Comorbid pathology in herniology

In recent decades, there has been an aging population worldwide with an increasing proportion of the elderly and senile, leading to a significant increase in the prevalence of a variety of pathologies, especially cardiovascular disease, overweight and obesity, diabetes, neoplastic and dysplastic diseases, and diseases that require surgical treatment. The negative impact on health significantly increases in the presence of several diseases, which creates qualitatively new conditions that cannot be explained by the mechanical sum of the impact of individual diseases. The presence of concomitant pathology in surgical diseases, or comorbidity, adversely affects the general condition of the patient, the course of the underlying and concomitant pathology, and from a surgical point of view also the response to surgical aggression, postoperative period, and further rehabilitation of patients. This indicates the need for an individual approach to the organization of the patient’s examination and planning further treatment, which in most cases cannot be standardized. Age factors, overweight, and obesity, chronic obstructive pulmonary disease, chronic heart failure, coronary heart disease are considered the risk factors and predictors of mortality and complications after surgery. Comprehensive assessment of comorbidity and functional status allows optimizing patient care. The Charlson Comorbidity Index is most often used for this purpose. But the attempts to further increase the informativeness of comorbidity scales do not stop and new ones appear, which are used mainly for the administrative evaluation of treatment results. In the context of herniology, a very interesting pathological condition is connective tissue dysplasia, which is characterized by multiorgan and multisystem lesions with extremely diverse clinical manifestations. Connective tissue pathology is associated with many other surgical diseases. These are varicose veins, biliary dyskinesia with the development of gallstones, duodenogastric and gastroesophageal reflux, peptic ulcer of the stomach and duodenum, diverticula of the digestive tract, adhesive disease of the abdominal cavity. Thus, patients with hernias, especially the elderly and senile, have a fairly high incidence of comorbid pathology, which has a significant impact on the incidence of postoperative complications and mortality.

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Health risk assessment and countermeasure analysis of the elderly population exposed to PM2.5 microenvironment

Work ◽

10.3233/wor-205361 ◽

2021 ◽

pp. 1-11

Author(s):

Yan Xu ◽

Wantian Cui

Keyword(s):

Mental Health ◽

Health Risk ◽

Elderly Population ◽

Mental Health Problems ◽

Negative Impact ◽

The Elderly ◽

Exposure Concentration ◽

Physical Diseases ◽

The Impact

BACKGROUND: China’s atmospheric PM2.5 pollution is serious, and PM2.5 exerts a negative impact on the human respiratory system, cardiovascular, and mental health, and even more serious health risk for the elderly with weak immunity. OBJECTIVE: This work aims to analyse the impacts of PM2.5 microenvironment exposure on the health of the elderly and provide corresponding countermeasures. METHODS: The survey subjects are 118 retired elderly people in the community. PM2.5 exposure concentrations are monitored in summer (June 10 ∼ July 10, 2019) and winter (November 25 ∼ December 25, 2019). RESULTS: The exposure concentration in winter is higher than that in summer, with statistical difference (P < 0.05). Under the impact of PM2.5 microenvironment exposure, smoking in the elderly can increase the concentration of PM2.5, and long-term exposure to PM2.5 in the elderly can cause mental health problems. CONCLUSION: Long-term exposure of the elderly to the PM2.5 microenvironment leads to physical diseases and even psychological problems, which requires attention.

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A Case of COVID-19-Related Thrombocytopenia and Leukopenia in an Adolescent with Mild Symptoms

Children ◽

10.3390/children8060509 ◽

2021 ◽

Vol 8 (6) ◽

pp. 509

Author(s):

Lydia Kossiva ◽

Athanasios Thirios ◽

Eleni Panagouli ◽

Alexandros Panos ◽

Stavroula Lampidi ◽

...

