Sample records for early puerperal complications

  1. Complications In Pregnancy Part I: Early Pregnancy

    E-print Network

    Complications In Pregnancy Part I: Early Pregnancy It is Sunday evening and the place is dead. You appendicitis until urine is obtained and, low and behold, she has a positive urine pregnancy test. Blood the study...... Pregnancy-related complications are, unfortunately, a common experience for women and often

  2. Early and Late Complications of Inguinal Varicocelectomy

    Microsoft Academic Search

    RICHARD D. AMELAR

    2003-01-01

    PurposeI reviewed the early and late complications of inguinal and subinguinal varicocelectomy that I have personally encountered in an experience of more than 40 years as a urologist dealing with male infertility and offer suggestions to my colleagues for avoiding some of these pitfalls in the future.

  3. Early Complications Following Cemented Modular Hip Hemiarthroplasty

    PubMed Central

    Sullivan, Niall P.T; Hughes, Andrew W; Halliday, Ruth L; Ward, Abigail L; Chesser, Tim J.S

    2015-01-01

    Introduction : Hemiarthroplasty is the recommended treatment for displaced, intracapsular, femoral neck fractures. This study aimed to evaluate the early complications following insertion of the JRI Furlong cemented hemiarthroplasty, a contemporary, modular, double tapered, polished prosthesis. Method : A series of 459 consecutive patients (May 2006 - June 2009) treated with a JRI hemiarthroplasty with a minimum of one-year (1-4years) follow-up were evaluated. Data collected retrospectively from clinical records and hospital databases included patient demographics, mortality, deep infection, dislocation, periprosthetic fracture, and any requirement for revision or complications related to the prosthesis. Results : Full data were available for 429 of 459 (93%), partial data for 30 (7%). Average age was 83 years (52-100), 76% were female. One-year mortality was 24%. Intraoperative fractures occurred in 17 patients (3.7%). There were two intraoperative deaths. There were nine early deep wound infections (2%). There were two revisions to total hip replacement (THR), four patients required conversion to THR and one underwent an excision arthroplasty procedure. Discussion : Early surgical outcomes for the JRI hemiarthroplasty prosthesis are equivalent or superior to other major hemiarthroplasty prostheses previously reported however, there was a high intraoperative fracture rate of 3.7%. We recommend using a stem one size smaller than the final broach in fragile, osteoporotic bone. No patients re-presented with aseptic loosening or stem failure. PMID:25685248

  4. A magnetic resonance study of complicated early childhood convulsion

    Microsoft Academic Search

    R A Grünewald; T Farrow; P Vaughan; C D C Rittey; J Mundy

    2001-01-01

    OBJECTIVESThe relation between complicated early childhood convulsion (ECC) and adult epilepsy is unclear, although a history of complicated ECC is obtainable in half of adults with epilepsy associated with hippocampal sclerosis. It is not known if the ECC is a marker of pre-existing brain damage or is itself harmful to the developing brain. The objective of the study was to

  5. [Early and late complications of endocardial pacemaker wires (author's transl)].

    PubMed

    Bücking, J; Voss, H; Stein, J; Hahner, U

    1980-06-01

    Comparison of early and late complications of 769 endocardial pacemaker wires implanted in the period between 1969 and 1973 with 861 wires implanted between 1974 and 1978 revealed a decline of the complication rate from 17% to 7.6%. The dislocation rate could be lowered from 6.2% to 1.6%. Other early complications (exist and entrance block) were not effected (3.5% as compared with 3.2%). Late complications declined from 6.2% to 2.9%. Of these the number of intravascular wire breakages constitutes a high proportion. The main reason for this improvement is the use of a flexible Flange-tip lead. A variation of testing the positional stability of the wire is described.--The indications for pacemaker implantation shifted from 3rd degree AV-Block to the diagnoses "pathological bradycardia" and "hypersensitive carotis sinus". The comparatively low complication rate permits the application of new types of wires only in a few selected patients until a sufficient number of cases and an adequate follow-up period have been reached for clinical evaluation of these wires. PMID:7445644

  6. Early vascular complications after endovascular repair of aortoiliac aneurysms.

    PubMed

    Aljabri, B; Obrand, D I; Montreuil, B; MacKenzie, K S; Steinmetz, O K

    2001-11-01

    The purpose of this study was to estimate the frequency of and review the treatment options for intraoperative endograft access-related vascular complications and early postoperative vascular complications of endovascular repair for aortoiliac aneuryms (EVAR). Between February 1998 and April 2000, 53 patients (46 males, 7 females) with aneurysms of the abdominal aorta (AAA) and iliac arteries were treated with endovascular grafts (48 AAA, and 5 iliac aneurysms). All procedures were performed using open exposure of the femoral arteries. One patient with an AAA was converted to open repair (primary technical success, 98.1%). We recorded the need for adjunctive vascular procedures or intervention to the access arteries (iliofemoral) or the endograft because of thrombosis or distal embolization. Events were classified as either intraoperative, early postoperative (< 30 postoperative days), or late postoperative. Their etiology and treatment were recorded. The results were compared to those from other series reported in the literature and to published registry data. From our results we concluded that the need for adjunctive vascular procedures to the iliofemoral arteries at the time of EVAR is significant. These procedures are necessary to either repair damage to the access arteries from the delivery system or provide a conduit for graft delivery in cases where the access arteries are inadequate. Early postoperative vascular complications are due to technical factors resulting in residual graft limb stenoses. Both intraoperative and early postoperative vascular complications after EVAR are more common in female patients. These complications can be effectively treated with a variety of open surgical and transfemoral endovascular techniques. PMID:11769140

  7. Effect of Early Post Cesarean Feeding on Gastrointestinal Complications

    PubMed Central

    Adeli, Mohadese; Razmjoo, Nastaran; Tara, Fatemeh; Ebrahimzade, Saeed

    2013-01-01

    Background: Gastrointestinal complications are the main complication in patients after cesarean section. Previous studies have reported different results about the effect of early post cesarean feeding on vomiting, nausea, flatulence and illus. Objectives: To identify the effect of early post cesarean feeding on gastrointestinal complications. Materials and Methods: This randomized controlled trial was conducted on 82 women who underwent cesarean section in Mashhad Omolbanin hospital. They were randomly assigned to two equal experimental and control groups. The experimental group started oral fluids four hours after surgery, followed by a regular diet after bowel sounds returned. Mothers in the control group received fluid intravenously during the initial 12 hours, and then if bowel sounds were heard, they were permitted to receive oral fluids and they could start a solid diet if they had defecation. Vomiting and flatulence were assessed with a visual analog scale. Nausea was assessed with an observation questionnaire and illus was assessed via bowel sounds, gas passing and defecation 4, 12, 24, 36 and 48, hours post surgery in the two groups. Also, they were studied for the time of gas passing, bowel sound return, defecation, sitting, walking and breast-feeding. Data were analyzed using the chi-square, Fisher's exact test, t-test and Man-Whitney U test. Results: No mother experienced nausea, vomiting and illus. Flatulence severity 4 and 12 hours after surgery was similar in both groups (P = 0.856, P = 0.392). However, flatulence severity 24, 36 and 48 hours after surgery, was less in the experimental group (P = 0.030, P = 0.016, P = 0.001). Also, bowel sound return, time of gas passing, defecation, sitting and walking were less in the experimental group (P = 0.001). Conclusion: This study showed that early feeding decreased post cesarean gastrointestinal complications. PMID:25414855

  8. The relationship between early and late gastrointestinal complications of radiation therapy for carcinoma of the cervix

    SciTech Connect

    Bourne, R.G.; Kearsley, J.H.; Grove, W.D.; Roberts, S.J.

