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  1. 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

  2. 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.

  3. Preparation and management of complications in prostate biopsies

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    Chiang Jeng Tyng

    2013-12-01

    Full Text Available Transrectal ultrasonography-guided biopsy plays a key role in prostate sampling for cancer detection. Among interventional procedures, it is one of the most frequent procedures performed by radiologists. Despite the safety and low morbidity of such procedure, possible complications should be promptly assessed and treated. The standardization of protocols and of preprocedural preparation is aimed at minimizing complications as well as expediting their management. The authors have made a literature review describing the possible complications related to transrectal ultrasonography-guided prostate biopsy, and discuss their management and guidance to reduce the incidence of such complications.

  4. 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.

  5. 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

  6. 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.

  7. [Bifidogenic factors as drug preparations].

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    Murashova, A O; Lisitsin, O B; Abramov, N A

    1999-01-01

    The review of new data on the study of bifidobacterial factors of different origin and the probable mechanisms of their favorable action on the microflora of the intestinal tract if presented. The main emphasis is made on the analysis of data on the use of oligosaccharides, including fructo-oligosaccharides, as compounds stimulating the growth and development of bifidobacteria both in pure cultures and in intestinal microflora. Methods for the treatment of natural compounds with a view to enhancing their bifidogenic effect are presented. The possibilities and/or advantages of using bifidogenic factors in vivo and in vitro as medicinal preparations either alone or incorporated in probiotic compositions are evaluated. Suggestion has been made that the choice of the method for using bifidogenic factors may depend on the kind and severity of disturbances in indigenous microflora.

  8. 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.

  9. Factors that can minimize bleeding complications after renal biopsy

    OpenAIRE

    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...

  10. 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.

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

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    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.

  12. 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

  13. A method to minimize complications in endodontic access cavity preparation.

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    Zelikow, Robert; Cozzarelli-Moldauer, Gina; Keiner, Steven; Hardigan, Patrick C

    2008-06-01

    This article presents a method of avoiding some operative errors in endodontic-access cavity preparation. Utilizing the radiograph, a line representing the coronal extension of the image of the coronal two-thirds of the root canal(s) is drawn on the facial surface of the crown (Fig. 1). This line determines the proper angulation of the bur to facilitate entry into the pulp chamber in proper mesio-distal orientation, thereby reducing the likelihood of mesial and distal gouging and perforating. Marking the tooth to be treated prior to rubber-dam placement help in preventing treatment of an incorrect tooth. Two studies utilizing Nova Southeastern University College of Dental Medicine (NSUCDM) second-year dental students (D-2), one utilizing University of Florida, College of Dentistry (UFCD) second year dental students (D2) and one utilizing NSUCDM Advanced Education in General Dentistry (AEGD) faculty and students were undertaken to evaluate the method. Evaluation was by endodontic teachers. Results indicate use of the line-drawing method may facilitate more ideal access cavities than those prepared without the method. Welch's t-test, chi-square test and estimating equations were employed. One study showed significant difference between control and test groups (p less than 045). All studies indicated a difference. Further testing of the method is indicated. This valuable tool should be considered for use in teaching and practice.

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

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    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. 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...

  17. 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...

  18. Two-dimensional preparative liquid chromatography system for preparative separation of minor amount components from complicated natural products

    Energy Technology Data Exchange (ETDEWEB)

    Qiu, Ying-Kun, E-mail: qyk@xmu.edu.cn; Chen, Fang-Fang; Zhang, Ling-Ling; Yan, Xia; Chen, Lin; Fang, Mei-Juan; Wu, Zhen, E-mail: wuzhen@xmu.edu.cn

    2014-04-01

    Highlights: • Preparative MDLC system was developed for separation of complicated natural products. • Medium-pressure LC and preparative HPLC were connected by interface of SPE. • Automated multi-step preparative separation of 25 compounds was achieved by using this system. - Abstract: An on-line comprehensive two-dimensional preparative liquid chromatography system was developed for preparative separation of minor amount components from complicated natural products. Medium-pressure liquid chromatograph (MPLC) was applied as the first dimension and preparative HPLC as the second one, in conjunction with trapping column and makeup pump. The performance of the trapping column was evaluated, in terms of column size, dilution ratio and diameter-height ratio, as well as system pressure from the view of medium pressure liquid chromatograph. Satisfactory trapping efficiency can be achieved using a commercially available 15 mm × 30 mm i.d. ODS pre-column. The instrument operation and the performance of this MPLC × preparative HPLC system were illustrated by gram-scale isolation of crude macro-porous resin enriched water extract of Rheum hotaoense. Automated multi-step preparative separation of 25 compounds, whose structures were identified by MS, {sup 1}H NMR and even by less-sensitive {sup 13}C NMR, could be achieved in a short period of time using this system, exhibiting great advantages in analytical efficiency and sample treatment capacity compared with conventional methods.

  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. 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.

  1. Risk Factors for Postoperative Pulmonary Complications after Abdominal Surgery

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    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.

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

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    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.

  3. 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.

  4. 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.

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

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    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.

  6. Complicated appendicitis: Analysis of risk factors in children

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    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.

  7. 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

  8. 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.

  9. 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.

  10. 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.

  11. 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.

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

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    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

  13. 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

  14. 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.

  15. 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.

  16. 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....

  17. 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.

  18. 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

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

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    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.

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

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    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.

  1. 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.

  2. 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

  3. Factors influencing Complexity in Financial Report preparation - Evidence from the Banking Sector in Kenya

    Directory of Open Access Journals (Sweden)

    A.Mutiso

    2013-06-01

    Full Text Available The current developments in the business environment as well as in the accountancy profession have significantly affected the way the financial reports are prepared. This study sought to assess the factors influencing complexity of preparing financial reports in the banking sector in Kenya. The objectives included assessing whether disclosures, adoption of International financial Reporting Standard, regulations and lack of competence by the preparers have contributed to the complexity of preparing financial statements. Using a descriptive study design, data was collected from ten banks registered in the Nairobi Capital Market. The study found out that the identified variables positively contributed to complications in the preparation of financial reports. Management interference, lack of guidance on interpretations and frequent updates of the standards were identified as the main challenges in preparing financial reports. Several recommendations were given to help simplify the process of preparing financial statements.

  4. Perinatal complications, environmental factors and autism spectrum disorders

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    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.

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

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    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.

  6. 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.

  7. 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.

  8. [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.

  9. Control of equiaxed grains in a complicated Cu-Ni based alloy prepared by centrifugal casting

    Directory of Open Access Journals (Sweden)

    Luo Zongqiang

    2011-02-01

    Full Text Available A complicated Cu-Ni based alloy was developed to fabricate wear-resisting bush for high temperature application. The concern focuses on the control of equiaxed grains in the developed alloy ingot prepared by centrifugal casting. The results show that the equiaxed grains are determined by the pouring temperature of the melt, the cooling rate and the rotation speed of the mold. With the decrease in pouring temperature, the fraction of the equiaxed grains in the transverse section of the ingot increases and the average length of columnar grain decreases. When the pouring temperature is confined below 1,250℃, complete equiaxed grains can be obtained. Based on the optimal centrifugal casting processing, the tensile strength of the developed alloy ingot with complete equiaxed grains reaches to 810 MPa and 435 MPa at room temperature and 500℃, respectively, which is 14% and 110% higher than that of common commercial QAl10-4-4 alloy. The wear rate of the developed alloy is 7.0 × 10-8 and 3.8 × 10-7 mm3•N-1•mm-1 at room temperature and 500℃, respectively, which is 5 times and 39 times lower than that of QAl10-4-4 alloy.

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. Marriage Preparation: Factors Associated with Consumer Satisfaction.

    Science.gov (United States)

    Russell, Mary N.; Lyster, Rosanne Farnden

    1992-01-01

    Evaluated marriage preparation program to determine overall consumer satisfaction with the program, satisfaction with specific content areas, and extent to which consumer characteristics affected satisfaction ratings. Results of survey of 196 couples revealed high overall satisfaction levels, variability in satisfaction by content area, and…

  15. 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...

  16. 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...

  17. 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.

  18. 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

  19. 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

  20. Complications of first-trimester abortion by vacuum aspiration after cervical preparation with and without misoprostol: a multicentre randomised trial.

    Science.gov (United States)

    Meirik, Olav; My Huong, Nguyen Thi; Piaggio, Gilda; Bergel, Eduardo; von Hertzen, Helena

    2012-05-12

    Little information is available about the incidence of complications from vacuum aspiration for first-trimester abortion after cervical preparation with prostaglandin analogues. We compared incidence of complications from vacuum aspiration in women who had had cervical preparation with misoprostol and those who had not. We did a randomised parallel-group trial at 14 centres in nine countries between Oct 22, 2002, and Sept 24, 2005. Healthy women seeking first-trimester abortion were randomly assigned via a computer-generated randomisation sequence stratified by centre, to receive vaginal administration of either two 200 μg tablets of misoprostol or two placebo tablets 3 h before abortion by vacuum aspiration. Participants and health-care personnel other than staff administering the treatment were masked to group assignment. Follow-up was up to 2 weeks. The primary outcome was one or more complications of vacuum aspiration (cervical tear, uterine perforation, incomplete abortion, uterine re-evacuation, pelvic inflammatory disease, or any other serious adverse event). We included women undergoing treatment and vacuum aspiration in the analysis of immediate complications; whereas, in the analysis of delayed complications, we included only those followed-up. In the analysis of any immediate or delayed complication, we excluded women lost to follow-up. This trial is registered, number ISRCTN85366519. We randomly assigned 2485 women to the misoprostol group and 2487 to the placebo group. Two women in the misoprostol group did not have vacuum aspiration. 56 women in each group were lost to follow-up. 50 (2%) of 2427 women in the misoprostol group and 74 (3%) of 2431 in the placebo group had one or more complication of vacuum aspiration (relative risk [RR] 0·68, 95% CI 0·47-0·96). No women in the misoprostol group had cervical tears and three had uterine perforations compared with two women in the placebo group who had cervical tears and one who had perforation. 19

  1. 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.

  2. 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....

  3. 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.

  4. 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.

  5. 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.

  6. 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...

  7. Factors influencing quality of bowel preparation for colonoscopy.

    Science.gov (United States)

    Romero, Ronald V; Mahadeva, Sanjiv

    2013-02-16

    Recent technological advances in colonoscopy have led to improvements in both image enhancement and procedural performance. However, the utility of these technological advancements remain dependent on the quality of bowel preparation during colonoscopy. Poor bowel preparation has been shown to be associated with lower quality indicators of colonoscopy performance, such as reduced cecal intubation rates, increased patient discomfort and lower adenoma detection. The most popular bowel preparation regimes currently used are based on either Polyethylene glycol-electrolyte, a non-absorbable solution, or aqueous sodium phosphate, a low-volume hyperosmotic solution. Statements from various international societies and several reviews have suggested that the efficacy of bowel preparation regimes based on both purgatives are similar, although patients' compliance with these regimes may differ somewhat. Many studies have now shown that factors other than the type of bowel preparation regime used, can influence the quality of bowel preparation among adult patients undergoing colonoscopy. These factors can be broadly categorized as either patient-related or procedure-related. Studies from both Asia and the West have identified patient-related factors such as an increased age, male gender, presence of co-morbidity and socio-economic status of patients to be associated with poor bowel preparation among adults undergoing routine out-patient colonoscopy. Additionally, procedure-related factors such as adherence to bowel preparation instructions, timing of bowel purgative administration and appointment waiting times for colonoscopy are recognized to influence the quality of colon cleansing. Knowledge of these factors should aid clinicians in modifying bowel preparation regimes accordingly, such that the quality of colonoscopy performance and delivery of service to patients can be optimised.

  8. [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.

  9. 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.

  10. 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.

  11. 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.

  12. 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

  13. 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...

  14. 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.

  15. 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

  16. 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

  17. 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.

  18. 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....

  19. 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).

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. 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

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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

  20. 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.

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

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    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

  2. 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

  3. 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.)

  4. 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.

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

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    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

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

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    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

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

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    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.

  8. 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...

  9. 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.

  10. 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.

  11. 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

  12. 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

  13. 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

  14. 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.

  15. 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.

  16. 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.

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

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    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.

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

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    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.

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

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    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.

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

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    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.

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

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    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

  2. 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

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Preparation of Chitosan Nanoparticles: A Study of Influencing Factors

    Science.gov (United States)

    Thakur, Anupama; Taranjit

    2011-12-01

    Chitosan (CS), a cationic polysaccharide, offers great advantages for ionic interactions with negatively charged species such as sodium tripolyphosphate (STPP) leading to the formation of biocompatible crosslinked chitosan nanoparticles In the present work, an attempt has been made to systematically study the following factors influencing the ionotropic gelation of chitosan with STPP to produce CS nanoparticles: effect of pH of solution, CS concentration, STPP concentration and CS/STPP ratio. The results show that with the increase in CS concentration, the yield of the nanoparticle decreases whereas size increases. The mean size of the prepared nanoparticles varied between 120 to 720 nm and zeta potential between +14 mV to +53 mV . Nanoparticle size and yield was found to be strongly dependent on solution pH. Nanoparticle size decreased with increase in solution pH from 4 to 5 and yield was found to be maximum at pH = 5. With increase in STPP concentration, the size and yield of the nanoparticle increased. The potential of CS nanoparticles to trap amoxicillin trihydrate, taken as the model drug, was also studied. The maximum drug loading capacity was found to be 35% at a solution pH = 5 for 0.2% CS and 0.086% STPP.

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

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    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

  9. 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

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

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    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.

  11. 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.

  12. 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.

  13. 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.

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

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    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

  15. 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...

  16. 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...

  17. 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...

  18. 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.

  19. 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

  20. 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.

  1. 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

  2. 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.

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  6. Motivating Factors for Philanthropy at a Ministry Preparation Graduate Institution

    Science.gov (United States)

    Reimer, Jay Paul

    2013-01-01

    A qualitative case study was conducted to determine whether major donors to an institution of higher education that existed to prepare ministers and missionaries were perceived by the institution's leaders as motivated by organizational effectiveness, financial efficiency, or evaluations by donor watchdog agencies. The case study was conducted…

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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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.

  9. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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.

  12. Influence of formulation factors on the preparation of zein nanoparticles.

    Science.gov (United States)

    Podaralla, Satheesh; Perumal, Omathanu

    2012-09-01

    The main objective of the present study was to investigate the influence of various formulation parameters on the preparation of zein nanoparticles. 6,7-dihydroxycoumarin (DHC) was used as a model hydrophobic compound. The influence of pH of the aqueous phase, buffer type, ionic strength, surfactant, and zein concentration on particle size, polydispersity index, and zeta potential of DHC-loaded zein nanoparticles were studied. Smaller nanoparticles were formed when the pH was close to the isoelectric point of zein. DHC-loaded zein nanoparticles prepared using citrate buffer (pH 7.4) was better than phosphate buffer in preventing particle aggregation during lyophilization. The ionic strength did not have a significant influence on the particle size of DHC-loaded zein nanoparticles. A combination of Pluronic F68 and lecithin in 2:1 ratio stabilized the zein nanoparticles. An increase in zein concentration led to increase in particle size of DHC-loaded zein nanoparticles. The use of optimal conditions produced DHC-loaded nanoparticles of 256 ± 30 nm and an encapsulation efficiency of 78 ± 7%. Overall, the study demonstrated the optimal conditions to prepare zein nanoparticles for drug encapsulation.

  13. 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.

  14. MAIN FACTORS IN PREPARATION OF ANTIBACTERIAL PARTICLES/PVC COMPOSITE

    Institute of Scientific and Technical Information of China (English)

    Xuehua Chen; Chunzhong Li; Ling Zhang; Shoufang Xu; Qiuling Zhou; Yihua Zhu; Xianzhang Qu

    2004-01-01

    Zirconium phosphate containing silver was chosen as antibacterial particles in preparing antibacterial particles/PVC composite. The effect of surface property of the antibacterial particles and of their filler content on the properties of antibacterial particles/PVC composite was studied. The effect of the interfacial compatibility on mechanical properties of the composite was also discussed. Experimental results showed that the antibacterial PVC composite had good antibacterial property, reaching almost 100% bacteriostatic level at an antibacterial powder filler content of 1.5 phr.

  15. 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.

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. Preparing Methods and Its Influencing Factors about Nanoparticles Based on Dendritic Polymer

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    Zhang Jianwei

    2017-01-01

    Full Text Available Based on the properties, structure and application of dendritic polymer, this paper analysed the methods of the preparation of nanoparticles using dendritic polymer, detailed preparation process, technical parameters and application effect about a single metal nanoparticles, bimetallic nanoparticles, sulfide and halide nanoparticles. The influencing factors of the preparation about nanoparticles were discussed, including the molecular algebra, the molar ratio of the metal ions to the dendritic polymer, and so on.

  4. [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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

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

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    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.

  13. 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.

  14. 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.

  15. Complications in gynecological minimal-access oncosurgery.

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    Becker, Sven; De Wilde, Rudy Leon

    2016-08-01

    Complications are the limiting factors of all surgeries. More than performing the actual surgery, learning how to avoid complications before, during, and after surgery is the most important task of every surgeon. Severe complications can lead to patient death. Complications such as ureterovaginal fistulas, resulting from <2 s of inattentive preparation, can lead to years of hardship, suffering, accusation, and litigation. Excellent surgery is about performing the right surgery for the right patient without any complications. Minimally invasive surgery in complex cases is technically challenging. This article details the major causes of complications in laparoscopy for the gynecologic cancer patient and present strategies for prevention, early detection, and intra- and postoperative management.

  16. 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

  17. Preparation

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    M.M. Dardir

    2014-03-01

    Full Text Available Some hexanamide-mono and di-linoleniate esters were prepared by the reaction of linolenic acid and hexanamide (derived from the reaction of hexanoic acid and diethanolamine. The chemical structure for the newly prepared hexanamide-mono and di-linoleniate esters were elucidated using elemental analysis, (FTIR, H 1NMR and chemical ionization mass spectra (CI/Ms spectroscopic techniques. The results of the spectroscopic analysis indicated that they were prepared through the right method and they have high purity. The new prepared esters have high biodegradability and lower toxicity (environmentally friendly so they were evaluated as a synthetic-based mud (ester-based mud for oil-well drilling fluids. The evaluation included study of the rheological properties, filtration and thermal properties of the ester based-muds formulated with the newly prepared esters compared to the reference commercial synthetic-based mud.

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

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    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

  19. Preparation and properties of the specific anti-influenza virus transfer factor.

    Science.gov (United States)

    Li, Chongbi; Huang, Lihua; Wang, Yanping; Li, Xiangle; Liang, Shaowei; Zheng, Yingna

    2010-09-13

    Specific anti-influenza virus and normal transfer factors prepared in an experimental animal model, the pig, have been tested for their components, characteristics, and activity of known specificity. Two transfer factors are small molecular mixture which consist entirely or partly of polypeptides and polynucleosides. Moreover, the biological activity of transfer factors could be approved by Rosettes test and specific skin test. The study would lay a foundation for the research and development of other specific transfer factor.

  20. 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

  1. [Nicolau syndrome caused by penicillin preparations: review of the literature in search for potential risk factors].

    Science.gov (United States)

    Saputo, V; Bruni, G

    1998-01-01

    The Authors, who in 1977 published the first Italian case report of the Nicolau syndrome (N.S.) from penicillin preparations in the pediatric field, accomplished a thorough search for similar reports in the world literature finding a total of 102 cases, of whom 80 were less than 12-year old. They made a detailed analysis of each case in that series in order to identify or better define potential risk factors or predisposing circumstances worth being taken in consideration for preventive purposes. Indeed, the possible occurrence of N.S., which may include devastating complications such as limb gangrene, paraplegia, or death and have medico-legal implications, is still largely underrated or unrecognised by both physicians and nurses. It is unfortunate in particular that no acknowledgement of that syndrome is available in the teaching programs and textbooks used in professional nurse schools; in addition physicians are not enough zealous in discouraging unqualified lified people as well as patient's relatives from performing intramuscular injections, mainly using certain kinds of drugs such as crystalline suspensions. On the basis of the findings of their analysis as well as of an overall review of the relevant literature the Authors conclude their paper by making a series of specific recommendations and/or proposals addressed to the various operators involved in the matter (prescribing physicians, managers of nursing schools, nurses, pharmaceutical companies, Regulatory Health Authority), with special emphasis on the precautionary measures to be taken in doing intramuscular injection of long-acting penicillins or other drugs in crystalline suspension.

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

    Directory of Open Access Journals (Sweden)

    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.

  3. 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.

  4. 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.

  5. Infectious complications following allogeneic HLA-identical sibling transplantation with antithymocyte globulin-based reduced intensity preparative regimen.

    Science.gov (United States)

    Mohty, M; Jacot, W; Faucher, C; Bay, J O; Zandotti, C; Collet, L; Choufi, B; Bilger, K; Tournilhac, O; Vey, N; Stoppa, A M; Coso, D; Gastaut, J A; Viens, P; Maraninchi, D; Olive, D; Blaise, D

    2003-11-01

    In the setting of reduced-intensity conditioning (RIC) regimens for allogeneic stem cell transplantation (allo-SCT), the epidemiology of transplant-related infections is still poorly defined. In 101 high-risk patients who received an HLA-identical sibling allo-SCT after RIC, including fludarabine, busulfan and antithymocyte globulin (ATG), we report during the first 6 months a cumulative incidence of positive CMV antigenemia of 42% (95% CI 32-52%), developing at a median of 37 (range 7-116) days without evidence of CMV disease (median follow-up, 434 days). The cumulative incidence of bacteremia was 25% (95% CI 17-33%), occurring at a median of 67 (range 7-172) days, while patients had recovered a full neutrophil count. In all, 65% of the bacteremia (95% CI 49-81%) were gram negative. The cumulative incidence of fungal infections was 8% (95% CI 3-13%), with a median onset of 89 (range 7-170) days. In multivariate analysis, stem cell source (bone marrow; P=0.0002) was significantly associated with the risk of positive CMV antigenemia, while higher doses of prednisone (>2 mg/kg) represented the major risk factor for bacteremia (P=0.0001). Infectious-related mortality was 5% (95% CI 1-9%), with aspergillosis being the principal cause. Collectively, these results suggest that prospective efforts are warranted to develop optimal antimicrobial preventive strategies after RIC allo-SCT.

  6. [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.

  7. 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.

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

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    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.

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

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    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.

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

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    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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

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

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    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.

  17. Sedation-related complications in gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-11-16

    Sedation practices for gastrointestinal endoscopic (GIE) procedures vary widely in different countries depending on health system regulations and local circumstances. The goal of procedural sedation is the safe and effective control of pain and anxiety, as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation-related complications in gastrointestinal endoscopy, once occurred, can lead to significant morbidity and occasional mortality in patients. The risk factors of these complications include the type, dose and mode of administration of sedative agents, as well as the patient's age and underlying medical diseases. Complications attributed to moderate and deep sedation levels are more often associated with cardiovascular and respiratory systems. However, sedation-related complications during GIE procedures are commonly transient and of a mild degree. The risk for these complications while providing any level of sedation is greatest when caring for patients already medically compromised. Significant unwanted complications can generally be prevented by careful pre-procedure assessment and preparation, appropriate monitoring and support, as well as post-procedure management. Additionally, physicians must be prepared to manage these complications. This article will review sedation-related complications during moderate and deep sedation for GIE procedures and also address their appropriate management.

  18. 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

  19. 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

  20. 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

  1. 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

  2. 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)

  3. Preoperative inspiratory muscle training to prevent postoperative pulmonary complications in patients undergoing esophageal resection (PREPARE study) : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Valkenet, Karin; Trappenburg, Jaap Ca; Gosselink, Rik; Sosef, Meindert N; Willms, Jerome; Rosman, Camiel; Pieters, Heleen; Scheepers, Joris Jg; de Heus, Saskia C; Reynolds, John V; Guinan, Emer; Ruurda, Jelle P; Rodrigo, Els He; Nafteux, Philippe; Fontaine, Marianne; Kouwenhoven, Ewout A; Kerkemeyer, Margot; van der Peet, Donald L; Hania, Sylvia W; van Hillegersberg, Richard; Backx, Frank JG

    2014-01-01

    BACKGROUND: Esophageal resection is associated with a high incidence of postoperative pneumonia. Respiratory complications account for almost half of the readmissions to the critical care unit. Postoperative complications can result in prolonged hospital stay and consequently increase healthcare cos

  4. 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...

  5. 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.

  6. 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

  7. 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...

  8. 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.

  9. 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

  10. Altered regulation of brain-derived neurotrophic factor protein in hippocampus following slice preparation.

    Science.gov (United States)

    Danzer, S C; Pan, E; Nef, S; Parada, L F; McNamara, J O

    2004-01-01

    Brain-derived neurotrophic factor (BDNF) and its cognate receptor tyrosine kinase B (TrkB) play important roles in regulating survival, structure, and function of CNS neurons. One method of studying the functions of these molecules has utilized in vitro hippocampal slice preparations. An important caveat to using slices, however, is that slice preparation itself might alter the expression of BDNF, thereby confounding experimental results. To address this concern, BDNF immunoreactivity was examined in rodent slices using two different methods of slice preparation. Rapid and anatomically selective regulation of BDNF content followed slice preparation using both methodologies; however, different patterns of altered BDNF immunoreactivity were observed. First, in cultured slices, BDNF content decreased in the dentate molecular layer and increased in the CA3 pyramidal cell layer and the mossy fiber pathway of the hippocampus after 30 min. Furthermore, an initially "punctate" pattern of BDNF labeling observed in the mossy fiber pathway of control sections changed to homogenous labeling of the pathway in vitro. In contrast to these findings, slices prepared as for acute slice physiology exhibited no change in BDNF content in the molecular layer and mossy fiber pathway 30 min after slicing, but exhibited significant increases in the dentate granule and CA3 pyramidal cell layers. These findings demonstrate that BDNF protein content is altered following slice preparation, that different methods of slice preparation produce different patterns of BDNF regulation, and raise the possibility that BDNF release and TrkB activation may also be regulated. These consequences of hippocampal slice preparation may confound analyses of exogenous or endogenous BDNF on hippocampal neuronal structure or function.

  11. 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...

  12. 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...

  13. 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)...

  14. 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 ...

  15. 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.

  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. 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 ...

  18. 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 ...

  19. 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...

