scholarly journals Risk Factors for Postoperative Recurrence of Ovarian Endometrioma in Young Women

2021 ◽  
Author(s):  
Xing Xin ◽  
Xiaochen Song ◽  
Xinyang Zhao ◽  
Shanshan WU ◽  
Xinyao Hao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Women ◽  
Protective Factor ◽  
Univariate Analysis ◽  
Postoperative Recurrence ◽  
Disease Stage ◽  
Maximum Diameter ◽  
Ovarian Endometrioma ◽  
Recurrence Group

Abstract Background: Ovarian endometroma seriously affects women's health, and is susceptible to recurrence after surgery. However, only a few studies have been conducted to asses the risk factors for postoperative recurrence of ovarian endometrioma in young women, and no risk factors associated with recurrence have been found. The purpose of this study is to analyse the risk factors for postoperative recurrence of ovarian endometrioma in young women. Materials and Methods: We retrospectively analysed 196 young women who underwent ovarian endometrioma resection in Peking Union Medical College Hospital and Shengjing Hospital from January 2008 to January 2018 and were followed-up for at least 3 years postoperatively. The patients were divided into a recurrence group or a non-recurrence group. Their preoperative histories, laboratory indexes, intraoperative manifestations, and follow-up symptoms were analysed. Results: The cumulative recurrence rate of ovarian endometrioma in young women 3 and 5 years after surgery was 8.0%, and 20.3%, respectively. Univariate analysis showed significant differences in cancer antigen-125 levels (hazard ratio [HR]: 3.207, 95% confidence interval [CI]: 1.126–9.135, P = 0.029), the revised American Fertility Society (rAFS) disease stage (HR: 4.588, 95%CI: 1.422–14.805, P =0.011), postoperative pregnancy (HR: 0.28, 95%CI: 0.109–0.723, P = 0.008), and postoperative dysmenorrhoea (HR: 2.465, 95%CI :1.320–4.604, P = 0.005) between the two groups. Cox multivariate proportional risk analysis showed that rAFS disease stage (HR:3.783, 95%CI: 1.162–12.311, P=0.027) and postoperative dysmenorrhoea (HR: 2.291, 95%CI :1.222–4.296, P = 0.01) were risk factors for postoperative recurrence of ovarian endometrioma, whereas postoperative pregnancy (HR: 0.361, 95%CI: 0.138–0.944, P=0.038) was a protective factor for postoperative recurrence. There was no significant correlation between recurrence of ovarian endometrioma and age at surgery, age at the time of menarche, body mass index, duration of dysmenorrhoea, degree of dysmenorrhoea, genital malformation, surgical approach, maximum diameter of the cyst, and postoperative medication. Conclusion: rAFS disease stage and postoperative dysmenorrhoea are risk factors for the recurrence of ovarian endometrioma during long-term follow-up, whereas postoperative pregnancy is a protective factor.

scholarly journals Risk Factors for Postoperative Recurrence of Ovarian Endometrioma in Young Women

2021 ◽  
Author(s):  
Xing Xin ◽  
Xiaochen Song ◽  
Xinyang Zhao ◽  
Shanshan WU ◽  
Xinyao Hao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Women ◽  
Protective Factor ◽  
Univariate Analysis ◽  
Postoperative Recurrence ◽  
Disease Stage ◽  
Maximum Diameter ◽  
Ovarian Endometrioma ◽  
Recurrence Group

