scholarly journals Retrospective Analysis of Risk Factors for Postoperative Perineal Hernia After Endoscopic Abdominoperineal Excision for Rectal Cancer

2021 ◽  
Author(s):  
Tatsuya Manabe ◽  
Yusuke Mizuuchi ◽  
Yasuhiro Tsuru ◽  
Hiroshi Kitagawa ◽  
Takaaki Fujimoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Regression Analysis ◽  
Odds Ratio ◽  
Open Surgery ◽  
Abdominoperineal Excision ◽  
Perineal Hernia ◽  
Lower Rectal Cancer ◽  
Peritoneal Closure ◽  
Initial Surgery

Abstract Background: In contrast to open-surgery abdominoperineal excision (APE) for rectal cancer, postoperative perineal hernia (PPH) is reported to increase after extralevator APE and endoscopic surgery. In this study, therefore, we aimed to determine the risk factors for PPH after endoscopic APE.Methods: A total 73 patients who underwent endoscopic APE for lower rectal cancer were collected from January 2009 to March 2020, and the risk factors for PPH were analyzed retrospectively.Results: Nineteen patients (26%) developed PPH after endoscopic APE, and the diagnosis of PPH was made at 9–393 days (median: 183 days) after initial surgery. Logistic regression analysis showed that absence of pelvic peritoneal closure alone increased the incidence of PPH significantly (odds ratio; 13.76, 95% confidence interval; 1.48–1884.84, p = 0.004).Conclusions: Pelvic peritoneal closure should be performed when possible after endoscopic APE to prevent PPH.

scholarly journals Impact of the preoperative prognostic nutritional index as a predictor for postoperative complications after resection of locally recurrent rectal cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masakatsu Paku ◽  
Mamoru Uemura ◽  
Masatoshi Kitakaze ◽  
Shiki Fujino ◽  
Takayuki Ogino ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rectal Cancer ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Receiver Operating Characteristic ◽  
Odds Ratio ◽  
Inflammatory Markers ◽  
Operating Characteristic ◽  
Recurrent Rectal Cancer ◽  
Prognostic Nutrition Index

Abstract Background Local recurrence is common after curative resections for rectal cancer. Surgical intervention is among the best treatment choices. However, achieving a negative resection margin often requires extensive pelvic organ resections; thus, the postoperative complication rate is quite high. Recent studies have reported that the inflammatory index could predict postoperative complications. This study aimed to validate the correlation between clinical factors, including inflammatory markers, and severe complications after surgery for local recurrent rectal cancer. Methods This retrospective study included 99 patients that underwent radical resections for local recurrences of rectal cancer. Postoperative complications were graded according to the Clavien-Dindo classification. Grades ≥3 were defined as severe complications. Risk factors for severe complications were identified with univariate and multivariate logistic regression models and assessed with receiver-operating characteristic curves. Results Severe postoperative complications occurred in 38 patients (38.4%). Analyses of correlations between inflammatory markers and severe postoperative complications revealed that the strongest correlation was found between the prognostic nutrition index and severe postoperative complications. The receiver-operating characteristic analysis showed that the optimal prognostic nutrition index cut-off value was 42.2 (sensitivity: 0.790, specificity: 0.508). In univariate and multivariate analyses, a prognostic nutrition index ≤44.2 (Odds ratio: 3.007, 95%CI:1.171–8.255, p = 0.02) and a blood loss ≥2850 mL (Odds ratio: 2.545, 95%CI: 1.044–6.367, p = 0.04) were associated with a significantly higher incidence of severe postoperative complications. Conclusions We found that a low preoperative prognostic nutrition index and excessive intraoperative blood loss were risk factors for severe complications after surgery for local recurrent rectal cancer.

