji; Shibata, Michihiko; Miyagawa, Koichiro; Honma, Yuichi; Hiura, Masaaki; Abe, Shintaro; Harada, Masaru

    2015-08-28

    A 58-year-old man was admitted to our hospital. Laboratory data showed severe liver injury and that the patient was positive for immunoglobulin M anti-hepatitis A virus (HAV) antibodies. He was also complicated with severe renal dysfunction and had an extremely high level of serum hepatocyte growth factor (HGF). Therefore, he was diagnosed with severe acute liver failure with acute renal failure (ARF) caused by HAV infection. Prognosis was expected to be poor because of complications by ARF and high serum HGF. However, liver and renal functions both improved rapidly without intensive treatment, and he was subsequently discharged from our hospital on the 21(st) hospital day. Although complication with ARF and high levels of serum HGF are both important factors predicting poor prognosis in acute liver failure patients, the present case achieved a favorable outcome. Endogenous HGF might play an important role as a regenerative effector in injured livers and kidneys.

  8. Extremely high Q-factor toroidal metamaterials

    CERN Document Server

    Basharin, Alexey A; Volsky, Nikita; Kafesaki, Maria; Economou, Eleftherios N; Ustinov, Alexey V

    2016-01-01

    We demonstrate that, owing to the unique topology of the toroidal dipolar mode, its electric/magnetic field can be spatially confined within subwavelength, externally accessible regions of the metamolecules, which makes the toroidal planar metamaterials a viable platform for high Q-factor resonators due to interfering toroidal and other dipolar modes in metamolecules.

  9. Factors that can minimize bleeding complications after renal biopsy.

    Science.gov (United States)

    Zhu, M S; Chen, J Z; Xu, A P

    2014-10-01

    Renal biopsy is a very important diagnostic tool in the evaluation of renal diseases. However, bleeding remains to be one of the most serious complications in this procedure. Many new techniques have been improved to make it safer. The risk factors and predictors of bleeding after percutaneous renal biopsy have been extensively reported in many literatures, and generally speaking, the common risk factors for renal biopsy complications focus on hypertension, high serum creatinine, bleeding diatheses, amyloidosis, advanced age, gender and so on. Our primary purpose of this review is to summarize current measures in recent years literature aiming at minimizing the bleeding complication after the renal biopsy, including the drug application before and after renal biopsy, operation details in percutaneous renal biopsies, nursing and close monitoring after the biopsy and other kinds of biopsy methods.

  10. Obesity - a risk factor for postoperative complications in general surgery?

    NARCIS (Netherlands)

    E.K.M. Tjeertes (Elke); S.S.E. Hoeks (Sanne S.E.); S.S.B.J.C. Beks (Sabine S.B.J.C.); T.M. Valentijn (Tabita); A.A.G.M. Hoofwijk (Anton A.G.M.); R.J. Stolker (Robert J.)

    2015-01-01

    textabstractBackground: Obesity is generally believed to be a risk factor for the development of postoperative complications. Although being obese is associated with medical hazards, recent literature shows no convincing data to support this assumption. Moreover a paradox between body mass index and

  11. Extremely High Q-factor metamaterials due to Anapole Excitation

    CERN Document Server

    Basharin, Alexey A; Volsky, Nikita; Kafesaki, Maria; Economou, Eleftherios N

    2016-01-01

    We demonstrate that ideal anapole metamaterials have infinite Q-factor. We have designed and fabricated a metamaterial consisting of planar metamolecules which exhibit anapole behavior in the sense that the electric dipole radiation is almost cancelled by the toroidal dipole one, producing thus an extremely high Q-factor at the resonance frequency. The size of the system, at the mm range, and the parasitic magnetic quadrupole radiation are the factors limiting the size of the Q-factor. In spite of the very low radiation losses the local fields at the metamolecules are extremely high, of the order of higher than the external incoming field.

  12. Extreme macrosomia--obstetric outcomes and complications in birthweights >5000 g.

    Science.gov (United States)

    Hehir, Mark P; Mchugh, Ann F; Maguire, Patrick J; Mahony, Rhona

    2015-02-01

    Management of extremely large birthweight infants presents challenges during the period of labour and delivery. We sought to examine outcomes in infants with extreme macrosomia (birthweight > 5000 g), at an institution where the management of labour is standardised. This is a retrospective analysis of prospectively gathered data on all infants with a birthweight >5000 g delivered at a tertiary level institution from 2008 to 2012. Details of labour characteristics and outcomes were examined; these were compared according to parity. During the study period, there were 46 128 deliveries at the hospital and 182 infants with a birthweight >5000 g, giving an incidence of 0.4%. The majority of women (133/182) were multiparous. Among nulliparas, 47% (23/49) had a vaginal delivery, while 53% (26/49) had a caesarean delivery. 86% (97/113) of multiparas had a vaginal delivery, and 14% (16/113) had a caesarean delivery. 43% (69/162) required induction of labour. This was more common in nulliparous compared with multiparous women (58% [29/49] vs 30% [40/133], P = 0.005, OR = 3.4, 95% CI = 1.7-6.6). A total of 30% (49/162) of women had their labour accelerated with oxytocin. There were higher rates of oxytocin use in nulliparas than in multiparas (55% [27/49] vs 16.5% [22/133], P macrosomia affects 0.4% of pregnancies in contemporary practice. Multiparas have a low rate of caesarean section. Infants delivered vaginally are at increased risk of shoulder dystocia and associated complications. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  13. About risk factors in the development of thrombotic complications in patients with chronic myeloprolipherative diseases

    Directory of Open Access Journals (Sweden)

    Nikolayenko-Kamyshova T.P.

    2013-03-01

    Full Text Available Steady increasing number of patients with the diseases com¬plicated by thromboses and embolisms requires intensified study. Practically in all oncologic and oncogematologic patients readiness for the development of thrombotic complications is formed even before changes in hemo¬stasiogramm. In the hematologic clinic the problem of thrombotic compli¬cations especially acute in patients with chronic myeloprolipherative diseases (CMD: the manifestation of disease at the age of 50-70 years, its benign prolonged course with factors, which burden vascularly - thrombocytic changes – hypertonic disease, ischemic heart disease, metabolic syndrome - they aggravate the forecast of disease. The purpose of the work was to estimate influence of the risk factors of thrombotic complications in patients with CMD. Possible risk factors in the development of thrombotic complication in 110 patients with CMD were investigated. In 38 of them vascular complications, occurred which manifested in the age group of 50 years and over. During the expressed plethora and or progression of myelopro¬lipherative syndrome in combination with arterial hypertension, coronary heart disease, atherothrombosis of lower extremities vessels as well as changed laboratory data (significant increase of Hb, RBC,WBC,PLT; high level of cholesterol, LDH, uric acid in connection with high level of throm¬botic aggregation greatly enhance the risk of thrombotic complications. Taking into account complex of these changes and administration of the corresponding complex therapy it is possible to warn life threatening states.

  14. Risk factors for complications in patients with ulcerative colitis.

    Science.gov (United States)

    Manser, Christine N; Borovicka, Jan; Seibold, Frank; Vavricka, Stephan R; Lakatos, Peter L; Fried, Michael; Rogler, Gerhard

    2016-04-01

    Patients with ulcerative colitis may develop extraintestinal manifestations like erythema nodosum or primary sclerosing cholangitis or extraintestinal complications like anaemia, malabsorption or they may have to undergo surgery. The aim of this study was to investigate potential risk factors for complications like anaemia, malabsorption or surgery in ulcerative colitis. Data on 179 patients with ulcerative colitis were retrieved from our cross-sectional and prospective Swiss Inflammatory Bowel Disease Cohort Study data base for a median observational time of 4.2 years. Data were compared between patients with (n = 140) or without (n = 39) complications. Gender, age at diagnosis, smoking status, disease extent, delay of diagnosis or therapy, mesalamine (5-ASA) systemic and topical therapy, as well as other medication were analysed as potential impact factors. In the multivariate regression analysis a delay of 5-ASA treatment by at least two months (odds ratio (OR) 6.21 (95% confidence interval (CI) 2.13-18.14), p = 0.001) as well as a delay with other medication with thiopurines (OR 6.48 (95% CI 2.01-20.91), p = 0.002) were associated with a higher risk for complications. This significant impact of a delay of 5-ASA therapy was demonstrated for extraintestinal manifestations (EIMs) as well as extraintestinal complications (EICs). Extensive disease as well as therapy with methotrexate showed a significantly increased risk for surgery (extensive disease: OR 2.62 (1.02-6.73), p = 0.05, methotrexate: OR 5.36 (1.64-17.58), p = 0.006). A delay of 5-ASA therapy of more than two months in the early stage of ulcerative colitis (UC) constitutes a risk for complications during disease course. Extensive disease is associated with a higher risk for surgery.

  15. Risk Factors for Severe Bleeding Complications in Percutaneous Renal Biopsy.

    Science.gov (United States)

    Xu, Da-Min; Chen, Min; Zhou, Fu-de; Zhao, Ming-Hui

    2017-03-01

    Percutaneous renal biopsy is essential for diagnosis of many renal diseases. Previous studies have revealed a variety of factors associated with bleeding complications of renal biopsy; however, data are not sufficient in the Chinese population. We aimed to investigate the risk factors for severe post-biopsy bleeding events in a large cohort of Chinese patients. The data of patients who underwent percutaneous renal biopsy from January 2008 to December 2012 were collected. Severe bleeding complication was defined as requiring intervention, including blood transfusion or an invasive procedure (radiological or surgical) due to bleeding. Logistic regression analysis was used to assess risk factors. Over the 5-year period, 3,577 native kidney biopsies were performed. Severe bleeding complication occurred in 14 biopsies (0.39%). The patients with complications were older, had higher blood pressure, lower hemoglobin, lower platelet count and worse renal function. Multivariable logistic regression demonstrated that platelet level and the estimated glomerular filtration rate were independently associated with the risk of complications. Each 10 × 10(9)/L increase of platelet count was associated with an 11% decrease of severe bleeding risk (odds ratio = 0.89; 95% CI: 0.80-0.98; P = 0.02). Each 1mL/minute/1.73m(2) increase of the estimated glomerular filtration rate was associated with a 4% decrease of severe bleeding risk (odds ratio = 0.96; 95% CI: 0.94-0.99; P = 0.004). Patients with worse renal function and lower platelet counts had a higher risk of developing severe bleeding events after renal biopsy. Copyright © 2017 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

  16. Clinical features and risk factor analysis for lower extremity deep venous thrombosis in Chinese neurosurgical patients

    Directory of Open Access Journals (Sweden)

    Fuyou Guo

    2015-01-01

    Full Text Available Background: Deep venous thrombosis (DVT contributes significantly to the morbidity and mortality of neurosurgical patients; however, no data regarding lower extremity DVT in postoperative Chinese neurosurgical patients have been reported. Materials and Methods: From January 2012 to December 2013, 196 patients without preoperative DVT who underwent neurosurgical operations were evaluated by color Doppler ultrasonography and D-dimer level measurements on the 3rd, 7th, and 14th days after surgery. Follow-up clinical data were recorded to determine the incidence of lower extremity DVT in postoperative neurosurgical patients and to analyze related clinical features. First, a single factor analysis, Chi-square test, was used to select statistically significant factors. Then, a multivariate analysis, binary logistic regression analysis, was used to determine risk factors for lower extremity DVT in postoperative neurosurgical patients. Results: Lower extremity DVT occurred in 61 patients, and the incidence of DVT was 31.1% in the enrolled Chinese neurosurgical patients. The common symptoms of DVT were limb swelling and lower extremity pain as well as increased soft tissue tension. The common sites of venous involvement were the calf muscle and peroneal and posterior tibial veins. The single factor analysis showed statistically significant differences in DVT risk factors, including age, hypertension, smoking status, operation time, a bedridden or paralyzed state, the presence of a tumor, postoperative dehydration, and glucocorticoid treatment, between the two groups (P < 0.05. The binary logistic regression analysis showed that an age greater than 50 years, hypertension, a bedridden or paralyzed state, the presence of a tumor, and postoperative dehydration were risk factors for lower extremity DVT in postoperative neurosurgical patients. Conclusions: Lower extremity DVT was a common complication following craniotomy in the enrolled Chinese neurosurgical

  17. Hyperthyroidism secondary to hysterosalpingography: an extremely rare complication: A case report.

    Science.gov (United States)

    Ma, Guotao; Mao, Rui; Zhai, Haixin

    2016-12-01

    Hysterosalpingography (HSG), a standard procedure for the evaluation of women with infertility and repetitive pregnancy loss, is associated with complications such as uterine perforation, infection, allergic reactions, syncope, hemorrhage and shock, and pulmonary or retinal embolus. However, hyperthyroidism has not been reported as one of its complications. We report the case of a 33-year-old euthyroid woman who presented to our hospital with palpitation, hand tremor, fatigue, and excessive sweating after HSG. Thyroid function tests revealed a thyroid stimulating hormone (TSH) level of 0.012 μIU/mL (range 0.38-4.34 μIU/mL), free T4 of 2.886 ng/dL (range 0.81-1.89 ng/dL), and free T3 levels of 9.4 pg/mL (range 1.80-4.10 pg/mL), and antithyroglobulin antibody of 31.78 IU/mL (range hyperthyroidism (IIH), but was not treated with antithyroid drugs. She has spontaneously recovered and is pregnant currently. This is the first reported case of overt IIH caused by HSG in a euthyroid patient without risk factors. It suggests that HSG also leads to excessive iodine absorption, which induces secondary hyperthyroidism.

  18. Predisposing factors and surgical outcome of complicated liver hydatid cysts

    Institute of Scientific and Technical Information of China (English)

    Alper; Akcan; Erdogan; Sozuer; Hizir; Akyildiz; Zeki; Yilmaz; Ahmet; Ozturk; Altay; Atalay

    2010-01-01

    AIM: To evaluate the predisposing factors for peritoneal perforation and intrabiliary rupture and the effects of these complications on surgical outcome in liver hydatid disease.METHODS: A total of 372 patients with liver hydatid cysts who had undergone surgical treatment were evaluated retrospectively. Twenty eight patients with peritoneal perforation, 93 patients with spontaneous intrabiliary perforation, and 251 patients with noncomplicated hydatid cysts were treated in our clinics.RESULTS: When the pred...

  19. Risk factors for postoperative complications in robotic general surgery.

    Science.gov (United States)

    Fantola, Giovanni; Brunaud, Laurent; Nguyen-Thi, Phi-Linh; Germain, Adeline; Ayav, Ahmet; Bresler, Laurent

    2017-03-01

    The feasibility and safety of robotically assisted procedures in general surgery have been reported from various groups worldwide. Because postoperative complications may lead to longer hospital stays and higher costs overall, analysis of risk factors for postoperative surgical complications in this subset of patients is clinically relevant. The goal of this study was to identify risk factors for postoperative morbidity after robotic surgical procedures in general surgery. We performed an observational monocentric retrospective study. All consecutive robotic surgical procedures from November 2001 to December 2013 were included. One thousand consecutive general surgery patients met the inclusion criteria. The mean overall postoperative morbidity and major postoperative morbidity (Clavien >III) rates were 20.4 and 6 %, respectively. This included a conversion rate of 4.4 %, reoperation rate of 4.5 %, and mortality rate of 0.2 %. Multivariate analysis showed that ASA score >3 [OR 1.7; 95 % CI (1.2-2.4)], hematocrit value surgery [OR 1.5; 95 % CI (1-2)], advanced dissection [OR 5.8; 95 % CI (3.1-10.6)], and multiquadrant surgery [OR 2.5; 95 % CI (1.7-3.8)] remained independent risk factors for overall postoperative morbidity. It also showed that advanced dissection [OR 4.4; 95 % CI (1.9-9.6)] and multiquadrant surgery [OR 4.4; 95 % CI (2.3-8.5)] remained independent risk factors for major postoperative morbidity (Clavien >III). This study identifies independent risk factors for postoperative overall and major morbidity in robotic general surgery. Because these factors independently impacted postoperative complications, we believe they could be taken into account in future studies comparing conventional versus robot-assisted laparoscopic procedures in general surgery.

  20. [Hormonal changes in response to extreme environment factors].

    Science.gov (United States)

    Koubassov, R V

    2014-01-01

    In this paper presented current state about hormonal changes in sympathetic-adrenal, hypophysis-adrenal, hypophysis-gonads and thyroid levels from extreme environment factors. It's shown that hypophysis gonads and thyroid endocrine links along with sympathetic adrenal, hypophysis adrenal axes are very important relevance in response to extreme environment factors and organism adaptation. In this time a hormonal secretion changes corresponds as interrelated reactions cascade in mechanisms of homeostasis maintenance. A studying of this mechanisms and revealing of its role in stress pathogenesis is fundamental biomedical investigation task. A problem solving allow to perfect prophylactic and treatment methods against stress diseases.

  1. Risk factors and prevention of vascular complications in polycythemia vera.

    Science.gov (United States)

    Barbui, T; Finazzi, G

    1997-01-01

    Risk factors for vascular complications in polycythemia vera (PV) include laboratory and clinical findings. Among laboratory values, the hematocrit has been clearly associated with thrombosis, particularly in the cerebral circulation. Platelet count is a possible but not yet clearly established predictor of vascular complications. Platelet function tests are of little help in prognostic evaluation because most attempts to correlate these abnormalities with clinical events have been disappointing. Clinical predictors of thrombosis include increasing age and a previous history of vascular events. Identifying risk factors for thrombosis is important to initiate therapy. Phlebotomy is associated with an increased incidence of thrombosis in the first 3 to 5 years, whereas chemotherapy may induce a higher risk of secondary malignancies after 7 to 10 years of follow-up. New cytoreductive drugs virtually devoid of mutagenic risk include interferon-alpha and anagrelide, but their role in reducing thrombotic complications remains to be demonstrated. Antithrombotic drugs, such as aspirin, are frequently used in PV, despite doubts regarding safety and efficacy. Two recent studies from the Gruppo Italiano Studio Policitemia Vera (GISP) assessed the rate of major thrombosis as well as the tolerability of low-dose aspirin in PV patients. These investigations created a favorable scenario for launching a European collaborative clinical trial (ECLAP study) aimed at testing the efficacy of low-dose aspirin in preventing thrombosis and prolonging survival in patients with PV.

  2. Risk factors for lower extremity fatigue among assembly plant workers.

    Science.gov (United States)

    Gell, Nancy; Werner, Robert A; Hartigan, Anne; Wiggermann, Neal; Keyserling, W Monroe

    2011-03-01

    Work-related fatigue of the lower extremities is a known cause of lost productivity and significant employer costs. Common workplace solutions to reduce fatigue levels include anti-fatigue matting, shoe orthoses, or sit/stand work stations. However, assessment of these anti-fatigue measures within the workplace has been limited. This was a cross sectional study in an automotive assembly plant on employees with at least 6 months tenure. Subject data were collected via questionnaires including Likert-scale questions to define fatigue severity. Jobs were evaluated for lower extremity ergonomic exposures via videotaping, pedometers, interviews, and industrial engineering records. Lower extremity fatigue at the end of the work day was associated with a higher prevalence of smoking, rheumatoid arthritis, job dissatisfaction, use of shoes with firmer outsoles, and increased time on the job spent standing or walking. Supervisor support and increased time spent on carpet were protective. Lower extremity fatigue that interfered with activities outside of work had additional risk factors including higher BMI, prior diagnosis of osteoarthritis, and increased hours per week spent working. While these results identify carpet as being protective against lower extremity fatigue, no similar relationship was identified for anti-fatigue mats. No adverse relationship was found between hard surfaces such as concrete and lower extremity fatigue. Given the high costs associated with work-related fatigue, future areas for potential intervention include smoking cessation, specific shoe recommendations, and enhancing psychosocial aspects of work such as supervisor support. Copyright © 2010 Wiley-Liss, Inc.

  3. Extremely high Q -factor metamaterials due to anapole excitation

    Science.gov (United States)

    Basharin, Alexey A.; Chuguevsky, Vitaly; Volsky, Nikita; Kafesaki, Maria; Economou, Eleftherios N.

    2017-01-01

    We have designed and fabricated a metamaterial consisting of planar metamolecules which exhibit unusual, almost perfect anapole behavior in the sense that the electric dipole radiation is almost canceled by the toroidal dipole one, producing thus an extremely high Q -factor at the resonance frequency. Thus we have demonstrated theoretically and experimentally that metamaterials approaching ideal anapole behavior have very high Q -factor. The size of the system, at the millimeter range, and the parasitic magnetic quadrupole radiation are the factors limiting the size of the Q -factor. In spite of the very low radiation losses the estimated local fields at the metamolecules are extremely high, of the order of 104 higher than the external incoming field.

  4. Risk Factors for Postoperative Pulmonary Complications after Abdominal Surgery

    Directory of Open Access Journals (Sweden)

    Nertila Kodra

    2016-05-01

    Full Text Available BACKGROUND: Incidence of postoperative pulmonary complications (PPC in patients undergoing non-cardiothoracic surgery remains high and the occurrence of these complications has enormous implications for the patient and the health care system. AIM: The aim of the study was to identify risk factors for PPC in patients undergoing abdominal surgical procedures. MATERIALS AND METHODS: A prospective cohort study in abdominal surgical patients, admitted to the emergency and surgical ward of the UHC of Tirana, Albania, was conducted during the period: March 2014-March 2015. We collected data on the occurrence of a symptomatic and clinically significant PPC using clinical, laboratory, and radiology data. We evaluated the relations between PPCs and various pre-operative or intra-operative factors to identify risk factors. RESULTS: A total of 450 postoperative patients admitted to the surgical emergency and surgical ward were studied. The mean age were 59.85 ±13.64 years with 59.3% being male. Incidence of PPC was 27.3% (123 patients and hospital length of stay was 4.93 ± 4.65 days. Length of stay was substantially prolonged for those patients who developed PPC (7.48 ± 2.89 days versus 3.97± 4.83 days, p 2 (OR 6.37; 95% CI: 1.54-26.36, P = 0.01. CONCLUSION: We must do some efforts in reducing postoperative pulmonary complications, firstly to identify which patients are at increased risk, and then following more closely high-risk patients because those patients are most likely to benefit.

  5. Myotonic Dystrophy-1 Complicated by Factor-V (Leiden Mutation

    Directory of Open Access Journals (Sweden)

    Josef Finsterer

    2015-01-01

    Full Text Available Objectives. Presence of a factor-V Leiden mutation in a patient with myotonic dystrophy type 1 (DM1 has been reported only once. Here we report the second DM1 patient carrying a factor-V mutation who died from long-term complications of this mutation. Case Report. A 66-year-old DM1 patient with multi-organ-disorder syndrome developed a first deep venous thrombosis (DVT and consecutive pulmonary embolism (PE at age 50 y. Acetyl-salicylic acid was given. One year later he experienced a second DVT; that is why phenprocoumon was started. Despite anticoagulation, he experienced a third DVT bilaterally and a second PE bilaterally at 61 y; that is why a vena cava filter was additionally deployed. Despite therapeutic anticoagulation, he experienced a vena cava filter thrombosis at age 62 y. Genetic workup revealed a heterozygous factor-V mutation in addition to a CTG-repeat expansion of 500. As a consequence of PE he developed chronic obstructive pulmonary disease and experienced recurrent pulmonary infections, which were lastly responsible for decease at age 66 y despite intensive care measures. Conclusion. The heterozygous Leiden mutation may severely affect DM1 patients to such a degree that they die from its complications. If DM1 patients present with unusual manifestations, search for causes other than a CTG-repeat expansion is indicated.

  6. Distal wound complications following pedal bypass: analysis of risk factors.

    Science.gov (United States)

    Robison, J G; Ross, J P; Brothers, T E; Elliott, B M

    1995-01-01

    Wound complications of the pedal incision continue to compromise successful limb salvage following aggressive revascularization. Significant distal wound disruption occurred in 14 of 142 (9.8%) patients undergoing pedal bypass with autogenous vein for limb salvage between 1986 and 1993. One hundred forty-two pedal bypass procedures were performed for rest pain in 66 patients and tissue necrosis in 76. Among the 86 men and 56 women, 76% were diabetic and 73% were black. All but eight patients had a history of diabetes and/or tobacco use. Eight wounds were successfully managed with maintenance of patent grafts from 5 to 57 months. Exposure of a patent graft precipitated amputation in three patients, as did graft occlusion in an additional patient. One graft was salvaged by revision to the peroneal artery and one was covered by a local bipedicled flap. Multiple regression analysis identified three factors associated with wound complications at the pedal incision site: diabetes mellitus (p = 0.03), age > 70 years (p = 0.03), and rest pain (p = 0.05). Ancillary techniques ("pie-crusting") to reduce skin tension resulted in no distal wound problems among 15 patients considered to be at greatest risk for wound breakdown. Attention to technique of distal graft tunneling, a wound closure that reduces tension, and control of swelling by avoiding dependency on and use of gentle elastic compression assume crucial importance in minimizing pedal wound complications following pedal bypass.

  7. Extreme Preterm Premature Rupture of Membranes: Risk Factors and Feto Maternal Outcomes

    Directory of Open Access Journals (Sweden)

    Nihal Al Riyami

    2013-03-01

    Full Text Available Objectives: Preterm premature rupture of membranes (PPROM is defined as a rupture of the amniotic membranes occurring before 37 weeks of gestation and before the onset of labor. Extreme PPROM occurs prior to 26 weeks gestation and contributes to an increased risk of prematurity, leading to maternal and fetal complications. This study aims to estimate the risk factors associated with various maternal complications and to determine the worst outcomes in Omani females with extreme PPROM.Methods: A retrospective cohort study was conducted on 44 women with extreme PPROM, who delivered at Sultan Qaboos University Hospital (SQUH from January 2006 to December 2011. Women with incomplete information, multiple gestations, or a preterm delivery resulting from medical intervention, as well as women who delivered elsewhere were excluded from the study.Results: Forty-four women with extreme PPROM were included in our study. The results revealed the most important risk factor to be history of infection, which was noted in 24 study participants. The mean maternal age was 30 years. The mean gestational age at PPROM and at delivery were 20.7±3.2 (range: 16-26 weeks and 29.7±7.6 weeks (range: 17-40 weeks, respectively. The maternal complications observed in this study included; infection which was seen in 20 (45% patients, antepartum hemorrhage in 11 (25% patients, and cesarean section which was required in 12 (27% patients. There was no significant association between risk factors such as gestational age at delivery, parity, maternal age at PPROM, or maternal Body Mass Index (BMI and cesarean section rate. Infection played a major role, both as a risk factor and in causing extreme PPROM, which in turn increased in 12 patients (27%. In the multivariable model for predicting the need for cesarean section (gestational age at delivery, parity, maternal age at PPROM in years and maternal BMI, none of the factors were statistically significant.Conclusion: Overall

  8. Epidemiological and sociodemographic factors associated with complicated alcohol withdrawal syndrome.

    Science.gov (United States)

    Monte-Secades, R; Blanco-Soto, M; Díaz-Peromingo, J A; Sanvisens-Bergé, A; Martín-González, M C; Barbosa, A; Rosón-Hernández, B; Tejero-Delgado, M A; Puerta-Louro, R; Rabuñal-Rey, R

    2017-10-01

    To analyse the influence of epidemiological and sociodemographic factors in complicated alcohol withdrawal syndrome (AWS). A multicentre, observational prospective study was conducted on consecutively added patients with AWS hospitalised in internal medicine departments. We recorded sociodemographic, epidemiological, clinical and progression data. Complicated AWS was defined as that which progressed with seizures or delirium tremens. We studied 228 episodes of AWS in 219 patients. The mean age was 54.5 years (SD, 11.5), and 90.8% were men. AWS was the cause for hospitalisation in 39.9% of the patients. Some 27.1% of the cases presented seizures, and 32.4% presented delirium tremens. The daily quantity of alcohol ingested was 17.8 standard drink units (SD, 21.4), with 16.6 years of dependence (SD, 11.3). The pattern of alcohol abuse was regular in 82.8% of the patients. Some 38.4% of the patients were married or had a partner, and 45.6% had children. Some 72.7% of the patients were unemployed or retired. Some 68.5% had only completed primary studies. Some 4.8% consumed cannabis, 5.2% consumed cocaine and 3% consumed opioids. The independent variables related to complicated AWS were consumption of a drug other than alcohol (OR, 5.3; 95% CI 1.5-18.7), low education level (OR, 3.4; 95% CI 1.6-7.3) and hospitalisation for AWS (OR, 2.9; 95% CI 1.5-5.6). The model's receiver operating characteristic area was 0.718 (95% CI 0.643-0.793). Concomitant drug abuse and a low educational level could help identify patients at risk of complicated AWS. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.

  9. Splenectomy complicated by sustained extreme thrombocytosis and extensive portosplenomesenteric vein thrombosis in pyrimidine 5'-nucleotidase deficiency.

    Science.gov (United States)

    Al-Jafar, Hassan A; Taqi, Ali; Madda, John Patrick; Abdullah, Thamer A

    2013-11-28

    Reactive and redistributional thrombocytosis is a well-known postsplenectomy occurrence .Usually it is transient and it rarely reaches extreme levels. We report a rare case of haemolytic anaemia where splenectomy was carried out following trauma to a massively enlarged spleen and was followed by extreme sustained thrombocytosis associated with extensive portal, splenic and mesenteric vein thrombosis despite standard antithrombotic prophylaxis.

  10. Late amputation may not reduce complications or improve mental health in combat-related, lower extremity limb salvage patients.

    Science.gov (United States)

    Krueger, Chad A; Rivera, Jessica C; Tennent, David J; Sheean, Andrew J; Stinner, Daniel J; Wenke, Joseph C

    2015-08-01

    Following severe lower extremity trauma, patients who undergo limb reconstruction and amputations both endure frequent complications and mental health sequelae. The purpose of this study is to assess the extent to which late amputation following a period of limb salvage impacts the evolution of the clinical variables that can affect the patient's perception of his or her limb: ongoing limb associated complications and mental health conditions. A case series of US service members who sustained a late major extremity amputation from September 2001 through July 2011 were analysed. Pre- and post-amputation complications, mental health conditions, and reason(s) for desiring amputation were recorded. Forty-four amputees with detailed demographic, injury and treatment data were identified. The most common reasons for desiring a late amputation were pain and being dissatisfied with the function of the salvage limb. An average of 3.2 (range 1-10) complications were reported per amputee prior to undergoing late amputation and an average of 1.8 (range 0-5) complications reported afterwards. The most common complication prior to and after late amputation was soft tissue infection (24 (17%) and 9 (22%), respectively). Twenty-nine (64%) late amputees were diagnosed with a mental health condition prior to undergoing their amputation and 27 (61%) late amputees were diagnosed with mental conditions after late amputation. Only three of the 15 patients who did not have a mental health condition documented prior to their late amputation remained free of a documented mental health condition after the amputation. Ongoing complications and mental health conditions can affect how a patient perceives and copes with his or her limb following severe trauma. Patient dissatisfaction following limb reconstruction can influence the decision to undergo a late amputation. Patients with a severe, combat related lower extremity injury that are undergoing limb salvage may not have a reduction in

  11. Upper Extremity Sports Injury: Risk Factors in Comparison to Lower Extremity Injury in More Than 25 000 Cases

    NARCIS (Netherlands)

    Sytema, R.; Dekker, R.; Dijkstra, P.U.; ten Duis, H.J.; van der Sluis, C.K.

    2010-01-01

    Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting:

  12. Upper Extremity Sports Injury : Risk Factors in Comparison to Lower Extremity Injury in More Than 25 000 Cases

    NARCIS (Netherlands)

    Sytema, Renee; Dekker, Rienk; Dijkstra, Pieter U.; ten Duis, Hendrik J.; van der Sluis, Corry K.

    Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting:

  13. Upper Extremity Sports Injury : Risk Factors in Comparison to Lower Extremity Injury in More Than 25 000 Cases

    NARCIS (Netherlands)

    Sytema, Renee; Dekker, Rienk; Dijkstra, Pieter U.; ten Duis, Hendrik J.; van der Sluis, Corry K.

    2010-01-01

    Objective: To analyze differences in sports injury characteristics of the upper and lower extremity and to identify factors that contribute to the risk of sustaining an upper extremity injury compared with the risk of sustaining a lower extremity injury. Design: Retrospective cohort study. Setting:

  14. The temerloh hospital cataract complications study: factors associated with, types and outcomes of cataract surgery complications

    Directory of Open Access Journals (Sweden)

    Thevi Thanigasalam

    2014-08-01

    Full Text Available AIM: To study the prevalence of complications of cataract surgery and any association between the occurrence of complications and experience of surgeon, type of surgery, type of anaesthesia and visual outcome.METHODS: This was a retrospective study of patients who underwent cataract surgery over a period of two years in a district hospital in Malaysia. The demographic details of patients, type of surgery done, as well as type of anaesthesia used and experience of the surgeon were noted. The types of intraoperative and postoperative complications were recorded. The final best corrected visual outcome was recorded.RESULTS: Complications occurred in 11.1% of the total 1007 patients operated. Posterior capsule rupture(3.6%was the most common complication. The experience of the surgeon and the type of anaesthesia used did not affect complications during surgery. Intracapsular cataract extraction(ICCEand phacoemulsification converted to extracapsular cataract extraction(ECCEwere significantly associated with more complications(PPCONCLUSION: The occurrence of complications during cataract surgery significantly affected the visual outcome. The type of surgery done was associated by the occurrence of complications. However, the experience of the surgeon and the type of anaesthesia used did not affect the occurrence of complications. We recommend that particular attention be given to ICCE and phacoemulsification converted to ECCE to minimise the complications and thereby reducing the chances of poor vision postoperatively.

  15. Complicated appendicitis: Analysis of risk factors in children

    Directory of Open Access Journals (Sweden)

    Mahavir Singh

    2014-01-01

    Full Text Available Background: Acute appendicitis (AA is the most common surgical emergency in childhood. The risk of rupture is negligible within the first 24 h, climbing to 6% after 36 h from the onset of symptoms. Because of difficulty in accurate diagnosis of AA a significant number of children still are being managed when it is already perforated. There is always a need to make an early diagnosis of AA and to find out the risk factors associated with development of complication in this condition. Patients and Methods: A total of 102 patients with a clinical diagnosis of AA were admitted during the study period. On admission, a good clinical history and proper physical examination was performed. All the eligible patients who finally diagnosed clinically as having AA were planned for emergency open appendectomy. The removed appendix was sent for histopathological examination in all the study subjects. Results: Out of 102 cases, 93 cases were histopathologically appendicitis, rest nine cases showed no evidence of inflammation so the rate of negative appendectomy was around 9%. On histopathology normal appendix was found in nine patients (8.9%, AA in 71 patients (69.6%, complicated appendicitis (CA which includes perforated and gangrenous appendicitis was present in 22 patients (21.5%. Perforations were more common in patients who were younger than 5 years. >60% patients presented with CA when the duration of pain was >72 h. Presence of appendicolith increased the probability of CA.

  16. Uterine prolapse in pregnancy: risk factors, complications and management.

    Science.gov (United States)

    Tsikouras, Panagiotis; Dafopoulos, Alexandros; Vrachnis, Nikolaos; Iliodromiti, Zoe; Bouchlariotou, Sofia; Pinidis, Petros; Tsagias, Nikolaos; Liberis, Vasileios; Galazios, Georgios; Von Tempelhoff, Georg Friedrich

    2014-02-01

    Presentation of uterine prolapse is a rare event in a pregnant woman, which can be pre-existent or else manifest in the course of pregnancy. Complications resulting from prolapse of the uterus in pregnancy vary from minor cervical infection to spontaneous abortion, and include preterm labor and maternal and fetal mortality as well as acute urinary retention and urinary tract infection. Moreover, affected women may be at particular risk of dystocia during labor that could necessitate emergency intervention for delivery. Recommendations regarding the management of this infrequent but potentially harmful condition are scarce and outdated. This review will examine the causative factors of uterine prolapse and the antepartum, intrapartum and puerperal complications that may arise from this condition as well as therapeutic options available to the obstetrician. While early recognition and appropriate prenatal management of uterine prolapse during pregnancy is imperative, implementation of conservative treatment modalities throughout pregnancy, these applied in accordance with the severity of the uterus prolapse and the patient's preference, may be sufficient to achieve uneventful pregnancy and normal, spontaneous delivery.

  17. Diabetic foot complications and their risk factors from a large retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Khalid Al-Rubeaan

    Full Text Available Foot complications are considered to be a serious consequence of diabetes mellitus, posing a major medical and economical threat. Identifying the extent of this problem and its risk factors will enable health providers to set up better prevention programs. Saudi National Diabetes Registry (SNDR, being a large database source, would be the best tool to evaluate this problem.This is a cross-sectional study of a cohort of 62,681 patients aged ≥ 25 years from SNDR database, selected for studying foot complications associated with diabetes and related risk factors.The overall prevalence of diabetic foot complications was 3.3% with 95% confidence interval (95% CI of (3.16%-3.44%, whilst the prevalences of foot ulcer, gangrene, and amputations were 2.05% (1.94%-2.16%, 0.19% (0.16%-0.22%, and 1.06% (0.98%-1.14%, respectively. The prevalence of foot complications increased with age and diabetes duration predominantly amongst the male patients. Diabetic foot is more commonly seen among type 2 patients, although it is more prevalent among type 1 diabetic patients. The Univariate analysis showed Charcot joints, peripheral vascular disease (PVD, neuropathy, diabetes duration ≥ 10 years, insulin use, retinopathy, nephropathy, age ≥ 45 years, cerebral vascular disease (CVD, poor glycemic control, coronary artery disease (CAD, male gender, smoking, and hypertension to be significant risk factors with odds ratio and 95% CI at 42.53 (18.16-99.62, 14.47 (8.99-23.31, 12.06 (10.54-13.80, 7.22 (6.10-8.55, 4.69 (4.28-5.14, 4.45 (4.05-4.89, 2.88 (2.43-3.40, 2.81 (2.31-3.43, 2.24 (1.98-2.45, 2.02 (1.84-2.22, 1.54 (1.29-1.83, and 1.51 (1.38-1.65, respectively.Risk factors for diabetic foot complications are highly prevalent; they have put these complications at a higher rate and warrant primary and secondary prevention programs to minimize morbidity and mortality in addition to economic impact of the complications. Other measurements, such as decompression of lower

  18. Factors influencing ischemic cerebrovascular disease complicated by hyperhomocysteinemia

    Institute of Scientific and Technical Information of China (English)

    Zhongping An; Yonghong Xing; Sha Jin

    2008-01-01

    BACKGROUND: Hyperhomocysteinemia, as an important risk factor for ischemic cerebrovascular disease is receiving increasing attention.OBJECTIVE: To analyze whether differences of gender, age, cerebrovascular disease typing, and disease conditions exist when ischemic cerebrovascular disease occurs together with hyperhomocysteinemia. DESIGN: A controlled observation. SETTING: Department of Neurology, Tianjin Huanhu Hospital. PARTICIPANTS: A total of 601 acute ischemic cerebrovascular disease inpatients, comprising 386 males and 215 females, aged 33-90 years old, were admitted to the Department of Stroke, Tianjin Huanhu Hospital between August 2005 and April 2007, and were recruited for this study. All included patients consisted of 342 aged patients (≥ 60 years old) and 92 middle-aged and young patients ( 0.05). No significant difference in incidence of hyperhomocysteinemia existed between mild, moderate, and severe cerebrovascular disease patients (P > 0.05). CONCLUSION: There is a greater chance of ischemic cerebrovascular disease complicated by hyperhomocysteinemia in older, male patients.

  19. Predictive factors of hemorrhagic complications after partial nephrectomy.

    Science.gov (United States)

    Fardoun, T; Chaste, D; Oger, E; Mathieu, R; Peyronnet, B; Rioux-Leclercq, N; Verhoest, G; Patard, J J; Bensalah, K

    2014-01-01

    To identify the predictive factors of hemorrhagic complications (HC) in a contemporary cohort of patients who underwent partial nephrectomy (PN). Records of 199 consecutive patients who underwent PN between 2008 and 2012 at our institution were retrospectively analyzed. HC was defined as a hematoma requiring transfusion, an arterio-veinous fistula, a false aneurysm or a post-operative decrease of hemoglobin >3 g/dl. Patients with or without HC were compared using Wilcoxon and Fisher exact tests for continuous and categorical variables, respectively. We performed a univariate and multivariate analysis with a logistic regression model using the occurrence of an HC as the dependent variable. 54% of the patients were male with a median age of 61 (22-86) years. Median BMI was 26 (18-47) kg/m(2). Surgery was done open, laparoscopically or with robotic assistance in 106, 54 and 39 cases, respectively. Global complication rate was 40% including 21.6% HC. There were more complex tumors (75.6% vs. 66.5%, p = 0.04) and median length of stay was increased (11 days compared to 7 days, p imperative indication (p = 0.08), RENAL score (p = 0.07), operating time (p = 0.07) and operative blood loss > 250 ml (p = 0.002) were statistically relevant. In multivariate analysis, only operative blood loss >250 ml was identified as a predictive factor of HC (p = 0.0007). Patients who underwent a procedure with estimated blood loss >250 ml should be carefully monitored in the postoperative course. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  20. Vitrectomy as a Risk Factor for Complicated Cataract Surgery.

    Science.gov (United States)

    Fenberg, Moss J; Hainsworth, Kenneth J; Rieger, Frank G; Hainsworth, Dean P

    2016-01-01

    A retrospective review of 98 cases of complicated cataract surgery and/or delayed intraocular lens (IOL) dislocation examined the relationship between vitrectomy and cataract surgery complications. Nine (9.2%) of the 98 patients had a history of vitrectomy, before or after cataract surgery, and each had complicated cataract surgery. Six patients who underwent vitrectomy before cataract surgery experienced intraoperative complications. Three patients in whom vitrectomy was performed after uneventful cataract surgery subsequently had delayed IOL dislocation.

  1. Urological complications after radical hysterectomy: Incidence rates and predisposing factors

    Directory of Open Access Journals (Sweden)

    Likić-Lađević Ivana

    2007-01-01

    Full Text Available Bacground/Aim. Radical hysterectomy is a surgical approach for stage Ib and IIa of cervical cancer. The incidence of intraoperative injuries of the bladder during radical hysterectomy ranges from 0.4-3.7%. The ureter can be crushed, caught in sutures, transsected, obstructed by angulation, or ischemic by the stippling or periureteric fascia. Vesicovaginal and ureterovaginal fistuls are reported to develop in 0.9-2% of patients after radical abdominal hysterectomy. Fistulas usually become manifested or visible at speculum examination within 14 days following the surgery. The aim of this study was to establish the incidence and predisposing factor of urological complications after radical hysterectomy. Methods. The study included a total of 536 patients with invasive stage Ib to IIb cancer of the cervix uteri who had underwent radical hysterectomy. The special elements considered were: the patient’s age; the International Federation of Ginecology and Obstetrics (FIGO stage after pathohistology; duration of operation; the result of preoperative laboratory tests for diabetes, anemia, hypoproteinemia, or disorders of liver or kidney function; ASA status; postoperative surgical infection. Results. The average age of the patients with complications was 48.68 years. All patients with intraoperative ureteric and bladder injuries had statisticaly significant higher stage of disease and operation lasted more than in others without injury. We noticed 1.3% ureteral injuries and 1.49% bladder injuries, more than 50% of the patients with a previously mentioned injuries were operated on more than 3 hours. We found 2.61% vesicovaginal and 2.43% ureterovaginal fistuls. A total of 50% of the patients with bladder injury and vesicovaginal fistuls and 70% of the patients with ureterovaginal fistuls had diabetes mellitus. Postoperative infection of surgical site is a very important factor for the development of fistule. Half of the patients with vesicovaginal

  2. Neonatal Meningitis: Risk Factors, Causes, and Neurologic Complications

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    Nasrin KHALESSI

    2014-12-01

    Full Text Available How to Cite This Article: Khalessi N, Afsharkhas L. Neonatal Meningitis: Risk Factors, Causes and Neurologic Complications.Iran J Child Neurol. 2014 Autumn;8(4: 46-50.AbstractObjectiveNeonates are at greater risk for sepsis and meningitis than other ages and in spite of rapid diagnoses of pathogens and treatments, they still contribute to complications and mortality. This study determines risk factors, causes, andneurologic complications of neonatal meningitis in  ospitalized neonates.Material & MethodsIn this descriptive, cross sectional study, we evaluated 415 neonates with sepsis and meningitis admitted to the neonatal intensive care unit at our center between 2008 and 2012. The data that was recorded was age, sex, birth weight, prenatalrisk factors, clinical features, blood and cerebrospinal fluid analysis, and brain sonographic findings and outcomes.Results Twenty patients had meningitis. Eleven cases (55% were male. The mean age was 8. 41 days and mean birth weight was 2891.5±766 grams. Poor feeding, seizures, and tachypnea were detected in 12 (60%, 11 (55%, and 6 (30%patients, respectively. Prenatal risk factors were prolonged rupture of membranes, maternal vaginitis, asymptomatic bacteriuria, prematurity, low birth weights, and asphyxia. Four patients had positive cerebrospinal fluid cultures with klebsiella pneumoniae 2 (50%, Enterococcus spp. 1 (25%, and Group B streptococcus 1 (25% cases, respectively. Two cases had positive blood cultures with klebsiella pneumoniae. Neurologic complications were brain edema, subdural effusion,and brain abscesses with hydrocephaly. One neonate (5% died.ConclusionOur study provides some information about risk factors, pathogens, and neurologic complications for neonatal meningitis. Prenatal assessments help to diagnose and reduce risk factors of this hazardous disease. ReferencesVolpe JJ. Bacterial and fungal intracranial infections. In:Neurology of the Newborn. 5th. Edition

  3. Lower Extremity Arterial Occlusive Disease As a Rare Complication of Crohn's Disease

    Institute of Scientific and Technical Information of China (English)

    Wei-wei Wu; Xue-ying Jiang; Chang-wei Liu; Yong-jun Li; Rong Zeng

    2009-01-01

    Objective To investigate the dinical characteristics and treatment strategy of lower extremity arterial occlusive disease in patients with Crohn's disease(CD).Methods Clinical information of 9 cases suffering from lower extremity arterial occlusion and CD was investigated retrospectively.Results All the cases were less than 50 years old and the most were females(8/9).Arterial occlusions occurred in either active(5/9)or inactive(4/9)stage of CD.Besides the arteries of lower extremities,other arteries could also be involved such as aorta,iliac artery,renal artery or mesentery artery.Seven cases had atherosclerotic imaging findings(4 had aortic plaques and 6 had iliac artery stenoses).Embolectomy or thromboendarterectomy were mostly performed.Four(44.4% )cases had recurrent lower limb ischemia.Conclusions Arterial occlusive disease is a rare extraintestinal manifestation of CD.A thorough inspection of aorta is necessary.Embolectomy is mostly preferred.Anticoagulation treatment is highly recommended after the operation.

  4. Surrounding rock deformation regularity of roadway under extremely complicated geological conditions in deep mine and its control

    Institute of Scientific and Technical Information of China (English)

    刘长友; 何卓军; 万志军

    2003-01-01

    By combining the practices of deep mine mining in Changguang Mine field and using the Universal Distinct Element Code 3.0(UDEC3.0) numerical computing method, the distribution characteristics of deformation field and stress field as well as the surrounding rock deformation regularity of soft rock roadway are analyzed under extremely complicated geological conditions, a technical principle of bolting to control the surrounding rock of roadway is put forward. And also using a dynamic control for surrounding rocks designing method, the supporting parameters and implement plan are rationally determined. The experimental tests have obtained a good controlling result of surrounding rock.

  5. Risk factors for development of complication following peripherally inserted central catheters: A retrospective analysis of 850 patients

    OpenAIRE

    Aydın, Hakan; Korfalı, Gülsen; Gören, Suna; Efe, Esra Mercanoğlu; Moustafa, Bachri Ramadan; Yazıcı, Tolga

    2014-01-01

    Objectives: Peripherally inserted central venous catheters (PICCs) are inserted into central veins through the upper extremity veins. In this retrospective study, we aimed to evaluate PICC procedures, related complications, their causes and factors influencing the success of the procedure during anaesthesia Methods: ‘Central Venous Catheterization Forms\\' filled out for 850 patients in whom a PICC was inserted by residents during general anaesthesia between November 2009 and Mar...

  6. Risk factors for development of complication following peripherally inserted central catheters: A retrospective analysis of 850 patients

    OpenAIRE

    Aydın, Hakan; Korfalı, Gülsen; Gören, Suna; Efe, Esra Mercanoğlu; Moustafa, Bachri Ramadan; Yazıcı, Tolga

    2015-01-01

    Objectives: Peripherally inserted central venous catheters (PICCs) are inserted into central veins through the upper extremity veins. In this retrospective study, we aimed to evaluate PICC procedures, related complications, their causes and factors influencing the success of the procedure during anaesthesia Methods: ‘Central Venous Catheterization Forms\\' filled out for 850 patients in whom a PICC was inserted by residents during general anaesthesia between November 2009...

  7. Risk factors for lead complications in cardiac pacing

    DEFF Research Database (Denmark)

    Kirkfeldt, Rikke Esberg; Johansen, Jens Brock; Nøhr, Ellen Aagaard;

    2011-01-01

    Lead complications are the main reason for reoperation after implantation of pacemakers (PM) or cardiac resynchronization therapy (CRT-P) devices.......Lead complications are the main reason for reoperation after implantation of pacemakers (PM) or cardiac resynchronization therapy (CRT-P) devices....

  8. Psychological factors in exceptional, extreme and torturous environments.

    Science.gov (United States)

    Leach, John

    2016-01-01

    Our cognitive system has adapted to support goal-directed behaviour within a normal environment. An abnormal environment is one to which we are not optimally adapted but can accommodate through the development of coping strategies. These abnormal environments can be 'exceptional', e.g., polar base, space station, submarine, prison, intensive care unit, isolation ward etc.; 'extreme', marked by more intense environmental stimuli and a real or perceived lack of control over the situation, e.g., surviving at sea in a life-raft, harsh prison camp etc.; or 'tortuous', when specific environmental stimuli are used deliberately against a person in an attempt to undermine his will or resistance. The main factors in an abnormal environment are: psychological (isolation, sensory deprivation, sensory overload, sleep deprivation, temporal disorientation); psychophysiological (thermal, stress positions), and psychosocial (cultural humiliation, sexual degradation). Each single factor may not be considered tortuous, however, if deliberately structured into a systemic cluster may constitute torture under legal definition. The individual experience of extremis can be pathogenic or salutogenic and attempts are being made to capitalise on these positive experiences whilst ameliorating the more negative aspects of living in an abnormal environment.

  9. Parsimonious kernel extreme learning machine in primal via Cholesky factorization.

    Science.gov (United States)

    Zhao, Yong-Ping

    2016-08-01

    Recently, extreme learning machine (ELM) has become a popular topic in machine learning community. By replacing the so-called ELM feature mappings with the nonlinear mappings induced by kernel functions, two kernel ELMs, i.e., P-KELM and D-KELM, are obtained from primal and dual perspectives, respectively. Unfortunately, both P-KELM and D-KELM possess the dense solutions in direct proportion to the number of training data. To this end, a constructive algorithm for P-KELM (CCP-KELM) is first proposed by virtue of Cholesky factorization, in which the training data incurring the largest reductions on the objective function are recruited as significant vectors. To reduce its training cost further, PCCP-KELM is then obtained with the application of a probabilistic speedup scheme into CCP-KELM. Corresponding to CCP-KELM, a destructive P-KELM (CDP-KELM) is presented using a partial Cholesky factorization strategy, where the training data incurring the smallest reductions on the objective function after their removals are pruned from the current set of significant vectors. Finally, to verify the efficacy and feasibility of the proposed algorithms in this paper, experiments on both small and large benchmark data sets are investigated.

  10. Patients with Risk Factors for Complications Do Not Require Longer Antimicrobial Therapy for Complicated Intra-Abdominal Infection.

    Science.gov (United States)

    Rattan, Rishi; Allen, Casey J; Sawyer, Robert G; Mazuski, John; Duane, Therese M; Askari, Reza; Banton, Kaysie L; Claridge, Jeffrey A; Coimbra, Raul; Cuschieri, Joseph; Dellinger, E Patchen; Evans, Heather L; Guidry, Christopher A; Miller, Preston R; O'Neill, Patrick J; Rotstein, Ori D; West, Michaela A; Popovsky, Kimberley; Namias, Nicholas

    2016-09-01

    A prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. We hypothesized that patients with specific risk factors for complications also had similar outcomes. Short-course patients with obesity, diabetes, or Acute Physiology and Chronic Health Evaluation II ≥15 from the STOP-IT trial were compared with longer duration patients. Outcomes included incidence of and days to infectious complications, mortality, and length of stay. Obese and diabetic patients had similar incidences of and days to surgical site infection, recurrent intra-abdominal infection, extra-abdominal infection, and Clostridium difficile infection. Short- and long-course patients had similar incidences of complications among patients with Acute Physiology and Chronic Health Evaluation II ≥15. However, there were fewer days to the diagnosis of surgical site infection (9.5 ± 3.4 vs 21.6 ± 6.2, P = 0.010) and extra-abdominal infection (12.4 ± 6.9 vs 21.8 ± 6.1, P = 0.029) in the short-course group. Mortality and length of stay was similar for all groups. A short course of antibiotics in complicated intra-abdominal infection with source control seems to have similar outcomes to a longer course in patients with diabetes, obesity, or increased severity of illness.

  11. Predictive factors for lower extremity amputations in diabetic foot infections

    Directory of Open Access Journals (Sweden)

    Zameer Aziz

    2011-09-01

    Full Text Available The objective of this study was to evaluate the epidemiology of diabetic foot infections (DFIs and its predictive factors for lower extremity amputations. A prospective study of 100 patients with DFIs treated at the National University Hospital of Singapore were recruited in the study during the period of January 2005–June 2005. A protocol was designed to document patient's demographics, type of DFI, presence of neuropathy and/or vasculopathy and its final outcome. Predictive factors for limb loss were determined using univariate and stepwise logistic regression analysis. The mean age of the study population was 59.8 years with a male to female ratio of about 1:1 and with a mean follow-up duration of about 24 months. All patients had type 2 diabetes mellitus. Common DFIs included abscess (32%, wet gangrene (29%, infected ulcers (19%, osteomyelitis (13%, necrotizing fasciitis (4% and cellulitis (3%. Thirteen patients were treated conservatively, while surgical debridement or distal amputation was performed in 59 patients. Twenty-eight patients had major amputations (below or above knee performed. Forty-eight percent had monomicrobial infections compared with 52% with polymicrobial infections. The most common pathogens found in all infections (both monomicrobial and polymicrobial were Staphylococcus aureus (39.7%, Bacteroides fragilis (30.3%, Pseudomonas aeruginosa (26.0% and Streptococcus agalactiae (21.0%. Significant univariate predictive factors for limb loss included age above 60 years, gangrene, ankle-brachial index (ABI <0.8, monomicrobial infections, white blood cell (WBC count ≥ 15.0×109/L, erythrocyte sedimentation rate ≥100 mm/hr, C-reactive protein ≥15.0 mg/dL, hemoglobin (Hb ≤10.0g/dL and creatinine ≥150 µmol/L. Upon stepwise logistic regression, only gangrene, ABI <0.8, WBC ≥ 15.0×109/L and Hb ≤10.0g/dL were significant.

  12. Risk factors for biliary complications after liver transplantation from donation after cardiac death

    Directory of Open Access Journals (Sweden)

    LYU Guoyue

    2015-12-01

    Full Text Available Liver transplantation has become the effective therapeutic method for end-stage liver disease, but the incidence of biliary complications after liver transplantation remains high. With an increasing number of liver transplantation procedures from donation after cardiac death (DCD, it is necessary to investigate the risk factors for biliary complications after liver transplantation from DCD and enhance our understanding of such risk factors in order to reduce biliary complications after liver transplantation from DCD.

  13. Complications and risk factors in transrectal ultrasound-guided prostate biopsies

    Directory of Open Access Journals (Sweden)

    Carlos Márcio Nóbrega de Jesus

    Full Text Available CONTEXT AND OBJECTIVE: Prostate biopsy is not a procedure without risk. There is concern about major complications and which antibiotics are best for routine use before these biopsies. The objective was to determine the rate of complications and the possible risk factors in prostate biopsies. DESIGN AND SETTING: Prospective study, Faculdade de Medicina de Botucatu. METHODS: Transrectal ultrasound (TRUS guided prostate biopsies were carried out in 174 patients presenting either abnormality in digital rectal examinations (DRE or levels higher than 4 ng/ml in prostate-specific antigen (PSA tests, or both. RESULTS: Hemorrhagic complications were the most common (75.3%, while infectious complications occurred in 19% of the cases. Hematuria was the most frequent type (56%. Urinary tract infection (UTI occurred in 16 patients (9.2%. Sepsis was observed in three patients (1.7%. The presence of an indwelling catheter was a risk factor for infectious complications (p < 0.05. Higher numbers of biopsies correlated with hematuria, rectal bleeding and infectious complications (p < 0.05. The other conditions investigated did not correlate with post-biopsy complications. CONCLUSIONS: Post-biopsy complications were mostly self-limiting. The rate of major complications was low, thus showing that TRUS guided prostate biopsy was safe and effective. Higher numbers of fragments taken in biopsies correlated with hematuria, rectal bleeding and infectious complications. An indwelling catheter represented a risk factor for infectious complications. The use of aspirin was not an absolute contraindication for TRUS.

  14. Examination of factors that lead to complications for new home parenteral nutrition patients.

    Science.gov (United States)

    de Burgoa, Lori Jeris; Seidner, Douglas; Hamilton, Cindy; Stafford, Judy; Steiger, Ezra

    2006-01-01

    Home parenteral nutrition carries a risk of infectious, metabolic, and mechanical complications that cause significant morbidity and mortality. This study investigated the incidence and the causative factors of these complications that occur within the first 90 days after discharge from the hospital to home. Data were prospectively collected and analyzed for 97 adult patients. A complication developed in one third of the patients, and the majority required rehospitalization. Infectious complications were the most prevalent, followed by mechanical and then metabolic complications. The authors describe their methods of collecting data in a quantifiable manner with the ultimate goal of improving patient outcomes.

  15. Use and Complications of Operative Control of Arterial Inflow in Combat Casualties with Traumatic Lower-extremity Amputations Caused by Improvised Explosive Devices

    Science.gov (United States)

    2013-08-01

    injuries: patterns of injuries and resource utilization associated with the multiple extremity amputee . J Surg Orthop Adv. 2012;21:32Y37. 11. Andersen RC...methods of proximal control in high wartime lower-extremity amputees . Although some casualties will have abdominal injuries that necessitate...of suprainguinal vascular control and complications that arose. In cases where multiple levels of control were used, data on all vessels were collected

  16. Atrial fibrillation and bleeding complication - risk factors and risk marker

    NARCIS (Netherlands)

    Breithardt, G.; Ravens, U.; Kirchhof, P.; van Gelder, I. C.

    2012-01-01

    The development of atrial fibrillation (AF) is closely linked to risk factors like hypertension and heart failure, diabetes mellitus, myocardial infarction and valvular heart disease. These factors partly overlap with those which determine the progression of atrial fibrillation and the incidence of

  17. Miniplate With a Bendable C-Tube Head Allows the Clinician to Alter Biomechanical Advantage in Extremely Complicated Anatomic Structure.

    Science.gov (United States)

    Seo, Kyung Won; Iskenderoglu, Nur Serife; Hwang, Eui Hwan; Chung, Kyu-Rhim; Kim, Seong-Hun

    2017-05-01

    This article reports C-tube miniplates as a practical temporary anchorage device choice to treat open bite patients with maxillary sinus pneumatization. The C-tube components are titanium anchor plates and monocortical screws that are basically similar to any other miniplate systems, but it has the unique characteristic of the tube head to be malleable. The manipulation of the head part is easy due to the composition of pure titanium. The I-shaped C-tube with 3 holes and T-shaped C-tube miniplates were placed above the apices of maxillary molars as an absolute anchorage system to intrude the posterior maxilla. The bending of the tube heads assisted in reduction of severe open bite patient with maxillary sinus pneumatization. Sinus perforation during placement of skeletal anchorage system weakens stability of the anchorage and further cause complications. Placement of titanium C-tube miniplates allowed reliable skeletal anchorage and avoided maxillary sinus perforation in patients with extreme pneumatizations. Simple bending of C-tube miniplates ensured increased orthodontic intrusion force without having to replace them, and eliminated consequences such as perforation of maxillary sinus, sinusitis, soft tissue irritation, or infection. Anatomic difficulties in the placement of temporary anchorage device can be easily managed by using the bendable C-tube miniplate. It can serve as a great alternative over miniscrews or regular miniplates with reduced risk of sinus perforation and ability to bend the head portion to control orthodontic vectors and forces.

  18. Perinatal complications, environmental factors and autism spectrum disorders

    Directory of Open Access Journals (Sweden)

    Mandić-Maravić Vanja

    2016-01-01

    Full Text Available Objectives: Autism spectrum disorders (ASD are characterized by qualitative impairment of social interactions, impairment of verbal and nonverbal communication, as well as restricted interests and repetitive behavior. ASD represent a group of complex psychiatric disorders, with both genetic and environmental factors implicated in their etiology. Recent neuroanatomical and epidemiological studies point out to prenatal and early postnatal genesis of ASD. Aim: In this review, we present recent studies that explored the effect of environmental, prenatal and perinatal risk factors on development of ASD. Also, we point out those factors that have been proven to have the strongest association with ASD, and emphasize a very complex interaction of individual factors that might eventually lead to manifestation of this group of disorders. Conclusion: A precise defining of risk factors might provide more insight not only into etiology of ASD, but might also give us a possibility for early recognition and possible prevention of autism spectrum disorders, especially in susceptible individuals. It is also a first step in defining the basis of the gene-environment interaction mechanism, which might enable the development of an individualized therapeutic approach for this group of disorders.

  19. Predictive factors of neurological complications and one-month mortality after liver transplantation

    Directory of Open Access Journals (Sweden)

    Katherine eFu

    2014-12-01

    Full Text Available Background: Neurological complications are common after orthotopic liver transplantation (OLT. We aimed to characterize the risk factors associated with neurological complications and mortality among patients who underwent OLT in the post-model for end-stage liver disease (MELD era.Methods: In a retrospective review, we evaluated 227 consecutive patients at the Keck Hospital of the University of Southern California before and after OLT to define the type and frequency of and risk factors for neurological complications and mortality.Results: Neurological complications were common (n=98, with encephalopathy being most frequent (56.8%, followed by tremor (26.5%, hallucinations (11.2%, and seizure (8.2%. Factors associated with neurological complications after OLT included preoperative dialysis, hepatorenal syndrome, renal insufficiency, intra-operative dialysis, preoperative encephalopathy, preoperative mechanical ventilation, and infection. Preoperative infection was an independent predictor of neurological complications (OR 2.83, 1.47 – 5.44. One-month mortality was 8.8% and was independently associated with urgent re-transplant, preoperative intubation, intraoperative arrhythmia, and intraoperative use of multiple pressors.Conclusion: Neurological complications are common in patients undergoing OLT in the post-MELD era, with encephalopathy being most frequent. An improved understanding of the risk factors related to both neurological complications and one-month mortality post-transplantation can better guide perioperative care and help improve outcomes among OLT patients.

  20. Identifiable risk factors for thirty-day complications following arthroscopic rotator cuff repair.

    Science.gov (United States)

    Heyer, Jessica H; Kuang, Xiangyu; Amdur, Richard L; Pandarinath, Rajeev

    2017-10-11

    Shoulder arthroscopy has increased in frequency over the past decade, with rotator cuff repair comprising the majority of cases performed. Prior studies have detailed risk factors for 30-day complications and readmission rates after arthroscopic shoulder surgery using the National Surgical Quality Improvement Program (NSQIP) database, but no study has specifically looked at arthroscopic rotator cuff repair. The purpose of the study is to evaluate the risk factors for 30-day complications following arthroscopic rotator cuff repair using the NSQIP database. The NSQIP database was queried for all patients undergoing arthroscopic rotator cuff repair from 2006-2015. Demographics and thirty-day outcomes for these patients were analyzed using univariate analyses and multivariate regression analysis to determine the risk factors for complications. 21,143 patients underwent arthroscopic rotator cuff repair, with 147 patients (0.70%) having a complication within 30-days. Univariate analysis found age >65 (p = 0.0028), male gender (p = 0.0053), elevated BMI (p = 0.0054), ASA class >2 (p 90 min (p = 0.0316) to be associated with increased risk of complications. Multivariate analysis found female sex to be protective or complication (OR 0.56, p = 0.0017), while American Society of Anesthesiology (ASA) class >2 (OR 1.51, p = 0.0335) and history of COPD (OR 2.41, p = 0.0030) and dyspnea (OR 1.89, p = 0.0359) to be risk factors for complication. The most common complication is venothromboembolic events, accounting for 36.7% of all complications. Male sex, ASA class > 2, and history of COPD and dyspnea were independent risk factors for thirty-day complications following arthroscopic rotator cuff repair. IV.

  1. Latex glove allergy in dental workers: complications and predisposing factors

    Directory of Open Access Journals (Sweden)

    Rezaee M

    2007-11-01

    Full Text Available Background: Dermal- respiratory reactions to latex glove is a common problem and sometimes life threatening. Among health care workers, dental working personnel have extensive use of latex gloves. A few numbers of researches have been done in Iran about prevalence of these reactions but there is no comprehensive study for dental workers. The purpose of this study was to evaluate reactions to latex gloves amongst dental workers in military dental health centers.Methods: In this cross-sectional descriptive survey, dental workers with a minimum of three months length of employment and most often use of latex gloves were asked to fill standard questionnaire (derived from South Carolina Medical University regarding latex related clinical manifestation and personal medical history and predisposing factors Data analysis was done by χ2 and Student's t test.Results: In our study 330 personnel were assessed. The mean age and length of employment was 31.6 and 8 years respectively. The most occupation was dentistry. A total of 232 subjects (70.3% reported latex gloves-allergic symptoms. 72 (21.8% of persons have history of atopy and food allergy was seen in 114 (34.5%. 63 (19.1% of subjects reported history of hand dermatitis. All of these predisposing factors had positive regression with dermal and respiratory reactions.Conclusion: In this survey the prevalence of allergic reactions was higher than similar studies which may be due to type of gloves, lack of preemployment assessments and other factors. Use of diagnostic methods such as serologic measures, SPT and pulmonary function testing (such as spirogram could be considered as tools for confirmatory and differential diagnosis and important complementary for these studies. Because of relationship between allergic reactions to latex gloves and some medical histories, it seems to be necessary for preemployment evaluation and periodic health surveillance of dental workers.

  2. [Risk Factors and extraneurological complications of stroke patients].

    Science.gov (United States)

    Guarnaschelli, M; Lucero, N; Moreno Andreatta, N; Buonanotte, M C; Atalah, D; Deabato, C; Frias, I; Fuentes, V; Perez Frias, J; Riccetti, J; Rivero, M; Sad, A; Buonanotte, C F

    2013-01-01

    El Accidente cerebro vascular (ACV) constituye la tercera causa de muerte a nivel mundial; actuar sobre los factores de riesgo modificables constituye hoy la mejor estrategia de prevención. Las complicaciones médicas son frecuentes en los pacientes internados por ACV; la valoración del NIHSS de ingreso, está asociado al resultado final en términos de duración de internación, supervivencia y ubicación al alta. Objetivo. Determinar los factores de riesgo (FR) en pacientes internados por ACV en el HNC de Córdoba y caracterizar las complicaciones no neurológicas en relación al NIHSS de ingreso. Material y métodos. Estudio prospectivo de pacientes internados en el HNC con diagnóstico de ACV del primero de septiembre de 2010 al 30 de diciembre de 2012, se aplicó la escala de NIHSS al ingreso. Se determinaron los factores de riesgo cerebrovasculares; se evaluaron las complicaciones no neurológicas durante la internación. Resultados. El total de pacientes ingresados por ACV fue de 200, con ACV isquémico 168 (84%) y ACV hemorrágico 32(16%). La Hipertensión Arterial fue el FR más frecuente (83,5%); más del 40% tenía 3 o más FR para ACV. Tuvieron complicaciones: 32% de los pacientes, la Infección respiratoria fue la más frecuente (14.5%)Pacientes con NIHSS superior a 10 puntos presentaron mayor porcentaje de complicaciones. Conclusión. El control de FR múltiples constituye una estrategia efectiva para disminuir la incidencia de ACV. La prevención de las complicaciones médicas permiten un mejor cuidado del paciente y reducen la morbilidad relacionada al ACV.

  3. Heparin as a risk factor for perigraft seroma complicating the modified Blalock-Taussig shunt

    NARCIS (Netherlands)

    Berger, R M; Bol-Raap, G; Hop, W J; Bogers, A J; Hess, J

    OBJECTIVE: The purpose of this study was to determine the risk factors associated with the occurrence of perigraft seromas complicating systemic-to-pulmonary polytetrafluoroethylene grafts. METHODS: Clinical and perioperative variables were reexamined, blinded for the outcome variable perigraft

  4. Risk factors for intra-operative complications during phacoemulsification performed by residents.

    Science.gov (United States)

    Lomi, Neiwete; Sharma, Reetika; Khokhar, Sudarshan; Dada, Tanuj; Vanathi, Murugesan; Agarwal, Tushar

    2016-06-01

    The purpose of this study was to determine the risk factors for occurrence of intra-operative complications during phacoemulsification performed by residents. One hundred fifty patients with cataract who underwent phacoemulsification by residents, with an experience of five or more phacoemulsification surgery, at a tertiary care centre were included in this study. The pre-operative data of these patients were collected from the hospital records. Surgeons were interviewed immediately after the surgery regarding the surgeon experience, phacoemulsification technique, machine factors, and intra-operative complications. Statistical analysis was done to determine pre-operative and intra-operative risk factors. The overall surgical complication rate in resident-performed phacoemulsification was 37 % of which major and minor complications were 21 and 16 %, respectively. Success in terms of placement of intraocular lens in capsular bag was 84 %. The most common major and minor complications found were posterior capsular tear and irregular capsulorhexis, respectively. Systemic and ocular features of patients as well as type of machine (longitudinal versus torsional longitudinal) had no significant association in terms of complication rate. Increase in success rate was seen with increase in semester and number of surgeries performed. Patient factors including general physical condition, systemic diseases, and anatomical factors do not influence success in resident-performed phacoemulsification. With increase in semester of residents, there is a significant decrease in intra-operative complications. Minor complications in the beginning of case lead to increase in major complications later on during the case and decrease in success rate by junior-semester residents.

