Gender-specific differences in haemostatic parameters and their influence on blood loss in bimaxillary surgery

Abstract Objective The objectives of this prospective cohort study were to establish gender-related differences in blood loss and haemostatic profiles associated with bimaxillary surgery. In addition, we aimed to identify if any gender differences could be established which might help predict blood loss volume. Materials and methods Fifty-four patients (22 males; 32 females) undergoing bimaxillary surgery for skeletal dentofacial deformities were eligible for inclusion. Blood samples were taken 1 day preoperatively and 48 h postoperatively for detailed gender-specific coagulation analysis incorporating global coagulation assays (endogenous thrombin potential) and specific coagulation parameters. Blood loss was measured at two different time points: (1) the end of surgery, visible intraoperative blood loss (IOB) using ‘subtraction method’; and (2) 48 h postoperatively perioperative bleeding volume (CBL-48 h) using ‘haemoglobin-balance method’ and Nadler’s formula. Correlation and regression analyses were performed to identify relevant parameters affecting the amount of blood loss. Results Significant differences in IOB and CBL-48 h were observed (p < 0.001). Men had higher IOB versus women, lacking statistical significance (p = 0.056). In contrast, men had significantly higher CLB-48 h (p = 0.019). Reduced CBL-48 h was shown to be most closely associated with the level of Antithrombin-III being decreased in females. Conclusions Male gender is associated with higher IOB and CBL-48 compared with females. Gender does not affect IOB regarding haemostatic profile but does correlate strongly with procedure length. Conversely, CBL-48 is closely associated with gender-specific imbalances in the anticoagulant system. Clinical relevance Knowledge of gender-related differences will help clinicians establish predictive factors regarding excessive blood loss in orthognathic surgery and identify at-risk patients.

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Does robotic assisted technology improve the accuracy of acetabular component positioning in patients with DDH?

Journal of Orthopaedic Surgery ◽

10.1177/23094990211025325 ◽

2021 ◽

Vol 29 (2) ◽

pp. 230949902110253

Author(s):

Yixin Zhou ◽

Hongyi Shao ◽

Yong Huang ◽

Wang Deng ◽

Dejin Yang ◽

...

Keyword(s):

Blood Loss ◽

Acetabular Component ◽

Statistical Significance ◽

Conventional Group ◽

Robotic Technology ◽

Robotic Group ◽

Surgical Time ◽

Robotic Assisted ◽

Perioperative Bleeding ◽

Safe Zones

Background: Accurate positioning of the acetabular component is key in performing total hip arthroplasty (THA). However, reconstruction of the acetabulum in the setting of developmental dysplasia of the hip (DDH) is a challenge. Robotic assisted THA has the potential to improve the accuracy of implantation of the acetabular cup in cases with DDH. The purpose of this study was to assess whether robotic technology improves the accuracy of acetabular component positioning in patients with DDH. Material and methods: We included 59 THAs using robotic assisted technology from June 2019 to January 2020 as the study group. These were compared to conventional THAs without robotic technology after control for age, gender, body mass index (BMI), Crowe type and operation date. Radiographic measurements were taken by 2 blinded orthopaedic residents. The percentage of hips within the Lewinnek and Collanan safe zones were calculated, along with acetabular rotation centers for the “target zone.” Surgical time and perioperative bleeding were also compared between both groups. Results: One patient suffered dislocation in conventional group while no dislocation occurred in robotic group. The acetabular components of the robotic assisted group had more cases located within the Lewinnek ( p = 0.013) and Collanan ( p = 0.008) safe zones than conventional group (94.9% vs 79.7% and 74.6% vs 50.8%). There were 7 cases in conventional group and 4 cases in robotic group that had more lateral or more superior rotational centers of THA, but did not reach statistical significance ( p = 0.342). No statistical difference was detected between groups with regards to blood loss ( p = 0.098) and surgical time ( p = 0.602). Conclusion: Robot assisted technology can assist surgeons with implanting acetabular cups more in Lewinnek and Callanan safe zone than conventional techniques without additional blood loss and surgical time. Level of Evidence: Therapeutic Level Ⅲ.