    1983-10-01

    In a retrospective analysis of 1,390 consecutive patients with carcinoma of the cervix treated by high dose radiation therapy alone at the Queensland Radium Institute, we report a quantitative relationship between the early and late gastrointestinal complications arising from such treatment. Of these 1,390 patients, 157 (11.3%) experienced early, serious complications. For geographic reasons, it was only possible to evaluate 784 patients for late post-irradiation complications. Twenty-eight (3.6%) developed one or more late bowel complications, which included adhesions, fistulae, strictures, perforation, colitis and vascular occlusion. Factors affecting the relative risk of developing either an early or late complication were analyzed and are discussed. There was an 8.2% incidence of late complications developing in those patients who had experienced early complications, compared with a 3.0% incidence of late complications developing in patients without early complications. Thus, the risk of developing a late complication was greater by a factor of 2.7 in those patients developing an early one (p < 0.05). However, of the 28 patients developing late complications, 21 (75%) did not experience a severe acute one.

  9. Prevention, early detection, and management of complications after 328 consecutive extrapleural pneumonectomies

    Microsoft Academic Search

    David J. Sugarbaker; Michael T. Jaklitsch; Raphael Bueno; William Richards; Jeanne Lukanich; Steven J. Mentzer; Yolonda Colson; Phillip Linden; Michael Chang; Leah Capalbo; Elizabeth Oldread; Siyamek Neragi-Miandoab; Scott J. Swanson; Lambros S. Zellos

    2004-01-01

    ObjectiveExtrapleural pneumonectomy for therapy of mesothelioma has been associated with significant perioperative mortality and morbidity. Postoperative complications of this procedure require a unique management approach. We developed treatment algorithms for most of the common complications of extrapleural pneumonectomy resulting in reduced mortality and hospital stay. Complications after extrapleural pneumonectomy were further analyzed to elucidate means of prevention, early detection, and

  10. [Endoscopic collection of v. saphena magna--early complication rates].

    PubMed

    Kurfirst, V; Dusil, I; Rezler, M; Mokrácek, A

    2009-11-01

    Endoscopic harvesting of v. saphena magna for CABG procedures represents a modern method, which in comparison to conventional methods reduces postoperative wound complications. We have analyzed 40 patients, who uderwent CABG procedure with endoscopic harvested venous graft. PMID:20662442

  11. Reverse Total Shoulder Replacement: Intraoperative and Early Postoperative Complications

    Microsoft Academic Search

    Carl Wierks; Richard L. Skolasky; Jong Hun Ji; Edward G. McFarland

    2009-01-01

    Reverse total shoulder arthroplasty is a treatment option for patients with symptomatic glenohumeral arthritis and a deficient\\u000a rotator cuff. The reported complication rates vary from 0% to 68%. Given this variation, our purposes were to (1) determine\\u000a the learning curve for the procedure, (2) identify complications and surgical pitfalls, and (3) compare our results with those\\u000a of similar published series.

  12. Early clinical outcome and complications related to balloon kyphoplasty.

    PubMed

    Bergmann, Martin; Oberkircher, Ludwig; Bliemel, Christopher; Frangen, Thomas Manfred; Ruchholtz, Steffen; Krüger, Antonio

    2012-05-01

    The treatment of painful osteoporotic vertebral compression fractures using transpedicular cement augmentation has grown significantly over the last two decades. The benefits of balloon kyphoplasty compared to conservative treatment remain controversial and are discussed in the literature. The complication rates of vertebroplasty and kyphoplasty are considered to be low. The focus of this study was the analysis of acute and clinically relevant complications related to this procedure. In our department, all patients treated between February 2002 and February 2011 with percutaneous cement augmentation (372 patients, 522 augmented vertebral bodies) were prospectively recorded. Demographic data, comorbidities, fracture types, intraoperative data and all complications were documented. The pre- and postoperative pain-level and neurological status (Frankel-Score) were evaluated. All patients underwent a standardized surgical procedure. Two hundred and ninety-seven patients were treated solely by balloon kyphoplasty; 216 females (72.7%) and 81 males (27.3%). Average patient age was 76.21 years (±10.71, range 35-98 years). Average American Society Anestesiologists score was 3.02. According to the Orthopedic Trauma Association classification, there were 69 A 1.1 fractures, 177 A 1.2 fractures, 178 A 3.1.1 fractures and 3 A 3.1.3 fractures. Complications were divided into preoperative, intraoperative and postoperative events. There were 4 preoperative complications: 3 patients experienced persistent pain after the procedure. In one case, the pedicles could not be visualized during the procedure and the surgery was terminated. One hundred and twenty-nine (40.06%) of the patients showed intraoperative cement leaking outside the vertebras, one severe hypotension and tachycardia as reaction to the inflation of the balloons, and there was one cardiac arrest during surgery. Postoperative subcutaneous hematomas were observed in 3 cases, 13 patients developed a urinary tract infection, and 2 patients died during hospitalization. Twenty-four patients (8.1%) returned because of new pain events and 23 patients reported a new painful fracture. Balloon kyphoplasty is a save and effective procedure to treat patients with painful vertebral compression fractures. Rapid patient mobilization after kyphoplasty, as well as a prompt reintegration into the social environment, are possible. Compared to other surgical procedures, especially in patients with an average age of 75 years, balloon kyphoplasty seems to offer some advantages. However, the procedure still has a potential for serious complications and should be performed by well trained personnel. PMID:22802993

  13. Early clinical outcome and complications related to balloon kyphoplasty

    PubMed Central

    Bergmann, Martin; Oberkircher, Ludwig; Bliemel, Christopher; Frangen, Thomas Manfred; Ruchholtz, Steffen; Krüger, Antonio

    2012-01-01

    The treatment of painful osteoporotic vertebral compression fractures using transpedicular cement augmentation has grown significantly over the last two decades. The benefits of balloon kyphoplasty compared to conservative treatment remain controversial and are discussed in the literature. The complication rates of vertebroplasty and kyphoplasty are considered to be low. The focus of this study was the analysis of acute and clinically relevant complications related to this procedure. In our department, all patients treated between February 2002 and February 2011 with percutaneous cement augmentation (372 patients, 522 augmented vertebral bodies) were prospectively recorded. Demographic data, comorbidities, fracture types, intraoperative data and all complications were documented. The pre- and postoperative pain-level and neurological status (Frankel-Score) were evaluated. All patients underwent a standardized surgical procedure. Two hundred and ninety-seven patients were treated solely by balloon kyphoplasty; 216 females (72.7%) and 81 males (27.3%). Average patient age was 76.21 years (±10.71, range 35–98 years). Average American Society Anestesiologists score was 3.02. According to the Orthopedic Trauma Association classification, there were 69 A 1.1 fractures, 177 A 1.2 fractures, 178 A 3.1.1 fractures and 3 A 3.1.3 fractures. Complications were divided into preoperative, intraoperative and postoperative events. There were 4 preoperative complications: 3 patients experienced persistent pain after the procedure. In one case, the pedicles could not be visualized during the procedure and the surgery was terminated. One hundred and twenty-nine (40.06%) of the patients showed intraoperative cement leaking outside the vertebras, one severe hypotension and tachycardia as reaction to the inflation of the balloons, and there was one cardiac arrest during surgery. Postoperative subcutaneous hematomas were observed in 3 cases, 13 patients developed a urinary tract infection, and 2 patients died during hospitalization. Twenty-four patients (8.1%) returned because of new pain events and 23 patients reported a new painful fracture. Balloon kyphoplasty is a save and effective procedure to treat patients with painful vertebral compression fractures. Rapid patient mobilization after kyphoplasty, as well as a prompt reintegration into the social environment, are possible. Compared to other surgical procedures, especially in patients with an average age of 75 years, balloon kyphoplasty seems to offer some advantages. However, the procedure still has a potential for serious complications and should be performed by well trained personnel. PMID:22802993

  14. Early Postoperative Complications after Heart Transplantation in Adult Recipients: Asan Medical Center Experience

    PubMed Central

    Kim, Ho Jin; Kim, Jae Joong; Kim, Joon Bum; Choo, Suk Jung; Yun, Tae-Jin; Chung, Cheol Hyun; Lee, Jae Won