  5. Is age a predisposing factor of postoperative complications after lung resection for primary pulmonary neoplasms?

    Science.gov (United States)

    Cañizares Carretero, Miguel-Ángel; García Fontán, Eva-María; Blanco Ramos, Montserrat; Soro García, José; Carrasco Rodríguez, Rommel; Peña González, Emilio; Cueto Ladrón de Guevara, Antonio

    2017-03-01

    Age has been classically considered as a determining factor for the development of postoperative complications related to lung resection for bronchogenic carcinoma. The Postoperative Complications Study Group of the Spanish Society of Thoracic Surgery has promoted a registry to analyze this factor. A total of 3,307 patients who underwent any type of surgical resection for bronchogenic carcinoma have been systematically and prospectively recorded in any of the 24 units that are part of the group. Several variables related to comorbidity and age, as well as postoperative complications, were analyzed. The mean age of patients was 65,44. Men were significantly more common than female. The most frequent complication was prolonged air leak, which was observed in more than one third of patients. In a univariant analysis, air leak presence and postsurgical atelectasis showed statistical association with patient age, when stratified in age groups. In a multivariate analysis, age was recognized as an independent prognostic factor in relation to air leak onset. However, this could not be confirmed for postoperative atelectasis. Age is a predisposing factor for the development of postoperative complications after lung resection. Other associated factors also influence the occurrence of these complications. Copyright © 2017 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Factors affecting wound complications in head and neck surgery: A prospective study

    Directory of Open Access Journals (Sweden)

    Devendra A Chaukar

    2013-01-01

    Full Text Available Context: Head and neck surgeries are complex. Wound complications are associated with considerable morbidity and can result in delay in the adjuvant treatment. Identification of factors will help in formulating preventive guidelines. Aims: The aim of this study is to identify perioperative factors responsible for wound complications. Settings and Design: Prospective study of 186 head and neck patients. Subjects and Methods: Pre-operative, intraoperative and post-operative factors were recorded. Each patient was evaluated for minor and major wound complications twice daily during the hospital stay. Statistical Analysis: Chi-square test was used for univariate and log regression test was used for multivariate analysis. Results: The overall wound complication rate was 29% with 7% major and 22% minor complications. On univariate analysis, laryngeal and hypopharyngeal location, advanced T stage, poor oral hygiene, clean-contaminated surgery, low Karnofsky performance status (KPS, flap reconstruction, blood loss more than 1000 ml, perioperative blood transfusion, duration of surgery greater than 4.3 h and post-operative hemoglobin lesser than 11 g%, post-operative tracheostomy and resection of mandible were statistical significant factors. On multivariate analysis, post-operative tracheostomy, low KPS, post-operative serum albumin less than 3.7 g/dl and duration of surgery greater than 4.3 h were significant factors. Conclusion : Apart from unavoidable factors, it is essential to take care of certain factors viz nutrition, haemoglobin, oral hygiene, asepsis and repeating antibiotics in prolonged surgery.

  7. Massive hemobilia due to hepatic arteriobiliary fistula during endoscopic retrograde cholangiopancretography: An extremely rare guidewir-related complication

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Jeong Gu; Seo, Young Woo; Hwang, Jae Cheol; Weon, Young Cheol; Kang, Byeong Seong; Bang, Sung Jo; Bang, Min Seo [Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan (Korea, Republic of)

    2015-05-15

    Although endoscopic retrograde cholangiopancreatography (ERCP) is an effective modality for diagnosis and treatment of biliary and pancreatic diseases, the risk for procedure-related complications is high. Hemorrhage is one of major complications of ERCP. Most ERCP-associated bleeding is primarily a complication related to sphincterotomy rather than diagnostic ERCP. We are reporting a case of massive hemobilia due to hepatic arteriobiliary fistula caused by guidewire-associated injury during ERCP, which was successfully treated with transarterial embolization of the hepatic artery.

  8. Is thrombophilia a major risk factor for deep vein thrombosis of the lower extremities among Lebanese patients?

    Directory of Open Access Journals (Sweden)

    R Kreidy

    2009-07-01

    Full Text Available R Kreidy1, N Irani-Hakime21Department of Vascular Surgery, 2Department of Laboratory Medicine, Saint George Hospital, University Medical Center, University of Balamand, Beirut, LebanonAim: Factor V Leiden (R506Q mutation is the most commonly observed inherited genetic abnormality related to vein thrombosis. Lebanon has one of the highest frequencies of this mutation in the world with a prevalence of 14.4% in the general population. The aim of this study is to define risk factors including inherited genetic abnormalities among Lebanese patients with lower extremity deep vein thrombosis. We report the clinical outcome of patients with thrombophilia.Methods: From January 1998 to January 2008, 162 patients (61 males and 101 females were diagnosed with lower extremity deep vein thrombosis. Mean age was 61 years (range: 21 to 95 years.Results: The most frequent risk factors for vein thrombosis were surgery, advanced age, obesity, and cancer. Twenty-five patients had thrombophilia, 16 patients had factor V Leiden (R506Q mutation, and seven patients had MTHFR C677T mutation. Ninety-two percent of patients screened for thrombophilia were positive. Screening was requested in young patients (16, patients with recurrent (11, spontaneous (8, and extensive (5 venous thrombosis, familial history (5, pregnancy (4, estroprogestative treatment (3, and air travel (1. Nine patients had one, 11 patients had two, and five had three of these conditions. Follow-up (6 to 120 months of these 25 patients treated with antivitamin K did not reveal recurrences or complications related to venous thromboembolism.Conclusion: Factor V Leiden mutation followed by MTHFR mutation are the most commonly observed genetic abnormalities in these series. Defining risk factors and screening for thrombophilia when indicated reduce recurrence rate and complications. Recommendations for thrombophilia screening will be proposed.Keywords: venous thrombosis, risk factors, genetics, factor V

  9. Splenectomy complicated by sustained extreme thrombocytosis and extensive portosplenomesenteric vein thrombosis in pyrimidine 5′-nucleotidase deficiency

    Science.gov (United States)

    Al-Jafar, Hassan A; Taqi, Ali; Madda, John Patrick; Abdullah, Thamer A

    2013-01-01

    Reactive and redistributional thrombocytosis is a well-known postsplenectomy occurrence .Usually it is transient and it rarely reaches extreme levels. We report a rare case of haemolytic anaemia where splenectomy was carried out following trauma to a massively enlarged spleen and was followed by extreme sustained thrombocytosis associated with extensive portal, splenic and mesenteric vein thrombosis despite standard antithrombotic prophylaxis. PMID:24287477

  10. Predisposing Factors of Complicated Deep Neck Infection: An Analysis of 158 Cases

    OpenAIRE

    Lee, Joon-Kyoo; Kim, Hee-Dae; Lim, Sang-Chul

    2007-01-01

    Both the introduction of antibiotics and improvements in oral hygiene have made deep neck infections occur less frequently today than in the past. Nevertheless, the complications from these infections are often life-threatening. The purpose of this article was to review the clinical findings of deep neck infections and identify the predisposing factors of these complications. The present study reviewed 158 cases of deep neck infections between the years of 1995 to 2004, 23 of which had life-t...

  11. Indications and Risk Factors for Complications of Lower Third Molar Surgery in a Nigerian Teaching Hospital

    OpenAIRE

    Osunde, OD; Saheeb, BD; Bassey, GO

    2014-01-01

    Background: The surgical extraction of impacted third molars is a common oral surgical procedure, and it is often associated with complications such as sensory nerve damage, dry socket, pain, swelling, trismus, infection and hemorrhage. Aim: The aim of this study was to determine the surgical indications and risk factors for complications of third molar surgery at a Nigerian teaching hospital. Materials and Methods: Medical records of patients referred to the Oral Surgery Clinic of our instit...

  12. Risk factors associated with relapse or infectious complications in Japanese patients with microscopic polyangiitis.

    Science.gov (United States)

    Kitagawa, Kiyoki; Furuichi, Kengo; Sagara, Akihiro; Shinozaki, Yasuyuki; Kitajima, Shinji; Toyama, Tadashi; Hara, Akinori; Iwata, Yasunori; Sakai, Norihiko; Shimizu, Miho; Kaneko, Shuichi; Wada, Takashi

    2016-10-01

    The prevention of relapse and infection complications during remission maintenance therapy is required to improve the prognosis of patients with microscopic polyangiitis (MPA) showing rapidly progressive glomerulonephritis (RPGN). The clinicopathological characteristics of patients with ANCA-positive MPA were examined to determine the risk factors for relapse or infectious complications after remission induction therapy. The study population consisted of 52 patients diagnosed as ANCA-positive MPA showing RPGN from 2002 to 2012, after publication of the Japanese guideline for RPGN. The clinicopathological findings were examined between the presence and absence of relapse or infectious complications. The value of vasculitis damage index (VDI) was high for the relapse group and VDI value was identified as the leading factor associated with relapse [hazard ratio (HR) 3.36, 95 % confidence interval (CI) 1.58-7.12, P < 0.01]. On the other hand, the values of Birmingham Vasculitis Activity Score, clinical grade category of RPGN at diagnosis, and VDI at remission were high in the infectious group. Furthermore, clinical grade category of RPGN was the leading factor associated with infectious complications (HR 5.30, 95 % CI 1.41-19.9, P = 0.01). The disease activity at diagnosis and severity of organ damage at remission were associated with relapse and infectious complications during remission maintenance therapy and infectious complication affected kidney survival and all-cause mortality in patients with ANCA-positive MPA exhibiting RPGN.

  13. Unsafe abortion in Kenya: a cross-sectional study of abortion complication severity and associated factors.

    Science.gov (United States)

    Ziraba, Abdhalah Kasiira; Izugbara, Chimaraoke; Levandowski, Brooke A; Gebreselassie, Hailemichael; Mutua, Michael; Mohamed, Shukri F; Egesa, Caroline; Kimani-Murage, Elizabeth W

    2015-02-15

    Complications due to unsafe abortion cause high maternal morbidity and mortality, especially in developing countries. This study describes post-abortion complication severity and associated factors in Kenya. A nationally representative sample of 326 health facilities was included in the survey. All regional and national referral hospitals and a random sample of lower level facilities were selected. Data were collected from 2,625 women presenting with abortion complications. A complication severity indicator was developed as the main outcome variable for this paper and described by women's socio-demographic characteristics and other variables. Ordered logistic regression models were used for multivariable analyses. Over three quarters of abortions clients presented with moderate or severe complications. About 65% of abortion complications were managed by manual or electronic vacuum aspiration, 8% by dilation and curettage, 8% misoprostol and 19% by forceps and fingers. The odds of having moderate or severe complications for mistimed pregnancies were 43% higher than for wanted pregnancies (OR, 1.43; CI 1.01-2.03). For those who never wanted any more children the odds for having a severe complication was 2 times (CI 1.36-3.01) higher compared to those who wanted the pregnancy then. Women who reported inducing the abortion had 2.4 times higher odds of having a severe complication compared to those who reported that it was spontaneous (OR, 2.39; CI 1.72-3.34). Women who had a delay of more than 6 hours to get to a health facility had at least 2 times higher odds of having a moderate/severe complication compared to those who sought care within 6 hours from onset of complications. A delay of 7-48 hours was associated with OR, 2.12 (CI 1.42-3.17); a delay of 3-7 days OR, 2.01 (CI 1.34-2.99) and a delay of more than 7 days, OR 2.35 (CI 1.45-3.79). Moderate and severe post-abortion complications are common in Kenya and a sizeable proportion of these are not properly managed

  14. Association Between Brain-Derived Neurotrophic Factor Genotype and Upper Extremity Motor Outcome After Stroke.

    Science.gov (United States)

    Chang, Won Hyuk; Park, Eunhee; Lee, Jungsoo; Lee, Ahee; Kim, Yun-Hee

    2017-06-01

    The identification of intrinsic factors for predicting upper extremity motor outcome could aid the design of individualized treatment plans in stroke rehabilitation. The aim of this study was to identify prognostic factors, including intrinsic genetic factors, for upper extremity motor outcome in patients with subacute stroke. A total of 97 patients with subacute stroke were enrolled. Upper limb motor impairment was scored according to the upper limb of Fugl-Meyer assessment score at 3 months after stroke. The prediction of upper extremity motor outcome at 3 months was modeled using various factors that could potentially influence this impairment, including patient characteristics, baseline upper extremity motor impairment, functional and structural integrity of the corticospinal tract, and brain-derived neurotrophic factor genotype. Multivariate ordinal logistic regression models were used to identify the significance of each factor. The independent predictors of motor outcome at 3 months were baseline upper extremity motor impairment, age, stroke type, and corticospinal tract functional integrity in all stroke patients. However, in the group with severe motor impairment at baseline (upper limb score of Fugl-Meyer assessment stroke. Brain-derived neurotrophic factor genotype may be a potentially useful predictor of upper extremity motor outcome in patients with subacute stroke with severe baseline motor involvement. © 2017 American Heart Association, Inc.

  15. Risk Factors for Medical Complication after Cervical Spine Surgery: a multivariate analysis of 582 patients

    Science.gov (United States)

    Lee, Michael J.; Konodi, Mark A.; Cizik, Amy M.; Weinreich, Mark A.; Bransford, Richard J.; Bellabarba, Carlo; Chapman, Jens

    2012-01-01

    Study Design Multivariate analysis of prospectively collected registry data Objective Using multivariate analysis, to determine significant risk factors for medical complication after cervical spine surgery. Summary of Background Data Several studies have examined the occurrence of medical complication after spine surgery. However many of these studies have been done utilizing large national databases. While these allow for analysis of thousands of patients, potentially influential co-variates are not accounted for in these retrospective studies. Furthermore, the accuracy of these retrospective data collection in these databases has been called into question. Methods The Spine End Results Registry (2003–2004) is a collection prospectively collected data on all patients who underwent spine surgery at our two institutions. Extensive demographic and medical information were prospectively recorded as described previously by Mirza et al. Complications were defined in detail a priori and were prospectively recorded for at least 2 years after surgery. We analyzed risk factors for medical complication after lumbar spine surgery using univariate and multivariate analysis. Results We analayzed data from 582 patients who met out inclusion criteria. The cumulative incidences of complication after cervical spine surgery per organ system are as follows: cardiac – 8.4%, pulmonary – 13%, gastrointestinal – 3.9%, neurological – 7.4%, hematological – 10.8% and urologic complications – 9.2%. The occurrence of cardiac or respiratory complication after cervical spine surgery was significantly associated with death within 2 years (RR 4.32, 6.43 respectively). Relative risk values with 95% confidence intervals and p values are listed individually in Tables 2 and 3. Conclusion Risk factors identified in this study can be beneficial to clinicians and patients alike when considering surgical treatment of the cervical spine. Future analyses and models that predict the

  16. Lower extremity anterior compartment syndrome complicating bilateral mastectomy and immediate breast reconstruction: A case report and literature review.

    Science.gov (United States)

    Tashakkor, A Yashar; Macadam, Sheina A

    2012-01-01

    'Well leg compartment syndrome' refers to compartment syndrome occurring in a nontraumatic setting. This occurs most commonly in the lower limb during surgery performed with the patient in an anatomically vulnerable position. While this complication is well documented in the setting of orthopedic, urological and gynecological surgeries, it is an exceptionally rare complication in plastic surgery; only seven cases have been published on compartment syndrome complicating an operation performed on a supine patient. A case involving a 56-year-old woman who developed an anterior compartment syndrome of her right lower leg following a bilateral mastectomy with immediate breast reconstruction is presented. A detailed literature review is also included.

  17. Factors Affecting Mortality After Major Nontraumatic Lower Extremity Amputation.

    Science.gov (United States)

    Dinc, Tolga; Polat Duzgun, Arife; Kayilioglu, Selami Ilgaz; Erdogan, Ahmet; Yavuz, Zeynep; Coskun, Faruk

    2016-09-01

    Our aim was to evaluate the factors affecting the mortality of patients who underwent nontraumatic major lower limb amputation due to ischemic and/or diabetic causes. A total of 100 patients were included in the study. Among these patients, 70 (70%) underwent below-knee amputation, whereas 30 (30%) underwent above-knee amputation. Eleven (15.7%) of the 70 patients who underwent below-knee amputation and 12 (40%) of the 30 patients who underwent above-knee amputation (P = .008) were deceased. After multivariable Poisson regression analysis, female gender (risk ratio [RR] = 2.00, 95% CI = 1.07-3.74) and a neutrophil lymphocyte ratio (NLR) less than 6.8 (RR = 5.12, 95% CI = 1.86-14.08) were found to be independent risk factors for mortality. The value of 6.8 was used as a cutoff point for the NLR (area under the curve = 0.73, 95% CI = 0.62-0.85), with a sensitivity, specificity, positive predictive value, and negative predictive value of 83%, 66%, 57%, and 92%, respectively. The NLR and female gender were found to be independent factors that are related to increased mortality in patients who underwent lower limb amputation due to diabetic and/or ischemic causes. The coexistence of congestive heart failure and the amputation level (above knee) were found to be predictors of mortality in univariable analysis, but significance could not be demonstrated in multivariable analysis. © The Author(s) 2016.

  18. Non-steroidal anti-inflammatory drugs and ulcer complications: a risk factor analysis for clinical decision-making

    DEFF Research Database (Denmark)

    Hansen, J M; Hallas, J; Lauritsen, Jens;

    1996-01-01

    Use of non-steroidal anti-inflammatory drugs (NSAIDs) is recognized as an important cause of peptic ulcer complications. The aim of this nested case-control study was to identify risk factors for NSAID-related ulcer complications.......Use of non-steroidal anti-inflammatory drugs (NSAIDs) is recognized as an important cause of peptic ulcer complications. The aim of this nested case-control study was to identify risk factors for NSAID-related ulcer complications....

  19. Frequency of and factors associated with vascular complications after pediatric liver transplantation

    Directory of Open Access Journals (Sweden)

    Mariana Orlandini

    2014-04-01

    Full Text Available OBJECTIVE: to evaluate the frequency and factors associated with vascular complications after pediatric liver transplantation. METHOD: risk factors were evaluated in 99 patients under 18 years of age with chronic liver disease who underwent deceased donor liver transplantation (DDLT between March of 1995 and November of 2009 at the Hospital de Clínicas de Porto Alegre, Brazil. The variables analyzed included donor and recipient age, gender, and weight; indication for transplant; PELD/MELD scores; technical aspects; postoperative vascular complications; and survival. RESULTS: vascular complications occurred in 19 patients (19%. Arterial events were most common, occurred earlier in the postoperative period, and were associated with high graft loss and mortality rates. In the multivariate analysis, the following factors were identified: portal vein diameter < 3 mm, donor-to-recipient body weight ratio (DRWR, prolonged ischemic time, and use of arterial grafts. CONCLUSION: the choice of treatment depends on the timing of diagnosis; however, in this study, surgical revision or correction produced worse outcomes than percutaneous angioplasty. The reduction of risk factors and early detection of vascular complications are key elements to a successful transplantation.

  20. Risk Factors for Complications after Peripheral Vascular Surgery in 3,202 Patient Procedures

    DEFF Research Database (Denmark)

    Kehlet, Mette; Jensen, Leif Panduro; Schroeder, Torben V.

    2016-01-01

    Background Complications after open vascular surgery are a major health challenge for the healthcare system and the patients. Infrainguinal vascular surgery is often perceived as less risky than aortic surgery and the aim of this study was to identify which risk factors correlated with postoperat...

  1. Prevalence and risk factor analysis of lower extremity abnormal alignment characteristics among rice farmers

    Directory of Open Access Journals (Sweden)

    Karukunchit U

    2015-06-01

    Full Text Available Usa Karukunchit,1,2 Rungthip Puntumetakul,1,3 Manida Swangnetr,1,4 Rose Boucaut5 1Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH, 2Faculty of Associated Medical Sciences, Khon Kaen University, 3School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, 4Department of Production Technology, Faculty of Technology, Khon Kaen University, Khon Kaen, Thailand; 5School of Health Sciences (Physiotherapy, iCAHE (International Centre for Allied Health Evidence, Sansom Institute for Health Research, University of South Australia, Adelaide, SA, Australia Background: Rice farming activities involve prolonged manual work and human–machine interaction. Prolonged farming risk-exposure may result in lower limb malalignment. This malalignment may increase the risk of lower extremity injury and physical disabilities. However, the prevalence and factors associated with lower extremity malalignment have not yet been reported. This study aimed to investigate the prevalence and risk factors of lower extremity malalignment among rice farmers.Methods: A cross-sectional survey was conducted with 249 rice farmers. Lower extremity alignment assessment included: pelvic tilt angle, limb length equality, femoral torsion, quadriceps (Q angle, tibiofemoral angle, genu recurvatum, rearfoot angle, and medial longitudinal arch angle. Descriptive statistics were used to analyze participant characteristics and prevalence of lower extremity malalignment. Logistic regression analysis was used to identify risk factors.Results: The highest prevalence of lower extremity malalignment was foot pronation (36.14%, followed by the abnormal Q angle (34.94%, tibiofemoral angle (31.73%, pelvic tilt angle (30.52%, femoral antetorsion (28.11%, limb length inequality (22.49%, tibial torsion (21.29%, and genu recurvatum (11.24%. In females, the risk factors were abnormal Q angle, tibiofemoral angle, and genu recurvatum. Being overweight

  2. [Risk factors of late complications after interstitial 192Ir brachytherapy in cancers of the oral cavity].

    Science.gov (United States)

    Peiffert, D

    1997-01-01

    Brachytherapy has confirmed its prevailing role in conservative treatment of oral cavity carcinomas. To describe late toxicity in long-term surviving patients, comparisons with other series are necessary. Study of series of patients implanted for floor of the mouth or mobile tongue shows the need for more detailed data. Dental prophylaxy and lead protection of the mandibule, good indications and techniques of brachytherapy are necessary to avoid late complications. Some treatment factors have proved to be of good prognosis for late complications through multivariate analysis of large series treated with lr 192 wires, using the Paris system, eg, dose rate lower than 0.5 or 0.7 Gy/h, intersource spacing smaller than 1.2 or 1.5 cm, treated surface less than 12 cm2, lineic activity less than 1.5 mCi/cm, less than 1 cm diameter hyperdose, and use of mandibular lead protections. Tumor volume and location to the floor of mouth lead to higher risk of complications. Knowledge of treatment-related factors is important, with the development of new afterloading projectors allowing to control the dose rate and correct small inhomogeneities. High-dose rate exclusive brachytherapy is not recommended. More precise and reproducible classification should be used to report complications in series leading to publications in the future, thus allowing to compare results, reduce complication rates and improve the quality of life.

  3. Gastroduodenal Complications After Concurrent Chemoradiation Therapy in Patients With Hepatocellular Carcinoma: Endoscopic Findings and Risk Factors

    Energy Technology Data Exchange (ETDEWEB)

    Chon, Young Eun [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Seong, Jinsil [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Beom Kyung [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Cha, Jihye [Department of Radiation Oncology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Seung Up; Park, Jun Yong; Ahn, Sang Hoon; Han, Kwang-Hyub; Chon, Chae Yoon [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Liver Cirrhosis Clinical Research Center, Seoul (Korea, Republic of); Shin, Sung Kwan, E-mail: kaarma@yuhs.ac [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Do Young, E-mail: dyk1025@yuhs.ac [Department of Internal Medicine, Yonsei University College of Medicine, Seoul (Korea, Republic of); Institute of Gastroenterology, Yonsei University College of Medicine, Seoul (Korea, Republic of); Liver Cirrhosis Clinical Research Center, Seoul (Korea, Republic of)

    2011-12-01

    Purpose: Concurrent chemoradiation therapy (CCRT) is useful in advanced hepatocellular carcinoma (HCC), but little is known about radiation-induced gastroduodenal complications following therapy. To determine risk factors, we investigated the prevalence and patterns of gastroduodenal complications following CCRT using endoscopy. Methods and Materials: Enrolled in the study were 123 patients treated with CCRT for unresectable HCC between January 1998 and December 2005. Radiation-induced gastroduodenal complications were defined as radiation gastritis/duodenitis, radiation gastric/duodenal ulcer, or other gastroduodenal toxicity associated with radiation, based on Common Terminology Criteria for Adverse Events (CTCAE 3.0). Serious gastroduodenal complications were defined as events occurring within 12 months from completion of CCRT, those requiring prompt therapeutic intervention, or symptoms equivalent to Grade 3 or 4 radiation-related gastroduodenal toxicity, including nausea or vomiting, based on CTCAE 3.0. Results: A month after completion of CCRT, 65 (52.8%) patients displayed endoscopic evidence of radiation-induced gastroduodenal complications. Radiation gastric and duodenal ulcers were found in 32 (26.0%) and 20 (16.3%) patients, respectively; radiation gastritis and duodenitis were found in 50 (40.7%) and 42 (34.1%) patients, respectively. Radiation-related bleeding was observed in 13 patients (10.6%). Serious gastroduodenal complications occurred in 18 patients (14.6%) and were significantly more frequent in patients with liver cirrhosis than in those without cirrhosis (p = 0.043). There were no radiation-related deaths. Conclusions: Endoscopically detectable radiation-induced gastroduodenal complications were common in HCC following CCRT. Although serious complications were uncommon, the frequency was higher in patients with liver cirrhosis; thus, these patients should be closely monitored when receiving CCRT.

  4. Calcaneal Fractures in Non-Racing Dogs and Cats: Complications, Outcome, and Associated Risk Factors.

    Science.gov (United States)

    Perry, Karen L; Adams, Robert J; Woods, Samantha; Bruce, Mieghan

    2017-01-01

    To estimate the prevalence of complications and describe the outcome associated with calcaneal fractures in non-racing dogs and in cats. Retrospective multicenter clinical cohort study. Medical records of client-owned dogs and cats (2004-2013). Medical records were searched and 50 animals with calcaneal fractures were included for analysis. Complications were recorded and an outcome score applied to each fracture. Associations between putative risk factors and both major complications, and final outcome scores were explored. Complications occurred in 27/50 fractures (61%) including 23 major and 4 minor complications. At final follow-up, 4 animals (10%) were sound, 27 (64%) had either intermittent or consistent mild weight-bearing lameness, 7 (17%) had moderate weight-bearing lameness, and 1 (2%) had severe weight-bearing lameness. Fractures managed using plates and screws had a lower risk of complications than fractures managed using pin and tension band wire, lag or positional screws or a combination of these techniques (Relative risk 0.16, 95% CI 0.02-1.02, P=.052). Non-sighthounds had reduced odds of a poorer outcome score than sighthounds (Odds ratio 0.11, 95% CI 0.02-0.50, P=.005) and fractures with major complications had 13 times the odds of a poorer outcome score (Odds ratio 13.4, 95% CI 3.6-59.5, Pdogs and in cats, and a poorer outcome score was more likely in animals with complications. A more guarded prognosis should be given to owners of non-racing dogs or cats with calcaneal fractures than previously applied to racing Greyhounds with calcaneal fractures. © 2016 The American College of Veterinary Surgeons.

  5. Risk factors for recurrence, complications and mortality in Clostridium difficile infection: a systematic review.

    Directory of Open Access Journals (Sweden)

    Claire Nour Abou Chakra

    Full Text Available BACKGROUND: Clostridium difficile infection (CDI can lead to complications, recurrence, and death. Numerous studies have assessed risk factors for these unfavourable outcomes, but systematic reviews or meta-analyses published so far were limited in scope or in quality. METHODS: A systematic review was completed according to PRISMA guidelines. An electronic search in five databases was performed. Studies published until October 2013 were included if risk factors for at least one CDI outcome were assessed with multivariate analyses. RESULTS: 68 studies were included: 24 assessed risk factors for recurrence, 18 for complicated CDI, 8 for treatment failure, and 30 for mortality. Most studies accounted for mortality in the definition of complicated CDI. Important variables were inconsistently reported, such as previous episodes and use of antibiotics. Substantial heterogeneity and methodological limitations were noted, mainly in the sample size, the definition of the outcomes and periods of follow-up, precluding a meta-analysis. Older age, use of antibiotics after diagnosis, use of proton pump inhibitors, and strain type were the most frequent risk factors for recurrence. Older age, leucocytosis, renal failure and co-morbidities were frequent risk factors for complicated CDI. When considered alone, mortality was associated with age, co-morbidities, hypo-albuminemia, leucocytosis, acute renal failure, and infection with ribotype 027. CONCLUSION: Laboratory parameters currently used in European and American guidelines to define patients at risk of a complicated CDI are adequate. Strategies for the management of CDI should be tailored according to the age of the patient, biological markers of severity, and underlying co-morbidities.

  6. Percutaneous renal biopsy of native kidneys: efficiency, safety and risk factors associated with major complications

    Science.gov (United States)

    Torres Muñoz, Abel; Valdez-Ortiz, Rafael; González-Parra, Carlos; Espinoza-Dávila, Elvy; Morales-Buenrostro, Luis E.; Correa-Rotter, Ricardo

    2011-01-01

    Introduction The use of an automated biopsy device and real-time ultrasound (current technology) for percutaneous renal biopsies (PRBs) has improved the likelihood of obtaining adequate tissue for diagnosis and has reduced the complications associated with renal biopsies. Our objective was to evaluate the efficacy and safety of the current PRB procedure and identify possible risk factors for the development of major complications. Material and methods We collected all native kidney PRBs performed with current technology in our institute from January 1998 to April 2008. Studied variables were collected from the patient's chart at the time of the biopsy. Results We analyzed 623 (96.4%) of 646 renal biopsies performed with the current automated procedure guided by real-time ultrasound. Although the effectiveness was 97.6%, there were 110 complications. Fourteen (2.24%) of these complications were major: 9 cases of renal hematoma, 2 cases with macroscopic hematuria (which needed blood transfusion), 1 case of intestinal perforation (which required exploratory laparotomy), 1 nephrectomy and 1 case of a dissecting hematoma. The logistic regression analysis demonstrated the following risk factors for developing major complications: diastolic blood pressure ≥ 90 mmHg, RR 7.6 (95% CI 1.35-43); platelet count ≤ 120×103/µl; RR 7.0 (95% CI 1.9-26.2); and blood urea nitrogen (BUN) ≥ 60 mg/dl, RR 9.27 (95% CI 2.8-30.7). Conclusions The observed efficacy and safety of the current technique in the present study were similar to observations in previous studies. Diastolic blood pressure ≥ 90 mmHg, platelets ≤ 120×103/µl and BUN ≥ 60 mg/dl were independent risk factors for the development of major complications following PRB. PMID:22291827

  7. A confirmatory factor analysis of the Harvard Trauma Questionnaire and the Inventory of Complicated Grief-Revised: Are we measuring complicated grief or posttraumatic stress?

    DEFF Research Database (Denmark)

    O'Connor, Maja; Lasgaard, Mathias Kamp; Shevlin, Mark

    2010-01-01

      The Inventory of Complicated Grief Revised (ICG-R) assesses symptoms of complicated grief in bereaved individuals. The aim of this study was to assess the factorial structure of Complicated Grief (CG) and investigate the relationship between CG and Posttraumatic Stress Disorder through the asse......  The Inventory of Complicated Grief Revised (ICG-R) assesses symptoms of complicated grief in bereaved individuals. The aim of this study was to assess the factorial structure of Complicated Grief (CG) and investigate the relationship between CG and Posttraumatic Stress Disorder through...... the assessment of models which combine both constructs. A secondary aim was to test the construct validity of the Danish version of ICG-R. The questionnaire was completed by respondents who were elderly and married with a history of at least one significant, interpersonal loss (145 males and 147 females, 60......-81 years). Confirmatory factor analysis (CFA) supported a two-factor model (separation distress and traumatic distress) of CG. To investigate the relationship between CG and PTSD three combined models were specified and estimated using CFA. A model where all five factors, the two factors of CG...

  8. Old and new risk factors for upper extremity deep venous thrombosis

    NARCIS (Netherlands)

    Blom, J.W.; Doggen, Catharina Jacoba Maria; Osanto, S.; Rosendaal, F.R.

    2005-01-01

    Background: Well known risk factors for upper extremity deep venous thrombosis are the presence of a central venous catheter (CVC) and malignancy, but other potential risk factors, such as surgery, injury and hormone replacement therapy (HRT), have not yet been explored. Methods: We performed a

  9. Does the use of arteriovenous loops increase complications rates in posttraumatic microsurgical lower extremity reconstruction?-A matched-pair analysis.

    Science.gov (United States)

    Momeni, Arash; Lanni, Michael A; Levin, Lawrence S; Kovach, Stephen J

    2017-06-28

    The use of arteriovenous (AV) loops in microsurgical lower extremity reconstruction is a controversial topic. The objective of the present study was to assess the impact of AV loops on complication rates following microsurgical reconstruction of posttraumatic lower extremity defects. Patients who underwent free flap coverage of posttraumatic defects in combination with an AV loop (Group 1) were identified and matched for age, body mass index (BMI), tobacco use, defect location, and flap type with patients who underwent reconstruction without vein grafts (Group 2). Outcomes of interest included complication rate and flap loss rate. Groups 1 and 2 consisted of 10 patients each with a mean age of 51 years (range, 21-79 years) and 47.3 years (range, 22-69 years), respectively (P = 0.596). No differences were noted regarding flap loss (P = 1.0), intraoperative (P = 0.474) or postoperative complication rate [surgical site infection (P = 1.0), bleeding (P = 1.0), delayed wound healing (P = 0.23), dehiscence (P = 0.58), and osseous non-union (P = 1.0)]. Only one flap loss was noted in Group 1. The only differences were increased operative time (P = 0.03) and increased length of stay (P = 0.009) in Group 1. Our results suggest that utilization of vein grafts with creation of AV loops followed by single-stage division and free flap transfer for reconstruction of posttraumatic lower extremity defects achieve reconstructive outcomes similar to those obtained in patients in whom no vein grafts are necessary. © 2017 Wiley Periodicals, Inc.

  10. Are "Human Factors" the Primary Cause of Complications in the Field of Implant Dentistry?

    Science.gov (United States)

    Renouard, Franck; Amalberti, René; Renouard, Erell

    Complications in medicine and dentistry are usually analyzed from a purely technical point of view. Rarely is the role of human behavior or judgment considered as a reason for adverse outcomes. When the role of human factors is considered, these are usually described in general terms rather than specifically identifying the factors responsible for an adverse event. The impact of cognitive and behavioral factors in the explanation of adverse events has been studied in other high-stakes areas such as aviation and nuclear power. Specific protocols have been developed to reduce rates of human error, and, where human error is unavoidable, to lessen its impact. This approach has dramatically reduced the incidence of accidents in these fields. This article aims to review how a similar approach may prove valuable in the reduction of complications in implant dentistry.

  11. Causing Factors for Extreme Precipitation in the Western Saudi-Arabian Peninsula

    Science.gov (United States)

    Alharbi, M. M.; Leckebusch, G. C.

    2015-12-01

    In the western coast of Saudi Arabia the climate is in general semi-arid but extreme precipitation events occur on a regular basis: e.g., on 26th November 2009, when 122 people were killed and 350 reported missing in Jeddah following more than 90mm in just four hours. Our investigation will a) analyse major drivers of the generation of extremes and b) investigate major responsible modes of variability for the occurrence of extremes. Firstly, we present a systematic analysis of station based observations of the most relevant extreme events (1985-2013) for 5 stations (Gizan, Makkah, Jeddah, Yenbo and Wejh). Secondly, we investigate the responsible mechanism on the synoptic to large-scale leading to the generation of extremes and will analyse factors for the time variability of extreme event occurrence. Extreme events for each station are identified in the wet season (Nov-Jan): 122 events show intensity above the respective 90th percentile. The most extreme events are systematically investigated with respect to the responsible forcing conditions which we can identify as: The influence of the Soudan Low, active Red-Sea-Trough situations established via interactions with mid-latitude tropospheric wave activity, low pressure systems over the Mediterranean, the influence of the North Africa High, the Arabian Anticyclone and the influence of the Indian monsoon trough. We investigate the role of dynamical forcing factors like the STJ and the upper-troposphere geopotential conditions and the relation to smaller local low-pressure systems. By means of an empirical orthogonal function (EOF) analysis based on MSLP we investigate the possibility to objectively quantify the influence of existing major variability modes and their role for the generation of extreme precipitation events.

  12. Statistical extremes and peak factors in wind-induced vibration of tall buildings

    Institute of Scientific and Technical Information of China (English)

    Ming-feng HUANG; Chun-man CHAN; Wen-juan LOU; Kenny Chung-Siu KWOK

    2012-01-01

    In the structural design of tall buildings,peak factors have been widely used to predict mean extreme responses of tall buildings under wind excitations.Vanmarcke's peak factor is directly related to an explicit measure of structural reliability against a Gaussian response process.We review the use of this factor for time-variant reliability design by comparing it to the conventional Davenport's peak factor.Based on the asymptotic theory of statistical extremes,a new closed-form peak factor,the so-called Gamma peak factor,can be obtained for a non-Gaussian resultant response characterized by a Rayleigh distribution process.Using the Gamma peak factor,a combined peak factor method was developed for predicting the expected maximum resultant responses of a building undergoing lateral-torsional vibration.The effects of the standard deviation ratio of two sway components and the inter-component correlation on the evaluation of peak resultant response were also investigated.Utilizing wind tunnel data derived from synchronous multi-pressure measurements,we carried out a wind-induced time history response analysis of the Commonwealth Advisory Aeronautical Research Council (CAARC) standard tall building to validate the applicability of the Gamma peak factor to the prediction of the peak resultant acceleration.Results from the building example indicated that the use of the Gamma peak factor enables accurate predictions to be made of the mean extreme resultant acceleration responses for dynamic serviceability performance design of modern tall buildings.

  13. Perinatal risk factors and neonatal complications in discordant twins admitted to the neonatal intensive care unit

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-rui; LIU Jie; ZENG Chao-mei

    2013-01-01

    Background Many studies have shown a relationship between birth weight discordance and adverse perinatal outcomes.This study aimed to investigate the perinatal risk factors and neonatal complications of discordant twins who are admitted to the neonatal intensive care unit.Methods A total of 87 sets of twins were enrolled in this retrospective study,of which 22 sets were discordant twins and 65 sets were concordant twins.Binary Logistic regression analysis was used to identify the risk factors associated with the occurrence of discordant twins.The common neonatal complications of discordant twins were also investigated.Results Multivariate analysis showed that the use of assisted reproductive techniques,pregnancy-induced hypertension,and unequal placental sharing were risk factors for the occurrence of discordant twins.The incidence of small for gestational age infants and very low birth weight infants of discordant twins was significantly higher,while the birth weight of discordant twins was significantly lower than those of concordant twins.The duration of hospitalization of discordant twins was longer than that of concordant twins.The incidence of several neonatal complications,such as neonatal respiratory distress syndrome and intracranial hemorrhage,was higher in discordant twins than that in concordant twins.The percentage of those requiring pulmonary surfactant and mechanical ventilation was significantly higher in discordant twins than that in concordant twins.Conclusions Use of assisted reproductive techniques,pregnancy-induced hypertension,and unequal placental sharing are perinatal risk factors of discordant twins who are admitted to the neonatal intensive care unit.These infants are also much more likely to suffer from various neonatal complications,especially respiratory and central nervous system diseases.It is important to prevent the occurrence of discordant twins by decreasing these risk factors and timely treatment should be given to discordant

  14. Extreme lateral lumbar interbody fusion. Surgical technique, outcomes and complications after a minimum of one year follow-up.

    Science.gov (United States)

    Domínguez, I; Luque, R; Noriega, M; Rey, J; Alia, J; Marco-Martínez, F

    «Minimally invasive» techniques have been recently been developed in order to achieve good clinical results with a low incidence of complications. The extralateral interbody fusion or direct transpsoas is a minimally invasive anterior arthrodesis. A total of 97 patients with 138 segments received surgery between May 2012 and May 2015. The follow-up was from 12-44 months. The mean age was 68 years (41-86). The most common cause of intervention was the adjacent segment (30%), deformity (22%), and lumbar disc disease (21%). The interbody cage was implanted as: Single (stand-alone) in 33%, and additional fixation was used in the others: Screws, percutaneous unilateral (11%), bilateral (27%), or with a lateral plate (62%). The mean stay was 3.2 days (2-6). The score on a lumbar visual analogue scale decreased from 9 to 4.1, and dropped to 3 after one year. The improvement in disc height was from 8.4mm to 13.8mm, and a larger increase in the foramen diameter from 10.5 to 13.1mm, which were statistically significant. The early major complications recorded were, three motor femoral nerve injuries and retroperitoneal haematoma (4%), and the early minor were: two fractures (2%). As major late complications there was an abdominal hernia, a mobilization of 10mm and three radiculopathy (5%), and as minor late, three fracture, two mobilisations greater than 10mm, four mobilisations of less than 10mm, and one mobilisation of a screw plate (10%). The extralateral interbody fusion technique is a safe and reliable when performing a lumbar fusion by an alternative minimally invasive route.

  15. Risk factors of surgical site infections in patients with Crohn's disease complicated with gastrointestinal fistula.

    Science.gov (United States)

    Guo, Kun; Ren, Jianan; Li, Guanwei; Hu, Qiongyuan; Wu, Xiuwen; Wang, Zhiwei; Wang, Gefei; Gu, Guosheng; Ren, Huajian; Hong, Zhiwu; Li, Jieshou

    2017-05-01

    Surgical site infection (SSI) is the most common complication following surgical procedures. This study aimed to determine risk factors associated with SSI in patients with Crohn's disease (CD) complicated with gastrointestinal fistula. This was a retrospective review of patients who underwent surgical resection in gastrointestinal fistula patients with CD between January 2013 and January 2015, identified from a prospectively maintained gastrointestinal fistula database. Demographic information, preoperative medication, intraoperative findings, and postoperative outcome data were collected. Univariate and multivariate analysis was carried out to assess possible risk factors for SSI. A total of 118 patients were identified, of whom 75.4% were men, the average age of the patients was 34.1 years, and the average body mass index (BMI) was 18.8 kg/m(2). The rate of SSI was 31.4%. On multivariate analysis, preoperative anemia (P = 0.001, OR 7.698, 95% CI 2.273-26.075), preoperative bacteria present in fistula tract (P = 0.029, OR 3.399, 95% CI 1.131-10.220), and preoperative enteral nutrition (EN) fistula tract, and preoperative EN fistula complicated with CD. Preoperative identification of these risk factors may assist in risk assessment and then to optimize preoperative preparation and perioperative care.

  16. Effect of laparoscopic cholecystectomy on inflammatory factors and immunoglobulin in elderly chronic cholecystitis complicated with cholecystolithiasis

    Institute of Scientific and Technical Information of China (English)

    Tian-Xue Wen; Hao Wang

    2016-01-01

    Objective:To investigate the effect of laparoscopic cholecystectomy on inflammatory factors and immunoglobulin in elderly chronic cholecystitis complicated with cholecystolithiasis. Methods: A total of 80 senile chronic cholecystitis complicated with cholecystolithiasis patients were randomly divided into observation group (n=40) and control group (n=40). The observation group was were treated with laparoscopic cholecystectomy while the control group was were treated with open cholecystectomy. Using nephelometry to detect the serum CRP, IgA, IgG and IgM levels, using enzyme-linked immunosorbent assay to detect the IL-6 level. The levels of inflammatory factors (CRP, IL-6) and immunoglobulin indexes (IgA, IgG and IgM) were compared before and after operation between the two groups.Results:Compared with before operation, the inflammatory factors (CRP, IL-6) had no significant difference in observation group, the inflammatory factors (CRP, IL-6) were increased significantly in control group, and there was significant difference on inflammatory factors (CRP, IL-6) in two groups after operation; compared with before operation, the levels of immunoglobulin indexes (IgA, IgG and IgM) had no significant difference in observation group, the levels of IgA, IgG and IgM were decreased significantly in control group, and the levels of IgA, IgG and IgM had significant difference after treatment between the two groups.Conclusion: Laparoscopic cholecystectomy had almost no effect on inflammatory factors and immune function in elderly chronic cholecystitis complicated with cholecystolithiasis.

  17. The effect of anti-tumor necrosis factor alpha agents on postoperative anastomotic complications in Crohn's disease

    DEFF Research Database (Denmark)

    El-Hussuna, Alaa Abdul-Hussein H; Krag, Aleksander; Olaison, Gunnar

    2013-01-01

    Patients with Crohn's disease treated with anti-tumor necrosis factor alpha agents may have an increased risk of surgical complications.......Patients with Crohn's disease treated with anti-tumor necrosis factor alpha agents may have an increased risk of surgical complications....

  18. What factors influence motor complications in Parkinson disease?: a 10-year prospective study.

    Science.gov (United States)

    García-Ruiz, Pedro J; Del Val, Javier; Fernández, Ignacio Mahillo; Herranz, Antonio

    2012-01-01

    The causes and mechanism behind motor complications in Parkinson disease (PD) are still a subject of debate. Several factors including age at onset, evolution in years, and initial medication can influence the onset and severity of motor complications in PD.We studied patients with recent diagnosis of PD who were followed up prospectively for 10 years. Analysis included the progression of these patients, as measured by the Unified Parkinson Disease Rating Scale scores and the presence of motor complications (motors fluctuations, dyskinesias, and gait freezing) over time. The patient group was studied as a whole and by subgroups classified according to age at onset, initial treatment, and sex.By the end of the first decade, most patients exhibited dyskinesias (91%), motor fluctuations (62%), and freezing of gait (68%). An association was found between several patients' characteristics and presence of motor complications by 5 years, though not after 10 years of follow up. The apparition of motor fluctuations was mainly related to initial treatment (odds ratio [OR], 3.87). The development of dyskinesias was linked to initial treatment (OR, 8.31), age at onset (OR, 0.90), and sex (OR, 12.87).

  19. Risk factors and implications of anastomotic complications after surgery for Crohn’s disease

    Institute of Scientific and Technical Information of China (English)

    Kristen; T; Crowell; Evangelos; Messaris

    2015-01-01

    Anastomotic complications occur more frequently in patients with Crohn’s disease leading to postoperative intra-abdominal septic complications(IASC). Patients with IASC often require re-operation or drainage to controlthe sepsis and have an increased frequency of disease recurrence. The aim of this article was to examine the factors affecting postoperative IASC in Crohn’s disease after anastomoses, since some risk factors remain controversial. Studies investigating IASC in Crohn’s operations were included, and all risk factors associated with IASC were evaluated: nutritional status, presence of abdominal sepsis, medication use, Crohn’s disease type, duration of disease, prior operations for Crohn’s, anastomotic technique, extent of resection, operative timing, operative length, and perioperative bleeding. In this review, the factors associated with an increased risk of IASC are preoperative weight loss, abdominal abscess present at time of surgery, prior operation, and steroid use. To prevent IASC in Crohn’s patients, preoperative optimization with nutritional supplementation or drainage of abscess should be performed, or a diverting stoma should be considered for patients with multiple risk factors.

  20. Incidence and Risk Factors for Upper Extremity Climbing Injuries in Indoor Climbers

    NARCIS (Netherlands)

    Van Middelkoop, M.; Bruens, M. L.; Coert, J. H.; Selles, R. W.; Verhagen, E.; Bierma-Zeinstra, S. M A; Koes, B. W.

    2015-01-01

    The purpose of this study was to describe the prevalence, incidence and risk factors for climbing-related injuries of the upper extremities in recreational climbers. A total of 426 recreational climbers were recruited from indoor climbing halls. The baseline questionnaire included questions on

  1. Risk factors in development of motor complications in Chinese patients with idiopathic Parkinson's disease.

    Science.gov (United States)

    Kum, Wan Fung; Gao, Jing; Durairajan, Siva Sundara Kumar; Man, Sui Cheung; Xie, Li Xia; Lu, Jia Hong; Fong, Wai Leuk; Li, Min

    2009-08-01

    Motor complications induced by levodopa (L-dopa) treatment in Parkinson's disease (PD) are not well documented in patients of Chinese ethnicity. We performed a cross-sectional study to investigate the prevalence of dyskinesias and motor fluctuations, and the factors determining their development, in a population of Chinese patients with PD. Among 137 patients with PD, 98 (71.5%) had received a L-dopa preparation. Motor fluctuations were found in 74.5% and dyskinesias in 77.6% of the 98 patients. Patients with dyskinesias were younger at onset of disease than those without. Patients with dyskinesias and motor fluctuations had significantly longer duration of PD and L-dopa treatment, higher daily doses of L-dopa, and higher scores in the 39-item Parkinson's Disease Questionnaire (PDQ-39), when compared to patients without motor complications. Among these factors, motor fluctuations were best predicted by duration of L-dopa treatment and dyskinesias by disease duration. We conclude that motor complications are closely related to disease and treatment parameters, especially the treatment and disease duration.

  2. Musculoskeletal neck pain in children and adolescents: Risk factors and complications.

    Science.gov (United States)

    Fares, Jawad; Fares, Mohamad Y; Fares, Youssef

    2017-01-01

    Neck pain is a major public health concern that has been extensively studied in adults but not in children and adolescents. Therefore, the purpose of this article is to explore musculoskeletal neck pain in children and adolescents, as well as to discuss its possible risk factors and complications. Participants were patients under 18 years of age, who had presented to the clinic (Beirut, Lebanon) in 2015, with nonspecific neck pain. They were examined and asked to evaluate and localize the pain. Neck positioning during various activities along with other complications were explored. Patients reporting pain associated with congenital or systemic diseases and fractures were excluded. Two-hundred-and-seven children and adolescents presented with nonspecific neck pain. Musculoskeletal neck pain with spasm was diagnosed in 180 patients (N = 180). Participants did not show any findings on physical examination and radiological studies, and had no comorbidities. More females (57%) than males (43%) and more adolescents (60%) than children (40%) were affected. All the 180 participants (100%) reported flawed flexion of their back and neck while studying and/or using smartphones and tablets. Eye symptoms were reported in 21% of the cases, and parents of most participants (82%) reported a change in the psychological and social behavior of their children. Musculoskeletal neck pain is an important disease in children and adolescents with numerous risk factors contributing to its development. Increased stresses regarding the cervical spine may lead to cervical degeneration along with other developmental, medical, psychological, and social complications.

  3. Effect of Intensive Therapy of Multiple Factors Intervention on Vascular Complications in Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    吴汉妮; 张淑玲; 沈迪

    2003-01-01

    The effects of intensive versus regular therapy on incidence and progress of microalbuminuria in type 2 diabetes were compared. During a follow-up of 3 years, 96 cases of diabetes mellitus were randomized to intensive and regular therapy groups. HbA1c goal was same in the two groups,but the goal of blood pressure (Bp) and lipid was more strict in the intensive therapy group than in the regular therapy group. There was statistically significant difference in the incidence and progression of vascular complications between the two groups. Logistic stepwise-regression analysis (odds ration, OR) showed that there was significant difference in the progression of nephropathy (OR 0. 24,95 % CI 0. 12-0. 76), retinopathy (OR 0.38, 95 % CI 0.16-0. 88), peripheral neuropathy (OR 0. 42, 95 % CI 0. 22-0. 86) and autonomic neuropathy (OR 0. 29, 95 % CI 0. 12-0. 86) between the two groups (P<0. 01). It was concluded that intensive blood glucose controlling could retard diabetic vascular complications. Intensive therapy of multiple factors interventions (controlling Bp, regulating blood lipid, improving microcirculation) could decrease various risk factors for diabetic vascular complications.

  4. Biliary complications after pediatric liver transplantation: Risk factors, diagnosis and management

    Institute of Scientific and Technical Information of China (English)

    Flavia; H; Feier; Eduardo; A; da; Fonseca; Joao; Seda-Neto; Paulo; Chapchap

    2015-01-01

    The expanded indications of partial grafts in pediatric liver transplantation have reduced waiting list mortality. However, a higher morbidity is observed, including an increased rate of biliary complications(BCs). Factors such as the type of graft, the preservation methods applied, the donor characteristics, the type of biliary reconstruction, and the number of bile ducts in the liver graft influences the occurrence of these complications. Bile leaks and strictures comprise the majority of posttransplant BCs. Biliary strictures require a high grade of suspicion, and because most children have a bileoenteric anastomosis, its diagnosis and management rely on percutaneous hepatic cholangiography and percutaneous biliary interventions(PBI). The success rates with PBI range from 70% to 90%. Surgery is reserved for patients who have failed PBI. BCs in children after liver transplantation have a prolonged treatment and are associated with a longer length of stay and higher hospital costs. However, with early diagnosis and aggressive treatment, patient and graft survival are not significantly compromised.

  5. Complications of systemic juvenile idiopathic arthritis: risk factors and management recommendations.

    Science.gov (United States)

    Woerner, Andreas; von Scheven-Gête, Annette; Cimaz, Rolando; Hofer, Michaël

    2015-05-01

    Systemic juvenile idiopathic arthritis (SJIA) is an inflammatory condition characterized by fever, lymphadenopathy, arthritis, rash and serositis. Systemic inflammation has been associated with dysregulation of the innate immune system, suggesting that SJIA is an autoinflammatory disorder. IL-1 and IL-6 play a major role in the pathogenesis of SJIA, and treatment with IL-1 and IL-6 inhibitors has shown to be highly effective. However, complications of SJIA, including macrophage activation syndrome, limitations in functional outcome by arthritis and long-term damage from chronic inflammation, continue to be a major issue in SJIA patients' care. Translational research leading to a profound understanding of the cytokine crosstalk in SJIA and the identification of risk factors for SJIA complications will help to improve long-term outcome.

  6. Indications and Risk Factors for Complications of Lower Third Molar Surgery in a Nigerian Teaching Hospital

    Science.gov (United States)

    Osunde, OD; Saheeb, BD; Bassey, GO

    2014-01-01

    Background: The surgical extraction of impacted third molars is a common oral surgical procedure, and it is often associated with complications such as sensory nerve damage, dry socket, pain, swelling, trismus, infection and hemorrhage. Aim: The aim of this study was to determine the surgical indications and risk factors for complications of third molar surgery at a Nigerian teaching hospital. Materials and Methods: Medical records of patients referred to the Oral Surgery Clinic of our institution for surgical extraction of their impacted mandibular third molars from January 2008 to December 2010 were retrospectively examined. Information on patients’ demography, types of impaction, operative parameters and complications were obtained and analyzed using Statistical Package for Social Sciences (SPSS Version 13), Chicago, IL, USA. A P pericoronitis (154/330 [46.7%]) was the most common indication for extraction. The complications were delayed healing (19/330 [5.8%]), alveolar, osteitis (9/330 [2.7%]) and injury to alveolar nerve (2/330 [0.6%]). Cigarette smoking (P < 0.001), Oral contraceptives use (P = 0.01), age of the patient (P = 0.03) and the surgeon's experience (P = 0.04) were found to be significantly associated with the development of alveolar osteitis; nerves injuries were significantly associated with the raising of a lingual flap (P < 0.001) and the technique of surgery (P ≤ 0.001). Conclusion: The age of the patient, cigarette smoking and oral contraceptive use at the time of surgery are some of the factors affecting outcome in third molar surgery. PMID:25506490

  7. Incidence, Risk Factors, Management, and Complications of Rectal Injuries During Radical Prostatectomy.

    Science.gov (United States)

    Mandel, Philipp; Linnemannstöns, Anna; Chun, Felix; Schlomm, Thorsten; Pompe, Raisa; Budäus, Lars; Rosenbaum, Clemens; Ludwig, Tim; Dahlem, Roland; Fisch, Margit; Graefen, Markus; Huland, Hartwig; Tilki, Derya; Steuber, Thomas

    2017-02-07

    Rectal injury (RI) during radical prostatectomy (RP) is a severe complication. So far, only limited data describing the incidence, risk factors, management, and complications of RI are available. In an analysis of data for 24178 patients, we identified 113/24076 patients (0.47%) undergoing open or robotic RP and 7/102 patients (6.86%) after salvage RP who experienced an RI. Besides salvage RP, local tumor stage, Gleason grade, lymph node status, and surgical experience, but not surgical approach (robotic vs open), could be identified as risk factors for RI in univariate and multivariate analysis. Intraoperative management of RI comprised closure with two to three layers. In 13/109 patients (11.9%), a diverting colostomy/ileostomy was carried out. Some 12% of men with closure of an RI developed a recto-anastomosis fistula, and 57% of those who had an additional diverting enterostomy. Thus, the overall incidence of recto-anastomosis fistula after RP was <0.1%. The extent of rectal laceration, prior radiation, and intraoperative signs of rectal infiltration were associated with the development of a subsequent recto-anastomosis fistula. Some 83% of patients with a recto-anastomosis fistula needed further intervention. We analyzed the incidence, risk factors, management, and complications of rectal injury during radical prostatectomy. Overall, the incidence of rectal injury and subsequent development of recto-anastomosis fistulas is low unless the patient has significant risk factors. Copyright © 2017 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  8. Prevalence of metabolic syndrome: association with risk factors and cardiovascular complications in an urban population.

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    Gisela Cipullo Moreira

    Full Text Available INTRODUCTION: Metabolic syndrome (MS is a set of cardiovascular risk factors and type 2 diabetes, responsible for a 2.5-fold increased cardiovascular mortality and a 5-fold higher risk of developing diabetes. OBJECTIVES: 1-to evaluate the prevalence of MS in individuals over 18 years associated with age, gender, socioeconomic status, educational levels, body mass index (BMI, HOMA index and physical activity; moreover, to compare it to other studies; 2-to compare the prevalence of elevated blood pressure (BP, high triglycerides and plasma glucose levels, low HDL cholesterol and high waist circumference among individuals with MS also according to gender; 3-to determine the number of risk factors in subjects with MS and prevalence of complications in individuals with and without MS aged over 40 years. METHODS: A cross-sectional study of 1369 Individuals, 667 males (48.7% and 702 females (51.3% was considered to evaluate the prevalence of MS and associated factors in the population. RESULTS: The study showed that 22.7% (95% CI: 19.4% to 26.0% of the population has MS, which increases with age, higher BMI and sedentary lifestyle. There was no significant difference between genders until age ≥70 years and social classes. Higher prevalence of MS was observed in lower educational levels and higher prevalence of HOMA positive among individuals with MS. The most prevalent risk factors were elevated blood pressure (85%, low HDL cholesterol (83.1% and increased waist circumference (82.5%. The prevalence of elevated BP, low HDL cholesterol and plasma glucose levels did not show significant difference between genders. Individuals with MS had higher risk of cardiovascular complications over 40 years. CONCLUSION: The prevalence of MS found is similar to that in developed countries, being influenced by age, body mass index, educational levels, physical activity, and leading to a higher prevalence of cardiovascular complications after the 4th decade of life.

  9. Extreme Thrombocytosis and Cardiovascular Surgery

    Science.gov (United States)

    Natelson, Ethan A.

    2012-01-01

    Extreme thrombocytosis is a major risk factor for excessive bleeding and for thrombosis, either of which can complicate cardiovascular surgical and interventional procedures. Extreme thrombocytosis can also cause an unusual syndrome, erythromelalgia, that results in a type of chronic microvascular occlusive arterial disease. We present the differential diagnosis of conditions that may lead to extreme thrombocytosis, 3 cases (each of which illustrates a different potential complication), and a review of the pertinent medical literature. Correcting excessive thrombocytosis is typically not difficult, whether electively or acutely, and effective therapy usually controls thrombosis and excessive hemorrhage postprocedurally. PMID:23304015

  10. Orofacial clefts at Bugando Medical Centre: associated factors and postsurgical complications.

    Science.gov (United States)

    Buyu, Yunus; Manyama, Mange; Chandika, Alphonce; Gilyoma, Japhet

    2012-11-01

    To determine factors associated with orofacial clefts and postsurgical complications of cleft lip and palate repair surgeries in northwestern Tanzania. This was a cohort study involving patients with orofacial clefts. Associated factors (family history of orofacial clefts, maternal use of alcohol and cigarette smoking during pregnancy) were obtained through interviews with accompanying parents. Antenatal cards were used to obtain maternal age at birth and birth weight. Ninety-four patients with different orofacial clefts were seen. Among them, 46.8% (44/94), 13.8% (13/94), and 39.4% (37/94) had cleft lip, cleft palate, and cleft lip and palate, respectively. About 15% of orofacial cleft cases had a positive family history of orofacial clefts. Among these, 7.4% had an affected relative on the maternal side, 4.3% had an affected relative on the paternal side, and 3.2% had an affected sibling. This difference was statistically significant (chi-square  =  27.7, p Orofacial cleft was significantly associated with order of birth (chi-square  =  21.0, p orofacial clefts and order of birth were significantly associated with orofacial clefts in northwestern Tanzania. These factors have been associated with risk of orofacial clefts elsewhere and suggest a hereditary role in the etiology of orofacial cleft. Palatal fistula and philtrum dehiscence were postsurgical complications observed in orofacial clefts patients who had primary surgery past the recommended age. These complications could have resulted from delayed surgery and absence of presurgical procedures.

  11. The Evaluation of Risk Factors for Postoperative Infectious Complications after Percutaneous Nephrolithotomy

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    Tian Yang

    2017-01-01

    Full Text Available This study was to evaluate the risk factors of infectious complications after percutaneous nephrolithotomy (PCNL and build a prediction tool for postoperative complications based on the risk factors. A total of 110 male (67.1% and 54 female (32.9% patients who underwent PCNL for renal stones between 2010 and 2014 in our institute were included. A detailed clinical information and laboratory results were obtained from patients. Systemic inflammatory response syndrome (SIRS and postoperative fever were recorded after PCNL surgery. In all, 45 cases (27.4% developed SIRS and fever was observed in 20 cases (12.2%. In multivariate analysis, stone size (odds ratio, OR = 1.471, p=0.009 and urine white blood cell (WBC (OR = 1.001, p=0.007 were related to the development of SIRS. Stone size (OR = 1.644, p=0.024, urine WBC (OR = 1.001, p=0.002 and serum albumin (OR = 0.807, p=0.021 were associated with postoperative fever. We concluded that patients with larger stone size and preoperative urinary tract infection might have a higher risk of developing SIRS and fever after operation, while a high-normal level of serum albumin might be the protective factor for postoperative fever.

  12. Risk factors for neurological complications in complete hemolytic uremic syndrome caused by Escherichia coli O157.

    Science.gov (United States)

    Yamamoto, Takehisa; Satomura, Kenichi; Okada, Shintaro; Ozono, Keiichi

    2009-04-01

    The aim of the present study was to investigate the predictive parameters for encephalopathy in complete hemolytic uremic syndrome (HUS) in a large outbreak of O157: H7 infection in 1996. A total of 182 inpatients, 71 of whom had complete HUS, including 12 patients with neurological complications, and 46 colitis patients were studied. Presenting signs and symptoms (n = 115) and laboratory data (n = 69) were analyzed using monovariate and multivariate analysis. After adjusting for age and gender, logistic regression showed that presenting symptoms such as bloody diarrhea (odds ratio [OR] = 7.39), proteinuria (OR = 6.16), hematuria (OR = 8.31), oliguria (OR = 17.4) and a pale face (OR = 10.7) were useful for predicting complete HUS. Also, increased white blood cell counts >12,000 microL/mL (OR = 10.0) and C-reactive protein >1.5 mg/dL (OR = 7.39) at the onset of infection, were useful as predictive laboratory parameters. To predict neurological complications in complete HUS patients, the average daily increase of lactate dehydrase >1200 IU/L per day (OR = 26.3) and creatinine >0.5 mg/dL per day (OR = 12) were found to be useful on multivariate logistic regression. There are useful predictive clinical factors for neurological complications in complete HUS.

  13. Neurological complications after neonatal bacteremia: the clinical characteristics, risk factors, and outcomes.

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    Shih-Ming Chu

    Full Text Available BACKGROUND: Neonates with bacteremia are at risk of neurologic complications. Relevant information warrants further elucidation. STUDY DESIGN: This was a retrospective cohort study of neonates with bacteremia-related neurologic complications (BNCs in a tertiary-level neonatal intensive care unit (NICU. A systemic chart review was performed conducted to identify clinical characteristics and outcomes. A cohort of related conditions was constructed as the control group. Logistic regression analysis was used to identify independent risk factors for BNC. RESULTS: Of 1037 bacteremia episodes, 36 (3.5% had BNCs. Twenty-four cases of BNCs were related to meningitis, five were presumed meningitis, and seven occurred after septic shock. The most common causative pathogens were Group B streptococcus (41.7% and E. coli (16.7%. The major BNCs consisted of seizures (28, hydrocephalus (20, encephalomalacia (11, cerebral infarction (7, subdural empyema (6, ventriculitis (8, and abscess (4. Eight (22.8% neonates died and six (16.7% were discharged in critical condition when the family withdrew life-sustaining treatment. Among the 22 survivors, eight had neurologic sequelae upon discharge. After multivariate logistic regression analysis, neonates with meningitis caused by Group B streptococcus (adjusted odds ratio [OR]: 8.90, 95% confidence interval [CI]: 2.20-36.08; p = 0.002 and combined meningitis and septic shock (OR, 5.94; 95% CI: 1.53-23.15; p = 0.010 were independently associated with BNCs. CONCLUSIONS: Neonates with bacteremia-related neurologic complications are associated with adverse outcomes or sequelae. Better strategies aimed at early detection and reducing the emergence of neurologic complications and aggressive treatment of Group B streptococcus sepsis are needed in neonates with meningitis and septic shock.

  14. Risk factors for long term complications among patients of endocrine clinic in Hospital Penang, Malaysia

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    Syed Wasif Gillani

    2012-09-01

    Full Text Available Introduction: The prevalence of diabetes is on the increase and an estimated 239 million people worldwide are expected to have the condition by the year 2020 (1. Diabetes mellitus (DM represents a serious healthcare challenge. The aim of the study was to evaluate the patient clinical characteristics and risk factors for long term complications in the endocrine clinic of Hospital Penang, Malaysia.Methods: Descriptive Prospective cross-sectional study design was chosen. To achieve a power of 0.7 with alpha set at 0.05, 186 subjects were required for the study but researcher increase the sample to 297 in caseof drop out. Self-developed data collection form was used to collect the patient information.Results: 297 (100% patients were enrolled from OPD diabetic clinic of Hospital Palau Pinang. Among the sample 150 (50.5% were males and rest 147 (49.5% females. Malay males mean weight at the time of diagnosis significantly higher (pshowed that hypertension found among all the classes of diagnosis. Signifi cant variable are diagnosis class and medication consideration.Conclusion of the study suggested that majority of patients are at high risk of long-term complications and comorbidies. It has been found that increased rate of risk factors have been found among the study population and non-significant to sociodemographic differences.

  15. Risk factors for HBV-related liver cirrhosis complicated by acute upper gastrointestinal bleeding

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    YU Zhirui

    2017-05-01

    Full Text Available ObjectiveTo investigate the risk factors for HBV-related liver cirrhosis complicated by acute upper gastrointestinal bleeding (AUGIB. MethodsA total of 58 patients with HBV-related liver cirrhosis complicated by AUGIB who were hospitalized in our hospital from January to December, 2011 were enrolled as study group, and 100 patients with HBV-related liver cirrhosis who did not experience upper gastrointestinal bleeding during the same period of time were enrolled as control group. Their general clinical data were collected. The t-test was used for comparison of continuous data between groups, the chi-square test was used for comparison of categorical data between groups, the multivariate Cox regression model was used to analyze the risk factors, and the life table method was used to analyze 1-, 2-, and 3-year cumulative survival rates and plot survival curves. ResultsThe 1-, 2-, and 3-year cumulative survival rates in the patients with HBV-related liver cirrhosis complicated by AUGIB were 72.2%, 51.9%, and 35.2%, respectively, with a median survival time of 24.7 months. The univariate analysis showed that AUGIB was associated with bleeding history (χ2=7.128, P=0008, course of disease (t=8.283, P<0.001, bad eating habits (χ2=7.612, P=0.006, Child-Pugh class (χ2=6.045, P=0049, degree of esophageal varices (χ2=46.241, P<0.001, gastric varices (χ2=14.211, P<0.001, and portal hypertension (χ2=6.846, P=0009. The multivariate Cox regression analysis revealed that course of disease (RR=0.745, 95%CI: 0.824-0967, P=0.026, bad eating habits (RR=1.426, 95%CI: 1.033-2.582, P=0.032, Child-Pugh class (RR=2.032, 95%CI: 1.05-2.34, P=0036, degree of esophageal varices (RR=0.796, 95%CI: 1.23-3.37, P=0.015, degree of gastric varices (RR=0825, 95%CI: 2.46-392, P=0.043, and portal hypertension (RR=0.983, 95%CI: 1.26-3.75, P=0.007 were independent risk factors for the prognosis of patients with HBV-related liver cirrhosis

  16. Fatores que influenciam nas complicações das tireoidectomias Factors influencing thyroidectomy complications

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    Miguel Ernandes Neto

    2012-06-01

    Full Text Available O resultado pós-operatório das tireoidectomias é imputado a fatores relativos ao paciente, à tireopatia e ao cirurgião. OBJETIVO: Analisar a experiência de um serviço quanto a complicações com a tireoidectomia. Desenho do estudo: coorte histórica com corte transversal. MATERIAL E MÉTODO: Foram avaliados os prontuários de 228 pacientes submetidos à tireoidectomia, entre 1991 e 2004. Foram estudadas as complicações transitórias, definitivas e totais, persistência e recidiva da tireopatia de base, em relação a fatores clínico-laboratoriais. RESULTADOS: Ocorreram 34,65% de complicações totais, 18,86% de complicações transitórias (9,21% hipocalcemia, 0,44% paralisia de cordas vocais, 4,82% outras, associadas aos primeiros anos de cirurgia no serviço e queixas compressivas, e 17,98% de complicações definitivas (8,77% hipoparatireoidismo, 1,75% paralisia de cordas vocais, 0,44% rouquidão, associadas à malignidade e cirurgias mais radicais. Houve persistência da doença de base em 17,98% dos casos, associada à idade, e recidiva em 10,96%, associada aos primeiros anos de cirurgia, benignidade e cirurgias menos radicais. CONCLUSÃO: Complicações pós-operatórias se associaram a queixas compressivas, história curta, malignidade e cirurgias mais radicais. A recidiva se associou aos primeiros anos de cirurgia no serviço, tireopatias benignas e cirurgias menos radicais. A persistência da doença se associou à maior idade.The postoperative outcome of thyroidectomies is related to factors concerning the patient, the thyroid disease, and the surgeon. OBJECTIVES: To analyze a clinic's experience with thyroidectomy complications. Study design: historical cross-sectional cohort study. MATERIALS AND METHODS: We reviewed the charts from 228 patients submitted to thyroidectomy, between 1991 and 2004. Transient, permanent and total complications as well as persistence and recurrence of the basal disease were studied in relation to

  17. Endotracheal Intubation after Acute Drug Overdoses: Incidence, Complications, and Risk Factors.

    Science.gov (United States)

    Hua, Angela; Haight, Stephen; Hoffman, Robert S; Manini, Alex F

    2017-01-01

    Drug overdose is the leading cause of injury-related fatality in the United States, and respiratory failure remains a major source of morbidity and mortality. We aimed to identify the incidence and risk factors for endotracheal intubation after acute drug overdose. This secondary data analysis was performed on a 5-year prospective cohort at two urban tertiary-care hospitals. The present study analyzed adult patients with suspected acute drug overdose to derive independent clinical predictors of endotracheal intubation. We analyzed 2497 patients with acute drug overdose, of whom 87 (3.5%) underwent endotracheal intubation. Independent clinical risk factors for endotracheal intubation were: younger age (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.96-0.98), and history of obstructive lung disease (OR 6.6, 95% CI 3.5-12.3); however, heart failure had no association. Patients with obstructive lung disease had significantly more hypercapnia (mean difference 6.8 mm Hg, 95% CI 2.3-11.3) and a higher degree of acidemia (mean pH difference 0.04, 95% CI 0.01-0.07) than patients without obstructive lung disease. Lack of rapid sequence sedative/paralytic was associated with in-hospital fatality. Early complications of endotracheal intubation itself included desaturation (3.4%) and bradycardia (1%). Endotracheal intubation was infrequently performed on patients with acute drug overdose, and complications were rare when performed. Risk factors associated with endotracheal intubation included younger age and prior obstructive lung disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Risk factors for long term complications among patients of endocrine clinic in Hospital Penang, Malaysia

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    Syed Wasif Gillani

    2012-09-01

    Full Text Available Introduction: The prevalence of diabetes is on the increase and an estimated 239 million people worldwide are expected to have the condition by the year 2020 (1. Diabetes mellitus (DM represents a serious healthcare challenge. The aim of the study was to evaluate the patient clinical characteristics and risk factors for long term complications in the endocrine clinic of Hospital Penang, Malaysia.Methods: Descriptive Prospective cross-sectional study design was chosen. To achieve a power of 0.7 with alpha set at 0.05, 186 subjects were required for the study but researcher increase the sample to 297 in caseof drop out. Self-developed data collection form was used to collect the patient information.Results: 297 (100% patients were enrolled from OPD diabetic clinic of Hospital Palau Pinang. Among the sample 150 (50.5% were males and rest 147 (49.5% females. Malay males mean weight at the time of diagnosis significantly higher (p<0.001, as compared to other ethnics, same results found among Malay females (p<0.001. Findings suggested increased number of risk factors among the study population. Finding alsoshowed that hypertension found among all the classes of diagnosis. Signifi cant variable are diagnosis class and medication consideration.Conclusion of the study suggested that majority of patients are at high risk of long-term complications and comorbidies. It has been found that increased rate of risk factors have been found among the study population and non-significant to sociodemographic differences.

