scholarly journals Pediatric Tracheotomy: Comparison of surgical technique with early and late complications in 273 cases

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Murat Gumussoy
Keyword(s):  
Surgical Technique ◽  
Surgical Techniques ◽  
Skin Incision ◽  
Late Complications ◽  
Skill Level ◽  
Intubation Time ◽  
Early Complications ◽  
Creative Commons ◽  
Significant Difference ◽  
The Relationship

Objectives: This study was aimed to compare the early and late complications of tracheotomy in pediatric patient, with respect to surgical techniques. Methods: The relationship between demographic characteristics, surgical techniques obtained from the files of the children and complications developing after surgery were compared retrospectively. Results: One hundred fifty two out of 273 developed complications after tracheotomy. Among these, 75 were early complications and 77 were late complications. Results obtained concerning early complications showed a significant difference between Skin incision and Bleeding and Accidental decannulation; Tracheal incision and Subcutaneous emphysema; surgical time and accidental decannulation and tube/ventilation problem; Surgeon’s skill level and bleeding. As regards late complications there was a significant difference between Intubation Time and Stomal-tracheal granulation; Tracheal incision and Stomal infection; Surgeon’s skill level and Stomal-tracheal granulation. Conclusions: In pediatric tracheotomy the preferred skin incision and tracheal incision, surgeon’s experience, tracheotomoy time and intubation time are important as regards development of early or late complications. How to cite this:Gumussoy M. Pediatric Tracheotomy: Comparison of surgical technique with early and late complications in 273 cases. Pak J Med Sci. 2019;35(1):247-251. doi: https://doi.org/10.12669/pjms.35.1.132 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals The relationship between premenstrual syndrome and anger

2019 ◽  
Vol 35 (2) ◽  
Author(s):  
Havva Yeşildere Sağlam ◽  
Fatma Basar
Keyword(s):  
Premenstrual Syndrome ◽  
Personal Information ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Anger Control ◽  
Cross Sectional ◽  
Creative Commons ◽  
Syndrome Scale ◽  
Significant Difference ◽  
The Relationship

Objective: Premenstrual Syndrome (PMS) is a significant disorder affecting the daily life of women of reproductive age. The aims of this study was to determine the PMS prevalence and the examination of the relationship between PMS and anger. Methods: This was a cross sectional study. The study was carried out with 720 women between the ages of 15-49 living in the province of Kutahya, Turkey. A Personal Information Form, the Premenstrual Syndrome Scale (PMSS) and the State-Trait Anger Scale (STAS) were used to collect data. Results: The PMS prevalence was 48.75%. There was a statistically significant difference between the groups in terms of constant anger, anger-in, anger-out and anger control subscales (p <0.001). The average scores of women with PMS for constant anger anger-in and anger-out was significantly higher. The anger control scores were at a significantly lower level. Conclusion: Women with PMS had higher anger and lower anger control levels. It should be advisable to recommend anger control management and provide social support so these women can cope with the symptoms. The result of our study emphasizes the importance of careful assessment of anger in women with premenstrual symptoms. How to cite this:Saglam HY, Basar F. The relationship between premenstrual syndrome and anger. Pak J Med Sci. 2019;35(2):---------.  doi: https://doi.org/10.12669/pjms.35.2.232 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Stent or Surgery for Malignant Low Bileduct Obstruction?

HPB Surgery ◽  
1997 ◽  
Vol 10 (3) ◽  
pp. 179-181
Author(s):  
Ingemar Ihse ◽  
Lars Hansson ◽  
Lars-Erik Hammarström ◽  
Eva Lindström
Keyword(s):  
Controlled Trial ◽  
Surgical Techniques ◽  
Outlet Obstruction ◽  
Major Complication ◽  
Late Complications ◽  
Stent Insertion ◽  
Endoscopic Stenting ◽  
Total Hospital Stay ◽  
Significant Difference ◽  
Cast Doubt

