Mesh Exposure and Associated Risk Factors in Women Undergoing Transvaginal Prolapse Repair with Mesh

Objective. To determine frequency, rate, and risk factors associated with mesh exposure in women undergoing transvaginal prolapse repair with polypropylene mesh.Methods. Retrospective chart review was performed for all women who underwent Prolift Pelvic Floor Repair System (Gynecare, Somerville, NJ) between September 2005 and September 2008. Multivariable logistic regression was performed to identify risk factors for mesh exposure.Results. 201 women underwent Prolift. Mesh exposure occurred in 12% (24/201). Median time to mesh exposure was 62 days (range: 10–372). When mesh was placed in the anterior compartment, the frequency of mesh exposure was higher than that when mesh was placed in the posterior compartment (8.7% versus 2.9%,P=0.04). Independent risk factors for mesh exposure were diabetes (AOR = 7.7, 95% CI 1.6–37.6;P=0.01) and surgeon (AOR = 7.3, 95% CI 1.9–28.6;P=0.004).Conclusion. Women with diabetes have a 7-fold increased risk for mesh exposure after transvaginal prolapse repair using Prolift. The variable rate of mesh exposure amongst surgeons may be related to technique. The anterior vaginal wall may be at higher risk of mesh exposure as compared to the posterior vaginal wall.

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Early and Late Postoperative Seizures in Meningioma Patients and Prediction by a Recent Scoring System

Cancers ◽

10.3390/cancers13030450 ◽

2021 ◽

Vol 13 (3) ◽

pp. 450

Author(s):

Peter Baumgarten ◽

Mana Sarlak ◽

Daniel Monden ◽

Andrea Spyrantis ◽

Simon Bernatz ◽

...

Keyword(s):

Quality Of Life ◽

Risk Factors ◽

Tumor Volume ◽

Total Risk ◽

Increased Risk ◽

Independent Risk Factors ◽

Temporal Location ◽

Meningioma Surgery ◽

Impaired Quality

Seizures are among the most common symptoms of meningioma. This retrospective study sought to identify risk factors for early and late seizures in meningioma patients and to evaluate a modified STAMPE2 score. In 556 patients who underwent meningioma surgery, we correlated different risk factors with the occurrence of postoperative seizures. A modified STAMPE2 score was applied. Risk factors for preoperative seizures were edema (p = 0.039) and temporal location (p = 0.038). For postoperative seizures preoperative tumor size (p < 0.001), sensomotory deficit (p = 0.004) and sphenoid wing location (p = 0.032) were independent risk factors. In terms of postoperative status epilepticus; sphenoid wing location (p = 0.022), tumor volume (p = 0.045) and preoperative seizures (p < 0.001) were independent risk factors. Postoperative seizures lead to a KPS deterioration and thus an impaired quality of life (p < 0.001). Late seizures occurred in 43% of patients with postoperative seizures. The small sub-cohort of patients (2.7%) with a STAMPE2 score of more than six points had a significantly increased risk for seizures (p < 0.001, total risk 70%). We concluded that besides distinct risk factors, high scores of the modified STAMPE2 score could estimate the risk of postoperative seizures. However, it seems not transferable to our cohort

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Nasal symptoms increase the risk of snoring and snoring increases the risk of nasal symptoms. A longitudinal population study

Sleep And Breathing ◽

10.1007/s11325-020-02287-8 ◽

2021 ◽

Author(s):

Maria Värendh ◽

Christer Janson ◽

Caroline Bengtsson ◽

Johan Hellgren ◽

Mathias Holm ◽

...

Keyword(s):

Risk Factors ◽

Respiratory Health ◽

Smoking Status ◽

Northern Europe ◽

Nasal Breathing ◽

Nasal Symptoms ◽

Increased Risk ◽

Study Population ◽

Independent Risk Factors

Abstract Purpose Humans have a preference for nasal breathing during sleep. This 10-year prospective study aimed to determine if nasal symptoms can predict snoring and also if snoring can predict development of nasal symptoms. The hypothesis proposed is that nasal symptoms affect the risk of snoring 10 years later, whereas snoring does not increase the risk of developing nasal symptoms. Methods In the cohort study, Respiratory Health in Northern Europe (RHINE), a random population from Denmark, Estonia, Iceland, Norway, and Sweden, born between 1945 and 1973, was investigated by postal questionnaires in 1999–2001 (RHINE II, baseline) and in 2010–2012 (RHINE III, follow-up). The study population consisted of the participants who had answered questions on nasal symptoms such as nasal obstruction, discharge, and sneezing, and also snoring both at baseline and at follow-up (n = 10,112). Results Nasal symptoms were frequent, reported by 48% of the entire population at baseline, with snoring reported by 24%. Nasal symptoms at baseline increased the risk of snoring at follow-up (adj. OR 1.38; 95% CI 1.22–1.58) after adjusting for age, sex, BMI change between baseline and follow-up, and smoking status. Snoring at baseline was associated with an increased risk of developing nasal symptoms at follow-up (adj. OR 1.22; 95% CI 1.02–1.47). Conclusion Nasal symptoms are independent risk factors for development of snoring 10 years later, and surprisingly, snoring is a risk factor for the development of nasal symptoms.