  19. Multivariate analysis of risk factors for postoperative complications after laparoscopic liver resection.

    Science.gov (United States)

    Tranchart, Hadrien; Gaillard, Martin; Chirica, Mircea; Ferretti, Stefano; Perlemuter, Gabriel; Naveau, Sylvie; Dagher, Ibrahim

    2015-09-01

    The identification of modifiable perioperative risk factors in patients undergoing laparoscopic liver resection (LLR) should aid the selection of appropriate surgical procedures and thus improve further the outcomes associated with LLR. The aim of this retrospective study was to determine the risk factors for postoperative morbidity associated with laparoscopic liver surgery. All patients who underwent elective LLR between January 1999 and December 2012 were included. Demographic data, preoperative risk factors, operative variables, histological analysis, and postoperative course were recorded. Multivariate analysis was carried out using an unconditional logistic regression model. Between January 1999 and December 2012, 140 patients underwent LLR. There were 56 male patients (40%) and mean age was 57.8 ± 17 years. Postoperative complications were recorded in 30 patients (21.4%). Postoperative morbidity was significantly higher after LLR of malignant tumors [n = 26 (41.3%)] when compared to LLR of benign lesions [n = 4 (5.2%) (P multivariate analysis, operative time [OR = 1.008 (1.003-1.01), P = 0.001] and LLR performed for malignancy [OR = 9.8 (2.5-37.6); P = 0.01] were independent predictors of postoperative morbidity. In the subgroup of patients that underwent LLR for malignancy using the same multivariate model, operative time was the sole independent predictor of postoperative morbidity [OR = 1.008 (1.002-1.013); P = 0.004]. Postoperative complication rate increases by 60% with each additional operative hour during LLR. Therefore, expected operative time should be assessed before and during LLR, especially when dealing with malignant tumor.

  20. Complicated Whipple’s disease and endocarditis following tumor necrosis factor inhibitors

    Institute of Scientific and Technical Information of China (English)

    Thomas; Marth

    2014-01-01

    AIM: To test whether treatment with tumor necrosis factor inhibitors(TNFI) is associated with complications of Tropheryma whipplei(T. whipplei) infection. METHODS: Because unexplained arthritis is often the first Whipple’s disease(WD) symptom, patients may undergo treatment with TNFI before diagnosis. This may influence the course of infection with T. whipplei, which causes WD, because host immune defects contribute to the pathogenesis of WD. A literature search and cross referencing identified 19 reports of TNFI treatment prior to WD diagnosis. This case-control study compared clinical data in patients receiving TNFI therapy(group Ⅰ, n = 41) with patients not receiving TNFI therapy(group Ⅱ, n = 61). Patients from large reviews served as controls(group Ⅲ, n = 1059).RESULTS: The rate of endocarditis in patient group Ⅰ was significantly higher than in patient group Ⅱ(12.2% in group Ⅰ vs 1.6% in group Ⅱ, P < 0.05), and group Ⅲ(12.2% in group Ⅰ vs 0.16% in group Ⅲ, P < 0.01). Other, severe systemic or local WD complications such as pericarditis, fever or specific organ manifestations were increased also in group Ⅰ as compared to the other patient groups. However, diarrhea and weight loss were somewhat less frequent in patient group Ⅰ. WD istypically diagnosed with duodenal biopsy and periodic acid Schiff(PAS) staining. PAS-stain as standard diagnostic test had a very high percentage of false negative results(diagnostic failure in 63.6% of cases) in group I. Polymerase chain reaction(PCR) for T. whipplei was more accurate than PAS-stainings(diagnostic accuracy, rate of true positive tests 90.9% for PCR vs 36.4% for PAS, P < 0.01).CONCLUSION: TNFI trigger severe WD complications, particularly endocarditis, and lead to false-negative PAS-tests. In case of TNFI treatment failure, infection with T. whipplei should be considered.

  1. Biliary complications after pediatric liver transplantation: Risk factors, diagnosis and management

    Science.gov (United States)

    Feier, Flavia H; da Fonseca, Eduardo A; Seda-Neto, Joao; Chapchap, Paulo

    2015-01-01

    The expanded indications of partial grafts in pediatric liver transplantation have reduced waiting list mortality. However, a higher morbidity is observed, including an increased rate of biliary complications (BCs). Factors such as the type of graft, the preservation methods applied, the donor characteristics, the type of biliary reconstruction, and the number of bile ducts in the liver graft influences the occurrence of these complications. Bile leaks and strictures comprise the majority of post-transplant BCs. Biliary strictures require a high grade of suspicion, and because most children have a bileo-enteric anastomosis, its diagnosis and management rely on percutaneous hepatic cholangiography and percutaneous biliary interventions (PBI). The success rates with PBI range from 70% to 90%. Surgery is reserved for patients who have failed PBI. BCs in children after liver transplantation have a prolonged treatment and are associated with a longer length of stay and higher hospital costs. However, with early diagnosis and aggressive treatment, patient and graft survival are not significantly compromised. PMID:26328028

  2. Varicella zoster meningitis complicating combined anti-tumor necrosis factor and corticosteroid therapy in Crohn's disease.

    Science.gov (United States)

    Ma, Christopher; Walters, Brennan; Fedorak, Richard N

    2013-06-01

    Opportunistic viral infections are a well-recognized complication of anti-tumor necrosis factor (TNF) therapy for inflammatory bowel disease (IBD). Cases of severe or atypical varicella zoster virus infection, both primary and latent reactivation, have been described in association with immunosuppression of Crohn's disease (CD) patients. However, central nervous system varicella zoster virus infections have been rarely described, and there are no previous reports of varicella zoster virus meningitis associated with anti-TNF therapy among the CD population. Here, we present the case of a 40-year-old male with severe ileocecal-CD who developed a reactivation of dermatomal herpes zoster after treatment with prednisone and adalimumab. The reactivation presented as debilitating varicella zoster virus meningitis, which was not completely resolved despite aggressive antiviral therapy with prolonged intravenous acyclovir and subsequent oral valacyclovir. This is the first reported case of opportunistic central nervous system varicella zoster infection complicating anti-TNF therapy in the CD population. This paper also reviews the literature on varicella zoster virus infections of immunosuppressed IBD patients and the importance of vaccination prior to initiation of anti-TNF therapy.

  3. Physical Exam Risk Factors for Lower Extremity Injury in High School Athletes: A Systematic Review.

    Science.gov (United States)

    Onate, James A; Everhart, Joshua S; Clifton, Daniel R; Best, Thomas M; Borchers, James R; Chaudhari, Ajit M W

    2016-11-01

    A stated goal of the preparticipation physical evaluation (PPE) is to reduce musculoskeletal injury, yet the musculoskeletal portion of the PPE is reportedly of questionable use in assessing lower extremity injury risk in high school-aged athletes. The objectives of this study are: (1) identify clinical assessment tools demonstrated to effectively determine lower extremity injury risk in a prospective setting, and (2) critically assess the methodological quality of prospective lower extremity risk assessment studies that use these tools. A systematic search was performed in PubMed, CINAHL, UptoDate, Google Scholar, Cochrane Reviews, and SportDiscus. Inclusion criteria were prospective injury risk assessment studies involving athletes primarily ages 13 to 19 that used screening methods that did not require highly specialized equipment. Methodological quality was evaluated with a modified physiotherapy evidence database (PEDro) scale. Nine studies were included. The mean modified PEDro score was 6.0/10 (SD, 1.5). Multidirectional balance (odds ratio [OR], 3.0; CI, 1.5-6.1; P < 0.05) and physical maturation status (P < 0.05) were predictive of overall injury risk, knee hyperextension was predictive of anterior cruciate ligament injury (OR, 5.0; CI, 1.2-18.4; P < 0.05), hip external:internal rotator strength ratio of patellofemoral pain syndrome (P = 0.02), and foot posture index of ankle sprain (r = -0.339, P = 0.008). Minimal prospective evidence supports or refutes the use of the functional musculoskeletal exam portion of the current PPE to assess lower extremity injury risk in high school athletes. Limited evidence does support inclusion of multidirectional balance assessment and physical maturation status in a musculoskeletal exam as both are generalizable risk factors for lower extremity injury.

  4. Physical Exam Risk Factors for Lower Extremity Injury in High School Athletes: A Systematic Review

    Science.gov (United States)

    Onate, James A.; Everhart, Joshua S.; Clifton, Daniel R.; Best, Thomas M.; Borchers, James R.; Chaudhari, Ajit M.W.

    2016-01-01

    Objective A stated goal of the preparticipation physical evaluation (PPE) is to reduce musculoskeletal injury, yet the musculoskeletal portion of the PPE is reportedly of questionable use in assessing lower extremity injury risk in high school-aged athletes. The objectives of this study are: (1) identify clinical assessment tools demonstrated to effectively determine lower extremity injury risk in a prospective setting, and (2) critically assess the methodological quality of prospective lower extremity risk assessment studies that use these tools. Data Sources A systematic search was performed in PubMed, CINAHL, UptoDate, Google Scholar, Cochrane Reviews, and SportDiscus. Inclusion criteria were prospective injury risk assessment studies involving athletes primarily ages 13 to 19 that used screening methods that did not require highly specialized equipment. Methodological quality was evaluated with a modified physiotherapy evidence database (PEDro) scale. Main Results Nine studies were included. The mean modified PEDro score was 6.0/10 (SD, 1.5). Multidirectional balance (odds ratio [OR], 3.0; CI, 1.5–6.1; P anterior cruciate ligament injury (OR, 5.0; CI, 1.2–18.4; P < 0.05), hip external: internal rotator strength ratio of patellofemoral pain syndrome (P = 0.02), and foot posture index of ankle sprain (r = −0.339, P = 0.008). Conclusions Minimal prospective evidence supports or refutes the use of the functional musculoskeletal exam portion of the current PPE to assess lower extremity injury risk in high school athletes. Limited evidence does support inclusion of multidirectional balance assessment and physical maturation status in a musculoskeletal exam as both are generalizable risk factors for lower extremity injury. PMID:26978166

  5. Survey of 2002 cases of liver cirrhosis: Identification of etiological factors and related complications

    Directory of Open Access Journals (Sweden)

    AI Min

    2013-05-01

    Full Text Available ObjectiveTo identify the etiologies and associated complications of liver cirrhosis for new cases emerging over the past decade in the region served by the Second Affiliated Clinical College of Chongqing University of Medical Sciences. MethodsThe institute′s inpatient medical record database was searched for all individuals admitted with a new diagnosis of liver cirrhosis between January 2002 and December 2011. Data on demographics and clinical findings were collected for retrospective analysis to determine the regional and temporal profiles of etiologies and complications. The count data, expressed as percent of total, was analyzed by the Chi-squared test. ResultsAmong the total 2002 liver cirrhosis cases, the most frequent etiologies (>1.5% of total were viral hepatitis type B (60.6%, fatty liver caused by both hepatitis B virus (HBV and alcohol (16.6%, alcoholic fatty liver (6.6%, autoimmune liver disease (3.4%, autoimmune liver disease and alcohol (3.2%, and nonalcoholic fatty liver (1.7%. From the first half of the decade to the second half (January 2002-December 2006 vs. January 2007-December 2011, the incidences of two etiologies significantly increased (HBV and alcohol: 13.6% vs. 17.7%, P<0.05 and autoimmune liver disease: 3.5% vs. 7.1%, P<0.05 and the incidence of HBV significantly decreased (641% vs. 59.3%, P<0.05. The most common major complications of cirrhosis were primary hepatocellular carcinoma (HCC; 221%, spontaneous peritonitis (21.3%, upper gastrointestinal bleeding (193%, hepatic encephalopathy (7.3%, and hepatorenal syndrome (4.0%. The incidence of liver cancer was significantly higher in patients with a family history of hepatitis B (31.1% vs. 222%, P<0.05 and positively correlated with HBV DNA load (χ2 = 10.88, P<0.05. ConclusionIn Chongqing, HBV remains a major cause of cirrhosis, even though alcoholism and autoimmune disease are rising in importance as etiological factors, and HCC is still the

  6. Is thrombophilia a risk factor for placenta-mediated pregnancy complications?

    DEFF Research Database (Denmark)

    Hoffmann, Elise; Hedlund, Elisabeth; Perin, Trine

    2012-01-01

    PURPOSE: To determine if thrombophilia is a risk factor for placenta-mediated pregnancy complications (PMPC) (i.e., preeclampsia, intrauterine growth restriction (IUGR), placental abruption, intrauterine fetal death and recurrent pregnancy loss). METHODS: A 5-year retrospective cohort study....... Ongoing pregnancies in women with an antecedent PMPC with thrombophilia were compared with the pregnancies in similar women without thrombophilia. The main outcome measures were mean birth weight deviations, corrected for gestational age, and recurrence of PMPC. Low-molecular-weight heparin (LMWH......) was employed for thromboprophylaxis only. Mann-Whitney's, Fisher's and Chi-square tests were employed for comparison. RESULTS: PMPC recurred in 10/43 (23 %) in the thrombophilia group and in 7/41 (17 %) in the non-thrombophilia group, P

  7. Pulmonary complications of liver transplantation: radiological appearance and statistical evaluation of risk factors in 300 cases

    Energy Technology Data Exchange (ETDEWEB)

    Golfieri, R.; Giampalma, E.; d' Arienzo, P.; Maffei, M.; Muzzi, C.; Tancioni, S.; Gavelli, G. [Dipartimento Clinico di Scienze Radiologiche ed Istocitopatologiche, Policlinico S.Orsola, Universita di Bologna, Via Massarenti 9, I-40138 Bologna (Italy); Morselli Labate, A.M.; Sama, C. [Dipartimento di Medicina Interna e Gastroenterologia, Policlinico S.Orsola, Universita di Bologna, Via Massarenti 9, I-40138 Bologna (Italy); Jovine, E.; Grazi, G.L.; Mazziotti, A.; Cavallari, A. [Dipartimento di Discipline Chirurgiche, Rianimatorie e dei Trapianti, Policlinico S.Orsola, Universita di Bologna, Via Massarenti 9, I-40138 Bologna (Italy)

    2000-07-01

    The aim of this study was to evaluate the incidence, radiographic appearance, time of onset, outcome and risk factors of non-infectious and infectious pulmonary complications following liver transplantation. Chest X-ray features of 300 consecutive patients who had undergone 333 liver transplants over an 11-year period were analysed: the type of pulmonary complication, the infecting pathogens and the mean time of their occurrence are described. The main risk factors for lung infections were quantified through univariate and multivariate statistical analysis. Non-infectious pulmonary abnormalities (atelectasis and/or pleural effusion: 86.7%) and pulmonary oedema (44.7%) appeared during the first postoperative week. Infectious pneumonia was observed in 13.7%, with a mortality of 36.6%. Bacterial and viral pneumonia made up the bulk of infections (63.4 and 29.3%, respectively) followed by fungal infiltrates (24.4%). A fairly good correlation between radiological chest X-ray pattern, time of onset and the cultured microorganisms has been observed in all cases. In multivariate analysis, persistent non-infectious abnormalities and pulmonary oedema were identified as the major independent predictors of posttransplant pneumonia, followed by prolonged assisted mechanical ventilation and traditional caval anastomosis. A ''pneumonia-risk score'' was calculated: low-risk score (<2.25) predicts 2.7% of probability of the onset of infections compared with 28.7% of high-risk (>3.30) population. The ''pneumonia-risk score'' identifies a specific group of patients in whom closer radiographic monitoring is recommended. In addition, a highly significant correlation (p<0.001) was observed between pneumonia-risk score and the expected survival, thus confirming pulmonary infections as a major cause of death in OLT recipients. (orig.)

  8. Logistic regression analysis of the risk factors of acute renal failure complicating limb war injuries

    Directory of Open Access Journals (Sweden)

    Chang-zhi CHENG

    2011-06-01

    Full Text Available Objective To explore the risk factors of complication of acute renal failure(ARF in war injuries of limbs.Methods The clinical data of 352 patients with limb injuries admitted to 303 Hospital of PLA from 1968 to 2002 were retrospectively analyzed.The patients were divided into ARF group(n=9 and non-ARF group(n=343 according to the occurrence of ARF,and the case-control study was carried out.Ten factors which might lead to death were analyzed by logistic regression to screen the risk factors for ARF,including causes of trauma,shock after injury,time of admission to hospital after injury,injured sites,combined trauma,number of surgical procedures,presence of foreign matters,features of fractures,amputation,and tourniquet time.Results Fifteen of the 352 patients died(4.3%,among them 7 patients(46.7% died of ARF,3(20.0% of pulmonary embolism,3(20.0% of gas gangrene,and 2(13.3% of multiple organ failure.Univariate analysis revealed that the shock,time before admitted to hospital,amputation and tourniquet time were the risk factors for ARF in the wounded with limb injuries,while the logistic regression analysis showed only amputation was the risk factor for ARF(P < 0.05.Conclusion ARF is the primary cause-of-death in the wounded with limb injury.Prompt and accurate treatment and optimal time for amputation may be beneficial to decreasing the incidence and mortality of ARF in the wounded with severe limb injury and ischemic necrosis.

  9. Risk factors for tube exposure as a late complication of glaucoma drainage implant surgery

    Directory of Open Access Journals (Sweden)

    Chaku M

    2016-03-01

    Full Text Available Meenakshi Chaku,1 Peter A Netland,2 Kyoko Ishida,3 Douglas J Rhee4 1Department of Ophthalmology, Loyola University Chicago, Maywood, IL, 2Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, VA, USA; 3Department of Ophthalmology, Toho University, Tokyo, Japan; 4Department of Ophthalmology and Visual Sciences, Case Western Reserve University, Cleveland, OH, USA Purpose: The purpose of this study was to evaluate the risk factors for tube exposure after glaucoma drainage implant surgery.Patients and methods: This was a retrospective case-controlled observational study of 64 eyes from 64 patients. Thirty-two eyes of 32 patients with tube erosion requiring surgical revision were compared with 32 matched control eyes of 32 patients. Univariate and multivariate risk factor analyses were performed.Results: Mean age was significantly younger in the tube exposure group compared with the control group (48.2±28.1 years versus 67.3±18.0 years, respectively; P=0.003. The proportion of diabetic patients (12.5% in the tube exposure group was significantly less (P=0.041 compared with the control group (37.5%. Comparisons of the type and position of the drainage implant were not significantly different between the two groups. The average time to tube exposure was 17.2±18.0 months after implantation of the drainage device. In both univariate and multivariate analyses, younger age (P=0.005 and P=0.027 and inflammation prior to tube exposure (P≤0.001 and P=0.004 were significant risk factors. Diabetes was a significant risk factor only in the univariate analysis (P=0.027.Conclusion: Younger age and inflammation were significant risk factors for tube exposure after drainage implant surgery. Keywords: glaucoma drainage implant complications, Ahmed Glaucoma Valve, Baerveldt implant, tube erosion, pericardial patch graft

  10. A risk factors analysis of acute-on-chronic liver failure complicated by spontaneous bacterial peritonitis

    Directory of Open Access Journals (Sweden)

    LIU Zhengfang

    2017-04-01

    Full Text Available ObjectiveTo investigate the influencing factors for spontaneous bacterial peritonitis (SBP in patients with acute-on-chronic liver failure (ACLF, and to provide a reference for clinical diagnosis and prognosis evaluation. MethodsA retrospective analysis was performed for the clinical data of 667 patients with ACLF who were hospitalized and treated in our hospital from January 2009 to December 2014, and according to the presence or absence of SBP, they were divided into ACLF group(n=232 and ACLF-SBP group(n=435. The general information, laboratory markers, and incidence of complications were compared between the two groups. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for non-normally distributed continuous data between groups; the chi-square test was used for comparison of categorical data between groups, and a logistic regression analysis was used to identify independent risk factors for ACLF complicated by SBP. ResultsThe comparison of laboratory markers and comorbidities showed that there were significant differences between the two groups in albumin (Alb (t=-4.110, P<0.001, alanine aminotransferase (U=-6.653, P<0.001, aspartate aminotransferase (t=-8.045, P<0.001, blood sodium (t=-2.879, P=0006, prothrombin time activity (t=-2.140, P=0.037, international normalized ratio (t=1.453, P=0.042, hemoglobin (t=-3.446, P=0.001, upper gastrointestinal bleeding (χ2=48.252, P=0.002, hepatorenal syndrome (χ2=16.244, P=0.031, and pulmonary infection (χ2=13.564, P<0.001. The multivariate logistic regression analysis showed that there were significant differences in Alb(OR=1.119,95%CI:1.052~1.189, platelet count (PLT(OR=1.035,95%CI:0.755~1.084, upper gastrointestinal bleeding(OR=1.117,95%CI:0.072~1.135, and pulmonary infection(OR=2.275,95%CI:0.978~5.292 (P=0.002,0.038,0.022, and 0.036. ConclusionIn the treatment of ACLF patients, risk factors including low Alb

  11. Sepsis as a risk factor for neonatal morbidity in extremely preterm infants.

    Science.gov (United States)

    Ohlin, Andreas; Björkman, Louise; Serenius, Fredrik; Schollin, Jens; Källén, Karin

    2015-11-01

    This study evaluated sepsis as a risk factor for neonatal morbidities and investigated the association between specific pathogens and neonatal morbidities. This was a nationwide Swedish prospective cohort study, consisting of the 497 extremely premature children, who were born before 27 weeks of gestation between 2004 and 2007 and survived their first year of life. Neonatal sepsis was evaluated as a risk factor for neonatal morbidity using multiple logistic linear regression analyses. We found that 326 (66%) of the infants had at least one sepsis episode and coagulase-negative staphylococci was the most common pathogen. Definite sepsis, with an odds ratio (OR) of 1.6, was associated with severe bronchopulmonary dysplasia, but not clinical sepsis (OR 1.1). Definite sepsis was also associated with a prolonged hospital stay (OR 1.6). Sepsis was not significantly associated with a higher risk of retinopathy of prematurity or intraventricular haemorrhage. Extremely preterm infants face a great risk of acquiring neonatal sepsis, with coagulase-negative staphylococci being the most common pathogen in this population. Definite sepsis seemed to be a risk factor for severe bronchopulmonary dysplasia and prolonged hospital stay, but the associations were weaker than in previous studies. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  12. Risk Factors and Protective Factors for Lower-Extremity Running Injuries A Systematic Review.

    Science.gov (United States)

    Gijon-Nogueron, Gabriel; Fernandez-Villarejo, Marina

    2015-11-01

    A review of the scientific literature was performed 1) to identify studies describing the most common running injuries and their relation to the risk factors that produce them and 2) to search for potential and specific protective factors. Spanish and English biomedical search engines and databases (MEDLINE/PubMed, Database Enfermería Fisioterapia Podología [ENFISPO], Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature) were queried (February 1 to November 30, 2013). A critical reading and assessment was then performed by the Critical Appraisal Skills Programme Spanish tool. In total, 276 abstracts that contained the selected key words were found. Of those, 25 identified and analyzed articles were included in the results. Injuries result from inadequate interaction between the runner's biomechanics and external factors. This leads to an excessive accumulation of impact peak forces in certain structures that tends to cause overuse injuries. The main reasons are inadequate muscle stabilization and pronation. These vary depending on the runner's foot strike pattern, foot arch morphology, and sex. Specific measures of modification and control through running footwear are proposed.

  13. Cognition in type 2 diabetes: Association with vascular risk factors, complications of diabetes and depression

    Directory of Open Access Journals (Sweden)

    Iype Thomas

    2009-01-01

    Full Text Available Background : The role of variables like duration of diabetes, diabetic control and microvascular complications in the causation of cognitive decline in patients with type 2 diabetes is not well studied. The contribution of hypertension to the cognitive decline in nondemented diabetic patients is unclear. Aims: We wanted to see if cognition in patients with type 2 diabetes is associated with the duration of diabetes, control of diabetes, complications of diabetes, vascular risk factors, or depression. We also looked at association of noncompliance with cognition, and depression. Settings and Design: We recruited ambulant patients with type 2 diabetes who are 55 years or more in age from the weekly diabetic clinic. We excluded patients with past history of stroke. Methods and Material: We selected the time taken for the Trial A test, delayed recall on ten-word list from Consortium to Establish a Registry for Alzheimer′s Disease (CERAD, Rowland Universal Dementia Assessment Scale (RUDAS and Centre for Epidemiologic Studies Depression scale (CES-D screening instrument to assess these patients. Statistical Analysis Used: We utilized mean, standard deviation, Chi-square test and Pearson′s correlation for statistical analysis. We considered P < 0.05 to be significant. Results: RUDAS scores inversely correlated ( r = -0.360 with CES-D scores ( P = 0.002. Scores of the screening instrument for depression, the CES-D was associated with the duration of diabetes mellitus ( P = 0.018, fasting blood glucose ( P = 0.029 as well as with 2-hour post prandial blood glucose ( P = 0.017. Conclusions: There is correlation between depression and global cognitive score. Depression seems to be associated with duration of diabetes and control of diabetes.

  14. AGE AS A FACTOR IN THE COMPLICATIONS RATES AFTER REMOVAL OF IMPACTED MANDIBULAR THIRD MOLARS: A REVIEW OF LITERATURE

    OpenAIRE

    Samir; Abdul Mujeb

    2013-01-01

    ABSTRACT : PURPOSE: The purpose of the study was to estimate the frequency of complications after mandibular third molar surgery, with age as the primary risk factor. PATIENTS AND METHODS: Review of literatures were selected and It was analyzed from last 25 years publications with a pubmed search using the following ke y words such as : impacted third molar, age, wisdom tooth, age and post operative complications ,age and inflammatory tissue reaction, mandibul...

  15. Identification of independent risk factors for flap failure: A retrospective analysis of 1530 free flaps for breast, head and neck and extremity reconstruction.

    Science.gov (United States)

    Las, David E; de Jong, Tim; Zuidam, J Michiel; Verweij, Norbert M; Hovius, Steven E R; Mureau, Marc A M

    2016-07-01

    Reconstructive microsurgery is a powerful method of treating various complex defects. However, flap loss remains a possibility, leading to additional surgery, hospitalisation and costs. Consequently, it is important to know which factors lead to an increased risk of flap failure, so that measures can be undertaken to reduce this risk. Therefore, we analysed our results over a 20-year period to identify risk factors for flap failure after breast, head and neck and extremity reconstruction. The medical files of all patients treated between 1992 and 2012 were reviewed. Patient characteristics, surgical data and post-operative complications were scored, and independent risk factors for flap loss were identified. Reconstruction with a total of 1530 free flaps was performed in 1247 patients. Partial and total flap loss occurred in 5.5% and 4.4% of all free flaps, respectively. In all flaps, signs of compromised flap circulation were a risk factor for flap failure. More specifically, the risk factors for flap failure in breast reconstruction were previous radiotherapy, venous anastomosis revision, gluteal artery perforator (GAP) flap choice and post-operative bleeding. In head and neck reconstruction, pulmonary co-morbidity and anastomosis to the lingual vein or superficial temporal artery were risk factors, whereas a radial forearm flap reduced the risk. In extremity reconstruction, diabetes, prolonged anaesthesia time and post-operative wound infection were risk factors. Independent pre-, intra- and post-operative risk factors for flap failure after microvascular breast, head and neck and extremity reconstruction were identified. These results may be used to improve patient counselling and to adjust treatment algorithms to further reduce the chance of flap failure.

  16. Continuing Disparities in Cardiovascular Risk Factors and Complications Between Aboriginal and Anglo-Celt Australians With Type 2 Diabetes

    Science.gov (United States)

    Davis, Timothy M.E.; Hunt, Kerry; McAullay, Daniel; Chubb, Stephen A.P.; Sillars, Brett A.; Bruce, David G.; Davis, Wendy A.

    2012-01-01

    OBJECTIVE To determine whether disparities in the nature and management of type 2 diabetes persist between Aboriginal and the majority Anglo-Celt patients in an urban Australian community. RESEARCH DESIGN AND METHODS Baseline data from the observational Fremantle Diabetes Study collected from 1993 to 1996 (phase I) and from 2008 to 2011 (phase II) were analyzed. Patients characterized as Aboriginal or Anglo-Celt by self-report and supporting data underwent comprehensive assessment, including questionnaires, examination, and biochemical testing in a single laboratory. Generalized linear modeling with age/sex adjustment was used to examine differences in changes in variables in the two groups between phases I and II. RESULTS The indigenous participants were younger at entry and at diabetes diagnosis than the Anglo-Celt participants in both phases. They were also less likely to be educated beyond primary level and were more likely to be smokers. HbA1c decreased in both groups over time (Aboriginal median 9.6% [interquartile range 7.8–10.7%] to 8.4% [6.6–10.6%] vs. Anglo-Celt median 7.1% [6.2–8.4%] to 6.7% [6.2–7.5%]), but the gap persisted (P = 0.65 for difference between phases I and II by ethnic group). Aboriginal patients were more likely to have microvascular disease in both phases. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.90 or lower-extremity amputation) increased in Aboriginal but decreased in Anglo-Celt participants (15.8–29.7 vs. 30.7–21.5%; P = 0.055). CONCLUSIONS Diabetes management has improved for Aboriginal and Anglo-Celt Australian patients, but disparities in cardiovascular risk factors and complications persist. PMID:22815295

  17. Factors Related to Complicated Grief among Bereaved Individuals after the Wenchuan Earthquake in China

    Institute of Scientific and Technical Information of China (English)

    Xiao-Lin Hu; Xiao-Lin Li; Xin-Man Dou; Rong Li

    2015-01-01

    Background:The Wenchuan earthquake in China caused shock and grief worldwide.Sudden bereavement caused by the earthquake led to physical disorders as well as psychological disturbances in the bereaved individuals.The bereaved had a high risk for complicated grief (CG),which may have led to significant distress and impairment in their health.However,there was few available studies on CG among disaster-bereaved individuals in China after the disaster.The aim of this study was to identify factors (demographic characteristics and disaster-related variables) associated with symptoms of CG among the bereaved 18 months after the Wenchuan earthquake.Methods:This study was conducted with a cross-sectional design and a convenience sample of 27 1 bereaved individuals from three of the hardest hit areas.Data were collected by questionnaires and the instruments used in the study were:General questionnaire and Inventory ofCG (ICG).Multivariate linear regression analysis was used to identify factors associated with symptoms of CG.Results:The mean score on ICG was 52.77 (standard deviation:10.00).Being female and loss of a child were related to higher level of CG while having another child after the disaster and receiving psychological counseling experience were associated with lower level of CG.Forty-nine percent of the variance of CG was explained by these identified factors.Conclusions:Eighteen months after the Wenchuan earthquake,the symptoms of CG among the bereaved were higher than the previous studies with bereaved individuals.This study uncovers a vulnerable population of the bereaved at high risk for CG.Early assessments,targeted interventions,and policy support tailored for the disaster-bereaved individuals are necessary to identify and alleviate symptoms of CG and to improve their well-being.

  18. Systemic inflammation: a key factor in the pathogenesis of cardiovascular complications in obstructive sleep apnoea syndrome?

    LENUS (Irish Health Repository)

    Ryan, S

    2012-02-01

    Obstructive sleep apnoea syndrome (OSAS) is a highly prevalent disease and is recognised as a major public health burden. Large-scale epidemiological studies have demonstrated an independent relationship between OSAS and various cardiovascular disorders. The pathogenesis of cardiovascular complications in OSAS is not completely understood but a multifactorial aetiology is likely. Inflammatory processes have emerged as critical in the pathogenesis of atherosclerosis at all stages of atheroma formation. Increased levels of various circulating markers of inflammation including tumour necrosis factor alpha (TNFalpha), interleukin 6 (IL6), IL-8 and C-reactive protein (CRP) have been reported as associated with future cardiovascular risk. There is increasing evidence of elevated inflammatory markers in OSAS with a significant fall after effective treatment with continuous positive airway pressure. This evidence is particularly strong for TNFalpha, whereas studies on IL6 and CRP have yielded conflicting results possibly due to the confounding effects of obesity. Cell culture and animal studies have significantly contributed to our understanding of the underlying mechanisms of the association between OSAS and inflammation. Intermittent hypoxia, the hallmark of OSAS, results in activation of pro-inflammatory transcription factors such as nuclear factor kappa B (NF-kappaB) and activator protein (AP)-1. These promote activation of various inflammatory cells, particularly lymphocytes and monocytes, with the downstream consequence of expression of pro-inflammatory mediators that may lead to endothelial dysfunction. This review provides a critical analysis of the current evidence for an association between OSAS, inflammation and cardiovascular disease, discusses basic mechanisms that may be responsible for this association and proposes future research possibilities.

  19. RESISTANCE OF KARST CAVERNS NITROGEN-FIXING BACTERIA TO EXTREME FACTORS

    Directory of Open Access Journals (Sweden)

    Tashyrev O. B.

    2014-10-01

    Full Text Available To determine the studied bacteria resistance quantitative parameters of extreme factors such as toxic metals (Cu2+, organic xenobiotics (p-nitrochlorobenzene and UV-irradiation were the aim of the research. Six strains of nitrogen-fixing bacteria isolated from clays of two caverns Mushkarova Yama (Podolia, Ukraine and Kuybyshevskaya (Western Caucasus, Abkhazia and Azotobacter vinelandii УКМ В-6017 as a reference strain have been tested. For this purpose the maximum permissible concentration of Cu2+ and p-nitrochlorobenzene in the concentration gradient and lethal doses of UV by the survival caverns have been determined. Maximum permissible concentrations for strains were as 10 ppm Cu2+, 70–120 ppm of p-nitrochlorobenzene. The maximum doses of UV-irradiation varied in the range of 55–85 J/m2 (LD99.99. It is shown that three classes of extreme factors resistance parameters of karst caverns strains are similar to the strain of terrestrial soil ecosystems. The most active studied strains reduce the concentration of p-nitrochlorobenzene in the medium in 13 times. The ability of nitrogen-fixing bacteria to degrade p-nitrochlorobenzene could be used in creation new environmental biotechnology for industrial wastewater treatment from nitrochloroaromatic xenobiotics. Isolated strains could be used as destructors for soils bioremediation in agrobiotechnologies and to optimize plants nitrogen nutrition in terrestrial ecosystems.

  20. Identification of Novel Clinical Factors Associated with Hepatic Fat Accumulation in Extreme Obesity

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    Glenn S. Gerhard

    2014-01-01

    Full Text Available Objectives. The accumulation of lipids stored as excess triglycerides in the liver (steatosis is highly prevalent in obesity and has been associated with several clinical characteristics, but most studies have been based on relatively small sample sizes using a limited set of variables. We sought to identify clinical factors associated with liver fat accumulation in a large cohort of patients with extreme obesity. Methods. We analyzed 2929 patients undergoing intraoperative liver biopsy during a primary bariatric surgery. Univariate and multivariate regression modeling was used to identify associations with over 200 clinical variables with the presence of any fat in the liver and with moderate to severe versus mild fat accumulation. Results. A total of 19 data elements were associated with the presence of liver fat and 11 with severity of liver fat including ALT and AST, plasma lipid, glucose, and iron metabolism variables, several medications and laboratory measures, and sleep apnea. The accuracy of a multiple logistic regression model for presence of liver fat was 81% and for severity of liver fat accumulation was 77%. Conclusions. A limited set of clinical factors can be used to model hepatic fat accumulation with moderate accuracy and may provide potential mechanistic insights in the setting of extreme obesity.

  1. [Risk factors for lower extremity amputation in patients with diabetic foot].

    Science.gov (United States)

    Xu, B; Yang, C Z; Wu, S B; Zhang, D; Wang, L N; Xiao, L; Chen, Y; Wang, C R; Tong, A; Zhou, X F; Li, X H; Guan, X H

    2017-01-01

    Objective: To explore the risk factors for lower extremity amputation in patients with diabetic foot. Methods: The clinical data of 1 771 patients with diabetic foot at the Air Force General Hospital of PLA from November 2001 to April 2015 were retrospectively analyzed. The patients were divided into the non-amputation and amputation groups. Within the amputation group, subjects were further divided into the minor and major amputation subgroups. Binary logistic regression analyses were used to assess the association between risk factors and lower extremity amputation. Results: Among 1 771 patients with diabetic foot, 323 of them (18.24%) were in the amputation group (major amputation: 41; minor amputation: 282) and 1 448 (81.76%) in the non-amputation group. Compared with non-amputation patients, those in the amputation group had a longer hospital stay and higher estimated glomerular filtration rate(eGFR)levels. Fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), C-reaction protein (CRP), ESR, ferritin, fibrinogen and WBC levels of the amputation group were higher, while hemoglobin albumin, transferrin, TC, TG, HDL-C and LDL-C were lower than those of the non-amputation group (all Pamputation and non-amputation groups (all Pamputation in hospitalized patients with diabetic foot. Conclusion: Wagner's grade, ischemia of lower limbs and infection are closely associated with amputation of diabetic foot patients.

  2. Complications of Radiotherapy after Immediate Breast Reconstruction with Implant: Risk Factors and Management - Our Institute’s Experience

    Directory of Open Access Journals (Sweden)

    Heba G. El-Sheredy

    2016-01-01

    Full Text Available Background: Breast cancer is the most frequent malignant tumor in women worldwide. In recent years, defined reconstruction principles along with numerous surgical techniques with volume replacement have been published. Autologous breast reconstruction is more natural but leaves donor site morbidity. It provides the opportunity to restore the breast mound without the need for scars. This study aims to evaluate the complications of radiotherapy after immediate breast reconstruction with implants in breast cancer patients who submitted to skin sparing mastectomy and nipple sparing mastectomy by taking into consideration the risk factors and management at our institution. Methods: The current study prospectively included patients with invasive breast cancer admitted between January and June 2012 who were scheduled for skin sparing mastectomy or nipple sparing mastectomy and axillary dissection followed by immediate breast reconstruction with implant. Patients received adjuvant chemotherapy followed by conventional fractionated radiation. Complications were classified as either minor or major. The minor complications included capsular contracture (Baker 1-2, seroma, minor skin infection and skin dehiscence without exposure of the implant. Major complications included capsular contracture (Baker 3-4, severe infection and major wound dehiscence with implant exposure. Capsular contracture was scored according to the modified Baker classification. Results: The study included 38 patients. Of these, 28 had skin sparing mastectomy while 10 underwent nipple sparing mastectomy. The overall complication rate was 71%. We observed minor complications in 18 patients while 9 patients had major complications. Complications occurred with a median time of 13 months following radiotherapy completion. All minor complications were managed conservatively whereas all major complications required repeat surgery. No loco-regional recurrences occurred during the follow up

  3. Overweight in epilepsy as a risk factor for pregnancy and delivery complications.

    Science.gov (United States)

    Kolstad, Eivind; Veiby, Gyri; Gilhus, Nils Erik; Bjørk, Marte

    2016-11-01

    To investigate whether prepregnancy overweight in women with epilepsy increases their risk for complications during pregnancy and delivery. This study is based on The Norwegian Mother and Child Cohort Study (MoBa) linked to the Medical Birth Registry of Norway. A diagnosis of epilepsy was reported in 706 pregnancies. Overweight was defined as body mass index ≥ 25 prepregnancy. Overweight women with epilepsy (n = 259) were compared to normal-weight women with epilepsy (n = 416), and to women without epilepsy with and without overweight (n = 30,516 and n = 67,977, respectively). The risks of pregnancy and delivery complications were calculated as odds ratios (ORs) with 95% confidence intervals (CIs) adjusted for adverse socioeconomic factors, age, parity, and smoking. Women with epilepsy were more often overweight than women without epilepsy (38.4% vs. 31.3%, p < 0.001). The majority of pregnancy and delivery complications were more frequent in overweight women with epilepsy. Compared to overweight women without epilepsy, the risk was increased for cesarean section (OR 1.6, CI 1.2-2.2, p < 0.001), excessive bleeding (OR 1.4, CI 1.0-1.8, p = 0.04), peripartum anxiety and depressive symptoms (OR 1.9, CI 1.3-2.8, p < 0.001), small for gestational age children (OR 2.4, CI 1.2-4.8, p = 0.02), and transfer of the infant to a neonatal ward (OR 1.5, CI 1.1-2.2, p = 0.02). Compared to normal-weight women with epilepsy, the risk of cesarean section (OR 1.6, CI 1.1-2.3, p < 0.05), gestational hypertension (OR 2.0, CI 1.1-3.5, p < 0.05), preeclampsia (OR 2.3, CI 1.2-4.5, p < 0.05), and transfer of the infant to a neonatal ward (OR 2.2, CI 1.3-3.6, p < 0.01) was increased. Prepregnancy overweight in combination with epilepsy entails a strong negative effect on risk of complications during pregnancy and delivery. In women with epilepsy and overweight referral to a nutritionist should be considered when an antiepileptic drug is started as well as

  4. [Resistance of microorganisms of coastal ecosystems of the Dead Sea to extremal factors].

    Science.gov (United States)

    Romanovskaia, V A; Avdeeva, L V; Gladka, G V; Pritula, I R; Kharkhota, M A; Tashirev, A B

    2013-01-01

    Such extreme factors as UV radiation, high temperature and salinity, and also the small amount of accessible water have an influence on microorganisms of coastal ecosystems of the Dead Sea. Resistance to these factors of the microorganisms isolated from ecosystems of this region (vertical steep gorge around the Dead Sea, clay-salt plain and black highly mineralized muds) is studied. Aerobic, chemoorganotrophic, thermotolerant, moderately halophilic bacteria which, according to their morphological and physiological properties, are similar to species Gracilibacillus halotolerans, Salimicrobium album and genus Caryophanon have been isolated from these ecosystems. All strains grew at 0-10% of NaCl in the medium (one strain--at 15% of NaCl), in the range of 30-50 degrees C. Resistance to UV radiation has been revealed in all the investigated bacteria Lethal doses of UV (LD90 and LD99.99) for spore-forming strains of genus Gracilibacillus were 100-170 and 1100-1500 J/m2, respectively; for strain Salimicrobium 6t1 (does not form spores)--70 and 400 J/m2; for the strain lt4 (genus Caryophanon), forming filamentous (or trychomes)--150 and 1400 J/m2. Some strains of genus Gracilibacillus had strong antagonistic effect on conditionally pathogenic test cultures Staphylococcus aureus 209p and Candida albicans UCM Y-690. It is conceivable that resistance of microorganisms of coastal ecosystems of the Dead Sea to extreme factors was generated under the influence of abiotic (physical and chemical) factors typical of this region.

  5. Risk factors for postoperative complications after total laryngectomy following radiotherapy or chemoradiation

    DEFF Research Database (Denmark)

    Wulff, N B; Kristensen, C.A.; Andersen, E

    2015-01-01

    total laryngectomy for squamous cell carcinoma of the larynx or hypopharynx. MAIN OUTCOME MEASURES: Overall postoperative complications and fistula formation. RESULTS: Overall postoperative complications, fistula formation, wound infection, bleeding and wound necrosis within one year after total....... Tumour localisation in the hypopharynx was associated with overall postoperative complications (P = 0.036). Residual tumour or cancer recurrence was associated with late-onset fistulas (P

  6. Oncological outcome and prognostic factors in the therapy of soft tissue sarcoma of the extremities

    Directory of Open Access Journals (Sweden)

    Ingmar Ipach

    2012-11-01

    Full Text Available Uniform conclusions about therapeutic concepts and survival time of bone and soft tissue sarcoma patients are difficult due to the heterogeneity of histological subtypes as well as the different responses to neoadjuvant therapy. The subject of this retrospective study was the analysis of tumour free survival, risk and prognostic factors of sarcoma patients treated by limb sparing techniques or amputation. We included 118 patients with soft tissue sarcoma of the extremities treated primarily or secondarily at our institution between 1990 and 2008 with a minimum follow-up of 12 months. Data about the tumour free survival time, operative techniques and potential prognostic factors were analysed. The tumour-specific and overall survival were significantly influenced by two factors: the grading and distant metastases present at time of diagnosis. Optimal multimodal therapeutic concepts at a specialized Cancer Center decreased the risk of local recurrence. The importance of optimal preoperative and surgical course concerning the oncological long term outcome was investigated. The decrease in local recurrence as a result of multimodal therapeutic concepts at a specialized Cancer Center was confirmed. To evaluate the individual prognosis of a patient, multiple factors have to be considered. Factors for a poor prognosis are primary metastasis, high-grade tumours and several histological entities (e.g. synovial sarcoma, not other specified.

  7. The impact of occupational stress factors on temporary work disability related to arterial hypertension and its complications.

    Science.gov (United States)

    Lazaridis, Konstantinos; Jovanović, Jovica; Jovanović, Jovana; Šarac, Ivana; Jovanović, Stefan

    2017-06-01

    To determine which specific groups of occupational stress factors influence the duration of temporary work disability related to arterial hypertension and joint complications/co-morbidities. Workers (n = 1398; 1009 in the exposed group, 389 in the control group) with arterial hypertension who worked at one workplace for a minimum of 10 years were divided into 10 subgroups, depending on the presence of joint complications/co-morbidities. The intensity of seven groups of occupational stress factors, the total score of Occupational Stress Index (OSI) and the average number of lost working days during 1 year were analysed. The number of lost working days due to arterial hypertension and joint complications/co-morbidities was significantly higher in the exposed group. In all subgroups of the exposed group there was a high correlation between the number of lost working days and the total OSI score. Specific occupational stress factors were associated with specific complications: High Demands with chronic myocardial infarction, Strictness with cerebral haemorrhage, Conflict/Uncertainty with cerebral infarction, Extrinsic Time Pressure with acute myocardial infarction, and Avoidance/Symbolic Aversiveness with non-insulin-dependent diabetes. There are specific groups of occupational stress factors which can influence the duration of work disability associated with certain complications and co-morbidities of arterial hypertension.

  8. Sarcopenia, but not visceral fat amount, is a risk factor of postoperative complications after major hepatectomy.

    Science.gov (United States)

    Higashi, Takaaki; Hayashi, Hiromitsu; Taki, Katsunobu; Sakamoto, Keita; Kuroki, Hideyuki; Nitta, Hidetoshi; Hashimoto, Daisuke; Chikamoto, Akira; Beppu, Toru; Baba, Hideo

    2016-04-01

    Major hepatectomy is associated with significant morbidity and mortality rates, particularly in patients aged more than 70 years. This study assessed whether physical indicators, such as sarcopenia and visceral fat amount, could predict morbidity and mortality after major hepatectomy. The study enrolled 144 patients who underwent curative major hepatectomy. Skeletal muscle and visceral fat amount at the third lumbar vertebra (L3) in the inferior direction were quantified using enhanced computed tomography scans. The patients were divided into two subgroups, with and without sarcopenia, based on median skeletal muscle mass in men and women (43.2 cm(2)/m(2) in men; 35.3 cm(2)/m(2) in women). The study included 108 men and 36 women, with median skeletal muscle tissue of 43.2 and 35.3 cm(2)/m(2), respectively. The mortality rate was significantly higher in patients with than without sarcopenia [seven cases (9.7 %), one case (1.4 %), respectively; P = 0.021], whereas liver-related morbidity and mortality rates were similar. In patients aged >70 years, the morbidity, liver dysfunction-related morbidity, and mortality rates were significantly higher in patients with than without sarcopenia (P Sarcopenia was a risk factor for postoperative complications after major hepatectomy, particularly in elderly patients.

  9. Birth Preparedness and Complication Readiness Practice and Associated Factors among Pregnant Women, Northwest Ethiopia

    Science.gov (United States)

    2016-01-01

    Background. Little is known about birth preparedness and complication readiness (BPCR) plan in resource limited settings to decrease maternal mortality. Therefore, this study was done to assess the status of BPCR and associated factors among pregnant women in South Wollo, Northwest Ethiopia, by involving 819 pregnant women from March to April, 2014. Data were collected by using pretested interviewer administered questionnaire and analyzed using a computer program of SPSS version 20.00. Results. Pregnant women who were prepared for at least three elements of BPCR were 24.1%. Pregnant women knowing at least three key danger signs during pregnancy, delivery, and postnatal period were 23.2%, 22.6%, and 9.6%, respectively. Women having secondary education and higher were 6.20 (95% CI = [1.36, 28.120]) times more likely to be prepared than illiterates. Women having a lifetime history of stillbirth [5.80 (1.13, 29.63)], attending ANC for last child pregnancy [5.44 (2.07, 14.27)], participating in community BPCR group discussion [4.36 (1.17, 16.26)], and having their male partner involved in BPCR counseling during ANC follow-up [4.45 (1.95, 10.16)] were more likely to be prepared. Conclusions. BPCR was very low and should be strengthened through health communication by involving partner in BPCR counseling. PMID:27722201

  10. Study of the risk factors and complications of diabetes mellitus after live kidney donation.

    Science.gov (United States)

    Abuelmagd, Mohammed M; Nagib, Ayman M; Abuelmagd, Megahed M; Refaie, Ayman F; Elhindi, Yasser A; Ahmed, Mohammed F; Ali, Mohammed H; Elmaghrabi, Hanzada M; Bakr, Mohammed A

    2015-04-01

    Kidney donors, similar to the general population, are at risk for development of type 2 diabetes mellitus. The course of donors who develop type 2 diabetes mellitus has not been well studied. This work is aimed at estimating the incidence of diabetes after kidney donation, and study some risk factors and some complications of diabetes mellitus after donation. The material of this record based work comprised the records 2267 donors who donated 1 of their kidneys between 1976 and 2014 in the Urology and Nephrology Center, Mansoura University, Egypt, and regularly followed-up at its outpatient clinic. There were 388 donors included in the study and their medical records were revised. Postdonation weight gain and family history of diabetes mellitus were statistically significant on both the development of diabetes mellitus, high, very high albuminuria, and/or decreased creatinine clearance. Metformin and insulin use seemed to significantly reduce the protein excretion, and creatinine clearance decline in the studied group. There is a significant effect of the family history of diabetes mellitus on the development of high, very high albuminuria, and/or decreased creatinine clearance.

  11. The Role of Defense Mechanisms, Personality and Demographical Factors on Complicated Grief following Death of a loved one by Cancer

    Directory of Open Access Journals (Sweden)

    Isaac Rahimian-Boogar

    2015-10-01

    Full Text Available Objective: Identification of the risk factors and psychological correlates of prolonged grief disorder is vital for health promotions in relatives of persons who died of cancer. The aim of this research was to investigate the role of defense mechanisms, character dimension of personality and demographic factors on complicated grief following a loss of a family member to cancer .Method: A number of 226 persons who had lost a family member to cancer in a cancer institute at Tehran University of Medical Science were selected through compliance sampling and completed the Inventory of complicated Grief-Revised (ICG-R, the Defense Styles Questionnaire (DSQ, the Character dimension of Temperament and Character Inventory (TCI, and the Demographical questionnaire. Data were analyzed by stepwise multiple regression analysis, using the PASW version 18 .Results: Findings revealed that neurotic defense style had a significant positive predictive role in the complicated grief; and cooperativeness, age of the deceased person, self-transcendence and mature defense style had a significant negative predictive role in complicated grief (p<0.001. R2 was 0.73 for the final model (p<.001.Conclusion: The results revealed that two character dimensions (low cooperativeness and self-transcendence, high neurotic defense style and young age of the deceased person were involved in the psychopathological course of the complicated and prolonged grief. It was concluded that personality characteristics of the grieving persons and demographics of the deceased person should be addressed in designing tailored interventions for complicated grief.

  12. Prognostic factors associated with rebleeding in cirrhotic inpatients complicated with esophageal variceal bleeding

    Institute of Scientific and Technical Information of China (English)

    WANG Mei-tang; LIU Tao; MA Xiu-qiang; HE Jian

    2011-01-01

    Background Esophageal variceal bleeding is a frequent and severe complication in patients with cirrhosis. The aim of this study was to identify prognostic factors of esophageal variceal rebleeding in cirrhotic inpatients.Methods Consecutive cirrhotic patients who were admitted to Changhai Hospital because of esophageal variceal bleeding were retrospectively analyzed. To assess the independent factors for recurrent hemorrhage after esophageal variceal bleeding, medical assessment was completed at the time of their initial hospital admission, including documentation of clinical, biochemical, and treatment methods that might contribute to variceal rebleeding. Univariate and multivariate analyses were retrospectively performed.Results Totally 186 patients (35.8%) were assigned to a rebleeding group and the other 334 patients (64.2%) to a non-rebleeding group. Multivariate stepwise regression analysis showed that four variables were positively correlated with rebleeding: Child-pugh grade B (OR=2.664, 95% CI 1.680-4.223) (compared with Child-pugh grade A), total bilirubin (Tbil) (OR=1.0006, 95% CI 1.002-1.0107), creatinine (OR=1.008, 95% CI 1.002-1.015) and the cumulative volume of blood transfusion (OR=1.519, 95% CI 1.345-1.716). The presence of ascites (OR=0.270, 95% CI 0.136-0.536) and prophylactic antibiotics (OR=0.504, 95% CI 0.325-0.780) were negatively correlated with rebleeding of the cirrhotic inpatients. According to standardized coefficient, the importance of rebleeding predictors ranked from the most to the least was as follows: the cumulative volume of blood transfusion, Child-pugh grade B, Tbil and creatinine.Conclusion Rebleeding in cirrhotic inpatients was associated with more blood transfusions, Child-pugh grade B, higher Tbil and creatinine.

  13. Nipple Sparing Mastectomy: Does Breast Morphological Factor Related to Necrotic Complications?

    Directory of Open Access Journals (Sweden)

    Prakasit Chirappapha, MD

    2014-01-01

    Conclusions: Large glandular specimen increases the risk of NAC necrosis. The degree of ptosis and the distance between the sternal notch and the NAC have no significant impact on necrotic complications in NSM. To reduce the necrotic complications in large breast after NSM, reconstruction should better be performed with autologous flap or slow skin expansion using the expander technique.

  14. A review of the risk factors for lower extremity overuse injuries in young elite female ballet dancers.

    Science.gov (United States)

    Bowerman, Erin Anne; Whatman, Chris; Harris, Nigel; Bradshaw, Elizabeth

    2015-06-01

    The objective of this study was to review the evidence for selected risk factors of lower extremity overuse injuries in young elite female ballet dancers. An electronic search of key databases from 1969 to July 2013 was conducted using the keywords dancers, ballet dancers, athletes, adolescent, adolescence, young, injury, injuries, risk, overuse, lower limb, lower extremity, lower extremities, growth, maturation, menarche, alignment, and biomechanics. Thirteen published studies were retained for review. Results indicated that there is a high incidence of lower extremity overuse injuries in the target population. Primary risk factors identified included maturation, growth, and poor lower extremity alignment. Strong evidence from well-designed studies indicates that young elite female ballet dancers suffer from delayed onset of growth, maturation, menarche, and menstrual irregularities. However, there is little evidence that this deficit increases the risk of overuse injury, with the exception of stress fractures. Similarly, there is minimal evidence linking poor lower extremity alignment to increased risk of overuse injury. It is concluded that further prospective, longitudinal studies are required to clarify the relationship between growth, maturation, menarche, and lower extremity alignment, and the risk of lower extremity overuse injury in young elite female ballet dancers.

  15. Upper extremity injuries in Danish children aged 6–12, mechanisms, and risk factors

    DEFF Research Database (Denmark)

    Nauta, J.; Jespersen, Eva; Verhagen, Evert

    2017-01-01

    Although injuries to the upper extremity are most costly, the picture of the upper extremity injury problem remains incomplete. This study is the first to describe the etiology and mechanisms of upper extremity injuries in Danish children. A 2.5-year observational prospective cohort study was con...... childhood injury prevention.......Although injuries to the upper extremity are most costly, the picture of the upper extremity injury problem remains incomplete. This study is the first to describe the etiology and mechanisms of upper extremity injuries in Danish children. A 2.5-year observational prospective cohort study...... was conducted to record upper extremity injuries in 1048 children. Data were weekly collected by sending a text message. A total of 176 upper extremity injuries were reported (128 acute injuries). Of the acute upper extremity injuries, 55% were sprains, 47% occurred in the hand/wrist, and 53% of cases were...

  16. AGE AS A FACTOR IN THE COMPLICATIONS RATES AFTER REMOVAL OF IMPACTED MANDIBULAR THIRD MOLARS: A REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    Samir

    2013-10-01

    Full Text Available ABSTRACT : PURPOSE: The purpose of the study was to estimate the frequency of complications after mandibular third molar surgery, with age as the primary risk factor. PATIENTS AND METHODS: Review of literatures were selected and It was analyzed from last 25 years publications with a pubmed search using the following ke y words such as : impacted third molar, age, wisdom tooth, age and post operative complications ,age and inflammatory tissue reaction, mandibular third molar surgery, tooth extraction and age, wisdom tooth. Additionally, hand searching of key texts, refer ences, and reviews relevant to the field were performed. RESULTS: The effect of age on post operative complications after third molar surgery was combined with other factors such as tooth, operating and clinical factors. Studies reviewed have shown that no specific age demonstrate increase morbidity. Pain, swelling and trismus were most common complications associated with increase age. CONCLUSIONS: The results of these analyses suggest that increased age appears to be associated with a higher complication rate for mandibular third molar extractions.

  17. Vulnerability to extreme heat and climate change: is ethnicity a factor?

    Science.gov (United States)

    Hansen, Alana; Bi, Linda; Saniotis, Arthur; Nitschke, Monika

    2013-07-29

    With a warming climate, it is important to identify sub-populations at risk of harm during extreme heat. Several international studies have reported that individuals from ethnic minorities are at increased risk of heat-related illness, for reasons that are not often discussed. The aim of this article is to investigate the underpinning reasons as to why ethnicity may be associated with susceptibility to extreme heat, and how this may be relevant to Australia's population. Drawing upon literary sources, the authors provide commentary on this important, yet poorly understood area of heat research. Social and economic disparities, living conditions, language barriers, and occupational exposure are among the many factors contributing to heat-susceptibility among minority ethnic groups in the United States. However, there is a knowledge gap about socio-cultural influences on vulnerability in other countries. More research needs to be undertaken to determine the effects of heat on tourists, migrants, and refugees who are confronted with a different climatic environment. Thorough epidemiological investigations of the association between ethnicity and heat-related health outcomes are required, and this could be assisted with better reporting of nationality data in health statistics. Climate change adaptation strategies in Australia and elsewhere need to be ethnically inclusive and cognisant of an upward trend in the proportion of the population who are migrants and refugees.

  18. Vulnerability to extreme heat and climate change: is ethnicity a factor?

    Directory of Open Access Journals (Sweden)

    Alana Hansen

    2013-07-01

    Full Text Available Background: With a warming climate, it is important to identify sub-populations at risk of harm during extreme heat. Several international studies have reported that individuals from ethnic minorities are at increased risk of heat-related illness, for reasons that are not often discussed. Objective: The aim of this article is to investigate the underpinning reasons as to why ethnicity may be associated with susceptibility to extreme heat, and how this may be relevant to Australia's population. Design: Drawing upon literary sources, the authors provide commentary on this important, yet poorly understood area of heat research. Results: Social and economic disparities, living conditions, language barriers, and occupational exposure are among the many factors contributing to heat-susceptibility among minority ethnic groups in the United States. However, there is a knowledge gap about socio-cultural influences on vulnerability in other countries. Conclusion: More research needs to be undertaken to determine the effects of heat on tourists, migrants, and refugees who are confronted with a different climatic environment. Thorough epidemiological investigations of the association between ethnicity and heat-related health outcomes are required, and this could be assisted with better reporting of nationality data in health statistics. Climate change adaptation strategies in Australia and elsewhere need to be ethnically inclusive and cognisant of an upward trend in the proportion of the population who are migrants and refugees.

  19. Radioablation of liver malignancies with interstitial high-dose-rate brachytherapy. Complications and risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Mohnike, Konrad; Wolf, Steffen; Damm, Robert; Seidensticker, Max; Seidensticker, Ricarda; Fischbach, Frank; Pech, Maciej; Ricke, Jens [Otto-von-Guericke-Universitaet, Klinik fuer Radiologie und Nuklearmedizin, Universitaetsklinikum Magdeburg A.oe.R., Magdeburg (Germany); Peters, Nils; Hass, Peter; Gademann, Guenther [Otto-von-Guericke-Universitaet, Klinik fuer Strahlentherapie, Universitaetsklinikum Magdeburg A.oe.R., Magdeburg (Germany)

    2016-05-15

    To evaluate complications and identify risk factors for adverse events in patients undergoing high-dose-rate interstitial brachytherapy (iBT). Data from 192 patients treated in 343 CT- or MRI-guided interventions from 2006-2009 at our institution were analyzed. In 41 %, the largest tumor treated was ≥ 5 cm, 6 % of the patients had tumors ≥ 10 cm. Prior to iBT, 60 % of the patients had chemotherapy, 22 % liver resection, 19 % thermoablation or transarterial chemoembolization (TACE). Safety was the primary endpoint; survival data were obtained as the secondary endpoints. During follow-up, MRI or CT imaging was performed and clinical and laboratory parameters were obtained. The rate of major complications was below 5 %. Five major bleedings (1.5 %) occurred. The frequency of severe bleeding was significantly higher in patients with advanced liver cirrhosis. One patient developed signs of a nonclassic radiation-induced liver disease. In 3 patients, symptomatic gastrointestinal (GI) ulcers were detected. A dose exposure to the GI wall above 14 Gy/ml was a reliable threshold to predict ulcer formation. A combination of C-reactive protein ≥ 165 mg/l and/or leukocyte count ≥ 12.7 Gpt/l on the second day after the intervention predicted infection (sensitivity 90.0 %; specificity 92.8 %.) Two patients (0.6 %) died within 30 days. Median overall survival after the first liver treatment was 20.1 months for all patients and the local recurrence-free surviving proportion was 89 % after 12 months. Image-guided iBT yields a low rate of major complications and is effective. (orig.) [German] Evaluierung der Komplikationsrate und Identifizierung von Risikofaktoren fuer Komplikationen und Nebenwirkungen bei Patienten mit Lebermalignomen, die mit der hochdosierten interstitiellen Brachytherapie (iBT) behandelt wurden. Von 2006 bis 2009 wurden 192 Patienten in 343 CT- oder MRT-gefuehrten Interventionen behandelt und deren Daten ausgewertet. Der groesste behandelte Tumor war in

  20. Current perspective of venous thrombosis in the upper extremity

    OpenAIRE

    Flinterman, L.E.; Meer, van der, D; Rosendaal, F.R.; Doggen, C. J. M.

    2008-01-01

    Venous thrombosis of the upper extremity is a rare disease. Therefore, not as much is known about risk factors, treatment and the risk of recurrence as for venous thrombosis of the leg. Only central venous catheters and strenuous exercise are commonly known risk factors for an upper extremity venous thrombosis. In this review an overview of the different risk factors, possible treatments and the complications for patients with a venous thrombosis of the upper extremity is given

  1. A methodology for designing urban solid waste collection by means of extreme generation factors: fixed box systems (FBS

    Directory of Open Access Journals (Sweden)

    Carlos Alfonso Zafra Mejía

    2010-07-01

    Full Text Available Economic development and that of consumer society implies large-scale production of solid waste in any determined locality. This becomes a serious environmental problem if there is no suitable infrastructure for its integral management. This paper pre- sents a methodology for designing urban solid waste collection using fixed box systems (FBS, considering temporary variations in the amounts generated and collected. Temporary variation has been included by analysing three generation point factors: weekly extreme coefficient (WEC, daily extreme coefficient (DEC and daily extreme coefficient of heterogeneous distribution (DECH. Such time-based consideration allows making reasonable designs which can be adjusted to maximum generation and collection rates. The proposed model considers per capita production (PCP, weekly extreme coefficient (WEC and daily extreme coefficient of heterogeneous distribution (DECH. The proposed methodology can be used for selecting the equipment and the size of the in- tegral management units for urban solid waste.

  2. DISTRIBUTION OF RIVER RUNOFF AND ITS CLIMATE FACTORS IN AVERAGE AND EXTREME YEARS

    Directory of Open Access Journals (Sweden)

    Vladimir Konovalov

    2011-01-01

    Full Text Available Schematic maps of spatial distribution of seasonal precipitation amounts and average air temperatures were obtained for the areas studied in years with normal and extreme values of annual river runoff. Data on precipitation for January–December (I–XII and on average air temperatures for June–September (VI–IX during 1961–1990 collected at 93 meteorological stations located along 30.20°–44.08°N and 67.20°–82.98°E, altitude 122–4 169 m above sea level, were used in the maps’ compilation. For each point-element (i.e. a meteorological station with proper data, the ordinates of an integral empirical function of distribution of probabilities P were calculated from these data for a 30-year sample period and for each year were received average values and standard deviations of P. In characteristic years were revealed, significant differences of spatial distribution of climatic factors and runoff. It was found out also that the spatial distribution of the total volume of glaciers melting is less variable in the years with extreme water yields compared to the average years. This peculiarity is very beneficial for hydropower and agriculture sectors because it provides additional natural ability to stabilize water balance of reservoirs. Piecewise multi-factor linear equations were obtained to calculate the statistical probability of glaciers’ total melting in low and high flow years as a function of geographical coordinates and the average altitude of firn boundary.

  3. New insights in the bacterial spore resistance to extreme terrestrial and extraterrestrial factors

    Science.gov (United States)

    Moeller, Ralf; Horneck, Gerda; Reitz, Guenther

    Based on their unique resistance to various space parameters, Bacillus endospores are one of the model systems used for astrobiological studies. The extremely high resistance of bacterial endospores to environmental stress factors has intrigued researchers since long time and many characteristic spore features, especially those involved in the protection of spore DNA, have already been uncovered. The disclosure of the complete genomic sequence of Bacillus subtilis 168, one of the often used astrobiological model system, and the rapid development of tran-scriptional microarray techniques have opened new opportunities of gaining further insights in the enigma of spore resistance. Spores of B. subtilis were exposed to various extreme ter-restrial and extraterrestrial stressors to reach a better understanding of the DNA protection and repair strategies, which them to cope with the induced DNA damage. Following physical stress factors of environmental importance -either on Earth or in space -were selected for this thesis: (i) mono-and polychromatic UV radiation, (ii) ionizing radiation, (iii) exposure to ultrahigh vacuum; and (iv) high shock pressures simulating meteorite impacts. To reach a most comprehensive understanding of spore resistance to those harsh terrestrial or simulated extraterrestrial conditions, a standardized experimental protocol of the preparation and ana-lyzing methods was established including the determination of the following spore responses: (i) survival, (ii) induced mutations, (iii) DNA damage, (iv) role of different repair pathways by use of a set of repair deficient mutants, and (v) transcriptional responses during spore germi-nation by use of genome-wide transcriptome analyses and confirmation by RT-PCR. From this comprehensive set of data on spore resistance to a variety of environmental stress parameters a model of a "built-in" transcriptional program of bacterial spores in response to DNA damaging treatments to ensure DNA restoration

  4. Preoperative factors and early complications associated with hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures.

    Science.gov (United States)

    Miller, Christopher P; Buerba, Rafael A; Leslie, Michael P

    2014-06-01

    Displaced femoral neck fractures are common injuries in the elderly individuals. There is controversy about the best treatment with regard to total hip arthroplasty (THA) versus hemiarthroplasty. This study uses the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to evaluate the preoperative risk factors associated with the decision to perform THA over hemiarthroplasty. We also evaluate the risk factors associated with postoperative complications after each procedure. Patients older than 50 years undergoing hemiarthroplasty or THA after fracture in the NSQIP database from 2007 to 2010 were compared to each other in terms of preoperative medical conditions, postoperative complications, and length of stay. Multivariate logistic regression models were used to adjust for preoperative risk factors for undergoing a THA versus a hemiarthroplasty and for complications after each procedure. In all, 783 patients underwent hemiarthroplasty and 419 underwent THA for fracture. Hemiarthroplasty patients had longer hospital stays. On multivariate logistic regression, the only significant predictor for having a THA after fracture over hemiarthroplasty was being aged 50 to 64 years. The patient characteristics/comorbidities that favored having a hemiarthroplasty were age >80 years, hemiplegia, being underweight, having a dependent functional status, being on dialysis, and having an early surgery. High body mass index, American Society of Anesthesiologists (ASA) class, gender, and other comorbidities were not predictors of having one procedure over another. Disseminated cancer and diabetes were predictive of complications after THA while being overweight, obese I, or a smoker were protective. High ASA class and do-not-resuscitate status were significant predictors of complications after a hemiarthroplasty. This study identified clinical factors influencing surgeons toward performing either THA or hemiarthroplasty for elderly patients

  5. Relationship between expression of hepatocyte grow factor and apoptosis of trophoblasts in hypertensive disorder complicating pregnancy

    Institute of Scientific and Technical Information of China (English)

    OUYANG Shan; QIAO Fuyuan; ZHANG Qinghua

    2007-01-01

    The aim of this study was to investigate the expression of hepatocyte growth factor(HGF)and Fas in placentas of uncomplicated pregnant women and those with hypertensive disorder complicating pregnancy(HDCP),and elucidate the possible relationship between HGF and apoptosis of trophoblasts.Reverse transcription-polymerase chain reaction(RT-PCR)was undertaken to examine the concentration of HGF mRNA and Fas mRNA obtained from 34 cases of HDCP and 30 cases of uncomplicated pregnancy.The expression of HGF mRNA in mild preeclampsia,severe preeclampsia and eclampsia cases was significantly lower than that in the uncomplicated cases(0.43±0.12,0.38±0.09,0.19±0.17 versus 0.67±0.19,P<0.05),while the expression of Fas mRNA in mild preeclampsia,severe preeclampsia and eclampisa cases was significantly higher than that in the uncomplicated cases(1.58±0.26,2.96±0.14,5.98±1.17versus 1.01±0.36,P<0.05).For HGF mRNA and Fas mRNA,there was no difference between gestational hypertension cases and control cases.Decreased HGF mRNA or increased Fas mRNA was found along with the progress of HDCP.Negative correlation was found between the expressions of HGF and Fas.These results indicate that HGF inhibits the apoptosis mediated by Fas,and the reduced expression of HGF in HDCP may be responsible for the apoptosis of trophoblasts.

  6. Effect of atorvastatin combine with aspirin on flammatory factors, endothelial function and the cardiovascular complications with diabetic patients

    Institute of Scientific and Technical Information of China (English)

    Hong Wang; Ping Gong

    2016-01-01

    Objective:To investigate the effect of atorvastatin combine with aspirin on flammatory factors, endothelial function and the cardiovascular complications with diabetic patients.Methods:A total of 85 type 2 diabetic patients were randomly divided into observation group (43 cases) and control group (42 cases). All patients recieved routine treatment of hypoglycemic drug, while patients in observation group also received atorvastatin and aspirin. Levels of blood lipid, flammatory factors (hs-CRP, TNF-α, IL-6) endothelial function(ET-1,NO), and incidence of cardiovascular complications were tested and compared.Results:Blood lipid have statistical significance after treatment between two groups, TC, TG, LDL-C were significantly lower in observation group, HDL-C was significantly higher in observation group (P <0.05). Observation group flammatory factors (hs-CRP, TNF-α, IL-6) levels decreased significantly after treatment (P<0.05); Observation group ET-1 level decreased significantly, NO level increased significantly after treatment (P<0.05); Incidence of cardiovascular complications was lower than control group in observation group.Conclusions:Atorvastatin combine with aspirin treatment has reliable curative effect in diabetic patients, which can regulate flammatory factors, endothelial function and incidence of cardiovascular complications.