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Controlled Hemostasis in Thoracic Surgery Using Drugs with Oxidized Cellulose

Acta Medica (Hradec Kralove Czech Republic) ◽

10.14712/18059694.2016.40 ◽

2011 ◽

Vol 54 (4) ◽

pp. 153-156 ◽

Cited By ~ 2

Author(s):

Petr Habal ◽

Nedal Omran ◽

Jiří Manďák ◽

Jiří Šimek ◽

Milan Štětina

Keyword(s):

Blood Loss ◽

Thoracic Surgery ◽

Cancer Stage ◽

Oxidized Cellulose ◽

Surgical Results ◽

Extended Resection ◽

The Third ◽

Perioperative Blood Loss ◽

Perioperative Bleeding ◽

Risk Patients

The authors demonstrate the possibility of improving surgical results by the reduction of perioperative bleeding in thoracic surgery associated with extended resection procedures. We focused on patients in whom the expected perioperative blood loss was greater than 500 ml. The first group consisted of patients with lung cancer stage III A after neoadjuvant chemotherapy had been indicated to extend the resection procedure. The second group consisted of patients with chest wall and mediastinum tumors of various etiologies. The third group consisted of patients with post-inflammatory thoracic complications in whom combined decortication and pleurectomy was necessary. By the using the local hemostyptic Traumastem TAF on the basis of oxidized cellulose, it is possible to minimize the perioperative blood loss, thus sparing the blood derivative requirement and enabling surgeons to provide the desired treatment even to high-risk patients.

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Gender-specific differences in the expression of selenoproteins in mammals

Experimental and Clinical Endocrinology & Diabetes ◽

10.1055/s-2005-862874 ◽

2005 ◽

Vol 113 (S 1) ◽

Author(s):

C Riese ◽

F Streckfuss ◽

U Schweizer ◽

J Köhrle ◽

L Schomburg

Keyword(s):

Gender Specific Differences ◽

Gender Specific

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Gender-specific differences in the pattern of gene expression during post-MI remodeling

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-2006-925793 ◽

2006 ◽

Vol 54 (S 1) ◽

Author(s):

M Bauer ◽

G Mitterer ◽

W Dietl ◽

K Trescher ◽

E Wolner ◽

...

Keyword(s):

Gene Expression ◽

Gender Specific Differences ◽

Gender Specific

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Faculty Opinions recommendation of Gender-Specific Differences in All-Cause Mortality Between Incomplete and Complete Revascularization in Patients With ST-Elevation Myocardial Infarction and Multi-Vessel Coronary Artery Disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.732770788.793543712 ◽

2018 ◽

Author(s):

Wilbert Aronow

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Coronary Artery ◽

Complete Revascularization ◽

All Cause Mortality ◽

Gender Specific Differences ◽

St Elevation ◽

Artery Disease ◽

Gender Specific ◽

Vessel Coronary Artery

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Antithrombotic drugs have a minimal effect on intraoperative blood loss during emergency surgery for generalized peritonitis: a nationwide retrospective cohort study in Japan

World Journal of Emergency Surgery ◽

10.1186/s13017-021-00374-z ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Tadashi Matsuoka ◽

Nao Ichihara ◽

Hiroharu Shinozaki ◽

Kenji Kobayashi ◽

Alan Kawarai Lefor ◽

...

Keyword(s):

Cohort Study ◽

Propensity Score ◽

Blood Loss ◽

Emergency Surgery ◽

Retrospective Cohort ◽

Confounding Factors ◽

Intraoperative Blood Loss ◽

Antithrombotic Drugs ◽

Generalized Peritonitis ◽

Blood Loss Volume

Abstract Background The effect of antithrombotic drugs on intraoperative operative blood loss volume in patients undergoing emergency surgery for generalized peritonitis is not well defined. The purpose of this study was to investigate the effect of antithrombotic drugs on intraoperative blood loss in patients with generalized peritonitis using a nationwide surgical registry in Japan. Method This retrospective cohort study used a nationwide surgical registry data from 2011 to 2017 in Japan. Propensity score matching for the use of antithrombotic drugs was used for the adjustment of age, gender, comorbidities, frailty, preoperative state, types of surgery, surgical approach, laboratory data, and others. The main outcome was intraoperative blood loss: comparison of intraoperative blood loss, ratio of intraoperative blood loss after adjusted for confounding factors, and variable importance of all covariates. Results A total of 70,105 of the eligible 75,666 patients were included in this study, and 2947 patients were taking antithrombotic drugs. Propensity score matching yielded 2864 well-balanced pairs. The blood loss volume was slightly higher in the antithrombotic drug group (100 [10–349] vs 70 [10–299] ml). After adjustment for confounding factors, the use of antithrombotic drugs was related to a 1.30-fold increase in intraoperative blood loss compared to non-use of antithrombotic drugs (95% CI, 1.16–1.45). The variable importance revealed that the effect of the use of antithrombotic drugs was minimal compared with surgical approach or type of surgery. Conclusion This study shows that while taking antithrombotic drugs is associated with a slight increase in intraoperative blood loss in patients undergoing emergency surgery for generalized peritonitis, the effect is likely of minimal clinical significance.

