scholarly journals Prognostication of complications in patients with diseases of gallbladder after laparoscopic cholecystectomy

2020 ◽  
Vol 87 (7-8) ◽  
pp. 10-14
Author(s):  
М. А. Каshtalyan ◽  
А. E. Тkachenko ◽  
О. А. Кvasnevskiy ◽  
А.О. Коlotvin
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Laparoscopic Cholecystectomy ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Theoretical Substantiation ◽  
Scientific Practical ◽  
Premorbid State

Objective. To elaborate a prognostic classification of possibilities for occurrence of іntra- and postoperative complications, basing on determination of a premorbid state and the risk factors, concerning operative intervention in patients, suffering surgical diseases of gallbladder. Маterials and methods. Retrospective analysis of treatment of 911 patients, suffering cholelithiasis disease, оperated by the laparoscopic cholecystectomy procedure, was conducted, and factors of possibility of occurrence for іntra- and postoperative complications were determined with further establishment of their criteria. Results. The factors of risk for the complications occurrence after laparoscopic cholecystectomy in patients with diseases of gallbladder (n=911) were investigated. Prognostication pattern of the complications occurrence was built, taking into account the results of correlation-regression analysis conducted, and on its base the clinic-epidemiological groups of the complications risk were formatted with determination of their frequency of confidence intervals. Conclusion. Theoretical substantiation and scientific-practical decision of the task was presented, concerning raising of efficacy of miniinvasive operative interventions in patients with diseases of gallbladder, using elaborated methods of prophylaxis and surgical treatment of complications.

FEATURES OF OPHTHALMIC CARE FOR PATIENTS WITH COMPLICATED CATARACTS

2020 ◽  
pp. 84-89
Author(s):  
Inna Ivanovna Lapkina
Keyword(s):  
Health Care ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Key Words ◽  
Outpatient Treatment ◽  
Practical Application ◽  
Unified Approach ◽  
Case Histories ◽  
High Prevalence

Today, around 50 million people worldwide suffer from cataracts, more than a half of them need surgical treatment. High prevalence of this pathology in Ukraine, the need to improve the provision of ophthalmic care to patients, and the reform of the health care system have made the research relevant. Concomitant diseases and special conditions of the eye increase the risk of intra− and postoperative complications, worsen the functional parameters of patients after surgery. In order to develop a unified approach to the treatment of complicated cataracts based on diagnostically related groups of patients, a retrospective analysis of case histories of patients with different variants of complications related to the condition of the lens itself, its ligament apparatus and other structures of the eye was conducted. In each case, the surgeon has to choose the appropriate modification of cataract phacoemulsification surgery. The study proposed the classification of cataract phacoemulsification modifications on the basis of the techniques and the sequence of operation stages, taking into account the classification of the degrees of turbidity of the lens, proposed by L. Buratto. It has been noted that in complicated cases, according to the indications of the patient, surgery may be performed on several modifications of cataract phacoemulsification. The developed classification made it possible to generalize the various variants of pathology and greatly facilitate the choice of tactics of surgical treatment in complicated cataracts. It can be used not only for practical application, but also for improving the qualification of trained professionals. The prospect of further research is to identify contraindications for outpatient treatment of the patients with complicated cataracts. Key words: cataract complication, classification of phacoemulsification modifications, diagnostically related groups.

Efficacy and safety of surgery for spontaneous pneumothorax in elderly patients

2019 ◽  
Author(s):  
Shunichi Nagata ◽  
Mitsugu Omasa ◽  
Kosuke Tokushige ◽  
Takao Nakanishi ◽  
Hideki Motoyama
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Spontaneous Pneumothorax ◽  
Performance Status ◽  
Multivariable Analysis ◽  
Efficacy And Safety ◽  
Air Leaks ◽  
Grade 3

Abstract OBJECTIVES There is no clear consensus on the surgical indications for spontaneous pneumothorax in elderly patients. In this study, we aimed to assess the efficacy and safety of surgical treatment of spontaneous pneumothorax in patients aged ≥70 years. We also sought to identify the risk factors for postoperative prolonged air leaks and complications in such patients. METHODS Data pertaining to 104 elderly patients who underwent surgery out of 206 patients (aged ≥70 years) who were diagnosed with spontaneous pneumothorax at our institution between 1994 and 2018 were retrospectively reviewed. The incidences of postoperative persistent air leaks (≥2 days) and postoperative complications (≥grade 3; Clavien–Dindo classification) were analysed for efficacy and safety assessment, respectively. RESULTS Median postoperative air leaks continued for 0 days (range 0–25); 14.4% patients developed ≥grade 3 postoperative complications. On the basis of results of multivariable analysis, it was observed that a higher PaCO2 level was significantly associated with prolonged postoperative air leaks [odds ratio (OR) 1.08, 95% confidence interval (CI) 1.00–1.17; P = 0.047]. Poorer performance status was associated with a significantly increased risk of postoperative complications, as assessed by multivariable analysis (OR 6.13, 95% CI 1.38–27.3; P = 0.017). The recurrence rate was 4.8%; mortality rate of patients was 2.9%. Three-year survival rate after surgery was 73.8%. CONCLUSIONS Surgical treatment of spontaneous pneumothorax may be effective and safe in selected elderly patients. Moreover, higher PaCO2 and poorer performance status were independent risk factors for postoperative persistent air leaks and complications, respectively.