  7. Pregnancy, obesity and other risk factors for complications in influenza A(H1N1) pdm09 infection.

    Science.gov (United States)

    Rodríguez-Baño, Jesús; Paño-Pardo, José Ramón; Múñez Rubio, Elena; Segura Porta, Ferran

    2012-10-01

    Although influenza is usually a self-limited disease, patients who develop complications are at increased risk of hospitalization, intensive care unit admission and death. Since preventive and early therapeutic measures should be prioritized in higher risk patients, identification of the risk factors for severe infection is important from a public health perspective. Risk factors for complications in pandemics may show some differences with regard to seasonal influenza. During the influenza A(H1N1)pmd09 pandemic, although many cases occurred in younger adults, the risk factors identified for severe infections and complications were similar to those for seasonal influenza, including chronic respiratory, renal, liver, and heart diseases. Aged patients, although less frequently affected, were also at higher risk. Obesity, and particularly morbid obesity (>40 body mass index) has been noted as a significant risk factor for severe disease in the 2009 influenza pandemic. Some interesting recent studies provide insights into the biological reasons behind the poor outcomes in morbidly obese patients. In terms of pregnancy, the studies have shown contradictory results due to variations in methodology and medical care. However, it seems that pregnancy, particularly during the third trimester, increases the risk of complications, and that early antiviral treatment is associated with improved outcomes.

  8. Sarcopenia in overweight and obese patients is a predictive factor for postoperative complication in gastric cancer: A prospective study.

    Science.gov (United States)

    Lou, N; Chi, C-H; Chen, X-D; Zhou, C-J; Wang, S-L; Zhuang, C-L; Shen, X

    2017-01-01

    Sarcopenia is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength. This study aims to explore the prevalence of sarcopenia in overweight and obese gastric cancer (GC) patients and figured out the impacts of sarcopenia on the postoperative complication of overweight and obese GC patients. According to the recommended body-mass index (BMI) for Asian populations by WHO, we conducted a prospective study of overweight and obese gastric cancer patients (BMI ≥ 23 kg/m(2)) under curative gastrectomy from August 2014 to December 2015. Including lumbar skeletal muscle index, handgrip strength and gait speed as the sarcopenic components were measured before surgery. Patients were followed up after gastrectomy to gain the actual clinical outcomes. Factors contributing to postoperative complications were analyzed by univariate and multivariate analysis. Total of 206 overweight or obese patients were enrolled in this study, 14 patients were diagnosed sarcopenia and were demonstrated having significantly association with higher risk of postoperative complications, higher hospital costs, and higher rate of 30-days readmission compared with the non-sarcopenic ones. On the basis of univariate and multivariate analysis, sarcopenia was an independent risk factor for postoperative complication of overweight and obese patients with gastric cancer (P = 0.002). Sarcopenia is an independent predictor of postoperative complications in overweight or obese patients with gastric cancer after radical gastrectomy. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  9. Do work-related factors affect care-seeking in general practice for back pain or upper extremity pain?

    DEFF Research Database (Denmark)

    Jensen, J. C.; Haahr, J. P.; Frost, P.

    2012-01-01

    . Repetitive work and psychosocial factors did not have any statistically significant impact on care-seeking for neither back pain nor upper extremity pain. CONCLUSION: Work-related factors such as heavy lifting do, to some extent, contribute to care-seeking with MP. We suggest that asking the patient about...

  10. Adjuvant radiotherapy after radical hysterectomy of the cervical cancer. Prognostic factors and complications

    Energy Technology Data Exchange (ETDEWEB)

    Chatani, Masashi; Nose, Takayuki; Masaki, Norie [Osaka Univ. Medical School (Japan). Dept. of Radiation Therapy; Inoue, Toshihiko [Osaka Univ. Medical School (Japan). Dept. of Radiation Oncology

    1998-10-01

    Aim: To investigate prognostic factors and complications after radical hysterectomy followed by postoperative radiotherapy for carcinoma of the uterine cervix. Patients and Methods: One hundred twenty-eight patients with T1b-2b carcinoma of the uterine cervix following radical hysterectomy with bilateral pelvic lymphadenectomy and postoperative radiation therapy were reviewed. Pathologic and treatment variables were assessed by multivariate analysis for local recurrence, distant metastases and cause specific survival. Results: The number of positive nodes (PN) in the pelvis was the strongest predictor of pelvic recurrence and distant metastases. These 2 failure patterns independently affect the cause specific survival. The 5-year cumulative local and distant failure were PN(0): 2% and 12%, PN(1-2): 23% and 25%, PN(2<): 32% and 57%, respectively (p=0.0029 and p=0.0051). The 5-year cause specific survival rates were PN(0): 90%, PN(1-2): 59% and PN(2<): 42% (p=0.0001). The most common complication was lymphedema of the foot experienced by one-half of the patients (5-year: 42%, 10-year: 49%). Conclusion: These results suggest that patients with pathologic T1b-T2b cervix cancer with pelvic lymph node metastases are at high risk of recurrence or metastases after radical hysterectomy with pelvic lymphadenectomy and postoperative irradiation. (orig.) [Deutsch] Ziel: Untersuchung der prognostischen Faktoren und Komplikationen der adjuvanten Radiotherapie nach radikaler Hysterektomie bei Patienten mit Zervixkarzinom. Patienten und Methoden: In dieser Studie wurden 128 Patientinnen mit Zervixkarzinom untersucht, bei denen die pathologische Untersuchung nach radikaler Hysterektomie mit gleichzeitiger bilateraler pelvischer Lymphadenektomie und postoperativer Radiotherapie die Klassifikation als T1b-T2b-Karzinome ergab. Dabei wurden pathologische und therapeutische Parameter auf der behandelten Seite mit Hilfe der Multivarianzanalyse auf lokale Rezidive und Fernmetastasen

  11. Frequency and Risk Factors of Endocrine Complications in Turkish Children and Adolescents with Sickle Cell Anemia

    Directory of Open Access Journals (Sweden)

    Samim Özen

    2013-03-01

    Full Text Available Objective: To define frequency and risk factors of abnormalities in growth, puberty, thyroid function, and bone and carbohydrate metabolisms in children and adolescents with sickle cell disease (SCD. Materials and Methods: Endocrine problems including short stature, puberty and thyroid disorders, and carbohydrate and bone metabolisms in 50 Turkish children and adolescents with SCD were evaluated. Relationships among sex, disease type, blood transfusions, exchange and exacerbation frequency, ferritin levels, and endocrine pathologies were investigated. Results: The mean age of the study group was 13.1±2.9 years. Weights and heights of 12 participants (24% were below -2 standard deviations and 4 participants (8% had malnutrition. Mean difference (±standard deviation between bone and chronological age of patients was -1.73±1.86 years. Fifty percent of patients had at least one endocrine abnormality other than vitamin D deficiency and insufficiency. Hypergonadotropic hypogonadism in 3 patients (6%, hypogonadotropic hypogonadism in 1 female patient (2%, and small testicular volume in respect to age in 3 male patients (8.5% were seen. Growth hormone deficiency was detected in 1 (2% female patient, and hypothyroidism was diagnosed in 3 patients (6%; 1 central case, 2 cases of primary hypothyroidism. At vertebral level, 5 patients (11.1% had osteopenia and 1 patient (2.2% had osteoporosis, while 5 patients (11.1% had osteopenia at femur neck level. The most common endocrine abnormality was vitamin D deficiency. 25-Hydroxyvitamin D was deficient in 63.2% and insufficient in 18.4% of patients. Sex, disease type, blood transfusion frequency, exacerbation frequency, and ferritin levels were not related to endocrine pathologies. As the age was increased, standard deviation scores of femur neck bone mineral density was decreased (r =-0.56; p<0.05. Vitamin D was lower in patients whose weights and/or heights were below -2 standard deviations from the mean

  12. Compliance as factor for prevent complications of using of contact lenses

    Directory of Open Access Journals (Sweden)

    E. Y. Markova

    2015-01-01

    Full Text Available The main goal of this study is to identify the role of compliance in the prevention of complications while wearing soft contact lenses (SCL. 2257 patients in the «Center of vision correction contact» were examined. The age of patients was from12 till 46 years. 58 % female, 42 % male. 47.5 % patients were using daily disposable lenses, 52.5 % — lenses of planned replacement: 23.4 % — 2 weeks, 25.1 % — 1 month, 4 % — 3 months. All patients were using SCL for at least 1 year. The benefits of contact lens are compared with the glasses by different authors. However, any contact lens are a foreign body for the eye, which requires special care, and in case of non-compliance with the doctor’s recommendations may cause the complications. This study has shown that compliance among patients using contact lenses is below 50 %. The main reason for noncompliance of patients is the lack of time and attention to the health of patients. For achievement of compliance and prevention of complications of contact lens is recommended to regularly take the following necessary measures: patient education, explaining to him the need for each stage of lens care, which increases motivation. At the same time, the learning process can be demonstrated to have complications arise in the case of disturbances. Optimization of individual therapeutic program, which is the correct selection of contact lenses and care products tailored to the individual needs of the patient, his lifestyle and personal finance. However, the risk of complications depends not only on the doctor or the manufacturer, but to a greater extent on the patient. In other words, compliance — a necessary condition for ensuring the effectiveness of contact lens and avoiding the occurrence of complications.

  13. ANAEMIA AS A RISK FACTOR FOR MICROVASCULAR COMPLICATIONS IN TYPE 2 DM- A CROSS-SECTIONAL STUDY

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    Kamanuru Ethirajulu Govindarajulu

    2016-11-01

    Full Text Available BACKGROUND It is well known that diabetes adversely affects the kidneys finally leading to anaemia by various mechanisms. Several studies had postulated that anaemia developing before renal complications has an independent association with microvascular complication in type 2 diabetic patients. The aim of the study is to estimate the prevalence of anaemia in persons with type 2 diabetes mellitus and its role as a risk factor for the presence and the severity of microvascular complication in a populationbased study. MATERIALS AND METHODS This is a cross-sectional study conducted in patients coming to OPD of the Department of General Medicine in Government Vellore Medical College for a duration of 3 months from June 01, 2016, to August 31, 2016. Type 2 DM patients between the age group 20-60 years attending our diabetic clinic of both sex were included in our study. RESULTS From a total of 100 patients, 41% had anaemia including 34% with normochromic normocytic, 65.85% with hyperchromic microcytic anaemia and none of the patient had macrocytic anaemia. Patients who are anaemic had more frequent microvascular complications. There was no significant difference between males and females. The average duration of diabetes has a positive correlation with anaemia. All the microvascular complications like neuropathy, nephropathy and retinopathy had significant association with the presence of anaemia in type 2 patients. Nephropathy had a significant higher frequency compared to others as a complication in type 2 DM. CONCLUSION Our study shows that there is increased prevalence of anaemia in type 2 DM patients and the prevalence of microvascular complications is significantly higher among the diabetic patients with anaemia.

  14. Are Preexisting Retinal and Central Nervous System-Related Comorbidities Risk Factors for Complications Following Robotic-Assisted Laparoscopic Prostatectomy?

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    David Chalmers

    2015-08-01

    Full Text Available ABSTRACTPurpose:To assess whether retinal and central nervous system (CNS comorbidities are risk factors for complications following robotic assisted laparoscopic prostatectomy (RALP.Materials and Methods:A retrospective review of our RALP database identified 1868 patients who underwent RALP by a single surgeon between December 10, 2003-March 14, 2014. We hypothesized that patients with preexisting retinal or CNS comorbidities were at a greater risk of suffering retinal and CNS complications following RALP. Perioperative complications and risk of recurrence were graded using the Clavien and D'Amico systems, respectively.Results:40 (2.1% patients had retinal or CNS-related comorbidities, of which 15 had a history of retinal surgery and 24 had a history of cerebrovascular accident, aneurysm and/or neurosurgery. One additional patient had a history of both retinal and CNS events.Patients with retinal or CNS comorbidities were significantly older, had elevated PSA levels and CCI (Charlson Comorbidity Index scores than the control group. Blood loss, length of stay, surgical duration, BMI, diagnostic Gleason score and T-stage were not statistically different between groups.No retinal or CNS complications occurred in either group. The distribution of patients between D'Amico risk categories was not statistically different between the groups. There was also no difference in the incidence of total complications between the groups.Conclusions:RALP-associated retinal and CNS complications are rare. While our RALP database is large, the cohort of patients with retinal or CNS-related comorbidities was relatively small. Our dataset suggests retinal and CNS pathology presents no greater risk of suffering from perioperative complications following RALP.

  15. Common Factors and Outcome in Late Upper Extremity Amputations After Military Injury

    Science.gov (United States)

    2014-04-01

    are no quality studies that attempt to define an upper extremity limb salvage in a consistent way such as the Lower Extremity Assessment Project study...their prosthetic arm frequently despite all of them receiving multiple prostheses. This percentage is lower than the 76% found in a previous study that...following limb - threatening lower limb trauma: lessons learned from the Lower Extremity Assessment Project (LEAP). J Am Acad Orthop Surg. 2006;14:S205

  16. Extremely low frequency electric and magnetic fields as risk factors in chemical industry.

    Science.gov (United States)

    Troptcheva, T; Ivanova, M; Israel, M

    1998-09-01

    The risk assessment for staff in the chemical industry is usually related to accident hazards, production emergencies, blast and fire danger, or to the adverse effects of toxic substances. The combined effect of electric and magnetic fields with other factors combined with other hazards and working conditions, has not yet been studied. In all branches of industry, the members of staff who endure the most exposure to electric and magnetic fields, are electricians. This group is considered at high risk because of the increased probability of cancer. We studied electric and magnetic fields with low frequencies in the nitrogen chemical fertilizer plant "HIMCO", Vratza. Sources of extremely low frequency fields (50 Hz) are local thermal power plants, substations, open (110 kV) and closed (6 kV and 0.4 kV) distribution devices, transformers, compressors and turbocompressors, command halls, and video display units. The methods used for assessing exposure of low frequency electric and magnetic fields were based on the separate measurement of the electric and magnetic components of the field, using spot measurements and evaluation of the real time duration of exposure for different staff groups. The measured values for the different staff groups were within the limits of national and international standards. The measured magnetic flux densities in the "HIMCO" plant exceeded 3 mG, a value which is considered by many investigations in the literature, as a possible carcinogenic factor. The prolonged exposure to low frequency electric and magnetic fields determines the place of these physical factors in the complex of hazardous environmental factors for the staff. The simultaneous performance of combined investigations of all risk factors would result in the complete risk assessment for staff in the chemical industry. Electricians are considered to be a professional group who have an increased risk of contracting cancer. Extensive measurement and assessment of exposure of the

  17. The relevance of hemodynamic factors to perioperative ischemic complications in childhood moyamoya disease.

    Science.gov (United States)

    Iwama, T; Hashimoto, N; Yonekawa, Y

    1996-06-01

    Of 124 children younger than 15 years who underwent surgery for moyamoya disease, 21 (16.9%) experienced perioperative ischemic complications that could not be unequivocally attributed to the surgery. Eleven of the 21 patients experienced infarctions, and 10 experienced reversible ischemic neurological deficits without new lesions, as revealed by computed tomographic scans. An examination of the patients' perioperative clinical and laboratory data revealed that the mean values of intra- and postoperative minimum arterial carbon dioxide pressure, maximum arterial carbon dioxide pressure, and mean arterial pressure were similar in patients with and without ischemic complications. However, in patients with perioperative complications, the incidence of preoperative transient ischemic attacks (TIAs) and intra- and postoperative hypercapnia (maximum arterial carbon dioxide pressure > 45 mm Hg) was significantly higher. In addition, 7 of the 11 perioperative infarctions occurred in patients with frequent preoperative TIAs and intra- and postoperative hypercapnia. Cerebral blood flow studies with preoperative acetazolamide loading showed that the new infarctions were located in areas in which the cerebral blood flow had been compromised. Our results suggest that the occurrence of frequent preoperative TIA is an important indicator of the instability of the cerebral hemodynamics and of the risk of perioperative ischemic complications. To prevent these complications, preoperative management aimed at stabilizing the hemodynamic status is very important. Children who have moyamoya disease and who experience frequent preoperative TIAs are at risk for ischemic brain damage caused by hypercapnia as well as hypocapnia and hypotension. The establishment and maintenance of normocapnia with normotension are highly desirable for the perioperative management of moyamoya disease in children.

  18. Prognosis of complicated clinical course of varicose veins of lower extremities on the basis of analysis of phenotypic characteristics of connective tissue dysplasia

    OpenAIRE

    Tsarev О.А.; Anisimov A.Yu.; Zakharov N.N.

    2015-01-01

    Aim: to identify the phenotypic characteristics of indeterminate connective tissue dysplasia, which help to predict the progression of varicose veins of lower extremities and disease recurrence after surgery. Material and Methods. The long-term results of surgical treatment of 60 patients with varicose veins of lower extremities in a 5-year period after phlebectomy were analyzed. The phenotypic characteristics of indeterminate connective tissue dysplasia were researched. 24 patients had recur...

  19. Risk factors for and results of late or delayed amputation following combat-related extremity injuries.

    Science.gov (United States)

    Helgeson, Melvin D; Potter, Benjamin K; Burns, Travis C; Hayda, Roman A; Gajewski, Donald A

    2010-09-07

    We studied patients with combat-related injuries that required delayed amputation at least 4 months after the initial injury due to dysfunction, persistent pain, and patient desires. Late amputations were performed 22 times in 22 patients (21 men, 1 woman) since 2003. Fourteen patients underwent transtibial amputation, 5 transfemoral amputations, 1 knee disarticulation, and 2 transradial amputations. The primary indications for late amputation were neurologic dysfunction in 6 patients, persistent or recurrent infection in 6, neurogenic pain in 3, non-neurogenic pain in 5, and a globally poor functional result in 2. Sixteen of 22 patients reported multiple indications for electing to undergo amputation, with an average of 2.1 specific indications per patient. At final clinical follow-up an average of 13 months after amputation, all patients reported subjectively improved function and reported that they would undergo amputation again under similar circumstances. When medically and functionally practicable, every effort is given to limb salvage following severe combat-related extremity injuries. There is no single risk factor that increases the likelihood of delayed amputation, but the combination of complex pain symptoms with neurologic dysfunction appears to increase the risk, particularly if the initial insult is a severe hindfoot injury or distal tibia fracture. With appropriately selected and counseled patients, elective late amputation results in a high degree of patient satisfaction and subjectively improved function.

  20. Factors associated with postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians

    Directory of Open Access Journals (Sweden)

    Kim YW

    2016-05-01

    Full Text Available Young Wan Kim, Ik Yong Kim Division of Colorectal Surgery, Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea Purpose: To identify the factors affecting 30-day postoperative complications and 1-year mortality after surgery for colorectal cancer in octogenarians and nonagenarians. Methods: Between 2005 and 2014, a total of 204 consecutive patients aged ≥80 years who underwent major colorectal surgery were included. Results: One hundred patients were male (49% and 52 patients had American Society of Anesthesiologists (ASA score ≥3 (25%. Combined surgery was performed in 32 patients (16%. Postoperative complications within 30 days after surgery occurred in 54 patients (26% and 30-day mortality occurred in five patients (2%. Independent risk factors affecting 30-day postoperative complications were older age (≥90 years, hazard ratio [HR] with 95% confidence interval [CI] =4.95 [1.69-14.47], P=0.004, an ASA score ≥3 (HR with 95% CI =4.19 [1.8-9.74], P=0.001, performance of combined surgery (HR with 95% CI =3.1 [1.13-8.46], P=0.028, lower hemoglobin level (<10 g/dL, HR with 95% CI =7.56 [3.07-18.63], P<0.001, and lower albumin level (<3.4 g/dL, HR with 95% CI =3.72 [1.43-9.69], P=0.007. An ASA score ≥3 (HR with 95% CI =2.72 [1.15-6.46], P=0.023, tumor-node-metastasis (TNM stage IV (HR with 95% CI =3.47 [1.44-8.39], P=0.006, and occurrence of postoperative complications (HR with 95% CI =4.42 [1.39-14.09], P=0.012 were significant prognostic factors for 1-year mortality. Conclusion: Patient-related factors (older age, higher ASA score, presence of anemia, and lower serum albumin and procedure-related factors (performance of combined surgical procedure increased postoperative complications. Avoidance of 30-day postoperative complications may decrease 1-year mortality. Keywords: colonic neoplasms, rectal neoplasms, laparoscopy, laparotomy, aged 80 years and above

  1. Prognosis of complicated clinical course of varicose veins of lower extremities on the basis of analysis of phenotypic characteristics of connective tissue dysplasia

    Directory of Open Access Journals (Sweden)

    Tsarev О.А.

    2015-12-01

    Full Text Available Aim: to identify the phenotypic characteristics of indeterminate connective tissue dysplasia, which help to predict the progression of varicose veins of lower extremities and disease recurrence after surgery. Material and Methods. The long-term results of surgical treatment of 60 patients with varicose veins of lower extremities in a 5-year period after phlebectomy were analyzed. The phenotypic characteristics of indeterminate connective tissue dysplasia were researched. 24 patients had recurrence of varicose veins of lower extremities associated with disease progression; 36 patients did not have recurrence of varicose veins of lower extremities. Results. All the patients demonstrated the signs of indeterminate connective tissue dysplasia, whereas their frequency was different. There were specified nine phenotypic characteristics of indeterminate connective tissue dysplasia, which were significantly more frequent for patients with recurrence of varicose vein disease of lower extremities: 1 postural abnormality, 2 flat foot, 3 skin pallor, 4 hyperextension of skin, 5 positive "wrist test", 6 positive "pollex test", 7 diastasis recti abdominis, 8 myopia, 9 hematomas which form quickly. Conclusion. The determined sum of phenotypic characters of indeterminate connective tissue dysplasia allows to predict progression of varicose vein disease of lower extremities, and offers new opportunities for improving the results of surgical treatment via developing special therapeutic measures aimed at improving lifestyle and dysplasia treatment.

  2. Factors associated with death 1 year after lower extremity bypass in Northern New England.

    Science.gov (United States)

    Goodney, Philip P; Nolan, Brian W; Schanzer, Andres; Eldrup-Jorgensen, Jens; Stanley, Andrew C; Stone, David H; Likosky, Donald S; Cronenwett, Jack L

    2010-01-01

    Using 30-day operative mortality reported with lower extremity bypass (LEB) in preoperative decision making may underestimate the actual death rate encountered before patients have truly recovered from surgery, especially in elderly, debilitated patients with significant tissue loss. Therefore, we examined preoperative, patient-level risk factors that predict survival within the first year following LEB. Using our regional quality improvement initiative in 11 hospitals in Northern New England, we studied 2306 LEB procedures performed in 2031 patients between January 2003 and December 2007. Sixty surgeons contributed to our database, and over 100 demographic and clinical variables were abstracted by trained researchers. Cox proportional hazards models were used to generate hazard ratios (HR) and surrounding 95% confidence intervals (CI) for our combined outcome measure of death occurring within the first year postoperatively. We found that within our cohort of 2306 bypass procedures, 11% of patients died within 1 year of surgery (2% prior to discharge, 9% prior to 1-year follow-up). We identified six preoperative patient characteristics associated with higher risk of death in multivariate analysis: congestive heart failure (HR 1.3, 95% CI 1.0-1.8), diabetes (HR 1.5, 95% CI 1.1-2.1), critical limb ischemia (CLI) (HR 1.7, 95% CI 1.3-2.4), lack of single-segment saphenous vein (HR 1.9, 95% CI 1.5-2/5), age over 80 (HR 2.0, 95% CI 1.5-2.7), dialysis dependence (HR 2.7, 95% CI 1.9-3.6), and emergent nature of the procedure (HR 3.4, 95% CI 1.7-6.8). While patients with no risk factors had 1-year death rates that were less than 5%: patients with three or more risk factors had a 28% chance of dying before 1 year postoperatively. When we compared risk-adjusted survival across centers, we found that one center in our region performed significantly better than expected (observed-to-expected outcome ratio 0.7, 95% CI 0.6-0.9, P = .04). Preoperative risk factors allow surgeons

  3. A review of forty five open tibial fractures covered with free flaps. Analysis of complications, microbiology and prognostic factors

    DEFF Research Database (Denmark)

    Olesen, Ulrik Kähler; Juul, Rasmus; Bonde, Christian Torsten

    2015-01-01

    whether early flap coverage improved the clinical outcome and whether we could improve our antibiotic treatment of open fractures. METHODS: From 2002 to 2013 we treated 56 patients with an open tibial fracture covered with a free flap. We reviewed patient records and databases for type of trauma, smoking......PURPOSE: Treatment of open fractures is complex and controversial. The purpose of the present study is to add evidence to the management of open tibial fractures, where tissue loss necessitates cover with a free flap. We identified factors that increase the risk of complications. We questioned......, time to tissue cover, infection, amputations, flap loss and union of fracture. We identified factors that increase the risk of complications. We analysed the organisms cultured from open fractures to propose the optimal antibiotic prophylaxis. Follow-up was a minimum of one year. Primary outcome...

  4. Recurrence factors and prevention of complications of pediatric differentiated thyroid cancer

    Directory of Open Access Journals (Sweden)

    Changyuan Wang

    2017-01-01

    Conclusion: Pediatric differentiated thyroid cancer has a high metastatic rate to lymph nodes and distant organs, but the total prognosis is good. Application of total resection cannot necessarily reduce the relapse rate of pediatric differentiated thyroid cancer, but it may increase the postoperative hypocalcemia and hoarseness. The authors propose strictly adhering to various operation indicators, and carrying out various operations with a full understanding of the local lesion and lymph nodes in order to reduce relapse and postoperative complications.

  5. Analyzing Factors Associated with Major Complications after Adenotonsillectomy in 4776 Patients: Comparing Three Tonsillectomy Techniques

    Science.gov (United States)

    2010-01-01

    Norfolk, VA No sponsorships or competing interests have been disclosed for this article. ABSTRACT OBJECTIVE: To compare the rates of major complications...reviewing. Disclosures Competing interests: None. Sponsorships: None. References 1. Cullen KA, Hall MJ, Golosinskiy A. National Health Statistics Re- ports...www.cdc.gov/nchs/data/nhsr/nhsr011.pdf. Ac- cessed April 18, 2009. 2. Paradise JL, Bluestone CD, Bachman RZ, et al. Efficacy of tonsillec- tomy for

  6. Analysis of complications of prone position in acute respiratory distress syndrome: quality standard, incidence and related factors.

    Science.gov (United States)

    Jové Ponseti, E; Villarrasa Millán, A; Ortiz Chinchilla, D

    The monitoring system based on standards of quality allows clinicians to evaluate and improve the patient's care. According to the quality indicators recommended by Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias, and due to the importance of prone position (PP) as a treatment in patients with acute respiratory distress syndrome, it is fundamental to keep accurate record of serious adverse events occurring during the prone position procedure and its posterior analysis. To establish fulfilment of the Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias standards of quality according to the register of serious complications. To identify the incidence of serious complications registered as well as to identify possible factors related to these complications. Retrospective, cross-sectionsl descriptive study, polyvalent ICU (16 beds). Study population Patients with acute respiratory distress syndrome treated with PP (January 2012-December 2013). Study variables PP recording, accidental extubation, removal of catheters, decubitus ulcers (DU), ETT obstruction, urgency of the procedure, hours in PP, nutritional intake, type of feeding tube, food regurgitation/retention and use of prokinetics/muscle relaxant. The study sample comprised 38 cases, with an adequate record of complications in 92.1% of the cases. DU were the only serious complication recorded, with a 25.7% incidence. Possible factors related to DU: more hours in PP in patients developing DU (p= .067). Less incidence of DU in well-nourished patients (p= .577). 82.9% of patients were not appropriately nourished. The percentage of records duly completed is very high. The presence of DU (grade 1-2 mostly) is to be noted. There is no stastistical significance, although a trend is obversed, between DU and hours in PP. Copyright © 2017 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Angiopoietin-1 prevents severe bleeding complications induced by heparin-like drugs and fibroblast growth factor-2 in mice

    Science.gov (United States)

    Jerebtsova, Marina; Das, Jharna R.; Tang, Pingtao; Wong, Edward

    2015-01-01

    Critically ill children can develop bleeding complications when treated with heparin-like drugs. These events are usually attributed to the anticoagulant activity of these drugs. However, previous studies showed that fibroblast growth factor-2 (FGF-2), a heparin-binding growth factor released in the circulation of these patients, could precipitate intestinal hemorrhages in mice treated with the heparin-like drug pentosan polysulfate (PPS). Yet very little is known about how FGF-2 induces bleeding complications in combination with heparin-like drugs. Here, we examined the mechanisms by which circulating FGF-2 induces intestinal hemorrhages in mice treated with PPS. We used a well-characterized mouse model of intestinal hemorrhages induced by FGF-2 plus PPS. Adult FVB/N mice were infected with adenovirus carrying Lac-Z or a secreted form of recombinant human FGF-2, and injected with PPS, at doses that do not induce bleeding complications per se. Mice treated with FGF-2 in combination with PPS developed an intestinal inflammatory reaction that increased the permeability and disrupted the integrity of submucosal intestinal vessels. These changes, together with the anticoagulant activity of PPS, induced lethal hemorrhages. Moreover, a genetically modified form of the endothelial ligand angiopoietin-1 (Ang-1*), which has powerful antipermeability and anti-inflammatory activity, prevented the lethal bleeding complications without correcting the anticoagulant status of these mice. These findings define new mechanisms through which FGF-2 and Ang-1* modulate the outcome of intestinal bleeding complications induced by PPS in mice and may have wider clinical implications for critically ill children treated with heparin-like drugs. PMID:26276817

  8. Contributing Factors for Complications and Outcomes in Patients With Snakebite: Experience in a Medical Center in Southern Taiwan.

    Science.gov (United States)

    Hsieh, Yu-Hsuan; Hsueh, Jung-Hua; Liu, Wen-Chung; Yang, Kuo-Chung; Hsu, Kuei-Chang; Lin, Cheng-Ta; Ho, Yen-Yi; Chen, Lee-Wei

    2017-03-01

    Snakebite usually results in various complications, such as significant soft tissue damage, infection, hematological, and neurological deficit. Surgical intervention, usually, is indicated in patients with tissue necrosis, infection, and compartment syndrome. To identify the contributing factors for complications and outcomes in different patients with snakebite so that outcomes can be evaluated and treatment of such patients can be initiated at the earliest. Information was collected regarding age, sex, underlying disease, species of snake, and the course of treatment of the victims of snakebite who visited the emergency department of a medical center in southern Taiwan between 2004 and 2014. The data obtained were analyzed using SPSS 20.0. The bites from Taiwan cobra (Naja naja atra) significantly resulted in more complications than those from other snakes and required surgical intervention. The use of antivenin and antibiotics, immediate presentation to the hospital, and the location of the bite also were significant contributing factors. Taiwan cobra significantly results in higher possibility of prolonged hospitalization, operation, tissue necrosis, infection, and necrotizing fasciitis. Location of the bite, immediate presentation to the hospital, and use of antivenin and antibiotics affect the outcome of snakebite. Knowledge of these factors will help in a better management of patients with snakebite.

  9. Identifying predictive factors for long-term complications following button battery impactions: A case series and literature review.

    Science.gov (United States)

    Eliason, Michael J; Melzer, Jonathan M; Winters, Jessica R; Gallagher, Thomas Q

    2016-08-01

    To complement a case series review of button battery impactions managed at our single military tertiary care center with a thorough literature review of laboratory research and clinical cases to develop a protocol to optimize patient care. Specifically, to identify predictive factors of long-term complications which can be used by the pediatric otolaryngologist to guide patient management after button battery impactions. A retrospective review of the Department of Defense's electronic medical record systems was conducted to identify patients with button battery ingestions and then characterize their treatment course. A thorough literature review complemented the lessons learned to identify potentially predictive clinical measures for long-term complications. Eight patients were identified as being treated for button battery impaction in the aerodigestive tract with two sustaining long-term complications. The median age of the patients treated was 33 months old and the median estimated time of impaction in the aerodigestive tract prior to removal was 10.5 h. Time of impaction, anatomic direction of the battery's negative pole, and identifying specific battery parameters were identified as factors that may be employed to predict sequelae. Based on case reviews, advancements in battery manufacturing, and laboratory research, there are distinct clinical factors that should be assessed at the time of initial therapy to guide follow-up management to minimize potential catastrophic sequelae of button battery ingestion. Published by Elsevier Ireland Ltd.

  10. Cerebral Damage May Be the Primary Risk Factor for Visual Impairment in Preschool Children Born Extremely Premature

    DEFF Research Database (Denmark)

    Slidsborg, Carina; Bangsgaard, Regitze; Fledelius, Hans Callø;

    2012-01-01

    OBJECTIVES To investigate the importance of cerebral damage and retinopathy of prematurity (ROP) for visual impairment in preschool children born extremely premature and to determine the primary risk factor of the two. METHODS A clinical follow-up study of a Danish national cohort of children bor...

  11. Upper extremities musculoskeletal disorders: Prevalence and associated ergonomic factors in an electronic assembly factory

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    Somthus Pullopdissakul

    2013-10-01

    Full Text Available Objectives:To determine the magnitude, distribution and associated ergonomic factors of upper extremities musculoskeletal disorders (UEMSD among workers of electronic assembly in Thailand. Material and Methods: This was a cross-sectional study. 591 of 853 workers in an electronic and electrical appliance assembly factory in Bangkok, Thailand, participated in this study. A self-administered questionnaire consisting of demographic data and ergonomic factors was collected from October 2010 to January 2011. Clinical examination of each worker was performed by an occupational physician. The criteria for diagnosis of UEMSD came as a result of a consensus reached by a group of orthopedists. The associated factors were analyzed using a multiple logistic regression. Results: The point prevalence of clinically diagnosed UEMSD was as follows: radial styloid tenosynovitis - 13.03% (95% CI: 10.31-15.75, trigger finger - 9.48% (95% CI: 7.11-11.84, carpal tunnel syndrome - 8.12% (95% CI: 5.91-10.33, lateral epicondylitis - 3.38% (95% CI: 1.92-4.85, and medial epicondylitis - 1.69% (95% CI: 0.65-2.73, respectively. The adjusted odds ratio with statistical significance associated with UEMSD was as follows: high force of wrist - 1.78 (95% CI: 1.06-2.99, awkward posture of wrist - 2.37 (95% CI: 1.28-4.37 and contact stress at wrists - 1.75 (95% CI: 1.02-3.00 to develop radial styloid tenosynovitis. For trigger finger, the ratios were awkward posture of fingers - 2.09 (95% CI: 1.12-3.90 and contact stress on finger - 1.86 (95% CI: 1.04-3.34. For medial epicondylitis, it was an awkward posture of using elbows - 3.14 (95% CI: 1.10-8.95. However, this study did not find any associations between repetitive motion and any UEMSD. Conclusions: UEMSD are most commonly found in electronic assembly workers. The relevant parties should provide comprehensive ergonomic resolution for these workers.

  12. Pre-surgery Factors to Predict Mortality and Major Complications in Coronary Surgery with no Extracorporeal Circulation

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    Yanier Coll Muñoz

    2011-03-01

    Full Text Available Background: mortality predicting models in cardiac surgery have been created based on certain population groups. It would be important to know their effectiveness in patients who underwent surgery with no extracorporeal circulation and cardioplegic cardiac arrest. Objective: To determine risk factors to predict mortality and major complications in revascularized patients with no use of extracorporeal circulation and to analyze the behaviour of two stratification models of preoperative risk in cardiac surgery. Methods: A prospective observational study conducted from January 2007 to December 2008 at the Cardiology Center of Santa Clara. The sample included 136 patients who underwent coronary artery bypass grafting with no extracorporeal circulation. Variables collected prospectively were the basis to identify. Risk scales Parsonnet and EuroSCORE 97 were calculated for each patient. Their capacity to predict mortality and possible complications was analyzed through ROC curves. Results: Preoperative variables that significantly increased death risk and major complications were: history of chronic obstructive pulmonary disease, history of diabetes mellitus and three vessel coronary artery disease. Conclusions: Parsonnet and Euroscore 97 risk scales are accurate for mortality and major complications prediction in beating heart revascularization.

  13. Patient-related independent clinical risk factors for early complications following Nd: YAG laser resection of lung cancer

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    Branislav Perin

    2012-01-01

    Full Text Available Introduction: Neodymium:yttrium aluminum garnet (Nd:YAG laser resection is one of the most established interventional pulmonology techniques for immediate debulking of malignant central airway obstruction (CAO. The major aim of this study was to investigate the complication rate and identify clinical risk factors for complications in patients with advanced lung cancer. Methods: In the period from January 2006 to January 2011, data sufficient for analysis were identified in 464 patients. Nd:YAG laser resection due to malignant CAO was performed in all patients. The procedure was carried out in general anesthesia. Complications after laser resection were defined as severe hypoxemia, global respiratory failure, arrhythmia requiring treatment, hemoptysis, pneumothorax, pneumomediastinum, pulmonary edema, tracheoesophageal fistulae, and death. Risk factors were defined as acute myocardial infarction within 6 months before treatment, hypertension, chronic arrhythmia, chronic obstructive pulmonary disease (COPD, stabilized cardiomyopathy, previous external beam radiotherapy, previous chemotherapy, and previous interventional pulmonology treatment. Results : There was 76.1% male and 23.9% female patients in the study, 76.5% were current smokers, 17.2% former smokers, and 6.3% of nonsmokers. The majority of patients had squamous cell lung cancer (70%, small cell lung cancer was identified in 18.3%, adenocarcinoma in 3.4%, and metastases from lung primary in 8.2%. The overall complication rate was 8.4%. Statistically significant risk factors were age (P = 0.001, current smoking status (P = 0.012, arterial hypertension (P < 0.0001, chronic arrhythmia (P = 0.034, COPD (P < 0.0001, and stabilized cardiomyopathy (P < 0.0001. Independent clinical risk factors were age over 60 years (P = 0.026, arterial hypertension (P < 0.0001, and COPD (P < 0.0001. Conclusion : Closer monitoring of patients with identified risk factors is advisable prior and immediately after

  14. Cardiovascular risk factor treatment targets and renal complications in high risk vascular patients: a cohort study

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    Visseren Frank LJ

    2011-07-01

    Full Text Available Abstract Background To determine if recommended treatment targets, as specified in clinical practice guidelines for the management of cardiovascular disease, reduces the risk of renal complications in high risk patient populations. Methods This was a cohort study. Participants in Utrecht, The Netherlands either at risk of, or had cardiovascular disease were recruited. Cardiovascular treatment targets were achievement of control in systolic and diastolic blood pressure, total and low-density cholesterol, and treatment of albuminuria. Outcome measures were time to development of end stage renal failure or symptomatic renal atherosclerotic disease requiring intervention. Results The cohort consisted of 7,208 participants; 1,759 diabetics and 4,859 with clinically manifest vascular disease. The median age was 57 years and 67% were male. Overall, 29% of the cohort achieved the treatment target for systolic blood pressure, 39% for diastolic blood pressure, 28% for total cholesterol, 31% for LDL cholesterol and 78% for albuminuria. The incidence rate for end stage renal failure and renal atherosclerotic disease reduced linearly with each additional treatment target achieved (p value less than 0.001. Achievement of any two treatment targets reduced the risk of renal complications, hazard ratio 0.46 (95% CI 0.26-0.82. For patients with clinically manifest vascular disease and diabetes, the hazard ratios were 0.56 (95% CI 0.28 - 1.12 and 0.28 (95%CI 0.10 - 0.79 respectively. Conclusion Clinical guidelines for cardiovascular disease management do reduce risk of renal complications in high risk patients. Benefits are seen with attainment of any two treatment targets.

  15. Treatment resistance and other complicating factors in the management of schizophrenia.

    Science.gov (United States)

    Strassnig, Martin T; Harvey, Philip D

    2014-12-01

    Treatment resistance, along with its sibling partial response, remains a common phenomenon in schizophrenia, complicating the disability burden inherent in the disease. Antipsychotic medications are the mainstay of treatment, and treatment resistance has mainly been defined in terms of poor response to antipsychotic medication. At the same time, clozapine, the most effective antipsychotic, remains underutilized at the expense of exposing patients to polypharmacy. We review known causes of disability in schizophrenia, how they impact various areas of everyday functioning, and discuss potential treatment options including but not limited to pharmacological approaches aimed at maximizing treatment response and reducing treatment resistance.

  16. Pregnancy complications in spontaneous and assisted conceptions of women with infertility and subfertility factors. A comprehensive review.

    Science.gov (United States)

    Palomba, Stefano; Santagni, Susanna; Gibbins, Karen; La Sala, Giovanni Battista; Silver, Robert M

    2016-11-01

    In the literature, there is growing evidence that assisted reproductive techniques increase the risk of pregnancy complications in subfertile couples. Moreover, many concomitant preconception risk factors for subfertility are frequently present in the same subject and increase the risk of pregnancy complications. This review aimed to summarize in a systematic fashion the best current evidence regarding the effects of preconception maternal factors on maternal and neonatal outcomes. A literature search up to March 2016 was performed in IBSS, SocINDEX, Institute for Scientific Information, PubMed, Web of Science and Google Scholar. An evidence-based hierarchy was used to determine which articles to include and analyse. Available data show that the risk of pregnancy complications in spontaneous and assisted conceptions is likely multifactorial, and the magnitude of this risk is probably very different according specific subgroups of patients. Notwithstanding the only moderate level and quality of the available evidence, available data suggest that the presence and the treatment of specific preconception cofactors of subfertility should be always taken into account both in clinical practice and for scientific purposes.

  17. INCIDENCE, RISK FACTORS AND COMPLICATIONS OF ACUTE PERFORATED AND NON - PERFORATED APPENDICITIS IN A RURAL SETUP OF ANDHRA PRADESH

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    Anil Kumar

    2015-05-01

    Full Text Available Appendicitis is one of the most common surgical emergencies. The incidence of appendicitis and chances of complication in the form of perforation are dependent on both the patients and non - patient factors . There are various studies conducted to address this problem, but there are no studies conducted to look in to the incidence of appendicitis in east Godavari district of Andhra Pradesh. Our study was aimed to bridge thi s gap. METHOD S AND MATERIALS: this was a retrospective study, patient data from 2009 - 2014 was analyzed and the age, distance from hospital, educational and socioeconomic background of the patients was collected. The duration between first appearance of sy mptoms and hospitalization was recorded. The incidence of post - op complication was also recorded. RESULTS: T he incidence of perforation was 15% in our study population, most of the patients were from low socioeconomic group and having income less than 5000 /month. The middle age group between 30 - 40 years was commonly affected by the appendicitis. The time laps between appearance of symptoms and hospitalization was found to be a predominant factor in the perforation. Surgical site infection was most common co mplication in the patients treated. CONCLUSION: T he incidence of perforation is still high and the time laps between first appearance of symptoms and hospitalization is a major determinant of perforation or complication in the appendicitis.

  18. Risk factors for progression of microvascular complications in the Stockholm Diabetes Intervention Study (SDIS).

    Science.gov (United States)

    Reichard, P

    1992-05-01

    Ninety-six patients with insulin-dependent diabetes mellitus (IDDM), non-proliferative retinopathy, normal s-creatinine and previously high blood glucose levels were followed for 5 years. In multivariate analyses the mean HbA1c level (14 values during 6-60 months) was significantly correlated with albumin excretion level (P less than 0.01), retinopathy (P less than 0.001), motoric and sensoric nerve conduction velocities (P less than 0.01), thermal threshold on the foot (P less than 0.01), the respiratory sinus arrhythmia (P less than 0.01), the valsalva ratio (P less than 0.05) and the orthostatic blood pressure reaction (P = 0.05) after 5 years. Neuropathy was related to both the HbA1c value at baseline (P less than 0.05) and the mean HbA1c value during the study (P less than 0.001). Smoking habits were correlated with the total number of complications deteriorating (P less than 0.05), as was HbA1c during the study (P less than 0.001). Patients with an initial HbA1c of 9% or more could reduce the risks for deterioration of microvascular complications to 10-15% by reducing their HbA1c below this level.

  19. Channel response to extreme floods: Insights on controlling factors from six mountain rivers in northern Apennines, Italy

    Science.gov (United States)

    Surian, Nicola; Righini, Margherita; Lucía, Ana; Nardi, Laura; Amponsah, William; Benvenuti, Marco; Borga, Marco; Cavalli, Marco; Comiti, Francesco; Marchi, Lorenzo; Rinaldi, Massimo; Viero, Alessia

    2016-11-01

    This work addresses the geomorphic response of mountain rivers to extreme floods, exploring the relationships between morphological changes and controlling factors. The research was conducted on six tributaries of the Magra River (northern Apennines, Italy) whose catchments were affected by an extreme flood (estimated recurrence interval > 100 years in most of the basins) on 25 October 2011. An integrated approach was deployed to study this flood, including (i) analysis of channel width changes by comparing aerial photographs taken before and after the flood, (ii) estimate of peak discharges in ungauged streams, (iii) detailed mapping of landslides and analysis of their connectivity with the channel network. Channel widening occurred in 35 reaches out of 39. In reaches with channel slope hydraulic variables alone are not sufficient to satisfactorily explain the channel response to extreme floods, and inclusion of other factors such as lateral confinement is needed to increase explanatory capability of regression models. Concerning hydraulic variables, this study showed that the degree of channel widening is more strongly related to unit stream power calculated based on pre-flood channel width than to cross-sectional stream power and to unit stream power calculated with post-flood channel width. This could suggest that most width changes occurred after the flood peak. Finally, in terms of hazard, it is crucial to document the type and magnitude of channel changes, to identify controlling factors, and most importantly, to develop tools enabling us to predict where major geomorphic changes occur during an extreme flood.

  20. Examination of Turkish extreme athletes' personality traits in terms of gender and some demographic factors

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    Merve Ceylan

    2015-09-01

    Full Text Available The present study was conducted for the purpose of examining the personality traits of extreme athletes. In line with this purpose a total of 227 extreme athletes, as 86 female and 141 male athletes selected through judgment sampling, that either actively compete or trains to compete in any of the branches of snowboarding, snowkiting, kitesurfing, windsurfing, river kayaking, mountain biking, free diving, paragliding and rafting were included within the sample group of the study. Questionnaire applications were carried out in extreme sports facilities throughout the country. Within the scope of the study, an 85-item short form of the Five Factor Personality Scale developed by Somer, Korkmaz and Tatar was used as the data collection tool. Data analysis was carried out by means of the SPSS 16.0 software and the percentages frequencies, mean, standard deviation and to find the differences between the sexes "independent t" test were calculated. Examining the obtained results showed that the male athletes have higher extravertion level from female athletes (p <0.05. This finding obtained in our study suggest that, in an essentially male-dominant society, the higher level of pressure women are subjected to in social, economic, cultural and psychological terms and the difficulties and pressure they experience in the working life are significant factors for women to be more introvert.     Özet Bu araştırma, ekstrem sporcuların kişilik özelliklerinin incelemesi amacıyla yapılmıştır. Bu amaç doğrultusunda araştırmaya, yargısal örnekleme yöntemiyle seçilmiş, snowboard, snowkite, uçurtma sörfü, rüzgar sörfü, akarsu ve nehir kanosu, dağ bisikleti, serbest dalış, yamaç paraşütü, kaya tırmanışı ve rafting branşlarında yarışmacı olan ya da bir yarışmaya katılmak için hazırlık yapan, 86’sı kadın, 141’i erkek olmak üzere 227 ekstrem sporcu katılmıştır.  Anket uygulamaları, ülke genelinde bulunan

  1. A Confounding Case of Inherited Factor V Deficiency Complicated by Inhibitors at First Presentation.

    Science.gov (United States)

    Subramanian, Hema; Kar, Rakhee; Charles, Deepak; Babu, Hitha; Ambika, Pagadalu; Dutta, Tarun Kumar

    2017-04-01

    Inherited factor V deficiency / Owren's disease has varied clinical manifestations ranging from asymptomatic laboratory abnormalities to massive hemorrhage. The acquired form due to inhibitors following antibiotic therapy, infection, or surgery is less common, and spontaneous development of inhibitors is not known. An 18-year-old boy presented with bleeding axillary and groin ulcers. At the age of 15, due to recurrent epistaxis and gum bleed, he was diagnosed with acquired factor V deficiency with positive inhibitor screen and treated with fresh frozen plasma (FFP) transfusion and temporary azathioprine. Coagulation workup at his current presentation also revealed acquired factor V deficiency with presence of inhibitors. The tests were repeated after 6 weeks of intermittent FFP transfusion, and the differences observed included negative inhibitor screen and complete correction on mixing studies, but factor V level was 2%. Evidence of inhibitors at presentation favored acquired disease. However, younger age of onset, detection of inhibitors 1 year after first episode of self-regressing bleed, lack of identifiable triggers, and persistent bleeding with reduced factor levels after disappearance of inhibitors favored inherited factor V deficiency. In this case report, we have described an interesting case of severe inherited factor V deficiency with spontaneous appearance and disappearance of inhibitors exhibiting nonspecific factor inhibitory activity.

  2. IMMUNOLOGICAL AND METABOLIC FACTORS INTERACTION IN THE DEVELOPMENT AND PROGRESSION OF MICROVASCULAR COMPLICATIONS IN LATENT AUTOIMMUNE DIABETES OF ADULTS (LADA

    Directory of Open Access Journals (Sweden)

    T. V. Saprina

    2014-01-01

    Full Text Available Some researchers found that the development of microvascular complications (nephropathy, retinopathy with latent autoimmune diabetes adults (LADA occurs much earlier than in type 1 diabetes mellitus. The research devoted to the study of the spectrum and the time of development of microangiopathy in patients with latent autoimmune diabetes of adults, compared to patients with type 1 and 2 diabetes mellitus. Also studied immunological factors (cytokine secretion of mononuclear leukocytes as one of the possible mechanisms of diabetic angiopathy progression. It has been shown that in LADA, as in patients with type 2 diabetes mellitus, the development of microvascular complications (nephropathy, retinopathy occurs much earlier than in type 1 diabetes mellitus (after a 4-year course of the disease due to a sharp decline in the serum concentration of C peptide. Thus in patients with LADA, having microvascular complications in the supernatants of cell cultures of mononuclear leukocytes determined a significant increase in the concentrations of cytokines IL-2, IL-4, TNFα.

  3. Neurological complications and risk factors of cardiopulmonary failure of EV-A71-related hand, foot and mouth disease.

    Science.gov (United States)

    Long, Lili; Xu, Lin; Xiao, Zhenghui; Hu, Shixiong; Luo, Ruping; Wang, Hua; Lu, Xiulan; Xu, Zhiyue; Yao, Xu; Zhou, Luo; Long, Hongyu; Gong, Jiaoe; Song, Yanmin; Zhao, Li; Luo, Kaiwei; Zhang, Mengqi; Feng, Li; Yang, Liming; Sheng, Xiaoqi; Fan, Xuegong; Xiao, Bo

    2016-03-22

    From 2010 to 2012, large outbreaks of EV-A71-related- hand foot and mouth disease (HFMD) occurred annually in China. Some cases had neurological complications and were closely associated with fatal cardiopulmonary collapse, but not all children with central nervous system (CNS) involvement demonstrated a poor prognosis. To identify which patients and which neurological complications are more likely to progress to cardiopulmonary failure, we retrospectively studied 1,125 paediatric inpatients diagnosed with EV-A71-related HFMD in Hunan province, including 1,017 cases with CNS involvement. These patients were divided into cardiopulmonary failure (976 people) group and group without cardiopulmonary failure (149 people). A logistic regression analysis was used to compare the clinical symptoms, laboratory test results, and neurological complications between these two groups. The most significant risk factors included young age, fever duration ≥3 days, coma, limb weakness, drowsiness and ANS involvement. Patients with brainstem encephalitis and more CNS-involved regions were more likely to progress to cardiopulmonary failure. These findings can help front-line clinicians rapidly and accurately determine patient prognosis, thus rationally distributing the limited medical resources and implementing interventions as early as possible.

  4. A propensity score matched analysis of obesity as an independent risk factor for postoperative complications in reduction mammaplasty

    Institute of Scientific and Technical Information of China (English)

    James D Goggin; Stacy Wong; Jessica E Pruszynski; Jon P Ver Halen

    2016-01-01

    Aim: Reduction mammaplasty is a commonly performed procedure for the treatment of symptomatic macromastia and is increasingly desired by the obese population. With the increasing prevalence obesity in the population, it is imperative to understand its effect on postoperative outcomes. The purpose of this study is to evaluate obesity as an independent risk factor for postoperative complications in breast reduction surgery using 1:1 patient matching through propensity scores between obese patients and non-obese controls.Methods: Between 2005 and 2013, the National Surgical Quality Improvement Program dataset identified a total of 6,016 patients as having undergone primary reduction mammaplasty with 30-day postoperative follow-up. Patients were divided into obese [body mass index (BMI) of 30 or more] vs. not obese (BMI below 30). Patients were initially analyzed using standard multivariable analysis. Using propensity scores obtained from a logistic regression model, patients were subsequently matched 1:1 according to preoperative and operative variables to truly isolate the effect of obesity on surgical outcomes. Outcomes were compared between the matched cohorts using McNemar’s test and the Wilcoxon signed rank test.Results: In unmatched multivariable analysis, rates of overall complications (7.2%vs. 5.3%,P = 0.0024), wound complications (5.5%vs. 3.6%,P = 0.0004), superficial surgical site infection (4.1%vs. 2.8%,P = 0.0050), and wound dehiscence (0.3%vs. 1.1%,P = 0.0005) were found to be statistically different between obesevs. non-obese, respectively. However, when comparing 1:1 matched obese and non-obese patients, only wound complications (4.6%vs. 3.1%,P = 0.0334) were significantly increased in the obese cohort.Conclusion: Using the most robust statistical tools available, obesity was determined to affect wound complications after breast reduction without increased detriment on other major complications when compared to the non-obese. Obesity should be a

  5. Prevalence, Risk Factors, and Complications of Diabetes in the Kilimanjaro Region: A Population-Based Study from Tanzania

    Science.gov (United States)

    Makuka, Gerald Jamberi; Egger, Joseph R.; Maro, Venance; Maro, Honest; Karia, Francis; Patel, Uptal D.; Burton, Matthew J.

    2016-01-01

    Background In sub-Saharan Africa, diabetes is a growing burden, yet little is known about its prevalence, risk factors, and complications. To address these gaps and help inform public health efforts aimed at prevention and treatment, we conducted a community-based study assessing diabetes epidemiology. Methods and Findings We conducted a stratified, cluster-designed, serial cross-sectional household study from 2014–2015 in the Kilimanjaro Region, Tanzania. We used a three-stage cluster probability sampling method to randomly select individuals. To estimate prevalence, we screened individuals for glucose impairment, including diabetes, using hemoglobin A1C. We also screened for hypertension and obesity, and to assess for potential complications, individuals with diabetes were assessed for retinopathy, neuropathy, and nephropathy. We enrolled 481 adults from 346 urban and rural households. The prevalence of glucose impairment was 21.7% (95% CI 15.2–29.8), which included diabetes (5.7%; 95% CI 3.37–9.47) and glucose impairment with increased risk for diabetes (16.0%; 95% CI 10.2–24.0). Overweight or obesity status had an independent prevalence risk ratio for glucose impairment (2.16; 95% CI 1.39–3.36). Diabetes awareness was low (35.6%), and few individuals with diabetes were receiving biomedical treatment (33.3%). Diabetes-associated complications were common (50.2%; 95% CI 33.7–66.7), including renal (12.0%; 95% CI 4.7–27.3), ophthalmic (49.6%; 95% CI 28.6–70.7), and neurological (28.8%; 95% CI 8.0–65.1) abnormalities. Conclusions In a northern region of Tanzania, diabetes is an under-recognized health condition, despite the fact that many people either have diabetes or are at increased risk for developing diabetes. Most individuals were undiagnosed or untreated, and the prevalence of diabetes-associated complications was high. Public health efforts in this region will need to focus on reducing modifiable risk factors, which appear to include

  6. Frequent Use of Fresh Frozen Plasma Is a Risk Factor for Venous Thrombosis in Extremely Low Birth Weight Infants: A Matched Case-control Study

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    Maruyama,Hidehiko

    2012-02-01

    Full Text Available Percutaneously inserted central catheters (PICCs are often used in neonatal medicine. Venous thrombosis (VT is one of the complications associated with PICC use. According to some reports, fresh frozen plasma (FFP may be a risk factor for VT. The purpose of this study was to determine whether FFP use is associated with VT in extremely low birth weight infants (ELBWIs. We performed a matched case-control study on risk factors for VT in ELBWIs born over a period of 5 years in the neonatal intensive care unit of a tertiary hospital. Controls were infants from the unit matched for gestational age and birth weight. We performed univariate analyses and created receiver operating characteristic (ROC curves for the cut-off values of continuous parameters such as FFP. We also conducted multivariate conditional logistic regression analysis and calculated adjusted odds ratios and their 95% confidence intervals. Thirteen VT cases and 34 matched controls were examined. Using an ROC curve, FFP by day 5>50mL/kg was selected as the cut-off value. In multivariate conditional logistic regression analysis, FFP by day 5>50mL/kg exhibited an adjusted odds ratio of 5.88 (95% confidence interval:1.12-41.81, p=0.036. FFP by day 5>50mL/kg may be a risk factor for VT in ELBWIs.

  7. Sagittal deformities of the spine: factors influencing the outcomes and complications.

    Science.gov (United States)

    Diebo, Bassel G; Henry, Jensen; Lafage, Virginie; Berjano, Pedro

    2015-01-01

    Degenerative changes have the potential to greatly disrupt the normal curvature of the spine, leading to sagittal malalignment. This phenomenon is often treated with operative modalities, such as osteotomies, though even with surgery, only one-third of patients may reach neutral alignment. Improvement in surgical outcomes may be achieved through better understanding of radiographic spino-pelvic parameters and their association with deformity. Methodical surgical planning, including selection of levels of instrumentation and site of the osteotomy, is crucial in determining the optimal plan for a patient's specific pathology and may minimize risk of developing postoperative proximal junctional kyphosis/failure. While sagittal alignment is essential in operative strategy, the coronal plane should not be overlooked, as it may affect the osteotomy technique. The concepts of sagittal balance and alignment are further complicated in patients with neuromuscular diseases such as Parkinson's disease, and appreciation of the interplay between anatomic and postural deformities is necessary to properly treat these patients. Finally, given the importance of sagittal alignment and the role of osteotomies in treatment for deformity, the need for future research becomes apparent. Novel intraoperative measurement techniques and three-dimensional analysis of the spine may allow for vastly improved operative correction. Furthermore, awareness of the relationship between alignment and balance, the soft tissue envelope, and compensatory mechanisms will provide a more comprehensive conception of the nature of spinal deformity and the modalities with which it is treated.

  8. Factors influencing QTL mapping accuracy under complicated genetic models by computer simulation.

    Science.gov (United States)

    Su, C F; Wang, W; Gong, S L; Zuo, J H; Li, S J

    2016-12-19

    The accuracy of quantitative trait loci (QTLs) identified using different sample sizes and marker densities was evaluated in different genetic models. Model I assumed one additive QTL; Model II assumed three additive QTLs plus one pair of epistatic QTLs; and Model III assumed two additive QTLs with opposite genetic effects plus two pairs of epistatic QTLs. Recombinant inbred lines (RILs) (50-1500 samples) were simulated according to the Models to study the influence of different sample sizes under different genetic models on QTL mapping accuracy. RILs with 10-100 target chromosome markers were simulated according to Models I and II to evaluate the influence of marker density on QTL mapping accuracy. Different marker densities did not significantly influence accurate estimation of genetic effects with simple additive models, but influenced QTL mapping accuracy in the additive and epistatic models. The optimum marker density was approximately 20 markers when the recombination fraction between two adjacent markers was 0.056 in the additive and epistatic models. A sample size of 150 was sufficient for detecting simple additive QTLs. Thus, a sample size of approximately 450 is needed to detect QTLs with additive and epistatic models. Sample size must be approximately 750 to detect QTLs with additive, epistatic, and combined effects between QTLs. The sample size should be increased to >750 if the genetic models of the data set become more complicated than Model III. Our results provide a theoretical basis for marker-assisted selection breeding and molecular design breeding.

  9. Assessment of M2/ANXA5 haplotype as a risk factor in couples with placenta-mediated pregnancy complications.

    Science.gov (United States)

    Rogenhofer, Nina; Nienaber, Lara R M; Amshoff, Lea C; Bogdanova, Nadia; Petroff, David; Wieacker, Peter; Thaler, Christian J; Markoff, Arseni

    2017-09-13

    The aim of this study was to confirm the associated M2/ANXA5 carrier risk in women with placenta-mediated pregnancy complications (PMPC) and to test their male partners for such association. Further analysis evaluated the influence of maternal vs. paternal M2 alleles on miscarriage. Two hundred eighty-eight couples with preeclampsia (PE), intrauterine growth restriction (IUGR), or premature birth (PB) were recruited (n = 96 of each phenotype). The prevalence of the M2 haplotype was compared to two control cohorts. They included a group of women with a history of normal pregnancy without gestational pathology (Munich controls, n = 94) and a random population sample (PopGen controls, n = 533). Significant association of M2 haplotype and pregnancy complications was confirmed for women and for couples, where prevalence was elevated from 15.4 to 23.8% (p < 0.001). Post hoc analyses demonstrated an association for IUGR and PB individually. A strong link between previous miscarriages and M2 carrier status was identified which may explain the predisposition to placental pregnancy complication. M2/ANXA5 appears to be a risk factor for adverse pregnancy outcomes related, but not limited to miscarriages, with similar prevalence in women and their male partners. These findings support the proposed physiological function of ANXA5 as an embryonic anticoagulant that appears deficient in contiguous specter of thrombophilia-related pregnancy complications culminating more frequently in miscarriage in a maternal M2 carrier background.

  10. A RARE CASE OF FACTOR V LEIDEN MUTATION COMPLICATING PREGNANCY IN INDIA

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    Chitra

    2016-05-01

    Full Text Available Factor V Leiden mutation (Factor V Leiden is an autosomal dominant haemostatic disorder that predisposes affected persons to venous thromboembolic events (VTE. Although the mutation causing FVL is easily diagnosed using molecular DNA techniques, (1 patients who are heterozygous for this disorder often remain asymptomatic until they develop a concurrent prothrombotic condition. Pregnancy, which may increase an individual woman’s risk of venous thromboembolic events by 5- to 6-fold. (2 Because there are potentially serious effects of FVL for both the mother and the child, and availability of effective treatment strategies, early detection and treatment of this condition is warranted. (3 We are presenting this case in order to emphasise the existence of Factor V Leiden in Indian population and its approach during pregnancy.

  11. Sigmoid volvulus complicating pregnancy

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    De Utpal

    2005-07-01

    Full Text Available Sigmoid volvulus complicating pregnancy is an extremely rare complication with fewer than 76 cases reported in literature. We report a case of sigmoid volvulus complicating pregnancy. The sigmoid colon was resected and Hartman′s colostomy was performed. The patient had a successful recovery. Aggressive resuscitation followed by early surgical intervention should be undertaken to reduce maternal and fetal morbidity and mortality.

  12. Identification and mapping stripe rust resistance gene YrLM168a using extreme individuals and recessive phenotype class in a complicate genetic background.

    Science.gov (United States)

    Feng, Junyan; Chen, Guoyue; Wei, Yuming; Liu, Yaxi; Jiang, Qiantao; Li, Wei; Pu, Zhien; Lan, Xiujin; Dai, Shoufen; Zhang, Min; Zheng, Youliang

    2015-12-01

    The identification and characterization of resistance genes effective against stripe rust of wheat is beneficial for modern wheat breeding programs. Molecular markers to such genes facilitate their deployment. The variety Milan has resistance that is effective against the predominant stripe rust races in the Sichuan region. Two resistant and two susceptible F8 lines from a cross between Milan and the susceptible variety Chuannong 16 were used to investigate inheritance of the Milan resistance. Three F2 populations were developed from crosses between the resistant lines and their susceptible sibling lines (LM168a × LM168c, LM168c × LM168a, LM168b × LM168d) and used for genetic analysis and molecular mapping of the genes for resistance. The stripe rust resistance in LM168a and LM168b was conferred by a single dominant gene, temporarily designated as YrLM168a. Forty-five extreme susceptible plants from the F2 families of LM168d × LM168b were genotyped with 836 simple sequence repeat (SSR) markers to map YrLM168a. YrLM168a was mapped in chromosome 6BL. The nearest flanking markers Xwmc756 and Xbarc146 were 4.6 and 4.6 cM away from the gene at both sides, respectively. The amplification results of twenty extreme resistant (IT 0) and susceptible (IT 4) F2 plants of LM168c × LM168a and LM168a × LM168c with marker Xwmc756 further validated the mapping results. The study suggested that extreme individuals and recessive phenotype class can be successfully used for mapping genes, which should be efficient and reliable. In addition, the flanking markers near YrLM168a should be helpful in marker-assisted breeding.

  13. [Risk factors of upper gastrointestinal complications in outpatients on antiplatelet therapy: description and management].

    Science.gov (United States)

    Ducrocq, G; Bigard, M-A; Marouene, S; Delaage, P-H; Fabry, C; Barthelemy, P; Steg, P-G

    2012-08-01

    Patients on antiplatelet therapy have a gastrointestinal bleeding risk. It is increased by risk factors. The frequency of those risk factors, the prevalence of upper digestive symptoms and their management in patients on antiplatelet agents is unknown. We performed an observational multi-centred prospective survey among 560 French cardiologists with private practice. Each cardiologist completed a questionnaire for the first four patients treated with antiplatelet agents in primary or secondary prevention. Among the 2182 patients included, (age = 67 ± 11 years; 74% male), 83% had at least one gastrointestinal bleeding risk factor and 38.9% had a history of upper digestive tract symptom. A history of gastrointestinal bleeding was reported in 3.4% and a history of documented gastro-duodenal ulcer in 5.5%. A proton pump inhibitor was already prescribed in 39% of the patients. At the time of the consultation, upper digestive symptoms were described in 21% of the patients. In those patients with symptoms, 85% had no modification in antiplatelet therapy and 62.7% were prescribed gastro-protective drugs (proton pump inhibitors: 51.8%, H(2)-blockers 3.6% other anti-acid medication: 7.3%). Among patients on antiplatelet agents, the prevalence of upper digestive symptoms and risk factors for gastrointestinal bleeding is high. Preventative management needs to be clarified in this population. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  14. Predictive factors of in-hospital mortality and of severe perioperative complications in myocardial revascularization surgery

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    Almeida Fernanda Fuscaldi

    2003-01-01

    Full Text Available OBJECTIVE: To investigate preoperative predictive factors of severe perioperative intercurrent events and in-hospital mortality in coronary artery bypass graft (CABG surgery and to develop specific models of risk prediction for these events, mainly those that can undergo changes in the preoperative period. METHODS: We prospectively studied 453 patients who had undergone CABG. Factors independently associated with the events of interest were determined with multiple logistic regression and Cox proportional hazards regression model. RESULTS: The mortality rate was 11.3% (51/453, and 21.2% of the patients had 1 or more perioperative intercurrent events. In the final model, the following variables remained associated with the risk of intercurrent events: age superscript three 70 years, female sex, hospitalization via SUS (Sistema Único de Saúde - the Brazilian public health system, cardiogenic shock, ischemia, and dependence on dialysis. Using multiple logistic regression for in-hospital mortality, the following variables participated in the model of risk prediction: age superscript three 70 years, female sex, hospitalization via SUS, diabetes, renal dysfunction, and cardiogenic shock. According to the Cox regression model for death within the 7 days following surgery, the following variables remained associated with mortality: age superscript three 70 years, female sex, cardiogenic shock, and hospitalization via SUS. CONCLUSION: The aspects linked to the structure of the Brazilian health system, such as factors of great impact on the results obtained, indicate that the events investigated also depend on factors that do not relate to the patient's intrinsic condition.

  15. Predictive factors of in-hospital mortality and of severe perioperative complications in myocardial revascularization surgery

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    Fernanda Fuscaldi Almeida

    2003-01-01

    Full Text Available OBJECTIVE: To investigate preoperative predictive factors of severe perioperative intercurrent events and in-hospital mortality in coronary artery bypass graft (CABG surgery and to develop specific models of risk prediction for these events, mainly those that can undergo changes in the preoperative period. METHODS: We prospectively studied 453 patients who had undergone CABG. Factors independently associated with the events of interest were determined with multiple logistic regression and Cox proportional hazards regression model. RESULTS: The mortality rate was 11.3% (51/453, and 21.2% of the patients had 1 or more perioperative intercurrent events. In the final model, the following variables remained associated with the risk of intercurrent events: age ³ 70 years, female sex, hospitalization via SUS (Sistema Único de Saúde - the Brazilian public health system, cardiogenic shock, ischemia, and dependence on dialysis. Using multiple logistic regression for in-hospital mortality, the following variables participated in the model of risk prediction: age ³ 70 years, female sex, hospitalization via SUS, diabetes, renal dysfunction, and cardiogenic shock. According to the Cox regression model for death within the 7 days following surgery, the following variables remained associated with mortality: age ³ 70 years, female sex, cardiogenic shock, and hospitalization via SUS. CONCLUSION: The aspects linked to the structure of the Brazilian health system, such as factors of great impact on the results obtained, indicate that the events investigated also depend on factors that do not relate to the patient's intrinsic condition.

  16. Lead Burden as a Factor for Higher Complication Rate in Patients With Implantable Cardiac Devices

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    Christopher Kolibash

    2015-01-01

    Full Text Available Purpose: Lead revisions have increased over the last decade. Patients who do not undergo lead extraction face an increased lead burden. Consequences of increased lead burden have not been fully defined. We sought to characterize the complication rate and outcomes in patients with sterile redundant leads. Methods: We retrospectively reviewed 242 consecutive patients [mean age 74 ± 12 years; 66.9% male] who underwent lead revision that resulted in an abandoned lead from January 2005 to June 2010. Patients were placed in a cohort based on number of leads after last recorded procedure (Group A: ≤2 [n=58]; Group B: 3-4 [n=168]; Group C: ≥5 [n=16]. Prespecified inhospital and long-term follow-up events were compared. Mortality rates were obtained from Social Security Death Index. Median follow-up was 2 years. Results: Baseline age, gender and race demographics were similar among the three groups. Increasing lead burden was associated with more adverse periprocedural events (A: 3.4%, B: 10.1%, C: 25.0%; P=0.031 and long-term device-related events (A: 1.7%, B: 13.0%, C: 18.8%; P=0.031. Device-related readmissions increased in frequency as lead burden increased (A: 3.5%, B: 18.5%, C: 37.5%; P=0.002. Combined periprocedural and late events also increased with more redundant leads (A: 5.2%, B: 23.2%, C: 44.0%; P=0.001. Total major events were infrequent (3.3%. There was no procedure-related mortality. Long-term all-cause mortality was not significantly different (A: 17.2%, B: 23.8%, C: 25.0%; P=0.567. Conclusions: Greater lead burden was associated with increased number of periprocedural and long-term minor events. It did not significantly impact major events or mortality.

  17. Ventriculoperitoneal shunt complications in hydrocephalus patients with intracranial tumors: an analysis of relevant risk factors.