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Bugs That Can Resist Antibiotics but Not Men: Gender-Specific Differences in Notified Infections and Colonisations in Germany, 2010–2019

Microorganisms ◽

10.3390/microorganisms9050894 ◽

2021 ◽

Vol 9 (5) ◽

pp. 894

Author(s):

Michael Brandl ◽

Alexandra Hoffmann ◽

Niklas Willrich ◽

Annicka Reuss ◽

Felix Reichert ◽

...

Keyword(s):

Methicillin Resistant Staphylococcus Aureus ◽

Incidence Rates ◽

Federal State ◽

German Population ◽

Hygiene Measures ◽

Invasive Infections ◽

Gender Specific Differences ◽

Acinetobacter Spp ◽

Notification Data ◽

Gender Specific

Data from surveillance networks show that men have a higher incidence rate of infections with anti-microbial-resistant (AMR) pathogens than women. We systematically analysed data of infections and colonisations with AMR pathogens under mandatory surveillance in Germany to quantify gender-specific differences. We calculated incidence-rates (IR) per 100,000 person–years for invasive infections with Methicillin-resistant Staphylococcus aureus (MRSA), and for infections or colonisations with carbapenem-non-susceptible Acinetobacter spp. (CRA), and Enterobacterales (CRE), using the entire German population as a denominator. We limited the study periods to years with complete notification data (MRSA: 2010–2019, CRA/CRE: 2017–2019). We used Poisson regression to adjust for gender, age group, federal state, and year of notification. In the study periods, IR for all notifications were 4.2 for MRSA, 0.90 for CRA, and 4.8 for CRE per 100,000 person-–years. The adjusted IR ratio for infections of men compared to women was 2.3 (95% confidence interval [CI]: 2.2–2.3) for MRSA, 2.2 (95%CI: 1.9–2.7) for CRA, and 1.7 (95%CI: 1.6–1.8) for CRE. Men in Germany show about double the risk for infection with AMR pathogens than women. This was also true for colonisations, where data were available. Screening procedures and associated hygiene measures may profit from a gender-stratified approach.

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The effect of short-term use of finasteride versus cyproterone acetate on perioperative blood loss with monopolar transurethral resection of prostate

African Journal of Urology ◽

10.1186/s12301-021-00211-4 ◽

2021 ◽

Vol 27 (1) ◽

Author(s):

Shabieb A. Abdelbaki ◽

Adel Al-Falah ◽

Mohamed Alhefnawy ◽

Ahmed Abozeid ◽

Abdallah Fathi

Keyword(s):

Blood Loss ◽

Transurethral Resection ◽

Cyproterone Acetate ◽

Histopathological Examination ◽

Microvascular Density ◽

Controlled Study ◽

Control Group ◽

Transurethral Resection Of Prostate ◽

Perioperative Bleeding ◽

And Control

Abstract Background Perioperative bleeding is the most common complication related to transurethral resection of prostate; the aim of the study was to compare the effect of pre-operative use of finasteride versus cyproterone acetate (CPA) on blood loss with monopolar TURP. Methods This prospective randomized controlled study was conducted on (60) patients with BPH underwent monopolar TURP between July 2019 and July 2020. Patients were distributed into three equal groups; CPA group: 20 patients received cyproterone acetate 50 mg tab BID for two weeks before TURP, finasteride group: 20 patients received single daily dose of finasteride 5 mg for two weeks before TURP, control group: 20 patients received no treatment before TURP, all patients underwent monopolar TURP, and then histopathological examination of the resected tissues was done with assessment of the microvascular density of the prostate. Results Our study showed that there was significant decrease in intraoperative blood loss and operative time in CPA and finasteride groups in comparison with control group (p = 0.0012) (p < 0.0001), respectively, significant decrease in post-operative Hb and HCT value in finasteride and control groups in comparison with CPA group (p < 0.01), significant increase in specimen weight in CPA group compared to other groups (p < 0.01), and there was also significant decrease in microvascular density in CPA group in comparison with other groups (p < 0.01). Conclusion Cyproterone acetate is more effective than finasteride in decreasing perioperative bleeding with TURP by decreasing microvascular density of the prostate.

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