    2013-01-01

    Background Heart transplantation has become a widely accepted surgical option for end-stage heart failure in Korea since its first success in 1992. We reviewed early postoperative complications and mortality in 239 patients who underwent heart transplantation using bicaval technique in Asan Medical Center. Methods Between January 1999 and December 2011, a total of 247 patients aged over 17 received heart transplantation using bicaval technique in Asan Medical Center. After excluding four patients with concomitant kidney transplantation and four with heart-lung transplantation, 239 patients were enrolled in this study. We evaluated their early postoperative complications and mortality. Postoperative complications included primary graft failure, cerebrovascular accident, mediastinal bleeding, renal failure, low cardiac output syndrome requiring intra-aortic balloon pump or extracorporeal membrane oxygenation insertion, pericardial effusion, and inguinal lymphocele. Follow-up was 100% complete with a mean follow-up duration of 58.4±43.6 months. Results Early death occurred in three patients (1.3%). The most common complications were pericardial effusion (61.5%) followed by arrhythmia (41.8%) and mediastinal bleeding (8.4%). Among the patients complicated with pericardial effusion, only 13 (5.4%) required window operation. The incidence of other significant complications was less than 5%: stroke (1.3%), low cardiac output syndrome (2.5%), renal failure requiring renal replacement (3.8%), sternal wound infection (2.0%), and inguinal lymphocele (4.6%). Most of complications did not result in the extended length of hospital stay except mediastinal bleeding (p=0.034). Conclusion Heart transplantation is a widely accepted option of surgical treatment for end-stage heart failure with good early outcomes and relatively low catastrophic complications. PMID:24368968

  15. Management of Early and Late Complications of Ileocolonic Continent Urinary Reservoir (Miami Pouch)

    Microsoft Academic Search

    Manuel A. Penalver; Roberto Angioli; Ramin Mirhashemi; Rizwan Malik

    1998-01-01

    Purpose.The object of this study is to review our experience and formulate a plan for early recognition and effective management of early and late complications seen in patients who have undergone construction of the ileocolonic continent urinary reservoir.Method.Charts of patients who underwent continent urinary diversion at the Division of Gynecologic Oncology, University of Miami School of Medicine, from 1988 to

  16. Early central nervous system complications after reduced-intensity stem cell transplantation.

    PubMed

    Kishi, Yukiko; Miyakoshi, Shigesaburo; Kami, Masahiro; Ikeda, Masayuki; Katayama, Yuta; Murashige, Naoko; Kusumi, Eiji; Yuji, Koichiro; Kobayashi, Kazuhiko; Kato, Daisuke; Hamaki, Tamae; Matsumura, Tomoko; Kim, Sung-Won; Morinaga, Shinichi; Mori, Shinichiro; Kanemaru, Mineo; Hayashi, Tatsuyuki; Takaue, Yoichi; Taniguchi, Shuichi

    2004-08-01

    To investigate clinical characteristics of early central nervous system (CNS) complications after reduced-intensity stem cell transplantation (RIST), we reviewed the medical records of 232 patients who had undergone RIST for hematologic diseases at our institutions between September 1999 and June 2003. All patients had received purine analog-based preparative regimens. Stem cell sources comprised granulocyte colony-stimulating factor-mobilized blood from HLA-identical or 1 locus-mismatched related donors (n = 151), unrelated bone marrow (n = 44), or unrelated cord blood (n = 37). Graft-versus-host disease prophylaxis incorporated cyclosporine with or without methotrexate. Diagnosis of CNS complications was based on clinical, radiologic, and microbiological findings. CNS complications occurred in 18 patients (7.8%), with a median onset of 22 days, and were infectious (n = 1), metabolic (n = 15), or cerebrovascular (n = 2). Symptoms included seizures (n = 7), visual disturbance (n = 2), headache (n = 8), nausea (n = 8), vomiting (n = 6), impaired consciousness (n = 16), and hemiparesis (n = 3). Complications improved promptly in 10 patients, and 8 patients died without improvement within 30 days. Multivariate analysis with logistic regression identified umbilical cord blood transplantation as a significant risk factor for early CNS complications (odds ratio, 14.5; 95% confidence interval, 3.7-56.9; P <.0001). CNS complications are a significant problem after RIST, particularly with umbilical cord blood. Limbic encephalopathy is an unrecognized subtype of neurotoxicity after umbilical cord blood transplantation. PMID:15282534

  17. Penile fracture repair: assessment of early results and complications using color Doppler ultrasound

    Microsoft Academic Search

    P Gontero; PS Sidhu; GH Muir

    2000-01-01

    The aim of this study was to determine early results and complications of penile fracture treated with immediate surgical repair by means of color Doppler ultrasound study. Four patients with the clinical features of penile fracture were submitted to immediate surgical exploration via a subcoronal incision with repair of the torn cavernosal albuginea (unilateral in three cases, bilateral in one

  18. Lower skeletal muscle index and early complications in patients undergoing radical cystectomy for bladder cancer

    PubMed Central

    2014-01-01

    Background Radical cystectomy (RC) is the standard treatment for patients with muscle-invasive bladder cancer (BC), and it is also a valid option for selected patients with high-risk non-muscle-invasive BC. The purpose of this study was to evaluate the effect on the lower skeletal muscle index (SMI) of short-term postoperative complications of radical cystectomy (RC) in patients with bladder cancer (BC). Methods A total of 247 patients who received RC for BC and 204 age-matched healthy population-based controls were retrospectively assessed. SMI was measured by preoperative computed tomography scans at the L4 to L5 level. Early complications were graded by Clavien-Dindo classification; severity of grade III or greater was identified as a severe complication. Logistic regression was utilized to determine the relationships between covariables and severe complications. Results A total of 125 (50.61%)/19 (7.69%) patients exhibited overall/severe complications during the early postoperative period. SMI was strongly associated with gender (P <0.01), but not age and body mass index (BMI), among patients with BC. Compared with the matched control group, BC patients exhibited lower SMI. The difference was statistically significant in the subgroup of male patients (P?=?0.03). In the multivariate analysis, SMI was an independent predictor of developing severe complications. Each 1 cm2/m2 increase in SMI was associated with a decrease in the odds of morbidity by 4.8%. Conclusions A lower SMI is frequently observed in bladder cancer patients undergoing RC and is shown to be strongly associated with early complications following surgery. PMID:24423007

  19. Prospective analysis of indications and early complications of emergency temporary loop ileostomies for perforation peritonitis

    PubMed Central

    Chaudhary, Poras; Nabi, Ishaq; Ranjan, Gyan; Tiwari, Alok Kumar; Kumar, Sanjay; Kapur, Arun; Arora, Mohinder P.

    2015-01-01

    Background To determine the indications, nature, and rate of early complications of temporary loop ileostomy created in emergency for benign diseases, their management, and to find out the associated risk factors. Methods A total of 630 patients undergoing temporary loop ileostomy for benign diseases were studied prospectively over a period of 6 years. Stoma-related early complications occurring within 6-8 weeks were analyzed. Only emergency cases were included in this study. Descriptive statistics were used to summarize the data and statistical significance was evaluated by applying the Pearson’s chi-square test. Results Typhoid perforation (n=402) was the most commonpathology, followed by tuberculosis (n=106); trauma (n=81); and intestinal obstruction with gangrenous bowel (n=41). 299 patients had no stoma-related complications. Skin excoriation was the most commonstoma-related complication. Age more than 50 years; shock at presentation; delay in presentation; delay in surgery; presence of comorbidities; and surgery done out of working hours, were associated with increased complications. Conclusion Temporary loop ileostomy for perforation peritonitis due to benign systemic diseases like typhoid fever and tuberculosis confers a very high morbidity. PMID:25609137

  20. Effect of Positioning and Early Ambulation on Coronary Angiography Complications: a Randomized Clinical Trial

    PubMed Central

    Abdollahi, Ali Akbar; Mehranfard, Shahzad; Behnampour, Nasser; Kordnejad, Abdol Mohamad