    Science.gov (United States)

    Reddy, G Kesava; Bollam, Papireddy; Caldito, Gloria; Willis, Brian; Guthikonda, Bharat; Nanda, Anil

    2011-06-01

    Patients with intracranial tumors are predisposed to persistent hydrocephalus, often requiring a permanent CSF diversion procedure with shunts. This study reviews the long-term experience with ventriculoperitoneal shunts for the management of hydrocephalus in patients with intracranial tumors. Patients with intracranial tumors who underwent ventriculoperitoneal shunt placement for hydrocephalus from October 1990 to October 2009 were included in this study. During the 19-year period, medical charts, operative reports, imaging studies, and clinical follow- up evaluations were reviewed and analyzed retrospectively for all patients. A total of 187 intracranial tumor patients with hydrocephalus were included. The median follow up was 391 days. Malignant tumors were present in 40% of the patients. Overall shunt failure was 27.8%. Single shunt revision occurred in 13% of the patients and 14% had multiple shunt revision. Tumor histology, age and a procedure prior to shunt placement (ventriculostomy/Ommaya reservoirs) were significantly associated with the shunt revisions. Shunt system replacement and proximal shunt complication were significantly attributed to multiple shunt revisions. The overall shunt revision within 3 months, 6 months, 1 year and 5 years was 17.7%, 18.7%, 19.8% and 24.1%, respectively. The results of the study demonstrate that VP shunting is an effective for the management of hydrocephalus in patients with intracranial tumors. The overall incidence of shunt revision was 27.8%. Age, tumor histology, and a procedure prior to shunt placement (ventriculostomy/Ommaya reservoirs) were significantly associated with the shunt revisions. Additional studies using minimally invasive techniques are being explored for the management of hydrocephalus in patients with intracranial tumors.

  18. Factors Associated with Complications in Older Adults with Isolated Blunt Chest Trauma

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    Lotfipour, Shahram

    2009-05-01

    Full Text Available OBJECTIVE: To determine the prevalence of adverse events in elderly trauma patients with isolated blunt thoracic trauma, and to identify variables associated with these adverse events.METHODS: We performed a chart review of 160 trauma patients age 65 and older with significant blunt thoracic trauma, drawn from an American College of Surgeons Level I Trauma Center registry. Patients with serious injury to other body areas were excluded to prevent confounding the cause of adverse events. Adverse events were defined as acute respiratory distress syndrome or pneumonia, unanticipated intubation, transfer to the intensive care unit for hypoxemia, or death. Data collected included history, physical examination, radiographic findings, length of hospital stay, and clinical outcomes.RESULTS: Ninety-nine patients had isolated chest injury, while 61 others had other organ systems injured and were excluded. Sixteen patients developed adverse events [16.2% 95% confidence interval (CI 9.5-24.9%], including two deaths. Adverse events were experienced by 19.2%, 6.1%, and 28.6% of those patients 65-74, 75-84, and >/=85 years old, respectively. The mean length of stay was 14.6 days in patients with an adverse event and 5.8 days in patients without. Post hoc analysis revealed that all 16 patients with an adverse event had one or more of the following: age >/=85, initial systolic blood pressure <90 mmHg, hemothorax, pneumothorax, three or more unilateral rib fractures, or pulmonary contusion (sensitivity 100%, CI 79.4-100%; specificity 38.6%, CI 28.1-49.9%.CONCLUSION: Adverse events from isolated thoracic trauma in elderly patients complicate 16% of our sample. These criteria were 100% sensitive and 38.5% specific for these adverse events. This study is a first step to identifying variables that might aid in identifying patients at high risk for serious adverse events.

  19. Predictive factors for reintubation following noninvasive ventilation in patients with respiratory complications after living donor liver transplantation.

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    Yuichi Chihara

    Full Text Available BACKGROUND: Postoperative respiratory complications are a major cause of mortality following liver transplantation (LT. Noninvasive ventilation (NIV appears to be effective for respiratory complications in patients undergoing solid organ transplantation; however, mortality has been high in patients who experienced reintubation in spite of NIV therapy. The predictors of reintubation following NIV therapy after LT are not exactly known. METHODS: Of 511 adult patients who received living-donor LT, data on the 179 who were treated by NIV were retrospectively examined. RESULTS: Forty-three (24% of the 179 patients who received NIV treatment required reintubation. Independent factors associated with reintubation by multivariate logistic regression analysis were controlled preoperative infections (odds ratio [OR] 8.88; 95% confidence interval (CI 1.64 to 48.11; p = 0.01, ABO-incompatibility (OR 4.49; 95% CI, 1.50 to 13.38; p = 0.007, and presence of postoperative pneumonia at the time of starting NIV (OR 3.28; 95% CI, 1.02 to 11.01; p = 0.04. The reintubated patients had a significant higher rate of postoperative infectious complications and a significantly longer intensive care unit stay than those in whom NIV was successful (p<0.0001. Of the 43 reintubated patients, 22 (51.2% died during hospitalization following LT vs. 8 (5.9% of the 136 patients in whom NIV was successful (p<0.0001. CONCLUSIONS: Because controlled preoperative infection, ABO-incompatibility or pneumonia prior to the start of NIV were independent risk factors for reintubation following NIV, caution should be used in applying NIV in patients with these conditions considering the high rate of mortality in patients requiring reintubation following NIV.

  20. A STUDY OF THE CLINICAL MANIFESTATIONS, BIOCHEMICAL FINDINGS, PRECIPITATING FACTORS AND COMPLICATIONS IN 56 EPISODES OF DIABETIC KETOACIDOSIS

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    M. Rafii

    1998-03-01

    Full Text Available Fifty six episodes of DKA occurred in 33 patients during the period between 1998 -96. These patients were admitted and treated in Bahrami children hospital, a Tehran University teaching medical center. The most frequent clinical manifestations consisted of polyuria and polydipsia (66%, nausea and vomiting (64%, reduction in consciousness (53%, and Kussmaul respiration (53.5%. 54.6% of DKA episodes showed a pH below 7.1. There was a relationship between the severity of acidosis and the time needed for its correction. Complications during treatment appeared in 47.5% of DKA attacks, hypokalemia (18.8%, hyperkalemia (16% , hypoglycemia (10% were the most common. No brain edema or death occurred in our patients. The most common precipitating factors of DKA include unavailability of insulin or syringes (39.4%, infections (32%, and unknown causes (28.6%. The patients were divided in two different groups. The first group experienced 31 episodes of DKA in known patients suffering from diabetes mellitus and receiving insulin treatment. 25 episodes of DKA occurred in the second group with no previous history of diabetes; of interest is the finding that in 75% of recurrent attacks in group 1, the unavailability of insulin or syringes was the precipitating factor. The clinical, laboratory and complications of these two groups of patients were studied and the results obtained were compared with similar studies in other countries.

  1. Vertebral subluxation during three-column osteotomy in surgical correction of adult spine deformity: incidence, risk factors, and complications.

    Science.gov (United States)

    Qiao, Jun; Xiao, Lingyan; Sun, Xu; Shi, Benlong; Liu, Zhen; Xu, Leilei; Zhu, Zezhang; Qian, Bangping; Qiu, Yong

    2017-08-24

    To investigate incidence, risk factors, and complications of vertebral subluxation (VS) during three-column osteotomy in surgical correction of adult spine deformity. Adult spine deformity patients who underwent three-column osteotomies including VCR, PSO, and other modified types from March 2000 to December 2014 in our center were retrospectively reviewed. The following parameters were measured pre- and postoperatively: Cobb angle of main curve, global kyphosis, sagittal vertical axis, and kyphosis flexibility. Radiographic parameters between groups (VCR vs. PSO and subluxation vs. non-subluxation) were compared. 171 ASD patients were recruited, 18 of which (10.5%) developed sagittal vertebral subluxation at the osteotomy site. 5 of 18 patients (27.8%) developed neurological complications after surgery. For these five patients, two patients got partial recovery, and three got complete recovery at 2-year follow-up. 116 patients underwent PSO, 12 of which (10.3%) developed sagittal vertebral subluxation. In 55 patients receiving VCR, 6 (10.9%) developed sagittal vertebral subluxation. No significant difference was noted between the two groups (P > 0.05). The mean age of VS group was larger than that of non-VS group (46.2 vs. 34.2, P column osteotomies, one-fourth of which would develop neurological deficits. Older age, rigid kyphosis, and the pre-existence of VS were risk factors for developing VS.

  2. Multivariate analysis of perioperative risk factors associated with postoperative pulmonary complications in elder patients undergoing upper abdominal surgery

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    Wen-bing LI

    2011-06-01

    Full Text Available Objective To explore the correlation between the perioperative risk factors and postoperative pulmonary complications(POPC in elder patients undergoing upper abdominal surgery.Methods A retrospective survey of 169 elder patients(age over 60 years,received elective upper abdominal surgery under general anesthesia from Jan.1,2006 to Jan.1,2010 was conducted.The perioperative factors influencing respiratory function were evaluated,including clinical manifestations,chest X-ray,pulmonary function,arterial blood gas analysis,duration of anesthesia,incision type,duration of nasogastric tube and ambulation time.Meanwhile,the relationship between POPC and the factors mentioned above was analyzed.Results POPC were seen to occur in 77 of the 169 patients(45.6%,and the most common complication was pneumonia(20 cases,followed by atelectasis(18 cases,tracheobronchitis or acute exacerbations of chronic bronchitis(17 cases,bronchospasm(15 cases,acute respiratory failure(5 cases and pulmonary embolism(2 cases.Multivariate logistic analysis showed that the postoperative nasogastric intubation,preoperative respiratory symptoms,decreased forced expiratory volume in 1st second/forced vital capacity(FEV1/FVC and longer duration of anesthesia were the valuable risk factors for prediction of POPC.Conclusions It is recommend that a detailed preoperative pulmonary examination and pulmonary function test in elder patients who are going to have upper abdominal surgery should be done to identify the risk for POPC.Preoperative intervention therapy may be helpful to improve pulmonary function,decrease the incidence of POPC and lower mortality of the patients.

  3. Incidence and risk factors of infections complications related to implantable venous-access ports

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    Shim, Ji Sue; Seo, Tae Seok; Song, Myung Gyu; Cha, In Ho; Kim, Jun Suk; Choi, Chul Won; Seo, Jae Hong; Oh, Sang Cheul [Korea University Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2014-08-15

    The purpose of this study was to determine the incidence and risk factors of infections associated with implantable venous access ports (IVAPs.) From August 2003 through November 2011, 1747 IVAPs were placed in our interventional radiology suite. One hundred forty four IVAPs were inserted in patients with hematologic malignancy and 1603 IVAPs in patients with solid tumors. Among them, 40 ports (23 women and 17 men; mean age, 57.1 years; range, 13-83) were removed to treat port-related infections. We evaluated the incidence of port-related infection, patient characteristics, bacteriologic data, and patient progress. Univariable analyses (t test, chi-square test, and Fisher's exact test) and multiple logistic regression analyses were used to determine the risk factors for IVAP related infection. Overall, 40 (2.3%) of 1747 ports were removed for symptoms of infection with an incidence rate of 0.067 events/1000 catheter-days. According to the univariable study, the incidences of infection were seemingly higher in the patients who received the procedure during inpatient treatment (p = 0.016), the patients with hematologic malignancy (p = 0.041), and the patients receiving palliative chemotherapy (p = 0.022). From the multiple binary logistic regression, the adjusted odds ratios of infection in patients with hematologic malignancies and those receiving palliative chemotherapy were 7.769 (p = 0.001) and 4.863 (p = 0.003), respectively. Microorganisms were isolated from 26 (65%) blood samples, and two of the most causative organisms were found to be Staphylococcus (n = 10) and Candida species (n = 7). The underlying hematologic malignancy and the state of receiving palliative chemotherapy were the independent risk factors of IVAP-related infection.

  4. Age-related vessel calcification at distal extremities is a risk factor of osteoporosis

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    Ling Qin

    2014-01-01

    Full Text Available We conducted a cohort study to investigate if the vessel calcifications (VCs found in the distal extremities are an index of low bone mass at multiskeletal sites. A total of 332 healthy women aged 41–80 years were recruited for bone mineral content (BMC and bone mineral density measurement using peripheral quantitative computed tomography (pQCT and dual-energy X-ray absorptiometry (DXA. Seven percent of the women showed VC at both upper and lower distal extremities based on pQCT images. Women who had VC were then compared with their age-matched non-VC counterparts. Results showed that peripheral VC was mainly formed at distal lower extremities, and the prevalence of VC increased with advancing age, with 0%, 5.6%, 9.3%, and up to 34.5% in the age groups of 41–50 years, 51–60 years, 61–70 years, and 71–80 years, respectively. Compared with the control group, the VC group showed a significantly higher body mass index (25.2 vs. 23.2, p < 0.01, lower BMC at the spine (27.4 g vs. 31.3 g, p < 0.05, and lower BMC (1.8 g vs. 2.0 g, p < 0.05 and bone mineral density (0.57 g/cm2 vs. 0.66 g/cm2, p < 0.05 at the hip as measured by DXA. The diagnosis of VC in the distal extremities by pQCT increased the diagnosis sensitivity of osteoporosis by 50%. The significance of our findings imply that in clinical settings using pQCT for bone assessment and identification of patients with VC in the distal extremities, patients should also be referred for central DXA measurement at the femoral neck for diagnosis of osteoporosis as well as further assessment of vascular disorders.

  5. 117 例极低和超低出生体重儿并发症及结局分析%Complications and outcomes of 117 cases of extremely low birth weight and very low birth weight

    Institute of Scientific and Technical Information of China (English)

    曾军安; 李占魁; 李清红; 邓科委

    2015-01-01

    目的 了解极低出生体重儿( VLBWI)和超低出生体重儿( ELBWI)常见并发症及影响预后的相关因素,为提高极早早产儿救治水平提供参考. 方法 选择西北妇女儿童医院新生儿重症监护病房(NICU)2014年1月1日至12月31日收治的117例VLBWI和ELBWI,根据预后情况分为预后良好组和预后不良组,对其临床资料进行整理和统计分析. 结果 117例患儿中治愈或好转(预后良好)89例(76.1%),放弃治疗或死亡(预后不良)28例(23.9%). VLBWI和ELBWI主要并发症发生率前6位依次是:呼吸窘迫综合征(53.0%),早产儿贫血(50.4%),颅内出血(45.3%),败血症(早发型和晚发型)(36.8%),病理性黄疸(34.2%),呼吸暂停(27.4%). 预后良好组与预后不良组相比较,胎龄较大(t=3.56,P<0.05)、出生体重较重(t=5.30,P<0.05),产时窒息、妊娠期高血压疾病、妊娠糖尿病、肺出血、先天畸形和机械通气率较低(χ2 值分别为4.92、10.73、11.36、5.13、8.79、6.78,均P<0.05). 结论 VLBWI和ELBWI易出现各种并发症,严重并发症及母孕期疾病易导致患儿死亡,并影响家属救治信心,导致预后不良发生,因此,要加强围产期保健,并加强对其并发症的认识,进行及时有效的处理,尽量减少这类患儿的病死率.%Objective To investigate the common complications of very low birth weight infant ( VLBWI) and extremely low birth weight infant ( ELBWI) and related factors influencing prognosis, so as to provide reference for improving the level of treating very preterm infants.Methods From January 1 to December 31 in 2014, totally 117 VLBWIs and ELBWIs treated in neonatal intensive care unit (NICU) of Northwest Women and Children' s Hospital were divided into good prognosis group and poor prognosis group according to prognosis.All these clinical data were collected and analyzed.Results Eighty-nine cases ( 76.1%) were cured or improved ( good prognosis) and 28 cases (23.9%) gave up or died (poor diagnosis

  6. The biological factors influence on the conversion of mineral components of Extremely Arid Desert Soils (Kazakhstan)

    Science.gov (United States)

    Kutovaya, Olga; Vasilenko, Elena; Lebedeva, Marina; Tkhakakhova, Azida

    2013-04-01

    Extremely arid soils of stony deserts (hamadas) along the southern periphery of the Ili Depression are considered to be analogous to extremely arid soils of Mongolia, also named as "ultra-arid primitive gray-brown soils." In general, the morphology of extremely arid soils of hamadas in the Ili Depression is similar to that of the soils of stony deserts in other parts of the world, including the Gobi, Atacama, and Tarim deserts. The diagnostics of the active communities of microorganisms were performed according to the method of Rybalkina-Kononenko. The exact identification of the living forms of microorganisms to the species level is not always possible with the use of this method. However, it allows us to study the physiological role of the microorganisms and their ecological functions, including the relationships with the soil matrix and other organisms. In particular, it is possible to estimate the contribution of the microorganisms to the transformation of mineral soil components. The obtained materials allow us to conclude that the extremely arid desert soils are characterized by the very high biological activity during short periods of the increased soil moistening after rare and strong rains. The diversity of living forms is very considerable; both prokaryotes (cyanobacteria, actinomycetes, and iron bacteria) and protists (green algae, diatoms, and dinoflagellates) are developed in the soil. Thus, during a short period after the rains, these microorganisms pass from the stage of anabiosis to the stage of active growth and reproduction. Then, upon drying of the soil, the biotic activity of the soil slows down and, finally, terminates. The organisms remain in the state of anabiosis until the next rain. During the period of active growth, the microorganisms compose a specific consortium of different species and exert a profound impact on the soil properties. They participate in the transformation of the soil minerals with the formation of amorphous substances

  7. Regional anesthesia for an upper extremity amputation for palliative care in a patient with end-stage osteosarcoma complicated by a large anterior mediastinal mass.

    Science.gov (United States)

    Hakim, Mumin; Burrier, Candice; Bhalla, Tarun; Raman, Vidya T; Martin, David P; Dairo, Olamide; Mayerson, Joel L; Tobias, Joseph D

    2015-01-01

    Tumor progression during end-of-life care can lead to significant pain, which at times may be refractory to routine analgesic techniques. Although regional anesthesia is commonly used for postoperative pain care, there is limited experience with its use during home hospice care. We present a 24-year-old male with end-stage metastatic osteosarcoma who required anesthetic care for a right-sided above-the-elbow amputation. The anesthetic management was complicated by the presence of a large mediastinal mass, limited pulmonary reserve, and severe chronic pain with a high preoperative opioid requirement. Intraoperative anesthesia and postoperative pain management were provided by regional anesthesia using an interscalene catheter. He was discharged home with the interscalene catheter in place with a continuous local anesthetic infusion that allowed weaning of his chronic opioid medications and the provision of effective pain control. The perioperative applications of regional anesthesia in palliative and home hospice care are discussed.

  8. Factores relevantes en complicaciones de fracturas mandibulares: Relato de 5 años Factors relevant to mandibular fracture complications: A 5-year experience

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    E. Serena Gómez

    2009-04-01

    Full Text Available Objetivo: Este estudio ayudará a comprender factores relevantes y su relación con complicaciones post-operatorias en pacientes con tratamiento de fracturas mandibulares. Diseño de estudio: Para el estudio fueron obtenidos datos de pacientes atendidos en un periodo de cinco años por el Área de Cirugía y Traumatología Buco-Maxilofacial de la Facultad de Odontología de Piracicaba, UNICAMP, Brasil. Los datos relevantes de los pacientes en esta investigación fueron; edad, género, actividad económica, consumo de sustancias, etiología del trauma, demora de tratamiento de fractura, tipo de fractura mandibular, complicación post-operatoria y tratamiento a la complicación. Resultados: Un total de 472 pacientes presentaron fracturas mandibulares, de los cuales 54 pacientes (11,4% desarrollaron alguna complicación postoperatoria al tratamiento. En el grupo de pacientes con complicaciones postoperatorias, el género masculino predominó con 44 pacientes y la media de edad fue de 29,3 años de edad. En este grupo se presentaron sin actividad económica 35,2% de los pacientes y 33 (61% relataron abuso en sustancias nocivas a la salud. La agresión física fue la causa mas común (35,1%. Fracturas mandibulares múltiples fueron relatadas en 34 pacientes (62,9%. Infección se presento en 32 pacientes (59,2%. Tratamiento hospitalario para las complicaciones fue necesario para 30 pacientes (55,5%. Conclusiones: Actividad económica y demora en el tratamiento de fracturas mandibulares no fueron significantes en el desarrollo de complicaciones post-operatorias. Por otra parte, la severidad del trauma y el tipo de fractura, consideradamente pueden influir, así como el consumo de sustancias, que presentó una fuerte relación en la presencia de complicaciones.Objective: This study was made to determine the factors relevant to postoperative complications in patients treated for mandibular fracture. Study design: The study was based on the medical

  9. Proximal location in extremity long bones is a poor prognostic factor for osteosarcoma: A retrospective cohort study of 153 patients.

    Science.gov (United States)

    Cates, Justin M M; Schoenecker, Jonathan G

    2016-08-01

    Osteosarcomas arising in the proximal femur, humerus, and tibia appear to have poorer outcomes than those arising in distal long bones. However, the strength of this association is uncertain, particularly in light of other prognostic factors. Therefore, this retrospective cohort study was performed to compare patient outcomes between proximal and distal tumor location within extremity long bones. A total of 153 patients with conventional high-grade osteosarcoma of the extremity long bones, pelvis, or axial skeleton who had undergone neoadjuvant chemotherapy and surgical resection between 1985 and 2010 were identified in the Surgical Pathology files at Vanderbilt Medical Center. Effect of anatomic location within a proximal long bone was assessed using multivariable Cox proportional hazard regression. Proximal tumor location was a strong predictor of poor prognosis in univariate survival analysis. Multivariate regression analysis showed that after controlling for American Joint Committee on Cancer (AJCC) stage, histologic response to chemotherapy, surgical resection margin status, and histologic type, location in the proximal femur, tibia, and humerus were independent risk factors for death due to osteosarcoma, but not event-free survival. Osteosarcomas of the proximal extremity long bones are associated with decreased disease-specific survival compared to tumors of the distal long bones, even after accounting for other key prognostic covariates.

  10. Evaluation of risk factor and complication of umbilical cord prolapsed in cesarean section

    Directory of Open Access Journals (Sweden)

    Zahra Rezaee

    2015-03-01

    Full Text Available Objectives: Considering the rarity of umbilical cord prolapse (UCP and lack of accurate data about the risk factors and health outcomes, we aimed to evaluate cases of cesarean section (CS due to UCP in order to reduce treatment costs and provide information about the mortality and morbidity associated with this condition.Patients & Methods: Of 35,259 cases of CS performed in four hospitals during 2004-2012, 103 cases of UCP were selected as the case group; on the other hand, 318 cases without UCP were classified as the control group. Information was extracted from patients' records and analyzed by SPSS version 18. Results: Prevalence of UCP was estimated at 0.2%. In the case group, the active phase of labor was reported 1.4 times (81% vs 57%-P

  11. CHRONIC ENTERITIS IN PATIENTS UNDERGOING PELVIC RADIOTHERAPY: PREVALENCE, RISK FACTORS AND ASSOCIATED COMPLICATIONS.

    Science.gov (United States)

    Hernández-Moreno, Ana; Vidal-Casariego, Alfonso; Calleja-Fernández, Alicia; Kyriakos, Georgios; Villar-Taibo, Rocío; Urioste-Fondo, Ana; Cano-Rodríguez, Isidoro; Ballesteros-Pomar, María D

    2015-11-01

    Introducción: la radiacion de los tumores de la cavidad pelvica puede provocar mucositis a nivel intestinal. El objetivo de nuestro estudio fue determinar la prevalencia, los factores de riesgo y las complicaciones de la enteritis radica cronica en los pacientes tratados con radioterapia pelvica. Pacientes y métodos: estudio transversal sobre 150 pacientes tratados con radioterapia pelvica durante el ano 2008 debido a un cancer de prostata, cervix, endometrio o recto. Se interrogo a los pacientes sobre la presencia de sintomas sugestivos de enteritis y sobre cambios en el peso habitual y modificaciones en su dieta. Los parametros considerados como posibles factores de riesgo de enteritis cronica (sexo, edad, tratamiento antitumoral, enteritis aguda previa y tipo de tumor) se analizaron con metodos univariantes y multivariantes. Resultados: el estudio incluyo finalmente a 100 pacientes, el 84% varones, con una mediana de edad de 72,3 anos. Se encontro una prevalencia de enteritis radica cronica del 20%, en la mayoria de grado 1 (45%). Por otra parte, el 10% referian una perdida de peso ≥ 5 kg, el 3% habian requerido hospitalizacion debido a diarrea incoercible o a obstruccion intestinal, y el 11% habian modificado su patron de alimentacion habitual, reduciendo principalmente el consumo de verduras, legumbres y dulces. Se encontro asociacion entre la enteritis radica cronica y el sexo masculino, la edad, la enteritis radica aguda previa y la quimioterapia, pero solo esta resulto asociarse de forma independiente con el desarrollo de enteritis radica cronica despues del analisis multivariante (OR = 3,59 [95% CI 1,20–10,73]). Conclusión: la enteritis cronica es una entidad frecuente en los pacientes tratados con radioterapia pelvica, sobre todo cuando se asocia con quimioterapia. La tasa de complicaciones por esta patologia es baja, pero un numero importante de pacientes realiza modificaciones en su dieta habitual para aliviar o evitar la sintomatologia derivada

  12. Clinical complications in pregnant women with sickle cell disease: prospective study of factors predicting maternal death or near miss

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    Patrícia Santos Resende Cardoso

    2014-07-01

    Full Text Available OBJECTIVE: To evaluate complications in pregnant women with sickle cell disease, especially those leading to maternal death or near miss (severe obstetric complications. METHODS: A prospective cohort of 104 pregnant women registered in the Blood Center of Belo Horizonte (Hemominas Foundation was followed up at high-risk prenatal units. They belonged to Group I (51 hemoglobin SS and three hemoglobin S/ß0-thalassemia or Group II (49 hemoglobin SC and one hemoglobin S/ß+-thalassemia. Both groups had similar median ages. Predictive factors for 'near miss' or maternal death with p-value = 0.25 in the univariate analysis were included in a multivariate logistic model (significance set for p-value = 0.05. RESULTS: Group I had more frequent episodes of vaso-occlusive crises, more transfusions in the antepartum and postpartum, and higher percentage of preterm deliveries than Group II. Infections and painful crises during the postpartum period were similar in both the groups. The mortality rate was 4.8%: three deaths in Group I and two in Group II. One-third of the women in both the groups experienced near miss. The most frequent event was pneumonia/acute chest syndrome. Alpha-thalassemia co-inheritance and ß-gene haplotypes were not associated with near miss or maternal death. In multivariate analysis predictors of near miss or death were parity above one and baseline red blood cell macrocytosis. In Group I, baseline hypoxemia (saturation < 94% was also predictive of near miss or death. CONCLUSION: One-third of pregnant women had near miss and 4.8% died. Both hemoglobin SS and SC pregnant women shared the same risk of death or of severe complications, especially pulmonary events.

  13. Weight loss before a diagnosis of type 2 diabetes mellitus is a risk factor for diabetes complications.

    Science.gov (United States)

    Yang, Shanshan; Wang, Shuang; Yang, Bo; Zheng, Jinliang; Cai, Yuping; Yang, Zhengguo

    2016-12-01

    Our goal was to investigate the relationship between weight loss before a diagnosis of type 2 diabetes mellitus (T2DM) and diabetic complications among hospitalized patients with T2DM.We conducted a cross-sectional study and evaluated 347 and 642 hospitalized patients with T2DM who experienced and did not experienced weight loss before T2DM diagnosis, respectively. We used propensity score matching to reduce the confounding bias between the groups. In addition, a logistic regression analysis of the matched data was performed to evaluate the risk of diabetic complications.A total of 339 patients who experienced weight loss were matched to 339 patients who did not experience weight loss. After adjusting for age, gender, origin, occupation, smoking history, alcohol use, and duration of diabetes, the logistic regression analysis showed that compared with patients who did not experience weight loss, patients who lost ≤5 kg had a higher risk of diabetic nephropathy (DN) (odds ratio [OR]: 2.05, 95% confidence interval [CI]: 1.35-3.10) and diabetic retinopathy (OR: 1.79, 95% CI: 1.11-2.87). However, we did not observe a dose-response relationship in terms of weight loss.We found that weight loss before a diagnosis of T2DM might serve as a risk factor for DN and diabetic retinopathy. Our findings demonstrate that we should strengthen the management and prevention of complications in patients who experience weight loss of ≤5 kg prior to a T2DM diagnosis, particularly those who are centrally obese.

  14. Risk factors for amputation in extremities vascular injuries in Saudi Arabia

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    Al Wahbi A

    2016-05-01

    Full Text Available Abdullah Al Wahbi, Salman Aldakhil, Saud Al Turki, Abdulrahman El Kayali, Hussein Al Kohlani , Abdulaziz Al Showmer Department of Surgery, Division of Vascular Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia Abstract: Amputation is most closely associated with blunt, lower limb injuries associated with vascular trauma. These vascular injuries require a special attention to prevent life and limb loss. Patient outcomes can also be improved by organizing vascular trauma data into appropriate systems to facilitate future studies. Keywords: vascular injuries, extremities trauma, amputation, ischemia

  15. Renal Complications in Patients with Renal Infarction: Prevalence and Risk Factors

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    Jae Hyun Kwon

    2016-11-01

    Full Text Available Background/Aims: This study aimed to investigate the incidence and risk factors for acute kidney injury (AKI and chronic kidney disease (CKD in patients with renal infarction. Methods: A single-center retrospective study was conducted from January 2005 to December 2013. Baseline and clinical characteristics of the enrolled patients with renal infarction were evaluated and analyzed according to the presence of AKI and CKD. In particular, predictors for AKI and CKD were determined using logistic regression analysis. Results: Of the 105 patients included in present study, 41 (39.0% patients had AKI. A total of 80 patients were followed up for 2 years after hospital discharge. Among these patients, 27 (33.8% patients had CKD. In the multivariate analysis, the predictors were mean blood pressure (odds ratio [OR] 1.062, 95% confidence interval [CI] 1.015-1.112, p = 0.009 and bilateral involvement (OR 4.396, 95% CI 1.096-17.632, p = 0.037 for AKI, and AKI (OR 14.799, 95% CI 4.173-52.490, p Conclusions: Physicians should pay attention to the development of AKI and CKD after renal infarction and follow patients over a long term.

  16. [Factors related with post-surgical complications in elderly patients with glioblastoma multiforme].

    Science.gov (United States)

    Martin-Risco, M; Rodrigo-Paradells, V; Olivera-Gonzalez, S; Del Rio-Perez, C M; Bances-Florez, L; Calatayud-Perez, J B; Villagrasa-Compaired, F J

    2017-02-16

    Introduccion. El glioblastoma multiforme es el tumor maligno mas frecuente del sistema nervioso central, y su incidencia es del 80% en los mayores de 50 años. En los ultimos tiempos se ha producido un aumento en la esperanza de vida de la poblacion, y el analisis de las complicaciones posquirurgicas en pacientes de edad avanzada resulta de gran relevancia para una correcta indicacion quirurgica. Objetivo. Analizar factores relacionados con las complicaciones posquirurgicas en pacientes de edad avanzada. Pacientes y metodos. Se analizan retrospectivamente 88 pacientes diagnosticados de glioblastoma multiforme entre 31 y 78 años. Las variables estudiadas son: antecedentes personales, edad, estado funcional, estado preanestesico, caracteristicas tumorales, tipo de cirugia y complicaciones posquirurgicas. Resultados. Se observa una influencia de la edad en las complicaciones quirurgicas locales (p = 0,006) y sistemicas (p = 0,034) y en la escala de Clavien-Dindo (p = 0,001). Las personas con peor estado funcional y riesgo cardiovascular presentaron mas complicaciones sistemicas (p = 0,006 y 0,044) y peor graduacion en dicha escala (p = 0,024 y 0,025). Asimismo, hallamos mas complicaciones locales en las cirugias de exeresis que en las biopsias (p = 0,027). El estado preanestesico y los tratamientos antihemostaticos no se relacionaron con dichos eventos. Conclusiones. Los pacientes mayores de 65 años presentan una mayor incidencia de antecedentes patologicos y peor estado funcional prequirurgico. La edad, el riesgo cardiovascular, el estado funcional y el tipo de cirugia han aumentado de manera significativa las complicaciones posquirurgicas.

  17. Previous Preterm Birth and Current Maternal Complications as a Risk Factor of Subsequent Stillbirth

    Directory of Open Access Journals (Sweden)

    Boubakari Ibrahimou

    2015-01-01

    Full Text Available Purpose. To examine the association between previous preterm birth and the risk of stillbirth. Methods. This population-based retrospective cohort study analyzed live births and stillbirth records in Missouri (1989–1997. The main outcome of interest was stillbirth occurrence while the exposures were prior preterm birth. Adjusted odds ratios and 95% confidence intervals were computed using logistic regression. Results. Women who had a previous preterm birth have 63% increased odds of stillbirth in singleton pregnancies and 75% increased odds in twins as compared to those who did not have a preterm birth in a prior pregnancy (AOR = 1.63, 95% CI = 1.41–1.88 and AOR = 1.75, 95% CI = 1.20–2.56, respectively. The most significant risk factor for stillbirth in singleton pregnancies was uterine bleeding (AOR = 5.89, 95% CI = 5.13–6.76. In twin pregnancies, it was the condition hydramnios/oligohydramnios (AOR = 4.72, 95% CI = 3.70–6.02. Eclampsia was associated with a heightened risk of stillbirth in singletons (AOR = 2.45, 95% CI = 1.41–4.12, but not in twins (AOR = 0.96, 95% CI = 0.13–7.00. Black mothers were more likely than white to experience stillbirth (AOR = 2.10, 95% CI = 1.99–2.22 for singletons and AOR = 1.51, 95% CI = 1.27–1.79 for twins. Conclusion. Stillbirth is a vital public health issue and its etiology is not well understood. Previous history of preterm birth was found to be associated with future stillbirth. Targeted early medical and obstetric care and interventions among women with preterm birth history may potentially reduce the likelihood of stillbirth.

  18. Evaluation of risk factor and complication of umbilical cord prolapsed in cesarean section

    Directory of Open Access Journals (Sweden)

    Zahra Rezaee

    2015-03-01

    Full Text Available Objectives: Considering the rarity of umbilical cord prolapse (UCP and lack of accurate data about the risk factors and health outcomes, we aimed to evaluate cases of cesarean section (CS due to UCP in order to reduce treatment costs and provide information about the mortality and morbidity associated with this condition. Patients & Methods: Of 35,259 cases of CS performed in four hospitals during 2004-2012, 103 cases of UCP were selected as the case group; on the other hand, 318 cases without UCP were classified as the control group. Information was extracted from patients' records and analyzed by SPSS version 18. Results: Prevalence of UCP was estimated at 0.2%. In the case group, the active phase of labor was reported 1.4 times (81% vs 57%-P<0.00, engagement 8 times (14% vs 2% -P<0.001, transverse presentation 8 times (6% vs 2%-P<0.002, grand multiparity 3.9 times (4% vs 0-P<0.001, oligohydramnios 4.7 times (5% vs. 0-P<0.0001, and polyhydramnios 5.9 times (6% vs 0 - P<0.001. UCP was more prevalent in post-term deliveries (P<0.043. One-minute Apgar score < 7 was 3 times more prevalent in neonates of the case group (P<0.00. Prepartum vaginal bleeding was 4 times more common in the case group, compared to the control group; also, decreased fetal movement and heart rate drop were more prevalent in the case group. Mortality rate was 5.2% in the case group and 1.7% in the control group. Overall, the control group had a better general health at discharge, compared to the case group. Conclusion: A statistically significant correlation was detected between UCP and gestational age, active phase of labor, fetal presentation, engagement, parity, and amniotic fluid volume.

  19. Prognostic factors for transcatheter arterial chemoembolization in patients with hepatocellular carcinoma complicated by portal vein tumor thrombus

    Directory of Open Access Journals (Sweden)

    ZHANG Cheng

    2016-01-01

    Full Text Available ObjectiveTo investigate the therapeutic effect of transcatheter arterial chemoembolization (TACE in patients with hepatocellular carcinoma (HCC complicated by portal vein tumor thrombus, and to identify related prognostic factors. MethodsThe clinical data of 152 HCC patients with portal vein tumor thrombus who were admitted to Xijing Hospital of Fourth Military Medical University and received TACE from January 2006 to December 2010 were analyzed retrospectively. The occurrence of post-TACE liver failure, upper gastrointestinal bleeding, and post-embolization syndrome was observed, and survival data and prognostic factors were analyzed. The Kaplan-Meier method was used to calculate cumulative survival rate, the log-rank test was used for univariate analysis, and the Cox proportional hazards model was used for multivariate analysis. ResultsThe median survival time was 5.0 months, and the 6-, 12-, and 18-month cumulative survival rates were 37%, 18%, and 9%, respectively. Univariate analysis showed that tumor size, tumor type, involvement of both liver lobes, distant metastasis, and Child-Pugh class were the prognostic factors for TACE in HCC patients with portal vein tumor thrombus (χ2=5.108, 11.542, 6.036, 12.319, and 22.574, respectively, all P<0.05; multivariate analysis showed that tumor size, tumor type, distant metastasis, and Child-Pugh class were the independent prognostic factors (Wald values=11.243, 5.021, 7.651, and 25876, respectively, all P<0.05; Child-Pugh class was the only influencing factor for liver failure in HCC patients with portal vein tumor thrombus (P=0.015. ConclusionTACE is safe and effective in HCC patients with portal vein thrombus and good liver function. Tumor size, tumor type, distant metastasis, and Child-Pugh class are the main factors influencing survival, which provides a basis for clinicians to select appropriate interventional therapies.

  20. Regional anesthesia for an upper extremity amputation for palliative care in a patient with end-stage osteosarcoma complicated by a large anterior mediastinal mass

    Directory of Open Access Journals (Sweden)

    Hakim M

    2015-09-01

    Full Text Available Mumin Hakim,1 Candice Burrier,1 Tarun Bhalla,1 Vidya T Raman,1 David P Martin,1,2 Olamide Dairo,1 Joel L Mayerson,3,4 Joseph D Tobias1,2 1Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, 2Department of Anesthesiology and Pain Medicine, The Ohio State University, 3Department of Orthopedic Surgery, Nationwide Children's Hospital, 4Department of Orthopedic Surgery, The Ohio State University, Columbus, OH, USA Abstract: Tumor progression during end-of-life care can lead to significant pain, which at times may be refractory to routine analgesic techniques. Although regional anesthesia is commonly used for postoperative pain care, there is limited experience with its use during home hospice care. We present a 24-year-old male with end-stage metastatic osteosarcoma who required anesthetic care for a right-sided above-the-elbow amputation. The anesthetic management was complicated by the presence of a large mediastinal mass, limited pulmonary reserve, and severe chronic pain with a high preoperative opioid requirement. Intraoperative anesthesia and postoperative pain management were provided by regional anesthesia using an interscalene catheter. He was discharged home with the interscalene catheter in place with a continuous local anesthetic infusion that allowed weaning of his chronic opioid medications and the provision of effective pain control. The perioperative applications of regional anesthesia in palliative and home hospice care are discussed. Keywords: osteosarcoma, peripheral nerve block, palliative care

  1. Extreme thrombocytosis and cardiovascular surgery: risks and management.

    Science.gov (United States)

    Natelson, Ethan A

    2012-01-01

    Extreme thrombocytosis is a major risk factor for excessive bleeding and for thrombosis, either of which can complicate cardiovascular surgical and interventional procedures. Extreme thrombocytosis can also cause an unusual syndrome, erythromelalgia, that results in a type of chronic microvascular occlusive arterial disease. We present the differential diagnosis of conditions that may lead to extreme thrombocytosis, 3 cases (each of which illustrates a different potential complication), and a review of the pertinent medical literature. Correcting excessive thrombocytosis is typically not difficult, whether electively or acutely, and effective therapy usually controls thrombosis and excessive hemorrhage post-procedurally.

  2. Analysis of early respiratory complications on extremely low and very low birth weight infants%超低和极低出生体重儿早期呼吸系统并发症分析

    Institute of Scientific and Technical Information of China (English)

    余华娟

    2013-01-01

    目的探讨超低和极低出生体重儿早期呼吸系统并发症的发生情况。方法对2010年3月~2012年12月本院出生的129例超低和极低出生体重儿早期呼吸系统并发症进行临床分析。结果新生儿呼吸窘迫综合征(NRDS),呼吸暂停,肺部感染,气漏,支气管肺发育不良(BPD)3组间比较,差异有统计学意义(P<0.05),其中<1000 g组发生率最高,1250~1499 g组发生率最低。3组痊愈率比较,差异有统计学意义(P<0.05)。结论对超低和极低出生体重儿早期呼吸系统并发症进行密切监护和针对治疗,可提高患儿的成活率,提高生存质量。%Objective To investigate the occurrence of early respiratory complications on extremely low and very low birth weight infants. Methods Early respiratory complications of 129 cases with extremely low and very low birth weight infants born in our hospital from March 2010 to December 2012 were analyzed. Results There were significant differences in NRDS,apnea,pulmonary infection,gas leakage and BPD among the three groups(P<0.05).The incidence of the group with birth weight less than 1000 g was the highest,while the incidence of the group with birth weight ranged from 1250 g to 1499 g was the lowest.There was significant difference in the cure rate among the three groups(P<0.05). Concluson Close monitoring and corresponding treatment of early respiratory complications on extremely low and very low birth weight infants can improve the survival rate and life quality of infants.

  3. Factores pronósticos de complicaciones postoperatorias en el trasplante hepático Prognostic factors associated with postoperative complications in liver transplantation

    Directory of Open Access Journals (Sweden)

    A. Rodríguez-Ariza

    2008-03-01

    Full Text Available Objetivo: la evolución postoperatoria de los pacientes sometidos a trasplante hepático ortotópico (THO se encuentra frecuentemente asociada a la aparición de diversas complicaciones tales como disfunción renal, rechazo agudo, infecciones y complicaciones neurológicas. Estas complicaciones constituyen las causas más significativas de morbilidad y mortalidad tempranas en pacientes que reciben un THO. El propósito del presente estudio es la identificación de factores relacionados con las distintas complicaciones postoperatorias del THO. Diseño experimental: se llevó a cabo un estudio prospectivo. Pacientes: se analizaron 78 variables en 32 pacientes consecutivos sometidos a THO. Utilizando un análisis de regresión logística se identificaron aquellos factores asociados de forma independiente con la aparición de complicaciones postoperatorias. Resultados: el análisis multivariante demostró que los niveles pretrasplante en suero de malondialdehído y creatinina estaban asociados con el desarrollo de disfunción renal. Los niveles pretrasplante de hemoglobina y las unidades de plaquetas administradas durante la cirugía fueron factores pronósticos de infecciones. El rechazo agudo fue pronosticado por los niveles séricos de γ-glutamil transpeptidasa y de bilirrubina total. Los niveles pretrasplante de sodio y glutaredoxina en suero estuvieron asociados con complicaciones neurológicas. Conclusiones: proponemos estos marcadores para la identificación de pacientes de alto riesgo, permitiendo una vigilancia y/o tratamiento anticipados que mejorarán la morbilidad y la supervivencia en pacientes sometidos a THO.Objectives: the postoperative evolution of patients submitted to orthotopic liver transplant (OLT is frequently associated with the appearance of different types of complications such as renal failure, graft rejection, infections, and neurological disorders. These complications are the most significant causes of early morbidity

  4. Effect of dietary factors in pregnancy on risk of pregnancy complications: results from the Norwegian Mother and Child Cohort Study.

    Science.gov (United States)

    Meltzer, Helle Margrete; Brantsæter, Anne Lise; Nilsen, Roy M; Magnus, Per; Alexander, Jan; Haugen, Margareta

    2011-12-01

    There has been a thrilling development , as well as profound changes, in our understanding of the effect of fetal nutrition on the development and health of the child. The Norwegian Mother and Child Cohort Study (MoBa) is an ongoing nationwide population-based pregnancy cohort study that between 1999 and 2008 recruited 90,723 women with 106,981 pregnancies and 108,487 children. The objective of MoBa is to test specific etiologic hypotheses by estimating the association between exposures and diseases with a special focus on disorders that may originate in early life. An important aspect in this regard is maternal diet and nutritional status during pregnancy. Nutritional factors have long been considered to be important determinants of maternal and fetal health, and dietary information is currently being collected in a number of pregnancy cohorts in Europe and the United States. Thus far, pregnancy complications studied in MoBa are preterm birth, preeclampsia, and fetal growth; and the aim of this article is to report results of recently published studies of dietary factors in relation to these outcomes. Numerous studies are planned using MoBa data, and the aim is to add to the knowledge of the interplay between dietary factors, nonnutrients, and toxic dietary substances and epigenetic modulation on fetal development and health later in life.

  5. A Survey on Prevalence of Ocular Complications and It’s Risk Factors in Diabetic Patients of Diabetic Center of Nader Kazemi Clinic Shiraz- Iran 1998-2010

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    SM Kashfi

    2014-03-01

    Full Text Available Background & Objective: With respect to an increase in diabetes prevalence, and the likelihood of ocular complications among them, this study was conducted to investigate the prevalence and risk factors and incidence of the ocular complications in patients of Nader Kazemi, Shiraz Diabetic center from 1998 to 2010.Materials & Methods: In a cross sectional study , subjects were selected based on a systematic random sampling to investigate the incidence of the ocular complications and the influence of factors such as age, sex, types of diabetes, job, education, blood triglyceride (TG and cholesterol level, Family history of diabetes, history of hypertension, history of participation in educational classes, methods of treatment, duration of diabetes and fasting blood sugar were considered on them.Results: Ocular complications were found among 229 diabetic patients (32.6%. patients having type II diabetic have more ocular complications comparing with patients with type I diabetes (P<0. 005. Factors such as job (P=0. 022, history of participation in educational classes (P<0. 001, education (P<0. 001, family history of diabetes (P<0. 001, blood triglyceride (TG (P=0. 021, duration of diabetes(P<0. 001,age (P<0. 001, method of treatment(P<0. 001and fasting blood sugar (P<0. 001 had a significant relationship with the occurrence of ocular complication. However, other risk factors such as hypertension,gender and cholesterol levels were not statistically significant relationship with the occurrence of ocular complication.Conclusion: Given the prevalence of ocular complications, educating diabetics’ patients can have a significant influence in reducing the occurrence of ocular complications.

  6. Motor Performance as Risk Factor for Lower Extremity Injuries in Children

    DEFF Research Database (Denmark)

    Runge, Lisbeth; Kristensen, Peter Lund; Junge, Tina

    2016-01-01

    for distance, core stability tests, vertical jump, shuttle run, and a cardiorespiratory fitness test. Lower extremity injuries were registered by clinicians by weekly questionnaires and classified according to the ICD-10 system. RESULTS: Poor balance increased risk for traumatic injury in the foot region (IRR......=1.09-1.15), and good performance in single leg hop for distance protected against traumatic knee injuries (IRR=0.66-0.68). Good performance in core stability tests and vertical jump increased the risk for traumatic injuries in the foot region (IRR=1.12-1.16). Poor balance increased the risk...... for overuse injuries in the foot region (IRR=1.65), as did good performance in core stability tests and shuttle run, especially for knee injuries (IRR=1.07-1.18). CONCLUSIONS: Poor balance (sway) performance was a consistent predictor of traumatic injuries, in particular for traumatic ankle injuries. Good...

  7. [Molecular-cellular and hormonal mechanisms of induced brain tolerance of extreme factors].

    Science.gov (United States)

    Samoĭlov, M O; Rybnikova, E A

    2012-01-01

    This review includes results of own studies and literature data on the topical problem of neurobiology and medicine: discovery of the mechanisms of increased brain resistance to extreme exposures. The emphasis is made on the molecular-cellular and hormonal mechanisms of hypoxic preconditioning-induced brain tolerance to injurious hypoxia, psychoemotional and traumatic stress. A role of basic hormonal and intracellular cascade pro-adaptive processes mediating the neuroprotective action of hypoxic preconditioning is reviewed. A dynamics of the mechanisms of development of induced susceptible brain areas (hippocampus, neocortex) tolerance which includes phases of induction, transformation and expression, is presented. New data on preconditioning-induced cross-tolerance providing increased brain resistance not only to hypoxia but also to other stresses are reported. For the first time neuroprotective effects of hypoxic postconditioning are described.

  8. Clinical factors associated with extreme sleep apnoea [AHI>100 events per hour] in Peruvian patients: A case-control study–A preliminary report

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    Jorge Rey de Castro

    2015-01-01

    Conclusion: Our results suggest that arterial hypertension, neck circumference, and over 10% SatO2Hb≤90% in total sleep time were associated with a higher probability of Extreme OSA. We recommend investigators to study this population of Extreme OSA looking for an early diagnosis and the identification of prognostic factors in comparison with moderate to severe levels.

  9. Influence of different factors on risk of complications of tubal ligation surgery: Study of 1780 women admitted to 13 hospitals in Tehran

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    Sadat Hashemi SM

    2000-08-01

    Full Text Available Tubal ligation is one of the most effective and reliable methods of contraception and of successful program of birth control in Iran. Present study was done to evaluate factors affecting risk of complications during tubal ligation surgery. We studied 1780 women that had tubal ligation in 13 hospitals in Tehran during the years 1993-95. Data on operation were collected by questionnaire and analyzed using logistic regression method. Risk of complications was increased in women had had operation after vaginal therapy, in luteal phase, after cesarean section and in follicular phase, respectively. Modified pomery, pomery and parkland methods of operation were ascendingly related to increased risk of complications. Age, history of pelvic pain, method of anesthesia, incision size and time of operation were not significantly correlated with complications. Frequency of complications was higher in women that had other procedures during surgery. We suggest that tubal ligation be done after vaginal delivery and by modified pomery method.

  10. Risk Factors for Macro- and Microvascular Complications among Older Adults with Diagnosed Type 2 Diabetes: Findings from The Irish Longitudinal Study on Ageing.

    LENUS (Irish Health Repository)

    Tracey, Marsha L

    2016-01-01

    Objective. To explore risk factors for macro- and microvascular complications in a nationally representative sample of adults aged 50 years and over with type 2 diabetes in Ireland. Methods. Data from the first wave of The Irish Longitudinal Study on Ageing (TILDA) (2009-2011) was used in cross-sectional analysis. The presence of doctor diagnosis of diabetes, risk factors, and macro- and microvascular complications were determined by self-report. Gender-specific differences in risk factor prevalence were assessed with the chi-squared test. Binomial regression analysis was conducted to explore independent associations between established risk factors and diabetes-related complications. Results. Among 8175 respondents, 655 were classified as having type 2 diabetes. Older age, being male, a history of smoking, a lower level of physical activity, and a diagnosis of high cholesterol were independent predictors of macrovascular complications. Diabetes diagnosis of 10 or more years, a history of smoking, and a diagnosis of hypertension were associated with an increased risk of microvascular complications. Older age, third-level education, and a high level of physical activity were protective factors (p < 0.05). Conclusions. Early intervention to target modifiable risk factors is urgently needed to reduce diabetes-related morbidity in the older population in Ireland.

  11. The 2011 survey on hypertensive disorders of pregnancy (HDP in China: prevalence, risk factors, complications, pregnancy and perinatal outcomes.

    Directory of Open Access Journals (Sweden)

    Chun Ye

    Full Text Available Hypertensive disorders of pregnancy (HDP are a group of medical complications in pregnancy and also a risk factor for severe pregnancy outcomes, but it lacks a large-scale epidemiological investigation in recent years. This survey represents a multicenter cross-sectional retrospective study to estimate the prevalence and analyze the risk factors for HDP among the pregnant women who had referred for delivery between January 1st 2011 and December 31st 2011 in China Mainland. A total of 112,386 pregnant women were investigated from 38 secondary and tertiary specialized or general hospitals randomly selected across the country, of which 5,869 had HDP, accounting for 5.22% of all pregnancies. There were significant differences in the prevalence of HDP between geographical regions, in which the North China showed the highest (7.44% and Central China showed the lowest (1.23%. Of six subtypes of HDP, severe preeclampsia accounted for 39.96%, gestational hypertension for 31.40%, mild preeclampsia for 15.13%, chronic hypertension in pregnancy for 6.00%, preeclampsia superimposed on chronic hypertension for 3.68% and eclampsia for 0.89%. A number of risk factors for HDP were identified, including twin pregnancy, age of >35 years, overweight and obesity, primipara, history of hypertension as well as family history of hypertension and diabetes. The prevalence of pre-term birth, placental abruption and postpartum hemorrhage were significantly higher in women with HDP than those without HDP. The possible risk factors confirmed in this study may be useful for the development of early diagnosis and appropriate treatment of HDP.

  12. Resective surgery for liver tumor:a multivariate analysis of causes and risk factors linked to postoperative complications

    Institute of Scientific and Technical Information of China (English)

    Enrico Benzoni; Dario Lorenzin; Umberto Baccarani; Gian Luigi Adani; Alessandro Favero; Alessandro Cojutti; Fabrizio Bresadola; Alessandro Uzzau

    2006-01-01

    BACKGROUND: In spite of accurate selection of patients eligible for resection, and although advances in surgical techniques and perioperative management have greatly contributed to reducing the rate of perioperative deaths, stress must be placed on reducing the postoperative complication rates reported to be still as high as 50%. This study was designed to analyze the causes and foreseeable risk factors linked to postoperative morbidity on the grounds of data derived from a single-center surgical population. METHODS: From September 1989 to March 2005, 287 consecutive patients, affected either with HCC or liver metastasis, had liver resection at our department. Among the HCC series we recorded 98 patients (73.2%) in Child-Pugh class A, 32 (23.8%) in class B and 4 in class C (3%). In 104 colorectal metastases, 71% were due to colon cancer, 25% rectal, 3% sigmoid, and 1% anorectal. In 49 non-colorectal metastases, 22.4% were derived from breast cancer, 63.2% gastrointestinal tumors (excluding colon) and 14.4%other cancers. We performed 80 wedge resections, 77 bisegmentectomies and/or left lobectomies, 74 segmentectomies, 22 major hepatectomies, 20 left hepatectomies, and 14 trisegmentectomies. RESULTS: The in-hospital mortality rate in this series was 4.5%, and the morbidity rate was 47.7%, because of pleural effusion (30%), hepatic abscess (25%), hepatic insufifciency (19%), ascites (10%), hemoperitoneum (10%), or biliary ifstula (6%). The variables associated with the technical aspects of the surgical procedure that were responsible for the complications were: a Pringle maneuver length more than 20 minutes (P=0.001);the type of liver resection procedure, including major hepatectomy (P=0.02), left hepatectomy (P=0.04), trisegmentectomy (P=0.04), bisegmentectomy and/or left lobectomy (P=0,04);and a blood transfusion of more than 600 ml (P=0.04). CONCLUSION: The evaluation of causes and foreseeable risk factors linked to postoperative morbidity during the planning of

  13. Factors associated with upper extremity contractures after cervical spinal cord injury: A pilot study.

    Science.gov (United States)

    Hardwick, Dustin; Bryden, Anne; Kubec, Gina; Kilgore, Kevin

    2017-06-05

    To examine the prevalence of joint contractures in the upper limb and association with voluntary strength, innervation status, functional status, and demographics in a convenience sample of individuals with cervical spinal cord injury to inform future prospective studies. Cross-sectional convenience sampled pilot study. Department of Veterans Affairs Research Laboratory. Thirty-eight participants with cervical level spinal cord injury. Not applicable. Contractures were measured with goniometric passive range of motion. Every joint in the upper extremity was evaluated bilaterally. Muscle strength was measured with manual muscle testing. Innervation status was determined clinically with surface electrical stimulation. Functional independence was measured with the Spinal Cord Independence Measure III (SCIM-III). Every participant tested had multiple joints with contractures and, on average, participants were unable to achieve the normative values of passive movement in 52% of the joints tested. Contractures were most common in the shoulder and hand. There was a weak negative relationship between percentage of contractures and time post-injury and a moderate positive relationship between percentage of contractures and age. There was a strong negative correlation between SCIM-III score and percentage of contractures. Joint contractures were noted in over half of the joints tested. These joint contractures were associated with decreased functional ability as measured by the SCIM-III. This highlights the need the need for detailed evaluation of the arm and hand early after injury as well as continued monitoring of joint characteristics throughout the life course of the individual with tetraplegia.

  14. Effects of paternal and maternal lifestyle factors on pregnancy complications and perinatal outcome. A population-based birth-cohort study : the GECKO Drenthe cohort

    NARCIS (Netherlands)

    Mutsaerts, M. A. Q.; Groen, H.; Buiter-Van der Meer, A.; Sijtsma, A.; Sauer, P. J. J.; Land, J. A.; Mol, B. W.; Corpeleijn, E.; Hoek, A.

    2014-01-01

    Do paternal and maternal lifestyle factors influence the risk of hypertensive pregnancy complications, gestational diabetes mellitus (GDM), spontaneous preterm birth and small-for-gestational-age (SGA)? Paternal lifestyle factors do not exert an independent effect on the investigated outcomes while

  15. Effects of paternal and maternal lifestyle factors on pregnancy complications and perinatal outcome. A population-based birth-cohort study : the GECKO Drenthe cohort

    NARCIS (Netherlands)

    Mutsaerts, M. A. Q.; Groen, H.; Buiter-Van der Meer, A.; Sijtsma, A.; Sauer, P. J. J.; Land, J. A.; Mol, B. W.; Corpeleijn, E.; Hoek, A.

    Do paternal and maternal lifestyle factors influence the risk of hypertensive pregnancy complications, gestational diabetes mellitus (GDM), spontaneous preterm birth and small-for-gestational-age (SGA)? Paternal lifestyle factors do not exert an independent effect on the investigated outcomes while

  16. The Benefits of Including Clinical Factors in Rectal Normal Tissue Complication Probability Modeling After Radiotherapy for Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Defraene, Gilles, E-mail: gilles.defraene@uzleuven.be [Radiation Oncology Department, University Hospitals Leuven, Leuven (Belgium); Van den Bergh, Laura [Radiation Oncology Department, University Hospitals Leuven, Leuven (Belgium); Al-Mamgani, Abrahim [Department of Radiation Oncology, Erasmus Medical Center - Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Haustermans, Karin [Radiation Oncology Department, University Hospitals Leuven, Leuven (Belgium); Heemsbergen, Wilma [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Van den Heuvel, Frank [Radiation Oncology Department, University Hospitals Leuven, Leuven (Belgium); Lebesque, Joos V. [Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands)

    2012-03-01

    Purpose: To study the impact of clinical predisposing factors on rectal normal tissue complication probability modeling using the updated results of the Dutch prostate dose-escalation trial. Methods and Materials: Toxicity data of 512 patients (conformally treated to 68 Gy [n = 284] and 78 Gy [n = 228]) with complete follow-up at 3 years after radiotherapy were studied. Scored end points were rectal bleeding, high stool frequency, and fecal incontinence. Two traditional dose-based models (Lyman-Kutcher-Burman (LKB) and Relative Seriality (RS) and a logistic model were fitted using a maximum likelihood approach. Furthermore, these model fits were improved by including the most significant clinical factors. The area under the receiver operating characteristic curve (AUC) was used to compare the discriminating ability of all fits. Results: Including clinical factors significantly increased the predictive power of the models for all end points. In the optimal LKB, RS, and logistic models for rectal bleeding and fecal incontinence, the first significant (p = 0.011-0.013) clinical factor was 'previous abdominal surgery.' As second significant (p = 0.012-0.016) factor, 'cardiac history' was included in all three rectal bleeding fits, whereas including 'diabetes' was significant (p = 0.039-0.048) in fecal incontinence modeling but only in the LKB and logistic models. High stool frequency fits only benefitted significantly (p = 0.003-0.006) from the inclusion of the baseline toxicity score. For all models rectal bleeding fits had the highest AUC (0.77) where it was 0.63 and 0.68 for high stool frequency and fecal incontinence, respectively. LKB and logistic model fits resulted in similar values for the volume parameter. The steepness parameter was somewhat higher in the logistic model, also resulting in a slightly lower D{sub 50}. Anal wall DVHs were used for fecal incontinence, whereas anorectal wall dose best described the other two endpoints

  17. Associations between Distal Upper Extremity Job Physical Factors and Psychosocial Measures in a Pooled Study

    Directory of Open Access Journals (Sweden)

    Matthew S. Thiese

    2015-01-01

    Full Text Available Introduction. There is an increasing body of literature relating musculoskeletal diseases to both job physical exposures and psychosocial outcomes. Relationships between job physical exposure measures and psychosocial factors have not been well examined or quantified. These exploratory analyses evaluate relationships between quantified exposures and psychosocial outcomes. Methods. Individualized quantification of duration, repetition, and force and composite scores of the Strain Index (SI and the Threshold Limit Value for Hand Activity Level (TLV for HAL were compared to 10 psychosocial measures. Relationships and predicted probabilities were assessed using ordered logistic regression. Analyses were adjusted for age, BMI, and gender. Results and Discussion. Among 1834 study participants there were multiple statistically significant relationships. In general, as duration, repetition, and force increased, psychosocial factors worsened. However, general health and mental exhaustion improved with increasing job exposures. Depression was most strongly associated with increased repetition, while physical exhaustion was most strongly associated with increased force. SI and TLV for HAL were significantly related to multiple psychosocial factors. These relationships persisted after adjustment for strong confounders. Conclusion. This study quantified multiple associations between job physical exposures and occupational and nonoccupational psychosocial factors. Further research is needed to quantify the impacts on occupational health outcomes.

  18. Evaluating the Bulk Lorentz Factors of Outflow Material: Lessons Learned from the Extremely Energetic Outburst GRB 160625B

    Science.gov (United States)

    Wang, Yuan-Zhu; Wang, Hao; Zhang, Shuai; Liang, Yun-Feng; Jin, Zhi-Ping; He, Hao-Ning; Liao, Neng-Hui; Fan, Yi-Zhong; Wei, Da-Ming

    2017-02-01

    GRB 160625B is an extremely bright outburst with well-monitored afterglow emission. The geometry-corrected energy is high, up to ˜5.2 × 1052 erg or even ˜8 × 1052 erg, rendering it the most energetic GRB prompt emission recorded so far. We analyzed the time-resolved spectra of the prompt emission and found that in some intervals there were likely thermal-radiation components and the high energy emission was characterized by significant cutoff. The bulk Lorentz factors of the outflow material are estimated accordingly. We found out that the Lorentz factors derived in the thermal-radiation model are consistent with the luminosity-Lorentz factor correlation found in other bursts, as well as in GRB 090902B for the time-resolved thermal-radiation components, while the spectral cutoff model yields much lower Lorentz factors that are in tension with the constraints set by the electron pair Compton scattering process. We then suggest that these spectral cutoffs are more likely related to the particle acceleration process and that one should be careful in estimating the Lorentz factors if the spectrum cuts at a rather low energy (e.g., ˜tens of MeV). The nature of the central engine has also been discussed, and a stellar-mass black hole is favored.

  19. Evaluation of immediate breast reconstruction and radiotherapy: Factors associated with complications; Reconstruction mammaire immediate apres mastectomie suivie de radiotherapie: facteurs de risque de complications

    Energy Technology Data Exchange (ETDEWEB)

    Gross, E.; Cowen, D. [Departement de radiotherapie, hopital de la Timone, 13 - Marseille (France); Hannoun-Levi, J.M. [Departement de radiotherapie, centre Antoine-Lacassagne, 06 - Nice (France); Rouanet, P. [Departement de chirurgie, centre Val-d' Aurelle-Paul-Lamarque, 34 - Montpellier (France); Houvenaeghel, G. [Departement de chirurgie, institut Paoli-Calmettes, 13 - Marseille (France); Teissier, E. [Centre azureen de cancerologie, 06 - Mougins (France); Ellis, S. [Centre catalan d' oncologie, 66 - Perpignan (France); Resbeut, M. [Centre de radiotherapie Saint-Louis, 83 - Toulon (France); Tallet, A. [Departement de radiotherapie, institut Paoli-Calmettes, 13 - Marseille (France); Vaini Cowen, V. [Departement de chirurgie gynecologique, polyclinique du Parc-Rambot, 13 - Aix-en-Provence (France); Azria, D. [Departement de radiotherapie, centre Val-d' Aurelle-Paul-Lamarque, 34 - Montpellier (France)

    2010-12-15

    Objectives: To determine prospectively the factors associated with reconstruction failure (i.e. requiring expander removal) and capsular contracture in patients undergoing mastectomy and immediate two-stage breast reconstruction with a tissue expander and implant, and radiotherapy for breast cancer. This is a multi-institutional prospective non-randomized trial. Patients and Methods: Between 2/1998 and 9/2006, we prospectively evaluated 141 consecutive patients who received 141 implants after mastectomy and underwent chest wall radiotherapy (46 to 50 Gy in 23 to 25 fractions). Patients were evaluated after 24 to 36 months by two senior physicians (radiation oncologist and surgeon). Results: Medical follow-up was 37 months. Baker 1 and 2 capsular contracture was observed in 67.5% of patients, Baker 3 and 4 in 32.5%. There were 32 reconstruction failures. In a univariate analysis, the following factors were associated with Baker 3 and 4 capsular contracture: surgeon, use of hormonotherapy and smoking, of which only one remained in the multivariate analysis: surgeon. In a univariate analysis, the following factors were associated with reconstruction failure: tumor size T3 or T4, smoking, pN+ axilla. Three factors remained associated with reconstruction failure in a multiple logistic regression: large tumors T3/T4, smoking and pN+ axilla. Conclusions: Mastectomy, radiotherapy and immediate breast reconstruction with a tissue expander and implant should be considered when breast conserving surgery has been denied. Adequate patients can be easily selected by using three factors of favourable outcome. (authors)

  20. Complications of Radiotherapy after Immediate Breast Reconstruction with Implant: Risk Factors and Management - Our Institute’s Experience

    National Research Council Canada - National Science Library

    Heba G. El-Sheredy; Rabie Ramadan; Yasser Hamed

    2016-01-01

    .... This study aims to evaluate the complications of radiotherapy after immediate breast reconstruction with implants in breast cancer patients who submitted to skin sparing mastectomy and nipple sparing...

  1. Risk Factors for Deep Venous Thrombosis in Lower Extremity Followinging Gynecological Operation%妇科手术后下肢深静脉血栓形成的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李丽军

    2014-01-01

    Objective To explore the risk factors for deep venous thrombosis ( DVT) in the lower extremity following gynecological operation .Methods Eighty-three patients with DVT in the lower extremity following gynecological operation were selected as case group and 83 patients without DVT in the lower extremity undergoing gynecological operation were selected as control group .The related factors including age , occupation , body weight , complications , operative method,operative time,menstrual cycle and cancer were analyzed by univariate unconditional logistic regression analysis and multivariate unconditional logistic regression analysis .Results The univariate unconditional logistic regression analysis suggested that DVT correlated with age ,body weight ,complications ( including hypertension ,diabetes mellitus and hyper-lipemia),cancer,operative method and occupation (P<0.05).The multivariate unconditional logistic regression analysis suggested that complications (including hypertension ,diabetes mellitus and hyperlipemia ),cancer and occupation were independent factors for DVT(P<0.05),the former two were risk factors ,occupation which was physical labor was the protective factor .Conclusion The complications ( including hypertension , diabetes mellitus and hyperlipemia ) and gynecological cancer are the related risk factors for deep venous thrombosis in the lower extremity following gynecological operation.Physical labor is the protective factor for deep venous thrombosis in the lower extremity following gynecological operation.%目的:探讨妇科手术后下肢深静脉血栓形成( DVT )的危险因素。方法选择妇科手术后发生下肢DVT的83例患者为病例组,同期行妇科手术但未发生下肢DVT的83例患者为对照组。对两组年龄、职业性质、体重、合并症、手术方式、手术时间、月经时期、恶性肿瘤等进行单因素及多因素非条件logistic回归分析。结果单因素分析结果显示,DVT发

  2. How extreme are extremes?

    Science.gov (United States)

    Cucchi, Marco; Petitta, Marcello; Calmanti, Sandro

    2016-04-01

    High temperatures have an impact on the energy balance of any living organism and on the operational capabilities of critical infrastructures. Heat-wave indicators have been mainly developed with the aim of capturing the potential impacts on specific sectors (agriculture, health, wildfires, transport, power generation and distribution). However, the ability to capture the occurrence of extreme temperature events is an essential property of a multi-hazard extreme climate indicator. Aim of this study is to develop a standardized heat-wave indicator, that can be combined with other indices in order to describe multiple hazards in a single indicator. The proposed approach can be used in order to have a quantified indicator of the strenght of a certain extreme. As a matter of fact, extremes are usually distributed in exponential or exponential-exponential functions and it is difficult to quickly asses how strong was an extreme events considering only its magnitude. The proposed approach simplify the quantitative and qualitative communication of extreme magnitude

  3. Evaluating the bulk Lorentz factors of outflow material: lessons learned from the extremely-energetic outburst GRB 160625B

    CERN Document Server

    Wang, Yuan-Zhu; Zhang, Shuai; Liang, Yun-Feng; Jin, Zhi-Ping; He, Hao-Ning; Liao, Neng-Hui; Fan, Yi-Zhong; Wei, Da-Ming

    2016-01-01

    GRB 160625B is an extremely-bright outburst with well-monitored afterglow emission. The geometry-corrected energy is high up to $\\sim 5.2\\times10^{52}$ erg or even $\\sim 8\\times 10^{52}$ erg, rendering it the most energetic GRB prompt emission recorded so far. We analyzed the time-resolved spectra of the prompt emission and found that in some intervals there were likely thermal-radiation components and the high energy emission were characterized by significant cutoff. The bulk Lorentz factors of the outflow material are estimated accordingly. We found out that the Lorentz factors derived in the thermal-radiation model are consistent with the luminosity-Lorentz factor correlation found in other bursts as well as in GRB 090902B for the time-resolved thermal-radiation components. While the spectral cutoff model yields much lower Lorentz factors that are in tension with the constraints set by the electron pair Compoton scattering process. We then suggest that these spectral cutoffs are more likely related to the ...

  4. An observational study on rhabdomyolysis in the intensive care unit. Exploring its risk factors and main complication: acute kidney injury.

    Science.gov (United States)

    El-Abdellati, Esmael; Eyselbergs, Michiel; Sirimsi, Halil; Hoof, Viviane Van; Wouters, Kristien; Verbrugghe, Walter; Jorens, Philippe G

    2013-03-14

    Because neither the incidence and risk factors for rhabdomyolysis in the ICU nor the dynamics of its main complication, i.e., rhabdomyolysis-induced acute kidney injury (AKI) are well known, we retrospectively studied a large population of adult ICU patients (n = 1,769). CK and sMb (serum myoglobin) and uMb (urinary myoglobin) were studied as markers of rhabdomyolysis and AKI (RIFLE criteria). Hemodialysis and mortality were used as outcome variables. Prolonged surgery, trauma, and vascular occlusions are associated with increasing CK values. CK correlates with sMb (p sMb or uMb.The logistic regression showed a positive correlation between CK and the development of AKI, with an OR of 2.21. Univariate logistic regression suggests that elevations of sMb and uMb are associated with the development of AKI, with odds ratios of 7.87 and 1.61 respectively. The ROC curve showed that for all three markers a significant correlation with AKI, for sMb with the greatest area under the curve. The best cutoff values for prediction of AKI were CK > 773 U/l; sMb > 368 μg/l and uMb > 38 μg/l respectively. Because it also has extrarenal elimination kinetics, our data suggest that measuring myoglobin in patients at risk for rhabdomyolysis in the ICU may be useful.

  5. Factors that influence emotional disturbance in adults living in extreme poverty.

    Science.gov (United States)

    Palomar-Lever, Joaquina; Victorio-Estrada, Amparo

    2012-04-01

    Living in poverty conditions implies exposure to severe circumstances of social disadvantage, associated with greater propensity to contract illnesses. A negative correlation has consistently been observed between health and poverty. The chronic exposure to stress affects people's well-being through the development of symptoms of anxiety and depression. The suffering of these symptoms for a long time period may be considered as part of a more general syndrome of emotional disturbance, in detriment to a person's mental health. The objective of this study is to identify psychological factors that influence emotional disturbance, measured as symptoms of anxiety and depression, in adults living in poverty conditions in Mexico's central region. A total of 913 adults, 65.2% female, were surveyed. The mean age of the participants was 43.71 (±12.58) years and the mean number of years of schooling was 4.04 (±3.36). Variables corresponding to personal characteristics were measured. The results indicate that the most important risk factor for depression is anxiety and vice versa. Additionally, gender, negative self-esteem, lack of adequate strategies for confronting and resolving difficulties, and lack of self-regulation predicted depression, whereas stress, lack of self-regulation, and coping style predicted anxiety. These variables were better predictors than optimism, locus of control, sense of humor or religiosity. © 2011 The Authors. Scandinavian Journal of Psychology © 2011 The Scandinavian Psychological Associations.