  20. A comparative study of complications of cataract surgery with phacoemulsification in eyes with high and normal axial length

    Directory of Open Access Journals (Sweden)

    Hamid Fesharaki

    2012-01-01

    Conclusions: As the results illustrate, in this survey, age and high axial length were statistically significant risk factors for incidence of intraoperative complications of cataract surgery with phacoemulsification technique. Anticipation of these complications and also preparation and prophylactic measures may decrease incidence of these complications.

  1. Postnatal depression - an examination of psychosocial factors | Mills ...

    African Journals Online (AJOL)

    Postnatal depression - an examination of psychosocial factors. ... South African Medical Journal ... pregnancy, complications after birth, marital relations, relationship with their own mothers, social support and preparation for motherhood.

  2. 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

  3. 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.

  4. Preoperative skin preparation with 2% chlorhexidine as a factor in the prevention of surgical site infection

    Directory of Open Access Journals (Sweden)

    Evelyn Solano Castro

    2014-04-01

    Full Text Available The results of secondary research that refers to preoperative skin preparation with antiseptic chlorhexidine 2% are presented. Surgical Site Infections are one of the most common complications in surgical procedures are associated with significant morbidity and mortality in the user and are the third -associated infection more frequent in the health care . Steps of clinical practice based on evidence were applied, considering in the first instance a question in PICO format, then a search for information in databases recommended in the Course of Clinical Nursing Practice Evidence-Based, taught by the program for Collaborative Research in Evidence-Based Nursing of Costa Rica ( CIEBE -CR . The PubMed database and Cochrane LIBRARY was consulted, National Center for Biotechnology Information ( NCBI, Google Scholar, CINAHL (cummulative Index of Nursing and Allied Health Literature. SCIELO (Scientific Electronic Library on line www.Scielo.org . 22 documents were recovered, but only three were selected because had methodological rigor. For the critical analysis Critical Reading Sheets 2.0 ( FLC software was used. Was concluded that 2% chlorhexidine, is the best choice for preoperative skin preparation antiseptic, however, it is necessary to conduct further studies in order to determine which is the correct way in strength, frequency, technical and adverse effects in the pediatric population.

  5. Factors influencing HPAM solution viscosity prepared by produced water using orthogonal method

    Institute of Scientific and Technical Information of China (English)

    康万利; 王志伟; 周阳; 孟令伟; 刘述忍; 白宝君

    2008-01-01

    The effect of temperature and metal ion components on the viscosity of HPAM solution was studied by means of orthogonal method.Five factors and 4 levels were considered for the orthogonal design.The five factors included temperature,contents of Na+,Mg2+,Ca2+ and S2-,and the four levels mainly considered the level of produced water components in main oilfields in China.The experiment results show that temperature is the most important factor to control HPAM solution viscosity prepared by produced water.The effect of ions was in order of Na+>S2->Mg2+>Ca2+.The mechanism of each factor influencing viscosity was also discussed.Based on the actual condition of Nanyang oilfield,the desulfurization was used to improve the solution viscosity,and satisfactory result was obtained.

  6. 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.

  7. 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.

  8. 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.

  9. Complications of labor and delivery: shoulder dystocia.

    Science.gov (United States)

    Anderson, Jane E

    2012-03-01

    This article reviews one of the less common but most dreaded complications of labor and delivery, shoulder dystocia, an infrequent but potentially devastating event that results from impaction of the fetal shoulders in the maternal pelvis. Shoulder dystocia occurs most commonly in patients without identified risk factors, and can result in both maternal and fetal morbidity. Because the vast majority of cases of shoulder dystocia are unpredictable, obstetric care providers must be prepared to recognize dystocia and respond appropriately in every delivery. Detailed documentation is essential after any delivery complicated by shoulder dystocia.

  10. Preparation and identification of transfer factor specific to Staphylococcus aureus in vitro.

    Science.gov (United States)

    Zhou, Jianwei; Kong, Cui; Wang, Xiukui; Shao, Jun; Feng, Lin; Zhang, Zhaocai

    2015-01-01

    The objective of the study was to explore the methods for preparing transfer factor specific to Staphylococcus aureus (SA-STF) in vitro. Under the optimum conditions, the spleen cells of rabbits were immunized with SA in vitro to prepare SA-STF, and the immune activities were identified with the phagocytosis and sterilization, skin delayed-type hypersensitivity, and immune protection tests. The concentration of polypeptide was 2.26 ± 0.27 mg/mL, and ribose was 0.684 ± 0.094 mg/mL. The phagocytosis and sterilization rates of the STF group were 70.9 ± 12.4% and 62.1 ± 12.2%, respectively, and compared with the non-specific transfer factor (NTF) group, there were no significant differences (P = 0.074 and 0.069, respectively). The skin was inflamed and marked nodules formed at the injection site in the mice of the STF group rather than the NTF and control groups. The survival rate of the STF-1 group was significantly higher than the survival rates of the STF-2 (P = 0.024) and NTF groups (P = 0.016). SA-STF was prepared and characterized successfully in vitro, and it probably is a biological candidate for therapy or adjuvant therapy for diseases caused by Staphylococcus aureus. © 2014 International Union of Biochemistry and Molecular Biology, Inc.

  11. 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.

  12. Contributor factors for the occurrence of salmonellosis during preparation, storage and consumption of homemade mayonnaise salad.

    Science.gov (United States)

    de Oliveira Elias, Susana; Varela Tomasco, Paula; Ortiz Alvarenga, Verônica; de Souza Sant'Ana, Anderson; Tondo, Eduardo Cesar

    2015-12-01

    This study aimed to analyze the impact of practices adopted for preparation, storage and consumption of homemade mayonnaise salad (HMS) as contributor factors for the occurrence of salmonellosis. A total of 493 individuals answered a questionnaire composed of demographic and socioeconomic questions and, preparing, storage and consumption practices of HMS. The level of good hygiene practices (GHP) of respondents was calculated using Good Practice and Outbreak Prevention Indexes. The consumer behavior and the correlation between practices were performed using Multiple Correspondence Analysis (MCA). 75% of respondents consume HMS, being 43% of interviewers doing this at least once per month. HMS was prepared from 30min to 1h before being served by 46% of individuals, it remaining for 30min to 1h at room temperature during the meal by 63% of people. Furthermore, 51% of respondents left the HMS container open or improperly closed, which may lead to cross-contamination. Most respondents (66%) stated reuse the HMS for less than one day (44%), at once (76%). 77% of participants declared that they prepare HMS, being only 7% preparing HMS without eggs. The majority (51%) used a cooked and a raw egg yolk. In addition, 75% of the cases showed raw eggs in recipe. The Weighted Good Practice Index, Weighted Outbreak Prevention Index and Weighted Harmonic Outbreak Prevention Index were 63%, 62% and 27% of participants, respectively. The MCA gathered the participants into two groups one commits various errors and other commits few errors on GHP. Thus, a consumer would probably perform multiple either good or bad practices simultaneously. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Coagulation Factor IX concentrate: method of preparation and assessment of potential in vivo thrombogenicity in animal models.

    Science.gov (United States)

    Menache, D; Behre, H E; Orthner, C L; Nunez, H; Anderson, H D; Triantaphyllopoulos, D C; Kosow, D P

    1984-12-01

    Thrombosis and/or disseminated intravascular coagulation (DIC) are complications specifically associated with the use of factor IX complex in some patients. Assuming that these complications might result from zymogen overload, we have produced, using diethylaminoethyl (DEAE)-Sephadex (Pharmacia, Piscataway, NJ) and sulfated dextran chromatography, a factor IX concentrate (coagulation factor IX) that is essentially free of prothrombin, factor VII, and factor X. Factor IX specific activity is at least 5 U/mg protein, a 250-fold purification compared to plasma. Amounts of factors II, VII, and X are less than 5 units each per 100 units of factor IX. The concentrate is essentially free of activated clotting factors and contains no added heparin. In the rabbit stasis model, a dose of 200 factor IX U/kg was less thrombogenic than 100 factor IX U/kg of the DEAE-Sephadex eluate from which the concentrate was derived. Infusion of 200 factor IX U/kg did not induce DIC in the nonstasis rabbit model, whereas 100 factor IX U/kg of the DEAE-Sephadex eluate resulted in DIC in this model. Several factor IX lots were found to have shortened nonactivated partial thromboplastin times (PTTs), but were nonthrombogenic in both animal models. These data indicate that coagulation factor IX concentrate is less thrombogenic than factor IX complex.

  14. 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...

  15. [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.

  16. 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.

  17. Absence of in vitro Procoagulant Activity in Immunoglobulin Preparations due to Activated Coagulation Factors

    Science.gov (United States)

    Oviedo, Adriana E.; Bernardi, María E.; Guglielmone, Hugo A.; Vitali, María S.

    2015-01-01

    Summary Background Immunoglobulin (IG) products, including intravenous (IVIG) or subcutaneous (SCIG) immunoglobulins are considered safe and effective for medical therapy; however, a sudden and unexpected increase in thromboembolic events (TE) after administration of certain batches of IVIG products has been attributed to the presence of activated coagulation factors, mainly factor XIa. Our aims were to examine the presence of enduring procoagulant activity during the manufacturing process of IGs, with special focus on monitoring factor XIa, and to evaluate the presence of in vitro procoagulant activity attributed to coagulation factors in different lots of IVIG and SCIG. Methods Samples of different steps of IG purification, 19 lots of IVIG and 9 of SCIG were analyzed and compared with 1 commercial preparation of IVIG and 2 of SCIG, respectively. Factors II, VII, IX, XI and XIa and non-activated partial thromboplastin time (NAPTT) were assayed. Results The levels of factors II, VII, IX, X and XI were non-quantifiable once fraction II had been re-dissolved and in all analyzed lots of IVIG and SCIG. The level of factor XIa at that point was under the detection limits of the assay, and NAPTT yielded values greater than the control during the purification process. In SCIG, we detected higher concentrations of factor XIa in the commercial products, which reached values up to 5 times higher than the average amounts found in the 9 batches produced by UNC-Hemoderivados. Factor XIa in commercial IVIG reached levels slightly higher than those of the 19 batches produced by UNC-Hemoderivados. Conclusion IVIG and SCIG manufactured by UNC-Hemoderivados showed a lack of thrombogenic potential, as demonstrated not only by the laboratory data obtained in this study but also by the absence of any reports of TE registered by the post marketing pharmacovigilance department. PMID:26733772

  18. 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.

  19. 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.

  20. 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

  1. 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

  2. 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 ...

  3. 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.

  4. Preparation, Characterization, and Determination of Immunological Activities of Transfer Factor Specific to Human Sperm Antigen

    Directory of Open Access Journals (Sweden)

    Jianwei Zhou

    2013-01-01

    Full Text Available Objective. The objective of this study was to prepare, characterize, and determine immunological activities of specific transfer factor (STF specific to human sperm antigen (HSA for the preparation of antisperm contraceptive vaccine that can be used as an immunocontraceptive. Methods. HSA-STF was prepared using the spleens of rabbits vaccinated with HSA. The specific immunological activities were examined by lymphocyte proliferation test (LPT, leukocyte adhesion inhibition test (LAIT, and by determining the concentrations of IL-4, γ-IFN, and IL-21. HSA-STF was a helveolous substance, having a pH value of 7.0±0.4 and UV absorption maxima at 258 ± 6 nm. It contained seventeen amino acids; glycine and glutamic acids were the highest in terms of concentrations (38.8 μg/mL and 36.3 μg/mL, resp.. Results. The concentration of polypeptide was 2.34±0.31 mg/mL, and ribose was 0.717±0.043 mg/mL. The stimulation index for lymphocyte proliferation test was 1.84, and the leukocyte adhesion inhibition rate was 37.7%. There was a statistically significant difference between the cultural lymphocytes with HSA-STF and non-HSA-STF for γ-IFN and IL-21 (P0.05. Conclusion. HSA-STF was prepared and characterized successfully. It had immunological activity which could transfer the immune response specific to HSA and prove to be a potential candidate for the development of male immunocontraceptive agents.

  5. 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.

  6. [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.

  7. Improvement in skin wrinkles using a preparation containing human growth factors and hyaluronic acid serum.

    Science.gov (United States)

    Lee, Do Hyun; Oh, In Young; Koo, Kyo Tan; Suk, Jang Mi; Jung, Sang Wook; Park, Jin Oh; Kim, Beom Joon; Choi, Yoo Mi

    2015-02-01

    Skin aging is accompanied by wrinkle formation. At some sites, such as the periorbital skin, this is a relatively early phenomenon. We evaluated the anti-wrinkle effect of a preparation containing human growth factor and hyaluronic acid serum on periorbital wrinkles (crow's feet). In total, 23 Korean women (age range: 39-59 years), who were not pregnant, nursing, or undergoing any concurrent therapy, were enrolled in this study. All the patients completed an 8-week trial of twice-daily application of human growth factor and hyaluronic acid serum on the entire face. Efficacy was based on a global photodamage score, photographs, and image analysis using replicas and visiometer analysis every 4 weeks. The standard wrinkle and roughness parameters used in assessing skin by visiometer were calculated and statistically analyzed. Periorbital wrinkles were significantly improved after treatment, with improvements noted both by physician's assessment and visiometer analysis. Topical application of human growth factor and hyaluronic acid was beneficial in reducing periorbital wrinkles.

  8. [Preparation and Determination of Insulin-like Growth Factor I in Deer Antler, Heart and Blood].

    Science.gov (United States)

    Chen, Fan-bo; Yin, Jian-yuan; Liu, Jing-yan; Yang, Yu-xia; Sun, Dan-dan; Liu, Ji-hua

    2014-12-01

    To optimize the method for preparation of the insulin-like growth factor I (IGF-I ) in deer antler, and to determine the IGF-I in deer antler, heart and blood. Ultrasonic extraction was used to extract IGF-I from different tissues of deer with ammonia-ammonium acetate buffer, followed by ultrafiltration and solid phase extraction to concentrate and purify the samples. At the same time, ethanol precipitation method was carried out in the purification of IGF-I ultrafiltratein deer antler, a parallel test proceeded and radio immune assay (RIA) was set to determine the IGF-I in deer antler, heart and blood. The IGF-I (60.8 ng/g) in deer antler by solid phase extraction was only existed in 30% methanol aqueous solution which was much higher than that (46.1 ng/g) by ethanol precipitation method. The quantities of IGF-I in deer antler, heart and blood were significantly different, it was 61.9 ng/g in antler and 21.9 ng/mL in blood, while there was no IGF-I tested in deer heart. Solid phase extraction is superior to ethanol precipitation method in preparing IGF-I in deer antler and it is clear that the IGF-I contained in deer antler is significantly higher than that in deer heart and blood, so it is the best choice to take IGF-I from deer antler.

  9. 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.

  10. [The role of leukocytic factors in the preparation for and induction of labor].

    Science.gov (United States)

    Ermoshenko, B G; Shubich, M G

    2000-01-01

    Preparation for labour and its induction are controlled by an integrative but not single process. The primary stimulus that comprises this integrative hormonal prostaglandin-leukocytic mechanism is a suppression of local progesterone action with further inhibition of perivascular prostaglandine dehydrogenase and sharp increase of E2 and F2 prostaglandine content in uteroplacentary mechanism bed. Vasodilatory effect of prostaglandines along with synergication of interleukine 8 leads to leukocyte emigration and formation of infiltrates consisting of neutrophilic granulocytes and certain number of macrophages and mast cells. Hydrolytic enzymes released by neutrophilic granulocytes cause degradation of collagenic tissue in uterine cervix promoting its ripening. The factors mentioned also influence loosening of choriodecidual interface. Further amplification of effect of prostaglandine including those produced by neutrophilic granulocytes along with the other uteroconstrictors increase myometrium contractions which leads to labour induction.

  11. Preparation and features of polycaprolactone vascular grafts with the incorporated vascular endothelial growth factor

    Energy Technology Data Exchange (ETDEWEB)

    Sevostyanova, V. V., E-mail: sevostyanova.victoria@gmail.com; Khodyrevskaya, Y. I.; Glushkova, T. V.; Antonova, L. V.; Kudryavtseva, Y. A.; Barbarash, O. L.; Barbarash, L. S. [Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo (Russian Federation)

    2015-10-27

    The development of tissue-engineered small-diameter vascular grafts is an urgent issue in cardiovascular surgery. In this study, we assessed how the incorporation of the vascular endothelial growth factor (VEGF) affects morphological and mechanical properties of polycaprolactone (PCL) vascular grafts along with its release kinetics. Vascular grafts were prepared using two-phase electrospinning. In pursuing our aims, we performed scanning electron microscopy, mechanical testing, and enzyme-linked immunosorbent assay. Our results demonstrated the preservation of a highly porous structure and improvement of PCL/VEGF scaffold mechanical properties as compared to PCL grafts. A prolonged VEGF release testifies the use of this construct as a scaffold for tissue-engineered vascular grafts.

  12. 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

  13. The influences and factors of an undergraduate research program in preparing women for science careers

    Science.gov (United States)

    Campbell, Ashley Mcdowell

    Progress has been made in diminishing barriers experienced by women in science in recent years, however obstacles still remain. One of the key elements of the Texas Tech University Howard Hughes Medical Institute (TTU/HHMI) Undergraduate Biological Sciences Education Program is to "support activities that broaden access to science for women." In light of the barriers women in science face, this dissertation examined how the experiences of females in the TTU/HHMI fellows program prepared them for a career in science. This study employed mixed methods, utilizing both a questionnaire involving all past female fellows, and in-depth interviews with seven fellows who chose a career as a professional scientist. According to the quantitative data, research experience, the relationship with mentors, and opportunities to present at state or national meetings were program factors that fellows identified as contributing to their career success. The TTU/HHMI program experiences positively influenced the fellows' level of interest in science, confidence in science, and motivation to pursue a science-related career. Encouragement from the mentor and increased confidence regarding the ability to be successful in science were significant predictors of career advantages. Motivation to pursue a science-related career was the most significant predictor of the fellows' preparation to overcome barriers. Qualitatively, six themes were identified for coding, which included (1) research experience, (2) the mentor, (3) support and interactions, (4) self-confidence, (5) career decisions, and (6) time demands related to a science career. The themes identified were important factors in preparing these past female fellows for a career in science by initiating a change in their attitudes, knowledge, and skills. With over 90% of past fellows currently pursuing a science career, the program, through research experience and encouraging mentors, made a large impact on the career paths of fellows

  14. 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.

  15. 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

  16. 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.

  17. FACTORS INFLUENCING THE PREPARATION OF TiO2 NANOPOWDERS FROM TITANIA SOL

    Directory of Open Access Journals (Sweden)

    F. MASTALI KHAN TEHRANI

    2011-03-01

    Full Text Available Titania nanoparticles with high photocatalytic activity were prepared from titanium alkoxide dissolved in alcohol and water under acidic conditions. The effects of the key parameters including (alkoxide/water ratio, (alkoxide/alcohol ratio, precursor type, solvent type, type and concentration of stabilizer, calcination temperature, presence of methylcellulose (MC and hydrothermal treatment were studied. The optimal conditions were obtained through an experimental design technique. This technique is also used to find the main factors influencing the degradation of methylene blue (MB and mass percent of anatase phase. The powders characteristics were investigated by XRD and Brunauer-Emmett-Teller (BET methods. The X-ray diffraction studies showed that the product has anatase crystal structure with average particle size below 13 nm. The photocatalytic activities of the TiO2 nanoparticles were assessed by the degradation of MB in aqueous solution. According to the obtained results, the kinetics of photocatalytic reaction followed pseudo-first-order model. The results showed that the main factors influencing the degradation of MB were the type of stabilizer, presence of MC, hydrothermal treatment, solvent type and calcination temperature. Specific surface areas of the nanoparticles were between 76-198 m2/g.

  18. 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...

  19. 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

  20. 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

  1. 复合纳米材料的制备及对路用煤沥青的改性研究%Preparation of nano complicated material and its application for road-paving coal tar pitch

    Institute of Scientific and Technical Information of China (English)

    郭建国; 任真; 李玉霞; 郭建平

    2012-01-01

    通过水热共沉淀法制备了改性纳米复合材料,利用比表面积、TEM和接触角对其进行了表征.将改性纳米复合材料应用于路用煤沥青的改性中,结果显示该纳米改性煤沥青的性能指标完全达到了90#路用石油沥青指标,可以应用于实际道路的铺设.%Modified nano complicated material is prepared by co-precipitation method and characterized by SBET, TEM and contact angle. The obtained nano complicated material is used for the application for road-paving coal tar pitch. The results show that the property of modified coal tar pitch is better than that of the road-paving 90 pitch. It means that the coal tar pitch modified by nano complicated material can used in paving road.

  2. Perceived social-ecological factors associated with fruit and vegetable purchasing, preparation, and consumption among young adults.

    Science.gov (United States)

    Graham, Dan J; Pelletier, Jennifer E; Neumark-Sztainer, Dianne; Lust, Katherine; Laska, Melissa N

    2013-10-01

    Most young adults do not consume recommended levels of fruits and vegetables (F/V), and interventions to increase F/V-related behaviors among this understudied population are needed. Therefore, it is important to identify correlates of F/V intake among young adults to guide intervention development. This cross-sectional study used data from an online survey to identify factors related to young adults' F/V purchasing, preparation, and consumption, and to explore between-factor relationships using mediation analysis. In 2010, 1,201 college students in Minnesota completed questionnaires assessing F/V behaviors as well as perceptions of F/V-related individual, social, and environmental factors. Factor analysis identified questionnaire items assessing similar constructs. Seven factors were identified (personal barriers, F/V knowledge, family, friends, neighborhood, access barriers, and campus) and evaluated for relationships with F/V purchasing, preparation, and consumption using linear regression. Results revealed that perceived personal barriers (eg, lacking cooking skills) were inversely related to all F/V outcomes. Perception that family and friends eat healthfully and neighborhood access to F/V were positively related to all outcomes. Individual-, social-, and environment-level perceptions were related to purchasing, preparation, and consumption, and the effects of these factors were similar when accounting for mediated effects. Factors at all three levels and the ways in which these various factors operate together may be important to consider in future efforts to improve F/V behaviors among young adults.

  3. 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

  4. Preparation for radioactive iodine therapy is not a risk factor for the development of hyponatremia in thyroid cancer patients

    Science.gov (United States)

    Kim, Jahae; Cho, Sang-Geon; Kang, Sae-Ryung; Kwon, Seong Young; Cho, Dong-Hyeok; Cho, Jin-Seong; Song, Ho-Chun

    2017-01-01

    Abstract The aim of this study was to evaluate whether the preparation for radioactive iodine (RAI) therapy by thyroid hormone withdrawal (THW) or a low-iodine diet (LID) can be risk factors for the development of hyponatremia in patients with differentiated thyroid cancer after thyroidectomy. We retrospectively reviewed the medical records and laboratory findings of 326 patients who underwent preparation for RAI therapy after thyroidectomy from 2012 to 2014. Demographic and clinical variables including the method of thyrotropin stimulation and duration of LID were assessed. Serum sodium was measured twice, before operation and before RAI therapy. Hyponatremia was detected in only 3 patients (0.9%) before operation, but in 15 patients (4.6%) before RAI therapy. None of the patients had severe hyponatremia after preparation for RAI therapy. Pre-RAI therapy serum sodium was correlated with the method of thyrotropin stimulation (TWH vs recombinant human thyroid stimulating hormone, P = 0.014) and duration of LID (r = −0.131, P = 0.018); however, the preparation of RAI therapy, THW and LID, did not affect the development of hyponatremia in logistic regression analysis. Preoperative serum sodium was a significant risk factor for hyponatremia during preparation for RAI therapy. Preparation for RAI therapy by THW or LID is not a risk factor for the development of hyponatremia in patients with thyroid cancer. The development of hyponatremia was neither frequent nor severe during preparation for RAI therapy. Physicians should not be greatly concerned about rare life-threatening hyponatremia during preparation for RAI therapy. PMID:28151897

  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. Oral complications of cancer therapies. Oral complications in the pediatric population

    Energy Technology Data Exchange (ETDEWEB)

    Leggott, P.J. (Univ. of California, San Francisco (USA))

    1990-01-01

    A number of acute oral complications may be associated with cancer therapy in children, but the extent and duration of these complications, and the most effective management techniques. have not been well described. The few studies differ in design, making comparisons difficult. Well-controlled, prospective clinical studies are needed to define the most effective strategies for the management of acute oral complications in children. However, it is clear that dental intervention prior to cancer therapy is an important factor in the optimal preparation of the patient. During cancer therapy, intensive supervised oral preventive protocols appear to be of benefit to the child's oral health, overall comfort, and well-being. Furthermore, the prevention of oral infection may significantly reduce the morbidity associated with cancer therapy. Long-term preventive oral care may help prevent dental disease and infection in medically compromised children and contribute to improving the quality of life. 41 references.

  7. Perceptions of preparation for further training: how our medical schools prepare graduates and the perceived factors influencing access to training.

    Science.gov (United States)

    Hyde, Sarah J; Craig, Pippa L; Sefton, Ann J; Ryan, Greg L; Arnold, Stephanie J; Naganathan, Vasi

    2010-09-06

    To investigate the specific factors that graduates perceive to influence their success in obtaining primary training in a chosen field. The New South Wales Medical Registration Board provided data on doctors who were registered to practise between 1995 and 2006. A brief, paper-based survey was sent to a random selection of 2000 doctors. Doctors' self-reported perceptions on the impact of demographic details, specialty training applied for, university training and other factors on opportunities for further training after medical school. Of the 375/1915 doctors (19.6%) who responded, most had completed a 6-year undergraduate degree from the University of Sydney, University of NSW or University of Newcastle, and most were at registrar level. Of 242/321 doctors (76%) who had applied for a training position, 240 (99%) had been accepted. The support of a mentor was considered the most positive influence on meeting long-term career goals (255/318 [80%]). Learning how to communicate with patients was valued as the most helpful aspect of medical school (270/318 [85%]). The personal attributes of graduates were considered more influential in achieving career goals and accessing further training than perceived features of a medical program. This suggests that more emphasis and research should be devoted to selecting the most appropriate candidates, rather than restructuring medical curricula to meet a presumed need for more content knowledge before graduation.

  8. 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

  9. 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

  10. [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.

  11. 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.

  12. 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。

  13. 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

  14. Platelet-rich plasma preparation using three devices : Implications for platelet activation and platelet growth factor release

    NARCIS (Netherlands)

    Everts, Peter A. M.; Mahoney, Christine Brown; Hoffmann, Johannes J. M. L.; Schonberger, Jacques P. A. M.; Box, Henk A. M.; Van Zundert, Andre; Knape, Johannes T. A.