    2015-01-01

    Introduction: After coronary angiography to prevent potential complications, patients are restricted to 4-24 hours bed rest in the supine position due to the complications. This study was designed to assess the effect of changing position and early ambulation on low back pain, urinary retention, bleeding and hematoma after cardiac catheterization. Methods: In this clinical trial, 140 patients by using a convenience sampling randomly divided into four 35-individual groups. The patients in the control group were in the supine position for 6 hours without a movement. Change position was applied to the second group (based on a specific protocol), early ambulation was applied to the third group and both early ambulation and change position were applied to the fourth group. Then, severity of bleeding, hematoma, back pain and urinary retention were measured at zero, 1, 2, 4, 6, and 24 hours after angiography. The data was collected through an individual data questionnaire, Numerical Rating Scale (NRS) of pain and Kristin Swain's check list was applied to evaluate the severity of bleeding and hematoma. Results:None of patients developed vascular complications. Incidence of urinary retention was higher in the control group, although this difference was not significant. The mean of pain intensity in the fourth and sixth hours showed a significant difference. Conclusion: Based on the findings of this study, changing patients' position can be safe and they can be ambulated early after angiography. PMID:26171374

  1. The importance of early diagnosis and treatment of kaposiform hemangioendothelioma complicated by Kasabach-Merritt phenomenon

    PubMed Central

    Vivas-Colmenares, Grecia V.; Ramirez-Villar, Gema L.; Bernabeu-Wittel, Jose; Matute de Cardenas, Jose A.; Fernandez-Pineda, Israel

    2015-01-01

    Kaposiform hemangioendothelioma (KHE) is a locally aggressive vascular tumor that may be complicated by Kasabach-Merritt phenomenon (KMP), a profound thrombocytopenia resulting from platelet trapping within a vascular tumor, either KHE or tufted angioma (TA). Typical features also include low fibrinogen and elevated D-dimers. It is well known that KMP is not caused by infantile hemangiomas. Management of vascular tumors complicated by KMP is challenging, and it is common for referral centers to receive patients in critical medical condition after multimodality treatment failure of vascular anomalies. Our aim is to communicate the importance of early diagnosis and treatment of KHE associated with KMP. A full-term male newborn with KHE complicated by KMP is reported. Treatment with vincristine, aspirin and ticlopidine normalized the coagulation parameters within one week, requiring a total of six doses of vincristine, seven months of ticlopidine and 17 months of aspirin. Early diagnosis and treatment of KHE complicated by KMP may allow the administration of fewer doses of vincristine and avoid the use of corticosteroids. PMID:25692091

  2. Early complications of volar plating of distal radius fractures and their relationship to surgeon experience

    Microsoft Academic Search

    Christina M. Ward; Taften L. Kuhl; Brian D. Adams

    2011-01-01

    Background  Fractures of the distal radius are among the most common fractures in adults. Recently, there has been a trend towards open\\u000a reduction and internal fixation of these fractures through a volar approach. The purpose of this study was to assess the early\\u000a complications of volar locking plate fixation of distal radius fractures with an emphasis on defining the relationship between

  3. Drug resistance and molecular epidemiology of aerobic bacteria isolated from puerperal infections in bangladesh.

    PubMed

    Ahmed, Salma; Kawaguchiya, Mitsuyo; Ghosh, Souvik; Paul, Shyamal Kumar; Urushibara, Noriko; Mahmud, Chand; Nahar, Kamrun; Hossain, Mohammad Akram; Kobayashi, Nobumichi

    2015-06-01

    Puerperal infection is a common complication during postnatal period in developing countries. Bacterial species, drug resistance, and genetic characteristics were investigated for a total of 470 isolates from puerperal infections in Bangladesh for a 2-year period (2010-2012). The most common species was Escherichia coli (n=98), followed by Enterococcus faecalis (n=54), Staphylococcus haemolyticus (n=33), Proteus mirabilis (n=32), Staphylococcus aureus (n=27), Klebsiella pneumoniae (n=22), and Enterobacter cloacae (n=21). S. aureus and Acinetobacter baumannii were isolated at a higher frequency from wound infections after cesarean section, while E. coli, E. cloacae, and K. pneumoniae were isolated from community-acquired endometritis and urinary tract infections. Resistance to third-generation cephalosporins was frequent for Enterobacteriacae, and was mainly mediated by blaCTX-M-1 group beta-lactamases. The CTX-M gene in E. coli from the four phylogroups was identified as blaCTX-M-15, and phylogroup B2 isolates with blaCTX-M-15 were classified into ST131 with O25b allele, harboring aac(6')-Ib-cr and various virulence factors. Carbapenemase genes blaNDM-1 and blaNDM-7 were identified in one isolate each of phylogroup A E. coli. Methicillin-resistant S. aureus isolates had type IV or V SCCmec, including isolates of ST361 (CC672), which is related to an emerging ST672 clone in the Indian subcontinent. This study revealed the recent epidemiological status of aerobic bacteria causing puerperal infections in Bangladesh, providing useful information to improve clinical practice and infection control. PMID:25555043

  4. Presentation, diagnosis, and management of early hepatic venous outflow complications in whole cadaveric liver transplant.

    PubMed

    Khorsandi, Shirin Elizabeth; Athale, Anuja; Vilca-Melendez, Hector; Jassem, Wayel; Prachalias, Andreas; Srinivasan, Parthi; Rela, Mohamed; Heaton, Nigel

    2015-07-01

    Early hepatic venous outflow obstruction (HVOO) can be a devastating complication leading to graft loss after liver transplantation (LT). A retrospective study on 777 adult LT recipients over a 5-year period (August 2007 to August 2012) was undertaken to determine the incidence of early HVOO presenting within 3 months of transplant, its clinical features and management, and potential technical risk factors related to the implanting technique. Cases of early HVOO were screened for by identifying recipients with problematic ascites within 3 months of transplant. Definitive diagnosis for HVOO was based on a wedge pressure of >12 mm Hg. Considering only whole livers, the incidence of early problematic ascites was 3% (20/695) of which more than one-third (35%, 7/20) were then confirmed to have HVOO. Overall, the incidence of early HVOO was 1% (7/695). Two hepatic veins (HVs) with extension piggybacks (PBs; n?=?423) were the dominant implanting technique in the time period of study rather than the 3 HV PB (n?=?182) and caval replacement techniques (n?=?82). Considering the implantation technique, all cases of HVOO occurred after 2 HVs when extension PBs had been used with an incidence of 1.7% (7/423). Institutionally, early HVOO was mainly managed surgically by either cavoplasty within a month of transplant (n?=?4) or retransplant (n?=?1), and the remainder (n?=?2) were medically managed with diuretics. In conclusion, early HVOO is rare, and there is no evidence from this study that a given implantation technique is at a higher risk of developing HVOO (2 HV with extension versus 3 HV and caval replacement; P?=?0.11). However, early revisional surgery for HVOO can preserve graft function with retransplantation being reserved for when surgical cavoplasty or radiological stenting is technically not possible. Liver Transpl 21:914-921, 2015. © 2015 AASLD. PMID:25907399

  5. Puerperal septic pelvic thrombophlebitis: Incidence and response to heparin therapy

    Microsoft Academic Search

    Charles E. Brown; R. William Stettler; Diane Twickler; F. Gary Cunningham

    1999-01-01

    Objective: Before the availability of modern imaging studies the diagnosis of septic pelvic thrombophlebitis causing prolonged puerperal fever was difficult to confirm without surgical exploration. With the use of computed tomography infection-related pelvic phlebitis can now be confirmed, and this study was designed to determine its incidence after delivery. We also designed a randomized clinical trial to evaluate the efficacy

