scholarly journals A Blumgart-Anastomosis Based Half-Invagination Pancreaticoenterostomy With Better Applicability to Laparoscopy and Lower Incidence of Pancreatic Leakage

Author(s):  
Qiang Sun ◽  
Peng Peng ◽  
Xueyi Gong ◽  
Jianlong Wu ◽  
Qiao Zhang ◽  
...  

Abstract Background The Blumgart anastomosis has been established as one of the safest anastomoses for pancreas remnant reconstruction, with low rates of postoperative pancreatic fistula (POPF) and postoperative complications. However, how to make laparoscopic pancreaticoenterostomy easier and safer is still a subject to be discussed. Methods Data of patients undergoing laparoscopic pancreaticoduodenectomy from April 2014 to December 2019 were retrospectively analyzed. Results 20 cases of half-invagination anastomosis (Group HI) and 26 cases of Cattell-warren anastomosis (Group CW) were included. Intraoperative blood loss, Operative time and Postoperative drainage tube placement time of Group HI was significantly less than those of Group CW. Patients of Clavien-Dindo grade III and above in Group HI was significantly less than Control Group. Group Incidence of POPF in Group HI was significantly lower than that in Group CW. No high-risk group emerged during Fistula risk score analytical phase, and the highest risk of moderate-risk group was pancreatic leakage. Respectively, incidence of pancreatic leakage in Group HI and Group CW was 7.7% and 46.67%, while incidence of Group HI was significantly lower than that in the Group CW. Conclusions The Blumgart-anastomosis based half-invagination pancreaticoenterostomy with better applicability to laparoscopy can effectively reduce the incidence of postoperative pancreatic leakage.

2016 ◽  
pp. 140-143
Author(s):  
N.V. Cotsabin ◽  
◽  
O.M. Makarchuk ◽  

The proportion of patients with multiple unsuccessful attempts of assisted reproductive technology (ART) is about 30% of all patients treated with the use of ART. Women with history of unsuccessful ART attempts - a special category of patients who require emergency attention and a thorough examination at the stage of preparation for superovulation stimulation,the selection of embryos and endometrium preparation for embryo transfer. The objective: to distinguish high-risk group of unsuccessful attempts based on a detailed analysis of anamnestic and clinical data of infertile women with repeated unsuccessful ART attempts that requires more in-depth study of hormonal features, ovarian reserve and condition of the endometrium. Materials and methods. For better understanding of the problem of repeated unsuccessful ART attempts and сreation of efficient infertility treatment algorithms for these couples we conducted a thorough analysis of anamnestic data of three groups of infertile women (105 patients), which were distributed by age: group I – younger than 35, the II group – from 35 to 40, the III group - over 40 years. These groups of patients were compared with each other and with the control group of healthy women (30 persons). Results. Leading stress factors in the percentage three times prevailed in the group of infertile women and had a direct connection with the fact of procedure «fertilization in vitro» and chronic stressors caused by prolonged infertility. Primary infertility was observed significantly more frequent in patients younger than 35 years (p <0.05), secondary infertility - mostly in the second and third experimental groups (p <0.05). Noteworthy significant percentage of wellknown causes of infertility and idiopathic factor in all groups, and the prevalence of tubal-peritoneal factor in the second and third experimental groups, and endocrine dysfunction in the I experimental group. The most common disorder among this category of woman was polycystic ovary syndrome. Frequency of usual miscarriage among patients of I ana II groups was two times higher than in the third group (p <0.05). Among the experimental groups the leading place belongs urinary tract infection, respiratory tract diseases, pathologies of the cardiovascular system. Data of the stratified analysis show an increase likelihood of repeated unsuccessful ART attempts under the influence of constant chronic stress (odds ratio OR=2.06; 95% CI: 0.95–3.17; p<0.05). Conclusions. Among infertile patients with repeated unsuccessful ART attempts must be separated a high risk group of failures. The identity depends on the duration of infertility, female age and leading combination of factors. Key words: repeated unsuccessful ART attempts, anamnesis, infertility, high risk.