The development of non-surgical techniques for the relief of malignant low bileduct obstruction has cast doubt on the best way of relieving jaundice, particularly in patients fit for surgery whose life expectancy is more than a few weeks.We did a randomised prospective controlled trial comparing endoscopic stent insertion and surgical biliary bypass in patients with malignant low bileduct obstruction. 204 patients were randomised (surgery 103, stent 101); 3 subsequently proved to have benign disease and were excluded, leaving 101 surgical and 100 stented patients for assessment. Technical success was achieved in 94 surgical and 95 stent patients, with functional biliary decompression obtained in 92 patients in both groups. In stented patients, there was a lower procedure-related mortality (3% vs 14%, p=0.01), major complication rate (11% vs 29%, p=0.02), and median total hospital stay (20 vs 26 days, p=0.001). Recurrent jaundice occurred in 36 stented patients and 2 surgical patients. Late gastric outlet obstruction occurred in 17% of stented patients and 7% of the surgical group. Despite the early benefits of stenting there was no significant difference in overall survival between the two groups (median survival: surgical 26 weeks; stented 21 weeks; p=0.065).Endoscopic stenting and surgery are effective palliative treatments with the former having fewer early treatment-related complications and the latter fewer late complications.

scholarly journals COVID-19 aerosol box as protection from droplet and aerosol contaminations in healthcare workers performing airway intubation: a randomised cross-over simulation study

2020 ◽  
pp. emermed-2020-210514 ◽  
Author(s):  
Muhaimin Noor Azhar ◽  
Aida Bustam ◽  
Khadijah Poh ◽  
Ahmad Zulkarnain Ahmad Zahedi ◽  
Mohd Zahir Amin Mohd Nazri ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Random Order ◽  
Transmission Risk ◽  
Intubation Time ◽  
Body Regions ◽  
Significant Difference ◽  
Intubation Success Rate ◽  
The Difference ◽  
Reduced Mobility ◽  
The Relationship

BackgroundConcerns over high transmission risk of SARS-CoV-2 have led to innovation and usage of an aerosol box to protect healthcare workers during airway intubation in patients with COVID-19. Its efficacy as a barrier protection in addition to the use of a standard personal protective equipment (PPE) is not fully known. We performed a simulated study to investigate the relationship between aerosol box usage during intubation and contaminations on healthcare workers pre-doffing and post-doffing of PPE.MethodsThis was a randomised cross-over study conducted between 9 April to 5 May 2020 in the ED of University Malaya Medical Centre. Postgraduate Emergency Medicine trainees performed video laryngoscope-assisted intubation on an airway manikin with and without an aerosol box in a random order. Contamination was simulated by nebulised Glo Germ. Primary outcome was number of contaminated front and back body regions pre-doffing and post-doffing of PPE of the intubator and assistant. Secondary outcomes were intubation time, Cormack-Lehane score, number of intubation attempts and participants’ feedback.ResultsThirty-six trainees completed the study interventions. The number of contaminated front and back body regions pre-doffing of PPE was significantly higher without the aerosol box (all p values<0.001). However, there was no significant difference in the number of contaminations post-doffing of PPE between using and not using the aerosol box, with a median contamination of zero. Intubation time was longer with the aerosol box (42.5 s vs 35.5 s, p<0.001). Cormack-Lehane scores were similar with and without the aerosol box. First-pass intubation success rate was 94.4% and 100% with and without the aerosol box, respectively. More participants reported reduced mobility and visibility when intubating with the aerosol box.ConclusionsAn aerosol box may significantly reduce exposure to contaminations but with increased intubation time and reduced operator’s mobility and visibility. Furthermore, the difference in degree of contamination between using and not using an aerosol box could be offset by proper doffing of PPE.