  6. Osteonecrosis in Systemic Lupus Erythematosus: An Early, Frequent, and Not Always Symptomatic Complication

    PubMed Central

    Caramaschi, Paola; Biasi, Domenico; Dal Forno, Ilaria; Adami, Silvano

    2012-01-01

    Osteonecrosis may complicate the course of systemic lupus erythematosus and may contemporaneously affect multiple joints. The major risk factor associated with the development of osteonecrosis is the use of glucocorticoid at high doses. Recent studies using serial MRI, which represents the “gold standard” for the early detection of osteonecrosis, yielded some interesting findings about the natural history of this clinical entity. Osteonecrosis in the majority of the cases is asymptomatic and occurs early in the course of the disease. Its later occurrence is associated with lupus flare that requires the increase of corticosteroid dose. The optimal treatment of osteonecrosis is controversial. In case of silent osteonecrosis involving a small area conservative strategy is usually adequate. When lesions are symptomatic surgical treatment as core decompression or free vascularized fibular grafting is required; extracorporeal shockwave treatment may represent an alternative therapeutic approach. When the lesion has a medium-large dimension or involves a weight-bearing area bone collapse is a common complication requiring total joint replacement. Coadministration of bisphosphonate or warfarin with high doses of corticosteroid might be a promising preventive strategy of osteonecrosis. PMID:22919470

  7. Early and Late Complications Related to Central Venous Catheters in Hematological Malignancies: a Retrospective Analysis of 1102 Patients

    PubMed Central

    Morano, Salvatore Giacomo; Coppola, Lorenzo; Latagliata, Roberto; Berneschi, Paola; Chistolini, Antonio; Micozzi, Alessandra; Girmenia, Corrado; Breccia, Massimo; Brunetti, Gregorio; Massaro, Fulvio; Rosa, Giovanni; Guerrisi, Pietro; Mandelli, Franco; Foà, Roberto; Alimena, Giuliana

    2014-01-01

    Several severe complications may be associated with the use of central venous catheters (CVC). We retrospectively evaluated on a large cohort of patients the incidence of CVC-related early and late complications. From 7/99 to 12/2005, 1102 CVC have been implanted at our Institution in 881 patients with hematological malignancies (142,202 total day number of implanted CVC). Early mechanic complications were 79 (7.2% - 0.55/1,000 days/CVC). Thirty-nine episodes of early infective complications (<1 week from CVC implant) occurred (3.5% - 0.3/1000 days/CVC): furthermore, 187 episodes of CVC-related sepsis (17% - 1.3/1000 days/CVC) were recorded. There were 29 episodes (2.6%) of symptomatic CVC-related thrombotic complications, with a median interval from CVC implant of 60 days (range 7 – 395). The rate of CVC withdrawal due to CVC-related complications was 26%. The incidence of CVC-related complications in our series is in the range reported in the literature notwithstanding cytopenia often coexisting in hematological patients. PMID:24678388

  8. Prediction of gestational diabetes early in pregnancy: targeting the long-term complications.

    PubMed

    Correa, Paula J; Vargas, J Francisco; Sen, Sarbattama; Illanes, Sebastián E

    2014-01-01

    Gestational diabetes (GD), defined as carbohydrate intolerance with onset or first recognition during pregnancy, has a prevalence of 7% and is a growing problem worldwide. Infants born to mothers with GD are more likely to be large for gestational age, incur traumatic birth injury, require a stay in the intensive care unit and develop postnatal metabolic disturbances. As the worldwide epidemic of obesity worsens, more women are entering pregnancy with metabolic alterations and preexisting insulin resistance, which is heightened by the hormonal milieu of pregnancy. The Hyperglycemia Adverse Pregnancy Outcome (HAPO) study has clearly shown that GD-related complications correlate with glycemic control. We will review the current understanding of the physiology of GD and the screening and treatment guidelines that are commonly utilized in clinical care. In addition, we will discuss the need for development of multiparametric models combining maternal clinical risk factors and biomarkers early in pregnancy to better stratify and predict risk of GD-related complications and offer targeted intervention. PMID:24401480

  9. Early diagnosis of diabetic vascular complications: impairment of red blood cell deformability

    NASA Astrophysics Data System (ADS)

    Shin, Sehyun; Ku, Yunhee; Park, Cheol-Woo; Suh, Jang-Soo

    2006-02-01

    Reduced deformability of red blood cells (RBCs) may play an important role on the pathogenesis of chronic vascular complications of diabetes mellitus. However, available techniques for measuring RBC deformability often require washing process after each measurement, which is not optimal for day-to-day clinical use at point of care. The objectives of the present study are to develop a device and to delineate the correlation of impaired RBC deformability with diabetic nephropathy. We developed a disposable ektacytometry to measure RBC deformability, which adopted a laser diffraction technique and slit rheometry. The essential features of this design are its simplicity (ease of operation and no moving parts) and a disposable element which is in contact with the blood sample. We studied adult diabetic patients divided into three groups according to diabetic complications. Group I comprised 57 diabetic patients with normal renal function. Group II comprised 26 diabetic patients with chronic renal failure (CRF). Group III consisted of 30 diabetic subjects with end-stage renal disease (ESRD) on hemodialysis. According to the renal function for the diabetic groups, matched non-diabetic groups were served as control. We found substantially impaired red blood cell deformability in those with normal renal function (group I) compared to non-diabetic control (P = 0.0005). As renal function decreases, an increased impairment in RBC deformability was found. Diabetic patients with chronic renal failure (group II) when compared to non-diabetic controls (CRF) had an apparently greater impairment in RBC deformability (P = 0.07). The non-diabetic cohort (CRF), on the other hand, manifested significant impairment in red blood cell deformability compared to healthy control (P = 0.0001). The newly developed slit ektacytometer can measure the RBC deformability with ease and accuracy. In addition, progressive impairment in cell deformability is associated with renal function loss in all patients regardless of the presence or absence of diabetes. In diabetic patients, early impairment in RBC deformability appears in patients with normal renal function.

  10. The effect of early ambulation on the incidence of neurological complication after spinal anesthesia with lidocaine

    PubMed Central

    Talakoub, Reihanak; Golparvar, Mohammad; Arshi, Rezvan

    2015-01-01

    Background: Transient neurological symptoms (TNS), was described in patients recovering from spinal anesthesia with lidocaine but its etiology remains unknown this study was evaluated the influence of ambulation time on the occurrence of TNSs after spinal anesthesia with lidocaine 5%. Materials and Methods: This randomized clinical trial was conducted on 60 patients with American Society of Anesthesiologists Grades I and II, who were candidates for lower abdominal surgery in supine or lithotomy positions. Patients were randomly divided into early ambulation group (Group A) who were asked to start walking as soon as the anesthesia was diminished or to the late ambulation group (Group B) who walked after at least 12 h bedridden. Participants were contacted 2 days after spinal anesthesia to assess any type of pain at surgical or anesthesia injection site, muscle weakness, fatigue, vertigo, nausea, vomiting, headache, and difficult urination or defecation. Results: Four subjects (13.3%) in Group A and two patients (6.7%) in Group B had pain at anesthesia injection site (P = 0.019). Fourteen patients in Group A (46.7%) and six patients in Group B (20%) had post-dural puncture headache (P = 0.014). Participants in Group B reported difficult urination more than Group A (P = 0.002). there were not statistically significant differences between two groups regarding frequency of fatigue, muscle weakness, vertigo, nausea, vomiting, difficult defecation, paresthesia, and the mean of visual analogue scale at the surgical site. Conclusion: Early ambulation after spinal anesthesia with lidocaine did not increase the risk of neurologic complication.