    2006-01-01

    Background: In this study, three commercial systems for the preparation of platelet-rich plasma (PRP) were compared and platelet growth factors release was measured. Methods: Ten healthy volunteers donated whole blood that was fractionated by a blood cell separator, and a table-top centrifuge to pre

  15. Black Teachers Matter: Qualitative Study of Factors Influencing African American Candidates Success in a Teacher Preparation Program

    Science.gov (United States)

    Dinkins, Elizabeth; Thomas, Kevin

    2016-01-01

    This qualitative study examined the perspectives and experiences of ten African American students at a predominantly White institution to understand why students persisted or discontinued in the teacher preparation program. Findings indicate three predominant factors influence Black candidates' decision to complete or leave the program: the role…

  16. 甲亢术前准备使用地塞米松致低钾血症的临床分析%Analysis of the hypokalemia complication of dexamethasone used for hyperthyroidism preoperative preparation

    Institute of Scientific and Technical Information of China (English)

    刘俊锋; 李利文; 邱新光

    2013-01-01

    目的 分析甲亢术前准备使用地塞米松引起低钾血症的时间及相关影响因素.方法 对2011年8月-2013年7月手术治疗的161例甲亢患者的临床资料进行统计、分析.结果 在161例甲亢患者中,27例患者发生低钾血症,92.6%低钾血症发生于首剂地塞米松使用后;男性患者41例,其中的26例在应用地塞米松完善甲亢术前准备时出现低血钾;女性患者120例,仅有1例患者应用地塞米松后出现低钾血症.11例患者有周期性麻痹病史的患者,10例在给予地塞米松后发生低钾血症,1例住院期间未发生低钾血症.结论 近年来临床实践已成功将地塞米松等综合用药应用于甲亢之术前快速准备,安全有效,但其导致低血钾的并发症,而且易发生在首剂量使用后24 h内,需要引起临床医师的关注,并给予及时诊断及治疗.%Objective Analyzed the cause and time of hypokalemia complication that dexamethasone used for hyperthyroidism preoperative preparation.Methods The study consisted of 161 patients with hyperthyroidism disease,who were used the dexamethasone in his or her preoperative preparation at the First Affiliated Hospital of Zhengzhou University between August 2011 and July 2013.Results In the 161 hyperthyroidism patients,composed of 41 men and 120 women,twenty-seven patients happened hypokalemia and 92.6% occurred after the first.Twenty-six men patients developed hypokalemia complication when used dexamethasone for hyperthyroidism preoperative preparation,while only 1 woman patient occurred the hypokalemia complication.Among the 11 patients who with a history of thyrotoxic periodic paralysis,10 cases occurred after given dexamethasone hypokalemia,only 1 case has no hypokalemia.Conclusion Dexamethasone and other drug used in hyperthyroidism preoperative preparation,which was rapid,safe and effective,but it can lead to hypokalemia complication,especial in the 24 hours after the first use,should be brought

  17. 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。

  18. [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.

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

    Science.gov (United States)

    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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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...

  6. 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.

  7. 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.

  8. 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

  9. 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.

  10. 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.

  11. Preparing Teachers for Technology Integration: Programs, Competencies, and Factors from the Literature

    Science.gov (United States)

    Oliver, Kevin; Townsend, Latricia

    2013-01-01

    This article presents a review of recent literature about preparing teachers for technology integration. The review found six types of training programs are commonly implemented: pre-service training, long-term courses, short-term workshops and institutes, coaching/mentoring, learning communities, and product/assessment approaches. The review…

  12. Factors influencing the preparation, support and training of South African expatriates

    Directory of Open Access Journals (Sweden)

    A. J. Vogel

    2008-12-01

    Full Text Available Purpose: The purpose of this paper is to determine if the independent variables; location of an international assignment, the age of an expatriate, the duration of an assignment and the management level of an expatriate, influence the preparation, support and training that they require for an international assignment. Design/Methodology/Approach: This formal, empirical study was undertaken using an electronic questionnaire that was distributed to expatriates who were on an international assignment. Expatriates who were on an international assignment were thought to be in the best position to respond to their preparation, support and training needs. Findings: The research found that the preparation, support and training required by South African expatriates are not influenced by the location of an international assignment, the age of the expatriate, the duration of an international assignment or the management level of the expatriate. Implications: The findings highlight the fact that human resource managers of South African multinational enterprises should provide all their expatriates with the same preparation, support and training, as well as identifies five requirements that should be included in all South African expatriate policies.

  13. 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].

  14. An ideal preparation for dermal regeneration: skin renewal growth factors, the growth factor composites from porcine platelets.

    Science.gov (United States)

    Wang, Kuo-Hsien; Wu, Yo-Ping Greg; Lo, Wen-Cheng

    2012-12-01

    The use of growth factor composites from platelets has been introduced to many areas of clinical applications and studies. With the richest source of growth factors (GFs), beneficial effects have been shown on tissue regeneration and wound healing. However, animal and clinical studies have revealed inconsistent outcomes with the use of platelet-derived growth factors (PDGFs), which were likely due to variations in the presence and concentrations of GFs between various sources. Autologous PDGFs are considered to be safer, but they are limited by the feasibility of large-scale production to be used extensively in the acute phase, greater surface area, or general cosmetic applications. This study employed a simple process to obtain growth factor composites from activated platelets of porcine origin, namely skin renewal growth factors (SRGF). The functions of SRGF were subsequently evaluated on cultured human fibroblasts, keratinocytes, and melanocytes. Our data revealed that SRGF significantly promoted the proliferation of fibroblasts, accompanied by increased expression of collagens (types I, III, IV, and VIII) and proteoglycans. Diminished proliferation and arrested differentiation of keratinocytes were evidenced by the attenuated expression of laminin V and keratin 10. In addition, SRGF also suppressed the growth of melanocytes and reduced the expression of microphthalmia-associated transcription factor (MITF), tyrosinase, and paired box 3 (PAX3), which mediates melanogensis. Our results suggest that SRGF possesses beneficial properties and is a promising and cost-effective composition for the development of a safe cosmetic agent or topical products for skin regeneration. The development of SRGF may also provide an alternative strategy for tissue engineering.

  15. 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

  16. 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.

  17. 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

  18. 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.

  19. 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.

  20. 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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  1. Preparation, Characterization, and Bioactivity of Chitosan Microspheres Containing Basic Fibroblast Growth Factor

    Directory of Open Access Journals (Sweden)

    Bo Lv

    2014-01-01

    Full Text Available The aim of this study is to evaluate, prepare, and characterize bioactivity of chitosan microspheres loaded with bFGF for providing sustained release of bFGF. Porous chitosan microspheres were prepared by freeze-drying process based on the interaction between chitosan and tripolyphosphate (TPP. The bFGF-loaded chitosan microspheres were well interconnected and have a narrow size distribution, spherical shape, and positive surface charges. The bFGF-loading capacity and encapsulation efficiency were 7.57 mg/g and 95.1%, respectively. Results of in vitro release showed that the extent of release was 82.1% at Day 25. Schwann cells were used as an in vitro model for cell response to bFGF and bFGF-loaded chitosan microspheres. Results indicated that the number, cell viability, and percentage of cells G2/M+S phase in the bFGF groups are higher than those in the bFGF-loaded chitosan microspheres groups before culturing for 2 days. However, the number, cell viability, and percent of cells G2/M+S phase in the bFGF-loaded chitosan microspheres groups are significantly higher than those in the bFGF groups after culture for 4 and 8 days. These findings indicated that bFGF-loaded chitosan microspheres may help to decrease the release of bFGF and provide a suitable three-dimensional environment for cell growth and proliferation.

  2. Study of Influencing Factors and the Mechanism of Preparing Triazinedithiol Polymeric Nanofilms on Aluminum Surfaces

    Directory of Open Access Journals (Sweden)

    Yanni Li

    2010-11-01

    Full Text Available Triazinedithiol polymeric nanofilm was prepared on a pure aluminum surface by electrochemical polymerization of AF17N. The mechanism of the process was proposed and electrochemical polymerization parameters were investigated. The triazinedithiol polymeric nanofilm had notable lubricity, high dielectric property and superhydrophobic property due to the allyl and fluoro alkyl groups in the AF17N monomer. The chemical structure of poly (6-(N-allyl-1,1,2,2-tetrahydroperfluorodecylamino-1,3,5-triazine-2,4-dithiol monosodium nanofilm (PAF17 was investigated by analysis of FT-IR spectra and X-ray photoelectron spectroscopy (XPS. The optimal conditions for the preparation process were based on the data of film weight and thickness. The optimal parameters of monomer concentration, electropolymerization time and temperature were 5 mM, 6 min and 15 °C, respectively. The electropolymerization mechanism was a radical polymerization reaction. It is expected that this technique will be applied in industrial fields for aluminum and aluminum alloy to achieve functional surfaces.

  3. Microdrop preparation factors influence culture-media osmolality, which can impair mouse embryo preimplantation development.

    Science.gov (United States)

    Swain, J E; Cabrera, L; Xu, X; Smith, G D

    2012-02-01

    Because media osmolality can impact embryo development, the effect of conditions during microdrop preparation on osmolality was examined. Various sizes of microdrops were prepared under different laboratory conditions. Drops were pipetted directly onto a dish and covered by oil (standard method) or pipetted on the dish, overlaid with oil before removing the underlying media and replaced with fresh media (wash-drop method). Drops were made at 23°C or on a heated stage (37°C) and with or without airflow. Osmolality was assessed at 5 min and 24h. The biological impact of osmolality change was demonstrated by culturing 1-cell mouse embryos in media with varying osmolality. Reduced drop volume, increased temperature and standard method were associated with a significant increase in osmolality at both 5 min and 24h (P-values media with elevated osmolality (>310mOsm/kg; P<0.05). Procedures in the IVF laboratory can alter osmolality and impact embryo development.

  4. Symptoms of Major Depression and Complicated Grief

    Science.gov (United States)

    ... Loss of a Loved One Symptoms of major depression and complicated grief Depression It’s common for people to have sadness, pain, ... ball game; reading a good book; listening to music; or getting a massage or manicure. Prepare for ...

  5. 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

  6. The effect of preparation factors on the structural and catalytic properties of mesoporous nanocrystalline iron-based catalysts for high temperature water gas shift reaction

    Energy Technology Data Exchange (ETDEWEB)

    Meshkani, Fereshteh; Rezaei, Mehran [University of Kashan, Kashan (Iran, Islamic Republic of)

    2015-07-15

    A systematic study was done on the effect of preparation factors on the structural and catalytic properties of mesoporous nanocrystalline iron-based catalysts in high temperature water gas shift reaction. The catalysts were prepared by coprecipitation method, and the effect of the main preparation factors (pH, refluxing temperature, refluxing time, concentration of the precursors solution) was studied. The catalysts were characterized by powder X-ray diffraction (XRD), N{sub 2} adsorption (BET), Temperature programmed reduction (TPR), transmission and scanning electron microscopies (TEM, SEM) techniques. The results revealed that the preparation factors affected the textural and catalytic properties of the Fe-Cr-Cu catalyst. The results showed that the prepared catalyst with the highest activity showed higher specific surface area compared to commercial catalyst and consequently exhibited higher activity in high temperature water gas shift reaction. The TEM analysis showed a nanostructure for this sample with crystallite size less than 20 nm.

  7. FACTORS AFFECTING RESULT IN CHINESE PROFICIENCY TEST (HSK LEVEL 6: READING SECTION AND PREPARATION STRATEGIES

    Directory of Open Access Journals (Sweden)

    Sri Haryanti

    2013-11-01

    Full Text Available Chinese Proficiency Test (HSK is an internationally standardized exam which tests and rates Chinese language proficiency. The highest level in this test is level 6. The writing part of the test consists of 3 (three parts, namely, (1 listening, (2 reading, (3 writing. Furthermore, the reading part is made of 4 components. Level 6 of this test implies a high degree of difficulty. This paper specifically looked on how to prepare effectively for participants to be able to work on the reading part in order to achieve best result. This article used the methods of literature review and observational study as well as field research and would also incorporate the author’s personal experience in taking the test into recommending strategies for doing the reading part in a level 6 HSK test. Finally, research suggested several techniques and tips that might assist participants in achieving maximum scores in handling the reading part of level 6 HSK test.

  8. Factors affecting the oxidative stability of omega-3 emulsions prepared with milk proteins

    DEFF Research Database (Denmark)

    Horn, Anna Frisenfeldt; Nielsen, Nina Skall; Jacobsen, Charlotte

    Omega-3 fatty acids are prone to lipid oxidation due to their unsaturated nature. In oil-in-water emulsions, lipid oxidation is expected to be initiated at the oil-water interface. The properties of the emulsifier used and the structure at the interface are therefore expected to be of great...... importance for the resulting oxidation. This presentation will give an overview of parameters that are expected to change the properties and structure of milk protein components at the interface of 10% fish oil-in-water emulsions. Results from three different studies will be included. The first study...... compared the effect of two different high pressure homogenizers on oxidation in caseinate and whey protein isolate emulsions. The second study evaluated the effect of homogenization pressure and temperature on emulsions prepared either with whey proteins or a combination of caseinate and β...

  9. FACTORS AFFECTING RESULT IN CHINESE PROFICIENCY TEST (HSK LEVEL 6 READING SECTION AND PREPARATION STRATEGIES

    Directory of Open Access Journals (Sweden)

    Sri Haryanti

    2015-02-01

    Full Text Available Chinese proficiency test (HSK is an internationally standardized exam which tests and rates Chinese language proficiency. The highest level in this test is level 6. The writing part of the test consists of 3 (three parts, namely, (1 listening, (2 reading, (3 writing. Furthermore, the reading part is made of 4 components. Level 6 of this test implies a high degree of difficulty. This paper specifically looked on how to prepare effectively for participants to be able to work on the reading part in order to achieve best result. This article used the methods of literature review and observational study as well as field research and would also incorporate the authors personal experience in taking the test into recommending strategies for doing the reading part in a level 6 HSK test. Finally, research suggested several techniques and tips that might assist participants in achieving maximum scores in handling the reading part of level 6 HSK test.

  10. 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.

  11. Contributing Factors to Student Success in Anatomy and Physiology: Lower outside Workload and Better Preparation

    Science.gov (United States)

    Harris, David E.; Hannum, Lynn; Gupta, Sat

    2004-01-01

    A study of students of a traditional two-semester Anatomy and Physiology class was made to determine factors that contributed to success in the coursework. The test established a co-relation between the amount of study in mathematics and science done previously in school and final grades in the subject.

  12. [Preparation and immunological evaluation of oral solution of egg yolk-derived hepatitis B virus-specific transfer factor].

    Science.gov (United States)

    Xu, Yanping; Zhang, Qing; Zhan, Xuejun; Xie, Daze; Dai, Ge; Yang, Hui

    2013-12-01

    To prepare the oral solution of egg yolk hepatitis B virus (HBV)-specific transfer factor (EYHBV-TF) and evaluate its immunological activity as an immune regulator against hepatitis B. From hens immunized with the Hepatitis B vaccine the egg yolk was isolated to extract the specific transfer factor EYHBV-TF, and its physicochemical properties were examined. Leukocyte adhesion inhibition test (LAI) was performed to detect the immunogenic activity of EYHBV-TF. The solution of EYHBV-TF was then administered orally in normal mice, and the specific cellular immune activity induced was assayed with delayed type skin hypersensitivity test (DTH), with the non-specific immune activity assessed with immune organ index. The immune responses induced by oral EYHBV-STF solution were compared with those by EYHBV-STF injection and by different dosages (injection and oral) of porcine spleen HBV-specific transfer factor (PSHBV-STF), porcine spleen nonspecific transfer factor, and egg yolk extracts from non-immunized hens. The prepared EYHBV-STF oral solution, which met the standards for biological products, could inhibit leukocyte adhesion in vitro and significantly enhance mouse foot pad swelling, demonstrating its capability of transferring antigen-specific delayed type hypersensitivity reactions to naive recipient. EYHBV-STF oral solution also significantly improved the immune organ index in mice (P<0 01) with similar effects to those caused by EYHBV-STF injections and by PSHBV-STF injection and oral solution. Orally administered EYHBV-STF and EYHBV-STF injection both possess hepatitis B antigen-specific cellular immune activity and can significantly enhance specific cellular immune responses.

  13. Cloning, Expression and Functional Characterization of In-House Prepared Human Basic Fibroblast Growth Factor

    Directory of Open Access Journals (Sweden)

    Hassan Rassouli

    2013-01-01

    Full Text Available Objective: Human basic fibroblast growth factor (bFGF plays an important role in cellular proliferation, embryonic development, and angiogenesis as well as in several signaling pathways of various cell types. bFGF is an essential growth factor for the maintenance of undifferentiated human embryonic stem cells (hESCs and human induced pluripotent stem cells (hiPSCs.Materials and Methods: In this experimental study, we present a straightforward method to produce biologically active recombinant human bFGF protein in E. coli that has long-term storage ability.Results: This procedure provides a rapid, cost effective purification of a soluble human bFGF protein that is biologically active and functional as measured in hESCs and hiPSCs in vitro and in vivo.Conclusion: The results show no significant difference in function between our in-house produced and commercialized bFGF.

  14. 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

  15. 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

  16. Complications encountered in contrast roentgenography of the colon

    Energy Technology Data Exchange (ETDEWEB)

    Vogel, H.; Steinkamp, U.

    1983-04-01

    The following problems are analysed referring to the literature and to practical experience of the authors: - Types of complications encountered in contrast roentgenography or in endoscopy of the colon, and their frequency. - Risk factors and secondary injuries. Intestinal perforation is the most frequent complication experienced as a consequence of contrast barium enema. The main risk factors are to be seen in the use of balloon-tipped catheters, or of intestinal tubes with hard tips, in a rise of hydrostatic pressure above 80 cm water column, and in an excessively strong air insufflation. Frequency of complications for contrast barium enema is stated to be 0.002 p.c. (Welin and Welin, 1980) or 0.08 p.c. (Clark et al. 1961). The frequency of perforations in rectoscopy is shown to be in the same order of magnitude. For diagnostic colonoscopy, the frequency of complications is about one per mil. Existing diseases such as carcinoma, diverticulosis, diverticulitis, colitis ulcerosa, or morbus Crohn are factors enhancing the risk. Also, patients of advanced age are running a higher risk due to decreasing intestine wall elasticity with age. Previous biopsy or excision forbids contrast barium enema for the next two weeks. Injuries and sequelae to be expected after perforation are abscesses, phlegmon, peritonitis including formation of adhesion and bands, retroperitoneal fibrosis with formation of hydronephrosis, and anus praeter, the latter being temporary or permanent. An extensive literature survey covering 200 publications has been prepared and is available from the authors upon request.

  17. 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

  18. [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.

  19. Report: Optimization study of the preparation factors for argan oil microcapsule based on hybrid-level orthogonal array design via SPSS modeling.

    Science.gov (United States)

    Zhao, Xi; Wu, Xiaoli; Zhou, Hui; Jiang, Tao; Chen, Chun; Liu, Mingshi; Jin, Yuanbao; Yang, Dongsheng

    2014-11-01

    To optimize the preparation factors for argan oil microcapsule using complex coacervation of chitosan cross-linked with gelatin based on hybrid-level orthogonal array design via SPSS modeling. Eight relatively significant factors were firstly investigated and selected as calculative factors for the orthogonal array design from the total of ten factors effecting the preparation of argan oil microcapsule by utilizing the single factor variable method. The modeling of hybrid-level orthogonal array design was built in these eight factors with the relevant levels (9, 9, 9, 9, 7, 6, 2 and 2 respectively). The preparation factors for argan oil microcapsule were investigated and optimized according to the results of hybrid-level orthogonal array design. The priorities order and relevant optimum levels of preparation factors standard to base on the percentage of microcapsule with the diameter of 30~40 μm via SPSS. Experimental data showed that the optimum factors were controlling the chitosan/gelatin ratio, the systemic concentration and the core/shell ratio at 1:2, 1.5% and 1:7 respectively, presetting complex coacervation pH at 6.4, setting cross-linking time and complex coacervation at 75 min and 30 min, using the glucose-delta lactone as the type of cross-linking agent, and selecting chitosan with the molecular weight of 2000~3000.

  20. 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.

  1. 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%

  2. What factors facilitate the engagement with flipped classrooms used in the preparation for postgraduate medical membership examinations?

    Directory of Open Access Journals (Sweden)

    Jesurasa A

    2017-06-01

    Full Text Available Amrita Jesurasa, Kelly Mackenzie, Hannah Jordan, Elizabeth C Goyder School of Health and Related Research (ScHARR, University of Sheffield, Regent Court, Sheffield, UK Background: The “flipped classroom,” a pedagogical model where typical lecture and homework elements are reversed, is being advocated in medical education to support the teaching of a large curriculum. However, research into the use of this model in postgraduate medical education, which requires the application of acquired knowledge, is limited. The aim of this study was to explore the barriers and facilitators to engagement with the flipped classroom model in preparation for the written element of postgraduate membership examinations. Methods: Three focus groups (n=14 were held between February and June 2016. Participants were drawn from a membership examination preparation course, run by the University of Sheffield. Two of the groups (n=10 involved “students” (public health registrars while the other focus group (n=4 was held with “tutors” (experienced registrars and consultants. The focus groups were audiorecorded and transcribed verbatim. Transcripts were thematically analyzed by using both predetermined and emergent themes. Results: Key themes that emerged from the data included variation in learning and teaching styles of individuals as well as the feasibility and flexibility of the overall course design. However, management of students’ expectations was found to be the fundamental factor, which underpinned the engagement. Conclusion: The complex interaction of factors affecting engagement in this study highlights the need to consider the appropriateness of the flipped classroom model. However, this must be balanced by the potential benefits of the approach for delivering a large curriculum. Recognizing the central importance of managing expectations at the outset would be useful when considering this model in postgraduate medical education. Keywords

  3. COLONOSCOPY COMPLICATIONS IN THE ELDERLY: the impact of age and multimorbidity

    Directory of Open Access Journals (Sweden)

    Francine de Cristo STEIN

    2013-12-01

    Full Text Available Context Age has been considered an independent risk factor for colonoscopy complications, especially when associated with multimorbidity. Objectives The primary objective was to verify the relationships between age, multimorbidity and colonoscopy complications in the elderly. Methods A retrospective cohort including patients of 60 years or older who had undergone a colonoscopy. Data relating to age, multimorbidities according to the cumulative illness scale for geriatrics and the Charlson index and complications related to bowel preparation and procedure (sedation and exam were collected. Results Of the 207 patients (mean age 70.47 ± 7.04 with appropriate indication for colonoscopy according to the American Society for Gastrointestinal Endoscopy, 43 (20.77% patients had some colonoscopy complications: 1 (0.48% with the sedation (apnea, 4 (1.93% with the procedure (abdominal pain and bacteremia and 38 (18.35% with the bowel preparation (acute renal failure, hypotension. Individuals ≥80 years had an RR = 3.4 (1.2-10.1, P = 0.025, and those with a Charlson index 3 had an RR = 5.2 (1.6-16.8, P = 0.006, for complications. The cumulative illness rating scale for geriatrics was not associated with complications (P = 0.45. Conclusion There was a significant risk of complications in ≥80 years and in the group with a Charlson index 3. The cumulative illness rating scale for geriatrics was not a good predictor of risk in this sample.

  4. THE EFFECT OF PLASMA PREPARATION RICH IN GROWTH FACTORS ON PATELLAR STABILITY AFTER MEDIAL PATELLOFEMORAL LIGAMENT REEFING

    Directory of Open Access Journals (Sweden)

    Andonovski Alan

    2016-07-01

    Full Text Available Introduction: Although more than 100 operative procedures have been described for the treatment of patellar instability, there is no single universally successful procedure. For the most patients with lateral patellar instability medial patellofemoral ligament (MPFL reefing is recommended. When we perform MPFL reefing we are not aware of the quality and strength of the MPFL tissue. In the presence of recurrent patellar instability,the quality and strength of MPFL tissue is often compromised and it disturbs patellar stability after MPFL reefing. Biomedicine development,recognizing the ligament healing process show us that autologous blood products, particularly PRP can enhance healing in soft tissue injuries. Purpose: The purpose of this study was to determine the potential effect of Plasma preparation rich in growth factorson patellar stability after MPFL reefing. Material and methods: Plasma preparationrich in growth factors was produced from a unit of autologous whole blood using Arthrex ACP double syringe system.Platelet gel was prepared by adding bovine thrombin and 10% solution of calcium chloride.The platelet gel was applied locally into the place where suturing of the MPFL was performed. In this prospective, randomized and double blindstudy12 patients were included:6 patients in the PG group who received platelet gel and 6 patients in the control group who were not treated with platelet gel. Patellar stability was evaluated before surgery and 3 months after surgery with Axial stress radiographs. Results: The calculated 3 month improvement was 12.67 ± 2.51 in the control group and 17.33 ± 1.52 in the PG group, (p=0.064.Although there was greater improvement in patellar stability in PG group comparing to the control group, the difference was not statistically significant (p>0.05.The main reason for this was probably the small number of patients included in the study. Conclusion: Results showed that growth factors from the plasma

  5. 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.

  6. 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.

  7. Preparation and characterization of anti-tissue factor single-chain variable fragment antibody for cancer diagnosis.

    Science.gov (United States)

    Sato, Ryuta; Obonai, Toshifumi; Tsumura, Ryo; Tsumoto, Kouhei; Koga, Yoshikatsu; Yasunaga, Masahiro; Matsumura, Yasuhiro

    2014-12-01

    Tissue factor (TF), which serves as the initiator of the extrinsic blood coagulation cascade, has been found to be overexpressed in various solid tumors, especially brain tumors, pancreatic cancer, and gastric cancer. Overexpression of TF is considered to contribute to the high incidence of thrombotic complications and poor prognosis in patients with such cancers. Therefore, detection or targeting of TF may be a promising approach for the diagnosis and treatment of solid tumors that are known to overexpress the protein. Here, we used the recombinant DNA technology to develop an anti-TF single-chain Fv (scFv) of small size and high affinity for its target. The biochemical characteristics of the anti-TF scFv were evaluated using surface plasmon resonance (SPR) sensing and flow cytometry. The data obtained showed that the affinity of the anti-TF scFv was 2.04 × 10(-8) (KD), and that the protein showed significant binding to the cancer cells. Then, Alexa 647-labeled anti-TF scFv and anti-TF IgG were administered to mice bearing chemically induced spontaneous tumors. The maximum tumor to background ratios of anti-TF scFv and anti-TF IgG were obtained 3 and 24 h after the injections, respectively. This study indicates anti-TF scFv may be suitable as an imaging probe for the diagnosis of solid tumors.

