scholarly journals Analysis of complications of surgical treatment of patients with autoimmune thyroiditis

2021 ◽  
pp. 19-23
Author(s):  
O. V. Shidlovskyi ◽  
V. O. Shidlovskyi
Keyword(s):  
Autoimmune Thyroiditis ◽  
Thoracic Duct ◽  
Main Group ◽  
Control Group ◽  
Postoperative Hypoparathyroidism ◽  
Increased Risk ◽  
Duration Of Surgery ◽  
Voice Tone ◽  
Complications Of Thyroidectomy ◽  
Toxic Goiter

Aim — to study the frequency and structure of specific complications in surgeries for autoimmune thyroiditis AIT associated with benign nodules in comparison with operations for multinodular non-toxic goiter. Materials and methods. The analysis of complications of thyroidectomy was performed for 237 patients operated for AIT (main group) and 261 for multinodular non-toxic goiter (control group). The evaluation was done to assess thesurgeryduration, the frequency of laryngeal paresis, postoperative hypoparathyroidism, thoracic duct damage, intense neck hematomas, dysphagia and changes in voice tone. Results. More complications were found in patients of the main group — 33 against 20 in the control group. The structure and number of individual complications from their total number in both groups was the same, and the frequency of the number of operated patients was significantly higher in the group of patients with AIT. The duration of thyroidectomy in AIT was (174.3 ± 4.2) min and depended on the severity of inflammatory changes in the gland and tissues around it, and in cases of multinodular non-toxic goiter — (127.0 ± 4.7) min (p < 0.01). Conclusions. Thyroidectomy for AIT compared to multinodular non-toxic goiter is accompanied by a greater number of complications and duration of surgery. There is an increased risk of developing hypoparathyroidism, laryngeal paresis, thoracic duct injuries, severe neck hematomas, dysphagia and changes in voice tone.

scholarly journals Malnutrition Was Not Related With Emergence Delirium in Elderly Patients After Noncardiac Surgery

2021 ◽  
Author(s):  
Fang Zhang ◽  
Shu-Ting He ◽  
Yan Zhang ◽  
Dong-Liang Mu ◽  
Dong-Xin Wang
Keyword(s):  
Elderly Patients ◽  
Multivariable Analysis ◽  
Noncardiac Surgery ◽  
Nutritional Risk ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Emergence Delirium ◽  
Increased Risk ◽  
Duration Of Surgery ◽  
The Relationship

Abstract Background: Delirium is one of the most common complications in elderly surgical patients. Although previous studies reported that preoperative malnutrition was related with postoperative delirium (POD), there was lack of evidence to illustrate the relationship between malnutrition and emergency delirium (ED). The objective of this study was to investigate the relationship between preoperative malnutrition and ED in elderly patients undergoing noncardiac surgery.Methods: The study was carried out in accordance with STROBE guidelines. This was a secondary analysis of a prospective cohort study. Elderly patients (65-90 years) who underwent noncardiac surgery under general anesthesia were enrolled in Peking University First Hospital.Preoperative malnutrition was defined as nutritional risk screening 2002 (NRS 2002) ≥3. Emergence delirium was assessed by Confusion Assessment Method for intensive care unit at 10 and 30 min after Post-anesthesia care unit (PACU) admission, and before PACU discharge. Multivariable analysis was employed to analyze the relationship between malnutrition and emergence delirium.Results: 915 patients were enrolled. The incidence of malnutrition was 53.6% (490/915). The incidence of emergency delirium was 41.8% (205/490) in malnutrition group and 31.5% (134/425) in control group, P<0.001. After adjusting confounding factors (i.e., age, mild cognitive impairment, American Society of Anesthesiologists classification (ASA), duration of surgery, pain score, low body temperature and allogeneic blood transfusion), malnutrition was not associated with increased risk of emergency delirium (OR=1.055, 95% CI 0.767-1.452, P=0.742).Conclusions: Malnutrition was common in elderly patients undergoing non-cardiac surgery, but it’s not related with emergence delirium after adjusted for confounders.Trial registration: Chinese Clinical Trial Registry (http://www.chictr.org.cn) (Number: ChiCTR-OOC-17012734).