  11. Perioperative complications and early follow-up with 100 TVT-SECUR procedures.

    PubMed

    Neuman, Menahem

    2008-01-01

    Our objective was to evaluate the complications and early follow-up of the tension-free vaginal tape (TVT)-SECUR, a new minimally invasive anti-incontinence operative procedure. A prospective, observational, and consecutive patient series was conducted. Perioperative and 12-month postoperative data were prospectively collected for the first 50 patients against the next consecutive 50 patients, among which TVT-SECUR specific surgical measurements were adopted (Canadian Task Force classification 2). In private hospital operative theatres, the TVT-SECUR operation was performed. Patients with urodynamically proved stress urinary incontinence were enrolled in this study after detailed informed consent was given. The TVT-SECUR, in the hammock shape to mimic the TVT-obturator placement, yet with no skin incisions, required neither bladder catheterization nor intraoperative diagnostic cystoscopy. The clinical and surgical data of 100 consecutive patients with TVT-SECUR were collected prospectively. Two patients had urinary obstructions and needed surgical tape-tension relief. One patient had a 50 mL paravesical self-remitting hematoma. At the first-month postoperative follow-up appointment, the objective therapeutic failure rate for the TVT-SECUR procedure among the 50 patients was 20.0% (10 patients). But when the tape was placed close to the urethra with no space allowed in between, the failure rate in the second patient group went down to 8.0% (4 patients); yet no further postoperative bladder outlet obstruction was diagnosed. Four (8.0%) patients in the first group had vaginal wall penetration with the inserters, requiring withdrawal, reinsertion, and vaginal wall repair. This was avoided with the second patient group by facilitating the inserters' introduction by widening the submucosal tunnel to 12 mm. Six (12.0%) other patients in the first group needed postoperative trimming of a vaginally extruded tape segment, performed in the office with satisfactory results. This problem was addressed later by making the submucosal dissection deeper to avoid intimate proximity of the tape with the vaginal mucosa. Consequently the tape protrusion rate was reduced to 8% (4 patients). Five (10.0%) patients in the first group had unintended tape removal at the time of inserter removal, necessitating the use of a second TVT-SECUR. This was addressed by meticulous detachment of the inserter before its withdrawal, after which no further unintended tape displacements were recorded. No clinical signs for bowel, bladder, or urethral injuries; intraoperative bleeding; or postoperative infections were evident. Telephone interview at the end of 12 months postoperatively was completed with 44 (88.0%) of the first patient group and 46 (92%) of the second patient group. In all, 39 (88.6%) and 43 (93.5%) of the telephone-interviewed patients of the first and second groups, respectively, reported objective urinary continence. The TVT-SECUR, a new midurethral sling, was associated with early safety and efficacy problems. These were identified and rectified, to make the TVT-SECUR a safe and effective anti-incontinence procedure. Operative complications associated with the TVT, such as bladder penetration and postoperative outlet obstruction, and TVT-obturator complications, such as postoperative thigh pain and bladder outlet obstruction, may be reduced with the TVT-SECUR. The first 100 operations' cumulative data analysis yielded some insights, including the necessity of meticulous and proper dissection before placement of the tape and the need for applying minimal extra tension to the tape. However, long-term comparative data collection will be required to draw solid conclusions regarding the appropriate position of this operative technique within the spectrum of anti-incontinence operations. PMID:18539095

  12. Subthalamic nucleus-deep brain stimulation for early motor complications in Parkinson's disease-the EARLYSTIM trial: early is not always better.

    PubMed

    Mestre, Tiago A; Espay, Alberto J; Marras, Connie; Eckman, Mark H; Pollak, Pierre; Lang, Anthony E

    2014-12-01

    Subthalamic nucleus deep brain stimulation (STN-DBS) has revolutionized the management of disabling motor complications in Parkinson's disease. The EARLYSTIM trial applied this treatment to patients who had been experiencing motor complications for less than three years. STN-DBS significantly improved all primary and secondary outcome measures while best medical therapy failed to provide any improvement at the two-year follow-up time point. On face value these results strongly favor the application of STN-DBS far earlier than is currently applied, when patients are just beginning to experience problems with motor complications. Here we review the application of early DBS and the EARLYSTIM trial from the perspectives of clinical issues, health economics and study design and patient expectation of benefit. We conclude that the most relevant issue is not when to operate but on whom and that early is not always better. © 2014 International Parkinson and Movement Disorder Society. PMID:25227325

  13. High complication rate in the early experience of minimally invasive total hip arthroplasty by the direct anterior approach

    PubMed Central

    2012-01-01

    Background and purpose There is growing interest in minimally invasive surgery techniques in total hip arthroplasty (THA). In this study, we investigated the learning curve and the early complications of the direct anterior approach in hip replacement. Methods In the period January through December 2010, THA was performed in 46 patients for primary osteoarthritis, using the direct anterior approach. These cases were compared to a matched cohort of 46 patients who were operated on with a conventional posterolateral approach. All patients were followed for at least 1 year. Results Operating time was almost twice as long and mean blood loss was almost twice as much in the group with anterior approach. No learning effect was observed in this group regarding operating time or blood loss. Radiographic evaluation showed adequate placement of the implants in both groups. The early complication rate was higher in the anterior approach group. Mean time of hospital stay and functional outcome (with Harris hip score and Oxford hip score) were similar in both groups at the 1-year follow-up. Interpretation The direct anterior approach is a difficult technique, but adequate hip placement was achieved radiographically. Early results showed no improvement in functional outcome compared to the posterolateral approach, but there was a higher early complication rate. We did not observe any learning effect after 46 patients. PMID:22880711

  14. Early postoperative complications of pediatric liver transplantation: experience at one center

    Microsoft Academic Search

    C Araz; A Pirat; A Torgay; P Zeyneloglu; G Arslan

    2004-01-01

    To evaluate the postoperative complications within the first month among 20 pediatric liver transplant recipients between April 1990 and March 2003 we retrospectively studied their medical charts to gather demographic data; primary diagnosis; operative duration; perioperative transfusions; time to extubation; length of intensive care unit (ICU) stay; mortality; perioperative laboratory values; and postoperative complications including respiratory, infections, renal, neurological, cardiovascular,

  15. Routine Doppler ultrasound for the detection of clinically unsuspected vascular complications in the early postoperative phase after orthotopic liver transplantation

    Microsoft Academic Search

    T. Kok; M. J. H. Slooff; C. J. P. Thijn; P. M. J. G. Peeters; R. Verwer; C. M. A. Bijleveld; A. P. van den Berg; E. B. Haagsma; I. J. Klompmaker

    1998-01-01

    To assess the role of routine Doppler ultrasound in the detection of clinically unsuspected vascular complications in the\\u000a early postoperative phase after orthotopic liver transplantation (OLT), the findings of 858 routinely performed Doppler ultrasound\\u000a examinations were analyzed in 268 transplants. At various time intervals after OLT, we encountered 46 abnormal Doppler findings:\\u000a hepatic artery (thrombosis), portal vein [anastomotic stenosis, (non)occlusive

  16. Can Early Rehabilitation after Total Hip Arthroplasty Reduce Its Major Complications and Medical Expenses? Report from a Nationally Representative Cohort

    PubMed Central

    Chiung-Jui Su, Daniel; Yuan, Kuo-Shu; Weng, Shih-Feng; Hong, Rong-Bin; Wu, Ming-Ping; Wu, Hing-Man; Chou, Willy

    2015-01-01

    Objective. To investigate whether early rehabilitation reduces the occurrence of posttotal hip arthroplasty (THA) complications, adverse events, and medical expenses within one postoperative year. Method. We retrospectively retrieve data from Taiwan's National Health Insurance Research Database. Patients who had undergone THA during the period from 1998 to 2010 were recruited, matched for propensity scores, and divided into 2 groups: early rehabilitation (Early Rehab) and delayed rehabilitation (Delayed Rehab). Results. Eight hundred twenty of 999 THA patients given early rehabilitation treatments were matched to 205 of 233 THA patients given delayed rehabilitation treatments. The Delayed Rehab group had significantly (all p < 0.001) higher medical and rehabilitation expenses and more outpatient department (OPD) visits than the Early Rehab group. In addition, the Delayed Rehab group was associated with more prosthetic infection (odds ratio (OR): 3.152; 95% confidence interval (CI): 1.211–8.203; p < 0.05) than the Early Rehab group. Conclusions. Early rehabilitation can significantly reduce the incidence of prosthetic infection, total rehabilitation expense, total medical expenses, and number of OPD visits within the first year after THA. PMID:26146625

