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PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262362
Author(s):  
Ujal Pradhan ◽  
Maliwan Oofuvong ◽  
Orarat Karnjanawanichkul ◽  
Jatuporn Pakpirom

Objective We aimed to determine the risk factors of perioperative drug hypersensitivity reaction (DHR) and develop a predictive score for use in clinical practice. Methods A case-control study was conducted in patients who underwent anesthesia at a tertiary hospital in Thailand, between 2015–2018. DHR cases were graded clinically from 1 to 4 according to the World Federation of Societies of Anesthesiologists by two anesthesiologists. Controls were randomly matched with cases (ratio 2:1) by age group and month and type of surgery. Patient and anesthesia-related factors and agents given intraoperatively were recorded. A risk score was derived from the coefficients of the significant predictors of the final multivariate logistic regression model. Risk scores, adjusted odds ratios (OR) for perioperative DHR and 95% confidence intervals (CI) were determined. Results Overall, 325 cases and 650 controls were recruited. The severity of DHR was grade 1 (72.9%), grade 2 (24%), and grade 3 (3.1%). Our risk predictive tools for perioperative DHR provided a sensitivity of 62% and specificity of 65%. Predictive scores of subgroups of moderate to severe DHR showed high specificity (80%) but low sensitivity (47%). Common predictors of overall DHR and moderate to severe DHR were history of drug allergy to 2 or more drug categories (score 2.5–3.5), being allergic to analgesics (score 2.5–4.0), and intraoperative morphine use (score of 1). The sole predictor of high-risk perioperative DHR (score ≥3.5) was airway management with an endotracheal tube intubation (OR 5.6, 95% CI 2.2–14.4) whereas history of allergic rhinitis (OR 11.7, 95% CI 1.3–105.1) was a predictor of high-risk moderate to severe DHR (score ≥2.5). Conclusions Our predictive tool for perioperative DHR provided a modest predictive ability. History of drug allergies, rhinitis, morphine use and endotracheal intubation were significant risk factors of DHR after adjusting for age and type of surgery.


2022 ◽  
Vol 11 (2) ◽  
pp. 314
Author(s):  
Matteo Fallico ◽  
Pietro Alosi ◽  
Michele Reibaldi ◽  
Antonio Longo ◽  
Vincenza Bonfiglio ◽  
...  

Scleral buckling represents a valuable treatment option for rhegmatogenous retinal detachment repair. The surgery is based on two main principles: the closure of retinal breaks and the creation of a long-lasting chorioretinal adhesion. Buckles are placed onto the sclera with the purpose of sealing retinal breaks. Cryopexy is usually performed to ensure a long-lasting chorioretinal adhesion. Clinical outcomes of scleral buckling have been shown to be more favorable in phakic eyes with uncomplicated or medium complexity retinal detachment, yielding better anatomical and functional results compared with vitrectomy. Several complications have been described following scleral buckling surgery, some of which are sight-threatening. Expertise in indirect ophthalmoscopy is required to perform this type of surgery. A great experience is necessary to prevent complications and to deal with them. The use of scleral buckling surgery has declined over the years due to increasing interest in vitrectomy. Lack of confidence in indirect ophthalmoscopy and difficulties in teaching this surgery have contributed to limiting its diffusion among young ophthalmologists. The aim of this review is to provide a comprehensive guide on technical and clinical aspects of scleral buckling, focusing also on complications and their management.


Author(s):  
Anne Lautenbach ◽  
Marie Wernecke ◽  
Oliver Mann ◽  
Philipp Busch ◽  
Tobias B. Huber ◽  
...  

Abstract Background Bariatric surgery (BS) was shown to promote a decline in thyroid-stimulating hormone (TSH) in euthyroid patients with severe obesity in the short-term. Aim of the present study was to assess the effect of weight loss on thyroid function in euthyroid patients in the long-term following different bariatric procedures. Methods In a retrospective cohort study including 135 patients at baseline, thyroid function was assessed at six time points up to 8 years after surgery. Patients were stratified by TSH levels at baseline and divided into two groups to compare the change in TSH at long-time. We used log-linear regression to assess the relation between thyroid hormones and TSH and linear regression analyses to identify variables that were thought to determine TSH and fT3/fT4-ratio as well as their change long-term. Results Over a mean follow-up of 8 years, TSH and fT3/fT4-ratio declined (both p < 0.001). Patients with high-normal TSH showed a greater decline in TSH than those with normal TSH compared to baseline. Thyroid hormones and TSH displayed a negative log-linear correlation at long-term follow-up. Change in TSH at long-time showed a negative correlation with TSH at baseline (B = −0.55; p < 0.001). With regard to type of surgery, there were no significant differences in TSH. Conclusion BS promotes a decline of TSH in euthyroid patients up to 8 years after intervention despite weight regain. The greatest change in TSH was seen among patients with high-normal baseline-TSH. Results of log-linear regression suggest recovery of the pituitary-thyroid axis. Type of surgery did not affect the change in TSH levels over time.