  8. 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。

  9. 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.

  10. 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.

  11. 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

  12. 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 ...

  13. 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...

  14. 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...

  15. 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 ...

  16. 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 ...

  17. 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...

  18. 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 ...

  19. 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

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. 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.

  5. Organizational factors and mental health in community volunteers. The role of exposure, preparation, training, tasks assigned, and support.

    Science.gov (United States)

    Thormar, Sigridur Bjork; Gersons, Berthold P R; Juen, Barbara; Djakababa, Maria Nelden; Karlsson, Thorlakur; Olff, Miranda

    2013-01-01

    During disasters, aid organizations often respond using the resources of local volunteer members from the affected population who are not only inexperienced, but who additionally take on some of the more psychologically and physically difficult tasks in order to provide support for their community. Although not much empirical evidence exists to justify the claim, it is thought that preparation, training, and organizational support limit (or reduce) a volunteer's risk of developing later psychopathology. In this study, we examined the effects of preparation, training, and organizational support and assigned tasks on the mental health of 506 Indonesian Red Cross volunteers who participated in the response to a massive earthquake in Yogyakarta, Indonesia, in 2006. Controlling for exposure level, the volunteers were assessed for post-traumatic stress disorder (PTSD), anxiety, depression, and subjective health complaints (SHCs) 6, 12, and 18 months post-disaster. Results showed high levels of PTSD and SHCs up to 18 months post-disaster, while anxiety and depression levels remained in the normal range. Higher levels of exposure as well as certain tasks (e.g., provision of psychosocial support to beneficiaries, handling administration, or handing out food aid) made the volunteers more vulnerable. Sense of safety, expressed general need for support at 6 months, and a lack of perceived support from team leaders and the organization were also related to greater psychopathology at 18 months. The results highlight the importance of studying organizational factors. By incorporating these results into future volunteer management programs the negative effects of disaster work on volunteers can be ameliorated.

  6. 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.

  7. [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.

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

    Science.gov (United States)

    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.

  9. 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

  10. 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.

  11. Complications of CT colonography: A Review

    Energy Technology Data Exchange (ETDEWEB)

    Pendsé, D.A., E-mail: mail@dougpendse.com [Department of Imaging, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Department of Medical Imaging, University College London, 250 Euston Rd (United Kingdom); Taylor, S.A., E-mail: csytaylor@yahoo.co.uk [Department of Imaging, University College London Hospitals NHS Foundation Trust, London (United Kingdom); Department of Medical Imaging, University College London, 250 Euston Rd (United Kingdom)

    2013-08-15

    Since its inception, one of the main advantages of computed tomography colonography (CTC) over colonoscopy has been its assumed superior safety profile. However CTC is not without complication and adverse events are well described. Although the risks of insufflation, bowel preparation, contrast media and radiation dose are very small, they are not insignificant. This review discusses the potential hazards and complications associated with the technique, and discuss precautions, which may lessen the risk of occurrence.

  12. 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

  13. 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

  14. 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

  15. Examining factors that influence the effectiveness of cleaning antineoplastic drugs from drug preparation surfaces: a pilot study.

    Science.gov (United States)

    Hon, Chun-Yip; Chua, Prescillia Ps; Danyluk, Quinn; Astrakianakis, George

    2014-06-01

    Occupational exposure to antineoplastic drugs has been documented to result in various adverse health effects. Despite the implementation of control measures to minimize exposure, detectable levels of drug residual are still found on hospital work surfaces. Cleaning these surfaces is considered as one means to minimize the exposure potential. However, there are no consistent guiding principles related to cleaning of contaminated surfaces resulting in hospitals to adopt varying practices. As such, this pilot study sought to evaluate current cleaning protocols and identify those factors that were most effective in reducing contamination on drug preparation surfaces. Three cleaning variables were examined: (1) type of cleaning agent (CaviCide®, Phenokil II™, bleach and chlorhexidine), (2) application method of cleaning agent (directly onto surface or indirectly onto a wipe) and (3) use of isopropyl alcohol after cleaning agent application. Known concentrations of antineoplastic drugs (either methotrexate or cyclophosphamide) were placed on a stainless steel swatch and then, systematically, each of the three cleaning variables was tested. Surface wipes were collected and quantified using high-performance liquid chromatography-tandem mass spectrometry to determine the percent residual of drug remaining (with 100% being complete elimination of the drug). No one single cleaning agent proved to be effective in completely eliminating all drug contamination. The method of application had minimal effect on the amount of drug residual. In general, application of isopropyl alcohol after the use of cleaning agent further reduced the level of drug contamination although measureable levels of drug were still found in some cases.

  16. Precipitation-lyophilization-homogenization (PLH) for preparation of clarithromycin nanocrystals: influencing factors on physicochemical properties and stability.

    Science.gov (United States)

    Morakul, Boontida; Suksiriworapong, Jiraphong; Leanpolchareanchai, Jiraporn; Junyaprasert, Varaporn Buraphacheep

    2013-11-30

    Nanocrystals is one of effective technologies used to improve solubility and dissolution behavior of poorly soluble drugs. Clarithromycin is classified in BCS class II having low bioavailability due to very low dissolution behavior. The main purpose of this study was to investigate an efficiency of clarithromycin nanocrystals preparation by precipitation-lyophilization-homogenization (PLH) combination method in comparison with high pressure homogenization (HPH) method. The factors influencing particle size reduction and physical stability were assessed. The results showed that the PLH technique provided an effective and rapid reduction of particle size of nanocrystals to 460 ± 10 nm with homogeneity size distribution after only the fifth cycle of homogenization, whereas the same size was attained after 30 cycles by the HPH method. The smallest nanocrystals were achieved by using the combination of poloxamer 407 (2%, w/v) and SLS (0.1%, w/v) as stabilizers. This combination could prevent the particle aggregation over 3-month storage at 4 °C. The results from SEM showed that the clarithromycin nanocrystals were in cubic-shaped similar to its initial particle morphology. The DSC thermogram and X-ray diffraction pattern of nanocrystals were not different from the original drug except for intensity of peaks which indicated the presenting of nanocrystals in the crystalline state and/or partial amorphous form. In addition, the dissolution of the clarithromycin nanocrystals was dramatically increased as compared to the coarse clarithromycin.

  17. PEGylated PLGA Nanoparticles as Tumor Ecrosis Factor-α Receptor Blocking Peptide Carriers: Preparation,Characterization and Release in vitro

    Institute of Scientific and Technical Information of China (English)

    LIU Wei; YANG Anshu; LI Zhuoya; XU Huibi; YANG Xiangliang

    2007-01-01

    To assess the merits of PEGylated poly (lactic-co-glycolic acid) (PEG-PLGA) nanoparticles as drug carriers for tumor necrosis factor-α receptor blocking peptide (TNFR-BP), PEG-PLGA copolymer,which could be used to prepare the stealth nanoparticles, was synthesized with methoxypolyethyleneglycol,DL-lactide and glycolide. The structure of PEG-PLGA was confirmed with 1H-NMR and FT-IR spectroscopy,and the molecular weight (MW) was determined by gel permeation chromatography. Fluorescent FITC-TNFR-BP was chosen as model protein and encapsulated within PEG-PLGA nanoparticles using the double emulsion method. Atomic force microscopy and photon correlation spectroscopy were employed to characterize the stealth nanoparticles fabricated for morphology, size with polydispersity index and zeta potential. Encapsulation efficiency (EE) and the release of FITC-TNFR-BP in nanoparticles in vitro were measured by the fluorescence measurement. The stealth nanoparticles were found to have the mean diameter less than 270 nm and zeta potential less than-20 mV. In all nanoparticle formulations, more than 45% of EE were obtained. FITC-TNFR-BP release from the PEG-PLGA nanoparticles exhibited a biphasic pattern, initial burst release and consequently sustained release. The experimental results show that PEG-PLGA nanoparticles possess the potential to develop as drug carriers for controlled release applications of TNFR-BP.

  18. 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危险因素( P <0.05)。结论OS 患者的颈围和呼吸困难/发绀是影响OS 患者的重要危险因素。

  19. Extended complications of urethroplasty

    Directory of Open Access Journals (Sweden)

    Hosam S. Al-Qudah

    2005-08-01

    Full Text Available INTRODUCTION: An extensive study of complications following urethroplasty has never been published. We present 60 urethroplasty patients who were specifically questioned to determine every possible early and late complication. MATERIALS AND METHODS: Retrospective chart review of urethroplasty patients between August 2000 and March 2004. An "open format" questioning style allowed maximal patient reporting of all complications, no matter how minor. RESULTS: 60 patients underwent 62 urethroplasties (24 anterior anastomotic, 19 buccal mucosal and 10 fasciocutaneous, 9 posterior anastomotic with mean follow-up of 29 months. Early complications occurred in 40%, but only 3% were major (rectal injury and urosepsis. Early minor complications included scrotal swelling, scrotal ecchymosis and urinary urgency. Late complications occurred in 48%, but only 18% were significant (erectile dysfunction, chordee and fistula. Late minor complications included a feeling of wound tightness, scrotal numbness and urine spraying. Fasciocutaneous urethroplasty caused the most significant complications, and buccal mucus urethroplasty the least, while also resulting in the lowest recurrence rate (0%. CONCLUSIONS: Serious complications after urethroplasty (3% early and 18% late appear similar to those reported elsewhere, but minor bothersome complications appear to occur in much higher numbers than previously published (39% early and 40% late. While all the early complications were resolved and most (97% were minor, less than half of the late complications were resolved, although most (82% were minor. These complication rates should be considered when counseling urethroplasty patients, and generally tend to support the use of buccal mucosal onlay urethroplasty as it had the lowest rate of serious side effects.

  20. Risk factors for preterm birth and complications in 287 late preterm infants%287例晚期早产儿早产危险因素及并发症研究

    Institute of Scientific and Technical Information of China (English)

    张晓蕊; 曾超美; 刘捷

    2011-01-01

    Objective To investigate the risk factors for preterm birth and complications in late preterm infants.Methods The clinical data of 287 late preterm infants were retrospectively studied. Two hundred and eighty-eight term infants served as the control group. Logistic regression analysis was used to identify risk factors associated with late preterm birth. The common complications in late preterm infants were investigated. Results Several significant risk factors for late preterm birth were identified by logistic regression analysis: twin pregnancy, gestational diabetes mellitus, eclampsia or preeclampsia, placenta previa, placental abruption and premature rupture of membranes. The duration of hospitalization in late preterm infants was longer than that in term infants. The complications were common in late preterm infants, with a high prevalence of anemia, aspiration pneumonia, hypoglycemia and intracranial hemorrhage. Conclusions The late preterm infants are much more likely to suffer various complications. It is important to reduce the incidence of late preterm births by decreasing perinatal risk factors above mentioned.%目的:探讨晚期早产儿(late preterm infant,LPI)早产相关危险因素及临床常见并发症.方法:对287例LPI临床资料进行回顾性分析,同时随机抽取288例同期住院的足月新生儿作对照,应用logistic回归分析的方法筛选LPI早产的危险因素,并分析其常见临床并发症的发生等情况.结果:Logistic回归显示双胎、妊娠期糖尿病、先兆子癎及子癎、前置胎盘、胎盘早剥及胎膜早破为LPI早产发生的危险因素.LPI住院时间明显长于足月儿,其各系统并发症发生率均较高,其中以贫血、吸人性肺炎、低血糖症、颅内出血等为主.结论:LPI生后易发生多种并发症,应注意密切观察,及时救治.避免围产期异常分娩因素的发生是降低LPI出生的关键.

  1. Influencing Factors on Diabetic Complications of Type 2 Diabetes Cases%糖尿病疗养员并发症影响因素的调查分析

    Institute of Scientific and Technical Information of China (English)

    何丽英; 杨琳; 许望纯

    2011-01-01

    Objective To investigate the influencing factors on complications of type 2 diabetes convales-cents with a view to providing evidence for prevention and treatment of diabetic complications. Methods The data of 150 convalescents with type 2 diabetes were retrospectively analyzed on the blood glucose mo-nitoring, conditions of diabetes health education, outpatient follow-up period, blood glucose and complica-tions. Results The prevalence of type2 diabetes complications of convalescents were 61. 3%(92/150). The prevalence of diabetic complications were significantly influenced by proper dietary control, regular health education,outpatient following-up and frequent blood glucose monitor. Conclusion Proper diet control, regular health education,outpatient following-up on time and frequent blood glucose monitor can postpone type 2 diabetic complications effectively.%目的 分析2型糖尿病疗养员并发症的影响因素,以期为糖尿病并发症防治提供依据.方法 对广州军区广州疗养院150例2型糖尿病疗养员的血糖检测情况、接受糖尿病健康教育情况、门诊随访周期、血糖达标及并发症的临床资料进行回顾性统计分析.结果 150例疗养员中患有并发症者92例,占61.3%.饮食控制、健康教育、门诊随访、血糖检测频次对并发症的发生有显著影响(P<0.05).结论 合理饮食、加强血糖检测、定期接受健康教育、按时门诊随访能有效延缓2型糖尿病疗养员并发症的发生.

  2. Discovering Diabetes Complications: an Ontology Based Model

    Science.gov (United States)

    Daghistani, Tahani; Shammari, Riyad Al; Razzak, Muhammad Imran

    2015-01-01

    Background: Diabetes is a serious disease that spread in the world dramatically. The diabetes patient has an average of risk to experience complications. Take advantage of recorded information to build ontology as information technology solution will help to predict patients who have average of risk level with certain complication. It is helpful to search and present patient’s history regarding different risk factors. Discovering diabetes complications could be useful to prevent or delay the complications. Method: We designed ontology based model, using adult diabetes patients’ data, to discover the rules of diabetes with its complications in disease to disease relationship. Result: Various rules between different risk factors of diabetes Patients and certain complications generated. Furthermore, new complications (diseases) might be discovered as new finding of this study, discovering diabetes complications could be useful to prevent or delay the complications. Conclusion: The system can identify the patients who are suffering from certain risk factors such as high body mass index (obesity) and starting controlling and maintaining plan. PMID:26862251

  3. Coagulation and Placenta-Mediated Complications

    Directory of Open Access Journals (Sweden)

    Anat Aharon

    2014-10-01

    Full Text Available Pregnancy is a physiological hypercoagulable state, preparing the mother for the hemostatic challenge of delivery. However, this is associated with an increased risk of venous thrombosis and placenta-mediated complications, which present major challenges for mother and fetus. Although these conditions are heterogeneous in their pathophysiology, hereditary and acquired thrombophilia has been associated with recurrent pregnancy loss and gestational vascular complications, such as early-onset pre-eclampsia and placental abruption. Prevention of such placenta-mediated complications, which collectively complicate up to 15% of pregnancies, is a major issue for women’s health. Prospective interventional studies stratified by current knowledge of pathophysiological mechanisms related to placental and systemic hemostatic alterations will impact on the management of pregnancies at risk of these complications.

  4. [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.

  5. 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

  6. [Complications of operative hysteroscopy].

    Science.gov (United States)

    Agostini, A; Bretelle, F; Cravello, L; Ronda, I; Roger, V; Blanc, B

    2003-05-24

    Assess the prevalence and severity of the various complications of operative hysteroscopy, the context in which they occur and the treatments proposed. A single-center observational study from 1/1/90 to 1/1/99 including 2,116 surgical hysteroscopies (resection of a fibroma (782) or polyp (422), section of a septate uterus (199), synechia uteri (90) and endometrectomy (623)). There were 74 complications (3.5%). The most frequent was uterine perforation (34 cases (1.61%)). There were 13 cases of haemorrhage (0.61%), 16 cases of post-surgical fever (0.76%) and 11 metabolic complications (0.47%). Synechia uteri was the surgical intervention with the greatest risk of complications. The complications of surgical hysteroscopy are rare and relatively benign. Uterine perforation appears to predominate. In our study, the risk of complication was enhanced in the case of synechia uteri.

  7. A Fatal Complication of Dermatomyositis: Spontaneous Pneumomediastinum

    Directory of Open Access Journals (Sweden)

    Ezgi Demirdöğen Çetinoğlu

    2016-04-01

    Full Text Available Interstitial lung disease (ILD is a negative prognostic factor associated with increased morbidity and mortality in patients with dermatomyositis (DM. Spontaneous pneumomediastinum is a rare complication of DM and it can be fatal. We present a 48-year-old woman with DM and ILD complicated by pneumomediastinum without pneumothorax and subcutaneous emphysema.

  8. Pulmonary complications of upper abdominal surgery.

    Directory of Open Access Journals (Sweden)

    Deodhar S

    1991-04-01

    Full Text Available Pulmonary complications encountered in 67 patients undergoing upper abdominal surgery in our unit in one year period are analysed. Pulmonary function tests and their post-operative reduction, as also the risk factors are discussed. Pathophysiology responsible for pulmonary complications is outlined.

  9. A Fatal Complication of Dermatomyositis: Spontaneous Pneumomediastinum

    OpenAIRE

    Ezgi Demirdöğen Çetinoğlu; Ediz Dalkılıç; Muharrem Erol; Nilüfer Aylin Acet; Ahmet Ursavaş; Ercüment Ege

    2016-01-01

    Interstitial lung disease (ILD) is a negative prognostic factor associated with increased morbidity and mortality in patients with dermatomyositis (DM). Spontaneous pneumomediastinum is a rare complication of DM and it can be fatal. We present a 48-year-old woman with DM and ILD complicated by pneumomediastinum without pneumothorax and subcutaneous emphysema.

  10. Sigmoid volvulus complicating pregnancy

    Directory of Open Access Journals (Sweden)

    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.

  11. Complications of nephrotic syndrome

    Directory of Open Access Journals (Sweden)

    Se Jin Park

    2011-08-01

    Full Text Available Nephrotic syndrome (NS is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox, thromboembolism (e.g., venous thromboembolism and pulmonary embolism, hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension, cardiovascular problems (e.g., hyperlipidemia, acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception. The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

  12. 脑梗死患者并发骨质疏松的相关危险因素及预防对策%The Related Risk Factors and the Preventive Measures of Cerebral Infarction Patients Complicated with Osteoporosis

    Institute of Scientific and Technical Information of China (English)

    陈炜; 张之福

    2015-01-01

    Objective To explore the related risk factors and the preventive measures of cerebral infarction patients complicated with osteoporosis. Methods 166 cases of cerebral infarction patients complicated with osteoporosis in our hospital from June 2012 to June 2014 were selected. Results Women with cerebral infarction in patients with the incidence of osteoporosis was significantly higher than that in male patients,the dif erence was statistical y significant ( < 0.05).The related risk factors and the preventive measures of cerebral infarction patients complicated with osteoporosis were cerebral infarction disease,severity,elderly,women,low body mass index,smoking,hypertension.Conclusion The related risk factors and the preventive measures of cerebral infarction patients complicated with osteoporosis are cerebral infarction disease,severity,elderly,women,low body mass index,smoking, hypertension,it should be pay at ention to the positive targete prevention.%目的:探讨脑梗死患者并发骨质疏松的相关危险因素及预防对策。方法从本院2012年6月~2014年6月收治的脑梗死患者中随机选择166例进行研究。结果女性脑梗死患者的骨质疏松发生率显著高于男性患者,差异有统计学意义(<0.05)。骨质疏松相关危险因素有脑梗死病程、病情程度、高龄、女性、低体重指数、高血压病、抽烟。结论脑梗死患者并发骨质疏松的相关危险因素有脑梗死病程、病情程度、高龄、女性、低体重指数、高血压病、吸烟,临床要注意积极的予以针对性预防。

  13. 重型颅脑损伤患者并发肺炎因素的分析及护理%Factor nalysis and nursing of severe head injury patients complicated pneumonia

    Institute of Scientific and Technical Information of China (English)

    杨绍梅

    2011-01-01

    目的:分析重型颅脑损伤患者并发肺炎的因素,总结护理经验,降低患者死亡率.方法:对32例重型颅脑损伤并发肺炎患者实施重点监护并总结护理干预措施.结果:32例经有效地治疗和积极地护理干预后,其中24例病情得到了有效控制,治愈出院,8例因病情严重,抢救无效死亡.结论:针对重型颅脑损伤患者并发肺炎的不同因素,进行科学、有效地治疗和护理干预,可以降低患者的死亡率.%Objective: To analysis the factors of severe head injury patients complicated pneumonia, and summarize nursing experience, reduce patients mortality.Methods: 32 patients with severe head injury complicated pneumonia were given intensive care and nursing intervention.Results: 32 cases by effective therapy and nursing intervention, which actively 24 cases were cured illness is effectively controlled, discharge, 8 cases because of illness is serious, the rescue invalid death.Conclusion: The results for severe head injury patients complicated pneumonia of different factors, scientific and effective therapy and nursing intervention, reduce patients mortality.

  14. Risk factors of complications analysis for infants with mycoplasma pneumonia pulmonary%婴幼儿肺炎支原体肺炎肺外并发症的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    沈睿; 高琳; 彭苏妍; 叶志琼

    2016-01-01

    目的:探讨婴幼儿肺炎支原体肺炎(MPP)肺外并发症的相关因素。方法将105例MPP 患儿根据是否合并肺外并发症分为肺外并发症组(72例)和无肺外并发症组(33例),对两组患儿一般情况相关因素以及疾病相关因素进行单因素分析,差异有统计学意义的因素进行 Logistic 回归分析。结果婴幼儿 MPP 肺外并发症发生率68.6%(72/105),患儿主要肺外受累系统是消化系统(54.2%)、心血管系统(44.4%)以及血液系统(33.3%)。与 MPP 肺外并发症相关的20个因素中,年龄、喂养方式(包括人工、混合、母乳)、发病季节、发热天数、肺炎支原体(MP)-IgM 滴度、C 反应蛋白、红细胞沉降率、开始使用大环内酯类药物时间两组比较差异有统计学意义(P<0.05)。多因素 Logistic回归分析显示,年龄≥2岁、发热天数≥7 d、MP-IgM 滴度≥1∶160、C 反应蛋白增高、红细胞沉降率加快是婴幼儿 MPP 发生肺外并发症的危险因素,母乳喂养和发病7 d 内使用大环内酯类药物是保护因素。结论婴幼儿 MPP 肺外并发症发生率较高,可累及多个系统,年龄较长、热程较长、MP-IgM滴度高、C 反应蛋白增高、红细胞沉降率加快以及既往病史较多的患儿肺外并发症发生率较高,临床要给予高度重视。%Objective To investigate the complications related factors in infants with mycoplasma pneumonia pulmonary(MPP). Methods According to the condition of pulmonary complications, 105 cases of infants MPP were divided into pulmonary complication group and no pulmonary complication group with 72 cases and 33 cases respectively,and the general related factors and disease related factors of two groups were analyzed. Results The incidence rate of pulmonary complication was 68.6% (72/105) in infants MPP, and the main involved extra-pulmonary systems were digestive system (54.2%), cardiovascular

  15. Accreta complicating complete placenta previa is characterized by reduced systemic levels of vascular endothelial growth factor and by epithelial-to-mesenchymal transition of the invasive trophoblast.

    Science.gov (United States)

    Wehrum, Mark J; Buhimschi, Irina A; Salafia, Carolyn; Thung, Stephen; Bahtiyar, Mert O; Werner, Erica F; Campbell, Katherine H; Laky, Christine; Sfakianaki, Anna K; Zhao, Guomao; Funai, Edmund F; Buhimschi, Catalin S

    2011-05-01

    We sought to characterize serum angiogenic factor profile of women with complete placenta previa and determine if invasive trophoblast differentiation characteristic of accreta, increta, or percreta shares features of epithelial-to-mesenchymal transition. We analyzed gestational age-matched serum samples from 90 pregnant women with either complete placenta previa (n = 45) or uncomplicated pregnancies (n = 45). Vascular endothelial growth factor (VEGF), placental growth factor, and soluble form of fms-like-tyrosine-kinase-1 were immunoassayed. VEGF and phosphotyrosine immunoreactivity was surveyed in histological specimens relative to expression of vimentin and cytokeratin-7. Women with previa and invasive placentation (accreta, n = 5; increta, n = 6; percreta, n = 2) had lower systemic VEGF (invasive previa: median 0.8 [0.02-3.4] vs control 6.5 [2.7-10.5] pg/mL, P = .02). VEGF and phosphotyrosine immunostaining predominated in the invasive extravillous trophoblasts that coexpressed vimentin and cytokeratin-7, an epithelial-to-mesenchymal transition feature and tumorlike cell phenotype. Lower systemic free VEGF and a switch of the interstitial extravillous trophoblasts to a metastable cell phenotype characterize placenta previa with excessive myometrial invasion. Published by Mosby, Inc.

  16. ACCRETA COMPLICATING COMPLETE PLACENTA PREVIA IS CHARACTERIZED BY REDUCED SYSTEMIC LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR AND EPITHELIAL-TO-MESENCHYMAL TRANSITION OF THE INVASIVE TROPHOBLAST

    Science.gov (United States)

    Wehrum, Mark J.; Buhimschi, Irina A.; Salafia, Carolyn; Thung, Stephen; Bahtiyar, Mert O.; Werner, Erica F.; Campbell, Katherine H.; Laky, Christine; Sfakianaki, Anna K.; Zhao, Guomao; Funai, Edmund F.; Buhimschi, Catalin S.

    2011-01-01

    OBJECTIVE To characterize serum angiogenic factor profile of women with complete placenta previa and determine if invasive trophoblast differentiation characteristic of accreta, increta or percreta shares features of epitehelial-mesenchymal-transition (EMT). STUDY DESIGN We analyzed gestational age matched serum samples from 90 pregnant women with either complete placenta previa (n=45) or uncomplicated pregnancies (n=45). Vascular-endothelial-growth-factor (VEGF), placental-growth-factor (PlGF) and soluble fms-like-tyrosine-kinase-1 (sFlt-1) were immunoassayed. VEGF and phosphotyrosine (P-Tyr) immunoreactivity was surveyed in histological specimens relative to expression of vimentin and cytokeratin-7. RESULTS Women with previa and invasive placentation [accreta (n=5); increta (n=6); percreta (n=2)] had lower systemic VEGF (invasive previa: median [IQR]: 0.8[0.02–3.4] vs. control: 6.5[2.7–10.5] pg/mL, P=0.02). VEGF and P-Tyr immunostaining predominated in the invasive extravillous trophoblasts (EVT) which co-expressed vimentin and cytokeratin-7, a EMT feature and tumor-like cell phenotype. CONCLUSIONS Lower systemic free VEGF and a switch of the interstitial EVT to a metastable cell phenotype characterize placenta previa with excessive myometrial invasion. PMID:21316642

  17. Hemorrhagic complications in dermatologic surgery

    Science.gov (United States)

    Bunick, Christopher G.; Aasi, Sumaira Z.