  17. Treatment of Acute Puerperal Mastitis and Breast Abscess

    PubMed Central

    Cantlie, Helene Bertrand

    1988-01-01

    Mastitis is a benign infection of the breast if it is treated early. If two days elapse before treatment is started, it can lead to serious complications such as chronic or recurrent mastitis or breast abscess. Treatment consists in frequent nursing and massaging or stripping the breast to keep it empty of milk or pus, and appropriate antibiotics. Incision and drainage of a breast abscess can be done in the office under local anesthesia, and the drainage continued at home by the mother. PMID:21253250

  18. Early postoperative complications of pediatric liver transplantation: experience at one center.

    PubMed

    Araz, C; Pirat, A; Torgay, A; Zeyneloglu, P; Arslan, G

    2004-01-01

    To evaluate the postoperative complications within the first month among 20 pediatric liver transplant recipients between April 1990 and March 2003 we retrospectively studied their medical charts to gather demographic data; primary diagnosis; operative duration; perioperative transfusions; time to extubation; length of intensive care unit (ICU) stay; mortality; perioperative laboratory values; and postoperative complications including respiratory, infections, renal, neurological, cardiovascular, and gastrointestinal tract (GIT) complications. Ten male and ten female patients of mean age 8 +/- 4 years had a mean operative duration, time to extubation, and length of stay in the ICU of 12.1 +/- 2.3 hours, 11.1 +/- 15.0 hours, and 7.2 +/- 5.5 days, respectively. The most frequent postoperative complication was respiratory (n = 14, 70%), followed by infections (n = 13, 65%), renal (n = 8, 40%), neurological (n = 7, 35%), cardiovascular (n = 4, 20%), and GIT (n = 4, 20%) infections. The overall mortality rate was 25% (n = 5). Compared with patients who survived, those who died displayed significantly lower perioperative platelet counts (P <.05), as well as a significantly higher incidence of postoperative neurological disorders (P =.031), and cardiovascular complications (P =.032). PMID:15013350

  19. Common complications of deep lamellar keratoplasty in the early phase of the learning curve

    PubMed Central

    Hosny, Mohamed

    2011-01-01

    Purpose: To evaluate and record the common complications that face surgeons when they perform their first few series of deep lamellar keratoplasty and measures to avoid these. Setting: Dar El Oyoun Hospital, Cairo, Egypt. Methods: Retrospective study of the first 40 eyes of 40 patients carried out by two corneal surgeons working in the same center. All patients were planned to undergo a deep anterior lamellar keratoplasty using the big bubble technique. Twelve patients suffered from keratoconus while 28 patients had anterior corneal pathologies. Recorded complications were classified as either intraoperative or postoperative. Results: Perforation of Descemet’s membrane was the most common intraoperative complication. It occurred in nine eyes (22.5%): five eyes (12.5%) had microperforations while four eyes (10%) had macroperforations, three eyes (7.5%) had central perforations, and six eyes (15%) had peripheral perforations. Other complications included incomplete separation of Descemet’s membrane and remnants of peripheral stromal tissue. Postoperative complications included double anterior chamber which occurred in four eyes (10%) and Descemet’s membrane corrugations. Postoperative astigmatism ranged from 1.25 to 4.5 diopters with a mean of 2.86 diopters in the whole series, but in the six cases with identified residual stroma in the periphery of the host bed, the astigmatism ranged from 2.75 to 4.5 diopters with a mean of 3.62 diopters. Conclusion: Deep lamellar keratoplasty is sensitive to procedural details. Learning the common complications and how to avoid them helps novice surgeons to learn the procedure faster. PMID:21750612

  20. An exploratory study to investigate if patients are able to aid the early diagnosis of peri-implant complications.

    PubMed

    Wright, S; Archer, C

    2015-06-12

    Objectives This study investigated if the patient can have a role in reporting early peri-implant complications.Design An exploratory, single-centred study comparing patient's perceptions of implant success to the clinical success at an examination.Setting, materials and methods Seventy-five patients were randomly selected from patients who had received implant treatment at an implant referral practice. Phase 1 - Patient perception: Patients were asked to complete a questionnaire relating to the health of their implants. Phase 2 - Clinical examination: The patients were examined for implant health/disease.Main outcome measures The responses from the patient perception questionnaires were correlated to the variables of the clinical examination. The null hypothesis 'Patients cannot perceive the difference between a successful implant and an implant that is suffering from complications' was then tested using Fisher's exact test.Results All the variables tested statistically show a positive association between patient perception and clinical examination (p <0.001). All variables gave a significant result for Fisher's exact test. Therefore, the null hypothesis can be rejected.Conclusions This study demonstrated that using validated questions an educated patient can perceive peri-implant health/disease. This can play a role in the early diagnosis of peri-implant complications. PMID:26068160

  1. Short communication Variation in the probability of cardiac complications with radiation technique in early breast cancer

    Microsoft Academic Search

    P A CANNEY; R SANDERSON; C DEEHAN

    Cardiac damage is recognized to be a potentially serious side effect of breast cancer radiotherapy, the risk of which may be reduced by the choice of appropriate radiotherapy technique. We have previously described variation in physical dose to the heart dependent upon radiotherapy technique. In this paper we report the calculated improvement in normal tissue complication probability (NTCP) (for cardiac

  2. Results and Complications of Laparoscopic Adjustable Gastric Banding: An Early and Intermediate Experience

    Microsoft Academic Search

    Subhi Abu-Abeid; Amir Szold

    1999-01-01

    Background: Laparoscopic adjustable silicone gastric banding (LASGB) has been performed as the initial procedure for weight\\u000a reduction in the authors' institution for the past 22 months. The efficacy and safety of the procedure were studied. Methods:\\u000a Patients were followed up prospectively during the perioperative and long-term course and for complications. Results: 391\\u000a patients, aged 16-72 years, with a mean body

  3. Gestational diabetes: a risk of puerperal hypovitaminosis A?

    PubMed

    Resende, Fernanda B S; De Lira, Larissa Q; Grilo, Evellyn C; Lima, Mayara S R; Dimenstein, Roberto

    2015-03-01

    The influence of gestational diabetes on vitamin A deficiency in lactating women and, consequently, in their newborn has been verified through a cross-sectional case-control study conducted with volunteer puerperal women. The control group consisted of healthy women and the test group was composed of women with gestational diabetes. One hundred and seven women were recruited, corresponding to 71 controls and 36 cases. Personal, gestational and newborn data were collected directly from medical records during hospitalization. The retinol was determined in maternal colostrum and serum by High Performance Liquid Chromatography. Postpartum women with gestational diabetes were older, had more children and a higher prevalence of cesarean delivery. No difference was found in retinol concentration in maternal milk and serum between the groups. However, it was observed that 16.7% had vitamin A deficiency in the group of patients with diabetes and only 4.1% had such deficiency in the control group. Although no difference was found in colostrum and serum retinol concentration between women with and without gestational diabetes, the individual analysis shows that those with diabetes are at higher risk of being vitamin A deficient. PMID:25714077

  4. [Early diagnosis and successful treatment of catastrophic antiphospholipid syndrome complicated by multiple organ failure].