Abstract Purpose Ovarian endometroma seriously affects women's health, and is susceptible to recurrence after surgery. However, only a few studies have been conducted to asses the risk factors for postoperative recurrence of ovarian endometrioma in young women, and no risk factors associated with recurrence have been found. The purpose of this study is to analyse the risk factors for postoperative recurrence of ovarian endometrioma in young women, and to provide data support for postoperative follow-up of high-risk groups. Materials and Methods We retrospectively analysed 196 young women who underwent ovarian endometrioma resection in Peking Union Medical College Hospital and Shengjing Hospital from January 2008 to January 2018 and were followed-up for at least 3 years postoperatively. The patients were divided into a recurrence group or a non-recurrence group. Their preoperative histories, laboratory indexes, intraoperative manifestations, and follow-up symptoms were analysed. Results The cumulative recurrence rate of ovarian endometrioma in young women 3 and 5 years after surgery was 8.0%, and 20.3%, respectively. Univariate analysis showed significant differences in cancer antigen-125 levels (hazard ratio [HR]: 3.207, 95% confidence interval [CI]: 1.126–9.135, P = 0.029), the revised American Fertility Society (rAFS) disease stage (HR: 4.588, 95%CI: 1.422–14.805, P = 0.011), postoperative pregnancy (HR: 0.28, 95%CI: 0.109–0.723, P = 0.008), and postoperative dysmenorrhoea (HR: 2.465, 95%CI :1.320–4.604, P = 0.005) between the two groups. Cox multivariate proportional risk analysis showed that rAFS disease stage (HR:3.783, 95%CI: 1.162–12.311, P = 0.027) and postoperative dysmenorrhoea (HR: 2.291, 95%CI :1.222–4.296, P = 0.01) were risk factors for postoperative recurrence of ovarian endometrioma, whereas postoperative pregnancy (HR: 0.361, 95%CI: 0.138–0.944, P = 0.038) was a protective factor for postoperative recurrence. There was no significant correlation between recurrence of ovarian endometrioma and age at surgery, age at the time of menarche, body mass index, duration of dysmenorrhoea, degree of dysmenorrhoea, genital malformation, surgical approach, maximum diameter of the cyst, and postoperative medication. Conclusion rAFS disease stage and postoperative dysmenorrhoea are risk factors for the recurrence of ovarian endometrioma during long-term follow-up, whereas postoperative pregnancy is a protective factor.

scholarly journals Risk Factors for Early Recurrence of Gallstones in Patients Undergoing Laparoscopy Combined With Choledochoscopic Lithotomy: A Single-Center Prospective Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Bo Wang ◽  
Anhua Huang ◽  
Min Jiang ◽  
Haidong Li ◽  
Wenqing Bao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Prospective Study ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Gallbladder Wall ◽  
Postoperative Recurrence ◽  
Factors Associated ◽  
History Of

Objective: For patients with gallstones, laparoscopy combined with choledochoscopic lithotomy is a therapeutic surgical option for preservation rather than the removal of the gallbladder. However, postoperative recurrence of gallstones is a key concern for both patients and surgeons. This prospective study was performed to investigate the risk factors for early postoperative recurrence of gallstones.Methods: The clinical data of 466 patients were collected. Each patient was followed up for up to 2 years. The first follow-up visit occurred 4 months after the operation, and a follow-up visit was carried out every 6 months thereafter. The main goal of each visit was to confirm the presence or absence of gallbladder stones. The factors associated with gallstone recurrence were analyzed by univariate analysis and Cox regression.Results: In total, 466 eligible patients were included in the study, and 438 patients (180 men and 258 women) completed the 2-year postoperative follow-up. The follow-up rate was 94.0%. Recurrence of gallstones was detected in 5.71% (25/438) of the patients. Univariate analysis revealed five risk factors for the recurrence of gallstones. Multivariate Cox regression analysis showed that multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallbladder stones were the three predictive factors for postoperative recurrence of gallstones (P < 0.05).Conclusion: The overall 2-year recurrence rate of gallstones after the operation was 5.71%. Multiple gallstones, a gallbladder wall thickness of ≥4 mm, and a family history of gallstones were the three risk factors associated with early postoperative recurrence of gallstones.

scholarly journals Premature STEMI in Men and Women: Current Clinical Features and Improvements in Management and Prognosis

2021 ◽  
Vol 10 (6) ◽  
pp. 1314
Author(s):  
Rebeca Lorca ◽  
Isaac Pascual ◽  
Andrea Aparicio ◽  
Alejandro Junco-Vicente ◽  
Rut Alvarez-Velasco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Coronary Artery ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Young Women ◽  
Artery Dissection ◽  
Men And Women ◽  
High Prevalence