Keyword(s):

Bone Marrow ◽

Viral Infection ◽

Nasal Congestion ◽

Pediatric Population ◽

Clinical Manifestations ◽

Bone Marrow Aspiration ◽

White Blood Count ◽

Chronic Obstructive ◽

First Case ◽

The Impact

Since the beginning of the COVID-19 pandemic, there have been numerous reports and reviews on the complications caused by the disease, analyzing the acute and chronic consequences. The main symptoms of SARS-CoV-2 are dry cough, fever, and fatigue. COVID-19 appears to affect all systems, including renal, cardiovascular, circulatory, and respiratory systems, causing chronic obstructive pulmonary disease. We report on a 14-year-old male adolescent, who presented with thrombocytopenia (platelet count 92 × 109 /L) and leukopenia (white blood count 4.2 × 103 /μL) that was observed two months ago. Ten days before the first blood test, a viral infection with nasal congestion and runny nose was reported, without other accompanying symptoms. Viral antibodies screening revealed positivity for all the three specific COVID-19 antibodies. Further haematological evaluation with bone marrow aspiration revealed non-specific dysplastic features of the red cell and megakaryocyte progenitors. Although haematological alterations due to COVID-19 infection are available from adult patients’ reports, the effect of COVID-19 infection in the pediatric population is underestimated and this is the first case with such haematological involvement. Noteworthy, in the current case, the impact of the COVID-19 infection was not related to the severity of the disease, as the symptoms were mild. In similar cases, bone marrow aspiration would not be performed as a part of routine work-up. Thus, it is important when evaluating pediatric patients with COVID-19 infection to search and report those alterations in order to better understand the impact and the spectrum of clinical manifestations of the specific viral infection in children and adolescents.

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Improving Cardiovascular Health through Nudging Healthier Food Choices: A Systematic Review

Nutrients ◽

10.3390/nu11102520 ◽

2019 ◽

Vol 11 (10) ◽

pp. 2520 ◽

Cited By ~ 2

Author(s):

Christine Tørris ◽

Hilde Mobekk

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Dietary Habits ◽

Negative Impact ◽

Experimental Studies ◽

Food Choices ◽

Overweight And Obesity ◽

Controlled Trials ◽

Randomized Controlled ◽

The Impact

Obesity and metabolic syndrome are considered major public health problems, and their negative impact on cardiovascular disease (CVD) and diabetes mellitus type 2 (DM2) is profound. Targeting modifiable risk factors such as dietary habits is therefore of great importance. Many of today’s health challenges with overweight and obesity may have behavioral roots, and traditional methods such as regulations and campaigns are often insufficient to improve dietary choices. Nudging or choice architecture might be a viable tool to influence people’s everyday choices and behaviors to better outcomes. This paper reviews the current state of the rapidly expanding number of experimental field studies that investigate the effects/associations of nudging on healthy food choices. A systematic literature search was conducted in PubMed, where 142 citations were identified. Based on selection criteria, six randomized controlled trials and 15 non-randomized controlled trials were ultimately included. The results of this systematic review show that many of the studies included traffic-light labeling, which may be a promising strategy. The reviewed findings, however, also highlight the challenges that confront experimental studies examining the impact of nudging on diet.

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Circulating Leukocytes and Oxidative Stress in Cardiovascular Diseases: A State of the Art

Oxidative Medicine and Cellular Longevity ◽

10.1155/2019/2650429 ◽

2019 ◽

Vol 2019 ◽

pp. 1-9 ◽

Cited By ~ 3

Author(s):

Speranza Rubattu ◽

Maurizio Forte ◽

Salvatore Raffa

Keyword(s):

Oxidative Stress ◽

Cardiovascular Diseases ◽

Stress Level ◽

Mononuclear Cells ◽

Pathological Condition ◽

Clinical Manifestations ◽

Therapeutic Interventions ◽

Oxidative Stress Level ◽

The Impact

Increased oxidative stress from both mitochondrial and cytosolic sources contributes to the development and the progression of cardiovascular diseases (CVDs), and it is a target of therapeutic interventions. The numerous efforts made over the last decades in order to develop tools able to monitor the oxidative stress level in patients affected by CVDs rely on the need to gain information on the disease state. However, this goal has not been satisfactorily accomplished until now. Among others, the isolation of circulating leukocytes to measure their oxidant level offers a valid, noninvasive challenge that has been tested in few pathological contexts, including hypertension, atherosclerosis and its clinical manifestations, and heart failure. Since leukocytes circulate in the blood stream, it is expected that they might reflect quite closely both systemic and cardiovascular oxidative stress and provide useful information on the pathological condition. The results of the studies discussed in the present review article are promising. They highlight the importance of measuring oxidative stress level in circulating mononuclear cells in different CVDs with a consistent correlation between degree of oxidative stress and severity of CVD and of its complications. Importantly, they also point to a double role of leukocytes, both as a marker of disease condition and as a direct contributor to disease progression. Finally, they show that the oxidative stress level of leukocytes reflects the impact of therapeutic interventions. It is likely that the isolation of leukocytes and the measurement of oxidative stress, once adequately developed, may represent an eligible tool for both research and clinical purposes to monitor the role of oxidative stress on the promotion and progression of CVDs, as well as the impact of therapies.

