scholarly journals Analysis of Related Influencing Factors of Deep Vein Thrombosis after Lumbar Internal Fixation and Treatment Strategy

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Sixiao Zhang ◽  
Guangjie Shen ◽  
Mingxing Luo ◽  
Xiqiang Zhong
Keyword(s):  
Lumbar Spine ◽  
Internal Fixation ◽  
Effective Treatment ◽  
Influencing Factors ◽  
Venous Blood ◽  
Univariate Analysis ◽  
Perioperative Period ◽  
Surgical Trauma ◽  
Related Factors ◽  
Functional Exercise

Lumbar internal fixation is a traditional surgical method for the treatment of degenerative diseases of the lumbar spine. However, due to its large surgical trauma, it easily causes complications such as deep venous thrombosis (DVT) after the operation. DVT refers to the abnormal coagulation of blood in deep veins, blocking the lumen, causing venous blood return disorder, causing venous blood return disorder to cause swelling and pain, which affects the recovery of the patient’s lumbar spine function. In severe cases, even complicated pulmonary embolism endangers the life and health of the patient. Therefore, it is extremely important to explore the related influencing factors and effective treatment of DVT. The purpose of this study was to investigate the influencing factors and effective treatment of DVT after lumbar internal fixation. Univariate analysis and multivariate a logistic regression model were used to analyze the related factors affecting DVT after lumbar internal fixation. Conventional treatments such as anticoagulation, promotion of venous blood return, and improvement of limb circulation were given to patients with DVT, and functional exercise was guided to compare the hypercoagulability and hyperviscosity of blood in patients with DVT before and after treatment. The results showed that the incidence of DVT after lumbar internal fixation was related to age, BMI, and bed time. Getting out of bed for functional exercise in time after surgery can effectively prevent the formation of DVT. Preoperative grading examination, intraoperative intervention, postoperative physical exercise, and other preventive guidance can be carried out according to different individuals during the perioperative period to prevent the formation of postoperative DVT.

scholarly journals FRI0322 INSULIN RESISTANCE IN NON-DIABETES PATIENTS WITH SPONDYLOARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 752.2-753
Author(s):  
J. C. Quevedo-Abeledo ◽  
F. Genre ◽  
J. Rueda-Gotor ◽  
A. Corrales ◽  
V. Hernández-Hernández ◽  
...  
Keyword(s):  
Cell Function ◽  
Inflammatory Diseases ◽  
Univariate Analysis ◽  
Serum Levels ◽  
Β Cell ◽  
Related Factors ◽  
C Peptide ◽  
Related Data ◽  
Β Cell Function ◽  
Beta Coefficient

