MP53-11 MORBIDITY AND PREDICTORS FOR DELAYED RECOGNITION OF IATROGENIC URETERIC INJURIES

Introduction: Although intraoperative iatrogenic ureteric injuries (IUI) are rare, significant consequences can occur if they are unrecognized at the time. The focus of our study is to characterize the associated morbidity and identify predictors of delayed recognition of IUI. Methods: Sunnybrook Health Sciences Centre Research Ethics Board approved the study. Patients with a diagnosis of IUI between 2002 and 2020 were identified through an institutional electronic medical record system. Data pertaining to the demographic characteristics, diagnosis, and management of IUI and overall outcomes were collected retrospectively. Results: Of the 103 patients identified, 83% were female, 52% had previous abdominal surgery, and 18% had previous radiation. The median age was 67 (21–88) years. Twenty percent were not recognized at the time of surgery. Although delayed recognition was not a significant predictor for poor outcome after subsequent repair (i.e., hydronephrosis, ureteric stricture/obstruction), it was associated with substantial morbidity to the patient (i.e., additional procedures) and increased cost to the healthcare system (i.e., longer hospital stay, readmission to hospital). Patients who underwent laparoscopic surgery had an 11 times more likely chance of having an unrecognized IUI as compared to those who underwent open surgery (odds ratio 11.515, p=0.0001). Conclusions: Delayed recognition of IUI may be associated with considerable adverse effects. In this retrospective case series, we identified laparoscopic surgery as a significant predictor for delayed recognition of IUI. This information underscores the need for future studies to facilitate intraoperative identification of ureteric injuries, particularly during laparoscopic procedures.

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A case of delayed recognition: Frederick Winslow Taylor and the immediacy of reinforcement.

American Psychologist ◽

10.1037/0003-066x.37.3.340 ◽

1982 ◽

Vol 37 (3) ◽

pp. 340-342 ◽

Cited By ~ 1

Author(s):

Ludy T. Benjamin ◽

Robert Perloff

Keyword(s):

Delayed Recognition

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Collaboration and individual memory: Evidence from immediate and delayed recognition

PsycEXTRA Dataset ◽

10.1037/e527352012-199 ◽

2006 ◽

Author(s):

Suparna Rajaram ◽

Luciane P. Pereira-Pasarin

Keyword(s):

Individual Memory ◽

Delayed Recognition

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Attention Deficit Hyperactivity Disorder in Autism Spectrum Disorder

The Oxford Handbook of Autism and Co-Occurring Psychiatric Conditions ◽

10.1093/oxfordhb/9780190910761.013.9 ◽

2020 ◽

pp. 158-176

Author(s):

Karen Bearss ◽

Aaron J. Kaat

Keyword(s):

Autism Spectrum Disorder ◽

Attention Deficit Hyperactivity Disorder ◽

Attention Deficit ◽

Autism Spectrum ◽

Developmental Trajectory ◽

Spectrum Disorder ◽

Adhd Symptoms ◽

Functional Impairments ◽

Hyperactivity Disorder ◽

Delayed Recognition

This chapter will review the available evidence on individuals with co-occurring diagnoses of autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). This chapter contends that children diagnosed with both disorders (ASD+ADHD) are a subset of the ASD population that is at risk for delayed recognition of their ASD diagnosis, poor treatment response, and poorer functional outcomes compared to those with ASD without ADHD. Specifically, the chapter highlights the best estimates of the prevalence of the comorbidity, the developmental trajectory of people with co-occurring ASD and ADHD, how ADHD symptoms change across development, overlapping genetic and neurobiological risk factors, psychometrics of ADHD diagnostic instruments in an ASD population, neuropsychological and functional impairments associated with co-occurring ASD and ADHD, and the current state of evidence-based treatment for both ASD and ADHD symptoms. Finally, the chapter discusses fruitful avenues of research for improving understanding of this high-risk comorbidity so that mechanism-to-treatment pathways for ADHD in children with ASD can be better developed.

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Atypical Pyoderma gangrenosum: a case of delayed recognition

Journal of Community Hospital Internal Medicine Perspectives ◽

10.1080/20009666.2020.1866250 ◽

2021 ◽

Vol 11 (2) ◽

pp. 242-248

Author(s):

Anum Qureshi ◽

Kia Persaud ◽

Sajida Zulfiqar ◽

Ranadheer Dande ◽

Chahat Puri ◽

...