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Population Aging, Household Savings and Asset Prices: A Study Based on Urban Commercial Housing Prices

Sustainability ◽

10.3390/su11113194 ◽

2019 ◽

Vol 11 (11) ◽

pp. 3194 ◽

Cited By ~ 2

Author(s):

Shihong Zeng ◽

Xinwei Zhang ◽

Xiaowei Wang ◽

Guowang Zeng

Keyword(s):

Asset Prices ◽

Negative Impact ◽

Interaction Analysis ◽

Population Aging ◽

Housing Prices ◽

The Elderly ◽

Dependency Ratio ◽

Household Savings ◽

Savings Rate ◽

The Impact

Currently, China’s aging population, high savings rate and high housing asset prices coexist, which has become a hot issue in academic research. First, considering the life-cycle hypothesis and overlapping generations model, asset prices are negatively correlated with the population dependency ratio and positively correlated with household savings. Second, based on census data from prefecture-level cities, a pooled regression model and two-stage least squares (2SLS) are used in this empirical research. The child dependency ratio was found to have a significant negative impact on housing prices, while the elderly dependency ratio had a positive impact on housing prices. The positive relationship between household savings and housing prices is highly significant. Finally, the interaction analysis shows that the impact of population aging on housing prices differs under different levels of household savings; thus, population aging affects housing prices through household savings, and the mediator dilutes and weakens this impact. The elderly generation’s release of savings could gradually inhibit housing prices. Population aging causes long-run downside risks but not a market meltdown.

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SUN-LB102 Development of a Conceptual Model to Present the Impacts of Obesity on Physical Functioning

Journal of the Endocrine Society ◽

10.1210/jendso/bvaa046.2058 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

Author(s):

Jiat Ling Poon ◽

Chris Marshall ◽

Chloe Johnson ◽

Hannah Pegram ◽

Maile Hunter ◽

...

Keyword(s):

Conceptual Model ◽

Physical Functioning ◽

Content Validity ◽

Clinical Studies ◽

Negative Impact ◽

The United States ◽

Overweight And Obesity ◽

Spontaneous Reports ◽

Patient Reported ◽

The Impact

Abstract Background. Obesity is a chronic disease with a significant negative impact on health-related quality of life (HRQoL) and specifically, physical functioning, including the ability to complete activities of daily living (ADLs). Weight loss based on lifestyle management (e.g. diet, exercise), surgery, and pharmacotherapy can improve physical functioning; however, there is a need for further qualitative research to support the content validity of patient-reported outcome (PRO) measures for use in clinical studies of obesity and thus inform regulatory decision-making. Objective. To explore the impacts of obesity on physical functioning and develop a conceptual model (a visual representation of the concepts of importance and relevance to the experience of living with obesity) to ultimately support the content validity of PRO measures.Methods. Qualitative semi-structured interviews were conducted in the United States with individuals who have overweight and obesity (Body Mass Index [BMI] ≥ 27.0 kg/m2) with a history of at least one unsuccessful dietary effort to lose body weight. Recruitment quotas targeted a sample with diverse demographic and clinical characteristics, including participants with and without diabetes. Experienced qualitative interviewers used open-ended questions to elicit spontaneous reports of the impact of obesity on individuals’ daily lives, and specific probing questions to explore impacts on physical functioning. Interviews were audio-recorded, transcribed and analyzed using thematic techniques. Results. A total of 33 participants were interviewed (mean BMI of 37.6 kg/m2 [27.4 kg/m2 to 56.6 kg/m2]; mean age of 45 years [19 to 81 years]). The sample included a mix of races (Caucasian: n=12, 36%), education completed (high school: n=17, 51%) and split of gender (female: n=16, 48%). During development of the conceptual model, two separate domains were identified to group the reported impacts on physical functioning: ‘Mobility/Movement’ and ‘ADLs’. The most frequently reported impacts related to Mobility/Movement were ‘running’ (n=31/33, 94%), ‘bending’ (n=27/33, 82%), ‘walking’ (n=26/33, 79%), ‘difficulty standing for prolonged periods’ (n=22/33, 67%), and ‘lifting’ (n=19/33, 58%). All participants reported effects on some aspect of physical functioning, which were often characterized in terms of their direct impact on ADLs such as ‘household chores’ (n=21/33, 64%). Conclusions. The conceptual model will serve as a basis to identify fit-for-purpose PRO measures with strong content validity to evaluate the impact of anti-obesity therapies on physical functioning in future clinical studies. Obesity has a consistent and significant impact on physical functioning, leading to limitations in various aspects of mobility and affecting an individual’s ability to carry out specific daily activities.