2021 ◽  
Vol 10 (11) ◽  
pp. 2293
Author(s):  
Joon Hwan Jang ◽  
Sun Ju Chung ◽  
Aruem Choi ◽  
Ji Yoon Lee ◽  
Bomi Kim ◽  
...  

This study aimed to examine the relationship of general cognitive function with gaming use, and to identify elements of intelligence predicting increased gaming use. In total, 160 young adults participated in this study. Two clinical groups (n = 97) were defined: excessive gaming users diagnosed with internet gaming disorder (IGD) (n = 64) and the high-risk users (n = 33). The control group (n = 63) was also divided into regular gamers (n = 14) and non-gamers (n = 49). Participants completed the Wechsler Adult Intelligence Scale-IV and self-reported questionnaires regarding IGD severity and gaming hours. The IGD group had significantly lower Full Scale Intelligence Quotient (FSIQ), Verbal Comprehension Index (VCI), and Processing Speed Index (PSI) scores, compared with regular gamers and non-gamers. The IGD group also exhibited lower Working Memory Index (WMI) scores, compared with non-gamers. The high-risk group demonstrated significantly lower PSI score, compared with non-gamers. Furthermore FSIQ, VCI, WMI, and PSI scores were significant predictors of gaming hours in the IGD group. For the high-risk group, FSIQ, WMI, and VCI scores were negatively associated with gaming hours. Our study demonstrates the need to address the importance of enhancing working memory and verbal ability, thus, preventing the development of gaming addiction among individuals at high-risk gamers.


1984 ◽  
Vol 144 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Tom Lundin

SummaryWith the help of data on the registered days of sickness per year, a study was made of a group of relatives (n = 32) who had suffered sudden and unexpected bereavement to determine whether this resulted in an increase in morbidity in the two-year period following the loss, compared with the previous two years. A comparison was made with a control group of relatives who had also suffered bereavement but where the deaths were not unexpected. Increased morbidity, especially psychiatric morbidity, was found following sudden and unexpected bereavement but not in the control group. It is concluded that persons exposed to sudden and unexpected loss of a close relative are subject to increased psychiatric morbidity and should be regarded as a high-risk group.


2021 ◽  
Vol 105 (1-3) ◽  
pp. 559-563
Author(s):  
Seungmin Lee ◽  
Kwang Yeol Paik

Background The aim of this study is to examine whether pancreaticogastrostomy (PG) or pancreaticojejunostomy (PJ) is the better reconstructive method to reduce postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy (PD) according to the fistula risk. Methods An institutional database was reviewed for patients undergoing PD between January 2008 and August 2019. A total of 159 patients were stratified into 4 groups according to the Clinical Risk Score-Pancreatic Fistula. POPF according to 4 risk groups was compared between PJ and PG. Results Of the 159 patients, 82 underwent PG (51.6%) and 77 underwent PJ (48.4%) reconstruction. POPF rate was 17.1% (n = 14) in the PG group and 12.9% (n = 10) in the PJ group (P = 0.51). POPF rates were not different in intermediate, low, and negligible risks between 2 reconstructive methods. In the high-risk group (n = 47), there were 4 POPFs (22.2%) in PJ group and 9 (31.0%) in the PG group, respectively (P = 0.74). Conclusion In PD, there was no superior method of reconstruction with regard to POPF, even in high-risk glands.


2015 ◽  
Vol 207 (3) ◽  
pp. 198-206 ◽  
Author(s):  
Paolo Fusar-Poli ◽  
Matteo Rocchetti ◽  
Alberto Sardella ◽  
Alessia Avila ◽  
Martina Brandizzi ◽  
...  

