scholarly journals Laparoscopic approach for huge benign ovarian cyst in woman with history of previous 5 laparotomies (including 4 cesarean section)

2020 ◽  
Vol 5 (1) ◽  
Author(s):  
Aisha Ebrahim Taraby ◽  
Ayman Zamreek ◽  
Nahla Alyawer ◽  
Saad Alsudairy ◽  
Dalal Boogis
Keyword(s):  
Cesarean Section ◽  
Abdominal Surgery ◽  
Ovarian Cyst ◽  
Laparoscopic Approach ◽  
The United States ◽  
Trocar Insertion ◽  
Previous Abdominal Surgery ◽  
Increased Risk ◽  
Previous Laparotomy ◽  
History Of

An adnexal mass (mass of the ovary, fallopian tube, or surrounding connective tissues) is a common gynecologic problem. In the United States, it is estimated that there is a 5 to 10% lifetime risk for women undergoing surgery for a suspected ovarian neoplasm. Adnexal masses may be found in females of all ages, from fetuses to older adults, and there are a wide variety of types of masses.  Today, the surgical treatment has become more conservative and less invasive; hence, a laparoscopic approach in the presence of benign cysts has become a golden standard. In the past, patients with previous abdominal surgery were discouraged from undergoing laparoscopic surgery because of its increased risk of bowel injury caused by needle and trocar insertion. Complications occur two times more frequently in patients with previous laparotomy in a study of long series. The potential risk for injury of organs adherent to the abdominal wall during veress needle or trocar insertion as well as the necessity for adhesiolysis and its attendant complications are the two major specific problems constraining surgeons from performing laparoscopic cystectomy/ oophorectomy for patients with previous abdominal surgery. Herein, we report a case of a 32-year-old woman P4 + 2 with history of previous four cesarean section and a following laparotomy for interval sterilization presented to our clinic with abdominal mass, discovered by ultrasound scan, managed by a laparoscopic approach.Keywords: Benign ovarian cyst, laparoscopy, ovary, previous cesarean section, previous laparotomy

The Effects of Previous Abdominal Operations and Intraperitoneal Adhesions on the Outcome of Peritoneal Dialysis Catheters

2010 ◽  
Vol 30 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Amir Keshvari ◽  
Mohammad Sadegh Fazeli ◽  
Alipasha Meysamie ◽  
Sepideh Seifi ◽  
Mohammad Kazem Nouri Taromloo
Keyword(s):  
Peritoneal Dialysis ◽  
Abdominal Surgery ◽  
Previous History ◽  
Laparoscopic Approach ◽  
Surgical Revision ◽  
Intraperitoneal Adhesions ◽  
Previous Abdominal Surgery ◽  
Increased Risk ◽  
History Of ◽  
Abdominal Operations

BackgroundPatients with previous history of abdominal operations are sometimes excluded from consideration for peritoneal dialysis because of concerns for increased risk of complications during the implantation procedure and inadequate dialysis due to reduced peritoneal surface area. Employing a laparoscopic approach, we compared the outcome of peritoneal dialysis catheters in 2 groups of patients with and without intra-abdominal adhesions.MethodsAll data in this report were recorded prospectively. Revision-free and overall survival of catheters, the incidence of mechanical and infectious complication, and surgical revision rates were compared between the 2 groups.ResultsIn 217 successful catheter implantations, there was a history of previous abdominal surgery in 42.9% of procedures; only 26.9% of them had intraperitoneal adhesions; 2.8% of patients without history of previous abdominal surgery had intraperitoneal adhesions. There were no significant differences between the 2 groups for 1- and 2-year revision-free and overall catheter survival, mechanical dysfunction, infectious complications, or surgical revision rates.ConclusionHistory of previous abdominal surgery should not be used to judge the eligibility of patients for peritoneal dialysis. Laparoscopic placement is the best way to ensure optimal catheter outcomes equivalent to patients without previous abdominal surgery.