    2014-01-01

    The ability to recognize, manage, and, most importantly, prevent hemorrhagic complications is critical to performing dermatologic procedures that have safe and high quality outcomes. This article reviews the preoperative, intraoperative, and postoperative factors and patient dynamics that are central to preventing such an adverse outcome. Specifically, the role that anticoagulants and antiplatelet agents, hypertension, and other medical conditions play in the development of postoperative hemorrhage are discussed. In addition, this article provides practical guidelines on managing bleeding during and after surgery. PMID:22515669

  18. Pulmonary Complications due to Esophagectomy

    Directory of Open Access Journals (Sweden)

    Yashar Talebi

    2011-08-01

    Full Text Available Introduction: Esophageal carcinoma is the scourge of human beings. Pulmonary compli-cations in patients who have undergone operation are common (20-30% of cases and there are no suitable tools and ways to predict these complications. Methods: During a period of 10 years, from March 1998 to February 2007, 200 patients (150 male and 50 female underwent Esophagectomy due to esophageal carcinoma in thoracic surgery ward retrospectively. Complications include the length of hospitalization, mechanical ventilation, morbidity and mortality. Patients’ risk factors include age, preoperative chemo-radiotherapy, stage of the disease and preoperative spirometry condition. Results: We grouped our patients into three categories: Normal (FEV1 ≥ 80% predicted, mildly impaired (FEV1 65% to 79% predicted, more severely impaired (FEV1 < 65% predicted.Although almost all patients had radiographic pulmonary abnormalities, significant pulmonary complications occurred in 40 patients (20% which underwent Esophagectomy. Pleural effusion and atelectasia in 160 patients (80%. 24 patients needed chest-tube insertion. 20 patients (10% developed ARDS. 14 patients (7% developed chylothorax. 20 patients (10% of patients died during their postoperative hospital stay. 30 patients (15% required mechanical ventilation for greater than 48 hours. Conclusion: We reviewed a number of preoperative clinical variables to determine whether they contributed to postoperative pulmonary complications as well as other outcomes. In general, age, impaired pulmonary function especially in those patients with FEV1 less than 65% predicted was associated with prolonged hospital length of stay (LOS. In fact pulmonary complications rate after Esophagectomy are high and there was associated mortality and morbidity.

  19. 胰十二指肠切除术后早期并发症的危险因素分析及干预对策%Risk factor analysis and intervention measures of early complications after pancreaticoduodenectomy

    Institute of Scientific and Technical Information of China (English)

    李丽芳; 马文婷; 郑翠英

    2013-01-01

    目的:探讨影响胰十二指肠切除术后早期并发症的相关因素,观察实施干预措施后的临床效果。方法随机选取2011年1月至2013年1月185例胰十二指肠切除术患者为研究对象,对其中出现了早期并发症的患者的影响因素进行分析。结果胰十二指肠切除术后早期并发症以上消化道出血为主,相关危险因素有高龄(大于65岁)、高血清胆红素(大于171μmol/L )、低清蛋白(小于或等于35 g/L )、血糖高、恶性肿瘤、无肠内营养、Child分级高(Ⅲ级)、手术时间长(大于6 h)、无术前减轻梗阻性黄疸(P<0.05);其中糖尿病、Child分级、清蛋白水平、手术时间、胆红素水平是胰十二指肠切除术后发生早期并发症的高危险因素。结论糖尿病、Child分级、清蛋白水平、手术时间、胆红素水平是影响胰十二指肠切除术后早期并发症的危险因素,予以早期干预有助于避免临床并发症的发生。%Objective To study the related risk factor of early complications after pancreaticoduodenectomy , and observe the clinical effect of intervention measures after the operation .Methods 185 cases of pancreaticoduode-nectomy patients were randomly selected as the research object from January 2011 to January 2013 ,and the related factors of the early complications were analyzed .Results In the early complications after pancreaticoduodenectomy , upper gastrointestinal bleeding was the main type ,and the related risk factors included advanced age (> 65 years old) ,high serum bilirubin (>171 μmol/L) ,low serum albumin (≤35 g/L) ,high blood sugar ,malignant tumor ,no enteral nutrition ,high Child grade (Ⅲ level) ,long operation time (>6 h) and no preoperative biliary drainage (P<0 .05) ,in which diabetes ,Child classification ,albumin level ,operation time and bilirubin level were the high risk fac-tors .Conclusion Diabetes ,child classification ,albumin level

  20. Subclinical hypothyroidism after vascular complicated pregnancy

    NARCIS (Netherlands)

    Zanden, M. van der; Hop-de Groot, R.J.; Sweep, F.C.; Ross, H.A.; Heijer, M. den; Spaanderman, M.E.A.

    2013-01-01

    OBJECTIVE: Women with a history of vascular complicated pregnancy are at risk for developing remote cardiovascular disease. It is associated with underlying cardiovascular risk factors both jeopardizing trophoblast and vascular function. Subclinical hypothyroidism may relate to both conditions. METH

  1. FOURNIER'S GANGRENE COMPLICATING VASECTOMY V.M. ...

    African Journals Online (AJOL)

    hi-tech

    2003-09-09

    Sep 9, 2003 ... The possible operational factors for the complications are explored and preventive ..... trauma, malignancy, malnutrition, renal failure, cortisone therapy, lupus ... second one depended on exogenous testosterone for "normal".

  2. COMPLICATIONS OF PERCUTANEOUS NEPHROLITHOTOMY

    Directory of Open Access Journals (Sweden)

    Ottra

    2016-03-01

    Full Text Available BACKGROUND The increasing global prevalence of nephrolithiasis continues to burden the health care delivery systems of developing nations. Percutaneous Nephrolithotomy (PCNL is considered the standard treatment for many types of calculi. This study focuses on the complications of PCNL in private practice setting at a peripheral center using the modified Clavien system and role of Guy’s stone score as a predictor of stone free rate and complications. METHODS This is a prospective cohort study of 480 patients who underwent PCNL during August 2011 to July 2015. The complications were classified according to modified Clavien system and correlated with the stone complexity as per the Guy’s stone score. RESULTS It was found that overall 120 complications were reported in 480 patients with the incidence of complications of Grade I, II, IIIa, IIIb, IVb being 48 (10%, 38 (7.9%, 15 (3.5%, 12 (2.5% and 4 (0.8% respectively. As per the Guy’s stone score there were 336, 104 and 40 cases belonging to GSS I, II and III respectively. All grades of complications were more common in GSS II and III. The stone clearance was found to be complete in 95%, 82% and 75% of GSS I, II, III respectively. CONCLUSION The stone complexity is related to complication rate and GSS helps to predict stone free rate and complications

  3. Pellagra complicating Crohn's disease.

    OpenAIRE

    Zaki, I.; Millard, L

    1995-01-01

    We report a 53-year-old patient with clinical features of pellagra as a complication of Crohn's disease. His symptoms improved rapidly on taking oral nicotinic acid and vitamin B complex. We suggest the paucity of reported cases of pellagra in Crohn's disease is a reflection of poor recognition of this complication.

  4. Preparation of redispersible liposomal dry powder using an ultrasonic spray freeze-drying technique for transdermal delivery of human epithelial growth factor.

    Science.gov (United States)

    Yin, Fei; Guo, Shiyan; Gan, Yong; Zhang, Xinxin

    2014-01-01

    In this work, an ultrasonic spray freeze-drying (USFD) technique was used to prepare a stable liposomal dry powder for transdermal delivery of recombinant human epithelial growth factor (rhEGF). Morphology, particle size, entrapment efficiency, in vitro release, and skin permeability were systematically compared between rhEGF liposomal dry powder prepared using USFD and that prepared using a conventional lyophilization process. Porous and spherical particles with high specific area were produced under USFD conditions. USFD effectively avoided formation of ice crystals, disruption of the bilayer structure, and drug leakage during the liposome drying process, and maintained the stability of the rhEGF liposomal formulation during storage. The reconstituted rhEGF liposomes prepared from USFD powder did not show significant changes in morphology, particle size, entrapment efficiency, or in vitro release characteristics compared with those of rhEGF liposomes before drying. Moreover, the rhEGF liposomal powder prepared with USFD exhibited excellent enhanced penetration in ex vivo mouse skin compared with that for powder prepared via conventional lyophilization. The results suggest that ultrasonic USFD is a promising technique for the production of stable protein-loaded liposomal dry powder for application to the skin.

  5. 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.

  6. [Complications of blepharoplasty].

    Science.gov (United States)

    Morax, S

    2004-06-01

    Blepharoplasty complications are infrequent, most often minor and transitory, rarely major and permanent with functional or esthetic consequences. Treatment is above all preventive: screening at risk patients with a history of ophthalmic problems, but also general illnesses that would contraindicate blepharoplasty. Patients must be informed of possible risks through informative booklets with the most important points underlined. Complications can be purely ophthalmological, the more serious sequelae being partial or complete visual loss due to ischemic optical neuropathy, with very poor prognosis, or more rarely compression of the ocular globe by intraorbital hemorrhage, which has a better prognosis provided the origins are quickly recognized and treated immediately. Other visual complications include oculomotor problems, keratoconjunctivitis sicca, epiphora, and chemosis of lymphatic origin. Eyelid complications are more frequent: ptosis on the upper eyelid or lagophthalmia caused by incorrect resection of the skin, scarring and eyelid fold anomalies. The most serious esthetic complication is the malposition of the lower eyelid, which can manifest as retraction, lagophthalmia, ectropion, deformation of the external canthus, or lower eyelid tissue relaxation. These malpositions are quite often minor, sometimes reversible, but at times major, with psychological, esthetic and functional consequences that are difficult for the patient. Other local complications also arise: enophthalmia with a sunken lid, as well as under- and overcorrection. General complications can include scarring related to pigmentation problems and residual hematomas, and exceptionally infections going as far as the orbital fat tissue. Finally, other complications are related to new laser surgical techniques that are responsible for ectropion of the lower eyelid and even burns or residual redness, or complications related to periocular injections of filling material. A comprehensive review of

  7. Simple Use of the Suppository Type Povidone-Iodine Can Prevent Infectious Complications in Transrectal Ultrasound-Guided Prostate Biopsy

    Directory of Open Access Journals (Sweden)

    Dong Soo Park

    2009-01-01

    Full Text Available Purpose. To determine the effect of simple use of suppository povidone-iodine on infectious complications after transrectal ultrasonography-guided biopsy of the prostate. Methods. All 481 patients are included and received antibiotic prophylaxis. Among them, 360 patients received povidone-iodine suppository (Gynobetadine; 200 mg immediately prior to biopsy and 121 patients did not. Infectious complications were classified. To evaluate bactericidal effects, we counted bacterial colonies in the rectum, harvested from a rectal swab before insertion of the suppository and after biopsy. Aliquots of the suspended bacterial strains were added to Mueller-Hinton agar medium for incubation. Colony counts were determined. Results. Infectious complications developed in 1 case (0.3% in the rectal preparation group (Group 1 and in 8 cases (6.6% in the nonrectal preparation group (Group 2. One in Group 1 had a fever without sepsis. Two patients had sepsis and six had fever without sepsis in Group 2. Rectal preparation was a statistically significant risk factor influencing the development of infectious complications. In vitro experiments, the mean number of colony-forming units decreased 99.9% after the rectal povidone-iodine preparation. Conclusions. All through the biopsy, povidone-iodine melted into the rectum and decreased the bacterial colony count. Simple use of povidone-iodine suppository before prostate biopsy minimizes the risk of infectious complications.

  8. Risk Factors Analysis and Prevention of Head Injury Complicated with Stress Ulceration and Bleeding%颅脑损伤后并发应激性溃疡出血的危险因素分析及预防

    Institute of Scientific and Technical Information of China (English)

    谭欣

    2011-01-01

    目的 分析颅脑损伤后并发应激性溃疡出血的危险因素,为临床实施有效的预防措施提供参考信息.方法 选择2009年2月-2011年6月本院收治的颅脑损伤患者148例,观察患者是否并发应激性溃疡出血并分析发生的危险因素.结果 本组148例颅脑损伤患者中并发应激性溃疡出血29例,其发生与患者的性别、年龄一般资料无关(P>0.05),与患者的损伤程度、体温、血糖、血压相关(P<0.05).结论 颅脑损伤患者的损伤程度严重、发热、高血糖、低血压均为并发应激性溃疡出血的危险因素,临床上针对以上危险因素采取相应的预防措施,可以促进颅脑损伤患者的康复.%Objective To analyze the risk factors of head injury complicated with stress ulceration and bleeding, and to provide the evidence for effective implementation of prevention measures in clinical practice. Methods Totally 148 patients with head injury hospitalized in the Hospital of Tanghai County from February 2009 to June 2011 were enrolled in the study. The development of stress ulceration and bleeding was observed and the risk factors for the occurrence were analyzed. Results Among the 148 cases of head injury, 29 cases complicated with stress ulceration and bleeding, its occurrence was unrelated to the patients' gender, age and general information (P>0.05), but correlated with the patients' degree of injury, body temperature, blood glucose, and blood pressure (P<0.05). Conclusions Severe head injury, fever, high blood sugar, and hypotension are the risk factors of head injury complicated with stress ulceration and bleeding. Adopting the appropriate preventive measures based on the above risk factors in clinical practice can promote the recovery of the patients with traumatic brain injury.

  9. 腹部皮瓣乳房重建术后并发症及危险因素的研究%Research on the postoperative complications and its risk factors of breast reconstruction with abdominal flaps

    Institute of Scientific and Technical Information of China (English)

    尹健; 张婷; 张学慧; 李海欣; 肖春花; 曹旭晨; 张天浩

    2009-01-01

    Objective To study the postoperative complications and its risk factors in patients underwent breast reconstruction with abdominal flaps. Methods The clinical data of 1 IS cases underwent breast reconstructions with abdominal flaps from May 2001 to October 2008 was reviewed. The postoperative complications included total flap necrosis, partial flap necrosis, fat necrosis, hemia, bulge, fat liquefaction and infection. The risk factors of complication rates were also evaluated. Results The total postoperative complications rate was 17.4% (20/115). No severe complications was found, such as total flap necrosis, hernia and bulge. The most common complications of flap was fat necrosis which occurred in 6 cases (5.2%), partial flap necrosis in 5 cases (4.3%) and infection in 1 case (0.9%). The donor-site complications included fat liquefaction which occurred in 8 cases(7. 0% ) and infection in 3 cases(2. 6% ). No significant relation was found between patient's age, body mass index (BMI) , timing of surgery and the postoperative complication rate. The postoperative complications occurred more frequently in active smokers, patients with radiotherapy history, or reconstructions with pedicled transverse rectus abdominis myocutaneous (TRAM) flaps. But no significant difference was found in those factors. Conclusions Fewer complications happens in patients with a reconstruction with deep inferior epigastric perforator( DIEP) flap. Abdominal flap should be performed with more consideration in active smokers or patients with a radiotherapy history. Age and obesity should not be contraindications to breast reconstruction with abdominal flaps.%目的 探讨腹部皮瓣乳房重建的术后并发症及其相关危险因素.方法 对2001年5月至2008年10月接受腹部皮瓣乳房重建的115例患者的资料和术后并发症情况进行回顾性分析.术后观察指标包括:皮瓣全部坏死、皮瓣部分坏死、脂肪坏死、腹壁疝、腹

  10. Early central nervous system complications after reduced-intensity stem cell transplantation.

    Science.gov (United States)

    Kishi, Yukiko; Miyakoshi, Shigesaburo; Kami, Masahiro; Ikeda, Masayuki; Katayama, Yuta; Murashige, Naoko; Kusumi, Eiji; Yuji, Koichiro; Kobayashi, Kazuhiko; Kato, Daisuke; Hamaki, Tamae; Matsumura, Tomoko; Kim, Sung-Won; Morinaga, Shinichi; Mori, Shinichiro; Kanemaru, Mineo; Hayashi, Tatsuyuki; Takaue, Yoichi; Taniguchi, Shuichi

    2004-08-01

    To investigate clinical characteristics of early central nervous system (CNS) complications after reduced-intensity stem cell transplantation (RIST), we reviewed the medical records of 232 patients who had undergone RIST for hematologic diseases at our institutions between September 1999 and June 2003. All patients had received purine analog-based preparative regimens. Stem cell sources comprised granulocyte colony-stimulating factor-mobilized blood from HLA-identical or 1 locus-mismatched related donors (n = 151), unrelated bone marrow (n = 44), or unrelated cord blood (n = 37). Graft-versus-host disease prophylaxis incorporated cyclosporine with or without methotrexate. Diagnosis of CNS complications was based on clinical, radiologic, and microbiological findings. CNS complications occurred in 18 patients (7.8%), with a median onset of 22 days, and were infectious (n = 1), metabolic (n = 15), or cerebrovascular (n = 2). Symptoms included seizures (n = 7), visual disturbance (n = 2), headache (n = 8), nausea (n = 8), vomiting (n = 6), impaired consciousness (n = 16), and hemiparesis (n = 3). Complications improved promptly in 10 patients, and 8 patients died without improvement within 30 days. Multivariate analysis with logistic regression identified umbilical cord blood transplantation as a significant risk factor for early CNS complications (odds ratio, 14.5; 95% confidence interval, 3.7-56.9; P <.0001). CNS complications are a significant problem after RIST, particularly with umbilical cord blood. Limbic encephalopathy is an unrecognized subtype of neurotoxicity after umbilical cord blood transplantation.

  11. 晚期早产儿围生期危险因素及并发症临床分析%Clinical analysis on the risk factors and complications of late preterm infants

    Institute of Scientific and Technical Information of China (English)

    吴怡玲

    2011-01-01

    Objective; To analyze the risk factors and complications of late preterm infants, provide a basis for prevention and treatment. Methods; The clinical data and perinatal complications of 137 late preterm infants and 329 term infants were analyzed and compared. Results; There was significant difference in Apgar score, birth weight, hospitalization time and maternal high risk factors during perinatal period between the two groups ( P < 0. 05) . The incidences of neonatal jaundice (92.0% ), low blood glucose and low temperature (31. 3% ) , respiratory system diseases ( 17. 5% ) and feeding intolerance (8. 8% ) in study group were significantly higher than those in control group (83.59% , 6. 99% , 2. 43% ,0) ( P <0.05) . The incidence of multiple neonatal complications in study group was 85.40% , which was significantly higher than that in control group (19. 45% ) (P <0. 05) . The incidences of complications among late preterm infants from high to low were listed as follows; jaundice (92. 0% ), cardiovascular system diseases (33. 6% ), low blood glucose and low temperature (31. 3% ), respiratory system diseases (17. 5% ) , intracranial hemorrhage and hypoxic - ischemic encephalopathy (16. 8% ), infectious diseases (14. 6% ) and feeding intolerance (8. 8% ) . Conclusion; Low Apgar score and maternal high risk factors during perinatal period may become risk factors of complications among late preterm infants, the monitoring of high bilirubin, electrocardiogram and blood glucose should be enhanced in clinic for early detection and timely treatment%目的:分析晚期早产儿围生期危险因素及并发症发生情况,为防治提供依据.方法:分析和比较137例晚期早产儿与329例足月儿临床资料和围生期并发症的发病情况.结果:Apgar评分、出生体重、住院天数、母体围产期高危因素方面两组新生儿均存在统计学差异(P<0.05);研究组新生儿黄疸(92.0%)、低血糖低体温(31.3%)、呼吸系统疾病(17.5

  12. Logistic regression analysis of risk factors of Type 2 diabetes mellitus complicated with cardiovascular disease factors%2型糖尿病并发心血管疾病危险因素Logistic 回归分析

    Institute of Scientific and Technical Information of China (English)

    刘明哲

    2015-01-01

    Objective To explore the main risk factors of type 2 diabetes mellitus(T2DM)complicated with cardiovascular disease(CVD).Methods The T2DMof 128 cases of CVD associated with CVD group were selected, the patients with T2DM 107 cases were selected as control group,used Logistic regression method for the analysis of the risk factors of concurrent CVD.Results The risk of CVD in patients with a family history of T2DM was 1.535 times of that of the other patients (OR =1.535,95%CI =1.145,2.057,P =0.036),the vegetarian diet patients was 41.3% (OR =0.413,95%CI =0.210,0.815,P =0.024),in patients with hypertension was 2.077 times (OR =2.077,95%CI =1.301,2.813,P =0.010).T2DM patients with TG,PBG,LDL -C,HDL -C per 1mmol/L rise,the risk of concurrent CVD was 1.192 times of that of the other patients (OR =1.192,95%CI 1.012,1.372, P =0.023),1.125 times(OR =1.125,95%CI =1.043,1.218,P =0.028),1.712 times (OR =1.712,95%CI =1.203,2.231,P =0.009)and 42.6% (OR =0.426,95%CI =0.239,0.776,P =0.011);HbA1c increased every 1%,the risk of concurrent CVD was 1.284 times of that of theother patients (OR =1.284,95%CI =1.132,1.413, P =0.013);BMI increased by 1kg/m2 ,the risk of concurrent CVD was 1.508 times of that of the other patients (OR =1.508,95%CI =1.143,1.825,P =0.026);C2 increased by 1mL/mmHg ×100,the risk was the other patient's 33.9% (OR =1.508,95%CI =1.143,1.825,P =0.026).Conclusion Family history of T2DM,hypertension, TG,PBG,LDL -C,HbA1c and BMI are major risk factors for T2DMwith CVD;vegetarian diet,HDL -C and C2 are protective factors.%目的:探讨2型糖尿病(T2DM)并发心血管疾病(CVD)的主要危险因素。方法选择 T2DM合并 CVD 患者128例为 CVD 组,单纯 T2DM患者107例为对照组,采用 Logistic 回归方法对其并发 CVD 的危险因素进行分析。结果有 T2DM家族史、素食膳食或高血压患者并发 CVD 的危险为其他患者的1.535倍(OR =1.535,95%CI =1.145,2.057,P =0.036)、41.3%(OR =0

  13. Illiteracy and diabetic foot complications.

    Science.gov (United States)

    Al-Kaabi, Juma M; Al Maskari, Fatma; Cragg, Paul; Afandi, Bachar; Souid, Abdul-Kader

    2015-12-01

    Diabetes is especially common in the United Arab Emirates. Its complications in patients residing in the region have yet to be fully explored. This study reports on foot problems in our diabetic patients, with emphasis on the impact of illiteracy on foot care and complications due to diabetes. Adults were randomly recruited from the Diabetes Center at Tawam-John Hopkins affiliated hospital. A questionnaire addressing foot care and problems was completed for all patients. In addition, an examination was performed by a trained nurse, an endocrinologist, and a podiatrist. Four hundred twenty-two adults with type 2 (93%) or type 1 (7%) diabetes were enrolled; 67% were females. Patients' mean age was 52 ± 13 years and duration of diabetes ≥ 1 year. Illiterate patients were 51% and were less likely to practice foot care (p=0.002), recognize foot risk factors (p=0.004), use proper footwear (p=0.010), and being physically active (pIlliteracy invoked significant challenges to diabetic attentiveness and imposed increased foot complications. Physicians should realize that illiterate patients are vulnerable and require effective strategies to improve their education about the disease and reduce their diabetic complications. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  14. Risk factors and prediction of inflammatory complications and local secondary osteoporosis in the bone structure of jaws in dental intraosseous implantation in healthy subjects

    Directory of Open Access Journals (Sweden)

    Mashchenko I.S.

    2013-03-01

    Full Text Available As a result of complex clinical, immunologic and biochemical investigations of 48 patients peculiarities of development of inflammatory com¬plications, local osteoporosis and destruction of bone tissue after performed dental intraosseous implantantion were first revealed. It was shown that multiple surgical traumas of soft tissues of jaws and bone tissue of alveolar processes with putting 4 or more implants simultaneously may lead to reducing biocidity of mucosa of jaw tissues; this promotes lesion of oral cavity hygiene and development of inflammatory process in zone of periimplant. It is set that massive accumulation of soft coat and dental calculus in the area of implant, superconstruction and marked deficit of sIgA production of oral mucosa promote development of periimplant mucositis in remote post-operative period. A sharp production of secretory ІL -1β is a risk factor in formation of general-destructive process in a periimplant zone, development of dental periimplant.

  15. Risk factors of postoperative complications in patients undergoing laparoscopic hysterectomy%腹腔镜下全子宫切除术术后并发症发生的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    姚国荣

    2015-01-01

    目的探讨腹腔镜下全子宫切除术患者术后并发症发生的相关因素。方法回顾性分析106例腹腔镜下全子宫切除术患者的临床资料。结果106例患者术后并发症发生率为14.15%,发生率最高的是皮下气肿(3.77%),其次是残端感染(2.88%)、盆腔包裹性积液(2.88%),盆腔手术史(P=0.037)、术前贫血(P=0.03)、子宫>孕12周大小(P=0.022)、手术时间>120min (P=0.033)、手术出血量>100ml(P=0.013)为术后并发症发生的危险因素,其中术前贫血(OR=9.939,P=0.048)、手术时间>120min (OR=6.120,P=0.038)为术后并发症发生的独立危险因素。结论术前贫血、手术时间>120min为患者术后并发症发生的独立危险因素。%Objective To assess the risk factors of postoperative complications in patients undergoing laparoscopic hysterectomy. Methods Clinical data of 106 patients undergoing laparoscopic total hysterectomy were analyzed retrospectively. Results Incidence rate of postoperative complications of 106 patients was 14.15%. The complication with highest incidence was subcutaneous emphysema (3.77%), fol owed by the vaginal wound infection (2.88%), pelvic cavity effusion (2.88%). History of pelvic surgery (P=0.037), preoperative anemia(P=0.03), uterine size>12w of pregnancy(P=0.022), operation time>120 min (P=0.033), intraoperative blood loss>100 ml (P=0.013) were associated with postoperative complications in laparoscopic total hys-terectomy. Preoperative anemia (OR=9.939, P=0.048) and operation time>120min(OR=6.120, P=0.038) are the independent risk factors of complications for laparoscopic total hysterectomy. Conclusion Preoperative anemia and operation time>120min are related to the incidence of complications for laparoscopic total hysterectomy.