  6. Prevalence and risk factors of upper extremity cumulative trauma disorder in dental hygienists.

    Science.gov (United States)

    Shenkar, O; Mann, J; Shevach, A; Ever-Hadani, P; Weiss, P L

    1998-01-01

    Cumulative trauma disorder (CTD) refers to a number of conditions arising from overuse of joints or soft tissues. The common risk factors that contribute to the development of these disorders are related to personal and occupational variables. Job analysis of the tasks performed by the dental hygienist have shown that this occupation is particularly at risk. The objectives of this study were to determine the prevalence of CTD symptoms amongst dental hygienists in Israel and to identify which are the factors that are related to CTD. A questionnaire including items concerning demographic data, employment history, professional occupational information, use of instrumentation, and CTD symptomatology was mailed to all 530 registered dental hygienists. Two hundred forty-six hygienists (46%) returned the questionnaire; 63% of the respondents were classified as CTD 'sufferers', Age, year of graduation, hours worked per week, and frequency of changing instruments were found to be significantly related to CTD symptoms. Hygienists at high risk included those aged 50 years or more (Odds ratio, OR = 6), those who graduated before 1986 (OR = 3), those who work more than 34 h per week (OR = 2.5) and those who change two or fewer instruments per patient (OR = 2). The major recommendation resulting from this study is to make dental hygienists aware that they work in a high-risk profession. It is hoped that increased awareness of the risk will spur the hygienist to make appropriate work practice, administrative, and engineering modifications and to seek treatment at the first indication of CTD symptoms.

  7. Factors affecting prenatal sonographic estimation of weight in extremely low birthweight infants.

    Science.gov (United States)

    Townsend, R R; Filly, R A; Callen, P W; Laros, R K

    1988-04-01

    Because critical management decisions are based on sonographic estimation of fetal weight in fetuses less than 1000 g, we sought to evaluate the accuracy of birthweight prediction in this range and to identify factors affecting this accuracy. Fetal weight was estimated using several published methods in 53 fetuses with birthweights less than 1000 g. Standard deviations greater than 12.3% indicate more random error in the sonographic weight prediction than has been reported in higher weight groups. No statistically significant differences were found between patient groups with decreased, normal, or increased amniotic fluid volume or portable examination. There was a trend toward lower mean deviation (2.9 vs 6.0%) and standard deviation (8.9 vs. 15.0%) in studies with scan quality judged "good" compared with "poor" based on ability to visualize anatomic landmarks.

  8. Patient and operative factors associated with complications following adolescent idiopathic scoliosis surgery: an analysis of 36,335 patients from the Nationwide Inpatient Sample.

    Science.gov (United States)

    De la Garza Ramos, Rafael; Goodwin, C Rory; Abu-Bonsrah, Nancy; Jain, Amit; Miller, Emily K; Huang, Nicole; Kebaish, Khaled M; Sponseller, Paul D; Sciubba, Daniel M

    2016-12-01

    OBJECTIVE The aim of this study was to investigate the incidence of and factors associated with complications following idiopathic scoliosis surgery in adolescents. METHODS The Nationwide Inpatient Sample database was used to identify patients 10-18 years of age who had undergone spinal fusion for adolescent idiopathic scoliosis (AIS) from 2002 to 2011. Twenty-three unique in-hospital postoperative complications, including death, were examined. A series of logistic regressions was used to determine if any demographic, comorbid, or surgical parameter was associated with complication development. Results of multiple logistic regression analyses were reported as odds ratios with 95% confidence intervals. All analyses were performed after the application of discharge weights to produce national estimates. RESULTS A total of 36,335 patients met the study inclusion criteria, 7.6% of whom (95% CI 6.3%-8.9%) developed at least one in-hospital complication. The 3 most common complications were respiratory failure (3.47%), reintubation (1.27%), and implant related (1.14%). Major complications such as death, pancreatitis, disseminated intravascular coagulation, visual loss, spinal cord injury, cardiac arrest, sepsis, nerve root injury, deep vein thrombosis, pulmonary embolism, shock, malignant hyperthermia, myocardial infarction, and iatrogenic stroke each had an incidence ≤ 0.2%. On multiple logistic regression analysis, an increasing age (OR 0.80) was associated with significantly lower odds of complication development; patients who were male (OR 1.80) or who had anemia (OR 2.10), hypertension (OR 2.51), or hypothyroidism (OR 2.27) or underwent revision procedures (OR 5.55) were at a significantly increased risk for complication development. The rates of postoperative complications for posterior, anterior, and combined approaches were 6.7%, 10.0%, and 19.8%, respectively (p < 0.001). Length of fusion (< 8 vs ≥ 8 levels) was not associated with complication development

  9. Bulimia Nervosa - medical complications.

    Science.gov (United States)

    Mehler, Philip S; Rylander, Melanie

    2015-01-01

    As with anorexia nervosa, there are many medical complications associated with bulimia nervosa. In bulimia nervosa, these complications are a direct result of both the mode and the frequency of purging behaviours. For the purposes of this article, we will review in detail the many complications of the two major modes of purging, namely, self-induced vomiting and laxative abuse; these two account for more than 90% of purging behaviours in bulimia nervosa. Some of these complications are potentially extremely dangerous and need to be well understood to effectively treat patients with bulimia nervosa. Other methods of purging, such as diuretic abuse, are much less frequently utilized and will only be mentioned briefly. In a subsequent article, the treatments of these medical complications will be presented.

  10. Metabolic Risk Factors of Type 2 Diabetes Mellitus and Correlated Glycemic Control/Complications: A Cross-Sectional Study between Rural and Urban Uygur Residents in Xinjiang Uygur Autonomous Region

    National Research Council Canada - National Science Library

    Du, Guo-Li; Su, Yin-Xia; Yao, Hua; Zhu, Jun; Ma, Qi; Tuerdi, Ablikm; He, Xiao-Dong; Wang, Li; Wang, Zhi-Qiang; Xiao, Shan; Wang, Shu-Xia; Su, Li-Ping

    2016-01-01

    .... To describe the differences of metabolic risk factors of type 2 diabetes, as well as glycemic control and complicated diabetic complications between rural and urban Uygur residents in Xinjiang Uygur...

  11. Prognostic factors for lymph node metastasis from advanced squamous cell carcinoma of the skin of the trunk and extremities

    Directory of Open Access Journals (Sweden)

    Carvalho Andre

    2008-07-01

    Full Text Available Abstract Background Squamous cell carcinoma (SCC of the skin of the trunk and extremities may present lymph node metastasis with difficult disease control and poor survival. The purpose of this study was to identify risk factors for lymph node metastasis and outcome. Patients/Methods Retrospective review of 57 patients with locally advanced SCC of the trunk and extremities was performed and several clinical variables including age, gender, ethnicity, previously injured skin (burns, scars, ulcers and others, patient origin (rural or urban, anatomic site and treatment were studied. Results Fifteen patients presented with previous skin lesions. Thirty-six were classified as T3 tumors and 21 as T4; 46 were N0, and 11, N1. Eleven N0 patients presented lymph node metastasis during follow up. Univariate analysis identified previous skin lesions (ulcers and scars as risk factor for lymph node metastasis (p = 0.047. Better survival was demonstrated for T3 (p = 0.018 classification. N0 patients who presented lymph node metastasis during follow up (submitted to lymphadenectomy had similar survival to patients without lymph node recurrence (p = 0.219. Conclusion Local advanced tumors are at risk of lymph node metastasis. Increased risk is associated to previous lesions at tumor site. T4 classification have worse prognosis. Lymph node recurrences in N0 patients, once treated, did not affect survival. For these patients, we propose close follow up and prompt treatment of lymph node metastasis. These results do not support indication for elective lymphadenectomy or sentinel node mapping. Further prospective studies must address this issue.

  12. Complications of mandibular fractures.

    Science.gov (United States)

    Zweig, Barry E

    2009-03-01

    Before any definitive treatment of mandibular fractures, the patient needs to be evaluated for more potentially life-threatening injuries. Complications can and do occur with treatment of mandibular fractures and can occur during any of the phases of treatment. The development of an accurate diagnosis and appropriate treatment plan is vital in achieving optimal success and decreasing complications. Knowledge of the anatomy and the principles of bone healing is also an important factor in preventing complications. To limit long-term untoward effects, complications should be recognized early and the appropriate treatment should be started before a minor complication becomes a complex one that is more difficult to manage.

  13. Extreme bilirubin levels as a causal risk factor for symptomatic gallstone disease.

    Science.gov (United States)

    Stender, Stefan; Frikke-Schmidt, Ruth; Nordestgaard, Børge G; Tybjærg-Hansen, Anne

    2013-07-08

    In individuals without blockage of their bile ducts, levels of plasma bilirubin likely reflect levels of biliary bilirubin; higher biliary bilirubin levels may increase the risk of gallstone disease. To test the hypothesis that a lifelong increase in plasma bilirubin levels is a causal risk factor for symptomatic gallstone disease in the general population. In a prospective study of the Danish general population (N = 61,212), we first tested whether elevated levels of plasma bilirubin predicted greater risk of symptomatic gallstone disease. Second, taking advantage of mendelian randomization, we tested whether a genetic variant in the bilirubin glucoronidating enzyme UGT1A1 (rs6742078) was associated with increased plasma bilirubin levels and, in turn, with an increased risk of symptomatic gallstone disease. Plasma bilirubin level and symptomatic gallstone disease. During 34 years of follow-up, 3374 individuals developed symptomatic gallstone disease. In adjusted analyses, persons with plasma bilirubin levels in the 10th decile had a greater risk of symptomatic gallstone disease compared with those with plasma bilirubin levels in deciles 1 through 9; the hazard ratios (HRs) (95% CIs) were 1.57 (1.26-1.96) overall, 1.36 (1.02-1.82) in women, and 2.00 (1.41-2.83) in men. UGT1A1 genotype explained 20% of the total variation in plasma bilirubin levels and was associated with increases in the mean plasma bilirubin level overall of +16% (+0.09 mg/dL) in GT heterozygotes and +90% (+0.50 mg/dL) in TT homozygotes compared with GG homozygotes, with similar effects in women and men (P for trend gallstone disease were 1.09 (1.02-1.17) for GT heterozygotes and 1.22 (1.09-1.36) for TT homozygotes vs GG homozygotes and similar in women and men (P for trend = .04-gallstone disease.

  14. Classification and Risk-factor Analysis of Postoperative Cardio-pulmonary 
Complications after Lobectomy in Patients with Stage I Non-small Cell Lung Cancer

    Directory of Open Access Journals (Sweden)

    Yutian LAI

    2016-05-01

    Full Text Available Background and objective There are incresing lung cancer patients detected and diagnosed at the intermediate stage when the pre-malignant or early lesions are amenable to resection and cure, owing to the progress of medical technology, the renewal of detection methods, the popularity of medical screening and the improvement of social health consciousness. The aim of this study is to investigate the risk factors of the occurrence of postoperative cardio-pulmonary complications in stage I non-small cell lung cancer (NSCLC patients, based on routine laboratory tests, basic characteristics, and intraoperative variables in hospital. Methods The 421 patients after lobectomy in patients with stage I NSCLC at the West China Hospital of Sichuan University from January 2012 to December 2013 were included into the study and stratified into complication group and non-complication group, according to whether to occur postoperative cardio-pulmonary complications after lobectomy in 30 days. Results Of them, 64 (15.2% patients were finally identified and selected into the complication group, compared with 357 (84.8% in non-complication group: pneumonia (8.8%, 37/421 was the primary complication, and other main complications included atelectasis (5.9%, 25/421, pleural effusion (≥middle (5.0%, 21/421, persistent air leak (3.6%, 15/421; The operation time (P=0.007, amount of blood loss (P=0.034, preoperative chronic obstructive pulmonary disease (COPD (P=0.027, white blood cell (WBC count (P<0.001, neutrophil-lymphocyte ratio (NLR (P<0.001 were significantly different between the two groups. According to the binary logistics regression analysis, preoperative COPD (OR=0.031, 95%CI: 0.012-0.078, P<0.001 and WBC count (OR=1.451, 95%CI: 1.212-1.736, P<0.001 were independent risk factors for postoperative cardio-pulmonary complications. Conclusion Among an array of clinical variables in hospital, operation time, preoperative white blood cell count, preoperative COPD

  15. Complications - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Complications - national data. This data set includes national-level data the hip/knee complication measure, and the Agency for Healthcare Research and Quality...

  16. Complications - State

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Complications measures - state data. This data set includes state-level data for the hip/knee complication measure, and the Agency for Healthcare Research and...

  17. Complications - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Complications - provider data. This data set includes provider data for the hip/knee complication measure, and the Agency for Healthcare Research and Quality (AHRQ)...

  18. Pregnancy Complications

    Science.gov (United States)

    ... To receive Pregnancy email updates Enter email Submit Pregnancy complications Complications of pregnancy are health problems that ... pregnancy. Expand all | Collapse all Health problems before pregnancy Before pregnancy, make sure to talk to your ...

  19. Cardiovascular risk factors, micro and macrovascular complications at diagnosis in patients with young onset type 2 diabetes in India: CINDI 2

    Directory of Open Access Journals (Sweden)

    Bhavana Sosale

    2016-01-01

    Full Text Available Context: Type 2 diabetes mellitus (T2DM in young adults is increasing in India. Data on the prevalence of cardiovascular (CV risk factors and complications associated with young-onset T2DM (YOD at the time of diagnosis of diabetes are limited. This data can aid in aggressive diabetes management, CV risk reduction, and prevention of complications. Aim: To determine the prevalence of CV risk factors, micro and macrovascular complications in patients with newly diagnosed YOD. To assess the percentage of patients who require statin therapy based on current American Diabetes Association (ADA guidelines. Settings and Design: This was a retrospective cross-sectional study of 1500 patients with newly detected YOD across seven centers from 2013 to 2015. Designs and Methods: Patients were evaluated for complications of diabetes and CV risk factors such as body mass index (BMI, hypertension, dyslipidemia, and smoking. Statistical Analysis: Measurements have been presented as mean ± standard deviation; results on categorical measurements have been presented in percentages. Results: The mean age, glycated hemoglobin and BMI were 34.7 ± 4.2 years, 9.9 ± 2.4%, and 26.8 ± 4.7 kg/m2. Hypertension, dyslipidemia, BMI >23 kg/m2, and smoking were presented in 27.6%, 62.4%, 84.2%, and 24%. Diabetic retinopathy, neuropathy, and nephropathy were seen in 5.1%, 13.2%, and 0.9%. Ischemic heart disease, peripheral vascular disease, and stroke were presented in 0.7%, 2%, and 0.1%. As per current guidelines, 95.33% needed statin therapy. Conclusion: This study demonstrates that patients with YOD have micro and macrovascular complications at diagnosis. Nearly, every patient required a statin to reduce CV risk. This highlights the importance of screening patients with YOD for CV risk factors and complications of diabetes at the time of diagnosis.

  20. Clinical factors associated with intracranial complications after pediatric traumatic head injury: an observational study of children submitted to a neurosurgical referral unit

    DEFF Research Database (Denmark)

    Åstrand, Ramona Alice; Undén, Johan; Hesselgard, Karin;

    2010-01-01

    Clinically validated guidelines for the management of head injury in children do not exist, and the treatment is often based upon adult management routines. In order to examine the safety of this procedure, an analysis of clinical factors associated with complications after pediatric head injury ...

  1. Clinical factors associated with intracranial complications after pediatric traumatic head injury: an observational study of children submitted to a neurosurgical referral unit

    DEFF Research Database (Denmark)

    Åstrand, Ramona Alice; Undén, Johan; Hesselgard, Karin

    2010-01-01

    Clinically validated guidelines for the management of head injury in children do not exist, and the treatment is often based upon adult management routines. In order to examine the safety of this procedure, an analysis of clinical factors associated with complications after pediatric head injury ...

  2. The Relationship between Smoking as a Modifiable Risk Factor and Chronic Complications on Elderly with Type 2 Diabetes Mellitus

    OpenAIRE

    Indang Trihandini

    2015-01-01

    Smoking is known as a variable that can be changed through a specific intervention activity. Recently in Indonesia, research related to chronic complication among elderly with type 2 Diabetes Mellitus (DM) was not available. This research has objective in exploring the risk of smoking towards chronic complication among elderly with type 2 DM. This research was using Riset Kesehatan Dasar (Riskesdas) in 2007. Riskesdas is a representative Indonesia Health Survey. 1,565 elderly (aged 60++ years...

  3. Supporting technique with advanced pipe-shed grouting in extremely complicated faulting zone%超前管棚注浆支护技术在极复杂断层带中的应用

    Institute of Scientific and Technical Information of China (English)

    赵毅鑫; 姜耀东; 孟磊; 王涛; 刘华博

    2013-01-01

    Based on the application cases of roadways successfully passing through the complicated fault zones by using supporting technique with advanced pipe-shed grouting, the technical problems of roadway support in passing through the extremely complicated fault zone were analyzed firstly in this paper. Meanwhile, the design parameters of advanced pipe-shed grouting were calculated, and the stress and deformation of surrounding rock in the fault zone under various supporting conditions were also analyzed by numerical simulation. Moreover, the in-situ deformation of roadway supported by advanced pipe-shed grouting was measured, and the successful application experiences of the pipe-shed grouting technique were summarized. The practice results show that the supporting technique with pipe-shed grouting can not only improve the integrity of surrounding rock and the supporting capacity, but also form a strong pre-support system. It can be well used as one of effective roadway support techniques in the complicated geological zones. However, some other measures, such as geophysical prospecting, effective in-situ monitoring, et al, are needed to improve the grouting quality and ensure the safety of passing through the complicated fault zones. The experiences in this paer can provide ref- erence to the design and construction of similar projects in complicated geological zones.%基于煤矿巷道采用超前管棚注浆支护技术顺利通过复杂断层带的实际案例,研究了巷道通过极复杂断层带面临的破碎围岩变形控制问题.通过计算确定了超前管棚注浆支护的设计参数,采用数值计算手段分析了过断层区域不同支护条件下的围岩应力和巷道变形情况,并针对施工后的管棚支护巷道变形量进行了现场实测,总结了超前管棚注浆支护技术在巷道通过复杂断层带的成功经验.实践证明:超前管棚注浆支护技术提高了围岩的完整性及整体承载能力,能够形成较强的

  4. Prevalence of and risk factors for postoperative pulmonary complications after lung cancer surgery in patients with early-stage COPD

    Directory of Open Access Journals (Sweden)

    Kim ES

    2016-06-01

    George Respiratory Questionnaire scores, were significantly associated with PPCs.Conclusion: Even in patients with early-stage COPD, the prevalence of PPCs is higher than in patients with NSCLC with normal spirometry. However, this rate is not different between group A and group B patients with COPD. In accordance with this, scores based on symptoms or QoL are not predictors of risk of PPCs in patients with early-stage COPD. Keywords: early COPD, postoperative pulmonary complication, prevalence, risk factor

  5. 103例超未成熟儿及超低出生体重儿转归及影响因素分析%Outcome and influencing factors of 103 cases of extremely premature infant and extremely low birth weight infants

    Institute of Scientific and Technical Information of China (English)

    王晓磊; 梅花; 刘春枝; 张亚昱; 刘春丽; 宋丹; 张钰恒

    2016-01-01

    目的 总结超未成熟儿及超低出生体重儿发生的原因、相关影响因素及转归情况.方法 分析内蒙古医科大学附属医院2009年1月至2015年12月NICU收治的符合条件的103例超低出生体重儿及超未成熟儿的临床资料,包括母孕期病史、新生儿出生时情况、诊治经过及预后.结果 103例患儿存活67例,死亡36例,存活率65.0% (67/103).妊娠高血压综合征、感染、胎膜早破等为发生超未成熟和超低出生体重儿的主要因素,影响两者的转归因素包括胎龄、性别、出生体重、肺出血、支气管肺发育不良、坏死性小肠结肠炎(P<0.05).长期住院的存活患儿后期易并发贫血.死亡直接原因前4位包括肺出血、呼吸窘迫综合征、新生儿肺炎及坏死性小肠结肠炎.结论 加强高危妊娠监测管理,预防早产,加强NICU超未成熟儿及超低出生体重儿的监护管理,及早发现、及早处理各种并发症,防止医院感染发生,是提高两者存活率,改善生活质量的根本措施.%Objective To summarize the causes,related factors and outcome of extremely premature infants and extremely low birth weight infants.Methods One hundred and three cases of extremely premature infants and extremely low birth weight infants were admired to First Affiliated Hospital of Inner Mongolia Medical University between January 2009 and December 2015.The study was performed to analyze the clinical data of the 103 cases,included history of pregnancy,birth situation,treatment and prognosis.Results In these 103 cases,67 infants survived,36 infants died.The survival rate was 65.0% (67/103).The extremely premature infants and extremely low birth weight infants were mainly associated with pregnancy-induced hypertension,infection,premature rupture of membranes.Factors that could affect the outcome of these cases included gestational age,sex,birth weight,pulmonary hemorrhage,bronchopulmonary dysplasia and necrotizing

  6. Risk factors for complications in donors at first and repeat whole blood donation: a cohort study with assessment of the impact on donor return.

    Science.gov (United States)

    Wiersum-Osselton, Johanna C; Marijt-van der Kreek, Tanneke; Brand, Anneke; Veldhuizen, Ingrid; van der Bom, Johanna G; de Kort, Wim

    2014-01-01

    First-time donation is among recognised risk factors for vasovagal reactions to blood donation and reactions are known to reduce donor return. We assessed associations between potential risk factors and vasovagal reactions and needle-related complications in first-time whole blood donation in comparison to repeat donation and analysed the impact of complications on donor return. We performed a cohort study on whole blood donations in The Netherlands from 1/1/2010 to 31/12/2010 using data extracted from the blood service information system. Donation data up to 31/12/2011 were used to ascertain donor return. In 2010 28,786 donors made first whole blood donations and there were 522,958 repeat donations. Vasovagal reactions occurred in 3.9% of first donations by males and 3.5% of first donations by females compared to in 0.2% and 0.6%, respectively, of repeat donations. Associations of vasovagal reactions with other factors including age, body weight, systolic and diastolic blood pressure were similar in first-time and repeat donors. Needle-related complications occurred in 0.2% of male and 0.5% of female first-time donations and in 0.1% and 0.3%, respectively, of repeat donations. Among first-time donors, the return rate within 1 year was 82% following an uncomplicated first donation, but 55% and 61% following vasovagal reactions and needle-related complications, respectively; the corresponding percentages among repeat donors were 86%, 58% and 82%. Among first-time donors, females suffered less than males from vasovagal reactions. Other risk factors had similar associations among first-time and repeat donors. Vasovagal reactions and needle-related complications in both first-time and repeat donors are followed by reduced donor return.

  7. Excessive visceral fat area as a risk factor for early postoperative complications of total gastrectomy for gastric cancer: a retrospective cohort study.

    Science.gov (United States)

    Takeuchi, Masashi; Ishii, Kenjiro; Seki, Hiroaki; Yasui, Nobutaka; Sakata, Michio; Shimada, Akihiko; Matsumoto, Hidetoshi

    2016-08-05

    Obesity is a known risk factor for complications after digestive surgery. Body mass index (BMI) is commonly used as an index of obesity but does not always reflect the degree of obesity. Although some studies have shown that high visceral fat area (VFA) is associated with poor outcomes in digestive surgery, few have examined the relationship between VFA and total gastrectomy. In this study, we demonstrated that VFA is more useful than BMI in predicting complications after total gastrectomy. Seventy-five patients who underwent total gastrectomy for gastric cancer were enrolled in this study; they were divided into two groups: a high-VFA group (n = 26, ≥100 cm(2)) and a low-VFA group (n = 49, <100 cm(2)). We retrospectively evaluated the preoperative characteristics and surgical outcomes of all patients and examined postoperative complications within 30 days of surgery (including cardiac complications, pneumonia, ileus, anastomotic leakage, pancreatic fistula, incisional surgical site infection [SSI], abdominal abscess, and hemorrhage). The incidence of anastomotic leakage (p = 0.03) and incisional SSI (p = 0.001) were higher in the high-VFA group than in the low-VFA group. No significant differences were observed in the other factors. We used univariate analysis to identify risk factors for anastomotic leakage and incisional SSI. Age and VFA were risk factors for anastomotic leakage, and BMI and VFA were risk factors for incisional SSI. A multivariate analysis including these factors found that only VFA was a predictor of anastomotic leakage (hazard ratio [HR] 4.62; 95 % confidence interval [CI] 1.02-21.02; p = 0.048) and incisional SSI (HR 4.32; 95 % CI 1.18-15.80; p = 0.027]. High VFA is more useful than BMI in predicting anastomotic leakage and SSI after total gastrectomy. Therefore, we should consider the VFA value during surgery.

  8. Assessment of factors relating to screening of diabetes complications in patients with Type 2 Diabetes Mellitus during follow up: A descriptive study in Sri Lanka

    Directory of Open Access Journals (Sweden)

    G.N.D Perera

    2015-01-01

    Full Text Available Diabetes is a growing epidemic disease in the world and the associated micro and macrovascular complications cause significant morbidity and mortality. We conducted a descriptive cross sectional study to evaluate the adequacy of screening and to identify the factors relating to poor diabetes complication screening in type 2 Diabetes Mellitus (DM patients during follow ups. We have included patients with type 2 DM, admitted to a medical unit in a tertiary care center. Study was conducted from September 1 to October 31, 2012. The study participants were interviewed using an interviewer administered questionnaire. Patients were examined to assess microvascular complications, macro vascular complications, BMI and blood pressure. All patients had FBS, lipid profile, Urine albumin estimation and renal function testing. Screening performed during their follow up was assessed during the interview. There were 147 patients (81 males and 66 females with an average age of 58.5 ± 9yrs. There were 97 (65.9% patients who followed up at National Hospital of Sri Lanka (NHSL. Majority (n=133, 90.5% were given disease education during follow up. Out of the total, 23(15.6% were using SMBG while only 69(46.9% had at least one HbA1c performed in the preceding year. Patients following up at NHSL had lower BMI, better glycaemic control, better lipid values and had received better microvascular complication screening. Follow up at a hospital other than NHSL was associated with poor microvascular complication screening. Female gender and increasing age was associated with poor retinopathy screening. Microvascular complication screening is suboptimal and the adherence to guidelines depends on the healthcare facility of follow up, sex and age of the patient. There is an urgent need to educate medical practitioners and patients on proper diabetes care.

  9. Retrospective analysis of risk factors and predictors of intraoperative complications in neuraxial blocks at Faculdade de Medicina de Botucatu-UNESP.

    Science.gov (United States)

    Pereira, Ivan Dias Fernandes; Grando, Marcela Miguel; Vianna, Pedro Thadeu Galvão; Braz, José Reinaldo Cerqueira; Castiglia, Yara Marcondes Machado; Vane, Luís Antônio; Módolo, Norma Sueli Pinheiro; do Nascimento, Paulo; Amorim, Rosa Beatriz; Rodrigues, Geraldo Rolim; Braz, Leandro Gobbo; Ganem, Eliana Marisa

    2011-01-01

    Cardiovascular changes associated with neuraxial blocks are a cause of concern due to their frequency and because some of them can be considered physiological effects triggered by the sympathetic nervous system blockade. The objective of this study was to evaluate intraoperative cardiovascular complications and predictive factors associated with neuraxial blocks in patients ≥ 18 years of age undergoing non-obstetric procedures over an 18-year period in a tertiary university hospital--HCFMB-UNESP. A retrospective analysis of the following complications was undertaken: hypertension, hypotension, sinus bradycardia, and sinus tachycardia. These complications were correlated with anesthetic technique, physical status (ASA), age, gender, and preoperative co-morbidities. The Tukey test for comparisons among proportions and logistic regression was used for statistical analysis. 32,554 patients underwent neuraxial blocks. Intraoperative complications mentioned included hypotension (n=4,109), sinus bradycardia (n=1,107), sinus tachycardia (n=601), and hypertension (n=466). Hypotension was seen more often in patients undergoing continuous subarachnoid anesthesia (29.4%, OR=2.39), ≥ 61 years of age, and female (OR=1.27). Intraoperative hypotension and bradycardia were the complications observed more often. Hypotension was related to anesthetic technique (CSA), increased age, and female. Tachycardia and hypertension may not have been directly related to neuraxial blocks. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

  10. Risk Factors for Adopting Extreme Weight-Control Behaviors among Public School Adolescents in Salvador, Brazil: A Case-Control Study.

    Science.gov (United States)

    de Santana, Mônica Leila Portela; Assis, Ana Marlúcia Oliveira; Silva, Rita de Cássia Ribeiro; Raich, Rosa María; Machado, Maria Ester Pereira da Conceição; Pinto, Elizabete de Jesus; de Moraes, Lia Terezinha Lana Pimenta; Ribeiro, Hugo da Costa

    2016-01-01

    This study identifies the risk factors for extreme weight-control behaviors among adolescents in public school in Salvador, northeastern Brazil. A case-control study nested to a cross-sectional study, including 252 adolescents of both sexes, age between 11 to 17 years, with 84 cases and 168 age-matched controls was conducted. The variable outcome is represented by extreme weight-control behaviors, integrated by following the variables: self-induced vomiting and the use of laxatives, diuretics, or diet pills. Covariables included body image dissatisfaction, dieting, prolonged fasting, and self-perception of body weight. The study also investigated the demographic and anthropometric variables and economic conditions of the students' families. Conditional logistic regression was used to identify risk factors for the adoption of extreme weight-control behaviors among adolescents. Among the adolescents investigated, the conditional logistic regression explained 22% the occurrence of extreme weight-control behaviors and showed that these behaviors were positively associated to overweight (odds ratio [OR] = 3.61; 95% confidence interval [CI], 1.42-9.17), body image dissatisfaction (OR = 3.87; 95% CI, 1.75-8.54), and the adoption of a restrictive diet (OR = 2.83; 95% CI, 1.16-6.91). The results of this study suggest that among adolescents, overweight, body image dissatisfaction, and restrictive diet are important risk factors to adoption of extreme weight-control behaviors.

  11. Expanding upon the 'extreme male brain' theory of autism as a common link between other major risk factors: a hypothesis.

    Science.gov (United States)

    Wen, Wendy; Wen, Shi Wu

    2014-05-01

    On average, males have a stronger preference for physical systems and machines over interpersonal interactions; they have lower average levels of cognitive empathy or social cognition than females; and they have higher rates of 'extreme' intelligence when it comes to abstract concepts such as those found in mathematics and sciences. All three traits are also commonly associated with individuals with an autism spectrum disorder or ASD; clearly, it is not coincidental that incidence rates of autism are reportedly four times higher in males than in females. The common link between the majority of risk factors assessed in this review (including technological advancements, advanced parental age, socioeconomic status, and genetic predispositions towards ASDs in families of scientists and engineers) can be traced to a specific hormone, testosterone. It was established that traits which are typically associated with males are also typically associated with ASDs as well as individuals with antisocial personality disorder, or APD. The key distinction between individuals who are considered to be 'autistic' as opposed to those who are considered 'sociopathic' lies in the difference between their empathy deficits: whereas those who are 'autistic' are said to lack cognitive empathy (the ability to identify and understand the thoughts and feelings of others and to respond to these with appropriate emotions), those who are 'sociopathic' are said to lack emotional empathy (which is responsible for inhibiting acts of physical aggression or violence). This would explain why autistic individuals can have elevated testosterone levels without becoming physically aggressive.

  12. The postanesthetic period. Complications.

    Science.gov (United States)

    Malamed, S F

    1987-01-01

    Postanesthetic complications can occur even in the best of circumstances. Proper preparation of the staff, aggressive monitoring of the recovering patient, and early recognition and management of the complications are essential if the outcome is to be successful. In reviewing postanesthetic complications, two factors are present in the overwhelming majority of situations--hypoxia and hypercarbia--often the direct result of inadequate monitoring during the postanesthetic period. The anesthetic procedure is not over once the anesthetic agents are discontinued. The skillful anesthetist is aware of the possibilities of postoperative complications and prevents problems by employing enhanced monitoring techniques during the recovery phase.

  13. Cataract complications

    Directory of Open Access Journals (Sweden)

    David Yorston

    2008-03-01

    Full Text Available Any eye surgeon, no matter how experienced, will occasionally encounter a serious cataract complication. Although complications may be devastating for the patient and are always distressing for the surgeon, are they really a major issue for VISION 2020? The evidence says that they are.

  14. Climate change impacts: The challenge of quantifying multi-factor causation, multi-component responses, and leveraging from extremes

    Science.gov (United States)

    Field, C. B.

    2012-12-01

    Modeling climate change impacts is challenging for a variety of reasons. Some of these are related to causation. A weather or climate event is rarely the sole cause of an impact, and, for many impacts, social, economic, cultural, or ecological factors may play a larger role than climate. Other challenges are related to outcomes. Consequences of an event are often most severe when several kinds of responses interact, typically in unexpected ways. Many kinds of consequences are difficult to quantify, especially when they include a mix of market, cultural, personal, and ecological values. In addition, scale can be tremendously important. Modest impacts over large areas present very different challenges than severe but very local impacts. Finally, impacts may respond non-linearly to forcing, with behavior that changes qualitatively at one or more thresholds and with unexpected outcomes in extremes. Modeling these potentially complex interactions between drivers and impacts presents one set of challenges. Evaluating the models presents another. At least five kinds of approaches can contribute to the evaluation of impact models designed to provide insights in multi-driver, multi-responder, multi-scale, and extreme-driven contexts, even though none of these approaches is a complete or "silver-bullet" solution. The starting point for much of the evaluation in this space is case studies. Case studies can help illustrate links between processes and scales. They can highlight factors that amplify or suppress sensitivity to climate drivers, and they can suggest the consequences of intervening at different points. While case studies rarely provide concrete evidence about mechanisms, they can help move a mechanistic case from circumstantial to sound. Novel approaches to data collection, including crowd sourcing, can potentially provide tools and the number of relevant examples to develop case studies as statistically robust data sources. A critical condition for progress in this

  15. Hormonal and reproductive factors are associated with chronic low back pain and chronic upper extremity pain in women--the MORGEN study.

    NARCIS (Netherlands)

    Wijnhoven, Hanneke A H; Vet, Henrica C W de; Smit, Henriëtte A; Picavet, H Susan J

    2006-01-01

    STUDY DESIGN: Cross-sectional study of 11,428 women aged 20-59 years who were included in a postal questionnaire survey in the Dutch general population. OBJECTIVE: To examine how hormonal and reproductive factors are associated with chronic low back pain (LBP) and chronic upper extremity pain (UEP)

  16. Complications of Radiotherapy after Immediate Breast Reconstruction with Implant: Risk Factors and Management - Our Institute’s Experience

    OpenAIRE

    Heba G. El-Sheredy; Rabie Ramadan; Yasser Hamed

    2016-01-01

    Background: Breast cancer is the most frequent malignant tumor in women worldwide. In recent years, defined reconstruction principles along with numerous surgical techniques with volume replacement have been published. Autologous breast reconstruction is more natural but leaves donor site morbidity. It provides the opportunity to restore the breast mound without the need for scars. This study aims to evaluate the complications of radiotherapy after immediate breast reconstructi...

  17. Related influencing factors of complications after gynecological laparoscopic surgery%妇科腹腔镜手术并发症的发生情况及相关影响因素研究

    Institute of Scientific and Technical Information of China (English)

    张小燕

    2015-01-01

    目的:分析影响腹腔镜下妇科手术并发症发生的相关危险因素,为预防和控制并发症的发生提供依据。方法对我院妇科2011年6月至2013年12月收治的112例腹腔镜手术患者的并发症情况及相关因素进行回顾性分析。结果112例腹腔镜下妇科手术患者中,26例患者出现并发症,发生率为23.2%,主要并发症为皮下气肿5例,大量出血5例,术后感染8例,下肢深静脉血栓4例,包裹性积液1例,肠管损伤1例,肠梗阻2例。经过单因素分析和多因素回归分析发现手术类型、医师工作经验、腹部手术史、子宫内膜异位症病史是腹腔镜下妇科手术并发症发生的独立危险因素(P<0.05)。结论腹腔镜下妇科手术的并发症中失血过多和术后感染最为常见多见,有腹部手术史、子宫内膜异位症病史的患者,出现并发症的风险较大;并且手术级别越高,或是主刀医师经验越少,患者出现并发症的风险越大。%Objective To study the risk factors of the complications of laparoscopic gynecologic operation,and put forward the basis for the prevention and control of complications. Methods The related factors of complications in 112 patients in our hospital from June 2011 to December 2013 were retrospectively analyzed. Results There were 26 patients with complications,the incidence rate was 23. 2%,of which 5 cases with subcutaneous emphysema,5 cases with massive hemorrhage,8 cases with postoperative infection,4 cases with deep venous throm-bosis of the lower extremity,1 cases with pleural effusion,1 cases with intestinal injury,2 cases with intestinal obstruction. Univariate analysis and multivariate regression analysis showed that the type of surgery, work experience of doctors,previous abdominal surgery,history of endometriosis were an independent risk factor for complications of laparoscopic surgery (P<0. 05). Conclusion Excessive blood loss and postoperative infection in laparoscopic

  18. [Delivery during time of shift change is not a risk factor for obstetric complication: a historical cohort study].

    Science.gov (United States)

    Reichman, Orna; Samueloff, Arnon; Gdansky, Efraim; Yekel, Yael; Calderon-Margalit, Ronit

    2015-03-01

    The time of shift change is a unique time because the continuity of routine care is interrupted. The association between delivery during time of shift change and obstetric complications has not been evaluated. We hypothesized that delivery during time of shift change is at risk for obstetric complications. A historical cohort study was performed of all women with a singleton pregnancy undergoing a trial of labor at term during 2006-2010. Data was extracted from a computerized database that is continuously updated during Labor. The hour of delivery was divided into two categories: "morning shift" (09:30-15:00) and "time of shift change" which was defined 30 minutes prior to and 90 minutes past the official time of shift change, which occurs twice daily at 07:30 and 15:30. Multivariate logistic regression models were implemented to estimate the association between deliveries during "time of shift change" compared to "morning weekdays", with instrumental delivery (primary outcome) and prolonged second stage, unplanned cesarean section, postpartum hemorrhage, 5 minutes Apgar score deliveries were included in the cohort. No statistical difference in instrumental vaginal delivery was documented for women delivering during "time of shift change compared to morning shift weekdays (OR = 0.96, 95% CI: 0.83- 1.11, p = 0.605). None of the secondary outcomes were found at risk for women delivering during "time of shift change". Delivery during "time of shift change" does not pose additional risk for obstetric complications.

  19. Knowledge about Danger Signs of Obstetric Complications and Associated Factors among Postnatal Mothers of Mechekel District Health Centers, East Gojjam Zone, Northwest Ethiopia, 2014.

    Science.gov (United States)

    Amenu, Gedefa; Mulaw, Zerfu; Seyoum, Tewodros; Bayu, Hinsermu

    2016-01-01

    Background. Developing countries like Ethiopia contributed highest level of maternal mortality due to obstetric complications. Women awareness of obstetric danger sign to recognize complications to seek medical care early is the first intervention in an effort to decrease maternal death. Objective. To assess knowledge about danger signs of obstetric complications and associated factors among postnatal mothers at Mechekel district health centers, East Gojjam zone, Northwest Ethiopia, 2014. Methods. An institution based cross-sectional study was conducted from August to October, 2014, in Mechekel district health centers. Systematic random sampling was used to select four hundred eleven study participants. A pretested structured questionnaire was used to collect data. Data were entered to Epi Info version 3.5.3 and exported to SPSS 20.0 for further analysis. Descriptive and summary statistics were done. Logistic regression analyses were used to see the association of different variables. Odds ratios and 95% confidence interval were computed to determine the presence and strength of association. Results. According to this study, 55.1% participants were knowledgeable about danger signs of obstetric complications. Maternal and husband educational level ((AOR = 1.977, 95% CI: 1.052, 3.716) and (AOR = 3.163, 95% CI: 1.860, 5.3770), resp.), family monthly income ≥ 1500 (AOR = 2.954, 95% CI: 1.289, 6.770), being multipara (AOR = 7.463, 95% CI: 1.301, 12.800), ANC follow-up during last pregnancy (AOR = 2.184, 95% CI: 1.137, 4.196), and place of last delivery (AOR = 1.955, 95% CI: 1.214, 3.150) were variables found to be significantly associated with women's knowledge on danger signs of obstetric complications. Conclusion. Significant proportion of respondents were not knowledgeable about obstetric danger signs and factors like educational status, place of last delivery, and antenatal follow-up were found to be associated.

  20. Hypoxia-inducible factor-1 and diabetic complications%低氧诱导因子-1与糖尿病并发症

    Institute of Scientific and Technical Information of China (English)

    阳诚; 南庆玲; 徐勇

    2010-01-01

    The pathogenesis of diabetic complications is related to many factors, including genetic susceptibility, glycometabolism disorder,oxidative stress and so on. But the pathogenesis is not so clear. Recent researches show that diabetic complications are closely related to hypoxia,and hypoxia-inducible factor-1 ( HIF-1 ) is an important factor for transcriptional control. HIF-1 participates in angiogenesis, energy metabolism, apoptosis and so on, through controlling the downstream transcription of genes in order to adapt hypoxia environment. Discussing the structure ,function adjustment and effect in diabetic complication of HIF-1, studying how to maintain moderate expression of HIF-1 ,can provide a new method for prevention of diabetic complications.%糖尿病并发症的发病机制涉及多个因素,与遗传易感性、糖代谢紊乱、氧化应激等密切相关,但具体机制尚未明确.近年研究发现其发病过程与低氧密切相关,而低氧诱导因子-1(HIF-1)是缺氧时重要的转录调控因子,可通过对下游基因的转录调控参与血管发生、能量代谢、细胞凋亡等病理生理过程,以适应低氧环境.探讨HIF-1结构和功能的调节及其在糖尿病并发症中的作用,研究如何维持HIF-1的适度表达,为防治糖尿病并发症提供了新的思路.

  1. Risk factors and obstetric complications of large for gestational age births with adjustments for community effects: results from a new cohort study

    Directory of Open Access Journals (Sweden)

    Cameron Cate M

    2010-08-01

    Full Text Available Abstract Background High birth weight has serious adverse impacts on chronic health conditions and development in children. This study identifies the social determinants and obstetric complications of high birth weight adjusted for gestational age and baby gender. Methods Pregnant women were recruited from three maternity hospitals in South-East Queensland in Australia during antenatal clinic visits. A questionnaire was completed by each participant to elicit information on eco-epidemiological exposures. Perinatal information was extracted from hospital birth records. A hierarchical mixture regression model was used in the analysis to account for the heterogeneity of birth weights and identify risk factors and obstetric complications of births that were large for gestational age. A generalized linear mixed model was used to adjust for (random "community" effects. Results Pre-pregnancy obesity (adjusted OR = 2.73, 95% CI = 1.49-5.01, previous pregnancy (adjusted OR = 2.03, 95% CI = 1.08-3.81, and married mothers (adjusted OR = 1.85, 95% CI = 1.00-3.42 were significantly associated with large for gestational age babies. Subsequent complications included the increased need for delivery by caesarean sections or instrumental procedures (adjusted OR = 1.98, 95% CI = 1.10-3.55, resuscitation (adjusted OR = 2.52, 95% CI = 1.33-4.79, and transfer to intensive/special care nursery (adjusted OR = 3.76, 95% CI = 1.89-7.49. Communities associated with a higher proportion of large for gestational age births were identified. Conclusions Pre pregnancy obesity is the principal modifiable risk factor for large for gestational age births. Large for gestational age is an important risk factor for the subsequent obstetric complications. The findings improve the evidence-base on which to base preventive interventions to reduce the impact of high birth weight on maternal and child health.

  2. Complicated Pancreatitis

    NARCIS (Netherlands)

    Bakker, O.J.

    2015-01-01

    Research questions addressed in this thesis: What is the accuracy of serum blood urea nitrogen as early predictor of complicated pancreatitis? ; What is difference in clinical outcome between patients with pancreatic parenchymal necrosis and patients with extrapancreatic necrosis without necrosis

  3. Complicated Pancreatitis

    NARCIS (Netherlands)

    Bakker, O.J.

    2015-01-01

    Research questions addressed in this thesis: What is the accuracy of serum blood urea nitrogen as early predictor of complicated pancreatitis? ; What is difference in clinical outcome between patients with pancreatic parenchymal necrosis and patients with extrapancreatic necrosis without necrosis

  4. Diphtheria Complications

    Science.gov (United States)

    ... Search Form Controls Cancel Submit Search The CDC Diphtheria Note: Javascript is disabled or is not supported ... message, please visit this page: About CDC.gov . Diphtheria Home About Diphtheria Causes and Transmission Symptoms Complications ...

  5. Complications of mechanical ventilation

    Directory of Open Access Journals (Sweden)

    Drašković Biljana

    2011-01-01

    Full Text Available Mechanical ventilation of the lungs, as an important therapeutic measure, cannot be avoided in critically ill patients. However, when machines take over some of vital functions there is always a risk of complications and accidents. Complications associated with mechanical ventilation can be divided into: 1 airway-associated complications; 2 complications in the response of patients to mechanical ventilation; and 3 complications related to the patient’s response to the device for mechanical ventilation. Complications of artificial airway may be related to intubation and extubation or the endotracheal tube. Complications of mechanical ventilation, which arise because of the patient’s response to mechanical ventilation, may primarily cause significant side effects to the lungs. During the last two decades it was concluded that mechanical ventilation can worsen or cause acute lung injury. Mechanical ventilation may increase the alveolar/capillary permeability by overdistension of the lungs (volutrauma, it can exacerbate lung damage due to the recruitment/derecruitment of collapsed alveoli (atelectrauma and may cause subtle damages due to the activation of inflammatory processes (biotrauma. Complications caused by mechanical ventilation, beside those involving the lungs, can also have significant effects on other organs and organic systems, and can be a significant factor contributing to the increase of morbidity and mortality in critically ill of mechanically ventilated patients. Complications are fortunately rare and do not occur in every patient, but due to their seriousness and severity they require extensive knowledge, experience and responsibility by health-care workers.

  6. Factors determining growth and vertical distribution of planktonic algae in extremely acidic mining lakes (pH 2.7)

    Science.gov (United States)

    Bissinger, Vera

    2003-04-01

    In this thesis, I investigated the factors influencing the growth and vertical distribution of planktonic algae in extremely acidic mining lakes (pH 2-3). In the focal study site, Lake 111 (pH 2.7; Lusatia, Germany), the chrysophyte, Ochromonas sp., dominates in the upper water strata and the chlorophyte, Chlamydomonas sp., in the deeper strata, forming a pronounced deep chlorophyll maximum (DCM). Inorganic carbon (IC) limitation influenced the phototrophic growth of Chlamydomonas sp. in the upper water strata. Conversely, in deeper strata, light limited its phototrophic growth. When compared with published data for algae from neutral lakes, Chlamydomonas sp. from Lake 111 exhibited a lower maximum growth rate, an enhanced compensation point and higher dark respiration rates, suggesting higher metabolic costs due to the extreme physico-chemical conditions. The photosynthetic performance of Chlamydomonas sp. decreased in high-light-adapted cells when IC limited. In addition, the minimal phosphorus (P) cell quota was suggestive of a higher P requirement under IC limitation. Subsequently, it was shown that Chlamydomonas sp. was a mixotroph, able to enhance its growth rate by taking up dissolved organic carbon (DOC) via osmotrophy. Therefore, it could survive in deeper water strata where DOC concentrations were higher and light limited. However, neither IC limitation, P availability nor in situ DOC concentrations (bottom-up control) could fully explain the vertical distribution of Chlamydomonas sp. in Lake 111. Conversely, when a novel approach was adopted, the grazing influence of the phagotrophic phototroph, Ochromonas sp., was found to exert top-down control on its prey (Chlamydomonas sp.) reducing prey abundance in the upper water strata. This, coupled with the fact that Chlamydomonas sp. uses DOC for growth, leads to a pronounced accumulation of Chlamydomonas sp. cells at depth; an apparent DCM. Therefore, grazing appears to be the main factor influencing the

  7. Extreme Heat

    Science.gov (United States)

    ... Landslides & Debris Flow Nuclear Blast Nuclear Power Plants Power Outages Pandemic Radiological Dispersion Device Severe Weather Snowstorms & Extreme ... Landslides & Debris Flow Nuclear Blast Nuclear Power Plants Power Outages Pandemic Radiological Dispersion Device Severe Weather Snowstorms & Extreme ...

  8. Risk Factors Associated With Complication Rates of Becker-Type Expander Implants in Relation to Implant Survival: Review of 314 Implants in 237 Patients.

    Science.gov (United States)

    Taboada-Suarez, Antonio; Brea-García, Beatriz; Magán-Muñoz, Fernando; Couto-González, Iván; González-Álvarez, Eduardo

    2015-12-01

    Although autologous tissue reconstruction is the best option for breast reconstruction, using implants is still a reliable and simple method, offering acceptable aesthetic results. Becker-type implants are permanent implants that offer a 1-stage reconstructive option. A retrospective study was carried out in our center reviewing the clinical reports of 237 patients, in whom a total of 314 Becker-type prostheses were implanted. Overall survival was calculated using a Kaplan-Meier estimate. Cox proportional hazard models were used to calculate adjusted hazard ratios. At the end of the study, 214 expanders (68.15%) presented no complications, 40 (12.47%) developed significant capsular contracture, in 27 (8.60%) infection occurred, 24 (7.64%) suffered minor complications, and 9 (2.87%) ruptured. The mean survival time of the expanders was 120.41 months (95% CI: 109.62, 131.19). Radiotherapy, chemotherapy, high Molecular Immunology Borstel, age, mastectomy performed previously to the implant, ductal carcinoma, advanced tumoral stage, experience of the surgeon, and Becker 35-type implants were significantly related to a high number of complications in relation to the survival of the implants. Cox regression analysis revealed that the main risk factors for the survival of expander implants included radiotherapy and surgeon experience. The complication hazard ratio or relative risk caused by these 2 factors was 1.976 and 1.680, respectively. One-stage reconstruction using Becker-type expanders is an appropriate, simple, and reliable option in delayed breast reconstruction in patients who have not received radiotherapy and as long as the procedure is carried out by surgeons skilled in the technique.

  9. Mandelbrot's Extremism

    NARCIS (Netherlands)

    Beirlant, J.; Schoutens, W.; Segers, J.J.J.

    2004-01-01

    In the sixties Mandelbrot already showed that extreme price swings are more likely than some of us think or incorporate in our models.A modern toolbox for analyzing such rare events can be found in the field of extreme value theory.At the core of extreme value theory lies the modelling of maxima

  10. Postoperative complications of surgical therapy for deep vein thrombosis (DVT) of the lower extremity%下肢深静脉血栓形成外科治疗的并发症分析

    Institute of Scientific and Technical Information of China (English)

    桑宏飞; 李晓强; 于小滨

    2009-01-01

    Objective To analyze postoperative complications of surgical therapy for deep vein thrombosis (DVT) of the lower extremity. Method From January 2001 to January 2008 vena cava filters were placed in 171 DVT cases before surgery. Fogarty catheter (73 cases), Amplatz thrombectomy device (ATD) (55 cases), Acolysis ultrasound ablation(43 cases) were used to extract the thrombi in iliac and proximal femoral vein. The full extraction of thrombi in distal end was facilitated by compressing and massaging the legs in all cases. Iliac venous stenosis or occlusion was managed by interventional therapy, and temporary femoral arteriovenous fistula were carried out routinly. Result Operations were successful in 157 cases(70 cases in Fogarty group, 52 in ATD group,35 in Acolysis ultrasound ablation group), and failed in 14 cases (3 cases in Fogarty group, 3 in ATD group, 8 in Acolysis ultrasound ablation group). Permanent,retrievable and temporary vena cava filters were placed in 51,32 and 88 cases respectively. Stenosis or occulsions of the iliac vein was found in 143 cases and stents were placed after balloon dilatation in 41 cases. During the operation, residual thrombi was found in 80 cases. Vessel perforation and rupture were complicated in 14 cases, thrombosis adhering in eava vein filters in 18 cases. There was no mortality and no pulmonary thromboembolism. During the follow-up, we found iliae vein restenosis in 21 cases, thrombosis recurrence in 36 cases, stents displacement in 6 cases, and stents fracture in 2 cases. Conclusion Surgical therapy is effective for DVT of the lower extremities.%目的 总结下肢深静脉血栓形成(deep vein thrombosis,DVT)外科治疗中并发症的治疗经验.方法 回顾性分析2001年1月至2008年1月外科治疗下肢深静脉血栓形成171例的临床资料.先行下腔静脉滤器置入,对近段髂股静脉血栓采用Fogarty取栓管取栓73例;Amplatz消融器(ATD)消融血栓55例;Acolysis超声消融器消融血栓43例,

  11. [Complications of obesity--pathogenesis].

    Science.gov (United States)

    Krahulec, Boris

    2010-10-01

    Author discuss possible pathogenetic mechanisms of obesity complications. He separates metabolic complications, especially risk factors of atherosclerosis collected in syndrome of insulin resistance. Here can be added also hyperuricaemia and nonalcoholic fatty liver disease. Mechanical complications of obesity are first of all breath disorders, gastrooesophageal reflux disease and ostaoarthritis.

  12. A narrative review on role of Yoga as an adjuvant in the management of risk factor, disease progression and the complications of type 2 diabetes mellitus.

    Science.gov (United States)

    Mooventhan, A

    2017-03-06

    Type 2 diabetes mellitus (T2DM) is one of the major health problems in the world as well as in India that greatly affects the health care sector and economy. Use of drugs has its own drawbacks and in recent days the use of non-medical measures were reported not only to manage T2DM, but also to prevent its complications. Through there are various review articles that are dealing with the effect of Yoga on risk profiles, management along with the mechanisms of action of yoga in T2DM separately, there is a lack of comprehensive review on the effect of Yoga in combination with all the above mentioned including the effect of Yoga in the management of T2DM complications. Hence, we performed a narrative review in Medline/PubMed using keyword "Yoga and diabetes". All the relevant articles published till 08th November 2016 were included. Based on the available literature, it could be concluded that Yoga plays a vital role as an adjuvant in the management of risk factors, disease progression and the complications of the T2DM. Further studies are warranted using standard research designs and variables to find out the various mechanisms of effects of Yoga in detail. Copyright © 2017 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  13. Complicated rhinosinusitis

    NARCIS (Netherlands)

    Hansen, F.S.

    2016-01-01

    Complicated rhinosinusitis: a title chosen for its multi-interpretable nature. In the Oxford dictionary ‘complicated’ is defined as ‘consisting of many interconnecting parts or elements’ and ‘involving many different and confusing aspects’ as well as ‘involving complications’ in medicine. It is the

  14. Evaluation of selected oral cavity microbiota--risk factors of management complications in patients with masticatory system disorders.

    Science.gov (United States)

    Zawadzki, Paweł J; Perkowski, Konrad; Starościak, Bohdan; Dybicz, Monika; Baltaza, Wanda; Pionkowski, Krzysztof; Chomicz, Lidia

    2016-01-01

    The retrospective analysis of data on oral cavity clinical status in relation to microbiota species composition is presented. The research regards patients of different age, with and without congenital malformation, pretreatment assessed for occurrence of pathological changes in the masticatory system. Samples of the swabs collected from each patient (from dental plaque, periodontium and dental pockets) were used for identification of oral protozoans in wet slides and stained preparations; additionally, transmission electron microscope examination was performed. The material was used for in vitro cultures to identify bacteria strains. Clinically, intensity of tissue deteriorations was higher in patients with a congenital disease. Alive Trichomonas tenax and Entamoeba gingivalis, species with confirmed pathogenic impact on oral cavity and neighboring structures, were detected with higher prevalence in older patients. Enterococci, Staphylococcus aureus, various Enterobacteriaceae were more frequently detected in patients with somatic and mental retardations; in mouths of those patients, Klebsiella pneumonia and Pseudomonas aeruginosa opportunistic strains occurred. Masticatory system abnormalities favor colonization of oral cavity by exogenous species and dissemination of infections, especially dangerous for patients with congenital diseases. Oral microbiota assessment and preventive measures may be helpful to avoid subsequent peri-surgery complications.

  15. Neurologic complication after anterior sciatic nerve block.

    Science.gov (United States)

    Shah, Shruti; Hadzic, Admir; Vloka, Jerry D; Cafferty, Maureen S; Moucha, Calin S; Santos, Alan C

    2005-05-01

    The lack of reported complications related to lower extremity peripheral nerve blocks (PNBs) may be related to the relatively infrequent application of these techniques and to the fact that most such events go unpublished. Our current understanding of the factors that lead to neurologic complications after PNBs is limited. This is partly the result of our inability to conduct meaningful retrospective studies because of a lack of standard and objective monitoring and documentation procedures for PNBs. We report a case of permanent injury to the sciatic nerve after sciatic nerve block through the anterior approach and discuss mechanisms that may have led to the injury. Intraneural injection and nerve injury can occur in the absence of pain on injection and it may be heralded by high injection pressure (resistance).

  16. Leukocytoclastic Vasculitis as a Complication of Recombinant Granulocyte Colony-Stimulating Factor Therapy in a Heart Transplant Patient

    Directory of Open Access Journals (Sweden)

    Giovanbattista Ippoliti

    2014-01-01

    Full Text Available Recombinant granulocyte colony-stimulating factor (rG-CSF is a myeloid growth factor that is widely used in haematology to recover neutropenia secondary to myelosuppressive chemotherapy. Leukocytoclastic vasculitis is an acknowledged side effect of the above therapy. Its pathogenesis involves many mechanisms that collectively induce an increase in neutrophil function and a subsequent release of cytokines. Here, we report a case of leukocytoclastic vasculitis proven by skin biopsy, following the use of rG-CSF in a heart transplant patient with leukopenia secondary to immunosuppressive therapy.

  17. Placental endoplasmic reticulum stress negatively regulates transcription of placental growth factor via ATF4 and ATF6β: implications for the pathophysiology of human pregnancy complications.

    Science.gov (United States)

    Mizuuchi, Masahito; Cindrova-Davies, Tereza; Olovsson, Matts; Charnock-Jones, D Stephen; Burton, Graham J; Yung, Hong Wa

    2016-03-01

    Low maternal circulating concentrations of placental growth factor (PlGF) are one of the hallmarks of human pregnancy complications, including fetal growth restriction (FGR) and early-onset pre-eclampsia (PE). Currently, PlGF is used clinically with other biomarkers to screen for high-risk cases, although the mechanisms underlying its regulation are largely unknown. Placental endoplasmic reticulum (ER) stress has recently been found to be elevated in cases of FGR, and to an even greater extent in early-onset PE complicated with FGR. ER stress activates the unfolded protein response (UPR); attenuation of protein translation and a reduction in cell growth and proliferation play crucial roles in the pathophysiology of these complications of pregnancy. In this study, we further identified that ER stress regulates release of PlGF. We first observed that down-regulation of PlGF protein was associated with nuclear localization of ATF4, ATF6α and ATF6β in the syncytiotrophoblast of placentae from PE patients. Transcript analysis showed a decrease of PlGF mRNA, and an increase from genes encoding those UPR transcription factors in placentae from cases of early-onset PE, but not of late-onset (>34 weeks) PE, compared to term controls. Further investigations indicated a strong correlation between ATF4 and PlGF mRNA levels only (r = - 0.73, p stress or hypoxia-reoxygenation. The stability of PlGF transcripts was unchanged. The use of small interfering RNA specific for transcription factors in the UPR pathways revealed that ATF4 and ATF6β, but not ATF6α, modulate PlGF transcription. To conclude, ATF4 and ATF6β act synergistically in the negative regulation of PlGF mRNA expression, resulting in reduced PlGF secretion by the trophoblast in response to stress. Therefore, these results further support the targeting of placental ER stress as a potential new therapeutic intervention for these pregnancy complications. © 2015 The Authors. The Journal of Pathology published by

  18. Fatores predisponentes das complicações incisionaisde laparotomias medianas em eqüinos Predisposal factors to incisional complications of ventral midline laparotomies in horses

    Directory of Open Access Journals (Sweden)

    Geane Maciel Pagliosa

    2004-10-01

    Full Text Available As complicações incisionais após laparotomia mediana em eqüinos têm prevalência de 35 a 87,5% e levam a aumento no período de convalescença ou mesmo ao óbito. Os fatores predisponentes destas complicações são pouco abordados na literatura médica eqüina e são inerentes ao paciente, ao ato cirúrgico, à anestesia e ao período pós-operatório. Considerações sobre os cuidados no pré-operatório, tamanho da incisão, roupa do cirurgião, escolha do fio cirúrgico e as condições clínicas e comportamentais do eqüino são salientadas entre os fatores predisponentes que, quando bem conhecidos, podem ser melhor administrados, no sentido de minimizar as complicações incisionais na laparotomia mediana.Incisional complications after equine midline laparotomy have an incidence of 35 to 87.5% and lead an increase in the convalescence period or to death. Predisposed factors to these complications are little approached in the equine medicine literature and consist of inherent factors to the patient, surgery, anesthesia and postoperative period. Preoperative cares, size of the incision, surgeon clothes, the choice of the suture material and equine clinical and behaviour conditions may be considered and well known in order to decrease the incisional complications after the midline laparotomy.

  19. Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications

    OpenAIRE

    Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; GHADERI, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

    2016-01-01

    Introduction: Self-rated health is a brief measure for general health. It is a comprehensive and sensitive index for prediction of health in future. Due to the high internet usage in medical students, the current study designed to evaluate the self-rated health (SRH) in relationship with internet addiction risk factors in medical students. Methods: This cross sectional study conducted on 254 students of Qom University of Medical Sciences 2014. Participants selected by two stage sampling metho...

  20. Prognostic factors for death and survival with or without complications in cardiac arrest patients receiving CPR within 24 hours of anesthesia for emergency surgery

    Directory of Open Access Journals (Sweden)

    Siriphuwanun V

    2014-10-01

    Full Text Available Visith Siriphuwanun,1 Yodying Punjasawadwong,1 Worawut Lapisatepun,1 Somrat Charuluxananan,2 Ketchada Uerpairojkit2 1Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand Purpose: To determine prognostic factors for death and survival with or without complications in cardiac arrest patients who received cardiopulmonary resuscitation (CPR within 24 hours of receiving anesthesia for emergency surgery. Patients and methods: A retrospective cohort study approved by the Maharaj Nakorn Chiang Mai University Hospital Ethical Committee. Data used were taken from records of 751 cardiac arrest patients who received their first CPR within 24 hours of anesthesia for emergency surgery between January 1, 2003 and October 31, 2011. The reviewed data included patient characteristics, surgical procedures, American Society of Anesthesiologist (ASA physical status classification, anesthesia information, the timing of cardiac arrest, CPR details, and outcomes at 24 hours after CPR. Univariate and polytomous logistic regression analyses were used to determine prognostic factors associated with the outcome variable. P-values of less than 0.05 were considered statistically significant. Results: The outcomes at 24 hours were death (638/751, 85.0%, survival with complications (73/751, 9.7%, and survival without complications (40/751, 5.3%. The prognostic factors associated with death were: age between 13–34 years (OR =3.08, 95% CI =1.03–9.19; ASA physical status three and higher (OR =6.60, 95% CI =2.17–20.13; precardiopulmonary comorbidity (OR =3.28, 95% CI =1.09–9.90; the condition of patients who were on mechanical ventilation prior to receiving anesthesia (OR =4.11, 95% CI =1.17–14.38; surgery in the upper abdominal site (OR =14.64, 95% CI =2.83–75.82; shock prior to cardiac arrest (OR =6.24, 95% CI =2.53–15

  1. Analysis of risk factors for pulmonary complications in patients with limited-stage small cell lung cancer. A single-centre retrospective study

    Energy Technology Data Exchange (ETDEWEB)

    Sas-Korczynska, Beata; Kamzol, Wojciech [Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow Branch, Clinic of Oncology and Department of Radiotherapy, Cracow (Poland); Luczynska, Elzbieta [Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Cracow Branch, Department of Diagnostic Radiology, Cracow (Poland); Sokolowski, Andrzej [Cracow University of Economics, Department of Statistics, Cracow (Poland)

    2017-02-15

    The most effective therapy in patients with limited-stage small cell lung cancer (LS SCLC) seems to be chemotherapy (using platinum-based regimens) and thoracic radiotherapy (TRT), which is followed by prophylactic cranial irradiation. The analysed group comprised 217 patients who received combined treatment for LS SCLC, i.e. chemotherapy (according to cisplatin and etoposide schedule) and TRT (concurrent in 101 and sequential in 116 patients). The influence of chemoradiotherapy (ChT-RT) schedule on treatment results (frequency of complete response, survival rates, and incidence of treatment failure and complications) was evaluated, and the frequency and severity of pulmonary complications were analysed to identify risk factors. The 5-year survival rates in concurrent vs. sequential ChT-RT schedules were 27.3 vs. 11.7% (overall) and 28 vs. 14.3% (disease-free). The frequencies of adverse events in relation to concurrent vs. sequential therapy were 85.1 vs. 9.5% (haematological complications) and 58.4 vs. 38.8% (pulmonary fibrosis), respectively. It was found that concurrent ChT-RT (hazard ratio, HR 2.75), a total dose equal to or more than 54 Gy (HR 2.55), the presence of haematological complications (HR 1.89) and a lung volume receiving a dose equal to or greater than 20 Gy exceeding 31% (HR 1.06) were the risk factors for pulmonary complications. Pulmonary complications after ChT-RT developed in 82% of patients treated for LS SCLC. In comparison to the sequential approach, concurrent ChT-RT had a positive effect on treatment outcome. However, this is a factor that can impair treatment tolerance, which manifests in the appearance of side effects. (orig.) [German] Die wirksamste Therapie bei einem kleinzelligen Lungenkrebs im limitierten Stadium (LS SCLC) scheinen Chemotherapie (platinbasierte Regime) und thorakale Strahlentherapie (TRT) zu sein, begleitet von der prophylaktischen Schaedelbestrahlung. Analysiert wurden 217 Patienten, die eine kombinierte Behandlung

  2. [Change in the activity of the key gluconeogenesis enzymes in the rat liver and kidneys during the action of subextreme and extreme factors on the body].

    Science.gov (United States)

    Panin, L E; Kolosova, I E; Nechaev, Iu S

    1979-06-01

    The activity of glucogenesis key enzymes (phosphoenolpyruvate carboxinase, fructoso-1,6-siphosphatase, glucoso-6-phosphatase) of the rat liver and kidneys was studied simultaneously under the effect of extreme and subextreme factors on the organism. The low initial phosphoenolpyruvate carboxikinase activity in the liver and its high inductivity under extreme conditions suggest a role of this enzyme as limiting link in glyconeogenesis. The activity of phosphoenolpyruvate carboxinase in the kidneys is comparable to that of fructoso-1,6-diphosphatase; it is considerably higher than the activity of glucoso-6-phosphatase. The phosphoenolpyruvate carboxinase activity in the kidneys is 5--6 times higher than in the liver. The activity of phosphoenolpyruvate carboxinase and glucoso-6-phosphatase is increased under the effect of extreme factors, and that of fructoso-1,6-diphosphatase remains unchanged. The lack of clear synchronous changes in the activity of glucogenesis key enzymes in the liver and kidneys indicates that the cells of these organs do not provide the united operon for phosphoenolpyruvate carboxinase, fructoso-1,6-diphosphatase and glucoso-6-phosphatase with common regulation mechanism.

  3. [Complications of Gaucher's disease].

    Science.gov (United States)

    Modrego Pardo, P J; Garzarán, G; González, N; Baiges, J J; Gazulla, J

    1992-10-01

    We discuss two cases of Gaucher's disease of the adult with neurological complications. First of the patients came to Hospital due to sudden pain in dorso-lumbar region and motor weakness of lower extremities. In the neurological exploration there were no concluding objective deficit signs except an unstable deambulation. After several hours of rest, symptoms disappeared progressively. In the radiology of the raquis a crushed in the last three dorsal vertebral was seen; this finding together with the clinic the patient showed, suggested a mild and transitory medullar compression. Second patient suffered an intraparenchymatous brain hemorrhage on the course of a platelet depletion and with other mild coagulation disorders. This type of complication have never been described in Gaucher's disease.