Integration of Row Spacing, Seeding Rates, and Fungicide Application for Control of Sclerotinia Stem Rot in Glycine max

Plant Disease ◽  
2021 ◽  
Author(s):  
Richard Wade Webster ◽  
Mitchell Roth ◽  
Brian Mueller ◽  
Daren S. Mueller ◽  
Martin I Chilvers ◽  
...  
Keyword(s):  
Glycine Max ◽  
The United States ◽  
Stem Rot ◽  
Row Spacing ◽  
Sclerotinia Stem Rot ◽  
Upper Midwest ◽  
Multiple Control ◽  
Economic Implications ◽  
Increased Risk ◽  
History Of

Soybean (Glycine max) farmers in the Upper Midwest region of the United States frequently experience severe yield losses due to Sclerotinia stem rot (SSR). Previous studies have revealed benefits of individual management practices on SSR. This study examined the integration of multiple control practices on the development of SSR, yield, and the economic implications of these practices. Combinations of row spacings, seeding rates, and fungicide applications were examined in multi-site field trials across the Upper Midwest from 2017-2019. These trials revealed that wide row spacing and low seeding rates individually reduced SSR levels but also reduced yields. Yields were similar across the three higher seeding rates examined. However, site-years where SSR developed showed the highest partial profits in the intermediate seeding rates. This indicates that partial profits in diseased fields were negatively impacted by high seeding rates, but this trend was not observed when SSR did not develop. Fungicides strongly reduced the development of SSR, while also increasing yields. However, there was a reduction in partial profits due to their use at a low soybean sale price, but at higher sale prices fungicide use was similar to not treating. Additionally, the production of new inoculum was predicted from disease incidence, serving as an indicator of increased risk for SSR development in future years. Overall, this study suggests the use of wide rows and low seeding rates could be useful in fields with a history of SSR, while reserving narrow rows and higher seeding rates for fields without a history of SSR.

scholarly journals Pregnancy with previous caesarean section: an overview of adverse fetomaternal sequelae

2018 ◽  
Vol 7 (5) ◽  
pp. 1817 ◽  
Author(s):  
Joyita Bhowmik ◽  
Amit Kyal ◽  
Indrani Das ◽  
Vidhika Berwal ◽  
Pijush Kanti Das ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Cesarean Section ◽  
Previous History ◽  
Successful Outcome ◽  
Maternal Complications ◽  
Cross Sectional ◽  
Medical College ◽  
Increased Risk ◽  
Fetal Complications ◽  
History Of

Background: The Caesarean section epidemic is a reason for immediate concern and deserves serious international attention. The purpose of this study was to evaluate adverse maternal and fetal complications associated with pregnancies with history of previous caesarean section.Methods: A cross-sectional, observational study carried out over a period of 1 year from 1st June 2016 to 31st July 2017 in Medical College Kolkata. 200 antenatal patients with previous history of 1 or more caesarean sections were included. In all cases thorough history, complete physical and obstetrical examination, routine and case specific investigations were carried out and patients were followed till delivery and for 7 days thereafter. All adverse maternal and fetal complications were noted.Results: Out of 200 women, 30 candidates were tried for VBAC, of them 20 (66.66%) had successful outcome. Most common antenatal complication was APH (5.5%) due to placenta praevia followed by scar dehiscence. There were 12 cases (6.66%) of PPH and 6 cases (3.33%) of scar dehiscence in the study group. 3 cases required urgent hysterectomy due to placenta accreta. 42 out of 196 babies required management in SNCU immediately or later after birth.Conclusions: Women with a prior cesarean are at increased risk for repeat cesarean section. Vigilance with respect to indication at primary cesarean delivery, proper counselling for trial of labor and proper antepartum and intrapartum monitoring of patients are key to reducing the cesarean section rates and maternal complications.