Background:Insulin resistance (IR) is a state in which a given concentration of insulin is associated with a subnormal glucose response. IR constitutes a major underlying abnormality driving cardiovascular disease in the general population and has been linked to inflammatory diseases. In this sense, several reports have confirmed that inflammation worsens IR and impairs pancreatic β-cell function in inflammatory diseases such as rheumatoid arthritis and systemic lupus erythematosus.Objectives:In this study we aimed to determine the prevalence of IR in patients with spondyloarthritis (SpA) compared to controls, and whether IR can be explained by disease-related features in SpA patients.Methods:Study of 577 subjects, 306 patients diagnosed with SpA according to ASAS criteria and 271 controls. Insulin and C-peptide serum levels, IR and β-cell function (%B) indexes by homeostatic model assessment (HOMA2), and lipid profiles were assessed in patients and controls. A multivariate regression analysis was performed to evaluate the differences in IR indexes between patients and controls and to determine how IR is associated with disease-related characteristics.Results:SpA patients showed higher serum levels of insulin (8.7 [4.8-15.9] vs. 8.0 [5.7-11.2] uU/ml, p=0.001) and C peptide (1.4 [0.7-2.5] vs. 1.2 [0.7-1.7] ng/ml, p=0.000) than controls in the univariate analysis. Similarly, HOMA2-B% and IR were all significantly higher in SpA patients. These differences were still evident when the comparisons were made after the multivariate analysis had been adjusted for traditional IR-related factors (sex, age, BMI, hypertension, dyslipidemia, smoking and, cholesterol), glucocorticoids intake, insulin and C-peptide. Moreover, HOMA2-B% and HOMA2-IR scores, both calculated with insulin or C-peptide, yielded statistically higher significant values in SpA patients than controls.Classic IR-related factors (age, BMI, waist circumference, hypertension, obesity, dyslipidemia, atherogenic index, and triglycerides), as well as CRP serum levels, were all related, to a greater or lesser degree, with IR and β-cell function. Regarding disease-related data, ASDAS-CRP, BASFI and BASMI scores were positively associated with IR; and BASMI and BASDAI scores were positively related to HOMA2-%B-C peptide. Moreover, the use of NSAID and prednisone were, respectively, positive and negatively related to β-cell function. However, only some of the associations of the univariate analysis were maintained after adjusting for confounders. In this sense, disease duration (beta coefficient 2 [95% CI 1-3], p=0.001) and positivity for HLA-B27 (beta coefficient 30 [95% CI 12-49], p=0.002) were associated with higher β-cell functionality after the multivariate analysis.Conclusion:Patients with SpA have an increased IR compared to controls. SpA disease-related data like disease duration and HLA-B27 are independently associated with β-cell dysfunction.Disclosure of Interests:Juan Carlos Quevedo-Abeledo Speakers bureau: Abbvie, Fernanda Genre: None declared, Javier Rueda-Gotor: None declared, Alfonso Corrales Speakers bureau: Abbvie, Vanessa Hernández-Hernández Speakers bureau: Pfizer, Abbvie, MSD, Natalia Fañanas-Rodríguez: None declared, Bernardo Lavín-Gómez: None declared, delgado frias esmeralda Speakers bureau: Pfizer, Abbvie, MSD, Antonia de Vera-González: None declared, Alejandra Delgado-González: None declared, Laura de Armas-Rillo: None declared, Maria Teresa García-Unzueta: None declared, Miguel A González-Gay Grant/research support from: Pfizer, Abbvie, MSD, Speakers bureau: Pfizer, Abbvie, MSD, Iván Ferraz-Amaro Grant/research support from: Pfizer, Abbvie, Speakers bureau: Pfizer, Abbvie, MSD.

scholarly journals Surgical treatment of pertrochanteric fractures by dynamic methods of external and internal fixation

2003 ◽  
Vol 60 (6) ◽  
pp. 663-667 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Mile Radenkovic ◽  
Desimir Mladenovic ◽  
Gordana Soldatovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
External Fixation ◽  
Functional Results ◽  
Surgical Trauma ◽  
Pertrochanteric Fractures ◽  
Skeletal Mass ◽  
Dynamic Methods ◽  
Life Threat ◽  
Methods Of Treatment

Pertrochanteric fractures usually occur in patients over 65 years of age, with greater loss of skeletal mass (osteoporosis). Nonsurgical methods of treatment are accompanied by relatively high lethality rate. Moreover, they do not produce satisfactory anatomical and functional results. Surgical treatment by using dynamic implants represents a method of choice in the fixation of pertrochanteric fractures. This paper presents the treatment results of 110 patients, 61 with pertrochanteric fractures, who were surgically treated by the dynamic method of internal fixation, and 49 patients who were treated by the method of external fixation. Dynamical implants enabled both dynamization and compression of the fracture in the axis of the neck, as well as the diaphysis of the femur, which lowered the risk of mechanical complications, and, at the same time, provided effective healing of the fracture, early activation, and mobilization of the patients on whom the surgery was performed. In patients infected by various diseases, for whom surgical trauma represents a life threat, the external fixation is recommended as a method of choice.

scholarly journals Type 2 diabetes mellitus – IL-8 and IL-10 profile in patients with intraabdominal postoperative abscesses

2020 ◽  
Vol 73 (2) ◽  
pp. 220-223
Author(s):  
Valeriy V. Boyko ◽  
Artem S. Riga
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Nosocomial Infection ◽  
Perioperative Period ◽  
Serum Levels ◽  
Surgical Trauma ◽  
Abdominal Abscesses ◽  
Group 2

The aim: To assess of pro-inflammatory IL-8 and anti-inflammatory IL-10 serum concentration in patients with T2DM with intraabdominal postoperative abscesses in perioperative period. Materials and methods: The 48 participants, aged 40 – 75 years, among them 24 males and 24 females. All patients were divided into groups: group 1 – 12 patients with T2DM and intra-abdominal postoperative abscesses, group 2 – 12 patients without T2DM but with intra-abdominal postoperative abscesses and 24 healthy individuals. The level of IL-8and IL-10 serum was determined on the day before surgery, on the 2-3rd and 5-7th day after surgery in patients with type 2 diabetes and intra-abdominal postoperative abscesses. Results and conclusions: The trajectories of the level of interleukins in patients with type 2 Diabetes mellitus were different from the trajectories of their level in patients without diabetes, which indicates a special immune response to nosocomial infection and surgical trauma. The mechanism of changes in serum levels of IL-8 and IL-10 in patients with type 2 Diabetes mellitus and postoperative intra-abdominal abscesses should be further studied in future studies on the specific causative agent of nosocomial infection and the cytokine response to it.