scholarly journals Regression analysis and statistical examination of Knoop Hardness on abrasion resistance in Lyca Beige Marbles

Filomat ◽  
2020 ◽  
Vol 34 (2) ◽  
pp. 609-614
Author(s):  
Burcu Aydin ◽  
Fusun Yalcin ◽  
Ozge Ozer ◽  
Gurhan Yalcin
Keyword(s):  
Mechanical Properties ◽  
Regression Analysis ◽  
Physical And Mechanical Properties ◽  
Production Method ◽  
Knoop Hardness ◽  
Decomposition Products ◽  
Marble Quarries ◽  
Selection Of

Marbles are secondary decomposition products formed by metamorphism of limestone. Effective classification of marble quarries in terms of quality enables the selection of a sustainable production method and safety application. This evaluation is based on physico-mechanical properties of the samples. Obtained results of physico-mechanical properties of the marbles were statistically analyzed using Stata 14 and SPSS 21 software. The marbles indicated mostly normal physical and mechanical properties. A strong inverse relationship exists between Abrasion Value and Knoop Hardness Determination that indicates a significant nonlinear relationship. Samples were distinguished into 3 groups of close similarity and related properties. The estimated value of the parameters is in the 95 % confidence interval. The equation obtained by regression analysis was used for the determination of resistance to abrasion.

scholarly journals ACTUAL ISSUES OF ONCOPLASTIC ORGAN-PRESERVING SURGERY OF BREAST CANCER

2019 ◽  
Vol 178 (5) ◽  
pp. 36-46
Author(s):  
D. A. Ryabchicov ◽  
I. K. Vorotnikov ◽  
I. A. Dudina ◽  
A. M. Kazakov ◽  
D. A. Denchik
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Resection Margins ◽  
The People ◽  
Past Half Century ◽  
New Variant ◽  
Positive Resection Margins ◽  
Medical University

Surgical treatment of breast cancer (BC) has undergone significant changes over the past half century. Oncoplastic operations are a relatively new variant of organ-preserving surgical treatment of breast cancer. Its idea is to combine the principles of oncology and plastic surgery in order to obtain oncological safe and cosmetic acceptable results. Despite the widespread implementation of these operations, high-quality studies on the benefits of oncoplastic operations in comparison with other methods are not enough. Actual issues of breast cancer oncoplastic surgery was considered in this literature review, such as indications for surgery, classification of oncoplastic techniques, determination of positive resection margins, evaluation of recurrence and survival, postoperative complications, cosmetic result.The authors declare no conflict of interest.The authors confirm that they respect the rights of the people participated in the study, including obtaining informed consent when it is necessary, and the rules of treatment of animals when they are used in the study (Conclusion of the local Ethics Committee at Northern State Medical University of 08.04.2015, Protocol No. 02/4-15). Author Guidelines contains the detailed information.

scholarly journals The Efficacy and Safety of Surgical Treatment for Patients With Tuberculosis Destroyed Lung With or Without Chronic Pulmonary Aspergillosis

2021 ◽  
Author(s):  
Hongyun Ruan ◽  
Changfan Gong ◽  
Jinxiang Wang
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Postoperative Mortality ◽  
Efficacy And Safety ◽  
Pulmonary Aspergillosis ◽  
Preoperative Serum ◽  
Chronic Pulmonary Aspergillosis ◽  
Independent Risk Factors ◽  
Destroyed Lung

Abstract Background To evaluate the efficacy and safety of surgical treatment of tuberculosis destroyed lung (TDL), and the influence of chronic pulmonary aspergillosis (CPA) on the outcomes of surgical treatment of TDL. Methods We performed a retrospective analysis of 113 patients with TDL who underwent surgical treatment from January 2005 to December 2019. Among them, 30 of these cases were complicated with CPA. The patients were divided into two groups: TDL group and TDL + CPA group. We analyzed the effectiveness and safety of surgical treatment of TDL, and further compared the effectiveness and safety of surgical treatment of TDL with or withoutthe presence of CPA. Results The TDL + CPA group had a significantly higher age (P=0.003), symptoms of hemoptysis (P=0.000), and a higher proportion of patients with preoperative serum albumin <30 g/L (P=0.014) as compared with TDL group. For all enrolled patients, the incidence of severe postoperative complications was 12.4% (14/113) and the postoperative mortality within 30 days after discharge was 4.4% (5/113). 86.7% (98/113) of the patients recovered and discharged, the incidence of severe postoperative complications in the TDA + CPA group was higher than that of TDL group (23.3% vs 8.4%, P = 0.034), although there was no difference in mortality between the two groups (P = 1.000). A binary logistic regression analysis showed that the independent risk factors for severe postoperative complications were male (OR 25.24, 95% CI 2.31–275.64; P = 0.008) and age ≥ 40 years (OR 10.34, 95% CI 1.56–68.65; P = 0.016). Conclusion Surgical treatment for patients with TDL is effective with an acceptable mortality rate whether or not the disease is complicated with CPA. The independent risk factors identified for severe postoperative complications in patients with TDL were male and ≥ 40 years old. It implies that when treating patients with TDA + CPA, particular attention should be paid to these patients who have these independent risk factors to avoid a poor outcome.