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Venous and Lung Thromboembolism in the Context of Lung Cancer: Clinical Manifestations, Risk Factors and Prognosis

Acta Médica Portuguesa ◽

10.20344/amp.10260 ◽

2019 ◽

Vol 32 (10) ◽

pp. 647 ◽

Cited By ~ 1

Author(s):

Rosana Maia ◽

Inês Neves ◽

António Morais ◽

Henrique Queiroga

Keyword(s):

Lung Cancer ◽

Venous Thromboembolism ◽

Cancer Diagnosis ◽

Negative Impact ◽

Clinical Manifestations ◽

Research Subjects ◽

Lung Cancer Diagnosis ◽

The Impact ◽

The Relationship

Introduction: The relationship between cancer and thromboembolic events has been known for a long time. Lung and venous thromboembolism are frequent complications of lung cancer and its treatment, being a great cause of morbidity and mortality. We pretend to establish the relationship between lung and venous thromboembolism and lung cancer, describe patient characteristics and analyze the impact in the survival and prognosis.Material and Methods: It was a retrospective study. All research subjects were selected from lung cancer patients with a newly diagnosed lung and venous thromboembolism event admitted to Hospital S. João, between January 2008 and December 2013 and were followed until December 2014. Statistical analysis was performed with SPSS.Results: From the search, we obtained 113 patients. The majority was male, smokers or ex-smokers, and adenocarcinoma was the most frequent histologic type, being diagnosed mostly in advanced stages. We noticed that the median time between lung cancer diagnosis and lung venous thromboembolism was 2.9 months. In 24 patients (21.4%), the lung cancer diagnosis occurred after the lung and venous thromboembolism event and in 86 patients (76.8%), it occurred before the event. After a median follow up of 1.4 months, 107 (94.7%) patients died, 1 (0.9%) was lost to follow-up and 5 (4.4%) were still alive. The median survival rate was 1.5 months.Discussion: The diagnosis of lung and venous thromboembolism in patients with lung cancer is associated with bad prognosis. It occurs most frequently in patients with advanced disease, in the first months after lung cancer diagnosis and after beginning chemotherapy.Conclusion: Disease progression is an independent predictor with negative impact in overall survival.

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Rethinking Elective Cataract Surgery Diagnostics, Assessments, and Tools after the COVID-19 Pandemic Experience and Beyond: Insights from the EUROCOVCAT Group

Diagnostics ◽

10.3390/diagnostics10121035 ◽

2020 ◽

Vol 10 (12) ◽

pp. 1035

Author(s):

Daniele Tognetto ◽

Antoine P. Brézin ◽

Arthur B. Cummings ◽

Boris E. Malyugin ◽

Ozlem Evren Kemer ◽

...

Keyword(s):

Cataract Surgery ◽

Negative Impact ◽

Waiting Times ◽

The Elderly ◽

Recovery Phase ◽

Diagnostic Tools ◽

Special Focus ◽

Critical Issues ◽

Precautionary Measures ◽

The Impact

The progressive deterioration of the visual function in patients on waiting lists for cataract surgery has a negative impact on their quality of life, especially in the elderly population. Patient waiting times for cataract surgeries in many healthcare settings have increased recently due to the prolonged stop or slowdown of elective cataract surgery as a result of coronavirus disease 19 (COVID-19). The aim of this review is to highlight the impact of such a “de-prioritization” of cataract surgery and to summarize some critical issues and useful hints on how to reorganize cataract pathways, with a special focus on perioperative diagnostic tools during the recovery phase and beyond. The experiences of a group of surgeons originating from nine different countries, named the European COVID-19 Cataract Group (EUROCOVCAT), have been combined with the literature and recommendations from scientific ophthalmic societies and healthcare institutions. Key considerations for elective cataract surgery should include the reduction of the number of unnecessary visits and examinations, adoption of precautionary measures, and implementation of telemedicine instruments. New strategies should be adopted to provide an adequate level of assistance and to guarantee safety conditions. Flexibility will be the watchword and regular updates would be necessary following scientific insights and the development of the pandemic.