Eleven years of children methadone poisoning in a referral center: A review of 453 cases

2017 ◽  
Vol 13 (1) ◽  
pp. 27 ◽  
Author(s):  
Hossein Hassanian-Moghaddam, MD, FACMT ◽  
Masumeh Hakiminejhad, MD ◽  
Fariba Farnaghi, MD ◽  
Amirhossein Mirafzal, MD ◽  
Nasim Zamani, MD ◽  
...  
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Respiratory Failure ◽  
Hospital Stay ◽  
Odds Ratio ◽  
Univariate Analysis ◽  
Tertiary Hospital ◽  
Alanine Transaminase ◽  
Qtc Interval ◽  
Great Caution

Objectives: Methadone can be fatal due to respiratory failure even in little doses. This study aimed to evaluate the possible risk factors of death and/or intubation in methadone-poisoned children of 12 years or younger. Design: Retrospective routine database study.Setting: The only tertiary hospital for children poisoning in Tehran.Patients: Four hundred fifty-three methadone-poisoned patients aged 12 or younger were studied between 2001 and 2012.Main Outcome Measures: In-hospital mortality and intubation/mechanical ventilation.Results: Of a total of 475 children included, 22 were excluded due to coingestion of other drugs. Three (0.66 percent) expired and 12 (2.65 percent) were intubated during the course of hospital stay. Intubation (p < 0.001), fever (T axillary ≥ 37.5 °C, p = 0.01), being unresponsive at presentation (p = 0.02), tachycardia (p = 0.01), acidosis (p = 0.03), leukocytosis (p = 0.02), and longer hospital stay (p = 0.01) associated with death. Mortality (p < 0.001), fever (p = 0.004), aspartate aminotransferase (AST; p = 0.006), alanine transaminase (p = 0.04), creatinine (p = 0.005), corrected QT (QTc) interval in triage electrocardiogram (p = 0.02), and longer hospital stay (p = 0.005) associated with intubation in univariate analysis. However, after running regression analysis, only fever, QTc ≥ 480 ms, tachycardia, and AST independently associated with intubation and death. Axillary T ≥ 37.45 °C with an accuracy of 91.9 (95% confidence interval [CI] 88.8-94.2) and odds ratio of 9.3 (95% CI 2.5-34.9) predicted intubation, and T ≥ 37.75 with an accuracy of 96.0 (95% CI 93.5-97.5) and odds ratio of 47.4 (95% CI 4.1-550.1) predicted death. Conclusion: A methadone-poisoned child presenting with tachycardia, fever, abnormal AST, or an initial prolonged QTc interval should be managed with great caution.

scholarly journals Unhealthy lifestyle is an important risk factor for BPPV recurrence

2020 ◽  
Author(s):  
Chang-yong Fu ◽  
Zhen-zhong Zhang ◽  
Jin Chen ◽  
Sandip Kumar Jaiswal ◽  
Fu-ling Yan
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Odds Ratio ◽  
Recurrence Risk ◽  
Physical Activities ◽  
Recumbent Position ◽  
Unhealthy Lifestyle ◽  
Lifestyle Risk Factors ◽  
Lifestyle Risk

Abstract Background: Benign paroxysmal positional vertigo (BPPV) is self-limiting and recurrent but the cost is considerable. The recurrence of BPPV increased significantly under the quarantine policy in Hangzhou. The unhealthy lifestyle risk factors of the recurrence of BPPV have not yet been investigated. So, the objective is to analyze the unhealthy lifestyle risk factors of recurrent BPPV.Methods: A retrospective observational study was conducted in the Department of Neurology in Tongde Hospital of Zhejiang Province from December 2018 to March 2020. The study included 186 patients aged 23–86 years. All patients received the definitive diagnosis and canalith repositioning maneuvers (CRM) treatment and finally accomplished follow-up for one year. Demographic variables, potential recurrence risk factors, neurological examination, cranial computed tomography and lifestyle were assessed.Data Analyses: The t-test or chi-squared test was first performed for group comparison, then logistic regression analysis was performed to investigate the recurrence risk factors in all of the patients.Results: The 1-year recurrence rates of BPPV patients after reposition maneuvers were 36.02%, is significantly higher than other study especially in the first quarter of 2020 (38.8% of patients with BPPV recurrence). Logistic regression analysis shows that BPPV patients who was poor physical activities and prolonged recumbent position time have more recurrence risks. Poor physical activities (odds ratio =5.690, 95% confidence interval: 1.650-19.618, p <0.006), prolonged recumbent position time (odds ratio = 1.651, 95% confidence interval: 1.370-2.003, p = 0.000), were risk factors for the recurrence of BPPV in patients.Conclusion: We conclude that poor physical activities and prolonged recumbent position time may be independent risk factors for the recurrence of BPPV patients, but aging, Ménière’s disease, sudden deafness migraine, hypertension, hyperlipemia, diabetes, CHD, POCI, mental factors, and mental labor do not increase the recurrence risk.