General medical disorders with psychiatric implications

2015 ◽  
Author(s):  
Erik J. Garcia ◽  
Warren J. Ferguson
Keyword(s):  
Mental Illness ◽  
Psychiatric Symptoms ◽  
The United States ◽  
Prior History ◽  
Medical Illness ◽  
Medical Conditions ◽  
Presenting Symptoms ◽  
Medical Disorders ◽  
Increased Risk ◽  
History Of

Traditionally the domain of consultation/ liaison psychiatry, the challenge of recognizing and then appropriately treating the psychiatric complications of general medical disorders requires thoughtful planning and attention in corrections. Medical conditions that have psychiatric symptoms represent a significant diagnostic dilemma, particularly in the correctional health setting. Over half of the inmates in the United States have symptoms of a major mental illness, but the pervasiveness of substance use disorders, the increasing prevalence of elderly inmates, and limited access to a patient’s past medical and psychiatric records all contribute to the challenge of discerning when a psychiatric presentation results from an underlying medical condition. One early study underscored this challenge, noting that 46% of the patients admitted to community psychiatric wards had an unrecognized medical illness that either caused or exacerbated their psychiatric illness. A more recent study observed that 2.8% of admissions to inpatient psychiatry were due to unrecognized medical conditions. Emergency room medical clearance of patients presenting for psychiatric admission has revealed an increased risk for such underlying medical conditions among patients with any of five characteristics: elderly, a history of substance abuse, no prior history of mental illness, lower socioeconomic status, or significant preexisting medical illnesses. This chapter examines several of these risk groups and focuses on the presenting symptoms of delirium, mood disorders, and psychosis and the underlying medical conditions that can mimic or exacerbate them.

scholarly journals Risk factors for childhood and adult primary brain tumors

2019 ◽  
Vol 21 (11) ◽  
pp. 1357-1375 ◽  
Author(s):  
Quinn T Ostrom ◽  
Maral Adel Fahmideh ◽  
David J Cote ◽  
Ivo S Muskens ◽  
Jeremy M Schraw ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ionizing Radiation ◽  
Brain Tumors ◽  
The United States ◽  
Primary Brain Tumors ◽  
Clinical Databases ◽  
Increased Risk ◽  
History Of ◽  
Adults And Children ◽  
Race Ethnicity

Abstract Primary brain tumors account for ~1% of new cancer cases and ~2% of cancer deaths in the United States; however, they are the most commonly occurring solid tumors in children. These tumors are very heterogeneous and can be broadly classified into malignant and benign (or non-malignant), and specific histologies vary in frequency by age, sex, and race/ethnicity. Epidemiological studies have explored numerous potential risk factors, and thus far the only validated associations for brain tumors are ionizing radiation (which increases risk in both adults and children) and history of allergies (which decreases risk in adults). Studies of genetic risk factors have identified 32 germline variants associated with increased risk for these tumors in adults (25 in glioma, 2 in meningioma, 3 in pituitary adenoma, and 2 in primary CNS lymphoma), and further studies are currently under way for other histologic subtypes, as well as for various childhood brain tumors. While identifying risk factors for these tumors is difficult due to their rarity, many existing datasets can be leveraged for future discoveries in multi-institutional collaborations. Many institutions are continuing to develop large clinical databases including pre-diagnostic risk factor data, and developments in molecular characterization of tumor subtypes continue to allow for investigation of more refined phenotypes. Key Point 1. Brain tumors are a heterogeneous group of tumors that vary significantly in incidence by age, sex, and race/ethnicity.2. The only well-validated risk factors for brain tumors are ionizing radiation (which increases risk in adults and children) and history of allergies (which decreases risk).3. Genome-wide association studies have identified 32 histology-specific inherited genetic variants associated with increased risk of these tumors.

scholarly journals Incidence of and Risk Factors for Glenohumeral Osteoarthritis After Anterior Shoulder Instability: A US Population–Based Study With Average 15-Year Follow-up

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096251
Author(s):  
Bradley M. Kruckeberg ◽  
Devin P. Leland ◽  
Christopher D. Bernard ◽  
Aaron J. Krych ◽  
Diane L. Dahm ◽  
...  
Keyword(s):  
Risk Factors ◽  
Shoulder Instability ◽  
The United States ◽  
Anterior Shoulder Instability ◽  
Geographic Population ◽  
Increased Risk ◽  
Modifiable Factors ◽  
History Of ◽  
Former Smokers