Author(s):  
Erika Guyot ◽  
Julie-Anne Nazare ◽  
Pauline Oustric ◽  
Maud Robert ◽  
Emmanuel Disse ◽  
...  

Changes in food preferences after bariatric surgery may alter its effectiveness as a treatment for obesity. We aimed to compare food reward for a comprehensive variety of food categories between patients who received a sleeve gastrectomy (SG) or a Roux-en-Y gastric bypass (RYGB) and to explore whether food reward differs according to weight loss. In this cross-sectional exploratory study, food reward was assessed using the Leeds Food Preference Questionnaire (LFPQ). We assessed liking and wanting of eleven food categories. Comparisons were done regarding type of surgery and Total Weight Loss (TWL; based on tercile distribution). Fifty-six patients (30 SG and 26 RYGB) were included (women: 70%; age: 44.0 (11.1) y). Regarding the type of surgery, scores were not significantly different between SG and RYGB, except for &lsquo;non-dairy products &ndash; without color&rsquo; explicit liking (p = 0.04). Regarding TWL outcomes, explicit liking, explicit wanting and implicit wanting, scores were significantly higher for Good responders than Low responders for &lsquo;No meat &ndash; High fat&rsquo; (post-hoc corrected p-value: 0.04, 0.03 and 0.04, respectively). Together, our results failed to identify major differences in liking and wanting regarding the type of surgery and tended to indicate that higher weight loss might be related to a higher reward for high protein-content food. Rather to focus only on palatable foods, future studies should also consider a broader range of food items, including protein reward.


2022 ◽  
Vol 6 (2) ◽  
pp. 1405-1410
Author(s):  
Muhammad Reza Azriyantha ◽  
Ambiar Manjas

Background. Cholelithiasis is a condition where there are stones in the gallbladder or the common bile duct or both. This study aims to describe the characteristics of cholelithiasis patients in RSUD Dr. Achmad Mochtar Bukittinggi. Methods. This research is a descriptive observational study on the incidence of cholelithiasis in hospitals. Dr. Achmad Mochtar Bukittinggi period January 2019 – December 2020. A total of 224 research subjects participated in this study. Secondary data was collected from medical records of research subjects, including data on age, gender, body mass index, clinical symptoms, and type of surgery. Data analysis was carried out with the help of SPSS 25 software. Results. Cholelithiasis was most commonly found in the age group over 50 years (47.8%), normal BMI (46%) cases. The most complained symptom in cholelithiasis patients in this study was abdominal pain (61.6%). All cholelithiasis patients (100%) in this study underwent laparoscopic cholecystectomy surgery. Conclusion. Cholelithiasis patients who underwent surgery in hospitals. Dr. Achmad Mochtar Bukittinggi for the period January 2019 – December 2020 were 224 patients. The majority of patients over 50 years of age, women, had a normal BMI. The patient frequently complained of abdominal pain and all had undergone laparoscopic cholecystectomy.


2021 ◽  
Vol 21 (4) ◽  
pp. 275-281
Author(s):  
Jae-Eun Kim ◽  
Young-Jae Yoon ◽  
Yong-Dae Kwon ◽  
Sang-Hwan Oh
Keyword(s):  

Author(s):  
Azade Ebrahimzadeh ◽  
Mohammad Najafi ◽  
Bita Bijari ◽  
Ahmad Amouzeshi ◽  
Mohammad Reza Abedini ◽  
...  