Background: Coronary artery disease (CAD) is the most frequent cause of ST-segment elevation myocardial infarction (STEMI). Etiopathogenic and prognostic characteristics in young patients may differ from older patients and young women may present worse outcomes than men. We aimed to evaluate the clinical characteristics and prognosis of men and women with premature STEMI. Methods: A total 1404 consecutive patients were referred to our institution for emergency cardiac catheterization due to STEMI suspicion (1 January 2014–31 December 2018). Patients with confirmed premature (<55 years old in men and <60 in women) STEMI (366 patients, 83% men and 17% women) were included (359 atherothrombotic and 7 spontaneous coronary artery dissection (SCAD)). Results: Premature STEMI patients had a high prevalence of classical cardiovascular risk factors. Mean follow-up was 4.1 years (±1.75 SD). Mortality rates, re-hospitalization, and hospital stay showed no significant differences between sexes. More than 10% of women with premature STEMI suffered SCAD. There were no significant differences between sexes, neither among cholesterol levels nor in hypolipemiant therapy. The global survival rates were similar to that expected in the general population of the same sex and age in our region with a significantly higher excess of mortality at 6 years among men compared with the general population. Conclusion: Our results showed a high incidence of cardiovascular risk factors, a high prevalence of SCAD among young women, and a generally good prognosis after standardized treatment. During follow-up, 23% suffered a major cardiovascular event (MACE), without significant differences between sexes and observed survival at 1, 3, and 6 years of follow-up was 96.57% (95% CI 94.04–98.04), 95.64% (95% CI 92.87–97.35), and 94.5% (95% CI 91.12–97.66). An extra effort to prevent/delay STEMI should be invested focusing on smoking avoidance and optimal hypolipemiant treatment both in primary and secondary prevention.

scholarly journals Logistic regression analysis on risk factors of augmented vertebra recompression after percutaneous vertebral augmentation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhongcheng An ◽  
Chen Chen ◽  
Junjie Wang ◽  
Yuchen Zhu ◽  
Liqiang Dong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Bone Cement ◽  
Vertebral Compression Fracture ◽  
Univariate Analysis ◽  
Compression Fracture ◽  
Osteoporotic Vertebral Compression Fracture ◽  
Vertebral Augmentation ◽  
Surgical Methods

Abstract Objective To explore the high-risk factors of augmented vertebra recompression after percutaneous vertebral augmentation (PVA) in the treatment of osteoporotic vertebral compression fracture (OVCF) and analyze the correlation between these factors and augmented vertebra recompression after PVA. Methods A retrospective analysis was conducted on 353 patients who received PVA for a single-segment osteoporotic vertebral compression fracture from January 2017 to December 2018 in our department according to the inclusion criteria. All cases meeting the inclusion and exclusion criteria were divided into two groups: 82 patients in the recompression group and 175 patients in the non-compression group. The following covariates were reviewed: age, gender, body mass index (BMI), injured vertebral segment, bone mineral density (BMD) during follow-up, intravertebral cleft (IVC) before operation, selection of surgical methods, unilateral or bilateral puncture, volume of bone cement injected, postoperative leakage of bone cement, distribution of bone cement, contact between the bone cement and the upper or lower endplates, and anterior height of injured vertebrae before operation, after surgery, and at the last follow-up. Univariate analysis was performed on these factors, and the statistically significant factors were substituted into the logistic regression model to analyze their correlation with the augmented vertebra recompression after PVA. Results A total of 257 patients from 353 patients were included in this study. The follow-up time was 12–24 months, with an average of 13.5 ± 0.9 months. All the operations were successfully completed, and the pain of patients was relieved obviously after PVA. Univariate analysis showed that in the early stage after PVA, the augmented vertebra recompression was correlated with BMD, surgical methods, volume of bone cement injected, preoperative IVC, contact between bone cement and the upper or lower endplates, and recovery of anterior column height. The difference was statistically significant (P < 0.05). Among them, multiple factors logistic regression elucidated that more injected cement (P < 0.001, OR = 0.558) and high BMD (P = 0.028, OR = 0.583) were negatively correlated with the augmented vertebra recompression after PVA, which meant protective factors (B < 0). Preoperative IVC (P < 0.001, OR = 3.252) and bone cement not in contact with upper or lower endplates (P = 0.006, OR = 2.504) were risk factors for the augmented vertebra recompression after PVA. The augmented vertebra recompression after PVP was significantly less than that of PKP (P = 0.007, OR = 0.337). Conclusions The augmented vertebra recompression after PVA is due to the interaction of various factors, such as surgical methods, volume of bone cement injected, osteoporosis, preoperative IVC, and whether the bone cement is in contact with the upper or lower endplates.