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Incidence and risk factors for deep venous thrombosis of lower extremity after surgical treatment of isolated patella fractures

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02240-9 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Zhanchao Tan ◽

Hongzhi Hu ◽

Xiangtian Deng ◽

Jian Zhu ◽

Yanbin Zhu ◽

...

Keyword(s):

Risk Factors ◽

Lower Extremity ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Medical Data ◽

Limited Information ◽

Related Factors ◽

Patella Fractures ◽

Independent Risk Factors ◽

Associated Risk Factors

Abstract Background Limited information exists on the incidence of postoperative deep venous thromboembolism (DVT) in patients with isolated patella fractures. The objective of this study was to investigate the postoperative incidence and locations of deep venous thrombosis (DVT) of the lower extremity in patients who underwent isolated patella fractures and identify the associated risk factors. Methods Medical data of 716 hospitalized patients was collected. The patients had acute isolated patella fractures and were admitted at the 3rd Hospital of Hebei Medical University between January 1, 2016, and February 31, 2019. All patients met the inclusion criteria. Medical data was collected using the inpatient record system, which included the patient demographics, patient’s bad hobbies, comorbidities, past medical history, fracture and surgery-related factors, hematological biomarkers, total hospital stay, and preoperative stay. Doppler examination was conducted for the diagnosis of DVT. Univariate analyses and multivariate logistic regression analyses were used to identify the independent risk factors. Results Among the 716 patients, DVT was confirmed in 29 cases, indicating an incidence of 4.1%. DVT involved bilateral limbs (injured and uninjured) in one patient (3.4%). DVT involved superficial femoral common vein in 1 case (3.4%), popliteal vein in 6 cases (20.7%), posterior tibial vein in 11 cases (37.9%), and peroneal vein in 11 cases (37.9%). The median of the interval between surgery and diagnosis of DVT was 4.0 days (range, 1.0-8.0 days). Six variables were identified to be independent risk factors for DVT which included age category (> 65 years old), OR, 4.44 (1.34-14.71); arrhythmia, OR, 4.41 (1.20-16.15); intra-operative blood loss, OR, 1.01 (1.00-1.02); preoperative stay (delay of each day), OR, 1.43 (1.15-1.78); surgical duration, OR, 1.04 (1.03-1.06); LDL-C (> 3.37 mmol/L), OR, 2.98 (1.14-7.76). Conclusion Incidence of postoperative DVT in patients with isolated patella fractures is substantial. More attentions should be paid on postoperative DVT prophylaxis in patients with isolated patella fractures. Identification of associated risk factors can help clinicians recognize the risk population, assess the risk of DVT, and develop personalized prophylaxis strategies.

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Abstract T P231: Does Intraventricular Hemorrhage Lead to a Normal Pressure Hydrocephalus-Like Syndrome?

Stroke ◽

10.1161/str.45.suppl_1.tp231 ◽

2014 ◽

Vol 45 (suppl_1) ◽

Author(s):

Andrew J Kruger ◽

Matthew Flaherty ◽

Padmini Sekar ◽

Mary Haverbusch ◽

Charles J Moomaw ◽

...

Keyword(s):