BackgroundThe nosology of the psychosis high-risk state is controversial. Traditionally conceived as an ‘at risk’ state for the development of psychotic disorders, it is also conceptualised as a clinical syndrome associated with functional impairment.AimsTo investigate meta-analytically the functional status of patients at high clinical risk for psychosis and its association with longitudinal outcomes.MethodThree meta-analyses compared level of functioning (n = 3012) and quality of life (QoL) (n = 945) between a high-risk group, a healthy control group and group with psychosis, and baseline functioning in people in the high-risk group who did or did not have a transition to psychosis at follow-up (n = 654).ResultsPeople at high risk had a large impairment in functioning (P<0.001) and worse QoL (P = 0.001) than the healthy control group, but only small to moderately better functioning (P = 0.012) and similar QoL (P = 0.958) compared with the psychosis group. Among the high-risk group, those who did not develop psychosis reported better functioning (P = 0.001) than those who did.ConclusionsOur results indicate that the high-risk state is characterised by consistent and large impairments of functioning and reduction in QoL similar to those in other coded psychiatric disorders.


2016 ◽  
Vol 97 (4) ◽  
pp. 656-661
Author(s):  
M G Tukhbatullin ◽  
K V Yanakova

Aim. To study capabilities of quantitative elastographic study to assess the elasticity of the uterine cervix in women with a fetal chromosomal abnormality in the first trimester of pregnancy.Methods. 230 pregnant women of high-risk group at 11-13.6 weeks of pregnancy (parietal-coccygeal length 45-84 mm) were included in this study. The first group consisted of 213 women without fetal pathology. The second group included 17 women, in whose fetuses different chromosomal abnormalities were detected. In ultrasound examination of pregnant women in the I trimester of pregnancy, in addition to standard methods of examination, quantitative cervical elastography was performed.Results. According to results of quantitative elastography in 14 (82.35%) out of 17 pregnant women (second group) one or another degree of the cervical tissue softening was found, and 3 (17.64%) pregnant women with fetal chromosomal pathology had stiff cervix (all 3 cases with Down syndrome). In the control group in 10 (4.7%) of 213 pregnant women relatively soft cervix was identified, and in 203 (95.3%) women cervical density was higher than the myometrial density. A statistically significant difference between the indices of SWE-Ratio in groups was revealed. Quantitative elastography, as a diagnostic test predicting the risk of miscarriage due to chromosomal abnormalities, has a high sensitivity (84.38%) and even higher specificity (95.26%) of negative predictive value 97.57%.Conclusion. Quantitative elastography reveals a significant decrease in the cervical elasticity (softening) in pregnant women with fetal chromosomal abnormality in the I trimester of pregnancy, which allows us to recommend this method of ultrasound examination as an additional marker for early diagnosis of miscarriage due to fetal chromosomal abnormality.


1998 ◽  
Vol 4 (3) ◽  
pp. 567-570
Author(s):  
A. Sadeghi Hassanabadi ◽  
M. Yaghout

The relation between drug addiction and tuberculosis was assessed in a comparative prevalence study. A group of 561 male addicts were compared with a group of 1532 non-addicts of similar sociocultural background. The results of infection rate showed a statistically significant difference X [2] = 72, P < 0.001] in the proportion of positive tuberculin sensitivity between the groups [66.7% among addicts versus 45.6% in the control group]. Fourteen active cases of pulmonary tuberculosis were found among the addicts with no case in the control group. This gives a prevalence rate of 2500/100 000 addicts, more than 150 times the rate in the general population. Thus, drug addicts are a high-risk group for tuberculosis and a "hidden source" of the disease in the community


2013 ◽  
pp. 14-9
Author(s):  
Wiwit Nurwidyaningtyas ◽  
Djanggan Sargowo ◽  
Achdiat Agoes ◽  
Titin Andri W ◽  
S Satuman