scholarly journals Risk Factors for Non-union in First MTPJ Arthrodesis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0035 ◽  
Author(s):  
Andrew Molloy ◽  
Clifford Butcher ◽  
Lyndon Mason
Keyword(s):  
Risk Factors ◽  
Relative Risk ◽  
Hallux Valgus ◽  
Locking Plate ◽  
Univariate Analysis ◽  
Dorsal Plate ◽  
First Metatarsophalangeal Joint ◽  
Non Union ◽  
Severe Hallux Valgus

Category: Midfoot/Forefoot Introduction/Purpose: Hallux rigidus occurs in up to 1 in 40 adults with 1st MTPJ arthrodesis being the gold standard operation for advanced disease. Our aim was to retrospectively identify risk factors for delayed / non-union of first metatarsophalangeal joint arthrodesis using a dorsal plate with cross screw. Methods: Case note and radiograph analysis was performed for operations between April 2014 and April 2016 with at least 6 months post-operative follow up. Union was defined as bridging bone across the fusion site on AP and lateral radiographic views with no movement or pain at the MTPJ on examination. All patients operations were performed or directly supervised by one of three fellowship trained consultant foot surgeons. Surgery was performed through a dorsal approach using a dorsal locking plate with compression screw. Blinded preoperative AP radiographs were analysed for the presence of a severe hallux valgus angle equal to or above 40 degrees. Intra-observer reliability was acceptable (95% CI: 1.6-2.3 degrees). Smoking and co-morbidities underwent univariate analysis for significance. Following initial result results, surgery in patients with arthritic hallux valgus were fixed using a separate plantar to dorsal / medial to lateral lag screw and dorsal locking plate Results: 71 patients with a mean age of 61 years (range, 29 to 81) comprised the initial patient group. Mean follow up time was 13 months for both union and nonunion groups (range 6 to 30 months). 7 patients were identified as delayed or nonunion (9.9%). All had hallux valgus angles of >25%. Age, diabetes, COPD and rheumatoid arthritis did not show significant associations with non-union. All smokers progressed to union (n = 17). Moderate to severe hallux valgus (relative risk: 1.29, p < 0.005) and under correction of >25 valgus at the MTPJ (relative risk: 14.44, p < 0.001) were significantly associated with non/delayed union. In the second group, 18 patients of similar demographics, there were no failure of reductions and 100% union rate Conclusion: Preoperative moderate to severe hallux valgus and under-correction of deformity are the most significant risk factors for non-union. The construct used for fixation needs to be chosen on the basis of the deforming forces. If so, excellent union rates can be achieved

scholarly journals Risk Factors for Progression in Vestibular Schwannomas After Incomplete Resection: A Single Center Retrospective Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Jiuhong Li ◽  
Xueyun Deng ◽  
Daibo Ke ◽  
Jian Cheng ◽  
Si Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Multivariate Analysis ◽  
Tumor Size ◽  
Tumor Volume ◽  
Univariate Analysis ◽  
Residual Tumor ◽  
Vestibular Schwannomas ◽  
Incomplete Resection ◽  
Cystic Component