Risk Factors ◽

Normal Pressure Hydrocephalus ◽

Barthel Index ◽

Intraventricular Hemorrhage ◽

Normal Pressure ◽

Stroke Study ◽

Increased Risk ◽

Independent Risk Factors ◽

Poor Outcomes

Background: Intracerebral hemorrhage (ICH) has the highest short and long-term morbidity and mortality rates of stroke subtypes. While increased intracranial pressure due to the presence of intraventricular hemorrhage (IVH) may relate to early poor outcomes, the mechanism of reduced 3-month outcome with IVH is unclear. We hypothesized that IVH may cause symptoms similar to normal pressure hydrocephalus (NPH), specifically urinary incontinence and gait disturbance. Methods: We used interviewed cases from the Genetic and Environmental Risk Factors for Hemorrhagic Stroke Study (7/1/08-12/31/12) that had 3-month follow-ups available. CT images were analyzed for ICH volume and location, and IVH presence and volume. Incontinence and dysmobility were defined by Barthel Index at 3 months. We chose a Barthel Index score of bladder less than 10 and mobility less than 15 to define incontinence and dysmobility, respectively. Multivariate analysis was used to assess independent risk factors for incontinence and dysmobility. ICH and IVH volumes were log transformed because of non-normal distributions. Results: Barthel Index was recorded for 308 ICH subjects, of whom 106 (34.4%) had IVH. Presence of IVH was independently associated with both incontinence (OR 2.7; 95% CI 1.4-5.2; p=.003) and dysmobility (OR 2.5; 95% CI 1.4-4.8; p=.003). The Table shows that increasing IVH volume was also independently associated with both incontinence and dysmobility after controlling for ICH location, ICH volume, age, baseline mRS, and admission GCS. Conclusion: Our data show that patients with IVH after ICH are at an increased risk for developing the NPH-like symptoms of incontinence and dysmobility. This may explain the worse long-term outcomes of patients who survive ICH with IVH than those who had ICH alone. Future studies are needed to confirm this finding, and to determine the effect of IVH interventions such as shunt or intraventricular thrombolysis.

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Changes in muscularis propria of anterior vaginal wall in women with pelvic organ prolapse

European Journal of Histochemistry ◽

10.4081/ejh.2016.2604 ◽

2016 ◽

Vol 60 (1) ◽

Cited By ~ 6

Author(s):

A. Vetuschi ◽

A. D'Alfonso ◽

R. Sferra ◽

D. Zanelli ◽

S. Pompili ◽

...

Keyword(s):

Risk Factors ◽

Smooth Muscle ◽

Pelvic Organ Prolapse ◽

Smooth Muscle Cells ◽

Muscularis Propria ◽

Muscle Cells ◽

Pelvic Organ ◽

Vaginal Wall ◽

Anterior Vaginal Wall ◽

Collagen Iii

The objective of this study was to evaluate the morphological and immunohistochemical alterations of tissue removed from the upper third of anterior vaginal wall in a sample group of the female population presenting homogenous risk factors associated with Pelvic Organ Prolapse (POP). The case study consisted of 14 patients with POP and there were 10 patients in the control group. Patient selection was carried on the basis of specific criteria and all of the patients involved in the study presented one or more of the recognized POP risk factors. Samples were taken from POP patients during vaginal plastic surgery following colpohysterectomy, and from control patients during closure of the posterior fornix following hysterectomy. Samples were processed for histological and immunohistochemical analyses for Collagen I and Collagen III, α-Smooth Muscle Actin (α-SMA), Platelet-Derived-Growth-Factor (PDGF), matrix metalloproteinase 3 (MMP3), Caspase3. Immunofluorescence analyses for Collagen I and III and PDGF were also carried out. In prolapsed specimens our results show a disorganization of smooth muscle cells that appeared to have been displaced by an increased collagen III deposition resulting in rearrangement of the muscularis propria architecture. These findings suggest that the increase in the expression of collagen fibers in muscularis could probably due to a phenotypic switch resulting in the dedifferentiation of smooth muscle cells into myofibroblasts. These alterations could be responsible for the compromising of the dynamic functionality of the pelvic floor.

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Preoperative Risk Factors for Complications in Elective Ankle and Hindfoot Reconstruction

Foot & Ankle Specialist ◽

10.1177/1938640017706155 ◽

2017 ◽

Vol 11 (1) ◽

pp. 54-60 ◽

Cited By ~ 10

Author(s):

Ryan P. Mulligan ◽

Kevin J. McCarthy ◽

Benjamin J. Grear ◽

David R. Richardson ◽

Susan N. Ishikawa ◽

...

Keyword(s):

Risk Factors ◽

Retrospective Chart Review ◽

Reoperation Rate ◽

Deep Infection ◽

Foot And Ankle ◽

Psychological Variables ◽

Reconstruction Methods ◽

Increased Risk ◽

Retrospective Comparative Study ◽

Alcohol Users

Background. The purpose of this study was to examine medical, social, and psychological factors associated with complications and reoperation after foot and ankle reconstruction. Methods. A retrospective chart review was conducted of 132 patients (135 feet; 139 operative cases) who had elective foot and ankle reconstruction. Medical, social, and psychological variables were documented. Primary outcomes included complications and reoperations. Results. The overall complication rate was 28% (39/139), and the reoperation rate was 17% (24/139). Alcohol use (P = .03) and preoperative narcotic use (P = .02) were risk factors for complications, with delayed wound healing more frequent in alcohol users (P = .03) and deep infection (P = .045) and nonunion (P = .046) more frequent preoperative narcotic use. Deep infection also was more frequent in tobacco users (P < .01). Older patients were less likely to undergo reoperation (risk of reoperation increased with age). Other variables were not associated with increased complications. Conclusion. Patients who consumed alcohol or had been prescribed any amount of narcotic within 3 months preoperatively were at increased risk for complications. Patients who smoked were more likely to have a wound infection. Surgeons should be aware of these factors and counsel patients before surgery. Levels of Evidence: Level III: Retrospective comparative study