Poor Functional Status as a Risk Factor for Surgical Site Infection Due to Methicillin-Resistant Staphylococcus aureus

2008 ◽  
Vol 29 (9) ◽  
pp. 832-839 ◽  
Author(s):  
Deverick J. Anderson ◽  
Luke F. Chen ◽  
Kenneth E. Schmader ◽  
Daniel J. Sexton ◽  
Yong Choi ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Surgical Site Infection ◽  
Functional Status ◽  
Surgical Patients ◽  
Control Group ◽  
Site Infection ◽  
Methicillin Resistant ◽  
Increased Risk ◽  
Duration Of Surgery ◽  
Poor Functional Status

Objective.To identify risk factors for surgical site infection (SSI) due to methicillin-resistant Staphylococcus aureus (MRSA).Design.Prospective case-control study.Setting.One tertiary and 6 community-based institutions in the southeastern United States.Methods.We compared patients with SSI due to MRSA with 2 control groups: matched uninfected surgical patients and patients with SSI due to methicillin-susceptible S. aureus (MSSA). Multivariable logistic regression was used to determine variables independently associated with SSI due to MRSA, compared with each control group.Results.During the 5-year study period, 150 case patients with SSI due to MRSA were identified and compared with 231 matched uninfected control patients and 128 control patients with SSI due to MSSA. Two variables were independendy associated with SSI due to MRSA in both multivariable regression models: need for assistance with 3 or more activities of daily living (odds ratio [OR] compared with uninfected patients, 3.97 [95% confidence interval {CI}, 2.18-7.25]; OR compared with patients with SSI due to MSSA, 3.88 [95% CI, 1.91-7.87]) and prolonged duration of surgery (OR compared with uninfected patients, 1.98 [95% CI, 1.11-3.55]; OR compared with patients with SSI due to MSSA, 2.33 [95% CI, 1.17-4.62]). Lack of independence (ie, poor functional status) remained associated with an increased risk of SSI due to MRSA after stratifying by age.Conclusions.Poor functional status was highly associated with SSI due to MRSA in adult surgical patients, regardless of age. A patient's level of independence can be easily determined, and this information can be used preoperatively to target preventive interventions.

scholarly journals Risk Factors of Postoperative Shivering at Post Anesthesia Care Unit in Normothermic Patients Underwent General Anesthesia

2021 ◽  
Author(s):  
Laortip Rattanapittayaporn ◽  
Maliwan Oofuvong
Keyword(s):  
Risk Factors ◽  
General Anesthesia ◽  
Core Temperature ◽  
Conditional Logistic Regression ◽  
Control Group ◽  
Anesthesia Care ◽  
Post Anesthesia Care Unit ◽  
Emergency Case ◽  
Increased Risk ◽  
Duration Of Surgery

Objective: The aim of study was to identify risk factors that can be modified to reduce incidence of postoperative shivering in normothermic patient who underwent general anesthesia.Material and Methods: A retrospective case control study was conducted between January 2017 and August 2018 by assessing the anesthetic records of normothermic patients at a post anesthesia care unit who underwent general anesthesia. A control group of 201 patients was randomly matched with 201 cases by age (±5 years) and site of surgery. Medical records were reviewed for data including patient demographics, operative time, anesthetic medication, type of fluid, core temperature at the end of surgery and occurrence of postoperative shivering. Conditional logistic regression analysis was performed to assess the association between potential risk factors and postoperative shivering.Results: Higher body mass index (BMI) [odds ratio (OR) 0.91, 95% confidence interval (CI) 0.87-0.96] and higher core temperature at end of surgery (OR 0.33 95% CI 0.18-0.63) are associated with reduced risk of postoperative shivering. Whereas emergency case compared with elective case (OR 3.06 95% CI 1.63-5.72) and longer duration every 10 minutes (OR 1.05 95% CI 1.03-1.08) are associated with an increased risk of postoperative shivering.Conclusion: Emergency case, longer duration of surgery, lower BMI and lower core temperature at end of surgery were significantly associated with postoperative shivering.

