Editors' Note: Association of Group A Streptococcus Exposure and Exacerbations of Chronic Tic Disorders: A Multinational Prospective Cohort Study

ObjectiveTo examine prospectively the association between group A Streptococcus (GAS) pharyngeal exposures and exacerbations of tics in a large multicenter population of youth with chronic tic disorders (CTD) across Europe.MethodsWe followed up 715 children with CTD (age 10.7 ± 2.8 years, 76.8% boys), recruited by 16 specialist clinics from 9 countries, and followed up for 16 months on average. Tic, obsessive-compulsive symptom (OCS), and attention-deficit/hyperactivity disorder (ADHD) severity was assessed during 4-monthly study visits and telephone interviews. GAS exposures were analyzed using 4 possible combinations of measures based on pharyngeal swab and serologic testing. The associations between GAS exposures and tic exacerbations or changes of tic, OC, and ADHD symptom severity were measured, respectively, using multivariate logistic regression plus multiple failure time analyses and mixed effects linear regression.ResultsA total of 405 exacerbations occurred in 308 of 715 (43%) participants. The proportion of exacerbations temporally associated with GAS exposure ranged from 5.5% to 12.9%, depending on GAS exposure definition. We did not detect any significant association of any of the 4 GAS exposure definitions with tic exacerbations (odds ratios ranging between 1.006 and 1.235, all p values >0.3). GAS exposures were associated with longitudinal changes of hyperactivity–impulsivity symptom severity ranging from 17% to 21%, depending on GAS exposure definition.ConclusionsThis study does not support GAS exposures as contributing factors for tic exacerbations in children with CTD. Specific workup or active management of GAS infections is unlikely to help modify the course of tics in CTD and is therefore not recommended.

Download Full-text

Open Technique Versus Blind Technique in Placement of Primary Ports in Laparoscopic Procedures- A Prospective Cohort Study

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/30610.15398 ◽

2021 ◽

Author(s):

Vivek Pahuja ◽

Nisha Rani ◽

Hershdeep Singh ◽

Kuldip Singh ◽

Pankaj Dugg ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Peritoneal Cavity ◽

Prospective Cohort ◽

P Value ◽

Open Technique ◽

Significant Difference ◽

Group A ◽

Group B ◽

Primary Port

Introduction: Laparoscopic access has always been a challenge because it has been associated with severe complications and sometimes fatal also. Aim:Tocompareopentechniqueversusblindtechniqueinplacement of primary port in various laparoscopic procedures in terms of operative time, complications, ease of use and acceptability. Materials and Methods: This prospective cohort study was conducted at Government Medical College, Patiala, Punjab, India, between June 2014 to August 2016. The study included 100 patients, which were divided into two groups. Group A (n=50) received placement of primary port by open technique and Group B (n=50) received placement of primary port by blind technique. The time taken for access into peritoneal cavity and duration of surgery was noted. Multivariate analysis done using Chi-square test, p-value of less than 0.05 was considered significant. Results: Mean age of patients in group A and group B was 42.66±12.37 years and 43.06±14.67 years, respectively. Majority of patients were females in both groups (n=45 in group A and n=39 in group B). There was no significant difference in time taken for access into peritoneal cavity (p-value>0.05). The duration of hospital stay (in hours) of the patients was 36.96 in Group A and 34.42 in Group B which was not statistically significant. The incidence of intraoperative and postoperative complications was not significant. Most common complication port site infections 3 (6%) in Group A. Conclusion: There was no significant difference between the two techniques with respect to time taken for peritoneal access and complications. In expert hands, both methods are comparable.

Download Full-text

Early versus delayed surgical evacuation of spontaneous supratentorial intracerebral hematoma: A prospective cohort study

Surgical Neurology International ◽

10.25259/sni_103_2020 ◽

2020 ◽

Vol 11 ◽

pp. 145 ◽

Cited By ~ 1

Author(s):

Mostafa Raafat ◽

Omar Abdelaleem Ragab ◽

Osama Mohamed Abdelwahab ◽

Mohamed Mamdouh Salama ◽

Mohamed Ahmed Hafez

Keyword(s):

Cohort Study ◽

Clinical Outcome ◽

Hospital Stay ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Intracerebral Hematoma ◽

Time Interval ◽

Surgical Evacuation ◽

Group A ◽

Group B

Background: The optimum timing for surgical evacuation of spontaneous supratentorial intracerebral hematoma (ICH) is still controversial. The aim of this study was to compare the clinical outcome following early versus delayed surgical evacuation of spontaneous supratentorial ICH. Methods: This is a prospective cohort study including 70 patients with spontaneous supratentorial ICH ≥30 cc in volume and Glasgow Coma Scale 8–12. Patients were divided into two groups based on the time interval between ictus and surgery; Group A (evacuated within 8 h from ictus) and Group B (evacuated >8 h from ictus). Outcome was assessed at discharge and at 2 months postoperative using extended Glasgow Outcome Scale. Results: The early evacuation group (Group A) included 44 patients and the late evacuation group (Group B) included 26 patients. Favorable outcome was achieved in 20.5% of the patients in Group A and in 11.5% of the patients in Group B. Mortality rate was 18.2% in Group A and 26.9% in Group B. Three patients in Group A and one patient in Group B required reoperation. The mean hospital stay was 17.18 days and 14.54 days in Groups A and B, respectively. Conclusion: Early surgical evacuation of spontaneous supratentorial ICH in patients with good preoperative conscious level is associated with better clinical outcome, particularly in the early postoperative period. Early surgical evacuation has no significant impact on the rate of reoperation or the length of hospital stay.

Download Full-text