Assessment of postoperative complications of transurethral contact pyelocalycоlithotripsy in patients with high-density stones according to the Clavien – Dindo classification

2020 ◽  
Vol 10 (4) ◽  
pp. 309-316
Author(s):  
Toirkhon Kh. Nazarov ◽  
Anisjon I. Tursunov ◽  
Ivan V. Rychkov ◽  
Magomed A. Ahmedov ◽  
Kseniya E. Trubnikova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Retrospective Analysis ◽  
Kidney Stones ◽  
Postoperative Period ◽  
Topical Issue ◽  
Unified Algorithm ◽  
Cavity System ◽  
Treatment Of Urolithiasis

Improving the effectiveness of treatment of urolithiasis is a topical issue in modern urology. Despite a large number of studies on this problem, there is currently no unified algorithm for assessing postoperative complications of removal of calculi of the renal cavity system by transurethral access. Purpose of the study: based on a retrospective analysis to adapt the classification of postoperative complications according to Clavien Dind from 2004 to describe the complications of transurethral contact pyelocalicolithotripsy. Materials and methods. A retrospective analysis of the results of surgical treatment of 211 patients with kidney stones with a density of 960 HU to 1840 HU was performed. Ultrasonic energy was used for lithotripsy. Criteria for the normal course of the postoperative period in patients have been formulated. Results. The number of postoperative complications was calculated. The obtained data are distributed according to the corresponding gradations of the adapted Clavien Dindо classification. Conclusion. The improved Clavien Dindo classification, taking into account the adaptation, can be used as an up-to-date, accessible and logical template for assessing the postoperative complications of transurethral contact pyelocalicolithotripsy.

Risk of Ethical Financial Investments of Firms

2020 ◽  
Vol XVI ◽  
pp. 59-77
Author(s):  
Leszek Kędzierski
Keyword(s):  
Risk Factors ◽  
Risk Classification ◽  
Risk Measurement ◽  
Measurement Process ◽  
Finance Management ◽  
Ethical Finance ◽  
Financial Investments

Ethical tangible, intagible and financial investments are realized in the framework of ethical finance management of firms. Ethical financial in-vestments projects by kinds are accompanied by different kinds of risk. Risk measurement process of these investments includes: classification of risk, classification of risk factors and determination of risk size using different methods.

scholarly journals Minimally invasive closure of transthoracic ventricular septal defect: postoperative complications and risk factors

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Chunnian Ren ◽  
Chun Wu ◽  
Zhengxia Pan ◽  
Yonggang Li
Keyword(s):  
Risk Factors ◽  
Regression Analysis ◽  
Postoperative Complications ◽  
Adverse Events ◽  
Ventricular Septal Defect ◽  
Minimally Invasive ◽  
Septal Defect ◽  
Residual Shunt ◽  
Serious Adverse Events ◽  
Logistics Regression

Abstract Objectives To summarize and analyze the clinical characteristics of postoperative complications after minimally invasive closure of transthoracic ventricular septal defect, and to explore the risk factors for its occurrence. Methods Retrospectively analyzed the clinical data of 209 patients underwent transthoracic ventricular septal defect closure performed in the Department of Cardiothoracic Surgery, Children’s Hospital of Chongqing Medical University from January 2018 to January 2020, obtained relevant clinical data from the electronic medical record system and summarized their postoperative complications. And used univariate logistics regression and multivariate logistics regression to analyze the risk factors of its occurrence. Results The postoperative hospital stay of 27 patients was longer than 9 days. Residual shunt occurred in 33 patients recently after operation. One patient underwent surgical treatment again because of mechanical hemolysis after the operation. Two patients were re-operated 1 month and 10 months after surgery because of persistent moderate to severe aortic regurgitation. After surgery, 3 patients underwent pericardiocentesis due to a large amount of pericardial effusion, and 2 patients developed a new atrioventricular block after the operation. No other serious adverse events occurred. Multivariate logistic regression analysis showed that the size of VSD defect (OR: 1.494, 95% Cl: 1.108–2.013, P value: 0.008) was related to long postoperative hospitalization. The residual shunt is related to the size of the occluder (OR: 1.452, 95%Cl: 1.164–1.810, P value: 0.001). In the univariate logistics regression analysis, no risk factors related to serious adverse events were found. Conclusions The minimally invasive closure of transthoracic ventricular septal defect is very effective, with no mortality and low incidence of serious adverse events after surgery. The size of the defect is related to the long postoperative hospitalization, and the size of the occluder is related to the residual shunt in the early postoperative period. No risk factors related to the occurrence of serious adverse events after the operation were found.

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