  4. Factores asociados a complicaciones de la colangiopancreatografía retrógrada endoscópica en un hospital de alta complejidad Factors associated to complications of endoscopic retrograde cholangiopancreatography in a third-level hospital

    Directory of Open Access Journals (Sweden)

    Angel Quispe-Mauricio

    2010-06-01

    Full Text Available El tratamiento endoscópico de las enfermedades de la vía biliar es posible gracias a la colangiopancreatografía retrógrada endoscópica (CPRE; no obstante, no está exenta de complicaciones. Objetivos. Describir las características e indicaciones de la CPRE y determinar los factores asociados al desarrollo de complicaciones tras la realización de este procedimiento. Materiales y métodos. Se realizó un estudio observacional retrospectivo en el Departamento de Gastroenterología del Hospital Nacional Guillermo Almenara Irigoyen en Lima, Perú; desde marzo de 2002 a junio de 2005. Resultados. Se evaluaron 294 informes en 280 pacientes, la mediana de la edad fue 58 y 155 (52,7% fueron mujeres; cinco procedimientos se efectuaron en la Unidad de Cuidados Intensivos (UCI. La indicación más frecuente fue la coledocolitiasis en el 67,3% de los casos, 205 (69,7% procedimientos fueron exitosos complicándose sólo 33 de ellos. Las complicaciones más frecuentes fueron la pancreatitis aguda y la hemorragia, en 16 y 13 pacientes, respectivamente. No se reportó casos de perforación o defunción. La canulación del conducto pancreático más de una vez fue un factor asociado (OR=2,01; IC95%: 1,11 - 5,92; p=0,03. Conclusiones. El 11,2% de los casos se complicaron, siendo la pancreatitis aguda y la hemorragia leve las complicaciones más frecuentes. Sólo la canulación al conducto pancreático en más de una oportunidad es un factor asociado para tener complicaciones.Endoscopic treatment of the bile duct diseases is possible thanks to the ERCP (endoscopic retrograde cholangio pancreatography, nevertheless, it is not free of complications. Objectives. To describe the characteristics and indications of the ERCP and determine the factors associated to the development of complications after performing the procedure. Materials and methods. An observational retrospective study was done in the Gastroenterology Department of the Hospital Guillermo Almenara

  5. Risk factor analysis of pulmonary hemorrhage complicating CT-guided lung biopsy in coaxial and non-coaxial core biopsy techniques in 650 patients

    Energy Technology Data Exchange (ETDEWEB)

    Nour-Eldin, Nour-Eldin A., E-mail: nour410@hotmail.com [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Diagnostic and Interventional Radiology Department, Cairo University Hospital, Cairo (Egypt); Alsubhi, Mohammed [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Naguib, Nagy N. [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany); Diagnostic and Interventional Radiology Department, Alexandria University Hospital, Alexandria (Egypt); Lehnert, Thomas; Emam, Ahmed; Beeres, Martin; Bodelle, Boris; Koitka, Karen; Vogl, Thomas J.; Jacobi, Volkmar [Institute for Diagnostic and Interventional Radiology, Johan Wolfgang Goethe – University Hospital, Theodor-Stern-Kai 7, 60590 Frankfurt am Main (Germany)

    2014-10-15

    Purpose: To evaluate the risk factors involved in the development of pulmonary hemorrhage complicating CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques. Materials and methods: Retrospective study included CT-guided percutaneous lung biopsies in 650 consecutive patients (407 males, 243 females; mean age 54.6 years, SD: 5.2) from November 2008 to June 2013. Patients were classified according to lung biopsy technique in coaxial group (318 lesions) and non-coaxial group (332 lesions). Exclusion criteria for biopsy were: lesions <5 mm in diameter, uncorrectable coagulopathy, positive-pressure ventilation, severe respiratory compromise, pulmonary arterial hypertension or refusal of the procedure. Risk factors for pulmonary hemorrhage complicating lung biopsy were classified into: (a) patient's related risk factors, (b) lesion's related risk factors and (d) technical risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher's exact tests for statistical analysis. p values <0.05 were considered statistically significant. Results: Incidence of pulmonary hemorrhage was 19.6% (65/332) in non-coaxial group and 22.3% (71/318) in coaxial group. The difference in incidence between both groups was statistically insignificant (p = 0.27). Hemoptysis developed in 5.4% (18/332) and in 6.3% (20/318) in the non-coaxial and coaxial groups respectively. Traversing pulmonary vessels in the needle biopsy track was a significant risk factor of the development pulmonary hemorrhage (incidence: 55.4% (36/65, p = 0.0003) in the non-coaxial group and 57.7% (41/71, p = 0.0013) in coaxial group). Other significant risk factors included: lesions of less than 2 cm (p value of 0.01 and 0.02 in non-coaxial and coaxial groups respectively), basal and middle zonal lesions in comparison to upper zonal lung lesions (p = 0.002 and 0.03 in non-coaxial and coaxial groups respectively), increased lesion

  6. Factors associated with the development of renal complications of diabetes mellitus in São Paulo city

    Directory of Open Access Journals (Sweden)

    S.R.G. Ferreira

    1997-06-01

    Full Text Available The incidence of diabetic end-stage renal failure (ESRF varies worldwide and risk factors have been demonstrated in several populations. The objective of the present study was to identify possible factors associated with the risk of development of ESRF in patients with diabetes mellitus (DM. Two groups of diabetic subjects were included in a case-control study: 1 one group was submitted to renal replacement therapies, attending dialysis centers in São Paulo city and 2 the same number of controls without clinical nephropathy (two negative dipstick tests for urine protein, matched for duration of DM, were obtained from an outpatient clinic. A standardized questionnaire was used by a single investigator and additional data were obtained from the medical records of the patients. A total of 290 diabetic patients from 33 dialysis centers were identified, and 266 questionnaires were considered to contain reliable information. Male/female ratios were 1.13 for ESRF and 0.49 for the control group. A higher frequency of men was observed in the ESRF group when compared with controls (53 vs 33%, P<0.00001, although logistic regression analysis did not confirm an association of gender and diabetic nephropathy (DN. Similar proportions of non-white individuals were found for both groups. Patients with insulin-dependent diabetes mellitus (IDDM were less common than patients with non-insulin-dependent diabetes mellitus (NIDDM, particularly in the control group (3.4 vs 26.3%, P<0.00001, for controls and ESRF patients, respectively; this type of DM was associated with a higher risk of ESRF than NIDDM, as determined by univariate analysis or logistic regression (OR = 4.1. Hypertension by the time of the DM diagnosis conferred a 1.4-fold higher risk of ESRF (P = 0.04, but no difference was observed concerning the presence of a family history. Association between smoking and alcohol habits and increased risk was observed (OR = 4.5 and 5.9, respectively, P<0.001. A 2

  7. 小儿脑瘫危险因素与合并症相关分析%Correlation Analysis of Risk Factors and Complications on Children Cerebral Palsy

    Institute of Scientific and Technical Information of China (English)

    王军英; 伍俊妮; 张惠佳; 汤清波; 覃蓉; 颜华; 熊毛伟; 易慧娟; 肖曙光; 王跑球

    2011-01-01

    Objective To investigate the risk factors related with children cerebral palsy (CP), the complications and the constituent ratio of types of cerebral palsies.Methods Retrospectively study 1204 cases of affected children' s clinical data from January 2005 to December 2009, using the statistical method of chi-square criterion, the relationships of the high risk factors and the complications resulted in children cerebral palsies were investigated, and the relationships of the incidence rate of types of CP constituent ratio and the complications were studied as well.Results There presented risk factors of 1044 in 1204 cases (86.71%).The major risk factors by turns were asphyxiation, preterm low weight, other un-definite factors, choloplania, intrauterine infection, superfoetation/twins, intracranial hemorrhage and the abnormal umbilical core.The rate of the CP children accompanied with complications was 91.35% (1102/1204), the incidence rate with mental retardation was 72.09% (868 cases), with language disturbance 43.52% (524 cases), with epilepsy 22.26% (268 cases), with hearing disturbance 22.09% (266 cases), with ingestion difficulty 58.47% (702 cases),with optic atrophy 25.75 % (310 cases), with hydrostomia 75.91% (914 cases), and there were statistical differences among different types of CP (P< 0.05), the three highest incidence rates was spasmus, athetosis and nixed types of CP by turns.And there were significant difference in statistics ( P < 0.01 ).Conclusions The CP was a kind of sophisticated disorder resulted from the lesion of brain, the affected presented a series of developmental disturbance.During the treatment, we should be pay attention to the entire rehabilitation for affected children.%目的 分析小儿脑瘫危险因素、脑瘫分型与合并症相关性.方法 回顾性调查2005年1月-2009年12月期间的1 204例脑瘫患儿临床资料,了解脑瘫高危因素与合并症的关系以及与脑瘫分型的发生率,用

  8. [Type 2 diabetes complications].

    Science.gov (United States)

    Schlienger, Jean-Louis

    2013-05-01

    People with type 2 diabetes are at increased risk of many complications, which are mainly due to complex and interconnected mechanisms such as hyperglycemia, insulino-resistance, low-grade inflammation and accelerated atherogenesis. Cardi-cerebrovascular disease are frequently associated to type 2 diabetes and may become life threatening, particularly coronaropathy, stroke and heart failure. Their clinical picture are sometimes atypical and silencious for a long time. Type 2 diabetes must be considered as an independent cardiovascular risk factor. Nephropathy is frequent in type 2 diabetes but has a mixed origin. Now it is the highest cause of end-stage renal disease. Better metabolic and blood pressure control and an improved management of microalbuminuria are able to slowdown the course of the disease. Retinopathy which is paradoxically slightly progressive must however be screened and treated in these rather old patients which are globally at high ophthalmologic risk. Diabetic foot is a severe complication secondary to microangiopathy, microangiopathy and neuropathy. It may be considered as a super-complication of several complications. Its screening must be done on a routine basis. Some cancer may be considered as an emerging complication of type 2 diabetes as well as cognitive decline, sleep apnea syndrome, mood disorders and bone metabolism impairments. Most of the type 2 diabetes complications may be prevented by a strategy combining a systematic screening and multi-interventional therapies.

  9. Self-rated Health and Internet Addiction in Iranian Medical Sciences Students; Prevalence, Risk Factors and Complications.

    Science.gov (United States)

    Mohammadbeigi, Abolfazl; Valizadeh, Farzaneh; Mirshojaee, Seyede Roqaie; Ahmadli, Robabeh; Mokhtari, Mohsen; Ghaderi, Ebrahim; Ahmadi, Ali; Rezaei, Heshmatollah; Ansari, Hossein

    2016-06-01

    Self-rated health is a brief measure for general health. It is a comprehensive and sensitive index for prediction of health in future. Due to the high internet usage in medical students, the current study designed to evaluate the self-rated health (SRH) in relationship with internet addiction risk factors in medical students. This cross sectional study conducted on 254 students of Qom University of Medical Sciences 2014. Participants selected by two stage sampling method including stratified and simple random sampling. The Young's questionnaire of internet addiction and SRH question used for data collection. Chi-square, t-test, and logistic regression used in data analysis. More than 79.9% of students reported their general health good and very good. The student's mean score of general health was higher than the average. In addition, the prevalence of internet addiction was 28.7%. An inverse significant correlation observed between SRH and internet addiction score (r=-0.198, p=0.002). Using internet for Entertainment, using private Email and chat rooms were the most important predictors of affecting to internet addiction. Moreover, internet addiction is the most predictors of SRH and increased the odds of bad SRH. The good SRH of medical students was higher than general population but in health faculty' students were lower than others. Due to the effect of internet addiction on SRH and increasing trend of internet use in medical students, as well as low age of participants, attention to psychological aspects and the job expectancy in future, can effective on increasing the good SRH.

  10. Analysis of the Related Factors of Complications of Acoustic Neuroma%听神经瘤并发症及相关因素分析

    Institute of Scientific and Technical Information of China (English)

    常丙林

    2016-01-01

    Objective To investigate the Operative complications and treatments of Acoustic neurinomas.Methods 57 cases of Acoustic neurinomas were treated by operation,their clinical data and postoperative follow-up were retrospectively analyzed. Results Among 57 cases of acoustic neuroma,49 cases (86.0%)adopted acoustic neuroma total resection,8 cases (14.0%)adopted acoustic neuroma subtotal resection,The facial nerve was preserved anatomically in 51cases (89.5%),The functional preservation of the facial nerve in postoperative 1 year was 53 cases (93.0%).There was no surgery -related fatality.The postoperative complications were:deaf,facial Paralysis,cerebrospinal fluid leakage,intracranial infection,intracranial hematoma,seroma,cranial nerve involvement,balance disorders.Conclusion The postoperative complications of acoustic neuroma are related to tumor size;Surgical techniques and postoperative management is a key factor in avoiding complications arise.%目的探讨听神经瘤手术并发症及其处理。方法对57例听神经瘤手术患者的临床资料和术后随访进行回顾性分析。结果57例患者中,听神经瘤全切共49例(86.0%),次全切共8例(14.0%),面神经解剖保留共51例(89.5%),术后6个月面神经功能保留共53例(93.0%),在手术过程中无1例患者死亡。术后并发症为:耳聋,面神经麻痹,脑脊液漏,颅内感染,颅内血肿,皮下积液,后组颅神经受累,平衡障碍。结论听神经瘤术后并发症与肿瘤大小有关;手术技术和术后管理是避免出现并发症的关键因素。

  11. Extreme cosmos

    CERN Document Server

    Gaensler, Bryan

    2011-01-01

    The universe is all about extremes. Space has a temperature 270°C below freezing. Stars die in catastrophic supernova explosions a billion times brighter than the Sun. A black hole can generate 10 million trillion volts of electricity. And hypergiants are stars 2 billion kilometres across, larger than the orbit of Jupiter. Extreme Cosmos provides a stunning new view of the way the Universe works, seen through the lens of extremes: the fastest, hottest, heaviest, brightest, oldest, densest and even the loudest. This is an astronomy book that not only offers amazing facts and figures but also re

  12. Assessing gene-environment interaction effects of FTO, MC4R and lifestyle factors on obesity using an extreme phenotype sampling design: Results from the HUNT study.

    Science.gov (United States)

    Bjørnland, Thea; Langaas, Mette; Grill, Valdemar; Mostad, Ingrid Løvold

    2017-01-01

    Our aim was to assess the influence of age, gender and lifestyle factors on the effect of the obesity-promoting alleles of FTO and MCR4. The HUNT study comprises health information on the population of Nord-Trøndelag county, Norway. Extreme phenotype participants (gender-wise lower and upper quartiles of waist-hip-ratio and BMI ≥ 35 kg/m2) in the third survey, HUNT3 (2006-08), were genotyped for the single-nucleotide polymorphisms rs9939609 (FTO) and rs17782313 (MC4R); 25686 participants were successfully genotyped. Extreme sampling was chosen to increase power to detect genetic and gene-environment effects on waist-hip-ratio and BMI. Statistical inference was based on linear regression models and a missing-covariate likelihood approach for the extreme phenotype sampling design. Environmental factors were physical activity, diet (artificially sweetened beverages) and smoking. Longitudinal analysis was performed using material from HUNT2 (1995-97). Cross-sectional and longitudinal genetic effects indicated stronger genetic associations with obesity in young than in old, as well as differences between women and men. We observed larger genetic effects among physically inactive compared to active individuals. This interaction was age-dependent and seen mainly in 20-40 year olds. We observed a greater FTO effect among men with a regular intake of artificially sweetened beverages, compared to non-drinkers. Interaction analysis of smoking was mainly inconclusive. In a large all-adult and area-based population survey the effects of obesity-promoting minor-alleles of FTO and MCR4, and interactions with life style factors are age- and gender-related. These findings appear relevant when designing individualized treatment for and prophylaxis against obesity.

  13. Risk Factors of Work-related Upper Extremity Musculoskeletal Disorders in Male Shipyard Workers: Structural Equation Model Analysis

    Directory of Open Access Journals (Sweden)

    Byung-Chan Park

    2010-12-01

    Conclusion: The model in this study provides a better approximation of the complexity of the actual relationship between risk factors and work-related musculoskeletal disorders. Among the variables evaluated in this study, physical factors (work posture had the strongest association with musculoskeletal disorders.

  14. Thrombophilia in complicated pregnancies

    Directory of Open Access Journals (Sweden)

    Ayşe Şahin

    2013-12-01

    Full Text Available Objective: To investigate the incidence and etiology of pregnancy complications associated with thrombophilic factors. Methods: Fifty-four patients with complicated pregnancy and 40 healthy pregnant subjects were included the study. Factor V Leiden (FVL mutation, protein S, protein C, anti-thrombin deficiency levels were investigated. Results: Of the 54 patients with complicated pregnancy, 29 had preeclampsia, 18 had intra uterine growth retardation, and 7 had intrauterine fetal loss. The most common defect was FVL mutation. FVL mutations in patient group and the control group were 27.2% and 10%, respectively, which were statistically significant. The protein S, protein C, and anti-thrombin deficiencies were found higher in the patient group compared to control (p>0.05 for each. Conclusion: FVL mutation was found higher in patient group compared to the control group, Protein C deficiency and anti-thrombin deficiency were related to preeclampsia but not other pregnancy complications. Clinicians should take into account the thrombophilia in complicated pregnancy, especially preeclampsia. J Clin Exp Invest 2013; 4 (4: 497-502

  15. 下肢动脉疾病危险因素研究现状%Study status on risk factors of lower extremity arterial disease

    Institute of Scientific and Technical Information of China (English)

    尹彦亮; 沈彦明

    2012-01-01

    Lower extremity arterial disease in the elderly has become a common disease, and slow progress of lower extremity arterial disease, longer duration, its risk factors contribute to the early high-risk groups to take preventive measures to avoid the serious consequences from occurring. And what are the factors promoting the development of LEAD play the more important role were not yet clear. The article from the smoking, hypertension, diabetes, blood lipids and other aspects-review the risk factors LEAD.%下肢动脉疾病已成为中老年人常见的疾病,而下肢动脉疾病进展慢,病程长,对其相关危险因素的研究有助于使高危人群早期采取预防措施,避免其严重后果的发生.而哪些因素在促进LEAD的发展中起到更加重要的作用,尚未明确.本文主要从吸烟、高血压、糖尿病、血脂等方面对LEAD的危险因素研究现状作一综述.

  16. The RosR transcription factor is required for gene expression dynamics in response to extreme oxidative stress in a hypersaline-adapted archaeon

    Directory of Open Access Journals (Sweden)

    Sharma Kriti

    2012-07-01

    Full Text Available Abstract Background Previous work has shown that the hypersaline-adapted archaeon, Halobacterium salinarum NRC-1, is highly resistant to oxidative stress caused by exposure to hydrogen peroxide, UV, and gamma radiation. Dynamic alteration of the gene regulatory network (GRN has been implicated in such resistance. However, the molecular functions of transcription regulatory proteins involved in this response remain unknown. Results Here we have reanalyzed several existing GRN and systems biology datasets for H. salinarum to identify and characterize a novel winged helix-turn-helix transcription factor, VNG0258H, as a regulator required for reactive oxygen species resistance in this organism. This protein appears to be unique to the haloarchaea at the primary sequence level. High throughput quantitative growth assays in a deletion mutant strain implicate VNG0258H in extreme oxidative stress resistance. According to time course gene expression analyses, this transcription factor is required for the appropriate dynamic response of nearly 300 genes to reactive oxygen species damage from paraquat and hydrogen peroxide. These genes are predicted to function in repair of oxidative damage to proteins and DNA. In vivo DNA binding assays demonstrate that VNG0258H binds DNA to mediate gene regulation. Conclusions Together these results suggest that VNG0258H is a novel archaeal transcription factor that regulates gene expression to enable adaptation to the extremely oxidative, hypersaline niche of H. salinarum. We have therefore renamed VNG0258H as RosR, for reactive oxygen species regulator.

  17. NGC 6778: Strengthening the link between extreme abundance discrepancy factors and central star binarity in planetary nebulae

    CERN Document Server

    Jones, David; García-Rojas, Jorge; Corradi, Romano L M; Boffin, Henri M J

    2015-01-01

    We present new optical spectra of the nearby, bright, planetary nebula NGC 6778. The nebula has been known to emit strong recombination lines for more than 40 years but this is the first detailed study of its abundances. Heavy element abundances derived from recombination lines are found to exceed those from collisionally excited lines by a factor of ~20 in an integrated spectrum of the nebula, which is among the largest known abundance discrepancy factors. Spatial analysis of the spectra shows that the abundance discrepancy factor is strongly, centrally peaked, reaching ~40 close to the central star. The central star of NGC 6778 is known to be a short period binary, further strengthening the link between high nebular abundance discrepancy factors and central star binarity.

  18. ANALYSIS OF PROGNOSTIC FACTORS IN HIGH-GRADE OSTEOSARCOMA OF THE EXTREMITIES IN CHILDREN: A 15-YEAR SINGLE-INSTITUTION EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Liliana eVasquez

    2016-02-01

    Full Text Available Background: The aim of this retrospective study was to define clinical and pathologic features and prognostic factors among children and adolescents diagnosed with high-grade osteosarcoma of the extremities. Methods: A total of 73 patients younger than 18 years old diagnosed with primary osteosarcoma of the extremities between January 1998 and December 2013 were retrospectively evaluated. Prognostic factors such as age, gender, primary tumor site, alkaline phosphatase and lactate dehydrogenase levels, metastatic disease, pathological fracture, histological response and surgery type were analyzed to evaluate their effects on overall (OS and event free survival (EFS. Results: At a median follow-up of 30 months (1.5-152, OS and EFS at 5 years was 64.5±8.1% and 48.5±8.7% for patients with localized disease; and 16.2±7.9% and 14.4±7.3% for patients with initial metastatic disease, respectively. In patients with localized disease, conservative surgery was performed on 22 of 46 patients (43.5%, and there was no significant difference in survival rates among patients who had conservative vs radical surgery (p=0.65. Although tumor size (>12cm was significant prognostic factor in univariate analysis; multivariate analysis identified elevated levels of alkaline phosphatase (p=0.033 and poor response to neoadjuvant chemotherapy (p<0.001 only as independent prognostic factors. Age, histological type, pathological fracture and primary tumor site did not significantly affect prognosis.Conclusion: Initial elevated presence of alkaline phosphatase in serum and poor histological response after neoadjuvant chemotherapy were significant factors for unfavorable prognosis. It is necessary to optimize staging and treatment intensification to improve survival rates, especially among patients with metastasis at initial presentation.

  19. Acquired Upper Extremity Growth Arrest.

    Science.gov (United States)

    Gauger, Erich M; Casnovsky, Lauren L; Gauger, Erica J; Bohn, Deborah C; Van Heest, Ann E

    2017-01-01

    This study reviewed the clinical history and management of acquired growth arrest in the upper extremity in pediatric patients. The records of all patients presenting from 1996 to 2012 with radiographically proven acquired growth arrest were reviewed. Records were examined to determine the etiology and site of growth arrest, management, and complications. Patients with tumors or hereditary etiology were excluded. A total of 44 patients (24 boys and 20 girls) with 51 physeal arrests who presented at a mean age of 10.6 years (range, 0.8-18.2 years) were included in the study. The distal radius was the most common site (n=24), followed by the distal humerus (n=8), metacarpal (n=6), distal ulna (n=5), proximal humerus (n=4), radial head (n=3), and olecranon (n=1). Growth arrest was secondary to trauma (n=22), infection (n=11), idiopathy (n=6), inflammation (n=2), compartment syndrome (n=2), and avascular necrosis (n=1). Twenty-six patients (59%) underwent surgical intervention to address deformity caused by the physeal arrest. Operative procedures included ipsilateral unaffected bone epiphysiodesis (n=21), shortening osteotomy (n=10), lengthening osteotomy (n=8), excision of physeal bar or bone fragment (n=2), angular correction osteotomy (n=1), and creation of single bone forearm (n=1). Four complications occurred; 3 of these required additional procedures. Acquired upper extremity growth arrest usually is caused by trauma or infection, and the most frequent site is the distal radius. Growth disturbances due to premature arrest can be treated effectively with epiphysiodesis or osteotomy. In this series, the specific site of anatomic growth arrest was the primary factor in determining treatment. [Orthopedics. 2017; 40(1):e95-e103.]. Copyright 2016, SLACK Incorporated.

  20. Related Factors Research of Hepatitis C Complicated with Thyroid Disease%丙型肝炎与甲状腺疾病的相关性研究

    Institute of Scientific and Technical Information of China (English)

    戴小灵; 黄镇

    2014-01-01

    Objective:To study related factors of hepatitis C virus (HCV) infection complicated with thyroid disease . Methods:The clinical data of 1 996 cases of chronic hepatitis infections diagnosed and treated in the hospital during the period of January 2003 to June 2014 were retrospectively analyzed .Results:Gender ,emotion ,interferon treatment time and thyroid autoantibodies are main influencing factors of HCV infection complicated with thyroid disease .Four fac-tors ,female (OR= 6 .801 ,95% CI:2 .051~22 .108) ,interferon treatment time is long (OR=7 .942 ,95% CI:4 .502~31 .018) ,adverse emotions (OR=1 .702 ,95% CI:1 .319~2 .296) and positive thyroid autoantibodies (OR= 9 .056 , 95% CI:1 .516~12 .071) were closely related to and HCV infection complicated with thyroid disease and were inde-pendent risk factors for it .Conclusion:Hepatitis C infection patients’gender ,the use of interferon ,bad mood ,and thy-roid autoantibodies positive are the main influence factors inducing thyroid disease .%目的:探讨丙型肝炎病毒(HCV )感染并发甲状腺疾病的相关因素。方法:回顾性分析2003年1月-2014年6月期间在我院诊治的1996例慢性肝炎感染者的临床资料。结果:性别、情绪、干扰素治疗时间和甲状腺自身抗体是HCV感染并发甲状腺疾病的主要影响因素。女性(OR=6.801,95% CI:2.051~22.108)、干扰素治疗时间长(OR=7.942,95% CI:4.502~31.018)、不良情绪(OR=1.702,95% CI:1.319~2.296)和甲状腺自身抗体阳性(OR=9.056,95% CI:1.516~12.071)等四项因素和HCV感染并发甲状腺疾病密切相关,为其独立危险因素。结论:丙肝感染者的性别、使用干扰素、不良情绪和甲状腺自身抗体阳性是诱发甲状腺疾病的主要影响因素。

  1. Effects of an extremely low-frequency electromagnetic field on stress factors: a study in Dictyostelium discoideum cells.

    Science.gov (United States)

    Amaroli, Andrea; Chessa, Maria Giovanna; Bavestrello, Giorgio; Bianco, Bruno

    2013-08-01

    The development of technologies that generate environmental electromagnetic fields (EMFs) has led public opinion and the scientific community to debate upon the existence of possible effects caused by man-made EMFs on the human population and, more generally, on terrestrial ecosystems. Protozoa are known to be excellent bioassay systems in bioelectromagnetic studies because of their features that combine the reliability of in vivo results with the practicality of in vitro ones. For this reason, we examined the possible stressful effects of a 50-Hz, 300-μT extremely low-frequency electromagnetic field (ELF-EMF) on the protozoan Dictyostelium discoideum, which was used as it is included in the eight bioassay alternatives to vertebrate models for the study of human disease by the U.S. National Institutes of Health. Our results show how a 24-h exposure of D. discoideum cells to ELF-EMF can affect the net fission rate, the activity and presence of the pseudocholinesterase as well as the presence of the heat shock protein-70, while no change in the catalase and glutathione peroxidase activities was observed. However, this effect seems to be transient and all the altered parameters returned to their respective control value after a 24-h stay under dummy exposure conditions.

  2. [Complications of tubal sterilization].

    Science.gov (United States)

    Schreiner, W E

    1986-05-01

    In Europe and the US, tubal sterilization by laparoscopy has become the most widely used technique for female sterilization. The overall rate of intra- and postoperative complications differs between 0.145% and 0.85% in the numerous studies which have been done. This means 1 severe complication in 120-700 laparoscopic sterilizations. The lethality of tubal sterilization by laparoscopy lies between 3-10 deaths/100,000 interventions. The so-called "post-tubal ligation syndrome" is a rare complication. The overall pregnancy rate after tubal sterilization is 3-10/1000 women. The rate of ectopic pregnancy is very high and varies between 13.6% and 90%. Only 5% of the sterilized women show dissatisfaction. Several factors are relevant with regard to psychological sequelae and must be considered before tubal sterilization can be performed. 1 of the most important is the individual comprehensive counselling of the female or the couple prior to the sterilization.

  3. Contribution of risk factors to extremely, very and moderately preterm births - register-based analysis of 1,390,742 singleton births.

    Directory of Open Access Journals (Sweden)

    Sari Räisänen

    Full Text Available BACKGROUND: Preterm birth, defined as birth occurring before 37 weeks gestation, is one of the most significant contributors to neonatal mortality and morbidity, with long-term adverse consequences for health, and cognitive outcome. OBJECTIVE: The aim of the present study was to identify risk factors of preterm birth (≤36+6 weeks gestation among singleton births and to quantify the contribution of risk factors to socioeconomic disparities in preterm birth. METHODS: A retrospective population-based case-control study using data derived from the Finnish Medical Birth Register. A total population of singleton births in Finland from 1987-2010 (n = 1,390,742 was reviewed. RESULTS: Among all singleton births (n = 1,390,742, 4.6% (n = 63,340 were preterm (<37 weeks, of which 0.3% (n = 4,452 were classed as extremely preterm, 0.4% (n = 6,213 very preterm and 3.8% (n = 54,177 moderately preterm. Smoking alone explained up to 33% of the variation in extremely, very and moderately preterm birth incidence between high and the low socioeconomic status (SES groups. Reproductive risk factors (placental abruption, placenta previa, major congenital anomaly, amniocentesis, chorionic villus biopsy, anemia, stillbirth, small for gestational age (SGA and fetal sex altogether explained 7.7-25.0% of the variation in preterm birth between SES groups. CONCLUSIONS: Smoking explained about one third of the variation in preterm birth groups between SES groups whereas the contribution of reproductive risk factors including placental abruption, placenta previa, major congenital anomaly, amniocentesis, chorionic villus biopsy, anemia, stillbirth, SGA and fetal sex was up to one fourth.

  4. Comparison of incidence and risk factors of delirium between general and regional anesthesia in elderly patients after lower extremity surgery

    Directory of Open Access Journals (Sweden)

    ilke Kupeli

    2016-03-01

    Conclusion: We found that the incidence of delirium is 12.5% in elderly patients undergoing total hip or knee arthroplasty and femur fracture surgery. Advanced age and polypharmacy are risk factors of delirium. Delirium increases the hospital stay and cost. [Cukurova Med J 2016; 41(1.000: 34-40

  5. Coupling semiconductor nanocrystals to a fused-silica microsphere: a quantum-dot microcavity with extremely high Q factors.

    Science.gov (United States)

    Fan, X; Palinginis, P; Lacey, S; Wang, H; Lonergan, M C

    2000-11-01

    We demonstrate a quantum-dot microcavity by coupling core-shell semiconductor nanocrystals to a fused-silica microsphere. We show that the composite microcavity can feature Q factors of the order of 10(8), providing a model system for investigating cavity QED and microlasers at the level of single quantum dots.

  6. The association of factor V leiden and prothrombin gene mutation and placenta-mediated pregnancy complications: a systematic review and meta-analysis of prospective cohort studies.

    Directory of Open Access Journals (Sweden)

    Marc A Rodger

    2010-06-01

    Full Text Available BACKGROUND: Factor V Leiden (FVL and prothrombin gene mutation (PGM are common inherited thrombophilias. Retrospective studies variably suggest a link between maternal FVL/PGM and placenta-mediated pregnancy complications including pregnancy loss, small for gestational age, pre-eclampsia and placental abruption. Prospective cohort studies provide a superior methodologic design but require larger sample sizes to detect important effects. We undertook a systematic review and a meta-analysis of prospective cohort studies to estimate the association of maternal FVL or PGM carrier status and placenta-mediated pregnancy complications. METHODS AND FINDINGS: A comprehensive search strategy was run in Medline and Embase. Inclusion criteria were: (1 prospective cohort design; (2 clearly defined outcomes including one of the following: pregnancy loss, small for gestational age, pre-eclampsia or placental abruption; (3 maternal FVL or PGM carrier status; (4 sufficient data for calculation of odds ratios (ORs. We identified 322 titles, reviewed 30 articles for inclusion and exclusion criteria, and included ten studies in the meta-analysis. The odds of pregnancy loss in women with FVL (absolute risk 4.2% was 52% higher (OR = 1.52, 95% confidence interval [CI] 1.06-2.19 as compared with women without FVL (absolute risk 3.2%. There was no significant association between FVL and pre-eclampsia (OR = 1.23, 95% CI 0.89-1.70 or between FVL and SGA (OR = 1.0, 95% CI 0.80-1.25. PGM was not associated with pre-eclampsia (OR = 1.25, 95% CI 0.79-1.99 or SGA (OR 1.25, 95% CI 0.92-1.70. CONCLUSIONS: Women with FVL appear to be at a small absolute increased risk of late pregnancy loss. Women with FVL and PGM appear not to be at increased risk of pre-eclampsia or birth of SGA infants. Please see later in the article for the Editors' Summary.

  7. Secretion of interleukin-6 and vascular endothelial growth factor by spindle cell sarcoma complicating Castleman's disease (so-called 'vascular neoplasia').

    Science.gov (United States)

    Kakiuchi, Chihiro; Ishida, Tsuyoshi; Sato, Hitoshi; Katano, Harutaka; Ishiko, Tositaka; Mukai, Hiroyuki; Kogi, Mieko; Kasuga, Naoki; Takeuchi, Kengo; Yamane, Kenichi; Fukayama, Masashi; Mori, Shigeo

    2002-06-01

    So-called 'vascular neoplasia' (VN) is a rare tumour of unknown origin that complicates hyaline vascular type Castleman's disease (CD). This paper reports a case of VN complicating CD of hyaline vascular type, in which neoplastic cells were shown to secrete interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF). In this case, VN first occurred in the retroperitoneum of a 60-year-old male. The lesion showed typical morphology, with three distinct areas: (1) a lymph node-like area with regressively transformed lymph follicles showing hyaline vascular changes and with a hypervascular interfollicular region filled with slit-like vascular channels; (2) an area composed of spindle cell sarcoma; and (3) an area showing angiolipomatous hamartoma. A proportion of the cells in the spindle cell area showed severe pleomorphism. Subcutaneous recurrence after 8 months was composed purely of pleomorphic spindle cells. A karyotypic analysis of the recurrent tumour showed 47, XXY with some instability. Supernatant from primary culture contained high levels of IL-6 and VEGF, suggesting high secretion of these cytokines from neoplastic cells. Immunohistochemically, p53 overexpression was identified only in the pleomorphic spindle cells of the primary lesion and metastatic tumour. No features suggestive of vascular origin were shown on immunohistochemical or electron microscopic analysis of the neoplastic cells. Human herpesvirus type 8 was not detected by immunohistochemistry or PCR analysis. High levels of IL-6 and/or VEGF have been reported to play a role in CD. This is the first case report that clarifies the site of such cytokine production, showing the possibility of CD as a paraneoplastic phenomenon.

  8. Hemodialysis Tunneled Catheter Noninfectious Complications

    Science.gov (United States)

    Miller, Lisa M.; MacRae, Jennifer M.; Kiaii, Mercedeh; Clark, Edward; Dipchand, Christine; Kappel, Joanne; Lok, Charmaine; Luscombe, Rick; Moist, Louise; Oliver, Matthew; Pike, Pamela; Hiremath, Swapnil

    2016-01-01

    Noninfectious hemodialysis catheter complications include catheter dysfunction, catheter-related thrombus, and central vein stenosis. The definitions, causes, and treatment strategies for catheter dysfunction are reviewed below. Catheter-related thrombus is a less common but serious complication of catheters, requiring catheter removal and systemic anticoagulation. In addition, the risk factors, clinical manifestation, and treatment options for central vein stenosis are outlined.

  9. Gastrointestinal Complications of Obesity

    Science.gov (United States)

    Camilleri, Michael; Malhi, Harmeet; Acosta, Andres

    2017-01-01

    Obesity usually is associated with morbidity related to diabetes mellitus and cardiovascular diseases. However, there are many gastrointestinal and hepatic diseases for which obesity is the direct cause (eg, nonalcoholic fatty liver disease) or is a significant risk factor, such as reflux esophagitis and gallstones. When obesity is a risk factor, it may interact with other mechanisms and result in earlier presentation or complicated diseases. There are increased odds ratios or relative risks of several gastrointestinal complications of obesity: gastroesophageal reflux disease, erosive esophagitis, Barrett’s esophagus, esophageal adenocarcinoma, erosive gastritis, gastric cancer, diarrhea, colonic diverticular disease, polyps, cancer, liver disease including nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, gallstones, acute pancreatitis, and pancreatic cancer. Gastroenterologists are uniquely poised to participate in the multidisciplinary management of obesity as physicians caring for people with obesity-related diseases, in addition to their expertise in nutrition and endoscopic interventions. PMID:28192107

  10. Gastrointestinal Complications of Obesity.

    Science.gov (United States)

    Camilleri, Michael; Malhi, Harmeet; Acosta, Andres

    2017-05-01

    Obesity usually is associated with morbidity related to diabetes mellitus and cardiovascular diseases. However, there are many gastrointestinal and hepatic diseases for which obesity is the direct cause (eg, nonalcoholic fatty liver disease) or is a significant risk factor, such as reflux esophagitis and gallstones. When obesity is a risk factor, it may interact with other mechanisms and result in earlier presentation or complicated diseases. There are increased odds ratios or relative risks of several gastrointestinal complications of obesity: gastroesophageal reflux disease, erosive esophagitis, Barrett's esophagus, esophageal adenocarcinoma, erosive gastritis, gastric cancer, diarrhea, colonic diverticular disease, polyps, cancer, liver disease including nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, gallstones, acute pancreatitis, and pancreatic cancer. Gastroenterologists are uniquely poised to participate in the multidisciplinary management of obesity as physicians caring for people with obesity-related diseases, in addition to their expertise in nutrition and endoscopic interventions. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  11. Geomorphic response to an extreme flood in two Mediterranean rivers (northeastern Sardinia, Italy): Analysis of controlling factors

    Science.gov (United States)

    Righini, Margherita; Surian, Nicola; Wohl, Ellen; Marchi, Lorenzo; Comiti, Francesco; Amponsah, William; Borga, Marco

    2017-08-01

    A high-magnitude, low-frequency flash flood affected two ungauged rivers (northeastern Sardinia, Italy) on 18 November 2013. This study investigates the response of channel reaches in a Mediterranean environment featuring different morphological settings (i.e., alluvial, semialluvial, and bedrock boundaries) with the aims of (i) detecting the morphological effects of this large flood and (ii) analyzing a range of morphological and hydraulic variables as potential controlling factors of channel response. Channel widening was the dominant geomorphic response observed, and it occurred at different magnitudes among the study subreaches. Within individual subreaches, channel width increased from 1.1 to 6.2 times the pre-flood width. A significant trend in channel widening is observed, especially in alluvial subreaches where the narrowest channels were prone to enlarge more compared to the widest channels. Considerable erosion of valley sides also occurred in confined and partly confined semialluvial and bedrock subreaches. A range of parameters influenced the geomorphic role of the flood, and a series of selected morphological and hydraulic controlling factors showed robust correlations with changes in channel width, although correlations were stronger in alluvial subreaches. Analysis and documentation of channel response and its variability through different morphological settings is crucial to provide a basis from which to forecast future river sensitivity to geomorphic adjustment to high-magnitude floods and improve flood management strategies.

  12. It's complicated

    DEFF Research Database (Denmark)

    Nielsen, Carsten Fogh

    2013-01-01

    The paper provides a critical discussion of certain limitations of current nativist approaches to the question of moral development. The aim of the paper is to warn against a lingering reductive tendency found among certain contemporary moral nativists: a tendency to exaggerate the importance...... of innate mechanisms for moral development while simultaneously downplaying the importance of other factors in this process. The paper argues that the morally relevant input available in the social and cultural environment of human beings is much richer and more varied than typically acknowledged by moral...

  13. Complications of Dermal Filling

    Directory of Open Access Journals (Sweden)

    Sajad Ahmad Salati

    2011-11-01

    Full Text Available Dermal fillers have globally become sought after drugs due to the desire of aging population to regain the youthful looks without any surgical operations. But like other procedures, dermal filling can become complicated. Besides the profitability have introduced the factor of malpractice which can bring in misery rather than beauty and youthful body contours. This article briefly reviews the common adverse effects of dermal fillers.

  14. Complications thromboemboliques apres catheterisme veineux ...

    African Journals Online (AJOL)

    11 s'agissait d'une etude retrospective sur 18 mois incluant tousles patients ayant ... occured thrombosis and the association of 3 comorbidities and risk factors. The prevalence of thromboembolic complication is too high in our population.

  15. Metabolic Risk Factors of Type 2 Diabetes Mellitus and Correlated Glycemic Control/Complications: A Cross-Sectional Study between Rural and Urban Uygur Residents in Xinjiang Uygur Autonomous Region

    Science.gov (United States)

    Yao, Hua; Zhu, Jun; Ma, Qi; Tuerdi, Ablikm; He, Xiao-dong; Wang, Li; Wang, Zhi-qiang; Xiao, Shan; Wang, Shu-xia; Su, Li-ping

    2016-01-01

    Background Diabetes is a major global public health problem driven by a high prevalence of metabolic risk factors. Objective To describe the differences of metabolic risk factors of type 2 diabetes, as well as glycemic control and complicated diabetic complications between rural and urban Uygur residents in Xinjiang Uygur Autonomous Region of China. Methods This comparative cross-sectional study, conducted among 2879 urban and 918 rural participants in Xinjiang, China, assessed the metabolic risk factors of diabetes and related complications differences between urban and rural settlements. Results Compared to rural areas, urban participants had higher education level and more average income, little physical activity, less triglycerides and higher HDL-c (p 8% (48.1% versus 54.5%, p = 0.019) between rural and urban diabetic participants. No significant difference in the prevalence of type 2 diabetic complications between urban and rural participants (74.9% versus 72.2%; p = 0.263) was detected. Compared to rural participants, the most prevalent modifiable risk factors associated with diabetic complications in urban participants were obesity (BMI ≥ 28 Kg/m2), HDL-c (< 1.04 mmol/l), physical inactivity and irregular eating habits (p = 0.035, p = 0.001, p < 0.001, and p = 0.013, respectively). Conclusions Urban settlers were significantly more likely to have metabolic risk factors highlighting the need for public health efforts to improve health outcomes for these vulnerable populations. Diabetes related complications risk factors were prevalent amongst rural and urban diabetes settlers. PMID:27622506

  16. Local activation of coagulation factor XIII reduces systemic complications and improves the survival of mice after Streptococcus pyogenes M1 skin infection.

    Science.gov (United States)

    Deicke, Christin; Chakrakodi, Bhavya; Pils, Marina C; Dickneite, Gerhard; Johansson, Linda; Medina, Eva; Loof, Torsten G

    2016-11-01

    Coagulation is a mechanism for wound healing after injury. Several recent studies delineate an additional role of the intrinsic pathway of coagulation, also known as the contact system, in the early innate immune response against bacterial infections. In this study, we investigated the role of factor XIII (FXIII), which is activated upon coagulation induction, during Streptococcus pyogenes-mediated skin and soft tissue infections. FXIII has previously been shown to be responsible for the immobilization of bacteria within a fibrin network which may prevent systemic bacterial dissemination. In order to investigate if the FXIII-mediated entrapment of S. pyogenes also influences the disease outcome we used a murine S. pyogenes M1 skin and soft tissue infection model. Here, we demonstrate that a lack of FXIII leads to prolonged clotting times, increased signs of inflammation, and elevated bacterial dissemination. Moreover, FXIII-deficient mice show an impaired survival when compared with wildtype animals. Additionally, local reconstitution of FXIII-deficient mice with a human FXIII-concentrate (Fibrogammin(®)P) could reduce the systemic complications, suggesting a protective role for FXIII during early S. pyogenes skin infection. FXIII therefore might be a possible therapeutically application to support the early innate immune response during skin infections caused by S. pyogenes. Copyright © 2016 Elsevier GmbH. All rights reserved.

  17. Geomorphic response to an extreme flood in two mountain rivers (northeastern Sardinia, Italy): the role of geomorphic and hydraulic controlling factors

    Science.gov (United States)

    Righini, Margherita; Surian, Nicola; Wohl, Ellen; Amponsah, William; Marchi, Lorenzo; Borga, Marco

    2016-04-01

    Geomorphic response to an extreme flood in two mountain rivers (northeastern Sardinia, Italy): the role of geomorphic and hydraulic controlling factors Margherita Righini (1), Nicola Surian (1), Ellen Wohl (2), William Amponsah (3, 4), Lorenzo Marchi (3), Marco Borga (4) (1) Department of Geosciences, University of Padova, Italy, (2) Department of Geosciences, Colorado State University, Fort Collins, Colorado, USA, (3) CNR IRPI, Padova, Italy, (4) Department of Land, Environment, Agriculture and Forestry, University of Padova, Italy. The investigation of geomorphic effectiveness of extreme floods is crucial to improve tools for assessing channel dynamics and our capability of forecasting geomorphological hazard. This work deals with geomorphic response of two mountain rivers in the Posada catchment (northeastern Sardinia, Italy), considering a range of morphological (i.e., lateral channel confinement, channel gradient, channel sinuosity, sediment sources, and vegetation) and hydraulic variables (i.e., cross-sectional stream power, unit stream power, flow duration and total energy expenditure) as possible controlling factors. On November 18th 2013, northeastern Sardinia was affected by an extreme meteorological event with hourly rainfall intensities up to 100 mm/h and a peak in rain accumulation up to 450 mm in 24 hours, with 18 casualties and damages to infrastructure and buildings. In the Posada and Mannu di Bitti Rivers, the geomorphic response (i.e., bank erosion, channel aggradation and incision, vegetation and wood dynamics, hillslope failure) was analyzed at different spatial scales. The observed dominant geomorphic change was channel widening. Therefore, channel width changes have been analyzed in detail by remote sensing and GIS tools integrated by field surveys. The study focuses on reaches (i.e., 22.5 km in the Posada River, upstream of Maccheronis dam; 18.2 km in the Mannu di Bitti River) affected by evident and significant geomorphic responses in terms

  18. [The ability for psych self-regulation as a factor in resistance to the stresses in extreme conditions of space flight].

    Science.gov (United States)

    Vinokhodova, A G; Bystritskaia, A F; Smirnova, T M

    2005-01-01

    Significance of the ability for psych self-regulation in the context of resistance to the stresses of space flight was studied in an experiment with 9 test-subjects simulating such factors of space flights as 8 to 9-day isolation and confinement, some physiological effects of microgravity in a head-down position at -8 degrees for 7 d, artificial climate, and implementation of dock and piloting operations. Stress resistance, self-regulation, mental performance and behavior were assessed with the use of computerized tests "Mirror coordinograph", "Relaxometer", and "SOPR-monitoring". The ability to voluntary control psych was shown to be favorable to stress-resistance and rapid recovery of mental efficiency after the natural decline in consequence of the experimental simulation. The ability for psych self-regulation is one of the major criteria of professional selection for exposure to extreme conditions.

  19. Why does minimally invasive coracoclavicular ligament reconstruction using a flip button repair technique fail? An analysis of risk factors and complications.

    Science.gov (United States)

    Schliemann, Benedikt; Roßlenbroich, Steffen B; Schneider, Kristian N; Theisen, Christina; Petersen, Wolf; Raschke, Michael J; Weimann, André

    2015-05-01

    Aim of the present study was to evaluate the risk factors for the failure of coracoclavicular ligament reconstruction using a flip button repair technique and to analyse complications related to this procedure. Seventy-one patients (3 female, 68 male) underwent surgical treatment using a flip button repair technique for an acute acromioclavicular joint dislocation. The following factors and its impact on clinical and radiographic outcome were assessed: age at trauma, interval between trauma and surgery, degree of displacement (according to Rockwood's classification), coracoid button position, button migration and post-operative appearance of ossifications. Sixty-three patients were available for follow-up. The overall Constant score was 95.2 points (range 61-100 points) compared to 97 points (range 73-100 points) for the contralateral side (p = 0.05). Nine patients (14.3 %) needed surgical revision. Inappropriate positioning of the coracoid bone tunnel with subsequent button dislocation was the most frequently observed mode of failure (6 cases, 9.5 %). Button migration into the clavicle was associated with loss of reduction (p = 0.02). The patient's age at the time of trauma had a significant impact on the clinical outcome, whereas younger patients achieved better results (p = 0.02). The interval between trauma and surgery did not significantly affect the outcome (n.s.). Good to excellent clinical results can be achieved with the presented surgical technique. The age of the patient at trauma had a significant influence on the functional outcome. Furthermore, placement of the coracoid button centrally under the coracoid base is crucial to prevent failure. IV.

  20. Renal posttransplant's vascular complications

    Directory of Open Access Journals (Sweden)

    Bašić Dragoslav

    2003-01-01

    present study demonstrate that the rate of this complication in LD group was low, only 0.3%, but significantly higher in CD group - 11.8%. Many factors should be considered in order to understand for such significant difference among these groups. First of all, cadaveric transplant activity in our country is very low. In our series, median waiting period for renal transplantation was 2.8 years in LD group vs. 4.8 years in CD group (p<0.01. Also, vascular damages because of long term hemodialysis are contributing factors. Mean age of CD recipients was 7.4 years bigger vs. LD recipients. Primary cadaveric graft damage by accident and further manipulations during cadaveric donor nephrectomy, preservation and per-fusion are additional factors compromising the quality of cadaveric renal transplant outcome. Also, preoperative evaluation of cadaveric grafts is not as exact as in cases of LD grafts (excretory urography arteriography, etc. In the available transplant literature it is almost impossible to find data about vascular complications by different donor types. Mostly, authors offer experiences related to all transplants and most of them agree that in the present time better results are obtained using living donors [17].

  1. Risk factors of hypertensive disorders complicating pregnancy%探讨妊娠期高血压疾病发生的相关危险因素

    Institute of Scientific and Technical Information of China (English)

    陈虹羽

    2012-01-01

    Objective To investigate the related risk factors of hypertensive disorders complicating pregnancy (HDCP).Methods Data of 1265 cases of pregnant women were retrospectively analyzed,and the risk factors of HDCP were analyzed statistically.Results Among the total 1265 pregnant women,HDCP occurred in 124 cases,with an incidence of 9.8%.The incidence of HDCP was 14.6% (37/254),11.3% (94/829) and 11.2% ( 101/903 ) respectively in women >35 years,women living in rural areas,and women without prenatal screening,which was significantly higher than that in women < 35 years,women living in urban areas,and women receiving prenatal screening.The difference had statistical significance( P <0.05 ).Primipara and women who had abortion history also had higher incidence of HDCP than multipara and women without abortion history,however,the difference had no statistical significance ( P >0.05 ).Additionally,logistic regression analysis showed that age,location and prenatal examination were associated with incidence of HDCP.Conclusions Old age,rural residence and lack of prenatal screening were the risk factors of HDCP.In order to prevent HDCP,prenatal screening should be popularized for pregnant women,especially women in rural areas.More attention should be paid to the pregnant women who are over 35 years,living in rural area and lacking of prenatal screening.%目的 探讨妊娠期高血压疾病(hypertensive disorders complicating pregnancy,HDCP)发生的相关危险因素.方法 回顾性分析1265例孕产妇的临床资料,对HDCP发生的相关危险因素进行回顾性分析.结果 1265例孕产妇中确诊HDCP 124例,发生率为9.8%.年龄≥35岁,居住农村和产前未作系统产前检查的产妇HDCP发生率分别为14.6%( 37/254)、11.3% (94/829)、11.2%( 101/903),分别高于年龄<35岁,居住城市和产前行系统产前检查的产妇,差异具有统计学意义(P<0.05).初产妇和有流产病史的产妇患HDCP的几率比经产妇

  2. Extremity perfusion for sarcoma

    NARCIS (Netherlands)

    Hoekstra, Harald Joan

    2008-01-01

    For more than 50 years, the technique of extremity perfusion has been explored in the limb salvage treatment of local, recurrent, and multifocal sarcomas. The "discovery" of tumor necrosis factor-or. in combination with melphalan was a real breakthrough in the treatment of primarily irresectable ext

  3. Extremity perfusion for sarcoma

    NARCIS (Netherlands)

    Hoekstra, Harald Joan

    2008-01-01

    For more than 50 years, the technique of extremity perfusion has been explored in the limb salvage treatment of local, recurrent, and multifocal sarcomas. The "discovery" of tumor necrosis factor-or. in combination with melphalan was a real breakthrough in the treatment of primarily irresectable

  4. Extreme Programming: Maestro Style

    Science.gov (United States)

    Norris, Jeffrey; Fox, Jason; Rabe, Kenneth; Shu, I-Hsiang; Powell, Mark

    2009-01-01

    "Extreme Programming: Maestro Style" is the name of a computer programming methodology that has evolved as a custom version of a methodology, called extreme programming that has been practiced in the software industry since the late 1990s. The name of this version reflects its origin in the work of the Maestro team at NASA's Jet Propulsion Laboratory that develops software for Mars exploration missions. Extreme programming is oriented toward agile development of software resting on values of simplicity, communication, testing, and aggressiveness. Extreme programming involves use of methods of rapidly building and disseminating institutional knowledge among members of a computer-programming team to give all the members a shared view that matches the view of the customers for whom the software system is to be developed. Extreme programming includes frequent planning by programmers in collaboration with customers, continually examining and rewriting code in striving for the simplest workable software designs, a system metaphor (basically, an abstraction of the system that provides easy-to-remember software-naming conventions and insight into the architecture of the system), programmers working in pairs, adherence to a set of coding standards, collaboration of customers and programmers, frequent verbal communication, frequent releases of software in small increments of development, repeated testing of the developmental software by both programmers and customers, and continuous interaction between the team and the customers. The environment in which the Maestro team works requires the team to quickly adapt to changing needs of its customers. In addition, the team cannot afford to accept unnecessary development risk. Extreme programming enables the Maestro team to remain agile and provide high-quality software and service to its customers. However, several factors in the Maestro environment have made it necessary to modify some of the conventional extreme

  5. Deep venous thrombosis of the upper extremity

    DEFF Research Database (Denmark)

    Klitfod, Lotte; Broholm, R; Baekgaard, N

    2013-01-01

    to the condition. Malignancy and therapeutic interventions are major risk factors for the secondary deep vein thrombosis in combination with the patient's characteristics, comorbidities and prior history of deep vein thrombosis. Complications: recurrent deep venous thrombosis, pulmonary embolism and Post......Upper extremity deep venous thrombosis (UEDVT) occurs either spontaneously, as a consequence of strenuous upper limb activity (also known as the Paget-Schroetter syndrome) or secondary to an underlying cause. Primary and secondary UEDVT differs in long-term sequelae and mortality. This review...... will focus on the clinical presentation, risk factors, diagnosis, and treatment strategies of UEDVT. In the period from January to October 2012 an electronic literature search was performed in the PubMed/MEDLINE database, and 27 publications were included. Clinical presentation: swelling, pain and functional...

  6. 低出生体质量儿经外周静脉置入中心静脉导管不同穿刺部位留置导管并发症的护理%Related factors analysis on complications caused by peripherally inserted central catheter puncture on low birth weight infant with different puncture sites

    Institute of Scientific and Technical Information of China (English)

    姜红; 贺琳晰; 范玲

    2015-01-01

    目的 对低出生体质量儿经外周静脉置入中心静脉导管(PICC)不同穿刺部位留置导管主要并发症的相关因素进行分析,以降低并发症发生,达到安全留置目的.方法 收集2008年1月至2013年1月留置PICC的低出生体质量儿431例,其中肘部静脉261例,肘部下行静脉147例,颞浅静脉5例,腋静脉12例,股静脉6例.对不同穿刺部位留置导管过程中的并发症进行分析,并采取相应的治疗或预防护理干预措施.结果 431例PICC均穿刺成功.穿刺部位主要在上臂静脉,并发症主要以静脉炎、肢端肿胀、堵管、感染为主.肘部下行静脉留置导管静脉炎、肿胀发生率高于肘部静脉[10.89%(16/147)比3.83%(10/261)、17.69%(26/147)比4.98%(13/261)],差异有统计学意义,x2=7.840、17.561,P<0.05.结论 PICC穿刺部位主要选择肘部和肘部下行静脉.对不同穿刺部位可能发生的并发症要及时评估并采取有效措施.良好的导管维护意识对减少并发症发生有重要意义.%Objective To analyze the correlative factors that affect the main complications caused by peripherally inserted central catheter puncture (PICC) on low birth weight infant with different puncture sites,in order to reduce the incidence of complications and achieve the purpose of indwelling safely.Methods A total of 431 infants with different PICC puncture sites were recruited in this study from January 2008 to January 2013,261 cases of them were punctured in the elbow upper extremity veins, 147 cases were in the elbows downward veins,5 cases were in the superficial temporal veins, 12 cases were in the axillary veins,and 6 cases were in the femoral veins.The complications occurring in the period of indwelling catheter were analyzed, and the effective treatments or preventive nursing measures were taken.Results 431 cases were punctured successfully.The sites of puncture were mainly in the veins of the upper arm,and the main complications were

  7. Precipitation extremes under climate change

    CERN Document Server

    O'Gorman, Paul A

    2015-01-01

    The response of precipitation extremes to climate change is considered using results from theory, modeling, and observations, with a focus on the physical factors that control the response. Observations and simulations with climate models show that precipitation extremes intensify in response to a warming climate. However, the sensitivity of precipitation extremes to warming remains uncertain when convection is important, and it may be higher in the tropics than the extratropics. Several physical contributions govern the response of precipitation extremes. The thermodynamic contribution is robust and well understood, but theoretical understanding of the microphysical and dynamical contributions is still being developed. Orographic precipitation extremes and snowfall extremes respond differently from other precipitation extremes and require particular attention. Outstanding research challenges include the influence of mesoscale convective organization, the dependence on the duration considered, and the need to...

  8. Neurological complications of underwater diving.

    Science.gov (United States)

    Rosińska, Justyna; Łukasik, Maria; Kozubski, Wojciech

    2015-01-01

    The diver's nervous system is extremely sensitive to high ambient pressure, which is the sum of atmospheric and hydrostatic pressure. Neurological complications associated with diving are a difficult diagnostic and therapeutic challenge. They occur in both commercial and recreational diving and are connected with increasing interest in the sport of diving. Hence it is very important to know the possible complications associated with this kind of sport. Complications of the nervous system may result from decompression sickness, pulmonary barotrauma associated with cerebral arterial air embolism (AGE), otic and sinus barotrauma, high pressure neurological syndrome (HPNS) and undesirable effect of gases used for breathing. The purpose of this review is to discuss the range of neurological symptoms that can occur during diving accidents and also the role of patent foramen ovale (PFO) and internal carotid artery (ICA) dissection in pathogenesis of stroke in divers.

  9. Influencing factors of diabetic complications and comprehensive nursing intervention measures%糖尿病并发症的发病影响因素及综合护理干预措施

    Institute of Scientific and Technical Information of China (English)

    刘敏

    2016-01-01

    目的:探讨糖尿病并发症的影响因素及护理措施。方法:收治糖尿病并发症患者80例,对其进行常规检查,分析糖尿病及并发症的影响因素及其综合护理干预措施。结果:病程、宣教、尿路感染是糖尿病患者并发症发病的主要影响因素。结论:糖尿病并发症的发病率较高,且临床缺乏理想的根治方法,根据糖尿病并发症的发病的影响因素应采取有效的护理干预,以提高患者遵医率,帮助患者实现治疗的最佳目标。%Objective:To explore the influencing factors and nursing measures on diabetic complications.Methods:80 patients with diabetic complications were treated with routine examination,then we analyzed the influencing factors of diabetes and complications,and the comprehensive nursing intervention measures.Results:The main influencing factors included course of disease,education,urinary tract infection are the incidence of complications in patients with diabetes.Conclusion:The onset of diabetic complications rate is higher and lack of an ideal method to cure the disease in clinical.Effective nursing intervention should be take according to the factors that influence the onset of diabetic complications,in order to improve the compliance rate of the patients,and help them achieve optimal therapeutic outcomes.

  10. Inflammatory cascades driven by tumor necrosis factor-alpha play a major role in the progression of acute liver failure and its neurological complications.

    Directory of Open Access Journals (Sweden)

    Anne Chastre

    Full Text Available BACKGROUND/AIMS: Acute liver failure (ALF due to ischemic or toxic liver injury is a clinical condition that results from massive loss of hepatocytes and may lead to hepatic encephalopathy (HE, a serious neuropsychiatric complication. Although increased expression of tumor necrosis factor-alpha (TNF-α in liver, plasma and brain has been observed, conflicting results exist concerning its roles in drug-induced liver injury and on the progression of HE. The present study aimed to investigate the therapeutic value of etanercept, a TNF-α neutralizing molecule, on the progression of liver injury and HE in mice with ALF resulting from azoxymethane (AOM hepatotoxicity. METHODS/PRINCIPAL FINDINGS: Mice were administered saline or etanercept (10 mg/kg; i.p. 30 minutes prior to, or up to 6 h after AOM. Etanercept-treated ALF mice were sacrificed in parallel with vehicle-treated comatose ALF mice and controls. AOM induced severe hepatic necrosis, leading to HE, and etanercept administered prior or up to 3 h after AOM significantly delayed the onset of coma stages of HE. Etanercept pretreatment attenuated AOM-induced liver injury, as assessed by histological examination, plasma ammonia and transaminase levels, and by hepatic glutathione content. Peripheral inflammation was significantly reduced by etanercept as shown by decreased plasma IL-6 (4.1-fold; p<0.001 and CD40L levels (3.7-fold; p<0.001 compared to saline-treated ALF mice. Etanercept also decreased IL-6 levels in brain (1.2-fold; p<0.05, attenuated microglial activation (assessed by OX-42 immunoreactivity, and increased brain glutathione concentrations. CONCLUSIONS: These results indicate that systemic sequestration of TNF-α attenuates both peripheral and cerebral inflammation leading to delayed progression of liver disease and HE in mice with ALF due to toxic liver injury. These results suggest that etanercept may provide a novel therapeutic approach for the management of ALF patients awaiting

  11. Weather and Climate Extremes.

    Science.gov (United States)

    1997-09-01

    Antarctica’s highest (New Zealand Antarctic Society, 1974). This extreme exceeded the record of 58°F (14.4°C) that occurred on 20 October 1956 at Esperanza ... Esperanza (also known as Bahia Esperanza , Hope Bay) was in operation from 1945 through the early 1960s. Meteorological/Climatological Factors: This extreme...cm) Location: Grand Ilet, La R’eunion Island [21°00’S, 55°30’E] Date: 26 January 1980 WORLD’S GREATEST 24-HOUR RAINFALL 72 in (182.5 cm

  12. Factors associated with tuberculosis cases in Semarang District, Indonesia: case-control study performed in the area where case detection rate was extremely low.

    Science.gov (United States)

    Rahayu, Sri Ratna; Katsuyama, Hironobu; Demura, Masashi; Katsuyama, Midori; Ota, Yoko; Tanii, Hideji; Higashi, Tomomi; Semadi, Ngakan Putu Djaja; Saijoh, Kiyofumi

    2015-07-01

    Indonesia is ranked as the 4th highest contributor to tuberculosis (TB) in the world. Semarang District in Central Java displays extremely low case detection rate (CDR), possibly contributing to the local prevalence of TB. A case-control study was performed to explore the factors that cause such low CDR. We recruited 129 TB cases and 83 controls that visited the same centers and were not diagnosed with TB. The cases had 7.5 ± 2.3 symptoms/person on average, indicating the delay in diagnosis because the controls only displayed 1.0 ± 1.7. The multiple logistic regression analysis comparing the cases/controls extracted following factors as a risk to have TB: farmer, close contact with TB patients, ignorance of whether Bacillus Calmette-Guérin (BCG) was accepted or no, smoking, low income, a lot of people living in the same room, irregular hand wash before meals, not wash hands after blow, soil floor, and no sunlight and no ventilation in the house. Neither the cases nor the controls knew the symptoms and how to avoid TB infection, which probably caused the delay in diagnosis. It is difficult to change the current living conditions. Thus, the amendment of the community-based education program of TB seems to be required.

  13. DSM-5 alternative personality disorder model traits as maladaptive extreme variants of the five-factor model: An item-response theory analysis.

    Science.gov (United States)

    Suzuki, Takakuni; Samuel, Douglas B; Pahlen, Shandell; Krueger, Robert F

    2015-05-01

    Over the past two decades, evidence has suggested that personality disorders (PDs) can be conceptualized as extreme, maladaptive variants of general personality dimensions, rather than discrete categorical entities. Recognizing this literature, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alternative PD model in Section III defines PDs partially through 25 maladaptive traits that fall within 5 domains. Empirical evidence based on the self-report measure of these traits, the Personality Inventory for DSM-5 (PID-5), suggests that these five higher-order domains share a structure and correlate in meaningful ways with the five-factor model (FFM) of general personality. In the current study, item response theory was used to compare the DSM-5 alternative PD model traits to those from a normative FFM inventory (the International Personality Item Pool-NEO [IPIP-NEO]) in terms of their measurement precision along the latent dimensions. Within a combined sample of 3,517 participants, results strongly supported the conclusion that the DSM-5 alternative PD model traits and IPIP-NEO traits are complimentary measures of 4 of the 5 FFM domains (with perhaps the exception of openness to experience vs. psychoticism). Importantly, the two measures yield largely overlapping information curves on these four domains. Differences that did emerge suggested that the PID-5 scales generally have higher thresholds and provide more information at the upper levels, whereas the IPIP-NEO generally had an advantage at the lower levels. These results support the general conceptualization that 4 domains of the DSM-5 alternative PD model traits are maladaptive, extreme versions of the FFM. (PsycINFO Database Record

  14. Incidence and risk factors of functional upper airway complications of primary esthetic closed rhinoplasty in two residency programs: A 6-month preliminary prospective cohort study

    Directory of Open Access Journals (Sweden)

    Hassan Mohajerani

    2013-01-01

    Conclusions : High complication rates were observed in both residency programs. Failure to follow home care instructions might prevent/delay recovery. Further in-depth studies are needed to assess this.

  15. Infectious disease and the extreme sport athlete.

    Science.gov (United States)

    Young, Craig C; Niedfeldt, Mark W; Gottschlich, Laura M; Peterson, Charles S; Gammons, Matthew R

    2007-07-01

    Extreme sport competition often takes place in locations that may harbor atypical diseases. This article discusses infections that may be more likely to occur in the extreme sport athlete, such as selected parasitic infections, marine infections, freshwater-borne diseases, tick-borne disease, and zoonoses. Epidemiology, presentation, treatment, complications, and return-to-sport issues are discussed for each of these diseases.

  16. Malnutrition Increases With Obesity and Is a Stronger Independent Risk Factor for Postoperative Complications: A Propensity-Adjusted Analysis of Total Hip Arthroplasty Patients.

    Science.gov (United States)

    Fu, Michael C; D'Ambrosia, Christopher; McLawhorn, Alexander S; Schairer, William W; Padgett, Douglas E; Cross, Michael B

    2016-11-01

    Obesity is frequently associated with complications after total hip arthroplasty (THA) and is often concomitant with malnutrition. The purpose of this study was to investigate the independent morbidity risk of malnutrition relative to obesity. The National Surgical Quality Improvement Program from 2005 to 2013 was queried for elective primary THA cases. Malnutrition was defined as albumin malnutrition with 30-day outcomes. A total of 40,653 THA cases were identified, of which 20,210 (49.7%) had preoperative albumin measurements. Propensity score adjustment successfully reduced potential selection bias, with P > .05 for differences between those with and without albumin data. Malnutrition incidence increased from 2.8% in obese I to 5.7% in obese III patients. With multivariable propensity-adjusted logistic regression, malnutrition was a more robust predictor than any obesity class for any postoperative complication(s) (odds ratio [OR] 1.61, 95% confidence interval [CI] 1.25-2.08), major complications (OR 1.63, 95% CI 1.21-2.19), respiratory complications (OR 2.35, 95% CI 1.27-4.37), blood transfusions (OR 1.71, 95% CI 1.44-2.03), and extended length of stay (OR 1.35, 95% CI 1.14-1.59). Malnutrition incidence increased significantly from obese I to obese III patients and was a stronger and more consistent predictor than obesity of complications after THA. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. 康复护理在创伤性脊髓损伤并发肢体肌痉挛患者中的应用%Application of rehabilitation nursing to patients with traumatic spinal cord injury complicated with muscle spasm of extremities

    Institute of Scientific and Technical Information of China (English)

    颜玲; 韩月明; 刘凡; 康玉闻; 曾彦

    2012-01-01

    Objective: To explore the approach and effect of rehabilitation nursing in the treatment of patients with traumatic spinal cord injury complicated with muscle spasm of extremities. Methods:68 patients with cervical and thoracic spinal cord injury were randomly divided into the rehabilitation group and control group ( 34 cases in each group ). The early comprehensive rehabilitation nursing methods were adopted in the rehabilitation group,including correct limb placement,joint ROM motion,stretching training;routine nursing measures were used in the control group. The modified Ashwoorth scoring method was used to assess the degree of muscle spasm of extremities of the patients and the incidence of complications in the two groups before nursing care and after nursing care for 1 to 2 months. Results:The incidence of complications and the scores of muscle spasm of extremities after nursing care were lower in the rehabilitation group than the control group and than those before nursing care ( P <0. 01 );the effective rate was significantly higher in the rehabilitation group than the control group ( P <0. 01 ). Conclusion: The early comprehensive rehabilitation nursing can effectively relieve the muscle spasm and promote the rehabilitation of patients in the treatment of traumatic spinal cord injury complicated with muscle spasm of extremities.%目的:探讨康复护理在创伤性脊髓损伤并发四肢肌痉挛患者中的应用方法及效果.方法:将68例颈、胸段脊髓损伤患者随机分为康复组和对照组各34例,康复组采用早期综合康复护理方法,包括正确肢体摆放、关节ROM运动、牵张训练等;对照组采用骨科常规护理措施.在护理前及护理后1、2个月对两组患者采用改良Ashwoorth评分法进行肢体肌痉挛程度及护理期间并发症发生情况评定.结果:康复组并发症发生情况少于对照组,康复组护理后痉挛评分明显低于护理前及对照组护理后(P<0.01),康复组护理

  18. Risk factors for foot ulceration and lower extremity amputation in adults with end-stage renal disease on dialysis: a systematic review and meta-analysis.

    Science.gov (United States)

    Kaminski, Michelle R; Raspovic, Anita; McMahon, Lawrence P; Strippoli, Giovanni F M; Palmer, Suetonia C; Ruospo, Marinella; Dallimore, Sarah; Landorf, Karl B

    2015-10-01

    Adults with end-stage renal disease are at increased risk of foot ulceration and lower extremity amputation. However, the central determinants of lower limb injury and loss are incompletely understood. We conducted a systematic review of non-randomized studies that quantified the major risk factors for foot ulceration and amputation in adults treated with dialysis and analysed patient populations in which risks were greatest. Random-effects meta-analysis was used to generate summary estimates. Thirty studies (48 566 participants) were identified. Risk factors for foot ulceration and amputation included previous foot ulceration (odds ratios, OR, 17.56 and 70.13), peripheral arterial disease (OR, 7.52 and 9.12), diabetes (OR, 3.76 and 7.48), peripheral neuropathy (OR, 3.24 and 3.36) and coronary artery disease (OR, 3.92 and 2.49). Participants with foot ulceration or amputation had experienced a longer duration of diabetes (mean difference, MD, 4.04 and 6.07 years) and had lower serum albumin levels (MD, -0.23 and -0.13 g/dL). Risk factors for foot ulceration also included retinopathy (OR, 3.03), previous amputation (OR, 15.50) and higher serum phosphorus levels (MD, 0.40 mg/dL), while risk factors for amputation also included male sex (OR, 1.50), current smoking (OR, 2.26) and higher glycated haemoglobin levels (MD, 0.75%). Dialysis patients who have markedly higher risks of ulceration or amputation include those with previous foot ulceration or amputation, peripheral neuropathy, diabetes or macrovascular disease. The temporal relationship between these risk factors and the development of foot ulceration and/or limb loss is uncertain and requires further study. Stable estimates of the key risk factors for ulceration and amputation can inform the design of future trials investigating clinical interventions to reduce the burden of lower limb disease in the dialysis population. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights

  19. Avaliação das complicações do tratamento cirúrgico das fraturas da extremidade proximal do úmero com "placa bloqueada" Evaluation of the complications of surgical treatment of fractures of the proximal extremity of the humerus using a locking plate

    Directory of Open Access Journals (Sweden)

    Alberto Naoki Miyazaki

    2012-10-01

    Full Text Available OBJETIVO: Avaliar as complicações do tratamento cirúrgico dos pacientes com fratura da extremidade proximal do úmero com "placa bloqueada". MÉTODOS: Entre julho de 2004 e dezembro de 2009, foram tratados 56 pacientes com fratura da extremidade proximal do úmero com a placa Philos®. Dezenove pacientes eram do sexo masculino e 37 do feminino, com média de idade de 62 anos, variando de 30 a 92 anos. Todos os casos tinham tempo de seguimento mínimo, no período pós-operatório, de 12 meses. Treze fraturas foram classificadas como em duas partes, 28 em três, oito em quatro e sete como fraturas epifisárias. RESULTADOS: Dos pacientes operados, 26 foram considerados como tendo obtido resultado excelente, 12 como bom, 10 como regular e oito como ruim, conforme o escore de UCLA. Trinta complicações ocorreram em 20 pacientes (35,7%, sendo a mais frequente a redução inadequada da fratura que ocorreu em oito casos. O impacto subacromial causado pela placa ocorreu em sete casos, enquanto a fixação inadequada da fratura em seis. Outras complicações como pseudoartrose, capsulite adesiva, necrose avascular, perda da redução em varo e infecção também foram verificadas. CONCLUSÃO: Os resultados funcionais do tratamento das fraturas da extremidade proximal do úmero com a "placa bloqueada" dependem da correta redução anatômica da fratura e fixação estável do implante. Complicações ainda são frequentes, principalmente devido à dificuldade técnica intraoperatória, à gravidade da fratura e à eventual inexperiência do cirurgião.OBJECTIVE: To evaluate the complications from surgical treatment using a locking plate among patients with fractures of the proximal extremity of the humerus. METHODS: Between July 2004 and December 2009, 56 patients with fractures of the proximal extremity of the humerus were treated using the PHILOS® plate. There were 19 male patients and 37 female patients, with a mean age of 62 years (range: 30 to

  20. Polymorphism of the interleukin-6 promoter 572C/G in patients with type 2 diabetes mellitus complicated with vascular disease of lower extremities%白细胞介素-6启动子572C/G基因多态性与2型糖尿病下肢血管病变的关系

    Institute of Scientific and Technical Information of China (English)

    汤绍芳; 卫红艳; 张鹏; 高志红; 邱明才

    2010-01-01

    Objective To investigate the polymorphism of the interleukin-6 promoter-572C/G and its relationship with type 2 diabetes mellitus(T2DM)complicated with vascular disease of lower extremities.Methods Two hundreds and eighty hospitalized T2DM patients from the Department of Endocrinology in General Hospital of Tianjin Medical University were recruited from February 2008 to January 2009.One hundred and thirty cases were male in(58.7±0.8)years and 150 cases were female(mesh age(58.1 ±0.5)years).Based upon the ultrasound test of the lower extremities.the participants were divided into vascular disease of lower extremities(VDLE)group,vascular and neuropathic disease of lower extremities (VNDLE)group,neuropathic disease of lower extremities(NDLE)group and non-complications group (NC).Seventy people for health care were non-randomly recruited as healthy control group.By PCR-RFLP technique.the polymorphism of the human IL-6 gene-572C/G in 70 health controls and 280 type 2 diabetic patients was evaluated.The genotype and allele frequency in different groups was evaluated by X2 teal The measurement data in different groups was evaluated by analysis of variance.Results The IL-6 promoter572C/G had polymorphism.The frequeney of genotype GG and CG,as well as allele G,had statistics difference between T2DM group and healthy control group(X2=12.649,12.054,respectively,all P<0.05).And so did they in T2DM patients who complicated with different vascular disease of the lower extremities compared with healthy control group(X2=22.015,20.471,respectively,all P<0.05).The genotype and allele frequency was also higher in T2DM patients complicated with vascular disease of lower extremities than those without the complications(X2=6.399,5.752,respectively,all P<0.05).Conclusion The genotype GG and CG and the allele G of the Interleukin-6 promoter-572C/G might be the susceptibility gene of the T2DM complicated with vascular disease of the lower extremities.The polymorphism of the Interleukin-6

  1. Extreme hypertriglyceridemia managed with insulin.

    Science.gov (United States)

    Thuzar, Moe; Shenoy, Vasant V; Malabu, Usman H; Schrale, Ryan; Sangla, Kunwarjit S

    2014-01-01

    Extreme hypertriglyceridemia can lead to acute pancreatitis and rapid lowering of serum triglycerides (TG) is necessary for preventing such life-threatening complications. However, there is no established consensus on the acute management of extreme hypertriglyceridemia. We retrospectively reviewed 10 cases of extreme hypertriglyceridemia with mean serum TG on presentation of 101.5 ± 23.4 mmol/L (8982 ± 2070 mg/dL) managed with insulin. Serum TG decreased by 87 ± 4% in 24 hours in those patients managed with intravenous insulin and fasting and 40 ± 8.4% in those managed with intravenous insulin alone (P = .0003). The clinical course was uncomplicated in all except 1 patient who subsequently developed a pancreatic pseudocyst. Thus, combination of intravenous insulin with fasting appears to be an effective, simple, and safe treatment strategy in immediate management of extreme hypertriglyceridemia. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  2. Risk factors for neck and upper extremity disorders among computers users and the effect of interventions: an overview of systematic reviews.