scholarly journals Measurement of operative femoral anteversion during cementless total hip arthroplasty and influencing factors for using neck-adjustable femoral stem

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jingyang Sun ◽  
Bohan Zhang ◽  
Lei Geng ◽  
Qingyuan Zheng ◽  
Juncheng Li ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Influencing Factors ◽  
Hip Arthroplasty ◽  
Perioperative Complications ◽  
Demographic Data ◽  
Univariate Analysis ◽  
Femoral Stem ◽  
Femoral Anteversion ◽  
Total Hip

Abstract Background Placement of femoral stem in excessive anteversion or retroversion can cause reduced range of motion, prosthetic impingement, and dislocation. The aim of this study was to assess the operative femoral anteversion in patients treated with total hip arthroplasty (THA) and analyze the need of adjusting stem anteversion. Methods We retrospectively included 101 patients (126 hips) who underwent cementless THA with a manual goniometer to determine the femoral anteversion between October 2017 and December 2018. The operative femoral anteversion we measured was recorded during THA. We further divided those hips into three subgroups based on the range of operative femoral anteversion: group 1 (<10°), group 2 (10–30°), and group 3 (>30°) and compared the differences of their demographic data. Univariate and multivariate logistic regression were used to identify the influencing factors for the need of neck-adjustable femoral stem. The clinical and radiographic outcomes were also assessed. Perioperative complications were recorded. Results After THA, the Harris hip scores improved from 52.87 ± 15.30 preoperatively to 90.04 ± 3.31 at the last follow-up (p < 0.001). No implant loosening, stem subsidence, and radiolucent lines were observed on radiographs. No severe complications occurred and no components needed revision at the latest follow-up. The mean operative femoral anteversion was 14.21° ± 11.80° (range, −9 to 60°). Patients with femoral anteversion more than 30° were about 10 years younger than others. Femoral anteversion >30° was more common in patients with developmental dysplasia of the hip (DDH). There were totally 14 hips treated with the neck-adjustable femoral stem. From the univariate analysis, we can observe that female sex, diagnosis of DDH (compared with osteonecrosis), and higher operative femoral anteversion and its value >30° (compared with <10°) are associated with higher rates of using the neck-adjustable femoral stem. However, all these factors were no longer considered as independent influencing factors when mixed with other factors. Conclusions This study highlighted the significance of operative femoral anteversion. Identification of abnormal femoral anteversion could assist in adjusting stem anteversion and reduce the risk of dislocation after THA.

scholarly journals The identification of pregnant women with renal colic who may need surgical intervention

2021 ◽  
Author(s):  
He Maomao ◽  
Ming Lei ◽  
Lin Xiaoting ◽  
Xiaolan Xu ◽  
Zhihui He
Keyword(s):  
Pregnant Women ◽  
Renal Colic ◽  
Surgical Intervention ◽  
Clinical Laboratory ◽  
Ureteral Stone ◽  
Univariate Analysis ◽  
White Blood Cells ◽  
Stone Size ◽  
Related Factors ◽  
In Pregnancy

Abstract Objectives: To analyze clinical data and stone-related factors to identify predictive factors for surgical intervention in pregnant women with renal colic. Methods: We conducted a retrospective review of 212 pregnant women presenting with renal colic between 1st January 2009 and 31st December 2019. Patients were grouped according to surgical intervention and a range of demographic, clinical, laboratory, and ultrasound data were obtained. Univariate and multivariate analyses identified a range of predictive variables for surgical intervention. In addition, we used receiver operating characteristic (ROC) curve analysis to evaluate the predictive power of our model and created a nomogram for clinical application. Results: Of the 212 patients presenting with acute renal colic in pregnancy, 100 patients (47.2%) underwent surgical intervention and 112 patients (52.8%) were treated conservatively. Univariate analysis identified significant differences between the two groups with regards to fever, the duration of pain, white blood cells (WBCs), C-reactive protein (CRP), ureteral stone size, hydronephrosis, and stone location. Multivariate analysis further identified a number of independent predictors for surgical intervention, including fever, a duration of pain ≥4 days, a ureteral stone size ≥ 8 mm, and moderate or severe hydronephrosis.Conclusions: We identified several independent predictors for surgical intervention for renal colic in pregnancy. Fever, a duration of pain ≥4 days, a ureteral stone size ≥8 mm, and moderate/severe hydronephrosis, play significant roles in predicting surgical intervention. Our nomogram can help to calculate the probability of surgical intervention in a simple and efficient manner. Prospective studies are now required to validate our model.