Laparoscopy compared with laparotomy for comprehensive surgical staging of early ovarian cancer: Results of a retrospective multicenter case-control study.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6067-6067
Author(s):  
Julia Caroline Radosa ◽  
Marc P Radosa ◽  
Pauline Mertke ◽  
Marie-Luise Hugo ◽  
Christoph Georg Radosa ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Case Control Study ◽  
Case Control ◽  
Surgical Staging ◽  
Control Group ◽  
Increased Risk ◽  
Duration Of Surgery ◽  
Early Ovarian Cancer ◽  
Control Study

6067 Background: The objective of this study was to compare laparoscopy and laparotomy for comprehensive surgical staging of early ovarian cancer in terms of efficacy and oncologic safety. Methods: Patients who had laparoscopic staging for early stage (I/II) ovarian cancer between 01/2000 and 10/2018 at the participating sites (Gynecologic comprehensive cancer centers with respective expertise in minimal invasive surgery) were included in this retrospective case-control study. The control group consisted of all patients treated via laparotomy during the study period. Clinical data were abstracted from medical record and recent follow up information were obtained. Comparisons were made between patients regarding surgical parameters and oncologic outcome and multivariate models were used to identify factors independently associated with disease recurrence. Results: Among 313 patients, staging was performed via laparoscopy in 208 (66 %) patients and via laparotomy in 105 (34 %) patients. Patients staged laparoscopically were younger (median 52 (15-86) vs. 59 (17-92) vears, p≤0.01) and had a lower BMI (24.4 (16.5-46.8) vs. 26 (15.5-53.8), p≤0.01). Regarding surgical parameters, duration of surgery was longer (291 (159-778) vs. 277 (159-690) minutes, p≤0.01), postoperative hospitalization was shorter (7 (0-27) vs. 9 (0-92) days, p≤0.01) and postoperative complications were lower in the laparoscopy group. On univariate analysis there were no differences in rates of tumor stage according to FIGO, intraoperative rupture of ovarian cysts (14 % vs. 13 %, p=0.87), number of lymph nodes removed (24 (0-89) vs. 22 (0-96), p=0.81) or any recurrence of disease (14 % vs. 16 %, p=0.52). At a median follow-up of 46 months (0-227), there were no differences in DFS and OS by surgical technique (5yr DFS 82 % (SE 0.04) vs. 83 % (SE 0.05), p=0.43; OS 91 % (SE 0.03) vs. 87 % (SE 0.04), p=0.87). On multivariate analysis route of surgery was not associated with an increased risk of recurrence. Conclusions: According to this preliminary analysis, laparoscopic surgical staging in patients with early ovarian cancer seems to be adequate and safe, but a longer follow-up and prospective data are needed to enhance evidence on oncologic outcomes.

scholarly journals Genetic and biochemical aspects of formation of professional chronic dust bronchitis

2019 ◽  
pp. 342-347
Author(s):  
A. S. Kazitskaya ◽  
N. I. Panev ◽  
T. K. Yadykina ◽  
O. N. Gulyaeva ◽  
N. A. Evseeva
Keyword(s):  
Respiratory System ◽  
Coal Industry ◽  
Main Group ◽  
The Body ◽  
Control Group ◽  
Immunological Parameters ◽  
Actual Problem ◽  
Functional Parameters ◽  
Increased Risk ◽  
The Impact