Keyword(s):

Pyoderma Gangrenosum ◽

Delayed Recognition

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Management of constipation in patients with schizophrenia—a case study and review of literature

Middle East Current Psychiatry ◽

10.1186/s43045-021-00097-6 ◽

2021 ◽

Vol 28 (1) ◽

Author(s):

Ashish Sarangi ◽

Sabiha Armin ◽

Aurelio Vargas ◽

Victoria M. Chu ◽

Kristen Fain ◽

...

Keyword(s):

Side Effect ◽

Negative Symptoms ◽

Early Recognition ◽

Cardiovascular Complications ◽

Cochrane Library ◽

Main Body ◽

Complication Rates ◽

Anticholinergic Effects ◽

Routine Surveillance ◽

Delayed Recognition

Abstract Background Schizophrenia is a disorder that affects about 1% of the US population, with an extensive impact on patients’ health and their risk of later developing comorbidities from treatment. While literature on the side effect profile of antipsychotics is abundant, there are few studies on identification of anticholinergic effects on gut motility and prophylaxis development. The aim of this review is to consider antipsychotic-associated constipation in patients with schizophrenia and to discuss management of antipsychotic-induced constipation as documented in the literature. Main body We present a case of antipsychotic-induced constipation and conducted a literature review assessing the prevalence of this issue in this population. The search was done on Embase, MEDLINE, Cochrane Library, and PubMed databases. Key word searches included constipation with concurrent antipsychotic use, antipsychotics and anticholinergic effects, factors causing constipation in schizophrenia, social disparities involved with constipation, and colorectal cancer screenings. Main findings included high complication rates that may be explained by clozapine-specific side effects, negative health habits, disease, and treatment-related metabolic disorders. Co-existing negative symptoms could also be associated with health outcomes and was found to have adverse consequences on schizophrenia progression. Comorbidities of diabetes and cardiovascular complications contributed to gut hypomotility. Caregiver burden was a factor in delayed recognition of constipation as a side effect. Routine surveillance for symptoms and optimization of medications facilitates early recognition of constipation. Conclusion Overall, there is insufficient trial-based evidence to compare the effectiveness and safety of common pharmacological interventions for constipation, such as lactulose, polyethylene glycol, stool softeners, and lubricant laxatives.

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Imaging features and differential diagnoses of non-neoplastic diffuse mediastinal diseases

Insights into Imaging ◽

10.1186/s13244-020-00909-z ◽

2020 ◽

Vol 11 (1) ◽

Author(s):

Flavian Tabotta ◽

Gilbert R. Ferretti ◽

Helmut Prosch ◽

Samia Boussouar ◽

Anne-Laure Brun ◽

...

Keyword(s):

Early Stage ◽

Specific Treatment ◽

Imaging Features ◽

Mediastinal Diseases ◽

Pictorial Review ◽

Wide Range ◽

Chest X Ray ◽

Delayed Recognition ◽

Patient’S History ◽

Contiguous Spread

Abstract Acute or chronic non-neoplastic diffuse mediastinal diseases have multiple causes, degrees of severity, and a wide range of management. Some situations require emergency care while others do not need specific treatment. Although the diagnosis may be suspected on chest X-ray, it is mainly based on CT. A delayed recognition is not uncommonly observed. Some findings may prompt the radiologist to look for specific associated injuries or lesions. This pictorial review will successively describe the various non-neoplastic causes of diffuse mediastinal diseases with their typical findings and major differentials. First, pneumomediastinum that can be provoked by extra- or intra-thoracic triggers requires the knowledge of patient’s history or recent occurrences. Absence of any usual etiological factor should raise suspicion of cocaine inhalation in young individuals. Next, acute mediastinitis may be related to post-operative complications, esophageal perforation, or contiguous spread of odontogenic or retropharyngeal infections. The former diagnosis is not an easy task in the early stage, owing to the similarities of imaging findings with those of normal post-operative appearance during the first 2–3 weeks. Finally, fibrosing mediastinitis that is linked to an excessive fibrotic reaction in the mediastinum with variable compromise of mediastinal structures, in particular vascular and airway ones. Differential diagnosis includes tumoral and inflammatory infiltrations of the mediastinum.

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