scholarly journals Addressing Adherence to Treatment: A Longstanding Concern. The Health Care Professional

2014 ◽  
Vol 4 (3) ◽  
pp. 25-26
Author(s):  
Farrukh Shah
Keyword(s):  
Health Care ◽  
Life Expectancy ◽  
Iron Overload ◽  
Effective Treatment ◽  
Cardiac Failure ◽  
Short Paper ◽  
Thalassaemia Major ◽  
Adherence To Treatment ◽  
Related Factors ◽  
Adequate Provision

Today a patient born with thalassaemia major can expect to have a near normal life expectancy and remain free of complications of iron overload with good monitoring and excellent transfusion and chelation regimes. Unfortunately patients still develop complications as a consequence of iron overload including endocrinopathies and cardiac failure. The main reason behind this failure of effective treatment is inadequate treatment. This can be due to either clinician related factors, patient related factors or lack of adequate provision of medicines and services. In this short paper I will highlight where the challenges lie with regards adherence to treatment and suggest approaches to manage this.

Danger of bacterial translocation for a surgical patient

2021 ◽  
Vol 100 (1) ◽  
Keyword(s):  
Early Recognition ◽  
Ischemia Reperfusion ◽  
Venous Blood ◽  
Intestinal Barrier ◽  
Perioperative Period ◽  
Infectious Complications ◽  
Lymphatic Transport ◽  
Surgical Patient ◽  
Toxic Substances ◽  
Patients At Risk

Intestinal barrier disorder manifestation occurs in connection with surgery in conditions of shock ischemia-reperfusion of the intestine or deterioration of an already damaged barrier due to chronic disease. The result is infectious complications caused by the transport of pathogens through the venous blood, most often postoperative pneumonia and sepsis. However, a more frequent manifestation is the intensification of the postoperative systemic inflammatory response through the lymphatic transport of toxic substances, inanimate antigens and cytokines through the lymphatic system of the splanchnic area (gut-lymph axis). The problem can affect up to half of patients with abdominal surgery. Preventive measures consist of strengthening the intestinal barrier before surgery and alleviating the loss of the intestinal barrier in the perioperative period. In the treatment of infectious complications, an early recognition indication for the therapeutic administration of antibiotics based on preoperative microbial screening of patients at risk may help.

Establishment of Predictive Model for Related Factors of Systemic Inflammatory Response Syndrome (SIRS) After Percutaneous Nephrolithotomy (PCNL)

2020 ◽  
Author(s):  
Min Ju ◽  
Jin Zheng ◽  
li Ying Pan ◽  
lin Lin Gao
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Percutaneous Nephrolithotomy ◽  
Operative Time ◽  
Univariate Analysis ◽  
Infection Process ◽  
Systemic Inflammatory Response ◽  
Related Factors

Abstract Background:The percutaneous nephrolithotomy (PCNL) is a primary method of stone treatment, but the infection is a very common postoperative complication. The systemic inflammatory response syndrome (SIRS) is a stage of the infection process and a very important early clinical manifestation of sepsis, so identifying the risk factors associated with SIRS after PCNL plays an important role in ensuring patients’ safety and preventing sepsis. Methods:Between September 2016 and September 2017,there were total 352 patients who were diagnosed as renal stone and were treated with PCNL, andincluded in this study at last.Patients were divided into two groups according to whether SIRS occurred or not.The univariate analysis was performed on the related risk factors such as patients' age, gender, number of stone, diabetes et al. Then logistic regression was used for multivariate analysis and established a prediction model.Results:There are 352renal stone patients were treated with PCNL, and 106 patients (30.1%) suffered SIRS after operation.It was found that the operative time, preoperative fever and diabetes could be deemed as risk factors, and the Then logistic regression results indicated that diabetes (OR=2.049, 95%CI 1.008～4.166) and operative time (OR=1.011, 95%CI 1.003～1.019) entered the regression equation.Conclusion: Diabetes and operative time are independent risk factors for SIRS after PCNL, so the probability of SIRS after PCNL can be determined in accordance with these two indicators.

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