Introduction. Th e actual problem of modern occupational health is the study of the role of exogenous and endogenous factors in the development of occupational pathology of the bronchopulmonary system. То identify groups at increased risk of developing a dusty pathology of the bronchopulmonary system, it is necessary to conduct a comprehensive study of clinical and genetic factors, as well as to determine the most signifi cant diagnostic markers of the development of this pathology.The aim of the study was to study the genetic status of a set of biochemical and molecular genetic markers, as well as biochemical parameters of blood and respiratory function in coal industry workers with chronic dust bronchitis and persons of the control group.Materials and methods. 115 workers of coal mines from the South of Kuzbass aged from 39 to 58 years were examined in the Clinic of the Institute. Among them — 71 people with a previously established diagnosis of chronic dust bronchitis (the main group) and 44 people of the control group of persons working in the same sanitary conditions, but not having this pathology. A complex of clinical, biochemical and genetic methods of research was used in the study, and functional parameters of the bronchopulmonary system were evaluated. Statistical processing of the results was carried out using IBM SPSS Statistics 22 soft ware. Results. Statistically signifi cant diff erences between biochemical (increase in the concentration of ceruloplasmin and α–1antitrypsin) and immunological parameters (increase in the total number of leukocytes and ESR, increase in the concentration of IgG) in miners with chronic dust bronchitis and coal industry workers without this pathology were revealed. The dependence of the functional changes of the respiratory system with the development of professional pathology is determined. Th e persons of the main group showed a statistically signifi cant decrease in functional parameters (forced exhalation per second and lung capacity), increased respiratory failure. A predisposition to the development of dust bronchitis in the owners of the HP 1–1 genotype and resistance to the formation of this pathology in persons with the HP 2–2 genotype were found. Th e study of GSTT 1 deletion polymorphism revealed that carriers of the GSTT 1 «+» variant are most susceptible to the development of chronic dust bronchitis, and owners of the GSTT 1 variant are» resistant to its formation. Th ere was a positive аssociation with the development of dust bronchitis of the holders of the MM phenotype (MN).Conclusions. When working in similar conditions, some workers have a deviation of biochemical and immunological parameters fr om the norm, as well as a violation of the respiratory system, while others have no changes. Th e response of the body to the impact of certain external adverse factors may be due to genetic predisposition or resistance to the development of the disease. 

Dystyreoz as risk factors for the formation of secondary amenoreyeyi girls who live in low iodine deficiency

2017 ◽  
pp. 16-20
Author(s):  
S.I. Turchinа ◽  
◽  
T.A. Nachetova ◽  
Keyword(s):  
Thyroid Gland ◽  
Iodine Deficiency ◽  
Thyroid Dysfunction ◽  
Thyroid Volume ◽  
Main Group ◽  
Control Group ◽  
Menstrual Dysfunction ◽  
Normal Thyroid ◽  
Secondary Amenorrhea ◽  
Toxic Goiter

The article highlights new data on the effect of thyroid dysfunction on the formation of secondary amenorrhea in adolescent girls who live for a long time in conditions of weak iodine deficiency. The objective: to determine the state of the thyroid system in girls with SA, taking into account the presence of thyroid disorders. Materials and methods. Under observation were 68 girls aged 14-17 years with SA, living in conditions of weak iodine deficiency in Kharkov and the Kharkov region. The examination provided for an ultrasound of the thyroid gland and determination of the functional state of the pituitary-thyroid system. Girls with SA entered the main group. Depending on the presence of thyreopathy, namely, diffuse non-toxic goiter (DNG), the patients of the main group were divided into two subgroups: 1-st subgroup consists of a girls with SA and normal thyroid volume (n=39); 2-nd subgroup consists of girls with SA and DNG (n=29). The control group included 78 female peers with normal thyroid volume, harmonious physical development and normal menstrual function. Results. The obtained results allowed to establish that the formation of SA in girls living in conditions of low iodine deficiency occurs against a background of thyroid dysfunction, the character of which differs in girls with normal thyroid gland volume and DNG. This can be regarded as a succession of stages of the pathological process when, in conditions of prolonged residence in regions with a mild iodine deficiency, a distearosis is formed which is characterized by an increase in the fT4 conversion in fT3, reflecting an increase in the fT3/fT4 ratio in the vast majority of the girls surveyed. These changes in the thyroid profile negatively affect the development of the reproductive system and can cause menstrual dysfunction even in the absence of thyroid disease. The conclusion. Prevention and treatment of SA in girls living in conditions of low iodine deficiency, provides long-term use of pharmacological drugs potassium iodide in age doses. Key words: girls, thyroid gland, thyroid status, secondary amenorrhea.

scholarly journals Malnutrition is not related with emergence delirium in older patients after noncardiac surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fang Zhang ◽  
Shu-Ting He ◽  
Yan Zhang ◽  
Dong-Liang Mu ◽  
Dong-Xin Wang
Keyword(s):  
Older Patients ◽  
Secondary Analysis ◽  
Noncardiac Surgery ◽  
Control Group ◽  
Clinical Trial Registry ◽  
Emergence Delirium ◽  
Link Type ◽  
Increased Risk ◽  
Duration Of Surgery ◽  
The Relationship