  16. Analysis in Life Quality and Influencing Factors of Patients with Pulmonary Tuberculosis Complicated with Diabetes%肺结核合并糖尿病患者生存质量及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    付喜花; 刘春龙; 陈健儿; 郭健; 黄晓燕; 吴文斌

    2014-01-01

    Objective:To investigate the life quality and influencing factors of patients with pulmonary tuberculosis complicated with diabetes. Meth-ods:WHOQOL-BREF was applied to investigate the life quality of 120 patients with pulmonary tuberculosis complicated with diabetes, which was compared with 40 healthy people. Results:The physiological, psychological, social relationship and environment scores in WHOQOL-BREF scale of observation group were all significantly lower than those of control group (P<0.01). Conclusion:The life quality of patients with pulmonary tubercu-losis complicated with diabetes was worse than that of healthy people, the medical staff should pay attention to improve the life quality of patients’.%目的:探讨肺结核合并糖尿病患者的生存质量及其影响因素。方法:应用世界卫生组织生存质量测定简表(WHO-QOL-BREF)调查120例肺结核合并糖尿病患者的生存质量,并与40例正常人比较。结果:观察组WHOQOL-BREF量表生理、心理、社会关系和环境评分均显著低于对照组(P<0.01)。结论:肺结核合并糖尿病患者生存质量较正常人差,医护人员需重视全面提高患者的生存质量。

  17. Cardiovascular complications of cirrhosis

    DEFF Research Database (Denmark)

    Møller, Søren; Henriksen, Jens Henrik

    2008-01-01

    and electrophysiological abnormalities, an entity that is different from alcoholic heart muscle disease. Being clinically latent, cirrhotic cardiomyopathy can be unmasked by physical or pharmacological strain. Consequently, caution should be exercised in the case of stressful procedures, such as large volume paracentesis......Cardiovascular complications of cirrhosis include cardiac dysfunction and abnormalities in the central, splanchnic and peripheral circulation, and haemodynamic changes caused by humoral and nervous dysregulation. Cirrhotic cardiomyopathy implies systolic and diastolic dysfunction....... The clinical significance of cardiovascular complications and cirrhotic cardiomyopathy is an important topic for future research, and the initiation of new randomised studies of potential treatments for these complications is needed.  ...

  18. Preparation of redispersible liposomal dry powder using an ultrasonic spray freeze-drying technique for transdermal delivery of human epithelial growth factor

    Directory of Open Access Journals (Sweden)

    Yin F

    2014-03-01

    Full Text Available Fei Yin,1 Shiyan Guo,2 Yong Gan,2 Xinxin Zhang21Department of Pharmacy, Liaoning Cancer Hospital and Institute, Shenyang, 2Shanghai Institute of Materia Medica, Chinese Academy of Science, Shanghai, People's Republic of ChinaAbstract: In this work, an ultrasonic spray freeze-drying (USFD technique was used to prepare a stable liposomal dry powder for transdermal delivery of recombinant human epithelial growth factor (rhEGF. Morphology, particle size, entrapment efficiency, in vitro release, and skin permeability were systematically compared between rhEGF liposomal dry powder prepared using USFD and that prepared using a conventional lyophilization process. Porous and spherical particles with high specific area were produced under USFD conditions. USFD effectively avoided formation of ice crystals, disruption of the bilayer structure, and drug leakage during the liposome drying process, and maintained the stability of the rhEGF liposomal formulation during storage. The reconstituted rhEGF liposomes prepared from USFD powder did not show significant changes in morphology, particle size, entrapment efficiency, or in vitro release characteristics compared with those of rhEGF liposomes before drying. Moreover, the rhEGF liposomal powder prepared with USFD exhibited excellent enhanced penetration in ex vivo mouse skin compared with that for powder prepared via conventional lyophilization. The results suggest that ultrasonic USFD is a promising technique for the production of stable protein-loaded liposomal dry powder for application to the skin.Keywords: spray freeze-drying, recombinant human epithelial growth factor, liposomes, skin permeability, transdermal drug delivery

  19. Postoperative Complications and Related Risk Factors in Neurosurgery Patients during Anesthesia Recovery%神经外科患者麻醉恢复期常见并发症及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王云霞; 王会文; 侯春梅; 彭宇明; 菅敏钰; 张雪梅; 房辉; 韩如泉

    2016-01-01

    Objective To investigate the characteristics of postoperative complications and related risk factors in neurosurgery patients. Methods A retrospective study was carried out in neurosurgery patients during anesthesia recovery period from March, 2009 to November, 2013. The recorded complications included respiratory and circulatory system complications, pain, shivering, nausea and vomiting, agitation and delaying recovery. Multivariate logistic regression analysis was performed to screen the risk factors for these complications. Results Da-ta of 13,495 patients were available for analysis. The general incidence was 48.8%. Post-operative complications included post-operative nausea and vomiting (PONV) (14.5%), agitation (13.5%), hypertension (13.4%), arrhythmia (9.3%), shivering (8.9%), pain (5.9%), hypox-emia (2.5%), delayed recovery (1.9%), airway obstruction (1.7%) and hypotension (0.3%). Regression analysis showed that the risk factors for hypoxemia included male,<59 years old and infratentorial tumor (P<0.05);the risk factors for PONV included male, supratentorial tu-mor, infratentorial tumor, cerebrovascular disease, inhalation anesthesia, the use of muscle relaxants antagonism and tramadol (P<0.05);and the risk factors for postoperative restlessness included male, infratentorial tumor and cerebrovascular disease, inhalation anesthesia, the use of muscle relaxants antagonism and no use of patient-controlled analgesia (PCA) pump (P<0.05). Conclusion Patients with different neuro-logical diseases showed different post-operative complications and exhibited different risk factors for these complications. Anesthesiologists should closely monitor patients receiving various neurosurgery and provide timely treatment.%目的:探讨神经外科患者麻醉恢复期常见并发症的发生情况及其相关危险因素。方法回顾性分析2010年3月~2014年11月期间麻醉恢复室神经外科全麻术后的患者,患者信息和并发症情况按统一标准由

  20. 直肠癌腹会阴联合切除术后会阴切口并发症的危险因素分析%Risk factors for the perineal incision complications after abdominoperineal excision for rectal cancer

    Institute of Scientific and Technical Information of China (English)

    王超; 王畅; 高志冬; 梁斌; 杨晓东; 尹慕军; 姜可伟; 谢启伟

    2016-01-01

    目的 探讨直肠癌患者腹会阴联合切除术(APE)后会阴切口并发症发生的危险因素.方法 回顾性分析北京大学人民医院胃肠外科1998年10月至2013年12月间接受腹会阴联合切除术的167例直肠癌患者的临床资料,采用多因素Logistic回归分析术后会阴切口并发症发生的危险因素.结果 全组患者会阴切口并发症总发生率为24.6%(41/167),其中切口感染7例,脂肪液化10例,切口愈合不良21例,切口窦道形成2例,切口裂开1例.单因素分析结果显示,手术时间(χ2=8.008,P=0.005)、术中出血量(χ2=5.672,P=0.017)、手术方式(P=0.048)、术中腹腔植入氟尿嘧啶(5-FU)缓释剂(χ2=6.007,P=0.014)以及淋巴结转移(χ2=7.646,P=0.006)与术后会阴切口并发症的发生有关.而性别、年龄、体质指数(BMI)、美国麻醉医师(ASA)评分、共患疾病、肿瘤远端距肛门距离、术前放化疗、术后入重症监护病房(ICU)、术后前3 d引流总量、肿瘤分化程度、术后病理T、M分期等与术后会阴切口并发症发生无关(均P>0.05).Logistic多因素回归分析结果显示,手术时间≥280 min(OR=5.217,95%CI:1.250~6.234,P=0.000)和术中腹腔植入5-FU缓释剂(OR=3.284,95%CI:1.156~9.334,P=0.026)是APE术后会阴切口并发症发生的独立危险因素.结论 对于施行APE的患者,术中是否予以腹腔植入5-FU缓释剂应权衡利弊,谨慎选择;同时应尽可能缩短手术时间.%Objective To evaluate the factors affecting perineal incision complications after abdominperineal excision (APE) for rectal cancer. Methods This was a retrospective study of 167 patients with rectal cancer undergoing APE at Peking University People′s Hospital between October 1998 and December 2013. Chi-square test and multivariate Logistic regression analysis were used to identify risk factors. Results The overall rate of perineal incision complication was 24.6%(41/167) including 7 cases of incision infection, 10 cases of

  1. Infection and Other Complications

    Science.gov (United States)

    ... 6) Position Papers (9) LSAP Perspective (9) National Lymphedema Network is now hiring! The NLN is looking ... and improve your overall health. Other Complications of Lymphedema The sudden onset of swelling anywhere in the ...

  2. Pertussis (Whooping Cough) Complications

    Science.gov (United States)

    ... CDC Cancel Submit Search The CDC Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... friendly Fact Sheet Pertussis Vaccination Pregnancy and Whooping Cough Clinicians Disease Specifics Treatment Clinical Features Clinical Complications ...

  3. Pregnancy Complications: Bacterial Vaginosis

    Science.gov (United States)

    ... Loss > Pregnancy complications > Bacterial vaginosis and pregnancy Bacterial vaginosis and pregnancy E-mail to a friend Please ... page It's been added to your dashboard . Bacterial vaginosis (also called BV or vaginitis) is an infection ...

  4. Complications of Mumps

    Science.gov (United States)

    ... Serology Publications and Resources Multimedia MMWR Articles Outbreak Articles Related Links World Health Organization Medline Plus Complications of Mumps Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ...

  5. Complications of Circumcision

    Directory of Open Access Journals (Sweden)

    Aaron J. Krill

    2011-01-01

    Full Text Available In the United States, circumcision is a commonly performed procedure. It is a relatively safe procedure with a low overall complication rate. Most complications are minor and can be managed easily. Though uncommon, complications of circumcision do represent a significant percentage of cases seen by pediatric urologists. Often they require surgical correction that results in a significant cost to the health care system. Severe complications are quite rare, but death has been reported as a result in some cases. A thorough and complete preoperative evaluation, focusing on bleeding history and birth history, is imperative. Proper selection of patients based on age and anatomic considerations as well as proper sterile surgical technique are critical to prevent future circumcision-related adverse events.

  6. Complications of shoulder dystocia.

    Science.gov (United States)

    Dajani, Nafisa K; Magann, Everett F

    2014-06-01

    Complications of shoulder dystocia are divided into fetal and maternal. Fetal brachial plexus injury (BPI) is the most common fetal complication occurring in 4-40% of cases. BPI has also been reported in abdominal deliveries and in deliveries not complicated by shoulder dystocia. Fractures of the fetal humerus and clavicle occur in about 10.6% of cases of shoulder dystocia and usually heal with no sequel. Hypoxic ischemic brain injury is reported in 0.5-23% of cases of shoulder dystocia. The risk correlates with the duration of head-to-body delivery and is especially increased when the duration is >5 min. Fetal death is rare and is reported in 0.4% of cases. Maternal complications of shoulder dystocia include post-partum hemorrhage, vaginal lacerations, anal tears, and uterine rupture. The psychological stress impact of shoulder dystocia is under-recognized and deserves counseling prior to home discharge.

  7. Dental Implant Complications.

    Science.gov (United States)

    Liaw, Kevin; Delfini, Ronald H; Abrahams, James J

    2015-10-01

    Dental implants have increased in the last few decades thus increasing the number of complications. Since many of these complications are easily diagnosed on postsurgical images, it is important for radiologists to be familiar with them and to be able to recognize and diagnose them. Radiologists should also have a basic understanding of their treatment. In a pictorial fashion, this article will present the basic complications of dental implants which we have divided into three general categories: biomechanical overload, infection or inflammation, and other causes. Examples of implant fracture, loosening, infection, inflammation from subgingival cement, failure of bone and soft tissue preservation, injury to surround structures, and other complications will be discussed as well as their common imaging appearances and treatment. Lastly, we will review pertinent dental anatomy and important structures that are vital for radiologists to evaluate in postoperative oral cavity imaging.

  8. Complications of pancreatic surgery

    Directory of Open Access Journals (Sweden)

    Åke Andrén-Sandberg

    2011-01-01

    Full Text Available Many diseases, including pancreatitis benign tumors and cancer, may require pancreas surgery. Pancreatic resection can lead to a prolonged survival in pancreatic cancer and even a potential chance for cure. However, the pancreatic surgery can result in complications, and high postoperative morbidity rates are still presence. This article reviews the pancreatic abstracts of American Pancreas Club 2011, which involves the more common complications, their prevention and treatment.

  9. Neurologic complications in oncology

    Directory of Open Access Journals (Sweden)

    Andrea Pace

    2010-06-01

    Full Text Available Neurologic side effects related to cancer therapy are a common problem in oncology practice. These complications can negatively affect the management of the patient, because they can inhibit treatment and diminish quality of life. Therefore specific skills are required to recognise symptoms and clinical manifestations. This review focuses on the most common neurologic complications to improve physician’s familiarity in determining the aetiology of these symptoms.

  10. Risk of placenta-mediated pregnancy complications or pregnancy-related VTE in VTE-asymptomatic families of probands with VTE and heterozygosity for factor V Leiden or G20210 prothrombin mutation.

    Science.gov (United States)

    Cordoba, Iris; Pegenaute, Carlota; González-López, Tomás José; Chillon, Carmen; Sarasquete, Maria Eugenia; Martin-Herrero, Francisco; Guerrero, Carmen; Cabrero, Mónica; Garcia Sanchez, Maria Helena; Pabon, Pedro; Lozano, Francisco Santiago; Gonzalez, Marcos; Alberca, Ignacio; González-Porras, José Ramón

    2012-09-01

    Few studies have evaluated the risk of pregnancy-related adverse events in asymptomatic relatives of probands for VTE and factor V Leiden or the G20210A variant. The antepartum management of this population ranges from antepartum anticoagulation therapy to clinical surveillance. To evaluate the risk of placenta-mediated pregnancy complications and pregnancy-related VTE in VTE-asymptomatic families of probands with VTE and who are heterozygous carriers of either factor V Leiden or PT-G20210A mutation. One hundred and fifty-eight relatives, who had 415 pregnancies, were retrospectively evaluated. Odds ratios and 95% confidence intervals were calculated to compare pregnancy outcomes between women with and without thrombophilia. In the factor V Leiden group, 22 placenta-mediated pregnancy events of 152 pregnancies (14.4%) were reported, compared with 25 adverse events of 172 pregnancies in the G20210A prothrombin group (14.5%) and 13 adverse events of 91 pregnancies in the non-carrier group (14.2%). Carriers of factor V Leiden or G20210A prothrombin were not associated with a higher risk of pregnancy-adverse outcomes compared with non-carriers: OR 1.02 (95% CI, 0.40-2.25) and 1.25 (95% CI, 0.48-3.24), respectively. Four episodes of pregnancy-associated VTE of 415 pregnancies (0.96%) were recorded. Two episodes of VTE in the G20210A group, one in the factor V Leiden group, and one episode in the non-carrier group were noted. In VTE-asymptomatic relatives of probands with VTE, the presence of factor V Leiden or the G20210A prothrombin mutation in heterozygosis should not lead to a decision to instigate antepartum prophylaxis. © 2012 John Wiley & Sons A/S.

  11. [Complications of cesarean deliveries].

    Science.gov (United States)

    Valgeirsdottir, Heiddis; Hardardottir, Hildur; Bjarnadottir, Ragnheidur I

    2010-01-01

    The objective of the study was to determine the rate of complications which accompany cesarean sections at Landspitali University Hospital (LSH). All deliveries by cesarean section from July 1st 2001 to December 31st 2002 were examined in a retrospective manner. Information was collected from maternity records regarding the operation and its complications if they occurred, during or following the operation. During this period 761 women delivered by cesarean section at LSH. The overall complication rate was 35,5%. The most common complications were; blood loss > or =1000 ml (16.5%), post operative fever (12.2%), extension from the uterine incision (7.2%) and need for blood transfusion (4.3%). Blood transfusion was most common in women undergoing cesarean section after attempted instrumental vaginal delivery (20%). Fever and extension from the uterine incision were most common in women undergoing cesarean section after full cervical dilation without attempt of instrumental delivery (19,4%). These complications were least likely to occur if the patient underwent an elective cesarean section. Complications following cesarean section are common, especially if labor is advanced. Each indication for an operative delivery should be carefully weighed and the patient informed accordingly.

  12. Neurologic complications of vaccinations.

    Science.gov (United States)

    Miravalle, Augusto A; Schreiner, Teri

    2014-01-01

    This chapter reviews the most common neurologic disorders associated with common vaccines, evaluates the data linking the disorder with the vaccine, and discusses the potential mechanism of disease. A literature search was conducted in PubMed using a combination of the following terms: vaccines, vaccination, immunization, and neurologic complications. Data were also gathered from publications of the American Academy of Pediatrics Committee on Infectious Diseases, the World Health Organization, the US Centers for Disease Control and Prevention, and the Vaccine Adverse Event Reporting System. Neurologic complications of vaccination are rare. Many associations have been asserted without objective data to support a causal relationship. Rarely, patients with a neurologic complication will have a poor outcome. However, most patients recover fully from the neurologic complication. Vaccinations have altered the landscape of infectious disease. However, perception of risk associated with vaccinations has limited the success of disease eradication measures. Neurologic complications can be severe, and can provoke fear in potential vaccines. Evaluating whether there is causal link between neurologic disorders and vaccinations, not just temporal association, is critical to addressing public misperception of risk of vaccination. Among the vaccines available today, the cost-benefit analysis of vaccinations and complications strongly argues in favor of vaccination. © 2014 Elsevier B.V. All rights reserved.

  13. Risk factors of postoperative pulmonary complications in patients with hepatocellular carcinoma undergoing hepatic resection%肝癌术后肺部并发症危险因素分析

    Institute of Scientific and Technical Information of China (English)

    王东; 曹利平

    2013-01-01

      目的探讨肝癌术后发生肺部并发症的相关因素分析,以期为减少或避免术后肺部并发症的发生提供思路。方法选取行肝癌根治术的肝癌患者105例,其中22例(观察组)术后发生肺部并发症,83例(对照组)术后未发生肺部并发症。比较两组患者的一般资料(性别、年龄、吸烟指数、高血压病史、呼吸系统病史、糖尿病史、术前2周呼吸道感染史、肺部听诊情况)、术前检查结果(肿瘤位置、肿瘤大小、侵犯门静脉、侵犯肝静脉、门静脉癌栓、门静脉宽度、胆红素水平、白蛋白水平、凝血酶原时间、腹水、Child评分、Child分级、ALT、AST、GPT、AFP、血红蛋白水平、血小板、血氧饱和度、ASA分级)以及手术信息(手术切口、手术方式、手术时间、麻醉时间、术中输血量)。对上述比较差异有统计学意义的相关因素,采用非条件二元多因素Logistic回归分析其与肝癌术后肺部并发症的相关性。结果单因素分析显示:低蛋白血症、手术时间、麻醉时间及术中输血量是肝癌术后发生肺部并发症(胸腔积液、肺炎)的危险因素(P<0.05或0.01)。多因素Logistic回归分析结果显示术前白蛋白水平是发生术后肺部并发症的独立危险因素(P<0.05)。结论术前白蛋白水平是肝癌术后肺部并发症的独立危险因素。%Objective To investigate the risk factors of postoperative pulmonary complications in patients with hepatocel-lar carcinoma undergoing hepatic resection. Methods One hundred and six patients with hepatocel ar carcinoma undergoing hepatectomy were included in the study. Postoperative pulmonary complications were identified in 22 patients (Observation group), 84 patients (Control group) did not have postoperative pulmonary complications. The clinical data of two group was com-pared, including general information (sex, age, history of

  14. Effects of reverse osmosis preparation deionized water operation factors%影响反渗透制备脱离子水的运行因素

    Institute of Scientific and Technical Information of China (English)

    陈华; 赵世伟; 夏鑫; 吕冰

    2012-01-01

    Reasons on effects of reverse osmosis preparation deionized water operation factors. Focusing analysis was proceeding, and the prevention measures were put forward.%介绍了影响反渗透装置制备脱离子水的运行因素并进行了有针对性的分析,提出了相应的预防措施。

  15. Factors Governing the Differences in the Degree to Which Preschool Learning Institutions are Prepared to Adopt the Federal State Educational Standard

    Directory of Open Access Journals (Sweden)

    Tatyana Afanaseva

    2015-03-01

    Full Text Available This article briefly describes the methodology and results of an empirical study into the preparedness of preschool learning institutions to adopt the Federal State Educational Standard (FSES, which was conducted as part of developing a theoretical model and tools for streamlining the mechanism of their development. The author identifies factors that determine the differences in the degree to which such institutions are prepared to introduce the FSES and establishes the extent of their impact.

  16. Complications and factors associated with severity of influenza in hospitalized children and adults during the pandemic wave of A(H1N1)pdm2009 infections--the Fluco French cohort.

    Science.gov (United States)

    Ploin, D; Chidiac, C; Carrat, F; Cohen, B; Javouhey, E; Mayaud, C; Desenclos, J-C; Lina, B; Leport, C

    2013-09-01

    The emergence of novel A(H1N1)pdm2009 virus threatened to lead to frequent severe manifestations. To describe the clinical, virological, and biological characteristics of the disease and identify the factors associated with severe presentations. This prospective multicenter study recruited consecutive hospitalized patients with confirmed A(H1N1)pdm2009 disease. Clinical, virological and biological assessments were carried out at inclusion and 30 days post-inclusion. Disease manifestations were assessed by an adjudication committee using pre-identified definitions of complications and severity scores. The study analyzed from November 30th, 2009 to February 8th, 2010, 40 hospitalized patients, 21 children and 19 adults. Eighteen (45%) were considered to have severe presentations. Except age, main characteristics in children and adults did not differ. The majority (18/21) of children and all adults had a respiratory presentation; extra-respiratory manifestations tended to be more frequent in children (12 vs. 6, P=0.10). Two children against 5 adults presented acute respiratory distress syndrome (ARDS, P=0.23), but more children suffered respiratory failure (7 vs. 1, P=0.046) without ARDS. At day 30, one death had occurred in each group. The main factor associated with non-severe presentation was an early (difficulty of carrying a study of this nature in the midst of a pandemic, it allowed the description of a panel of unusual and complicated forms and confirmed the added value of early oseltamivir treatment in limiting severity in hospitalized children and adults. Copyright © 2013 Elsevier B.V. All rights reserved.

  17. Statistical Analysis of Risk Factors on the Hypertensive Disorder Complicating Pregnancy%妊娠期高血压疾病危险因素的统计分析

    Institute of Scientific and Technical Information of China (English)

    徐登可; 张忠占; 张松; 张蕾

    2012-01-01

    Hypertensive disorder complicating pregnancy (HDCP) is a particular disease in the pregnancy. With risk factors appear, such as the fast pace of life, mental stress, the increasing of the elderly primipara, the number of women with HDCP tends to have increased gradually. At present, there are a lot researches about the risk factors of HDCP. In this article, we make variable selection for the risk factors based the double logistic regression models and give a method about forecasting at last.%妊娠期高血压疾病(以下简称妊高病)是妊娠期特有的疾病.随着生活节奏快、精神压力大、高龄初产妇增多等高危因素的凸现,妊高病倾向者也逐渐增多.目前,对妊高病发病高危因素的研究很多.本文基于双重logistic回归模型对影响妊高病的危险因素进行变量选择和预测分析.

  18. Divergent gene expression responses to complicated grief and non-complicated grief.

    Science.gov (United States)

    O'Connor, Mary-Frances; Schultze-Florey, Christian R; Irwin, Michael R; Arevalo, Jesusa M G; Cole, Steven W

    2014-03-01

    The "widowhood effect" (i.e., morbidity/mortality in recently bereaved spouses) may be related to changes in immune function, but little is known about the impact of bereavement on gene transcription in immune cells. This study examined how Complicated Grief and Non-complicated Grief responses to bereavement differentially affect leukocyte gene expression. Genome-wide transcriptional profiling and bioinformatic analyses were completed on 63 older adults. Thirty-six of them had lost their spouse/partner on average 2years ago, and 27 were nonbereaved, married controls. Twelve of the bereaved participants met criteria for Complicated Grief. Compared to nonbereaved controls, bereavement (both Complicated Grief and Non-complicated Grief) was associated with upregulated expression of genes involved in general immunologic activation and a selective downregulation of genes involved in B lymphocyte responses. However, Complicated Grief and Non-complicated Grief differed markedly in their expression of Type I interferon-related transcripts, with Non-complicated Grief subjects showing substantial upregulation relative to nonbereaved controls and Complicated Grief subjects showing substantial downregulation. Bereavement significantly modulates immune function gene expression. The magnitude of bereavement-related distress (i.e., Complicated Grief vs. Non-complicated Grief) is linked to differential patterns of transcription factor activation and gene expression involved in innate antiviral responses. These findings provide a molecular framework for understanding the health effects of bereavement, as well as new insights into the particular gene modules that are most sensitive to the individual's psychological response to loss.

  19. ANALYSIS OF RISK FACTORS OF CIRRHOSIS COMPLICATED BY HEPATOGENOUS DIABETES%肝硬化发生肝源性糖尿病的相关因素分析

    Institute of Scientific and Technical Information of China (English)

    鲍中英; 苑晓冬; 段淑红

    2011-01-01

    [Objective] To analyse the risk factors of hepatogenous diabetes in liver cirrhosis patients. [Methods] One hundred and eighty cirrhosis cases were enrolled and retrospectively analyzed including age, sex, causes and course of cirrhosis, score of Child-pugh, TG (triglyceride), Choi (cholesterol) and the concentrations of serum Fe+to observe the relationship between cirrhosis complicated by hepatogenous diabetes and above indices. SPSS 11.5 software was used for statistic analysis. [Results] The Logistic regression showed that cirrhosis complicated by hepatogenous diabetes had significant relationship with the age, courses of cirrhosis, grade of child-pugh score and infection of HCV (P< 0.05). [Conclusion] The risk factors of cirrhosis complicated by hepatogenous diabetes are age, courses of cirrhosis, grade of child-pugh score and infection of HCV.%[目的]分析肝硬化发生肝源性糖尿病的危险因素.[方法]对180例明确诊断肝硬化的住院病例进行回顾性分析,包括年龄、性别、肝硬化的病因、病程、Child-pugh分级、甘油三酯、胆固醇、血清铁水平,探讨肝硬化发生肝源性糖尿病与上迷指标的相关性,数据分析应用SPSS11.5统计学软件.[结果]经Logistic回归分析显示肝硬化发生肝源性糖尿病与年龄、病程、child-pugh分级、丙型肝炎病毒感染的相关性具有统计学意义(P < 0.05).[结论]肝硬化患者发生肝源性糖尿病的独立危险因素是年龄、肝病病程、child-pugh分级和丙型肝炎病毒感染.