Background and Purpose: The risk factors for progression in vestibular schwannomas (VSs) after incomplete resection (IR) remain to be elucidated. The purpose of this study was to investigate the risk factors for progression in remnant VSs after surgery.Methods: From January 2009 to January 2018, 140 consecutive patients who underwent IR of VSs via suboccipital retrosigmoid approach in our institution were retrospectively analyzed. During follow-up, if progression was detected, the patient was classified into Progressive Group (PG); if the residual tumor was stable or shrank, the patient was classified into Stable Group (SG). Univariate analysis and multivariate analysis were used to evaluate the risk factors for progression after IR of VSs.Results: After a mean follow-up of 80.4 months (range, 24–134 months), 35 (25.0%) patients (PG) had a progression, and no progression was detected in 105 (75.0%) patients (SG). The average tumor size was 36.5 ± 8.9 mm in PG and 31.0 ± 9.8 mm in SG, respectively. The residual tumor volume was 304.6 ± 443.3 mm3 in PG and 75.9 ± 60.0 mm3 in SG, respectively. Univariate analysis showed that preoperative tumor size, residual tumor volume, and irregular internal auditory canal (IAC) expansion were significantly different between the two groups, whereas gender, age, cystic component, or Ki-67 labeling index (LI) did not differ significantly between the two groups. Multivariate analysis showed residual tumor volume was the independent risk factor for progression.Conclusions: VSs that underwent IR with larger preoperative size, greater residual tumor volume, or irregular IAC expansion may have a higher progression rate. Strict follow-up with shorter interval in these patients to detect early progression is necessary.

Long-term observation on postoperative recurrence and complications of transvaginal mesh surgery for pelvic organ prolapse

2021 ◽  
Author(s):  
Junfang Yang ◽  
Kun Zhang ◽  
Jinsong Han ◽  
Yiting Wang ◽  
Ying Yao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pelvic Organ Prolapse ◽  
Protective Factor ◽  
Pelvic Organ ◽  
Vaginal Mesh ◽  
Transvaginal Mesh ◽  
Mesh Exposure ◽  
Mesh Surgery ◽  
Post Menopause

Objective: This study aims to evaluate the risk factors for subjective recurrence and complications of patients who underwent transvaginal synthetic mesh surgery. Design：This retrospective cohort study included patients who received transvaginal mesh (TVM) surgery between January 2005 and June 2019. Methods: The information of patients was collected, including basic characteristics, subjective recurrence, and mesh-related complications. The clinical characteristics of patients with and without subjective recurrence were compared. The sexual activities of patients before and after the operation were recorded. SPSS 20.0 was used for the statistical analysis. Results: A total of 257 patients were included. Among them, 62 (24.1%) patients were lost to follow-up. The median follow-up time was 80 months (12 months, 170 months). Finally, 195 patients were followed up, 11 (5.6%) patients had a subjective recurrence of pelvic organ prolapse, and 26 (13.3%) patients had mesh-related complications (11 patients with de novo pain and 15 patients with mesh exposure). We found significant differences in age (68.9±5.1 vs. 63.4±5.8 years old), years of post-menopause (17.5±6.3 vs. 13.3±6.9 years), previous hysterectomy (27.3% vs. 6.0%), and concomitant hysterectomy (45.5% vs. 81.0%) between patients with and without subjective recurrence (P<0.05). The mesh exposure proportion of patients with total vaginal mesh (47.6%) was significantly higher than that with anterior vaginal mesh (2.9%) (P<0.05). Furthermore, 6.7% of sexually active patients reported do novo dyspareunia. Limitation: The investigators could only record the subjective recurrence of patients, thus there is a lack of objective recurrence data. Conclusion: Age, years of post-menopause and previous hysterectomy are risk factors for subjective recurrence of transvaginal mesh surgery; however，concomitant hysterectomy is a protective factor. Mesh exposure is the most common complication, especially for total vaginal mesh repair surgery.