Abstract Background Delirium is one of the most common complications in older surgical patients. Although previous studies reported that preoperative malnutrition was related with postoperative delirium (POD), there was lack of evidence to illustrate the relationship between malnutrition and emergency delirium (ED). The objective of this study was to investigate the relationship between preoperative malnutrition and ED in older patients undergoing noncardiac surgery. Methods The study was carried out in accordance with STROBE guidelines. This was a secondary analysis of a prospective cohort study. Older patients (65–90 years) who underwent noncardiac surgery under general anesthesia were enrolled in Peking University First Hospital. Results 915 patients were enrolled. The incidence of malnutrition was 53.6 % (490/915). The incidence of emergency delirium was 41.8 % (205/490) in malnutrition group and 31.5 % (134/425) in control group, P < 0.001. After adjusting confounding factors (i.e., age, cognitive impairment, American Society of Anesthesiologists classification (ASA), duration of surgery, pain score, low body temperature and allogeneic blood transfusion), malnutrition was not associated with increased risk of emergency delirium (OR = 1.055, 95 % CI 0.767–1.452, P = 0.742). Conclusions Malnutrition was common in older patients undergoing non-cardiac surgery, but it’s not related with emergence delirium after adjusted for confounders. Trial registration Chinese Clinical Trial Registry (http://www.chictr.org.cn) (ChiCTR-OOC-17,012,734).

scholarly journals Hormonal contraception with progestagen desogestrel in women with diffuse non-toxic goiter аnd autoimmune thyroiditis

2013 ◽  
Vol 62 (6) ◽  
pp. 40-46
Author(s):  
Galina Petrovna Pologoyko ◽  
Maria Igorivna Yarmolinskaya ◽  
Tatyana Mihajlovna Lekareva
Keyword(s):  
Thyroid Gland ◽  
Autoimmune Thyroiditis ◽  
Hormonal Contraception ◽  
Serum Levels ◽  
Reproductive Age ◽  
Control Group ◽  
Blood Levels ◽  
Free Triiodothyronine ◽  
Toxic Goiter ◽  
And Function

The article represents influence of gestagen desogestrel on size and function of thyroid gland in women of reproductive age. Into the study we included 70 women who were prescribed gestagen desogestrel in a daily dose of 75 mg for a period of 12 months. All the patients were devided into two groups. The first group consisted of 20 women with diffuse nontoxic goiter, the second consisted of 30 women with autoimmune thyroiditis. Control group consisted of 20 women without thyroid gland pathology. Prior to therapy with desogestrel and after 12 month of treatment, serum levels of free triiodothyronine, free thyroxine and thyrotropin releasing hormone, thyroperoxidase antibodies were determined and thyroid gland sonigraphy was performed in all the patients. Obtained data show that gestagen desogestrel doesn’t influence the size and function of thyroid gland in healthy women and in patients with diffuse non-toxic goiter. In women with autoimmune thyroiditis implication of desogestrel significantly decreases blood levels of thyroperoxidase autoantibodies.

scholarly journals Association of rs10507391 polymorphism with the development of acute cerebrovascular event

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Chernova ◽  
S Nikulina ◽  
D Nikulin
Keyword(s):  
Risk Factors ◽  
Arterial Hypertension ◽  
Genetic Research ◽  
Statistical Processing ◽  
Main Group ◽  
Control Group ◽  
Cerebrovascular Event ◽  
Cardiovascular Pathology ◽  
Arterial Blood ◽  
Increased Risk