    Directory of Open Access Journals (Sweden)

    Johan H Andersen

    Full Text Available BACKGROUND: To summarize systematic reviews that 1 assessed the evidence for causal relationships between computer work and the occurrence of carpal tunnel syndrome (CTS or upper extremity musculoskeletal disorders (UEMSDs, or 2 reported on intervention studies among computer users/or office workers. METHODOLOGY/PRINCIPAL FINDINGS: PubMed, Embase, CINAHL and Web of Science were searched for reviews published between 1999 and 2010. Additional publications were provided by content area experts. The primary author extracted all data using a purpose-built form, while two of the authors evaluated the quality of the reviews using recommended standard criteria from AMSTAR; disagreements were resolved by discussion. The quality of evidence syntheses in the included reviews was assessed qualitatively for each outcome and for the interventions. Altogether, 1,349 review titles were identified, 47 reviews were retrieved for full text relevance assessment, and 17 reviews were finally included as being relevant and of sufficient quality. The degrees of focus and rigorousness of these 17 reviews were highly variable. Three reviews on risk factors for carpal tunnel syndrome were rated moderate to high quality, 8 reviews on risk factors for UEMSDs ranged from low to moderate/high quality, and 6 reviews on intervention studies were of moderate to high quality. The quality of the evidence for computer use as a risk factor for CTS was insufficient, while the evidence for computer use and UEMSDs was moderate regarding pain complaints and limited for specific musculoskeletal disorders. From the reviews on intervention studies no strong evidence based recommendations could be given. CONCLUSIONS/SIGNIFICANCE: Computer use is associated with pain complaints, but it is still not very clear if this association is causal. The evidence for specific disorders or diseases is limited. No effective interventions have yet been documented.

  3. An analysis of complications and risk factors in senile resident patients with traumatic spinal cord injuries%老年外伤性脊髓损伤住院患者并发症及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    陈华; 于铁强; 王国强; 左玉明; 王月光

    2015-01-01

    Objective To investigate the complications and risk factors in senile resident patients with traumatic spinal cord injuries.Methods From January 1, 2007 to December 31, 2011, senile resident patients with traumatic spinal cord injuries were adopted, whose age was more than 60 years old. Their age, gender, spinal cord injury level, American Spinal Injury Association ( ASIA ) scores and complications were retrospectively reviewed. Results There were 136 patients in total. Complications occurred in 39 patients, including respiratory complications in 20 patients, cardiovascular complications in 7 patients, digestive complications in 6 patients, urologic complications in 5 patients, bedsores in 5 patients, infections in 1 patient and spasticity in the lower limbs in 1 patients. The complications with more than 2 kinds of systems involved were found in 8 patients. The sensory score, motor score and surgery or not were correlated to the complications (P<0.05 ). The motor score and surgery or not are considered as the independent risk factors of spinal cord injuries in senile resident patients. A negative correlation existed between the motor score and the complications (P<0.05 ), and a positive correlation was noticed between the surgery or not and the complications (P<0.05 ).Conclusions The most common complications originate from the respiratory system in senile patients with spinal cord injuries, and the complications with multiple systems involved are frequently noticed. More serious the injuries are, higher the incidence rate of complications will be. The incidence rate of early complications will be increased due to the surgery.%目的:探讨老年外伤性脊髓损伤住院患者的并发症及其危险因素。方法回顾性分析2007年1月1日至2011年12月31日,就诊于我院的60岁以上的外伤性脊髓损伤住院患者的年龄、性别、脊髓损伤水平及美国脊髓损伤协会(Americanspinalinjuryassociation,ASIA

  4. COMPLICATIONS IN LAPAROSCOPIC GYNECOLOGIC SURGERY

    Institute of Scientific and Technical Information of China (English)

    冷金花; 朗景和; 黄荣丽; 刘珠凤; 孙大为

    2000-01-01

    Objective. To investigate retrospectively the complications and associated factors of gynecological laparescopies.Methods. 1769 laparoscopic surgeries were carried out from January 1994 to October 1999 at our department. The procedures included 1421 surgeries of ovary and tube, 52 myomectomies and 296 cases of laproscopic-assisted vaginal hysterectomy (LAVH). A total of 312 patients had a history of prior laparotomy (17.6%). Results. Complications occured in 34 cases, the overall complication rate was 1.92%. Unintended laparotomies occured in 6 cases(0.34% ). 12 complications were associated with insertion of Veress needle or trocar and creation of pneumoperitoneum, including 5 severe emphysema and 7 vascular injuries, this figure represents 35.3% of all complications of this series. Five intraopemtive complications (14.7 % ) occured during the laparescopic surgery (3 severe bleedings, one bladder injury and one skin bum of leg caused by damaged electrode plate), laparotomy was re-quired in four of these cases. Seventeen complications occured during postoperative stage: 2 intraperitoneal hemor-rhages needing laparotomy, 2 bowel injuries, 4 nerve paresis and 9 febrile morbidities. Cordusions. Operative gynecologic laparoscopy is associated with acceptable morbidity rate, but can not be over-looked. Complication rate seems to be higher in advanced procedures such as LAVH.

  5. 糖尿病合并高血压患者下肢动脉粥样硬化与大血管并发症的相关性研究%Correlation Study between Lower Extremity Atherosclerosis, Ankle Brachial Index and Macrovascular Complications in Diabetic Patients with Hypertension

    Institute of Scientific and Technical Information of China (English)

    袁慧娟; 田睿; 朱好辉; 刘岷; 赵志刚

    2012-01-01

    Objective To observe the characteristics of lower extremity atherosclerosis in diabetic patients and hypertension patients by Lower extremity vascular ultrasound and ankle brachial index(ABl), and to understand the relationship between the incidence and progression of lower extremity atherosclerosis and macrovascular complications. Methods We chose color Doppler ultrasound and ABI to monitor the incidence and characteristics of lower extremity atherosclerosis in diabctic patients(DM), hypertension patients(HT), diabetic patients with hypertension(DM-HT) and patients without diabetes(N-DM) and hypertension(N-HT). Then we collected the data of macrovasular complications in each group. Results The incidence of lower extremity atherosclerosis in DM group and HT group are significantly higher than that in non-diabetes mellitus-non-hypertension group(P<0.01). And the incidence of Lower extremity atherosclerosis in DM group is even higher than that in HT group, particularly in moderate to severe stenosis(82.06%). The incidence of marcovascular complications is closely related to the severity of lower extremity atherosclerosis. Conclusions The severity of lower extremity atherosclerosis is more severe in diabetic patients and hypertension patients. Color Doppler ultrasound and ABI are the easy and efficient ways to monitor the severity of lower extremity atherosclerosis; both of them are closely related to the incidence of macrovascular complincations.%目的 通过下肢血管彩超,踝-肱指数(ankle brachial index,ABI)监测,探讨糖尿病、高血压及糖尿病合并高血压患者下肢动脉粥样硬化病变的特征,并了解下肢动脉粥样硬化与大血管并发症的发病及进展的关系.方法 采用彩色多普勒超声技术及多普勒血流探测仪分别监测双下肢动脉血管粥样硬化情况及踝动脉与肱动脉收缩压的比值,通过卡方检验对糖尿病(diabetes mellitus,DM)组、高血压(hypertension,HT)组

  6. Prevention of deep venous thrombi of lower extremities and nursing of complication after obstetric and gynecologic operations%妇产科术后下肢深静脉血栓的预防和并发症的护理

    Institute of Scientific and Technical Information of China (English)

    何小倩; 温秀兰; 邓芳

    2011-01-01

    Objective To discuss the prevention and nursing of DVT after obstetric and gynecologic operations.Methods To retrospectively analyze the prevention and nursing for 55 patients with DVT from April, 2003 to October,2010.DVT occurrence was 2 to 6 days after operation and the morbidity age was from 26 to 74.Results Fifty-four patients of them were cured with effective nursing measures, but one case was transferred to another hospital because the embolus dropped out and induced pulmonary embolism.Conclusions The occurrence of DVT after gynecological operation is related to many factors. Earlier intervention and intensive care of high-risk groups can reduce the incidence of DVT based on the factor of danger and the size of operation.%目的 探讨妇科手术后并发下肢深静脉血栓形成( DVT) 的预防和护理对策.方法 自2003年4月至2010年8月,我院妇产科手术后并发下肢深静脉血栓共15例,发生时间为术后2~6 d,发病年龄为26~74岁,现回顾性分析这55例并发DVT患者的预防及护理措施.结果 55例并发DVT患者在早期干预及有效的护理之后,54例好转痊愈出院,1例因栓子脱落导致肺动脉栓塞予转院治疗.结论 妇科术后发生DVT与多种因素有关,根据其危险因素及手术大小,对高危人群进行早期干预及加强护理能提高DVT的治愈率.

  7. Distribution and Influencing Factors Analysis of Complications after Laparoscopic Cholecystectomy%腹腔镜胆囊切除术后并发症分布及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    王敏

    2015-01-01

    Objective To explore the distribution and influencing factors of complications after laparo-scopic cholecystectomy ( LC ) , and provide reference for preventing and treating complications after LC. Methods Total of 869 cases of LC were collected from Department of General Surgery in Hainan Nongken General Hospital from Jan. 2008 to Dec. 2013,and these cases were divided into complication group(31 cases) and non-complication group (838 cases) according to the existence of complications. The distribution and risk factors of complications after LC were analyzed. Results The risk factors of complications after LC included operation experience (OR=2. 054,95%CI 1. 390-2. 719),thickness of gallbladder wall (OR=2.591,95%CI1.591-3.590),triangle conglutination of Calot(OR =5.028,95%CI 3.380-6.676),con-glutination between gallbladder and surrounding tissue(OR=3. 967,95%CI 2. 738-5. 196),and complica-tions(OR=4. 043,95%CI 2. 404-5. 682),while drainage(OR=0. 354,95%CI 0. 060-0. 648) was the pro-tective factor. Conclusion The incidence of complications after LC is still high,and there are many risk fac-tors of the complications. So we should adopt prevention measures aimed at these risk factors, in order to reduce the incidence of the complications.%目的:探讨腹腔镜胆囊切除术( LC)后并发症的分布情况及其影响因素,为防治LC术后并发症提供依据。方法选择2008年1月至2013年12月在海南省农垦总医院普外科实施LC的患者869例,依据术后是否发生并发症分为并发症组(31例)和非并发症组(838例)。分析LC术后并发症的分布情况及并发症发生的危险因素。结果影响LC术后并发症发生的危险因素包括手术经验(OR=2.054,95%CI 1.390~2.719)、胆囊壁厚度(OR=2.591,95%CI 1.591~3.590)、Calot三角粘连(OR=5.028,95%CI 3.380~6.676)、胆囊与周围粘连(OR=3.967,95%CI 2.738~5.196)、合并症(OR=4.043,95%CI 2.404~5.682),而放置引流(OR=0.354,95%CI 0.060

  8. A Rare Hydrocephalus Complication: Cortical Blindness.

    Science.gov (United States)

    Ünal, Emre; Göçmen, Rahşan; Işıkay, Ayşe İlksen; Tekşam, Özlem

    2015-01-01

    Cortical blindness related to bilateral occipital lobe infarction is an extremely rare complication of hydrocephalus. Compression of the posterior cerebral artery, secondary to tentorial herniation, is the cause of occipital infarction. Particularly in children and mentally ill patients, cortical blindness may be missed. Therefore, early diagnosis and treatment of hydrocephalus is important. We present herein a child of ventricular shunt malfunction complicated by cortical blindness.

  9. Factores de riesgo y complicaciones crónicas en el diagnóstico reciente de la diabetes tipo 2 Risk factors and chronic complications in the newly diagnosis of type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Isaac Salama Benarroch

    2001-08-01

    Full Text Available Se pesquisó la frecuencia de complicaciones crónicas en pacientes con diabetes tipo 2 en el momento del diagnóstico y se evaluó la asociación con factores de riesgo como enfermedad cardiovascular, hipertensión arterial, obesidad, dislipidemia y factores bioquímicos asociados. Se estudiaron durante 3 meses, 24 casos con edades entre 30 y 70 años en los servicios de Diabetología y Nutrición, Cardiología y Retina del Hospital Municipal de Oftalmología "Dr. Pedro Lagleyze" de Buenos Aires. Se estudió perfil metabólico, microalbuminuria, fondo de ojo, vascular periférico, neurológico, tensión arterial y obesidad. Se comprobó que la edad promedio fue 50 años. Hallazgos: neuropatía: 5 (25 %: nefropatía: 3 (12,5 %; retinopatía: 6 (25 %; cardiopatía y enfermedad vascular periférica: 13 (54 %; hipertensión arterial: 13 (54 %; obesidad: 3 (12,5 %; hipercolesterolemia: 14 (58 %; LDLc elevado: 12 (50 %; HDLc bajo: 10 (41,6 %; hiperviscosidad sanguínea: 6 (25 %; hemoglobina glucosilada elevada 18 (75 %; hipertrigliceridemia: 7 (29, 7 %. Se halló que el 100 % de los pacientes tenían factores de riesgo asociados a la diabetes. Se consideró necesario promover la educación pública sobre diabetes, pesquisar los factores asociados y tratar de forma agresiva y precoz la hiperglucemia y los factores bioquímicos agregadosThe frequency of chronic complications in patients with type 2 diabetes at the time of diagnosis was screened and their association with risk factors such as cardiovascular disease, blood hypertension, obesity, dislipidemia and related biochemical factors were evaluated. During three months, 24 cases aged 30-70 years were studied by the Diabetology and Nutrition Service, Cardiology and Retina Services of "Dr Pedro Lagleyze" Municipal Ophthalmology Hospital in Buenos Aires. Metabolic, peripheral vascular and neurologic profiles, microalbuminuria, fundus oculi, blood pressure and obesity were studied. It was proved that

  10. [Predictive indicators for progression to severe complications(hemolytic-uremic syndrome and encephalopathy) and their prevention in enterohemorrhagic Escherichia coli infection].

    Science.gov (United States)

    Joh, K

    1997-03-01

    The treatment of infection with enterohemorrhagic Escherichia coli(EHEC) aims for early prediction and prevention of severe complications such as hemolytic-uremic syndrome, encephalopathy and/or thrombotic thrombocytopenic purpura. Factors related to the complications are divided into three categories; risk factors or predisposition, predictors, and indicators of severity and outcome. Risk factors for complications include two extreme ages, infection with verotoxin 2 producing E. coli, positive stool culture for EHEC, use of antimotility drug, use of trimethoprim-sulfamethoxazole. Predictors for complications include severe abdominal pain and bloody diarrhea development of high fever, change of consciousness, urinal protein and/or occult blood, abrupt increase of white blood cell count, urinal NAG, alpha 1 microglobulin, beta 2 microglobulin, low osmolar urine, high thrombomodulin level, marked thickening of intestinal wall, increased brightness of kidney in ultrasound sonography. No preventive treatment for these complications is proven except SYNSORB-pk which is expected to effectively aborb verotoxin in the intestine.

  11. Factores de mal pronóstico en pacientes internados con Neutropenia al inicio del episodio febril Prognostic risk factors for serious complications in an inpatient population with neutropenia at the onset of a febrile episode

    Directory of Open Access Journals (Sweden)

    Carlos Gómez Roca

    2006-10-01

    Full Text Available Los pacientes con neutropenia y fiebre constituyen una población heterogénea con riesgo variable para el desarrollo de complicaciones serias y mortalidad. El objetivo de este trabajo es identificar factores que, presentes al ingreso, estuvieran asociados a mayor riesgo de complicaciones graves en pacientes que se internan por neutropenia y fiebre. Se trata de un estudio de seguimiento de una cohorte de 238 episodios de neutropenia y fiebre (neutrófilos 38.3 °C en 167 pacientes internados en sala general en nuestra institución desde 1997 a 2004. Ochenta y dos por ciento de los pacientes tenían enfermedad hematológica, 14% tumores sólidos y 4% no asociados a quimioterapia. Se registraron 67 eventos adversos (46% de insuficiencia renal, 27% de hipotensión refractaria, 15% de insuficiencia respiratoria y 12% con sangrado mayor. Se hallaron diferencias significativas en presencia de comorbilidades previas, temperatura mayor a 39 °C, frecuencia cardíaca mayor a 120 latidos por minuto, frecuencia respiratoria mayor a 24 por minuto, tensión arterial sistólica menor a 90 mm Hg, presencia de 3 o más valores de laboratorio alterados al ingreso, presencia de foco clínico y hemocultivos positivos. En el análisis multivariado de regresión logística mantuvieron asociación independiente con mayor riesgo de eventos graves: hipotensión arterial sistólica (OR=7, pPatients with neutropenia and fever conform a heterogeneous population with a variable risk of serious complications and mortality. The goal of this study was to identify prognostic risk factors present at the beginning of the episode, for adverse events and serious complications in patients admitted in a general ward with fever and neutropenia. A cohort of 238 episodes with neutropenia and fever (neutrophils 38.3 °C in 167 patients admitted to our general hospital between 1997 and 2004 was followed. Eighty two percent of the patients had hematologic malignancies, 14% solid tumors

  12. [The local complications of appendicitis].

    Science.gov (United States)

    Ortega León, L H; Vargas Domínguez, A; Miranda Fraga, P

    1994-01-01

    In order to find out the predisposing factors of local complications after appendectomy in two general hospitals, 268 charts of patients with acute appendicitis confirmed by surgery were reviewed. There were 142 males and 126 females. All wounds were closed and prophylactic antibiotics were not used. Sixty patients (22 per cent) developed local complications; 49 (81.7 per cent) surgical wound infection and 11 (18.3 per cent) with intra-abdominal abscess. In the wound infection group 25 per cent had complicated acute appendicitis and only one per cent non-complicated acute appendicitis. The correlation between the preoperative period and wound sepsis showed, the longer period the higher incidence of wound infection, 1.7 per cent with less than 24 hr. 11 per cent with less than 72 hr. and 78.9 per cent with more than 96 hr.

  13. Patterns of shrub species richness and abundance in relation to environmental factors on the Alxa Plateau:Prerequisites for conserving shrub diversity in extreme arid desert regions

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Shrub species are considered the dominant plants in arid desert ecosystems,unlike in semiarid steppe zones or in grassland ecosystems.On the Alxa Plateau,northern China,sparse vegetation with cover ranging from 15% to 30% is characterized mainly by multifarious shrubs because herbaceous species are strongly restricted by the extreme drought climate,wind erosion,overgrazing and sand burial.Patterns in shrub species richness and species abundance in relation to environmental conditions were examined by DCA(detrended correspondence analysis) and interpreted by a biplot.The rela-tionships between species diversity and environmental factors were examined using regression analyses.Our results show that the distributions of the shrub species in response to environmental conditions can be grouped into four ecological types,corresponding with the biological traits of the shrubs and their responses to the gradients of soil texture and soil water content.Patterns in species richness and species abundance were mainly determined by the deeper soil water content,instead of the soil texture as hypothesized by numerous studies in semiarid grasslands.With exception of the deeper soil water content,soil organic matter and total N content were positively correlated with species abundance,while pH was negatively correlated with it.These findings imply that it is vital for cur-rent shrub diversity conservation to reduce agricultural water use in the middle reaches of the Heihe River,which supplies water for the lower reaches in the western parts of the plateau,and to reduce the amount of groundwater exploitation and urban and oasis water use,to increase the water supply from Helan Mountain to the eastern desert of the Alxa Plateau.

  14. Patterns of shrub species richness and abundance in relation to environmental factors on the Alxa Plateau: Prerequisites for conserving shrub diversity in extreme arid desert regions

    Institute of Scientific and Technical Information of China (English)

    LI XinRong; TAN HuiJuan; HE MingZhu; WANG XinPing; LI XiaoJun

    2009-01-01

    Shrub species are considered the dominant plants in arid desert ecosystems, unlike in semiarid steppe zones or in grassland ecosystems. On the Alxa Plateau, northern China, sparse vegetation with cover ranging from 15% to 30% is characterized mainly by multifarious shrubs because herbaceous species are strongly restricted by the extreme drought climate, wind erosion, overgrazing and sand burial. Patterns in shrub species richness and species abundance in relation to environmental conditions were examined by DCA (detrended correspondence analysis) and interpreted by a biplot. The rela-tionships between species diversity and environmental factors were examined using regression analyses. Our results show that the distributions of the shrub species in response to environmental conditions can be grouped into four ecological types, corresponding with the biological traits of the shrubs and their responses to the gradients of soil texture and soil water content. Patterns in species richness and species abundance were mainly determined by the deeper soil water content, instead of the soil texture as hypothesized by numerous studies in semiarid grasslands. With exception of the deeper soil water content, soil organic matter and total N content were positively correlated with spe-cies abundance, while pH was negatively correlated with it. These findings imply that it is vital for cur-rent shrub diversity conservation to reduce agricultural water use in the middle reaches of the Heihe River, which supplies water for the lower reaches in the western parts of the plateau, and to reduce the amount of groundwater exploitation and urban and oasis water use, to increase the water supply from Helan Mountain to the eastern desert of the Alxa Plateau.

  15. Radiological management of patients with urinary obstruction following urinary diversion procedures: technical factors, complications, long-term management and outcome. Experience with 378 procedures.

    LENUS (Irish Health Repository)

    Maher, M M

    2012-02-03

    We aimed to assess management by interventional radiology techniques of patients with urinary diversion procedures (UD) complicated by urinary obstruction (UO). A 12-year electronic database of interventional cases was searched for urinary access in patients with UD. Patients\\' records were assessed for aetiology of obstruction, indication for procedure, types of interventional radiology, complications and outcome. Management issues included frequency of visits for catheter care, type of catheter placement and technical problems associated with catheter maintenance. Three hundred and seventy eight procedures were carried out in 25 patients (mean age 70 years; Male : Female ratio 13:12). Indications for UD were malignancy (n = 22) and neuropathic bladder (n = 3). UD included ileal conduits (n = 17), cutaneous ureterostomy (n = 3 (2 patients)) and sigmoid colon urinary conduit (n = 6). In most patients, catheters were placed antegradely through nephrostomy tract, but subsequent access was through the UD. Twenty of 25 patients had unilateral stents where as 5 had bilateral stents (8-10- Fr pigtail catheters (20-45 cm in length)). The mean number of procedures including catheter changes was 15 +\\/- 4 per patient and 331 of 378 procedures (87 %) were carried out as outpatients. Since catheter placement, 11 patients required hospital admission on 22 occasions for catheter-related complications. Ureteric strictures in patients with UD can be successfully managed by interventional radiology.

  16. Anaesthetic complications in plastic surgery.

    Science.gov (United States)

    Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T

    2013-05-01

    Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients' experience and surgical outcome.

  17. Anaesthetic complications in plastic surgery

    Directory of Open Access Journals (Sweden)

    Soumya Sankar Nath

    2013-01-01

    Full Text Available Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist′s concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients′ experience and surgical outcome.

  18. Medical complications of self-induced vomiting.

    Science.gov (United States)

    Brown, Carrie A; Mehler, Philip S

    2013-01-01

    Bulimia nervosa, often characterized by self-induced vomiting, is complicated by medical manifestations that affect nearly every organ system in the body. Effects range from superficial skin and dental findings to esophageal pathology, electrolyte abnormalities, cardiac arrhythmias, and in extreme cases, death. Ultimately, cessation of vomiting is necessary to cure most associated medical complications. Improper management of medical complications may lead to significant psychological distress to the patient. Fortunately, efficacious treatments do exist both to ease symptoms and ideally help the patient make a smooth transition to cessation of self-induced vomiting behavior.

  19. [Orthognathic surgery: surgical failures and complications].

    Science.gov (United States)

    Guyot, Laurent

    2016-03-01

    Orthognathic surgery procedures mark the endpoint of lengthy orthodontic-surgical preparations and herald the completion of treatment for patients and their families. The main types of procedure are full maxillary Le Fort I osteotomies, mandibular osteotomies and chin surgery. To ensure a successful outcome, all require a favorable environment and extreme technical skill. But, like all surgical operations, they are also subject to peri- and post-operative complications resulting from treatment hazards or errors. Whatever the cause, surgical complications can entail failures in the management of the malformation. By seeking to understand and analyzing these complications, we can already help to prevent and reduce the contingent risks of failure.

  20. Influencing factors for prognosis of congenital heart disease complicated with infective endocarditis%影响先天性心脏病合并感染性心内膜炎的预后分析

    Institute of Scientific and Technical Information of China (English)

    刘海红; 赵铁英; 田甜

    2014-01-01

    OBJECTIVE To explore the influencing factors for prognosis of the shunt congenital heart disease com-plicated with infective endocarditis so as to provide guidance for clinical treatment .METHODS The shunt congenital heart disease patients complicated with infective endocarditis who were treated in the hospital from Apr 2002 to Oct 2012 were recruited in the study ,then the clinical data of the subjects were retrospectively analyzed ,the sur-vival rates of the patients were calculated by using Kaplan-Merier method ,and the influencing factors for the prog-nosis were observed .RESULTS The six-month survival rate of the patients was 84 .00% .The univariate analysis indicated that the congenital heart disease surgery ,complication of anemia ,complication of arrhythmia ,and com-plication of severe heart failure were the related influencing factors for the prognosis (P<0 .05);the multivariate analysis of the COX model showed that the congenital heart disease surgery ,severe heart failure ,and anemia were the independent influencing factors for the prognosis of the shunt congenital heart disease patients complicated with infective endocarditis .The relative risk of death of the patients with severe heart failure increased by 2 .267 times , the patients with anemia by 1 .473 times .CONCLUSION The complication of anemia and complication of severe heart failure are the important factors to increase the relative risk of death .It is an effective way to focus on the prevention of complications during the treatment process so as to raise the survival rates of the patients .%目的:探讨影响分流型先天性心脏病合并感染性心内膜炎的预后因素,为临床治疗提供参考依据。方法回顾性分析医院2002年4月-2012年10月收治的分流型先天性心脏病合并感染性心内膜炎患者临床资料,采用Kaplan-M erier法计算患者的生存率,研究影响患者预后的相关因素。结果患者治疗6个月后的生存率为84.00%

  1. 髋关节置换术后下肢深静脉血栓形成的影响因素分析%The influence factors of lower extremities deep venous thrombosis after hip replacement

    Institute of Scientific and Technical Information of China (English)

    郑桂娟; 郭佳

    2015-01-01

    Objective To analyze the influence factors of lower extremities deep venous thrombosis after hip replacement,and provide guidance for perioperative prevention.Methods 52 cases of patients underwent total hip replacement were selected,who were given color doppler ultrasound examination for lower limb venous thrombosis after hip replacement.And analyzed risk factors of lower extremity deep vein thrombosis from patient's gender,age,blood lipid,D -dimer,complications and surgical index.Results During the 52 cases,16 cases were found with postopera-tive lower limb deep vein thrombosis (30.8%);Single factor analysis showed that patients with age ≥65 years,over-weight or obese (BMI≥25kg/m2 ),high triglycerides (TG ≥ 1.7mmol/L)and high D -dimer level (≥500μg/L), diabetes or high blood pressure,large blood transfusion combined with a greater incidence of postoperative deep vein thrombosis (P <0.05).Further multiple factors regression analysis showed that age ≥65 years,overweight or obesity, high triglycerides,high D -dimer,diabetes,large blood transfusions were independent risk factors of lower extremity deep vein thrombosis (OR =15.693,1.278,9.832,3.053,1.855,1.014,all P <0.05).Conclusion Patients with total hip replacement should be given preoperative vein thrombosis risk assessment,patients with age ≥65,overweight or obese,high triglycerides,D -dimer level,diabetes,large number of blood transfusions have higher risk of deep vein thrombosis,we should focus on perioperative monitoring,application of low molecular heparin,lower limb vein pump, etc.early postoperative lower limb rehabilitation exercise,to reduce the occurrence of deep vein thrombosis.%目的:分析全髋关节置换术后下肢深静脉血栓形成的影响因素,为围术期预防提供指导。方法收集行全髋关节置换手术患者52例,全部患者术后行彩超检查下肢静脉血栓情况,统计术后下肢深静脉血栓发生率,并从患者性别、年龄、血脂、D

  2. Pneumatic tourniquets in extremity surgery.

    LENUS (Irish Health Repository)

    Wakai, A

    2012-02-03

    Pneumatic tourniquets maintain a relatively bloodless field during extremity surgery, minimize blood loss, aid identification of vital structures, and expedite the procedure. However, they may induce an ischemia-reperfusion injury with potentially harmful local and systemic consequences. Modern pneumatic tourniquets are designed with mechanisms to regulate and maintain pressure. Routine maintenance helps ensure that these systems are working properly. The complications of tourniquet use include postoperative swelling, delay of recovery of muscle power, compression neurapraxia, wound hematoma with the potential for infection, vascular injury, tissue necrosis, and compartment syndrome. Systemic complications can also occur. The incidence of complications can be minimized by use of wider tourniquets, careful preoperative patient evaluation, and adherence to accepted principles of tourniquet use.

  3. Complications in pediatric hepatobiliary surgery.

    Science.gov (United States)

    Grisotti, Gabriella; Cowles, Robert A

    2016-12-01

    This review highlights the complications and their risk factors encountered in pediatric hepatobiliary surgery, specifically in the context of pediatric hepatic resection, excision of choledochal cyst, and the Kasai hepatoportoenterostomy procedure for biliary atresia as well as other procedures potentially affecting the biliary tree. With the understanding that these are relatively rare procedures, case reports and small case series are included in addition to larger series when available. The review focuses on publications in English over the past 15 years. Complications included both surgery-specific pathology, such as biliary stricture after excision of choledochal cyst, and disease-specific entities, such as malnutrition in biliary atresia. This review may be useful when considering a particular procedure or in the discussion thereof with a patient and family. Additionally, it illuminates the need for additional work with larger patient databases to refine and expand our knowledge of these complications and precipitating risk factors. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Analysis of Perinatal Risk Factors for Preterm Children and Complications in 183 Cases%183例早产儿围产期高危因素及并发症分析

    Institute of Scientific and Technical Information of China (English)

    宋鹤; 姜亚峰; 赵凤; 吕明婕; 丁肖英

    2011-01-01

    Objective: To investigate the perinatal risk factors for preterm children and complications. Methods: Review the clinical information of preterm children in our hospital between Januery 2006 and December 2009.Analysis of perinatal risk factors for preterm children and complications in 183 cases. Results: Premature rupture of membranes, multiple pregnancy, pregnancy-induced hypertension is the main reason for preterm birth; preterm children with major complications such as pneumonia and intracranial hemorrhage. Conclusion: Enhance perinatal care, early intervention a variety of perinatal risk factors, active prevention of complications in preterm children, is the key to improve the survival rate of premature children and reduce disability.%探讨早产儿发生的围产期高危因素及并发症.方法:收集我院2006.1-2009.12出生的早产儿183例的临床资料,总结其早产的相关围产期高危因素及并发症.结果:胎膜早破、多胎妊娠、妊娠高血压综合征是早产发生的主要原因;早产儿的主要并发症为肺炎和颅内出血等.结论:加强围生期保健,早期干预各种围产期高危因素,积极防治早产儿各种并发症,是提高早产儿存活率降低致残率的关键.

  5. Influencing Factors for Chronic Kidney Disease Patients Complicated With Hypertension%慢性肾脏病患者合并高血压的影响因素研究

    Institute of Scientific and Technical Information of China (English)

    艾小叶; 刘健; 李素华

    2015-01-01

    Objective To research chronic kidney diseases( CKD)complicated with hypertension and investigate the influencing factors. Methods We enrolled 228 CKD patients who received hospitalized treatment in the nephrology department of the First Affiliated Hospital of Xinjiang Medical University from March to July 2013. According to whether hypertension occurred, the subjects were divided into two groups:non hypertension group ( n=92 )and hypertension group ( n=136 ) . Comparison was made between the two groups in general data and each laboratory indicator. The influencing factors for CKD complicated with hypertension were investigated. Results (1) Among all the subjects,the incidence of CKD complicated with hypertension was 59. 6%( 136/228 ) . The two groups were significantly different ( P 0. 05 ) in gender, ethnic group, education level, smoking history, respiratory diseases in complication, average course of disease, 24 h urine protein quantitation,triacylglycerol,cholesterol and BMI. ( 2 ) Among the 136 CKD patients complicated with hypertension, the hypertension treatment rate was 96. 3%(131/136)and the hypertension control rate was 45. 6%(62/136). The subjects in different illness stages were not significantly different ( P >0. 05 ) in hypertension control rate. ( 3 ) The logistic regression analysis showed that age,24 h urine protein quantitation and GFR were influencing factors for CKD complicated with hypertension ( P 0.05)。(2)136例合并高血压患者的高血压治疗率为96.3%(131/136),血压控制率为45.6%(62/136)。不同病情分期患者的血压控制率比较,差异无统计学意义( P>0.05)。(3)Logistic回归分析显示,年龄、24 h尿蛋白定量及GFR对CKD患者合并高血压的影响有统计学意义(P<0.05)。结论 CKD患者的高血压合并率较高,治疗率较高,但控制率较差;年龄、24 h尿蛋白定量及GFR是其影响因素。

  6. Bereavement and complicated grief.

    Science.gov (United States)

    Shear, M Katherine; Ghesquiere, Angela; Glickman, Kim

    2013-11-01

    Bereavement is a common experience in adults aged 60 and older. Loss of a loved one usually leads to acute grief characterized by yearning and longing, decreased interest in ongoing activities, and frequent thoughts of the deceased. For most, acute grief naturally evolves into a state of integrated grief, where the bereaved is able to reengage with everyday activities and find interest or pleasure. About 7 % of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). In CG, the movement from acute to integrated grief is derailed, and grief symptoms remain severe and impairing. This article reviews recent publications on the diagnosis of CG, risk factors for the condition and evidenced-based treatments for CG. Greater attention to CG detection and treatment in older adults is needed.

  7. Neurologic Complications of Transplantation.

    Science.gov (United States)

    Dhar, Rajat

    2017-03-01

    Neurologic disturbances including encephalopathy, seizures, and focal deficits complicate the course 10-30% of patients undergoing organ or stem cell transplantation. While much or this morbidity is multifactorial and often associated with extra-cerebral dysfunction (e.g., graft dysfunction, metabolic derangements), immunosuppressive drugs also contribute significantly. This can either be through direct toxicity (e.g., posterior reversible encephalopathy syndrome from calcineurin inhibitors such as tacrolimus in the acute postoperative period) or by facilitating opportunistic infections in the months after transplantation. Other neurologic syndromes such as akinetic mutism and osmotic demyelination may also occur. While much of this neurologic dysfunction may be reversible if related to metabolic factors or drug toxicity (and the etiology is recognized and reversed), cases of multifocal cerebral infarction, hemorrhage, or infection may have poor outcomes. As transplant patients survive longer, delayed infections (such as progressive multifocal leukoencephalopathy) and post-transplant malignancies are increasingly reported.

  8. Study of the relative factors of Acute Cerebrovascular Disease complicated by acute kidney injury%急性脑血管疾病并发急性肾损伤相关因素的分析

    Institute of Scientific and Technical Information of China (English)

    颜伟健; 胡杨青; 卢琳; 张驰; 袁银芳

    2013-01-01

    Objective To discuss and analyse the relative factors of acute cerebrovascular disease (ACVD) compli-cated by acute kidney injury (AKI),in order to provide referrence on early detection and proper treatment of the patient of ACVD complicated by AKI in clinical. Methods The patients of ACVD complicated by AKI in Affiliated Hospital of Shaoyang Medical College,during October 2009 to February 2012 were screened by Lab Administration Network. The incidence, Complications and related indexes of the patients of ACVD complicated by AKI were retrospectively ana-lyzed.Logistic regression analysis was used to investigate the etiology and relative factors in the patients of ACVD com-plicated by AKI. Results Forty-seven patients suffering from ACVD complicated by AKI were enrolled. The morbility of the ACVD complicated by AKI group was 10.28%, ACVD and AKI patients were merged or at least one disease, Logistic regression analysis showed that the most common reason of AKI was infection. Univariate analysis showed that age, the Serum creatinine(Scr) underlaying level, the blood urea anitrogen(BUN) underlaying level, the plasm carbon dioxide com-bining power (CO2CP) underlaying level, Scr peak level,BUN peak level,Serum uric acid peak level,Serum albumin were independent risk factors for ACVD complicated by AKI.Multivariate logistic regression analysis showed Scr peak level was the most important factor of ACVD complicated by AKI. Conclusion Patients with ACVD were prone to complicated by AKI, especially in the cases of intracerebral hemorrhage. infection was the most common reason of the ACVD compli-cated by AKI. The occurrence of ACVD complicated by AKI were closely related to age, the Scr underlaying level,the BUN underlaying level, the Serum CO2CP underlaying level, Scr peak level,BUN peak level,Serum uric acid peak level, Serum albumin. It's necessary to attach importance to the above-mentioned factors in clinical ralated to ACVD compli-cated by AKI.%目的:探讨急性

  9. Pregnancy Complications: Preeclampsia

    Science.gov (United States)

    ... Close X Home > Complications & Loss > Pregnancy complications > Preeclampsia Preeclampsia E-mail to a friend Please fill in ... even if you’re feeling fine. What is preeclampsia? Preeclampsia is a condition that can happen after ...

  10. Complications and Deaths - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — Complications and deaths - provider data. This data set includes provider data for the hip/knee complication measure, the Agency for Healthcare Research and Quality...

  11. Complications and Deaths - National

    Data.gov (United States)

    U.S. Department of Health & Human Services — Complications and deaths - national data. This data set includes national-level data for the hip/knee complication measure, the Agency for Healthcare Research and...

  12. Pregnancy Complications: Anemia

    Science.gov (United States)

    ... Close X Home > Complications & Loss > Pregnancy complications > Anemia Anemia E-mail to a friend Please fill in ... anemia at a prenatal care visit . What causes anemia? Usually, a woman becomes anemic (has anemia) because ...

  13. Pregnancy Complications: Bacterial Vaginosis

    Science.gov (United States)

    ... Complications & Loss > Pregnancy complications > Bacterial vaginosis and pregnancy Bacterial vaginosis and pregnancy E-mail to a friend Please ... this page It's been added to your dashboard . Bacterial vaginosis (also called BV or vaginitis) is an infection ...

  14. Mechanisms of diabetic complications

    National Research Council Canada - National Science Library

    Forbes, Josephine M; Cooper, Mark E

    2013-01-01

    .... These complications occur in the majority of individuals with both type 1 and type 2 diabetes. Among the most prevalent microvascular complications are kidney disease, blindness, and amputations, with current therapies only slowing disease progression...

  15. Eye Complications in IBD

    Science.gov (United States)

    ... Home > Resources > Eye Complications in IBD Go Back Eye Complications in IBD Email Print + Share Approximately 10% ... doctor’s attention sooner rather than later. TYPES OF EYE DISORDERS UVEITIS One of the most common eye ...

  16. Analysis of clinical features and risk factors of children with acute leukemia complicated with central nervous system complications%急性白血病患儿伴中枢神经系统并发症临床特点及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王毅捷; 马亚震; 孙和顺

    2016-01-01

    Objective To analyze the clinical features and risk factors of children with acute leukemia (AL) complicated with central nervous system (CNS) complications .Methods Seventy children with acute leukemia admitted into our hospital from March 2010 to March 2015 were selected as the research objects .The clinical data of all children were retrospectively an-alyzed ,including the occurrence rate of CNS complications and their clinical features and the risk factors of CNS complications were analyzed at the same time .Results There were 12 cases (17 .14% ) of CNS in 70 cases ,including 8 cases of AML com-plicated with CNS ,3 cases of ALL complicated with CNS and 1 case of acute granular lymphocyte leukemia and the complica-tions of CNS mainly were intracranial hemorrhage .The occurrence rates of CNS complications with platelet counts less than 50 × 109 L - 1 (whether or not) were 50 .00% and 2 .08% .The rates of white blood cell counts more than 100 × 109 L - 1 (whether or not) respectively were 50 .00% and 2 .08% .The rate of lymphadenectasis(whether or not) respectively was 47 .62% and 4 . 08% and there was significant difference between the two groups(P < 0 .01) .Logistic regression analysis showed that less than 50 × 109 L - 1 of the platelet counts ,more than 100 × 109 L - 1 of white blood cell counts and lymphadenectasis were the risk factors of AL with CNS complications .Conclusion Intracranial hemorrhage is common in children with acute leukemia com-plicated with central nervous system complications .And the risk factors affecting the occurrence of CNS complications include low platelet count ,high white blood cell count and lymphadenectasis .%目的:分析急性白血病(AL)患儿伴中枢神经系统(CNS)并发症的临床特点及危险因素。方法以我院2010-03—2015-03收治的70例急性白血病患儿为研究对象,回顾性分析 CNS 并发症发生率、CNS 并发症临床特点等,同时分析CNS 并发

  17. Factors associated with surgical site infection after lower extremity bypass in the Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI).

    Science.gov (United States)

    Kalish, Jeffrey A; Farber, Alik; Homa, Karen; Trinidad, Magdiel; Beck, Adam; Davies, Mark G; Kraiss, Larry W; Cronenwett, Jack L

    2014-11-01

    Surgical site infection (SSI) is a major source of morbidity after infrainguinal lower extremity bypass (LEB). This study examines processes of care associated with in-hospital SSI after LEB and identifies factors that could potentially be modified to improve outcomes. The Society for Vascular Surgery (SVS) Vascular Quality Initiative (VQI) registry (2003 to 2012) was queried to identify in-hospital SSI after 7908 consecutive LEB procedures performed by 365 surgeons at 91 academic and community hospitals in 45 states. Variables associated with SSI were identified using multivariable logistic regression and hierarchical clustering. Expected and observed SSI rates were calculated for each hospital. The overall in-hospital SSI rate after LEB was 4.8%. Univariate analysis showed that obesity, dialysis, tissue loss, preoperative ankle-brachial index 2 units of packed red blood cells, procedure time >220 minutes, and estimated blood loss >100 mL were associated with higher SSI rates, whereas chlorhexidine (compared with iodine) skin preparation was protective. Multivariable analysis showed independent predictors of SSI included ankle-brachial index 2 units (OR, 3.30; 95% CI, 2.17-5.02; P 220 minutes (OR, 2.11; 95% CI, 1.05-4.23; P < .04). Chlorhexidine was protective against SSI (OR, 0.53; 95% CI, 0.35-0.79; P = .002). Stratified analyses based on the presence of tissue loss yielded similar results. Across VQI hospitals, observed SSI rates ranged from 0% to 30%, whereas expected SSI rates adjusted by the four independent predictors ranged from 0% to 7.2%. In-hospital SSI after LEB varies substantially across VQI hospitals. Three modifiable processes of care (transfusion rate, procedure time, and type of skin preparation) were identified and may be used by hospitals to reduce SSI rates. This study demonstrates the value of the SVS VQI detailed shared clinical registry to identify improvement opportunities directly pertinent to providers that are not available in

  18. THE EFFECT OF INTENSIVE GLYCEMIC CONTROL ON THE FACTORS DETERMINING PREDICTION COMPLICATIONS OF ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH TYPE 2 DIABETES

    Directory of Open Access Journals (Sweden)

    A. I. Fedotova

    2015-01-01

    Full Text Available Objective. To determine predictors of complications of myocardial infarction (MI in patients with type 2 diabetes (2TDM and it’s value of intensive glycemic control during insulin infusion.Methods. The study included 112 patients with MI and 2TDM at first day of hospital admission with blood glucose level above 7.8 mmol/l. Prognosis of combined study endpoint included the death and ma-jor complications of MI for the hospital and long-term (6-month stages. The statistical analysis was per-formed (Statistica 6.0 for Windows. The predictive value was assessed with ROC-curves analysis meth-od.Results. Intensive glycemic control with insulin infusion reduced the activity of lipid peroxidation and improve prediction of study endpoint. Predictors of adverse hospital prognosis of MI in association with type 2 diabetes were hyperglycemia on admission above 10 mmol/l, and increase of C-peptide. The in-crease of C-peptide in the 1st and 7th day, hs-CRP on day 1, diene conjugates on the 7th day and glucose level on admission above 8.9 mmol/l (patients without 2TDM and 14.3 mmol/l (patients with 2TDM had the 6-month predictive value.Conclusion. The strict achievement of the target level of glucose in acute MI improves it’s prognosis at the hospital and at a 6-month prospective study.

  19. 锁定钢板治疗肱骨近端骨折术后并发症的相关因素分析%Correlative factor analysis of complications in proximal humerus fractures treated with locking plates

    Institute of Scientific and Technical Information of China (English)

    韦盛旺; 赵友明; 杨杰; 郭晓山; 陈华; 杨翔; 陈林

    2012-01-01

    目的 探讨应用锁定钢板治疗肱骨近端骨折发生术后并发症的相关因素.方法 回顾性分析80例(并发症组29例,无并发症组51例)行锁定钢板(LPHP或PHILOS)治疗肱骨近端骨折患者资料,应用Logistic回归分析研究各因素与术后并发症的关系.结果 单因素分析示,并发症组在年龄、术后内侧皮质缺损、肱骨颈干角复位不佳等方面与无并发症组比较,差异有统计学意义(P <0.05);Logistic回归分析发现术后内侧皮质缺损和肱骨颈干角复位不佳是发生术后并发症的独立预测因素.结论 影响锁定钢板治疗肱骨近端骨折术后并发症的相关因素较多,其中术后内侧皮质缺损及肱骨颈干角复位不佳是主要因素.%Objective To explore the correlative factors affecting the complications in proximal humerus fractures treated with locking plates. Methods Eighty patients (29 cases with complications and 51 cases without) with proximal humerus fractures were treated by locking plates (LPHP or PHILOS) and were retrospectively analyzed. And logistic regression analysis was used to find main factors. Results The univariate analysis showed that age, the integrity of the medial humerus wall postoperatively and head-shaft angle had a significant association with complications encountered in proximal humerus fractures treated with locking plate fixation (P<0.05). The multiple stepwise logistic regression showed that the postoperative integrity of the medial humerus wall and head-shaft angle were key factors affecting the complications. Conclusion The integrity of the medial humerus wall and head-shaft angle are the main factors affecting the complications.

  20. 晚期早产儿近期呼吸系统并发症高危因素分析%Analysis on risk factors of early respiratory complications in late preterm infants

    Institute of Scientific and Technical Information of China (English)

    周宏; 陶珂; 李星云

    2016-01-01

    Objective To explore the risk factors of early respiratory complications in late preterm infants. Methods A total of 112 late preterm infants diagnosed with early respiratory complications were collected as the re-search group. At the same time, 112 late preterm infants without early respiratory complications were selected as the con-trol group. The clinical data was analyzed between the two groups in order to identify the risk factors of early respiratory complications in late preterm infants. Results Single factor analysis showed that the related factors of early respiratory complications in late preterm infants included the pregnancy-induced hypertension syndrome, placenta previa, placental abruption, maternal fever during the late pregnancy, premature rupture of membranes, contamination of amniotic fluid, fetal intrauterine distress, asphyxia, small for gestational age infant, cesarean delivery, incidence of multiple pregnancy and neonatal sepsis (P<0.05). Multivariate logistic regression analysis of the above indexes revealed that maternal fever during the late pregnancy, premature rupture of membranes, fetal intrauterine distress, cesarean delivery, incidence of multiple pregnancy, asphysia, and neonatal sepsis were the risk factors for early respiratory complications in late preterm infants (P<0.05), which have early warning function. Conclusion It is important to focus the risk factors for effective monitoring and follow-up, which could provide timely reasonable intervention for neonates and reduce the incidence of early respiratory complications in late preterm infants and the neonatal mortality.%目的 探讨晚期早产儿发生近期呼吸系统并发症的危险因素.方法 选取2011年1月至2014年12月我院收治的112例发生了近期呼吸系统疾病的晚期早产儿为观察组,随机选取同期收治的112例未发生此类疾病的晚期早产儿为对照组,分别对两组患儿的临床资料进行分析,筛选出晚期早产儿发生

  1. Complications of blepharoplasty.

    Science.gov (United States)

    Morax, Serge; Touitou, Valerie

    2006-12-01

    The complications of blepharoplasty are infrequent, most often minor and transient, and rarely major and permanent with functional or aesthetic consequences. Treatment is above all preventive with screening of "at risk" patients in whom blepharoplasty would be contra-indicated. Patients must be informed of possible risks through informative booklets stressing the most important points. The complications may affect vision. Partial or complete visual loss due to ischemic optic neuropathy, or rarely to compression of the ocular globe by intraorbital hemorrhage, is the most serious complication. Other visual complications include oculomotor disorders, keratoconjunctivitis sicca, epiphora, and chemosis of lymphatic origin. Eyelid complications are more frequent: ptosis of the upper eyelid or lagophthalmia caused by incorrect resection of the skin, scarring, and eyelid fold anomalies. The most severe aesthetic complication is the malposition of the lower eyelid resulting in retraction, lagophthalmia, ectropion, deformation of the external canthus, or lower eyelid tissue relaxation. These malpositions are often minor, sometimes reversible, but they can be major, with psychological, aesthetic, and functional consequences. Other local complications include enophthalmia and hypo- or hypercorrection. General complications may include pigmentation anomalies or infections extending as far as the orbital fat tissue. Finally, complications observed after the newer procedures of laser surgery include ectropion, burns and residual redness. Complications related to periocular injections of filling material are also mentioned. The discussion of these complications is followed by a comprehensive review of the prevention, diagnosis and management of the complications after blepharoplasty.

  2. Complicated Horseshoe Kidney

    Energy Technology Data Exchange (ETDEWEB)

    Kim, K. S.; Kim, S. R.; Cha, K. S.; Park, S. S. [Chung Ang University College of Medicine, Seoul (Korea, Republic of)

    2010-05-15

    Horseshoe kidney is an important urological anomaly when it is complicated or accompanied by other diseases. Recently we have experienced four cases of horseshoe kidney which were complicated with hydronephrosis, renal stone and adrenal pheochromocytoma. With review of literatures, we emphasize the importance of detection of these complications.

  3. Rh isoimmunization complicating a triplet gestation. A case report.

    Science.gov (United States)

    Gast, M J; Rigg, L A; Martin, C M

    1991-04-01

    A case occurred of Rh isoimmunization complicating a triplet gestation. Management of that extremely rare situation required careful attention to the problems inherent in both multiple pregnancy and isoimmunization. Amniocentesis and frequent antepartum fetal monitoring were the cornerstones of therapy.

  4. Extremely Preterm Birth

    Science.gov (United States)

    ... Events Advocacy For Patients About ACOG Extremely Preterm Birth Home For Patients Search FAQs Extremely Preterm Birth ... Spanish FAQ173, June 2016 PDF Format Extremely Preterm Birth Pregnancy When is a baby considered “preterm” or “ ...

  5. Complications of strabismus surgery

    Directory of Open Access Journals (Sweden)

    Scott E Olitsky

    2015-01-01

    Full Text Available All surgeries carry risks of complications, and there is no way to avoid ever having a complication. Strabismus surgery is no different in this regard. There are methods to reduce the risk of a complication during or after surgery, and these steps should always be taken. When a complication occurs, it is important to first recognize it and then manage it appropriately to allow for the best outcome possible. This article will discuss some of the more common and/or most devastating complications that can occur during or after strabismus surgery as well as thoughts on how to avoid them and manage them should they happen.

  6. [Complications of urinary calculi].

    Science.gov (United States)

    Joual, A; Fekak, H; Rabii, R; el Moussasoui, A; Benjelloun, S

    1996-01-01

    Urinary stones is a frequent disease whose renal complications can engage both functional and vital prognosis. We report 769 complicated cases observed 10 years. The diagnosis was made by intravenous urography and ultrasonography. 607 cases were mechanical complications, 582 hydronephrosis, 25 anuria, 262 were infectious complications, 82 chronic pyelonephritis, 60 pyonephrosis, 10 perinephric abscess. Treatment included adapted antibiotic therapy, ureteral catheter in case of anuria ; surgical extraction of the stone nephrectomy was performed in 100 patients. Results were generally good. 9 patients had endstage chronic renal failure. The high frequency of urinary stone complications is due to the fact that most patients consult late. The diagnosis must obviously be made.

  7. Factors affecting the thermal environment of Agassiz’s Desert Tortoise (Gopherus agassizii) cover sites in the Central Mojave Desert during periods of temperature extremes

    Science.gov (United States)

    Mack, Jeremy S.; Berry, Kristin H.; Miller, David; Carlson, Andrea S.

    2015-01-01

    Agassiz's Desert Tortoises (Gopherus agassizii) spend >95% of their lives underground in cover sites that serve as thermal buffers from temperatures, which can fluctuate >40°C on a daily and seasonal basis. We monitored temperatures at 30 active tortoise cover sites within the Soda Mountains, San Bernardino County, California, from February 2004 to September 2006. Cover sites varied in type and structural characteristics, including opening height and width, soil cover depth over the opening, aspect, tunnel length, and surficial geology. We focused our analyses on periods of extreme temperature: in summer, between July 1 and September 1, and winter, between November 1 and February 15. With the use of multivariate regression tree analyses, we found cover-site temperatures were influenced largely by tunnel length and subsequently opening width and soil cover. Linear regression models further showed that increasing tunnel length increased temperature stability and dampened seasonal temperature extremes. Climate change models predict increased warming for southwestern North America. Cover sites that buffer temperature extremes and fluctuations will become increasingly important for survival of tortoises. In planning future translocation projects and conservation efforts, decision makers should consider habitats with terrain and underlying substrate that sustain cover sites with long tunnels and expanded openings for tortoises living under temperature extremes similar to those described here or as projected in the future.

  8. Study on the Factors of College Studellts Extreme Psychological Crisis%大学生极端心理危机事件影响因素研究

    Institute of Scientific and Technical Information of China (English)

    陈明娟

    2012-01-01

    目前,大学生心理危机现象表现较为突出,学校应关注他们极端的心理行,加强教育。%At present, college students" psychological crisis is a critical phenomenon. The school should be concerned about their extreme psychological behavior and strengthen education.

  9. Analysis on the risk factors of lower extremity deep venous thrombosis after cesarean section%剖宫产术后下肢深静脉血栓形成的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    高丹丽; 杨小杰; 林黎明

    2012-01-01

    Objective: To explore the risk factors of lower extremity deep venous thrombosis ( LEDVT) after cesarean section. Methods: A total of 20 998 patients who underwent cesarean section in Tangshan maternal and child health hospital, Tangshan workers hospital, and Xiehe hospital from January 2008 to January 2012 were selected, related tests were carried out before cesarean section, then color ultrasonography of bilateral lower extremities was performed at 2 - 7 days after cesarean section; except the patients with LEDVT, two times of peoples were selected from the whole population as control group; the influencing factors of LEDVT were analyzed by univariate and multivariate logistic regression analysis. Results; A total of 716 postoperative patients met the diagnostic criteria of LEDVT, the incidence of LEDVT was 3. 41%. Among the measurement data, the body mass index (BMI) , activated partial thromboplastin time ( APTT) , fibrinogen, D - dimer, antithrombin Ⅲ , and C — reactive protein ( CRP) in case group were statistically significantly higher than those in control group. Among the enumeration data, the incidences of LEDVT in the patients with the histories of hypertension, diabetic mellitus, smoking, thrombus, and oral administration of contraceptive were significantly higher than those in control group. Univariate logistic regression analysis showed that age, BMI, APTT, D - dimer, antithrombin Ⅲ , CRP, the medical histories of hypertension, diabetic mellitus, smoking, thrombus, and oral administration of contraceptive, and lacking sports were the independent risk factors of LEDVT; multivariate logistic regression analysis showed that age, BMI, D - dimer, antithrombin Ⅲ , and CRP were the independent risk factors of LEDVT. Conclusion: The incidence of LEDVT after cesarean section was high; the occurrence of LEDVT was correlated with age, BMI, D - dimer, antithrombin Ⅲ , and CRP. It is suggested to screen LEDVT routinely at 2 -7 days after cesarean section

  10. Analysis of Factors Influencing Postoperative Complications of Lung Cancer Treated with Minimally Invasive Surgery%肺癌微创手术术后并发症发生的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    耿耿; 陈荣林; 李勇

    2014-01-01

    目的:探讨肺癌微创手术切除术后,患者发生并发症的相关影响因素。方法所选53例肺癌患者均应用电视胸腔镜辅助进行肺癌切除术治疗。回顾性分析患者的临床资料,统计患者并发症发生情况,并应用单因素及多因素Logistic分析微创手术行肺癌切除术后,患者发生并发症的相关影响因素。结果53例患者术后出现并发症10例,发生率为18.87%。单因素分析显示,肺癌微创手术后发生并发症与年龄、FEV1%、吸烟指数、合并冠心病与糖尿病有关,而与其他合并症、手术时间、手术类型、性别无关。经Logistic多因素筛选后分析,70岁以上、FEV1%≤60%、合并冠心病为肺癌微创手术后发生并发症的独立危险因素。结论70岁以上、FEV1%≤60%、合并冠心病的肺癌患者,在微创手术后好发术后并发症,围手术期内应对上述患者进行危险评估并提供积极的干预。%Objective To explore influnece factors of postoperative complications of lung cancer treated with minimally invasive resection .Methods 53 cases of lung cancer patients received video-assisted thoracoscopic lung resection .Clinical data of patients and complications were retrospectively analyzed ,univariate and multivariate logistic regression were used to analyze in-flunece factors of postoperative complications of lung cancer treated with minimally invasive resection .Results In the 53 pa-tients,there had 10 cases of postoperative complications ,the incidence rate was 18.87%.Univariate analysis showed that postop-erative lung complications were related with age ,FEV1%,smoking index ,coronary heart disease and diabetes ,but not related with other complications,operative time,type of surgery and gender.Multivariate logistic analysis showed that over 70,FEV1% ≤60%,coronary heart disease were independent risk factors for complications after minimally invasive lung surgery .Conclusion Lung

  11. Body mass index as a prognostic factor for fracturing of the proximal extremity of the femur: a case-control study,

    Directory of Open Access Journals (Sweden)

    Renato Cavanus Pagani

    2014-10-01

    Full Text Available Objectives:To compare the body mass index (BMI of patients with fractures in the proximal extremity of the femur with the BMI of patients without any previous history of fractures.Methods:We investigated patients of both sexes, aged 65 years or over, who were admitted to Hospital Independência, Hospital Beneficência Portuguesa or ULBRA University Hospital, between December 2007 and December 2010, with histories of low-energy trauma such as falling from a standingposition. These individuals were compared with patients of the same age but without any history of fracturing of the proximal extremity of the femur (n = 89, who were attended at the geriatrics outpatient clinic of the Sociedade Porto-Alegrense de Auxílio aos Necessitados (SPAAN.Results:The age group of the patients with fractures in the proximal extremity of the femur ranged from 65 to 96 years (mean: 77.58. The main type of fracture was trochanteric (47; 62.2%, followed by femoral neck fractures (27; 36%. Among the patients who presented on fracturing the proximal extremity of the femur, 12% had low weight, 62.7% normal weight, 24% overweight, and 1.3% obesity. Among the patients without any history of fractures, 5.6% presented low weight, 43.8% normal weight, 33.7% overweight, and 9.8% obesity. It was observed that the patients with fractures in the proximal extremity of the femur (n = 75 presented a mean BMI of 22.6, while the patients without fractures presented a mean BMI of 25.5.Conclusion:The patients in the group with fractures were significantly taller than those in the group without fractures and presented significantly lower BMI than those in the group without fractures.

  12. Body mass index as a prognostic factor for fracturing of the proximal extremity of the femur: a case–control study☆☆☆

    Science.gov (United States)

    Pagani, Renato Cavanus; Kunz, Rodrigo Ernesto; Girardi, Ricardo; Guerra, Marcelo

    2014-01-01

    Objectives To compare the body mass index (BMI) of patients with fractures in the proximal extremity of the femur with the BMI of patients without any previous history of fractures. Methods We investigated patients of both sexes, aged 65 years or over, who were admitted to Hospital Independência, Hospital Beneficência Portuguesa or ULBRA University Hospital, between December 2007 and December 2010, with histories of low-energy trauma such as falling from a standing position. These individuals were compared with patients of the same age but without any history of fracturing of the proximal extremity of the femur (n = 89), who were attended at the geriatrics outpatient clinic of the Sociedade Porto-Alegrense de Auxílio aos Necessitados (SPAAN). Results The age group of the patients with fractures in the proximal extremity of the femur ranged from 65 to 96 years (mean: 77.58). The main type of fracture was trochanteric (47; 62.2%), followed by femoral neck fractures (27; 36%). Among the patients who presented on fracturing the proximal extremity of the femur, 12% had low weight, 62.7% normal weight, 24% overweight, and 1.3% obesity. Among the patients without any history of fractures, 5.6% presented low weight, 43.8% normal weight, 33.7% overweight, and 9.8% obesity. It was observed that the patients with fractures in the proximal extremity of the femur (n = 75) presented a mean BMI of 22.6, while the patients without fractures presented a mean BMI of 25.5. Conclusion The patients in the group with fractures were significantly taller than those in the group without fractures and presented significantly lower BMI than those in the group without fractures. PMID:26229845

  13. Complications of third molar surgery.

    Science.gov (United States)

    Bouloux, Gary F; Steed, Martin B; Perciaccante, Vincent J

    2007-02-01

    This article addresses the incidence of specific complications and, where possible, offers a preventive or management strategy. Injuries of the inferior alveolar and lingual nerves are significant issues that are discussed separately in this text. Surgical removal of third molars is often associated with postoperative pain, swelling, and trismus. Factors thought to influence the incidence of complications after third molar removal include age, gender, medical history, oral contraceptives, presence of pericoronitis, poor oral hygiene, smoking, type of impaction, relationship of third molar to the inferior alveolar nerve, surgical time, surgical technique, surgeon experience, use of perioperative antibiotics, use of topical antiseptics, use of intra-socket medications, and anesthetic technique. Complications that are discussed further include alveolar osteitis, postoperative infection, hemorrhage, oro-antral communication, damage to adjacent teeth, displaced teeth, and fractures.

  14. 妊娠期高血压疾病发病的高危因素研究%Study on the High Risk Factors of Pathogenesis of Hypertensive Disorder Complicating Pregnancy

    Institute of Scientific and Technical Information of China (English)

    方明; 何元芬; 章庆华

    2014-01-01

    目的:调查分析妊娠期高血压疾病发病的高危因素。方法:选取2010年1月~2013年4月本院的968例孕妇为研究对象,将其妊娠期高血压疾病发病率进行统计,并将其中不同年龄段、孕次、流产史、吸烟史、高血压家族史、心理评估结果及叶酸应用者的发生率进行比较,并以Logistic回归分析妊娠期高血压疾病的危险因素。结果:年龄≥35岁、孕次≥2次、有流产史、吸烟史、高血压家族史、Zung自评量表阳性及未早期应用叶酸者的妊娠期高血压疾病发病率均高于其他患者,且上述因素均为妊娠期高血压疾病发病的危险因素,P均<0.05,均有显著性差异。结论:年龄、孕次、流产史、吸烟史、高血压家族史、心理评估及叶酸应用情况均是对妊娠期高血压疾病发病有影响的因素,可根据此危险因素给予患者针对性干预。%Objective:To investigate and analyze the high risk factors of pathogenesis of hypertensive disorder complicating pregnancy.Methods:968 pregnant women in our hospital from January 2010 to April 2013 were selected as research object,then the hypertensive disorder complicating pregnancy rate of all the pregnant women was analyzed,and the rate of pregnant women with different ages,gravidity times,abortion history,smoking history,hypertension family history,psychological assessment results and folic acid application were compared,and the risk factors of pathogenesis of hypertensive disorder complicating pregnancy were analyzed with Logistic regression.Results:The hypertensive disorder complicating pregnancy rate of pregnant women with ≥35 years old,gravidity times≥2 times,abortion history,smoking history,hypertension family history,positive Zung checklist and without early folic acid application were all higher than those of others,and those factors were all the risk factors of pathogenesis of hypertensive disorder complicating pregnancy,all P<0.05,there were

  15. Analysis of risk factors of patients with chronic liver failure complicated invasive fungal infections%慢性肝衰竭患者侵袭性真菌感染的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    胡耀仁; 胡爱荣

    2009-01-01

    Objective To evaluate the risk factors of chronic liver failure(CLF) complicated invnsive fungal infections(IFI) and prevention and treatment. Methods The clinical data and risk factors of 52 patients with CLF complicated IFI were analyzed retrospectively and were compared with those not complicated IFI. Risk factors were analyzed by chi-square test and Logistic regression test and Ridit test. Results In 52 patients with CLF complicated IFI, there were 69 fungal infections in different tissue and organs, the most were in oral cavity, but other tissue and organs especially bellows infections were rising. Candida albieans infeefions were the most, but cryptococcus neoformans infections and aspergillus infections were rising. The risk factors included species of bacteria infections, serum total bilimbin, hospital days, times of antibiotics using, number of invasive operation,species of antibiotics and degrees of aseites. The mortality of patients with CLF complicated IFI were much higher than those not complicated IFI. Conclusion Patients with CLF complicated IFI have poor progress and prognosis. The effective prevent methods are treating primary disease actively, reducing hospital days, detecting patients' body fluids closely, identifying source of infection as early as possible, using antibiotics correctly, reducing or avoiding invasive operation, using immunoactivators and disinfecting air regularly.%目的 探讨慢性肝衰竭(Chronic liver failure,CLF)患者合并侵袭性真菌感染(Invnsivefunsal infections,IFl)的危险因素及防治措施.方法 回顾性分析52例CLF合并IFI患者的I临床特点、危险因素以及预后,并与随机选取同期住院的52例CLF未合并真菌感染患者作为对照.结果 52例真菌感染者发生了69例次不同部位感染,感染部位虽然以浅部口腔为主,但是其他部位感染有上升趋势,尤其是肺部感染;感染真菌种属虽然仍以白色念珠菌为主,但是新型隐

  16. Risk factors of biliary complications after liver transplantation from donation after cardiac death%心脏死亡供者肝移植受者胆道并发症风险因素分析

    Institute of Scientific and Technical Information of China (English)

    俞军; 谢尚奋; 夏伟良; 程龙宇; 张武; 俞松峰; 张珉; 郑树森

    2014-01-01

    目的:分析心脏死亡器官捐献( DCD)肝移植受者术后胆道并发症发生的高危因素。方法:收集浙江大学医学院附属第一医院2010年10月—2013年10月施行的109例DCD肝移植手术的临床资料,回顾分析供者因素对受者胆道并发症的影响。结果:109例DCD肝移植受者术后共24例发生胆道并发症,发生率为22.0%。单因素分析显示胆道并发症组与对照组间的热缺血时间( P<0.001)及ICU住院天数( P=0.013)差异均有统计学意义;ABO血型是否相容差异无统计学意义( P>0.05);使用升压药及患者脂肪肝有增加术后胆道并发症的趋势。多因素分析显示热缺血时间(P=0.001,OR=1.328,95%可信区间为1.124~1.526)和ICU住院天数( P=0.012,OR=0.840,95%可信区间为0.732~0.963)是术后胆道并发症的独立危险因素。结论:胆道并发症仍然是DCD肝移植术后的主要难题,热缺血时间和ICU治疗是受者术后胆道并发症的独立危险因素。在供肝紧缺的情况下,使用ABO血型不相容的供肝不失为拯救生命的有效方法。%Objective: To analyze the risk factors for biliary complications of liver transplantation from donation after cardiac death ( DCD ) .Methods: Clinical data of 109 patients undergoing liver transplantation from DCD in First Affiliated Hospital of Zhejiang University School of Medicine from October 2010 to October 2013 were studied retrospectively. The risk factors of biliary complications following DCD liver transplantation were analyzed.Results: Twenty-four (22%) patients developed biliary complications after DCD liver transplantation.Univariate analysis showed that biliary complications were associated with warm ischemia time ( P0.05). Administration of inotropic agents and fatty liver increased the trend of biliary complications.Multivariate analysis demonstrated that warm ischemia time and length of ICU stay were

  17. 慢阻肺合并 OSAS 患者呼吸衰竭的危险因素分析%Analysis of risk factors of respiratory failure in COPD patients complicated with OSAS

    Institute of Scientific and Technical Information of China (English)

    隋颖; 顾珏

    2016-01-01

    Objective To evaluate the risk factors of respiratory failure in COPD patients complicated with OSAS. Methods The clinical data of COPD patients complicated with OSAS were collected from December 2012 to December 2014. The single factor analysis and Logistic multivariate analysis was applied to evaluate the risk factors of respiratory failure. While P 0. 05). And neck circumfer-ence,dyspnea and/ or cyanosis,night hold awake,LAT and mSaO2 were statistical significant in respiratory failure (P 0.05)。而颈围、呼吸困难和/或发绀、夜间憋醒、LAT、mSaO2在呼吸衰竭组和非呼吸衰竭组之间的差异则具有统计学意义( P <0.05)。logisitc 多因素分析显示:颈围(OR =1.75)、呼吸困难/发绀(OR =20.01)为 OS 患者发生急性呼吸衰竭的