  20. Risk factors for wound complications after internal fixation of distal tibial fracture%胫骨远端骨折内固定治疗术后切口并发症的风险因素分析

    Institute of Scientific and Technical Information of China (English)

    赵晓伟; 张元民; 王国栋; 孟纯阳

    2014-01-01

    Objective To identify risk factors for wound complications related to internal fixation of distal tibial fracture.Methods A total of 125 patients undergone open reduction and internal fixation of the distal tibial fracture between January 2008 and December 2011 were enrolled.There were 72 men and 53 women with mean age of 41.46 years.Factors contributing to operative wound complications assessed were demographic characteristics (age,gender,and smoking history),types of fracture,operative time,time from injury to operation,and concomitant diseases (diabetes and peripheral vascular disease).Patients with wound complications were defined as those requiring dressing care and oral or intravenous antibiotics or those requiring further surgical treatment.Results At follow-up,wound complications were recorded including 1 patient (0.8%) had surgical debridement and 10 patients (8.0%) had dressing care and oral or intravenous antibiotic therapy.Logistic regression analysis identified risk factors for wound complications were open fracture (OR =23.077,95% CI 2.672-199.342,P <0.01) and age (OR =1.078,95% CI 1.011-1.150,P < 0.05).Otherwise,following factors exhibited no significant correlation with wound complications:age,body mass index,smoking history,types of fracture,multiple injury or not,and operative time.Conclusion Patients with older age or open fracture present an increased risk of wound complications after operation and need special concern.%目的 分析胫骨远端骨折内固定术后切口并发症及其相关的风险因素. 方法 纳入2008年1月-2011年12月行切开复位内固定治疗的125例胫骨远端骨折患者,其中男72例,女53例;平均年龄41.46岁.对患者的人口统计学数据(年龄、性别、吸烟史)、骨折类型、手术时间、受伤至手术时间及伴发疾病(糖尿病、周围血管疾病)等变量进行评估分析.对于需要进行换药处理、口服或静脉滴注抗生素或进一步手术治疗的

  1. Risk factors for surgical site infections and other complications in elective surgery in patients with rheumatoid arthritis with special attention for anti-tumor necrosis factor: a large retrospective study.

    NARCIS (Netherlands)

    Broeder, A. den; Creemers, M.C.W.; Fransen, J.; Jong, Eefje de; Rooij, D.J.R.A.M. de; Wymenga, A.B.; Waal Malefijt, M.C. de; Hoogen, F.H.J. van den

    2007-01-01

    OBJECTIVE: To identify risk factors for surgical site infection (SSI) in patients with rheumatoid arthritis (RA) with special attention for anti-tumor necrosis factor (anti-TNF) treatment. METHODS: All patients with RA who had undergone elective orthopedic surgery since introduction of anti-TNF were

  2. The Clinical Analysis of Risk Factors and Complications of 321 Cases of Low Birth Weight%321例低出生体重儿的高危因素及并发症的临床研究

    Institute of Scientific and Technical Information of China (English)

    任春丽; 朱艳菊; 郭艳巍

    2016-01-01

    Objective:To reduce the risk of LBWI and guide the obstetric clinical work through conclu-ding complications and risk factors of low birth weight. Methods: Clinical data of 321 cases with low birth weight in our hospital was collected and analyzed. Results:Risk factors of low birth weight were mainly gesta-tional hypertension disease, premature rupture of membranes, twins, spontaneous preterm birth and placenta previa, etc. Complications were mainly anemia, hypoalbuminemia, pathological jaundice, NRDS, pneumoni-a, sepsis, neonatal asphyxia, cerebral white matter lesions, wet lung, congenital heart disease, low blood sugar, intracranial hemorrhage, BPD, HIE and NEC. The risk rate of premature births less than 34 weeks in-creased significantly. Conclusions:High-risk groups should be taken seriously in clinical work, the quality of antenatal examination should be improved, and the rescue of critically ill premature infants should be strength-ened, to achieve early detection and intervention, to reduce the complications of low birth weight and improve the survival rate, through the analysis of high-risk factors and complications of low birth weight.%目的:分析总结低出生体重儿的高危因素及并发症,为指导产科临床工作,降低LBWI发生几率提供依据.方法:对我院收治的低出生体重儿321例进行临床资料收集及整理分析.结果:低出生体重儿高危因素主要是:妊娠期高血压疾病、胎膜早破、双胎、自发早产、前置胎盘等.并发症主要是:贫血、低蛋白血症、病理性黄疸、NRDS、肺炎、败血症、新生儿窒息、脑白质病变、湿肺、先天性心脏病、低血糖、颅内出血、BPD、HIE、NEC.且<34周早产儿发生几率明显升高.结论:通过对低出生体重儿的高危因素及并发症的分析,临床工作中需重视高危人群、提高产检质量、加强危重早产儿的抢救水平以达到早发现、早干预,降低低出生体重儿的并发症,提高存活率.

  3. Complications after Hip Arthroscopy

    Science.gov (United States)

    Larson, Christopher M.; Clohisy, John C.; Beaule, Paul; Kelly, Bryan T.; Giveans, Russell; Stone, Rebecca M.; Samuelson, Kathryn M.

    2013-01-01

    Objectives: There is very little published literature looking at comprehensive complication rates after hip arthroscopy with current techniques and indications. Methods: Between 01/2011 and 11/2012, 1,026 consecutive hips (507 males, 519 females) with a mean age of 31.2 years (range 12 - 73) underwent hip arthroscopy at three institutions. The diagnosis, demographic information, and procedures were recorded, and a validated complications grading classification for hip joint surgery (Clavian classification) was utilized for all patients prospectively. Results: There were 951 primary hip arthroscopies and 75 revision hip arthroscopies. Arthroscopy was performed for FAI in 936 hips (91.2%), and 760 hips (74.1%) had a labral repair and 229 hips (22.3%) had a labral debridement. The most common event (18.7% of hips) noted was post-operative sensory disturbance adjacent to the portals or involving the distal anterolateral thigh consistent with LFC nerve disturbance. This was typically not noticed by patients and found on physical examination and only persisted beyond 6 months in 7 hips (0.7%). Iatrogenic chondral injury was noted for 20 hips (1.9%), iatrogenic labral puncture in 11 hips (1.1%), superficial portal infection in 6 hips (0.6%), sensory deficit about the foot in 9 hips (0.9%), deep venous thrombosis in 3 hips (0.3%), pulminary embolism in 1 hip (0.1%), pulmonary edema in 1 hip (0.1%), wound hematoma in 2 hips (0.2%), perineal numbness (pudendal nerve) in 9 hips (0.9%), heterotopic ossification in 4 hips (0.4%), reflex sympathetic dystrophy in 1 hip (0.1%) and wound/skin (traction) dehiscence in 1 hips (0.1%). There were no femoral neck fractures, iatrogenic instability, AVN, or extra-abdominal fluid extravasation in this cohort. The overall complication rate not including temporary periportal and thigh numbness (sequalae) was 6.9% (71 hips). Overall 88.7% had a grade 1, 5.6% Grade 2, 4.2% grade 3, and 1.4% grade 4 complication. There was no difference in the

  4. [Surgical complications of pancreatectomy].

    Science.gov (United States)

    Sauvanet, A

    2008-01-01

    The mortality for pancreatectomy has decreased to a very low level in recent years but morbidity remains high. The most frequent post-operative complications of pancreaticoduodenectomy (PD) are delayed gastric emptying (DGE) in 20% and pancreatic fistula (PF) in 10-15%. DGE is associated with other abdominal complications in half the cases; these must be delineated by CT scan and specifically treated. Isolated DGE usually resolves within three weeks with the use of nasogastric suction and pro-kinetic drugs. FP following PD may be preventable with the use of temporary trans-jejunal intubation of Wirsung's duct or by intussusception of the pancreatic margin into the jejunal lumen. FP occurring after PD will heal with conservative management (total parenteral nutrition, peripancreatic drainage, somatostatin analogues) in 80-90% of cases but secondary complications such as peritonitis, arterial erosion and pseudo-aneurysm may be life-threatening. Early hemorrhage (in the first 48-72 hours) must be treated by re-operation. Late hemorrhage (usually secondary to PF) and ischemic complications are rare (3% and 1% respectively), difficult to treat, and associated with high mortality. PF is also the main complication of distal pancreatectomy and enucleation of pancreatic tumors (10-20% and 30% respectively). These PF resolve with conservative treatment in more than 95% of cases but may justify an ERCP sphincterotomy if drainage is prolonged. After medial pancreatectomy, PF occurs in 20-30% of cases, arising from either of the two transected pancreatic surfaces.

  5. Metabolomics in diabetic complications.

    Science.gov (United States)

    Filla, Laura A; Edwards, James L

    2016-04-01

    With a global prevalence of 9%, diabetes is the direct cause of millions of deaths each year and is quickly becoming a health crisis. Major long-term complications of diabetes arise from persistent oxidative stress and dysfunction in multiple metabolic pathways. The most serious complications involve vascular damage and include cardiovascular disease as well as microvascular disorders such as nephropathy, neuropathy, and retinopathy. Current clinical analyses like glycated hemoglobin and plasma glucose measurements hold some value as prognostic indicators of the severity of complications, but investigations into the underlying pathophysiology are still lacking. Advancements in biotechnology hold the key to uncovering new pathways and establishing therapeutic targets. Metabolomics, the study of small endogenous molecules, is a powerful toolset for studying pathophysiological processes and has been used to elucidate metabolic signatures of diabetes in various biological systems. Current challenges in the field involve correlating these biomarkers to specific complications to provide a better prediction of future risk and disease progression. This review will highlight the progress that has been made in the field of metabolomics including technological advancements, the identification of potential biomarkers, and metabolic pathways relevant to macro- and microvascular diabetic complications.

  6. 慢性肾功能衰竭患者心血管并发症相关危险因素分析%Analysis on the risk factors of cardiovascular complications in patients with chronic renal failures

    Institute of Scientific and Technical Information of China (English)

    宋宏雁

    2014-01-01

    目的:探讨慢性肾功能衰竭患者常见心血管并发症及其相关影响因素.方法:对2009-01/2013-10我院透析科住院的86例慢性肾功能衰竭患者分为心血管并发症组(A组)和无心血管并发症组(B 组),每组各43 例,对慢性肾功能衰竭患者心血管方面的并发症情况进行系统性分析.结果:A 组43 例中,心绞痛7 例,心肌梗死3 例,心律失常22 例,心力衰竭11 例,猝死2 例;B 组43 例中,42 例无心血管病并发症,其中死亡1 例.将A 组与B 组比较,发现C 反应蛋白(CRP)显著增加,同型半胱氨酸(Hcy)和心肌肌钙蛋白(cTnT)也显著升高(P <0.001 ),而内皮素(ET1 )、一氧化氮(NO)在两组无明显差异.结论:慢性肾功能衰竭患者心血管方面的并发症主要有心律失常、心力衰竭、心绞痛、心肌梗死和猝死,其中以心律失常最常见,其次是心理衰竭,cTnT 增高是居危险因素之首,CRP 和Hcy 也是主要的危险因素,所以临床对慢性肾功能衰竭患者心血管并发症患者应引起足够重视,及时预防不良后果的发生,减低死亡率。%AIM:To explore the common cardiovascular compli-cations in patients with chronic renal failure and related influen-cing factors.METHODS:86 patients with chronic renal failure, admitted to our hospital from January 2009 to October 2013 were divided into Group A (chronic renal patients with cardiovascular complications)and Group B(chronic renal patients without cardi-ovascular complications),with 43 cases in each group.Condi-tions of cardiovascular complications in patients with chronic renal failure were systematically analyzed.RESULTS:In all 43 cases of Group A,there were seven angina pectoris cases,three myo-cardial infarction cases,twenty two arrhythmia cases,eleven heart failure cases and two sudden deaths.While in Group B,42 cases presented no cardiovascular complications

  7. Placenta associated pregnancy complications in pregnancies complicated with placenta previa

    National Research Council Canada - National Science Library

    Yael Baumfeld; Reli Herskovitz; Zehavi Bar Niv; Salvatore Andrea Mastrolia; Adi Y. Weintraub

    2017-01-01

    Objectives: The purpose of our study was to examine the hypothesis that pregnancies complicated with placenta previa have an increased risk of placental insufficiency associated pregnancy complications...

  8. Complication with intraosseous access

    DEFF Research Database (Denmark)

    Hallas, Peter; Brabrand, Mikkel; Folkestad, Lars

    2013-01-01

    INTRODUCTION: Intraosseous access (IO) is indicated if vascular access cannot be quickly established during resuscitation. Complication rates are estimated to be low, based on small patient series, model or cadaver studies, and case reports. However, user experience with IO use in real...... physicians, anesthesiologists and pediatricians. RESULTS: 1,802 clinical cases of IO use was reported by n=386 responders. Commonly reported complications with establishing IO access were patient discomfort/pain (7.1%), difficulties with penetration of periosteum with IO needle (10.3%), difficulties...... with aspiration of bone marrow (12.3%), and bended/broken needle (4.0%). When using an established IO access the reported complications were difficulties with injection fluid and drugs after IO insertion (7.4%), slow infusion (despite use of pressure bag) (8.8%), displacement after insertion (8...

  9. Pneumothorax Complicating Coaxial and Non-coaxial CT-Guided Lung Biopsy: Comparative Analysis of Determining Risk Factors and Management of Pneumothorax in a Retrospective Review of 650 Patients

    Energy Technology Data Exchange (ETDEWEB)

    Nour-Eldin, Nour-Eldin A., E-mail: nour410@hotmail.com; Alsubhi, Mohammed, E-mail: mohammedal-subhi@yahoo.com; Emam, Ahmed, E-mail: morgan101002@hotmail.com; Lehnert, Thomas, E-mail: thomas.lehnert@kgu.de; Beeres, Martin, E-mail: beeres@gmx.net; Jacobi, Volkmar, E-mail: volkmar.jacobi@kgu.de; Gruber-Rouh, Tatjana, E-mail: tatjanagruber2004@yahoo.com; Scholtz, Jan-Erik, E-mail: janerikscholtz@gmail.com; Vogl, Thomas J., E-mail: t.vogl@em.uni-frankfurt.de; Naguib, Nagy N., E-mail: nagynnn@yahoo.com [Johan Wolfgang Goethe – University Hospital, Institute for Diagnostic and Interventional Radiology (Germany)

    2016-02-15

    PurposeTo assess the scope and determining risk factors related to the development of pneumothorax throughout CT-guided biopsy of pulmonary lesions in coaxial and non-coaxial techniques and the outcome of its management.Materials and MethodsThe 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 in a retrospective design. Patients were classified according to lung biopsy technique into 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 related to the occurrence of pneumothorax were classified into: (a) Technical risk factors, (b) patient-related risk factors, and (c) lesion-associated risk factors. Radiological assessments were performed by two radiologists in consensus. Mann–Whitney U test and Fisher’s exact tests were used for statistical analysis. p values <0.05 were considered statistically significant.ResultsThe incidence of pneumothorax complicating CT-guided lung biopsy was less in the non-coaxial group (23.2 %, 77 out of 332) than the coaxial group (27 %, 86 out of 318). However, the difference in incidence between both groups was statistically insignificant (p = 0.14). Significant risk factors for the development of pneumothorax in both groups were emphysema (p < 0.001 in both groups), traversing a fissure with the biopsy needle (p value 0.005 in non-coaxial group and 0.001 in coaxial group), small lesion, less than 2 cm in diameter (p value of 0.02 in both groups), location of the lesion in the basal or mid sections of the lung (p = 0.003 and <0.001 in non-coaxial and coaxial groups, respectively), and increased needle track path within the lung tissue of more than 2.5 cm (p = 0.01 in both

  10. 2型糖尿病合并泌尿系感染的危险因素及病原体分析%Analysis of Risk Factors of Type 2 Diabetes Mellitus Complicated with Urinary Tract Infection and Pathogen

    Institute of Scientific and Technical Information of China (English)

    杨早香

    2014-01-01

    Objective:To investigate the risk factors of type 2 diabetes mellitus complicated with urinary tract infection and pathogen.Method:The patients were observed and 176 cases of patients with type 2 diabetes mellitus complicated with urinary tract infection in 176 cases of clinically diagnosed type 2 diabetic non urinary tract infection patients,with or without concurrent other complications,and compared between the two groups of fasting blood glucose,24 hours urine protein,BUN,Cr results,and the type 2 diabetes combined with urinary infection pathogens were retrospectively analyzed.Result:The risk of type 2 diabetes mellitus complicated with urinary tract infection factors including 176 cases of long duration,complications,blood glucose concentration was high. The urine protein,BUN,Cr,and other factors,the detection of pathogens were Escherichia coli(61.9%),followed by Staphylococcus epidermidis(10.8%), checked out Klebsiella pneumonia(8.0%),Candida albicans(5.7%),Proteus(5.1%),Bauman Acinetobacter(2.8%),Enterobacter cloacae(2.3%),Staphylococcus aureus(1.7%),Pseudomonas aeruginosa(2.3%),Streptococcus faecalis(2.3%),the ratio was not high,but also can not be ignored.Conclusion:Understanding the risk factors of type 2 diabetes mellitus complicated with urinary tract infection and type specific pathogens can provide reasonable basis for the clinical early treatment,prevention is more effective in patients with type 2 diabetes mellitus urinary tract infection,improve the survival rate and the quality of life.%目的:探讨2型糖尿病合并泌尿系感染的危险因素及常见病原体。方法:观察176例经临床确诊的2型糖尿病合并泌尿系感染的患者与同期176例2型糖尿病非泌尿系感染的患者的病程、有无并发其他并发症及比较两组空腹血糖浓度、24 h尿蛋白、BUN、Cr的结果,并对2型糖尿病合并泌尿系感染检出的病原体进行回顾性分析。结果:176例2型糖尿病合并泌尿系感染的

  11. 腹股沟疝无张力修补术后并发症的多发因素分析%Risk factors for complications after inguinal hernia tension-free repair

    Institute of Scientific and Technical Information of China (English)

    刘磊; 王成宏; 丁锐; 童钟; 黄俊; 陈婧; 杨海涛; 黄强

    2014-01-01

    Objective To investigate risk factors associated with complications in inguinal hernia tension-free repair.Methods Clinical data of 497 patients with inguinal hernia treated at the Three Affiliated Hospital of Anhui Medical University from January 201 0 to September 201 3 were retrospectively analyzed to find the relationship between postoperative complication and clinical factors.Results The overall complication in a total of 497 patients were 46 cases,including wound infection in 1 0 cases,seroma in 8 cases,scrotal hydrops in 1 3 cases,foreign body sensation and chronic pain in 1 5 cases.Univariate analysis showed that body mass index (BMI)and hernia ring adhesion degree were associated with the postoperative complications.The gender(χ2 =0.1 20,P=0.729),age(χ2 =0.005,P=0.945),hernia types(χ2 =0.042, P=0.979),inguinal hernia size (χ2 =0.1 74,P =0.676 ),mesh types (χ2 =0.226,P =0.635 )and anesthesia(χ2 =0.001 ,P=0.977)had no significant effect on the occurrence of postoperative complications. When analyzed by multivariable logistic regression,BMI and hernia ring adhesion degree remained as the significant risk factors(P=0.01 8,0.045 ).Conclusion The BMI and the extent of hernia ring adhesion were two independent risk factors for the development ofpostoperative complications following tension-free inguinal hernia repair.%目的:探讨腹股沟疝无张力修补术术后并发症发生的危险因素。方法回顾性分析2010年1月至2013年9月,安徽医科大学第三附属医院收治的497例腹股沟疝无张力修补术患者的临床资料。研究术后的并发症发生率与临床病例因素的关系。结果497例患者中,术后出现并发症46例(切口感染10例,浆液样肿8例,阴囊肿胀13例,异物感及慢性疼痛15例)。单因素分析显示,患者的体重指数(BMI)、疝环粘连程度与术后并发症的发生有关,患者的性别(χ2=0.120,P=0.729)、年龄(χ2=0.005,P=0.945

  12. Ocular complications of orbital venography.

    Science.gov (United States)

    Safer, J N; Guibor, P

    1975-03-01

    Three ocular complications directly related to orbital venography are described, one resulting in permanent loss of vision,. The patient had lymphangioma of the orbit which evidently had bled secondary to increased venous pressure and injection of contrast bolus. Both of the 2 patients with transient visual disturbances had diabetic retinopathy. The common factor is felt to be an imparied vascular bed which cannot meet the stress of increased venous pressure and contrast medium injection. Conditions which predispose to ocular-orbital stasis and/or hemorrhage are discussed.

  13. Complications after placement of peritoneal catheter

    Directory of Open Access Journals (Sweden)

    Đurđević-Mirković Tatjana

    2011-01-01

    Full Text Available Introduction. Peritoneal dialysis is one of the modalities used for treatment of end-stage chronic kidney failure. Nowadays, this method is complementary to haemodialysis and renal transplantation. Owing to the rich vascularization of the peritoneum, it is used in the processes of osmosis and diffusion, enabling the removal of uremic material from the body. The procedure includes introduction of peritoneal fluid via the peritoneal catheter. Complications. The catheter is placed through the anterior abdominal wall with its tip positioned in the small pelvis. There are several techniques for catheter placement considered minimally invasive, which, however, may be associated with various complications. These complications can be divided into mechanical (catheter dysfunction, cuff protrusion, hernia, dialysate leaks, visceral perforation and infectious (early peritonitis, exit site or tunnel infection, surgical wounds. In most cases, such complications are rare and can be successfully managed using conservative therapy; however, in some situations severe complications can endanger the life of the patient. On-time recognition of complications, particularly in patients at risk, is of paramount importance for an effective treatment. The development of complications can increase the morbidity and the chance of treatment failure, and therefore transfer to haemodialysis. Conclusion. The preoperative evaluation and determination of the risk factors as well as the early recognition and adequate management of complications are essential in their prevention.

  14. Laparoscopic surgery in children: abdominal wall complications

    Directory of Open Access Journals (Sweden)

    Vaccaro S.

    2017-06-01

    Full Text Available Minimal invasive surgery has become the standard of care for operations involving the thoracic and abdominal cavities for all ages. Laparoscopic complications can occur as well as more invasive surgical procedures and we can classify them into non-specific and specific. Our goal is to analyze the most influential available scientific literature and to expose important and recognized advices in order to reduce these complications. We examined the mechanism, risk factors, treatment and tried to outline how to prevent two major abdominal wall complications related to laparoscopy: bleeding and port site herniation .

  15. Complications in colorectal surgery.

    Science.gov (United States)

    Frischer, Jason S; Rymeski, Beth

    2016-12-01

    Colorectal pediatric surgery is a diverse field that encompasses many different procedures. The pullthrough for Hirschsprung disease, the posterior sagittal anorectoplasty for anorectal malformations including complex cloaca reconstructions and the ileal pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis present some of the most technically challenging procedures pediatric surgeons undertake. Many children prevail successfully following these surgical interventions, however, a small number of patients suffer from complications following these procedures. Anticipated postoperative problems are discussed along with medical and surgical strategies for managing these complications. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Complications of pneumatic retinopexy.

    Science.gov (United States)

    Kovacević, D; Bedenicki, I

    2001-01-01

    Twenty-eight patients with rhegmatogenous retinal detachment were treated by pneumatic retinopexy using intravitreal perfluorpropane (C3F8) gas. Reattachment was successfully achieved in 22 eyes (78.6%) after one treatment. Most of the eyes were myopic and had a single retinal break or group of breaks within one o'clock hour. All retinal complications developed in the inferior retinal quadrants with postoperative proliferative vitreoretinopathy (PVR) as one of the most serious complications, occurring in 3 (10.7%) eyes. New retinal breaks developed in 2 (7.1%) eyes.

  17. Complications of cosmetic tattoos.

    Science.gov (United States)

    De Cuyper, Christa

    2015-01-01

    Cosmetic tattoos, which are better known as permanent make-up, have become popular in the last decades. This same procedure can be used to camouflage pathological skin conditions, to mask scars and to complete the aesthetic results of plastic and reconstructive surgeries. The risks and complications of tattooing procedures include infections and allergic reactions. Scarring can occur. Fanning and fading of the colorants and dissatisfaction with colour and shape are not unusual. Different lasers can offer solutions for the removal of unwanted cosmetic tattoos, but complications due to the laser treatment, such as paradoxical darkening and scarring, can arise.

  18. [Orbital complications of sinusitis].

    Science.gov (United States)

    Šuchaň, M; Horňák, M; Kaliarik, L; Krempaská, S; Koštialová, T; Kovaľ, J

    2014-12-01

    Orbital complications categorised by Chandler are emergency. They need early diagnosis and agresive treatment. Stage and origin of orbital complications are identified by rhinoendoscopy, ophtalmologic examination and CT of orbite and paranasal sinuses. Periorbital cellulitis and early stage of orbital cellulitis can be treated conservatively with i. v. antibiotics. Monitoring of laboratory parameters and ophtalmologic symptoms is mandatory. Lack of improvement or worsening of symptoms within 24-48 hours and advanced stages of orbital complications are indicated for surgery. The purpose of the study is to evaluate epidemiology, clinical features and management of sinogenic orbital complications. Retrospective data of 8 patients with suspicion of orbital complication admited to hospital from 2008 to 2013 were evaluated. Patients were analyzed in terms of gender, age, CT findings, microbiology, clinical features, stage and treatment. Male and female were afected in rate 1,66:1. Most of patients were young adult in 3rd. and 4th. decade of life (62,5 %). Acute and chronic sinusitis were cause of orbital complication in the same rate. The most common origin of orbital complication was ethmoiditis (62,5 %), than maxillary (25 %) and frontal (12,5 %) sinusitis. Polysinusitis with affection of ethmoidal, maxillary and frontal sinuses (75 %) was usual CT finding. Staphylococcus epidermidis and Staphylococcus aureus were etiological agens in half of cases. Periorbital oedema (100 %), proptosis, chemosis (50 %), diplopia and glaucoma (12,5 %) were observed. Based on examinations, diagnosis of periorbital oedema/preseptal cellulitis was made in 3 (37,5 %), orbital cellulitis in 3 (37,5 %) and subperiosteal abscess in 2 cases (25 %). All patients underwent combined therapy - i. v. antibiotics and surgery within 24 hours. Eradication of disease from ostiomeatal complex (OMC), drainage of affected sinuses and drainage of subperiosteal abscess were done via fuctional endonasal

  19. Complicated necrotizing otitis externa.

    Science.gov (United States)

    Nawas, Mariam T; Daruwalla, Vistasp J; Spirer, David; Micco, Alan G; Nemeth, Alexander J

    2013-01-01

    Necrotizing (malignant) otitis externa (NOE) is a rare and invasive infection originating in the external acoustic meatus seen most commonly in diabetes and other immunocompromised states. After a protracted course, disease can smolder and extend into the mastoid, skull base, dural sinuses, and intracranially. We present a case of NOE complicated by mastoiditis, dural sinus thrombosis, and Bezold's abscess in an uncontrolled diabetic presenting with a prolonged course of facial nerve palsy. We stress the importance of maintaining a high index of clinical suspicion for NOE in diabetic patients and offering timely, aggressive treatment to mitigate its complications.