Research background. Circulating Endothelial Cells (CEC) is a reflection of endothelial damage or endothelial stress, increasing of CEC amount depend on endothelial mechanism, edothelial adhesivity damage and cellular apoptosis as a result of decreasing sitoskleleton function. If higher exposure affects the increasing of CEC amount,VEGF other growth factor mediators will be reflected as endothelial stress manifestation which roles in the increasing of re-population and Endothelial Progenitor Cells (EPC) differentiation. Endothelial Progenitor Cells is a mononuclear cell (a part of stem cell) that could change to be mature endothel and roles in re-edothelialisation and neovascularisation. This research aimed to investigate the ratio of EPC : CEC in risk group through Framingham Risk Score (FRS) 10 years approach as endothelial dysfunction predictor.Research method and result. There were 55 research subjects whom taken by FRS scoring and devided into some risk groups and two control groups. They were control group I (health) and control group II (sick). Base blood was taken to every each of them to analyze their EPC and CEC with Flowcytometry. EPC was analyzed by CD34 Per CP Santa Cruz SC-19621 and CD 133 FITC (fluorescein isothiocyanate) Bioss bs-0395R-FITCmarker.WhileCEC was analyzed CD45 FITC Biolegend 202205 dan CD 146 PE Biolegend 134704 marker. Result showed, there was significant ratio differences of EPC : CEC in those six groups which was proven by p-value 0.032< ? (0.05). The higher ratio was in high risk group (139.06).Conclusion. Research showed that EPC amount was increase related to the increasing of high risk level according to FRS 10 years, but its increasing did not followed by its ability to homing in injury area as role part in re-endothelialisation process. It found that EPC amount was higher in high risk group than in low risk group.


2012 ◽  
Vol 02 (02) ◽  
pp. 06-09 ◽  
Author(s):  
Mithra N. Hegde ◽  
Suchetha Kumari ◽  
Nidarsh Hegde ◽  
Shilpa Shetty ◽  

AbstractThe aim of the present study is to evaluate the status of salivary nitric oxide in patients with dental caries. The study consisted of 80 individuals. According to DFMT index, the subjects were divided into control group (DMFT=0) and study group (DMFT>5). Saliva sample was collected from each subject. Nitric oxide concentration was measured as total nitrates and nitrites by the Griess reaction method. The results of this study show that the presence of NO and its metabolites in saliva of adults with natural healthy teeth is significantly higher compared to high risk group, suggesting the protective role of NO in relation to caries. From the study it can be concluded that highly significant increase of nitrates and nitrites in stimulated saliva of high caries risk group could be the host defense response opposing bacterial growth. The obtained results support the role of NO as modulator of bacterial proliferation and suggest that increased NO production might contribute to lower caries incidence in adults.


2005 ◽  
Vol 186 (1) ◽  
pp. 18-25 ◽  
Author(s):  
Eve C. Johnstone ◽  
Klaus P. Ebmeier ◽  
Patrick Miller ◽  
David G. C. Owens ◽  
Stephen M. Lawrie

BackgroundThe hypothesis that schizophrenia is neurodevelopmental was investigated in a prospective study of young people with a postulated 10–15% risk for the development of schizophrenia.AimsTo determine premorbid variables distinguishing high-risk people who will go on to develop schizophrenia from those who will not.MethodA high-risk sample of 163 young adults with two relatives with schizophrenia was recruited. They and 36 controls were serially examined. Baseline measures were compared between those who did develop schizophrenia, a well control group, a well high-risk group and high-risk participants with partial or isolated psychotic symptoms.ResultsOf those at high risk, 20 developed schizophrenia within 2½ years. More experienced isolated or partial psychotic symptoms. Those who developed schizophrenia differed from those who did not on social anxiety, withdrawal and other schizotypal features. The whole high-risk sample differed from the control group on developmental and neuropsychological variables.ConclusionsThe genetic component of schizophrenia affects many more individuals than will develop the illness, and partial impairment can be found in them. Highly significant predictors of the development of schizophrenia are detectable years before onset.


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