Background: The rate of osteoarthritis (OA) in patients with a history of previous anterior shoulder instability (ASI) varies within the literature, with the majority of studies investigating rates after surgical stabilization. ASI appears to lead to increased rates of OA, although risk factors for developing OA in cohorts treated nonoperatively and operatively are not well-defined. Purpose: To determine the incidence of clinically symptomatic OA and identify potential risk factors for the development of OA in patients younger than 40 years with a known history of ASI. Study Design: Case-control study; Level of evidence, 3. Methods: An established, geographically based database was used to identify patients in the United States who were younger than 40 years and were diagnosed with ASI between 1994 and 2014. Patient information, including demographic, imaging, and surgical details, was collected. Comparative analysis was performed between groups with and without OA at final follow-up as well as between patients who underwent surgical and nonsurgical management. Results: The study population consisted of 154 patients with a mean follow-up of 15.2 years (range, 5.1-29.8 years). The mean age at initial instability event was 20.9 years (95% CI, 19.9-22.0 years). Overall, 22.7% of patients developed clinically symptomatic glenohumeral OA. Multivariate analysis revealed that current or former smokers (odds ratio [OR], 4.3; 95% CI, 1.1-16.5; P = .030), hyperlaxity (OR, 10.1; 95% CI, 1.4-72.4; P = .020), laborer occupation (OR, 6.1; 95% CI, 1.02-36.1; P = .043), body mass index (BMI) (OR, 1.2; 95% CI, 1.03-1.3; P = .012), and age at initial instability (OR, 1.1; 95% CI, 1.02-1.2; P = .013) as potential independent risk factors when accounting for other demographic and clinical variables. Conclusion: In a US geographic population of patients younger than 40 years with ASI, approximately one-fourth of patients developed symptomatic OA at a mean follow-up of 15 years from their first instability event. When accounting for differences in patient demographic and clinical data, we noted a potentially increased risk for the development of OA in patients who are current or former smokers, have hyperlaxity, are laborers, have higher BMI, and have increased age at initial instability event. Smoking status, occupation, and BMI are modifiable factors that could potentially decrease risk for the development of symptomatic OA in these patients.

Risk of colonic adenoma in patients with non–colorectal cancers.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13070-e13070
Author(s):  
Hamzah Abu-Sbeih ◽  
Faisal Ali ◽  
Wei Qiao ◽  
Phillip Lum ◽  
Mehnaz Shafi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Risk Factors ◽  
The United States ◽  
Personal History ◽  
Control Group ◽  
Colonic Adenoma ◽  
Crc Screening ◽  
Adenoma Detection ◽  
Increased Risk ◽  
History Of

e13070 Background: In the last two decades, the incidence of colorectal cancer (CRC) has decreased dramatically after the implementation of CRC screening in the United States. Several risk factors for colonic adenoma (CA), the main precursor for CRC, have been found. Whether personal history of non-colorectal cancer (NCRC) is a risk factor for CA has not been studied. Here, we assess the risk of CA in patients with NCRCs. Methods: We conducted a retrospective study of cancer patients who underwent colonoscopy after cancer diagnosis between 2009 and 2018. We included patients without history of NCRC as a control group. Multivariate logistic regression was used to assess independent risk factors for CA (Table 1). Results: Total of 9408 patients with NCRC were included; CA was detected in 4503 (48%). Histology revealed tubulovillous features in 611 (14%) patients and villous in 51 (1%). High grade dysplasia was detected in 1,317 (29%) patients and adenocarcinoma in 388 (9%). The rate of adenocarcinoma was the highest in patients with multiple myeloma (14%). Adenoma detection rate (ADR) was 30% in patients younger than 40 years ( n= 1621), 32% in patients between 40 and 50 years ( n= 812), 47% in patients between 50 and 60 years ( n= 2892), and 55% in patients older than 60 years ( n= 4493). Multivariate analysis revealed an increased risk of CA with old age, male sex, family history of CRC, and high body mass index ( P< 0.05). The median time from NCRC diagnosis to CA detection was 3 years (IQR 1-8). Conclusions: ADR in patients with a personal history of NCRC is higher than the ADR of patients without NCRC. CRC screening should be performed after the diagnosis of NCRC is made, even if it was before the standard threshold of CRC screening age of 50 years.[Table: see text]