Extra-Levator AbdominoPerineal excision (eLAPE): a complicated postoperative perineal hernia

2021 ◽  
Vol 14 (1) ◽  
pp. e238562
Author(s):  
Holly Harris ◽  
Kausik Ray ◽  
Christie Swaminathan
Keyword(s):  
Rectal Cancer ◽  
Palliative Care ◽  
Case Report ◽  
Wound Dehiscence ◽  
Perineal Wound ◽  
Postoperative Recovery ◽  
Abdominoperineal Excision ◽  
Perineal Hernia ◽  
Care Services ◽  
Palliative Care Services

A 75-year-old woman presented with perineal wound dehiscence and small bowel prolapse of a perineal hernia, 6 years after extra-Levator AbdominoPerineal Excision (eLAPE) procedure for rectal cancer. She underwent emergency wound refashioning and perineal hernia repair with Parmacol mesh. Her postoperative recovery was complicated by long-standing ileus, wound infection, and she was discharged to community palliative care services. In this case report, we raise awareness of postoperative eLAPE complications and describe an unfortunate case where a postoperative perineal hernia was not repaired in a patient with multiple comorbidities.

scholarly journals Associations of Serum MicroRNA with Bone Mineral Density in Community-Dwelling Subjects: The Yakumo Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Hiroaki Nakashima ◽  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
Taisuke Seki ◽  
Shinya Ishizuka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Bone Mineral ◽  
Logistic Regression Analysis ◽  
Odds Ratio ◽  
Significant Risk ◽  
Mineral Density ◽  
Confidential Interval

Osteoporosis is a disease characterized by deterioration of bone tissue and mass, with an increasing global prevalence. Therefore, the discovery of biomarkers for osteoporosis would help to guide appropriate treatment. Circulating microRNAs (miRNAs) have become increasingly recognized as biomarkers for detecting diseases. However, few studies have investigated the association of circulating miRNA with osteoporosis in the general population. The aim of this study was to identify miRNA associated with osteoporosis in a general resident health check-up for potential use as an osteoporosis biomarker. We conducted a cross-sectional study as part of a health check-up program and recruited 352 volunteers (139 men, 213 women, mean age 64.1±9.6 years). Osteoporosis was diagnosed according to the WHO classification. Twenty-two candidate microRNAs were screened through real-time quantitative PCR, and miRNAs associated with osteoporosis were analyzed using logistic regression analysis including other risk factors. In total, 95 females and 30 males were diagnosed with osteoporosis with bone mineral density tests (BMD: T‐score<−2.5). We found that miR195 was significantly lower in females, while miR150 and miR222 were significantly higher in males. The results of the logistic regression analysis indicated that in females, higher age and lower miR195 (odds ratio: 0.45, 95% confidential interval: 0.03–0.98) were significant risk factors for lower BMD, while the presence of a smoking habit and lower miR150 (odds ratio: 1.35, 95% confidential interval: 1.02–1.79) were significant risk factors for osteoporosis. Serum levels of miR195 and miR150 are independently associated with low bone mineral density in females and males, respectively.

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