Abstract Purpose To study SNP rs10507391 association (A&gt; T) with development of Acute Cerebrovascular Event in the patients with cardiovascular pathology and risk factors of its development who are representatives of the east Siberian population. Material and methods 260 patients with Acute Cerebrovascular Event participated in a research (age [57.0; 51.0–62.0]) and 272 patients of control group (age [55.0; 51.0–62.0].). Among the patients who transferred Acute Cerebrovascular Event, 157 men and 103 women. The control group included 170 men and 102 women. Inspection of the main group included: collecting complaints, anamnesis, clinical examination, computer tomography of a brain, electrocardiography, echo, ultrasonic of arteries, daily monitoring of arterial blood pressure and cardiac rhythm, analysis of a coagulant system of blood. Patients of the main group had the following cardiovascular pathology and risk factors: arterial hypertension, supraventricular tachycardia, dislipidemiya, atherosclerosis brachiocephalic of arteries, disturbances of a system of a hemostasis. The control group is examined within the international HAPIEE project. The molecular and genetic research was conducted by PCR method in real time. Statistical processing of material was carried out with use of set of the Statistica for Windows 7.0, Excel and SPSS 22 application programs. Results When studying SNP rs10507391 association (A&gt; T) connection between a rare genotype of a TT and an allele of T and the increased risk of Acute Cerebrovascular Event is established with development of Acute Cerebrovascular Event in all analyzed groups and subgroups of patients. Conclusion A genotype of a TT and an allele of T of SNP rs10507391 (A&gt; T) increases risk of development of an acute disorder of cerebral circulation in patients regardless of the previous cardiovascular pathology and risk factors, including at patients with arterial hypertension, supraventricular tachyarrhythmias, atherosclerosis the brachiocephalic of arteries, disturbance of lipidic exchange and the system of a hemostasis. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Intraoperative Intraluminal Endoscopy in the Surgical Treatment of Patients with Esophageal Diverticula of Various Localization

2019 ◽  
Vol 29 (3) ◽  
pp. 33-37 ◽  
Author(s):  
A. L. Shestakov ◽  
M. V. Khrustaleva ◽  
M. E. Shahbanov ◽  
N. A. Bulganina ◽  
T. T. Bitarov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Main Group ◽  
Research Centre ◽  
Linear Stapler ◽  
Esophageal Wall ◽  
Control Group ◽  
Surgical Removal ◽  
Esophageal Lumen ◽  
Esophageal Diverticula ◽  
Duration Of Surgery

Aim. To improve the results of surgical treatment of patients with esophageal diverticulum of various localization using intraoperative intraluminal endoscopy. Materials and Methods: The Department of Surgery of the Esophagus and Stomach, the Petrovsky National Research Centre of Surgery, has accumulated a large experience in treating diverticulosis patients. Thus, during the 2010–2018 period, 74 patients with esophageal diverticula of various localization were operated. Out of them, 56 (75.7 %), 10 (13.5 %) and 8 (10.8 %) patients underwent surgical treatment with respect to faringo-esophageal, bifurcation and epiphrenic diverticula, respectively. The patients were divided into two groups: 31 people (41.9 %) in the main group underwent diverticulectomy with intraoperative intraluminal endoscopic assistance (IVEA), while 43 (58.1 %) people in the control group underwent diverticulectomy without IVEA. Intraoperatively, at the stage of discovering diverticulum, the endoscopist applied transillumination and air insufflation in the cavity of the diverticulum, followed by controlling the mobilization of diverticulum. At the resection stage, the completeness of the surgical removal was controlled, along with the absence of esophageal lumen narrowing after sewing the neck of the diverticulum using a linear stapler.Results. The average duration of the operation in patients with Zenker’s diverticula and those in the control group was 45.5 ± 8.8 min and 73.8 ± 12.7 min (p < 0.05), respectively. In patients with the diverticula of the middle and lower third of the esophagus, the average surgery duration was equal to 120.3 ± 11.2 min and 150.5 ± 17.3 (p <0.05) min in the main and control groups, respectively. Radiological examination 2–3 days after surgery revealed no complications in the main group. In the control group, 2 (4.7 %) patients showed a small leakage of the contrast agent outside the esophagus (stopped conservatively). Signs of mild dysphagia when taking solid foods were detected in 1 (2.4 %) patient of the control group. This condition was associated with excessive ingress of the esophageal wall into the apparatus suture, which led to a slight narrowing of its lumen. No patients with dysphagia in the postoperative period were recorded in the main group. Conclusion: The combination of surgical treatment of esophageal diverticula with IVEA allows the duration of surgery to be optimized, deformation of the esophageal lumen to be avoided, possible complications to be minimized, thereby improving the results of surgical treatment. 

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