Surgical technique of placement of an external jugular tunneled hemodialysis catheter in a large pig model

2018 ◽  
Vol 19 (5) ◽  
pp. 473-476
Author(s):  
Marius C Florescu ◽  
Joseph Runge ◽  
John Lof ◽  
Elizabeth Stolze ◽  
Gretchen Fry ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Jugular Vein ◽  
Surgical Techniques ◽  
Late Complications ◽  
Surgical Anatomy ◽  
Pig Model ◽  
Hemodialysis Catheter ◽  
Human Use ◽  
Large Animals ◽  
Insufficient Knowledge

Background: Currently, there is insufficient knowledge about the surgical anatomy and surgical techniques in large animals that can be used to test medical devices designed for human use. We encountered this problem in our study requiring the placement of jugular vein, tunneled, cuffed hemodialysis catheter in 70 kg pigs. Despite the operator’s extensive expertise in placing tunneled hemodialysis catheters in humans, the important differences in anatomy made the procedure and choosing the appropriate catheter length challenging. Methods: The following article describes the anatomy and our technique for the placement of tunneled hemodialysis catheter in the pig model. Results: We consider our surgical technique to be sound because in all animals the catheters were placed in the desired location, the procedures were well tolerated by the animals, and there were no immediate or late complications. Conclusion: We present our experience to help other researchers who might encounter the same problem.

scholarly journals The relationship between lymphedema severity and awareness of lymphedema surgery

2021 ◽  
Vol 48 (5) ◽  
pp. 534-542
Author(s):  
Hyun Seung Lee ◽  
Yong Chan Bae ◽  
Su Bong Nam ◽  
Chang Ryul Yi ◽  
Jin A Yoon ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Indocyanine Green ◽  
Upper Extremity ◽  
Surgical Techniques ◽  
Cancer Center ◽  
Limited Knowledge ◽  
Early Stages ◽  
Md Anderson ◽  
The Relationship

Background During the early stages of lymphedema, active physiologic surgical treatment can be applied. However, lymphedema patients often have limited knowledge and misconceptions regarding lymphedema and surgical treatment. We analyzed the correlations between lymphedema severity and surgical technique according to patients’ awareness of surgical treatment for secondary upper extremity lymphedema (UEL).Methods Patients with UEL diagnosed between December 2017 and December 2019 were retrospectively evaluated. At the time of their presentation to our hospital for the treatment of lymphedema, they were administered a questionnaire about lymphedema and lymphedema surgery. Based on the results, patients were classified as being aware or unaware of surgical treatment. Lymphedema severity was classified according to the arm dermal backflow (ADB) stage and the MD Anderson Cancer Center (MDACC) stage based on indocyanine green lymphography conducted at presentation. Surgical techniques were compared between the two groups.Results Patients who were aware of surgical treatment had significantly lower initial ADB and MDACC stages (P<0.05) and more frequently underwent physiologic procedures than excisional procedures (P=0.003).Conclusions If patients are actively educated regarding surgical treatment of lymphedema, physiologic procedures may be performed during the early stages of UEL.

scholarly journals Study on the Relationship between Sports Skills and Visual Image Operation

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Peng Zeng ◽  
Long Liu ◽  
Timon Cheng-Yi Liu ◽  
Xiang-Bo Yang
Keyword(s):  
Visual Image ◽  
Skill Level ◽  
Track And Field ◽  
Visual Images ◽  
Operation Speed ◽  
Significant Difference ◽  
Close Relationship ◽  
Sports Skills ◽  
The Relationship ◽  
Speed And Accuracy

120 college athletes including 30 gymnasts, 30 ball players, 30 athletes in track and field, and 30 swimmers with different levels of sports skills were measured on the operation speed and accuracy of visual images in the present study. The results showed that there was a close relationship between sport skill level and the operation level of visual images. The higher the sport skill level was, the higher the operation level was. The gymnasts were faster in the operation of visual images than the other athletes, but there was no significant difference among athletes of other sports games in visual image operation. The athletes achieved great improvement in their ability of visual image, but there was no significant difference between different genders.

scholarly journals Relationship between myocardial enzyme levels, hepatic function and metabolic acidosis in children with rotavirus infection diarrhea

2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Na-ying Zuo ◽  
Yuan-da Zhang ◽  
Qing-wei Dong ◽  
Li-po Han
Keyword(s):  
Creatine Kinase ◽  
Metabolic Acidosis ◽  
Hepatic Function ◽  
Infectious Diarrhea ◽  
Rotavirus Infection ◽  
Creative Commons ◽  
Significant Difference ◽  
Group A ◽  
The Relationship ◽  
Open Access Article