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Positive Signs on Physical Examination Are Not Always Indications for Endotracheal Tube Intubation in Patients with Facial Burn

10.21203/rs.3.rs-128508/v1 ◽

2020 ◽

Author(s):

Ruo-Yi Huang ◽

Szu-Jen Chen ◽

Yen-Chang Hsiao ◽

Ling-Wei Kuo ◽

Chien-Hung Liao ◽

...

Keyword(s):

Risk Factors ◽

Endotracheal Tube ◽

Odds Ratio ◽

Inhalation Injury ◽

Burn Patients ◽

Shortness Of Breath ◽

Airway Protection ◽

Increased Risk ◽

Independent Risk Factors ◽

Facial Burn

Abstract BackgroundAfter clinical evaluation in the emergency department (ED), facial burn patients are usually intubated to protect their airways. However, the possibility of unnecessary intubation or delayed intubation after admission exists. Objective criteria for the evaluation of inhalation injury and the need for airway protection in facial burn patients are needed.MethodsFacial burn patients between January 2013 and May 2016 were reviewed. Patients who were and were not intubated in the ED were compared. All intubated patients received routine bronchoscopy to evaluate whether they had inhalation injuries. Patients with and without confirmed inhalation injuries were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for inhalation injuries in facial burn patients. The reasons for intubation in patients without inhalation injuries were also investigated.ResultsDuring the study period, 121 patients were intubated in the ED among a total of 335 facial burn patients. Only 73 (60.3%) patients were later confirmed to have inhalation injuries on bronchoscopy. The comparison between patients with and without inhalation injuries showed that shortness of breath (odds ratio=3.376, p=0.027) and high total body surface area (TBSA) (odds ratio=1.038, p=0.001) were independent risk factors for inhalation injury. Other physical signs (e.g., hoarseness, burned nostril hair, etc.), laboratory examinations and chest X-ray findings were not predictive of inhalation injury in facial burn patients. All patients with a TBSA over 60% were intubated in the ED even if they did not have inhalation injuries.ConclusionIn the management of facial burn patients, positive signs on conventional physical examinations may not always be predictive of inhalation injury and the need for endotracheal tube intubation in the ED. More attention should be paid to facial burn patients with shortness of breath and a high TBSA because they have an increased risk of inhalation injuries. Airway protection is needed in facial burn patients without inhalation injuries because of their associated injuries and treatment.

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Retrospective analysis of risk factors of hypotensive bradycardic events during shoulder arthroscopic surgery under interscalene blockade in the sitting position

Korean Journal of Anesthesiology ◽

10.4097/kja.20035 ◽

2020 ◽

Vol 73 (6) ◽

pp. 542-549

Author(s):

Taeha Ryu ◽

Baek Jin Kim ◽

Seong Jun Woo ◽

So Young Lee ◽

Jung A Lim ◽

...

Keyword(s):

Risk Factors ◽

Logistic Regression ◽

Odds Ratio ◽

Arthroscopic Surgery ◽

Sitting Position ◽

Past Medical History ◽

Frequent Adverse Event ◽

Increased Risk ◽

Potential Risk Factors ◽

Independent Risk Factors

Background: Hypotensive bradycardic events (HBEs) are a frequent adverse event in patients who underwent shoulder arthroscopic surgery under interscalene block (ISB) in the sitting position. This retrospective study was conducted to investigate the independent risk factors of HBEs in shoulder arthroscopic surgery under ISB in the sitting position. Methods: A total of 2549 patients who underwent shoulder arthroscopic surgery under ISB and had complete clinical data were included in the study. The 357 patients who developed HBEs were included in the HBEs group, and the remaining 2192 in the non-HBEs group. The potential risk factors for HBEs, such as age, sex, past medical history, anesthetic characteristics, and intraoperative medications were collected and compared between the groups. Statistically significant variables were included in a logistic regression model to further evaluate the independent risk factors for HBEs in shoulder arthroscopic surgery under ISB. Results: The incidence of HBEs was 14.0% (357/2549). Logistic regression analysis revealed that the intraoperative use of hydralazine (odds ratio [OR] 4.2; 95% confidence interval [CI] 2.9–6.3), propofol (OR 2.1; 95% CI 1.3–3.6), and dexmedetomidine (OR 3.9; 95% CI 1.9–7.8) before HBEs were independent risk factors for HBEs in patients who received shoulder arthroscopic surgery under ISB. Conclusions: The intraoperative use of antihypertensives such as hydralazine and sedatives such as propofol or dexmedetomidine leads to increased risk of HBEs during shoulder arthroscopic surgery under ISB in the sitting position.