Association between Charlson-Deyo Score and delay to colonoscopy in veterans subsequently diagnosed with colorectal cancer.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 288-288
Author(s):  
Thi Khuc ◽  
Christian Jackson
Keyword(s):  
Colorectal Cancer ◽  
United States ◽  
Occult Blood ◽  
The United States ◽  
Fecal Occult Blood ◽  
Study Cohort ◽  
Fecal Occult ◽  
Final Study ◽  
Increased Risk ◽  
History Of

288 Background: Colorectal cancer (CRC) is the second most common cause of cancer deaths in the United States and expected to cause 51,020 deaths in 2019. Early detection with yearly fecal occult blood test (FOBT) has been proven to decrease CRC mortality. A 30-day delay from positive FOBT to colonoscopy is associated with increased risk of CRC. The Veterans Affairs Health System (VAHS) treats approximately 11% of CRCs in the United States. The effects of an aging population, physician shortage, and increased military personnel entering the VAHS may increase demands on VAHS resources. The primary aim of this study was to determine risk factors that caused delay to colonoscopy. Methods: We retrospectively reviewed records of 600 patients referred for colonoscopy from January 1999 to January 2009, who were subsequently diagnosed with CRC. Patients with a prior CRC diagnosis were excluded. The final study cohort consisted of 530 patients. We analyzed the relationship between 10 variables and delay in time from initial consultation to colonoscopy. Variables consisted of age, sex, race, ethnicity, CRC location, marital status, history of mental health diagnosis, tobacco use, substance abuse, Charlson/Deyo (C/D) score and season of referral for colonoscopy. A delay in time was defined as 30 days or greater. Logistic regression analysis adjusted for age, race, CRC location and C/D score. Results: A total of 87.17% of patients experienced a delay in time from initial consultation to colonoscopy. When analyzed with a predictive variable of delay to colonoscopy, C/D score of ≥ 2 versus 0, was associated with higher odds of delay in time to colonoscopy (OR = 2.18, p = 0.02). African American race and Hispanic ethnicity was associated with a higher odds of delay in time to colonoscopy, but was not statistically significant (OR = 1.47, p = 0.47, OR = 1.37, p = 0.48). Conclusions: Patients with a C/D score ≥ 2 were 218% more likely to have delay in time from initial consult to colonoscopy, resulting in a delayed CRC diagnosis. C/D score may be used to determine which patients should have more frequent reminders to schedule their colonoscopy to prevent delays in care. Randomized and prospective studies will need to be performed.

scholarly journals Complete Laparoscopic Extirpation of a Giant Ovarian Cyst in an Adolescent

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Saeed Baradwan ◽  
Feras Sendy ◽  
Sameer Sendy
Keyword(s):  
Ovarian Cyst ◽  
Laparoscopic Approach ◽  
Serous Cystadenoma ◽  
Open Approach ◽  
Abdominal Girth ◽  
Large Tumor ◽  
Imaging Appearance ◽  
History Of ◽  
Marker Profile ◽  
The Right

The giant ovarian serous cystadenoma is a rare finding and often benign. The use of the laparoscopic approach versus open approach for the management of huge ovarian cysts is controversial. We report a case of a 27-year-old woman with a history of increasing abdominal girth over a period of two years along with radiological investigations revealed a large tumor arising from the right ovary treated by complete laparoscopic extirpation of a giant ovarian cyst. The complete laparoscopic approach for huge cyst is a feasible treatment when having a normal tumor marker profile and benign imaging appearance. In addition to the advantages of laparoscopic surgery, it is less invasive, with perfect cosmetic outcome and shorter hospital stay, which are particularly important for young women.

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