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Back Pain and Heart Failure in Older Adults: Findings From the Health ABC Study

Innovation in Aging ◽

10.1093/geroni/igaa057.656 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 203-203

Author(s):

Jie Chen ◽

Yiming Zhang ◽

Eleanor Simonsick ◽

Angela Starkweather ◽

Ming-Hui Chen ◽

...

Keyword(s):

Heart Failure ◽

Older Adults ◽

Back Pain ◽

Negative Impact ◽

Smoking Status ◽

The Elderly ◽

Epidemiological Studies ◽

Negative Influence ◽

Epidemiologic Studies ◽

The Impact

Abstract Both back pain and heart failure (HF) have negative influence on all aspects of life. Little is known about the impact of back pain on older adults with HF. We include 1295 older adults who had data collected in the 11th year (2007-2008) of the Health, Aging and Body Composition (Health ABC) study to evaluate the effect of back pain on health status among older adults with and without HF. The participants aged 79-91, 54.8% were female and 34.8% were African American. Among 94 participants with HF, 63 (67.0%) had back pain; among 1201 participants without HF, 649 (54.0%) had back pain. Females reporting back pain had 4.76 (95% CI: 1.83, 12.37) times the odds of having HF compared to those without back pain. Male with back pain, compared to those without back pain, had 1.14 times (95% CI: 0.65, 2.02) the odds of having HF. Depressive symptoms were measured by the Center for Epidemiological Studies-Depression (CES-D) scale. Performance and functions were measured by the Established Populations for Epidemiologic Studies in the Elderly (EPESE) performance score, the Health ABC performance battery score and self-reported difficulty with functional tasks. These symptom and performance measures were significantly associated with both back pain and HF, but not the interaction terms of back pain and HF after adjusting demographic variables including gender, race, smoking status and BMI category. The high incidence and negative impact of back pain highlighted the needs of developing strategies in pain management among older adults with and without HF.

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Effect of intra-abdominal hypertension on the strength of the postoperative scar of a laparotomic wound

Reports of Vinnytsia National Medical University ◽

10.31393/reports-vnmedical-2020-24(2)-04 ◽

2020 ◽

Vol 24 (2) ◽

pp. 223-226

Author(s):

I. K. Morar

Keyword(s):

Mechanical Strength ◽

Negative Impact ◽

Abdominal Cavity ◽

Study Groups ◽

Laboratory Animals ◽

Abdominal Pressure ◽

Abdominal Hypertension ◽

Laparotomy Wound ◽

The Impact ◽

Postoperative Scar

Annotation. One of the main factors of postoperative eventration is intra-abdominal hypertension, which occurs in various surgical pathologies of the abdominal cavity. Despite the presence of a large number of scientific papers on the negative effect of intra-abdominal hypertension on the morphological state of granulation tissue in the area of the laparotomy wound, there are no publications on the impact on the strength of the postoperative scar. Therefore, the study aimed to investigate in an experiment on small laboratory animals the effect of intra-abdominal hypertension on the mechanical strength of the postoperative scar of a laparotomy wound. The experiment was performed on 120 laboratory rats, which underwent a median laparotomy and brought together the edges of the musculoaponeurotic layer of the anterior abdominal wall with simple nodal sutures. The main group consisted of 72 animals who developed intra-abdominal hypertension by inserting a container (condom) with a certain amount of Furacilin into the abdominal cavity. The comparison group consisted of 48 animals who had an empty condom inserted into the abdominal cavity after laparotomy. The mechanical strength of the postoperative scar of the laparotomy wound was determined by the method of G. V. Petrovich (2010) on the 1st, 3rd, and 5th day after the creation of intra-abdominal hypertension, by measuring the level of intra-abdominal pressure at the time of rupture of the postoperative scar of the laparotomy wound. Statistical analysis of the results was performed using Microsoft Excel spreadsheets and a package of statistical processing software PAST. Differences between study groups were determined using Mann-Whitney criteria. The results of the study indicate that the created intra-abdominal hypertension leads to a decrease in the mechanical strength of the postoperative scar of the laparotomy wound. The degree of the negative impact of intra-abdominal hypertension on the strength of the postoperative scar is inversely proportional to the level of intra-abdominal pressure.

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