  20. Pediatric ventriculoperitoneal shunts and their complications: An analysis

    Directory of Open Access Journals (Sweden)

    Nitin Agarwal

    2017-01-01

    Conclusion: With this retrospective review of complications of VP shunts, age at initial shunt insertion and the interval between the age of initial shunt placement and onset of complications were the most important patient-related predictors of shunt failure. The different predominant etiological factors responsible for early and late shunt failure were infective and mechanical complications, respectively.

  1. Fatores associados às complicações em crianças pré-escolares com pneumonia adquirida na comunidade Factors associated with complications of community-acquired pneumonia in preschool children

    Directory of Open Access Journals (Sweden)

    Pollyana Garcia Amorim

    2012-10-01

    Full Text Available OBJETIVO: Identificar os fatores socioeconômicos e clínicos associados à evolução para complicações em crianças internadas com pneumonia adquirida na comunidade (PAC. MÉTODOS: Estudo longitudinal prospectivo em crianças diagnosticadas com PAC (12-59 meses de idade internadas em enfermarias gerais de pediatria de dois hospitais na região de Campinas (SP. Os critérios de exclusão foram ter fibrose cística, cardiopatia, malformação pulmonar, neuropatias e doenças genéticas. PAC foi diagnosticada por características clínicas e radiológicas. Os dados foram coletados dos prontuários médicos e por um questionário semiestruturado. Os sujeitos foram divididos em dois grupos (PAC complicada e não complicada. Foram comparadas variáveis socioeconômicas e clínicas, e foi realizada análise de regressão logística multivariada. RESULTADOS: Das 63 crianças incluídas, 29 e 34, respectivamente, apresentaram PAC não complicada e PAC complicada. Não houve diferenças estatisticamente significantes entre os grupos quanto a idade na admissão, idade gestacional, peso ao nascer, gênero ou variáveis socioeconômicas. Houve diferenças significantes entre os grupos em relação a pneumonia anterior (p = 0,03, antibioticoterapia prévia (p = 0,004, tempo de início da doença (p = 0,01, duração da febre antes da internação (p OBJECTIVE: To identify socioeconomic factors and clinical factors associated with the development of complications in preschool children hospitalized with community-acquired pneumonia (CAP. METHODS: This was a prospective longitudinal study involving children (12-59 months of age diagnosed with CAP and admitted to the pediatric wards of two hospitals in the metropolitan area of Campinas, Brazil. Children with cystic fibrosis, heart disease, pulmonary malformations, neurological disorders, or genetic diseases were excluded. The diagnosis of CAP was based on clinical and radiological findings. Data were

  2. Risk factors of post endoscopic retrograde cholangiopancreatography complicated pancreatitis%经内镜逆行胰胆管造影术后并发胰腺炎危险因素分析

    Institute of Scientific and Technical Information of China (English)

    黄继征; 霞明; 龚传明; 程建国; 文峰

    2011-01-01

    Objective To explore the risk factors of post endoscopic retrograde cholangiopancreatography(ERCP) complicated pancreatitis(PEP) and to provide references to its prevention. Methods Totally 1 896 patients who underwent ERCP were divided into PEP group ( n= 285) and non-PEP group ( n= 1 161 ). The risk factors of patients, operation and operator were analyzed. Results In patient factors, female, age( less than 60), pancreatitis history,without choledocholithiasis, suspected Oddi's sphincter dysfunction were the risk factors for PEP ( P < 0.05 ), but bilirubin increase, common bile duct diameter( less than 0.4cm), ampulla diverticulum, complicated diabetes or hypertension were not related with PEP( P > 0.05 ). In operation factors, pancreas imaging, pancreatic duct sphincterotomy, aerocyst dilatation of bililary sphincter muscle were related with PEP( P < 0.05 ), but the remedial or diagnostic ERCP, Oddi's sphincterometry, bile duct sphincterotomy were not related with PEP. For operators, fewer operation cases, prolonged operation time and difficult intubation were related with PEP ( P < 0.05 ), but ERCP operation defeat was not the risk factor for PEP ( P>0.05 ). Conclusion Female, aged under 60, pancreatitis history, suspected Oddi's sphincter dysfunction, poor pancreas imaging and operator's skill as well as difficult intubation were the main risk factors for PEP.%目的 探讨经内镜逆行胰胆管造影术(ERCP)后并发胰腺炎(PEP)的危险因素,为PEP的预防提供参考.方法 回顾性分析1 896例ERCP患者,分为PEP组(n=285)及无PEP组(n=1 161),对比分析两组各相关危险因素,涉及患者因素、操作因素及术者因素.结果 患者因素中女性、年龄(小于60岁)、胰腺炎病史、无胆总管结石、疑有Oddi括约肌功能障碍者易并发PEP(P0.05).操作因素中胰腺显影、胰管括约肌切开术、胆道括约肌气囊扩张术患者在PEP组所占比例明显高于无PEP组(P0.05).结论 年龄小于60

  3. Perioperative complications in revision hip surgery.

    Science.gov (United States)

    Thomasson, E; Guingand, O; Terracher, R; Mazel, C

    2001-01-01

    Revision hip surgery now constitutes 10-30% of all joint procedures. The morbidity and associated with this demanding operation are not well established. The goal of this paper is to determine these rates and to identify some predictive factors. The complication rate ranges from 31,5 to more than 77% in the literature. Life threatening complications represent 1,8 to 8% of these, leading to death in about 1,6%. ASA score and age above 75 appear to be correlated with medical complications. The injection rate varies from 1 to 5,8%, and may be as high as 14% in cases with a past history of infection. Heterotopic ossification occurred in 13 to 65%, reaching severity in 3,3 to 8,3%. Surgical complications include dislocation and femoral injuries. Dislocations occur in almost 10%, leading to revision in1-4,2%. Age and the number of previous surgical operations appear to be significant risk factors. Femoral injuries (perforations or femoral fractures) occur in 6-37%, especially in impaction grafting technique and when uncemented implants are used. Age over 75 years and femoral defects appear to be significant risk factors for femoral fractures. The rate of complications in revision hip surgery continues to be high, but successful clinical outcome can be attained even in elderly patients. Attentive preoperative exams, good prevention of technical pitfalls, the experience of the surgeon and the use of specific tools may decrease these complications and make this demanding procedure safer.

  4. Neurological Complications of Lyme Disease

    Science.gov (United States)

    ... here Home » Disorders » All Disorders Neurological Complications of Lyme Disease Information Page Neurological Complications of Lyme Disease Information Page What research is being done? The ...

  5. Logistic regression analysis of risk factors of stress complications in patients with multiple trauma%多发伤患者应激并发症危险因素的logistic回归分析

    Institute of Scientific and Technical Information of China (English)

    徐文鹏; 应佑国; 方玉明; 秦宗和

    2014-01-01

    目的:探讨导致多发伤患者应激并发症相关的危险因素。方法:对64例多发伤患者应激并发症危险因素的相关指标进行单因素及多因素logistic 回归分析,收集血常规、C反应蛋白、血糖、血电解质、血气分析、肝肾功能等指标以及测定血清总三碘甲状腺原氨酸(TT3)、血清游离三碘甲状腺原氨酸(FT3)、血清总甲状腺素(TT4)、血清游离总甲状腺素、促甲状腺激素、促肾上腺皮质激素( ACTH)、血皮质醇( COR)、生长激素,细胞因子白介素( IL)-1、IL-6、IL-8、IL-10、肿瘤坏死因子( TNF-α)等。结果:64例出现应激性溃疡、急性呼吸窘迫综合征等应激并发症48例,出现应激并发症和无并发症患者,急性生理与慢性健康(APACH)Ⅱ评分、COR、ACTH、TT3、FT3、TT4、IL-6、IL-8、IL-10、TNF-α等差异均有统计学意义(P<0.05~P<0.01);多因素logistic分析表明,APACH Ⅱ评分、TT4、COR、IL-6和IL-10为早期应激并发症的独立危险因素(P<0.05~P<0.01)。结论:多发伤患者APACHⅡ评分以及创伤后TT4、COR、IL-6、IL-10等指标的变化与患者应激性消化道出血及呼吸窘迫综合征等应激并发症的出现密切相关。%Objective:To investigate the risk factors of stress complications in patients with multiple trauma. Methods:The clinical data of stress complications in 64 patients with multiple trauma were analyzed by univariate and multivariate binary Logistic regression. The data of routine blood,c-reactive protein,blood sugar,blood electrolytes,blood gas analysis,indexes of liver and kidney function, serum total iodine thyroid glycine(TT3),serum free thyroid original three iodine glycine(FT3),total serum thyroxine(TT4),serum free thyroid hormone,thyroid stimulating hormone,adrenocorticotropic hormone(ACTH),blood cortisol(COR),growth hormone,cytokine interleukin(IL)-1,IL-6,IL 8,IL-10 and tumor necrosis factor(TNF-α) in all cases were investigated. Results

  6. Analysis of influence factors of depression in gestation complicated with diabetes mellitus patients%妊娠合并糖尿病患者发生抑郁情况的影响因素分析

    Institute of Scientific and Technical Information of China (English)

    黄宏超; 李阳; 魏文峰; 刘子杰

    2015-01-01

    目的:探究分析妊娠合并糖尿病患者发生抑郁情况的影响因素。方法160例妊娠合并糖尿病患者作为试验组,随机选取同期入院的160例正常孕妇作为对照组。采用抑郁自评量表(SDS)对所有患者进行抑郁情况评分,并记录比较两组患者抑郁发生率,采用Logistic回归分析妊娠合并糖尿病患者发生抑郁的影响因素。结果多因素Logistic回归分析结果显示,并发症、年龄、社会支持(SSRS)总分是2型糖尿病(T2DM)患者合并抑郁的影响因素, OR值分别为1.892、0.672、0.558;试验组患者糖化血红蛋白水平、妊娠期抑郁发生率及SDS评分情况均明显高于对照组,组间比较差异有统计学意义(P<0.05);回归分析结果显示,孕妇年龄、体质量指数(BMI)、不良孕史、糖尿病病程以及孕期糖化血红蛋白水平在一定程度上均与抑郁的发生有关(P<0.05)。结论妊娠合并糖尿病患者在妊娠期间易发生抑郁,患者糖化血红蛋白含量与抑郁程度明显相关,而抑郁情况与妊娠结局息息相关,采用有效方法控制孕妇血糖值,改善抑郁状态,对于改善妊娠结局有积极意义。%Objective To investigate and analyze the influence factors of depression in gestation complicated with diabetes mellitus patients.Methods There were 160 gestation complicated with diabetes mellitus patients in experimental group, and another 160 healthy pregnant women in the same admission period in control group. Self-rating depression scale (SDS) was applied for grading depression status in all patients, and records were made on incidences of depression for comparison between the two groups. Influence factors of depression in gestation complicated with diabetes mellitus patients were analyzed by Logistic regression.Results Multivariate Logistic regression showed that complications, age and total score of social support rating scale (SSRS) were the influencing factors of

  7. Treatment of complicated grief

    Directory of Open Access Journals (Sweden)

    Rita Rosner

    2011-11-01

    Full Text Available Following the death of a loved one, a small group of grievers develop an abnormal grieving style, termed complicated or prolonged grief. In the effort to establish complicated grief as a disorder in DSM and ICD, several attempts have been made over the past two decades to establish symptom criteria for this form of grieving. Complicated grief is different from depression and PTSD yet often comorbid with other psychological disorders. Meta-analyses of grief interventions show small to medium effect sizes, with only few studies yielding large effect sizes. In this article, an integrative cognitive behavioral treatment manual for complicated grief disorder (CG-CBT of 25 individual sessions is described. Three treatment phases, each entailing several treatment strategies, allow patients to stabilize, explore, and confront the most painful aspects of the loss, and finally to integrate and transform their grief. Core aspects are cognitive restructuring and confrontation. Special attention is given to practical exercises. This article includes the case report of a woman whose daughter committed suicide.

  8. [Voluminous complicated epigastric hernia].

    Science.gov (United States)

    Palade, R; Voiculescu, D; Suliman, E; Lutic, C

    2009-01-01

    Epigastric hernia, apparently minor injury, neglected can reach impressive sizes, with major un-esthetic effect. In an unfavorable clinically context (morbid obesity, chronic respiratory failure, ground cancer, diabetes, heart failure) complications occur (incarceration, strangulation) with a complex picture. We present three clinical observations, including a low occlusion by fixed transverse colon necrosis in a strangulated epigastric hernia with pyo-stercoral phlegmon.

  9. Cardiovascular Complications of Pregnancy

    Directory of Open Access Journals (Sweden)

    Maria Carolina Gongora

    2015-10-01

    Full Text Available Pregnancy causes significant metabolic and hemodynamic changes in a woman’s physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia, gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.

  10. Cardiovascular Complications of Pregnancy.

    Science.gov (United States)

    Gongora, Maria Carolina; Wenger, Nanette K

    2015-10-09

    Pregnancy causes significant metabolic and hemodynamic changes in a woman's physiology to allow for fetal growth. The inability to adapt to these changes might result in the development of hypertensive disorders of pregnancy (hypertension, preeclampsia or eclampsia), gestational diabetes and preterm birth. Contrary to previous beliefs these complications are not limited to the pregnancy period and may leave permanent vascular and metabolic damage. There is in addition, a direct association between these disorders and increased risk of future cardiovascular disease (CVD, including hypertension, ischemic heart disease, heart failure and stroke) and diabetes mellitus. Despite abundant evidence of this association, women who present with these complications of pregnancy do not receive adequate postpartum follow up and counseling regarding their increased risk of future CVD. The postpartum period in these women represents a unique opportunity to intervene with lifestyle modifications designed to reduce the development of premature cardiovascular complications. In some cases it allows early diagnosis and treatment of chronic hypertension or diabetes mellitus. The awareness of this relationship is growing in the medical community, especially among obstetricians and primary care physicians, who play a pivotal role in detecting these complications and assuring appropriate follow up.

  11. 水性聚氨酯的制备及影响其性能因素%Preparation of Aqueous Polyurethane and Its Influencing Factors of Performance

    Institute of Scientific and Technical Information of China (English)

    桑潇

    2012-01-01

    Waterborne polyurethane is using water as medium,has noncombustible,non-toxic,no pollution,energy saving and easy storage and other advantages,easy to use.This paper discusses the preparation of waterborne polyurethane with raw material and preparation method thereof,as well as the influence of the performance factor.%水性聚氨酯是以水作为介质,具有不燃、无毒、无污染、节省能源及易贮存等优点,使用方便。本文论述了制备水性聚氨酯所用的原料和制备方法,以及影响其性能的因数。

  12. A novel collagen/platelet-rich plasma (COL/PRP) scaffold: preparation and growth factor release analysis.

    Science.gov (United States)

    Zhang, Xiujie; Wang, Jingwei; Ren, Mingguang; Li, Lifeng; Wang, Qingwen; Hou, Xiaohua

    2016-06-01

    Platelet-rich plasma (PRP) has been widely used in clinical practice for more than 20 years because it causes the release of many growth factors. However, the burst release pattern and short release period of PRP have become obstacles to its application. An optimal controllable release system is an urgent need for researchers. This study investigated whether collagen/PRP (COL/PRP) scaffolds can serve as a vehicle for the controllable release of growth factors. We fabricated a novel scaffold that integrates PRP activated by thrombin or collagen into type I collagen. The mechanical properties, cytotoxicity, and transforming growth factor β1 (TGF-β1), platelet derived growth factor (PDGF), fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF) content were evaluated. Our results demonstrate that the COL/PRP scaffolds were not cytotoxic to L-929 fibroblasts. The PDGF and FGF content in the thrombin group was at a higher level and lasted for a long period of time. Collagen and thrombin played the same role in the release of TGF-β1 and VEGF. These data suggest that the novel COL/PRP scaffolds provide a carrier for the controllable release of growth factors and may be used in tissue- regenerative therapies.

  13. Respiratory complications in the pediatric postanesthesia care unit.

    Science.gov (United States)

    von Ungern-Sternberg, Britta S

    2014-03-01

    This article focuses on common respiratory complications in the postanesthesia care unit (PACU). Approximately 1 in 10 children present with respiratory complications in the PACU. The article highlights risk factors and at-risk populations. The physiologic and pathophysiologic background and causes for respiratory complications in the PACU are explained and suggestions given for an optimization of the anesthesia management in the perioperative period. Furthermore, the recognition, prevention, and treatment of these complications in the PACU are discussed.

  14. 252例老年颅内肿瘤术后并发症的相关因素分析%Risk factors related to surgical complications in 252 elderly brain tumors

    Institute of Scientific and Technical Information of China (English)

    陈晓霖; 赵元立; 王硕; 叶迅; 赵继宗

    2013-01-01

    目的 分析与老年颅内肿瘤术后并发症相关的因素.方法 对北京天坛医院2005年1月至2007年12月252例手术治疗的老年颅内肿瘤相关资料进行回顾性研究.分析诸多临床因素与老年颅内肿瘤患者术后发生并发症的关系.应用SPSS 13.0软件进行单因素分析和多因素Logistic 回归分析.结果 单因素分析显示,术前患者卡氏评分(KPS)、肿瘤部位、术中出血量、麻醉时间、手术时间等与术后并发症的发生有关.多因素分析显示,术前患者KPS评分和肿瘤部位是术后并发症的主要影响因素.结论 术前KPS小于90分和肿瘤位于幕下等是术后并发症的主要影响因素.术中出血量、麻醉时间以及手术时间等因素也与术后并发症发生率有一定相关.而年龄、性别、肿瘤切除程度和术前美国麻醉师协会评分(ASA)等在本研究中显示不是术后并发症的主要影响因素.%Objective To investigate the factors associated with surgical complications.Methods A consecutive series of 252 surgeries performed from January 2005 to December 2007 were retrospectively analyzed.Age,sex,preoperative Karnofsky scale (KPS),American Society of Anesthesiologists (ASA) status,anatomic localization,extent of tumor resection,bleeding volume,anesthesia time and duration of the whole operation were evaluated.Results In multivariate analysis,only pre-operative KPS (P =0.001) and infratentorial tumors (P =0.019) showed the significant association with post-operative complications.Conclusion It shows that the preoperative KP5 and infratentorial location are the factors related to post-operative complications,whereas age,sex,ASA status,extent of tumor resection,the bleeding volume,anesthesia time and duration of the whole operation are not the risk factors.

  15. Risk factor analysis and prevention of acute cerebral infarction complicated with pulmonary infection%急性脑梗死合并肺部感染的危险因素分析及防治

    Institute of Scientific and Technical Information of China (English)

    茆华武

    2012-01-01

    目的 探讨急性脑梗死合并肺部感染的相关危险因素以及防治措施,为该病的治疗提供参考依据.方法 回顾性分析2010年5月~2012年4月本院收治的90例急性脑梗死患者,分为肺部感染组28例和对照组62例,分析相关危险因素及防治措施.结果 与对照组比较,肺部感染组合并吞咽困难、意识障碍以及大面积脑梗死、肺部疾病等基础疾病明显增多;肺部感染组NIHSS、临床神经功能缺损评分较对照组明显升高;肺部感染组血清的pH、氧分压(PaO2)、CO2分压(PaCO2)、全血高切黏度均与对照组差异显著,且血清肿瘤坏死因子-α和白细胞介素-6明显高于对照组.结论 COPD病史、入院时NIHSS 评分高、吞咽困难、意识障碍、大面积脑梗死以及基础疾病是急性脑梗死合并肺部感染的危险因素,一旦诊断,应当给予积极有效的治疗,包括保持呼吸道通畅,及时改善肺功能,纠正脑缺氧,降低脑梗死面积,协助患者经常改变体位,合理选用抗生素,加强营养支持等.%Objective To study the associated risk factors and prevention of acute cerebral infarction complicated with pulmonary infection, so as to provide the references for treatment. Methods Ninety patients with acute cerebral infarction complicated with pulmonary infection from 2010 May to 2012 April in our hospital were divided into pulmonary infection group (n =28) and control group (n =62). The associated risk factors and prevention were analyzed. Results Compared with the control group, the dysphagia, disturbance of consciousness, large area cerebral infarction, and pulmonary disease increased significantly in pulmonary infection group. The NIHSS score, neural function defect score of pulmonary infection group were significantly higher than that in the control group. The scrum pH, PaC>2, PaCO2, whole blood viscosity in the two groups had significant difference, and the serum TNF-a and IL 6 of pulmonary infection

  16. Cavity Preparation/assembly Techniques and Impact on Q, Realistic Q - Factors in a Module, Review of Modules

    Energy Technology Data Exchange (ETDEWEB)

    Peter Kneisel

    2005-03-19

    This contribution summarizes the surface preparation procedures for niobium cavities presently used both in laboratory experiments and for modules, such as buffered chemical polishing (BCP), electropolishing (EP), high pressure ultrapure water rinsing (HPR), CO{sub 2} snow cleaning and high temperature heat treatments for hydrogen degassing or postpurification. The impact of surface treatments and the degree of cleanliness during assembly procedures on cavity performance (Q - value and accelerating gradient E{sub acc}) will be discussed. In addition, an attempt will be made to summarize the experiences made in module assemblies in different labs/projects such as DESY(TTF), Jlab (Upgrade) and SNS.

  17. Cavity preparation/assembly techniques and impact on Q, realistic Q-factors in a module, review of modules

    Science.gov (United States)

    Kneisel, Peter

    2006-02-01

    This contribution summarizes the surface preparation procedures for niobium cavities presently used both in laboratory experiments and for modules, such as buffered chemical polishing (BCP), electropolishing (EP), high pressure ultrapure water rinsing (HPR), CO 2 snow cleaning and high temperature heat treatments for hydrogen degassing or post-purification. The impact of surface treatments and the degree of cleanliness during assembly procedures on cavity performance ( Q-value and accelerating gradient Eacc) will be discussed. In addition, an attempt will be made to summarize the experiences made in module assemblies in different labs/projects such as DESY (TTF), Jlab (Upgrade) and SNS.

  18. Cavity preparation/assembly techniques and impact on Q, realistic Q-factors in a module, review of modules

    Energy Technology Data Exchange (ETDEWEB)

    Kneisel, Peter [Jefferson Laboratory, 12000 Jefferson Avenue, Newport News, VA 23606 (United States)]. E-mail: kneisel@jlab.org

    2006-02-01

    This contribution summarizes the surface preparation procedures for niobium cavities presently used both in laboratory experiments and for modules, such as buffered chemical polishing (BCP), electropolishing (EP), high pressure ultrapure water rinsing (HPR), CO{sub 2} snow cleaning and high temperature heat treatments for hydrogen degassing or post-purification. The impact of surface treatments and the degree of cleanliness during assembly procedures on cavity performance (Q-value and accelerating gradient E {sub acc}) will be discussed. In addition, an attempt will be made to summarize the experiences made in module assemblies in different labs/projects such as DESY (TTF), Jlab (Upgrade) and SNS.

  19. Hemorrhagic complications and risk factors in transrectal ultrasound-guided prostate biopsies%经直肠超声引导前列腺穿刺引起出血并发症的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    李岩密; 唐杰; 徐丽; 杨敬春; 张舜欣; 费翔

    2008-01-01

    目的 探讨经直肠超声(TRUS)引导前列腺穿刺的出血性并发症及其有关的可能危险因素.方法 对252例行TRUS引导前列腺穿刺活检者进行病例对照研究,对比分析穿刺后出现出血事件者和非出血组的相关因素(年龄、病理诊断、前列腺体积、高血压、糖尿病、服用抑制血小板聚集及抗凝药物、穿刺针数),采用非条件Logistic回归进行多因素分析.结果 血尿是最常见的穿刺后出血事件(19.1%).特征分析年龄和前列腺体积在两组的构成情况有差异.多因素分析出血事件具有统计学意义的相关因素包括年龄(OR=0.97,95% CI:0.942 1.000)和前列腺的体积(OR=0.989,95% CI:0.979~0.999).穿刺后血尿具有统计学意义的相关因素有3个:前列腺癌患者(OR=0.479,95% CI:0.236~0.975)、前列腺体积(OR=0.987,95% CI:0.976~0.999)、穿刺前服用抑制血小板聚集及抗凝药物者(OR=3.589,95% CI:1.133~11.366).结论 TRUS引导前列腺穿刺活检是安全、有效的.年龄和前列腺体积与出血事件的发生率有关;前列腺癌患者及前列腺体积是穿刺后出现血尿的相关因素;服用抑制血小板聚集及抗凝药物是穿刺后出现血尿的危险因素.%Objective To determine the rate of hemorrhagic complications and the possible risk factors in transrectal ultrasound(TRUS)guided prostate biopsies.Methods TRUS guided prostate biopsies were carried out in 252 patients.Chi-aquare test,t test,conditional Logistic regression were used to comparatively analyze the risk factors(age,presence of prostate cancer,the volume of prostate,arterial hypertension,diabetes mellitus,use of acetylsalicylic acid and anticoagulant,number of samples)between hemorrhagic patients and non-hemorrhagic groups.Results Hematuria was the most frequent sing in all complications,corresponding to 19.1% of the cases.According to the general feature analysis between two groups,age and the volume of the prostate were significant

  20. Decompressive craniotomy: prognostic factors and complications in 89 patients Craniotomia descompressiva: análise de fatores prognósticos e complicações em 89 pacientes

    Directory of Open Access Journals (Sweden)

    Rodrigo Moreira Faleiro

    2008-06-01

    Full Text Available Decompressive craniotom