Background and Objectives: Taking unnecessary or inappropriate prophylactic antibiotics can cause infections with re- sistant organisms. The present study aimed to investigate administration prophylactic antibiotics in surgery ward and its compliance with standard protocol in Imam Reza teaching hospital of Birjand, Iran. Materials and Methods: This descriptive-analytical study was performed to evaluate the pattern of prophylactic antibiotics on patients who underwent surgical operations from October to December 2019. A checklist including demographic informa- tion, type of prophylactic antibiotics, dose and duration of using drug, type of surgery, and compliance with standard protocol was used. The validity and reliability of the checklist were evaluated and confirmed prior to the study. All eligible patients were enrolled and the information of the prescribed drugs in the surgical wards was compared with the Schwartz’s principles of surgery as standard protocol. Results: Out of a total of 300 patients, 187 (62.3%) were male. Among the patients, 155 (51.7%) cases underwent general surgery, 119 (39.6%) cases orthopedic surgery, and 26 (8.7%) cases neurosurgery. The most popular prescribed antibiotics were cefazolin (170 cases) and ceftriaxone + metronidazole (67 cases). Furthermore, the maximum antibiotic administrations were two days (127 cases) and one day (93 cases). More importantly, 67.7% and 92.3% of the patients were in compliance with the standard protocol in terms of the type and time of administration, respectively. Conclusion: Our results showed that duration and route of administrating antibiotics were consistent with the standard pro- tocol, but the type of drugs and indication did not match.


2021 ◽  
Vol 14 (12) ◽  
pp. e246714
Author(s):  
Chinedu Brian Egu ◽  
Ashwin Kumaria ◽  
Alistair Paterson ◽  
Iain Robertson

We present a case of syringomyelia following retrosigmoid craniectomy and resection of vestibular schwannoma complicated by Cerebrospinal fluid (CSF) leak, multiple infections and CSF diversion procedures. We believe this is the first reported case of syrinx formation after this type of surgery. Potential mechanisms by which the syrinx may have developed are discussed.


2021 ◽  
Vol 9 (11) ◽  
pp. 1221-1230
Author(s):  
Christian Fuentes ◽  
◽  
Paulo J. Llinas ◽  
Allan W. Chew ◽  
Fabricio Ponce ◽  
...  

The aim of this work was to assess the efficacy of viscosupplementation after knee arthroscopy in a series of cases and to propose an adequate dosage regimen.The cases studied corresponded to patients undergoing arthroscopic surgery presenting meniscal injury and/or free bodies and where osteoarthritis could be present. Viscosupplementation started 3 weeks after arthroscopy and one set of patients received one shot of 5 ml of hyaluronic acid and the other set received three injections of 2.5 ml with weekly intervals. Patients were followed at 3 and 6 months. Improvements in pain and function as well as patient satisfaction were assessed and the appearance of adverse events was monitored. The groups studied were homogeneous with no differences in the type of surgery, associated gestures or other procedures performed during the intervention. Considering the patients as a whole, significant improvements were observed at 3 weeks post-arthroscopy (prior to intra-articular treatment) and at 3 and 6 months compared to pre-arthroscopy scores. Pain reductions were of 39.8%, 63.4% and 80.9% respectively and function improvement was of 20.9%, 58.8% and 77.9% respectively. There were no differences between the two groups in any of the parameters analysed. The treatment was rated by the patients as excellent. The group concluded that viscosupplementation inpost-arthroscopy achieves significant pain reduction and function improvement; moreover, one shot of hyaluronic acidis a safe and effective option as an adjuvant treatment in arthroscopic surgery favouring a better recovery with a lower cost for both the patient and the Healthcare System.


2021 ◽  
Vol 5 (1) ◽  
pp. 85-95
Author(s):  
Mohamad Rofi'in ◽  
Sentot Imam Suprapto

A person's interest in services is related to the ability of the service provider to provide services. The purpose of this research is to analyze the influence of perception, service quality, anxiety and type of surgery on patient interest in performing surgery at Sumber Glagah Hospital, Mojokerto Regency. The design of this study is a quantitative analytic study with a cross sectional approach with the focus of the research being aimed at analyzingthe influence of perception, service quality, anxiety and type of surgery on patient interest in performing surgery at Sumber Glagah Hospital, Mojokerto Regency with a population of a number 143 respondents and a sample of 105 respondents who were taken using purposive sampling technique. Data analysis using Linear Regression test.The findings found that Most of the respondents had the perception of a sufficient category as many as 65 respondents (61.9%). Most of the respondents had a sufficient service quality category as many as 66 respondents (62.9%). Most of the respondents had moderate anxiety as many as 61 respondents (58.1%). Most of the respondents had a selective category of operation as many as 92 respondents (87.6%).  Most of the respondents have a moderate interest category as many as 69 respondents (65.7%). Based on the results of the Multiple Linear Regression analysis, it shows that with a p-value of 0.000 <0.05, H1 is accepted so it can be concluded that simultaneously there isinfluence perception, quality of service, anxiety and type of surgery on patient interest in performing surgery at Sumber Glagah Hospital, Mojokerto Regency with a magnitude of influence 70.4%. Basically, a person's interest can be influenced by various factors ranging from the patient's point of view, the quality of existing services and even the patient's level of anxiety.


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