Aortic diseases

ESC CardioMed ◽  
2018 ◽  
pp. 2861-2863
Author(s):  
Bernard Iung
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Marfan Syndrome ◽  
Bicuspid Aortic Valve ◽  
Young Women ◽  
Beta Blockers ◽  
Aortic Aneurysms ◽  
Maximum Diameter ◽  
Aortic Diseases

Aortic diseases encountered in young women are mainly associated with syndromic diseases, which are often heritable, or bicuspid aortic valve. The most frequent syndromic disease is Marfan syndrome. In Marfan syndrome, the risk of aortic dissection is low during pregnancy when the maximum diameter of the ascending aorta is less than 45 mm. Dissection may affect the thoracic ascending or descending aorta. The risk of aortic dissection is low in bicuspid aortic valve when the aortic diameter is less than 50 mm. Beta blockers are recommended throughout pregnancy in Marfan syndrome and are often used in other causes of aortic aneurysms. Close echocardiographic follow-up is needed during pregnancy and after delivery.

Aortic diseases

ESC CardioMed ◽  
2018 ◽  
pp. 2861-2863
Author(s):  
Bernard Iung
Keyword(s):  
Aortic Valve ◽  
Aortic Dissection ◽  
Marfan Syndrome ◽  
Bicuspid Aortic Valve ◽  
Young Women ◽  
Beta Blockers ◽  
Aortic Aneurysms ◽  
Maximum Diameter ◽  
Aortic Diseases

Aortic diseases encountered in young women are mainly associated with syndromic diseases, which are often heritable, or bicuspid aortic valve. The most frequent syndromic disease is Marfan syndrome. In Marfan syndrome, the risk of aortic dissection is low during pregnancy when the maximum diameter of the ascending aorta is less than 45 mm. Dissection may affect the thoracic ascending or descending aorta. The risk of aortic dissection is low in bicuspid aortic valve when the aortic diameter is less than 50 mm. Beta blockers are recommended throughout pregnancy in Marfan syndrome and are often used in other causes of aortic aneurysms. Close echocardiographic follow-up is needed during pregnancy and after delivery.

scholarly journals P720 Recurrent rectovaginal fistula in patients with Crohn’s disease: How can we improve the success rate of graciloplasty? A bi-centric European study in 30 patients

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S579-S580
Author(s):  
A Frontali ◽  
M Rottoli ◽  
A Chierici ◽  
G Poggioli ◽  
Y Panis
Keyword(s):  
Risk Factors ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Antibiotic Prophylaxis ◽  
Success Rate ◽  
Rectovaginal Fistula ◽  
Univariate Analysis ◽  
Diverting Stoma ◽  
Prospective Database

Abstract Background Graciloplasty (GP) is indicated in case of recurrent rectovaginal fistula (RVF), even in patients with Crohn’s disease, after failure of previous local treatments. The aim of this study was to evaluate risk factors for GP failure performed for recurrent RVF in these patients. Methods We realised a retrospective study based on a prospective database of GP, realised in two Tertiary expert Centers in Italy (Bologna) and France (Clichy). Results Thirty-two patients undergoing 34 GP (2 patients have undergone 2 GP for failure of first GP): we excluded second GP and 2 patients without available follow-up: 30 patients undergoing a first GP for RVF (n = 29) or ileal-vaginal fistula after ileal-pouch-anal-anastomosis (IPAA) (n = 1) with a mean age of 41 ± 10 years (range, 25–64) were analysed. After a mean follow-up of 65 ± 52 months (2–183), a success of GP (considered as absence of diverting stoma and RVF healing) was noted in 17/30 patients (57%). We evaluated risk factors for failure of the procedure and we found only 2 risk factors on univariate analysis: (1) absence of a postoperative prophylactic antibiotherapy: only 2/13 (15%) patients with a GP failure had a postoperative antibiotic-prophylaxis vs. 9/15 (60%) patients with success of GP (p = 0.0238); (2) a postoperative perineal infection: 7/13 (54%) with a GP failure developed a postoperative perineal infection vs. 2/17 (12%) patients (p = 0.0196). Conclusion Graciloplasty for recurrent rectovaginal fistula in patients with Crohn’s disease is effective in 57% of patients. Our study underlines the possible benefit of a postoperative antibiotic-prophylaxis because it seems to increase significantly the success rate of the procedure.

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