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Risk for Cardiovascular Disease and One-Year Mortality in Patients With Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea Syndrome Overlap Syndrome

Frontiers in Pharmacology ◽

10.3389/fphar.2021.767982 ◽

2021 ◽

Vol 12 ◽

Author(s):

Manyun Tang ◽

Yidan Wang ◽

Mengjie Wang ◽

Rui Tong ◽

Tao Shi

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Cardiovascular Diseases ◽

Overlap Syndrome ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Obstructive Sleep ◽

Increased Risk ◽

All Cause Mortality ◽

Independent Risk Factors

Background: Patients with chronic obstructive pulmonary disease (COPD) and obstructive sleep apnea (OSAS) overlap syndrome (OS) are thought to be at increased risk for cardiovascular diseases.Objective: To evaluate the burden of cardiovascular diseases and long-term outcomes in patients with OS.Methods: This was a retrospective cohort study. The prevalence of cardiovascular diseases and 1-year mortality were compared among patients diagnosed with OS (OS group), COPD alone (COPD group) and OSAS alone (OSAS group), and Cox proportional hazards models were used to assess independent risk factors for all-cause mortality.Results: Overall, patients with OS were at higher risk for pulmonary hypertension (PH), heart failure and all-cause mortality than patients with COPD or OSAS (all p < 0.05). In multivariate Cox regression analysis, the Charlson comorbidity index (CCI) score [adjusted hazard ratio (aHR): 1.273 (1.050–1.543); p = 0.014], hypertension [aHR: 2.006 (1.005–4.004); p = 0.048], pulmonary thromboembolism (PTE) [aHR: 4.774 (1.335–17.079); p = 0.016] and heart failure [aHR: 3.067 (1.521–6.185); p = 0.002] were found to be independent risk factors for 1-year all-cause mortality.Conclusion: Patients with OS had an increased risk for cardiovascular diseases and 1-year mortality. More efforts are needed to identify the causal relationship between OS and cardiovascular diseases, promoting risk stratification and the management of these patients.

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COMPUTER VISION SYNDROME: PREVALENCE AND ASSOCIATED RISK FACTORS AMONG UNDERGRADUATES IN A TERTIARY INSTITUTION IN NORTH WESTERN NIGERIA

Kanem Journal of Medical Sciences ◽

10.36020/kjms.2021.1503 ◽

2021 ◽

Vol 15 (1) ◽

pp. 1-8

Author(s):

Nwankwo B ◽

◽

Mumueh KP ◽

Olorukooba AA ◽

Usman NO

Keyword(s):

Risk Factors ◽

Computer Vision ◽

Computer Use ◽

P Value ◽

Tertiary Institution ◽

Blurred Vision ◽

Cross Sectional ◽

Computer Vision Syndrome ◽

Increased Risk ◽

Associated Risk Factors

Background: Computers and other visual display devices have become essential in the present era and have led to a rise in computer-related health problems. Using computers in homes, universities and other institutions has increased output greatly but has also led to an increased risk of developing Computer vision syndrome (CVS). Objectives: To determine the prevalence and risk factors associated with computer vision syndrome among undergraduates. Methodology: A cross-sectional study was conducted among153 respondents who were selected using a multi-stage sampling technique. A pretested, structured, interviewer-administered questionnaire was used to collect data. SPSS version 23 was used to analyze the data. A Chi-square test was used to determine the relationship between CVS and associated risk factors at a P-value of <0.05. Results: The mean age of respondents was 22.4 ± 3.4 years. The prevalence of CVS in this study was 83 (54.3%). The common symptoms experienced among the respondents were headache (51, 61.4%), eye strain (48, 57.8%) and blurred vision (42, 50.6%). The risk factors significantly associated with CVS in this study were duration of computer use, hours of computer use per day, level of a computer screen and taking breaks during computer use. Conclusion: About half of the students in this study had at least one symptom of CVS. Therefore, awareness of CVS should be created by the institution during which students would be educated on CVS and its prevention.

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