Objective: To investigate the relationship between myocardial enzymes, liver function and metabolic acidosis in children with rotavirus infection diarrhea. Methods: The data of 70 children with infectious diarrhea treated in Baoding Children’s Hospital, China, from October 2017 to April 2018 were retrospectively studied. The antigen of rotavirus in feces was positive by colloidal gold method. According to the clinical features of biochemical indicators and mental status, the patients were divided into four groups, an acidosis-free group, a mild acidosis group, a moderate acidosis group and a severe acidosis group, in line with acidosis severity. In addition to detecting the hepatic functions of the pediatric patients in the four groups, including aspartate aminotransferase (AST), alanine aminotransfer (ALT) levels, and myocardial enzyme levels (e.g., creatine kinase, or CK, and creatine kinase isoenzyme, or CK-MB), the relationships of hepatic function, myocardial enzyme levels and acidosis severity of the patients with infectious diarrhea caused by rotavirus infection were also analyzed. Results: There was no significant difference in sex and age among the four groups (P>0.05). However, there was a significant difference in the frequency of diarrhea and vomiting (p<0.05). In addition, there were significant differences in creatine kinase, CK-MB, AST and ALT levels in children with metabolic acidosis of different severities. Conclusion: With the aggravation of metabolic acidosis, infectious diarrhea caused by rotavirus is characterized by the aggravation of hepatic function and myocardial cells. doi: https://doi.org/10.12669/pjms.36.6.2325 How to cite this:Zuo NY, Zhang YD, Dong QW, Han LP. Relationship between myocardial enzyme levels, hepatic function and metabolic acidosis in children with rotavirus infection diarrhea. Pak J Med Sci. 2020;36(6):---------.    doi: https://doi.org/10.12669/pjms.36.6.2325 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Appropriate Head Position for Nasotracheal Intubation by Using Lightwand Device (Trachlight)

2014 ◽  
Vol 61 (2) ◽  
pp. 47-52
Author(s):  
Yozo Manabe ◽  
Shigeru Iwamoto ◽  
Mika Seto ◽  
Kazuna Sugiyama
Keyword(s):  
Nasotracheal Intubation ◽  
Head Position ◽  
Ordinal Scale ◽  
Neutral Position ◽  
Intubation Time ◽  
Point Scale ◽  
Intubation Difficulty ◽  
Significant Difference ◽  
The Relationship ◽  
Position Group

Abstract The purpose of this study was to determine the relationship between the head position and the subsequent ease of nasotracheal intubation by using the lightwand device Trachlight (TL). Patients requiring nasotracheal intubation were subdivided into 3 groups according to the intubated head position (group S: sniffing position; group E: extension position; and group N: neutral position). The number of attempts, the total intubation time, and the failures of the TL intubation were recorded. Intubation difficulty by means of TL was assessed by the ordinal 6-point scale. Of the 300 patients enrolled in the study, TL intubation was successful in 91.3% of them. There was no significant difference in the success rate of the first attempt between the groups. No correlation between the ordinal scale and the head position was observed. The total intubation time and the ratio of “unsuccessful” cases were not significantly different among the 3 groups. TL is an effective alternative for patients who require nasotracheal intubation. Our study did not determine the most favorable head position for nasotracheal intubation with the TL, so we recommend that nasotracheal intubation with TL be started with the head in the neutral position and then changed to a more appropriate position, if necessary, on an individual basis.

scholarly journals Does the Wilson frame assist with optimizing surgical exposure for minimally invasive lumbar fusions?

2010 ◽  
Vol 28 (5) ◽  
pp. E20 ◽  
Author(s):  
Mario J. Cardoso ◽  
Michael K. Rosner
Keyword(s):  
Surgical Technique ◽  
Minimally Invasive ◽  
Learning Curve ◽  
Sagittal Plane ◽  
Surgical Techniques ◽  
Lumbar Spine Surgery ◽  
Neural Structure ◽  
Disc Space ◽  
Significant Difference ◽  
The Mean

Object Minimally invasive lumbar spine surgery has dramatically evolved over the last decade. Minimally invasive techniques and transforaminal lumbar interbody fusion (TLIF) often require a steep learning curve. Surgical techniques require pre-positioning the patient in maximal kyphosis to optimize visualization of the disc space and prevent unnecessary retraction of neural structures. The authors describe their experience in validating the surgical technique recommendation of Wilson frame–induced kyphosis. Methods Over the past 6 months, data obtained in 20 consecutive patients (40 total levels) undergoing minimally invasive TLIF were reviewed. In each patient, preincision intraoperative radiographs were reviewed at L4–5 and L5–S1 with the patient on a Wilson frame in maximal lordosis and then in maximal kyphosis. The change in disc space angle at L4–5 and L5–S1 after changing from maximal lordosis to maximal kyphosis was reviewed. Descriptive statistics were calculated for sagittal plane angular measures at L4–5 and L5–S1 in lordosis and kyphosis, including absolute differences and percentage of change between positions. Inferential statistics were calculated using paired t-tests with α= 0.05. Results Twenty patients underwent single- or multilevel minimally invasive TLIF. Inducing kyphosis with the Wilson frame aided in optimizing exposure and decreasing the need for neural structure retraction. Both L4–5 and L5–S1 showed statistically significant (p < 0.001) and clinically meaningful changes with increased segmental flexion in the kyphotic position. At L4–5 the mean increase in flexion was 4.5° (95% CI 2.9–6.0°), representing an average 47% change. The mean increase in flexion at L5–S1 was 3.2° (95% CI 2.3–4.2°), representing an average 20.8% change. In lordosis the mean angle at L4–5 was 10.6 ± 4.4° and at L5–S1 was 17 ± 7.0°. In kyphosis the mean angle at L4–5 was 6.1 ± 4.5° and at L5–S1 was 13.8 ± 6.5°. Additionally, there was a statistically significant difference (p < 0.05) in percentage of change between the 2 levels, with L4–5 showing a greater change (27% more flexion) between positions, but the absolute mean difference between the levels was small (1.3°). Conclusions Minimally invasive TLIF is challenging and requires a significant learning curve. The recommended surgical technique of inducing kyphosis with the Wilson frame prior to incision significantly optimizes exposure. The authors' experience demonstrates that this technique is essential when performing minimally invasive lumbar spinal fusions.

Lack of Complications in Skin Surgery of Patients Receiving Clopidogrel as Compared with Patients Taking Aspirin, Warfarin, and Controls

2010 ◽  
Vol 76 (1) ◽  
pp. 11-14 ◽  
Author(s):  
Eyal Kramer ◽  
Eran Hadad ◽  
Melvyn Westreich ◽  
Avshalom Shalom
Keyword(s):  
Antiplatelet Agent ◽  
Surgical Techniques ◽  
Late Complications ◽  
Control Group ◽  
Study Group ◽  
Medical Conditions ◽  
Past Medical History ◽  
Significant Difference ◽  
Skin Surgery

Clopidogrel, a new antiplatelet agent that irreversibly inhibits platelet aggregation, is widely used today. This prospective work was conducted to evaluate the safety of performing skin surgery on patients taking clopidogrel. Patients undergoing surgery for excision of skin or subcutaneous lesions under local anesthesia taking clopidogrel were the study group. The control group comprised 2073 historical patients who had undergone a similar procedure. Data collected included: age, sex, past medical history, medications, and late complications. Follow-up was done at 1 to 2 weeks and 3 to 6 months. There were 32 patients on clopidogrel, having 38 lesions removed. Of these, seven patients were on aspirin and clopidogrel combined. The groups taking clopidogrel, aspirin, and warfarin had significantly more males, were older, and had significantly more comorbid medical conditions. There was no significant difference in the incidence of any of the complications in any of the groups. This study shows that patients taking clopidogrel before skin surgery, though older and with more associated medical conditions, do not experience a greater rate of complications. We conclude that patients undergoing minor excisional cutaneous surgery should continue taking clopidogrel because there is no apparent risk for increased complications when good meticulous surgical techniques are used.

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