    PubMed

    Inoue, Daichi; Togami, Katsuhiro; Shimoike, Norihiro; Tamura, Ryo; Imai, Yukihiro; Kimura, Takaharu; Shimoji, Sonoko; Mori, Minako; Nagai, Yuya; Tabata, Sumie; Matsushita, Akiko; Nagai, Kenichi; Takahashi, Takayuki

    2010-01-01

    A 50-year-old woman was emergently admitted because of rapidly progressive unconsciousness, renal failure, hepatic dysfunction, hemolytic anemia, thrombocytopenia, and high-grade fever in July, 2008. Based on clinical and laboratory findings, we made a tentative diagnosis of thrombotic thrombocytopenic purpura (TTP) and immediately initiated the plasma exchange (PE). Despite the PE, she developed panperitonitis due to multiple intestinal perforation and massive splenic infarction within a week after the admission. Thrombosis of arterioles at perforated portion in the resected small and large intestines was histologically confirmed. Therefore, we made a definite diagnosis of catastrophic antiphospholipid syndrome (CAPS) based on the presence of antiphosphatidylserine-prothrombin complex antibodies (aPS/PT) throughout the course and lupus anticoagulant that was revealed positive on one occasion, and multiple thrombotic lesions. The underlying disease of CAPS appeared to be lupus erythematosus because of her clinical history and laboratory findings such as persistent leukopenia. Although it has been reported that CAPS causes systemic thrombosis at microvessels mostly within a week from the onset and the mortality rate in this disorder is as high as 50%, we successfully treated her in combination with high-dose corticosteroid, anticoagulation, concentrated human IgG, surgical procedures, and hemodialysis in addition to PE. Early diagnosis of CAPS and immediate start of PE may have contributed to the successful treatment. PMID:20190507

  5. Early pregnancy urinary biomarkers of fatty acid and carbohydrate metabolism in pregnancies complicated by gestational diabetes

    PubMed Central

    Qiu, Chunfang; Enquobahrie, Daniel A.; Frederick, Ihunnaya O.; Sorensen, Tanya K.; Fernandez, Miguel Angel Luque; David, Robert M.; Bralley, J. Alexander; Williams, Michelle A.

    2014-01-01

    Aims Alterations in organic acid biomarkers from fatty acid and carbohydrate metabolism have been documented in type 2 diabetes patients. However, their association with gestational diabetes mellitus (GDM) is largely unknown. Methods Participants were 25 GDM cases and 25 non-GDM controls. Biomarkers of fatty acid (adipate, suberate and ethylmalonate) and carbohydrate (pyruvate, l-lactate and ?-hydroxybutyrate) metabolism were measured in maternal urine samples collected in early pregnancy (17 weeks) using liquid chromatography–mass spectrometry methods. Logistic regression were used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results GDM cases and controls differed in median urinary concentrations of ethylmalonate (3.0 vs. 2.3 µg/mg creatinine), pyruvate (7.4 vs. 2.1 µg/mg creatinine), and adipate (4.6 vs. 7.3 µg/mg creatinine) (all p-values <0.05). Women in the highest tertile for ethylmalonate or pyruvate concentrations had 11.4-fold (95%CI 1.10–117.48) and 3.27-fold (95%CI 0.72–14.79) increased risk of GDM compared with women in the lowest tertile for ethylmalonate and pyruvate concentrations, respectively. Women in the highest tertile for adipate concentrations, compared with women in the lowest tertile, had an 86% reduction in GDM risk (95%CI 0.02–0.97). Conclusions These preliminary findings underscore the importance of altered fatty acid and carbohydrate metabolism in the pathogenesis of GDM. PMID:24703806

  6. [Effectiveness and disposition of the newly developed cephalosporin cefquinome in puerperal septicemia and toxemia in gilts].

    PubMed

    Heinritzi, K; Hagn, J

    1999-04-01

    Epizootiological, clinical, bacteriological and haematological studies were carried out to assess the effectiveness of the recently developed cephalosporin preparation Cefquinome in the treatment of the puerperal septicaemia and toxaemia syndrome. Cefquinome was administered at three different doses (1, 2 and 4 mg/kg BW) to 188 sows with feverish puerperal illness. Amoxicillin (7 mg/kg BW) was used as a control drug. In 41% of cases endometritis was a monoinfection whereas in 70% of mammary infections mixed infections were diagnosed. Results showed that for therapy of puerperal septicaemia and toxaemia Cefquinome at doses of 2 mg/kg BW and 4 mg/kg BW is clearly more effective than the control drug Amoxicillin and Cefquinome at its lowest dose of 1 mg/kg BW. PMID:10326238

  7. A comparison between early maternal and neonatal complications of restrictive episiotomy and routine episiotomy in primiparous vaginal delivery

    PubMed Central

    Shahraki, Azar Danesh; Aram, Shahnaz; Pourkabirian, Soodabeh; Khodaee, Sepideh; Choupannejad, Shekofeh

    2011-01-01

    BACKGROUND: Routine episiotomy is a controversial issue among gynecologists. The aim of this study was to compare early maternal and neonatal complications of restrictive episiotomy and routine episiotomy in primiparus vaginal delivery. METHODS: In this descriptive cross-sectional study, two groups of primiparus normal vaginal delivery (NVD) cases with routine and restrictive episiotomy were studied. Immediately and in the first 24 and 48 hours after delivery, specific charts were used to compare the two groups in terms of perineal laceration size, neonatal Apgar score and post-delivery. For data analysis, SPSS was used to conduct student t-test and Kruskal-Wallis test. A p-value < 0.05 was considered significant. RESULTS: Forty primiparus pregnant women were studied in each group. Episiotomy was performed in 7.5% of the restrictive group. Perineal laceration was measured as 3.68 ± 0.47 cm and 1.21 ± 1.1 in routine and restrictive episiotomy groups, respectively (p < 0.05). Intact perineum or first-degree laceration was seen in 80% of the restrictive group. However, second- and third-degree laceration were respectively observed in 75% and 15% of the routine episiotomy group (p < 0.05). Pain relief (immediately, 24 and 48 hours after delivery) was significantly higher in the restrictive group (p < 0.05). On the contrary, no significant difference in Apgar scores at the first and fifth minutes after birth was found between the two groups (p > 0.05). CONCLUSIONS: Restrictive episiotomy results in low maternal complications. Therefore, avoiding routine episiotomy in unnecessary conditions would increase the rate of intact perineal and minor perineal trauma and reduce postpartum delivery pain with no adverse effects neither on maternal nor neonatal morbidities. PMID:22973367

  8. Postpartum practices of puerperal women and their influencing factors in three regions of Hubei, China

    Microsoft Academic Search

    Nian Liu; Limei Mao; Xiufa Sun; Liegang Liu; Banghua Chen; Qiang Ding

    2006-01-01

    BACKGROUND: 'Sitting month' is a Chinese tradition for women's postpartum custom. The present study aims to explore the postpartum dietary and health practices of puerperal women and identify their influential factors in three selected regions of Hubei, China. METHODS: A cross-sectional retrospective study was conducted in the selected urban, suburban and rural areas in the province of Hubei from 1

  9. Dose-Volume Histogram Predictors of Chronic Gastrointestinal Complications After Radical Hysterectomy and Postoperative Concurrent Nedaplatin-Based Chemoradiation Therapy for Early-Stage Cervical Cancer

    SciTech Connect

    Isohashi, Fumiaki, E-mail: isohashi@radonc.med.osaka-u.ac.jp [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan)] [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan); Yoshioka, Yasuo [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan)] [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan); Mabuchi, Seiji [Department of Obstetrics and Gynecology, Osaka University Hospital, Suita, Osaka (Japan)] [Department of Obstetrics and Gynecology, Osaka University Hospital, Suita, Osaka (Japan); Konishi, Koji [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan)] [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan); Koizumi, Masahiko; Takahashi, Yutaka; Ogata, Toshiyuki [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan) [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan); Division of Medical Physics, Oncology Center, Osaka University Hospital, Suita, Osaka (Japan); Maruoka, Shintaroh [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan)] [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan); Kimura, Tadashi [Department of Obstetrics and Gynecology, Osaka University Hospital, Suita, Osaka (Japan)] [Department of Obstetrics and Gynecology, Osaka University Hospital, Suita, Osaka (Japan); Ogawa, Kazuhiko [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan)] [Department of Radiation Oncology, Osaka University Hospital, Suita, Osaka (Japan)

    2013-03-01

    Purpose: The purpose of this study was to evaluate dose-volume histogram (DVH) predictors for the development of chronic gastrointestinal (GI) complications in cervical cancer patients who underwent radical hysterectomy and postoperative concurrent nedaplatin-based chemoradiation therapy. Methods and Materials: This study analyzed 97 patients who underwent postoperative concurrent chemoradiation therapy. The organs at risk that were contoured were the small bowel loops, large bowel loop, and peritoneal cavity. DVH parameters subjected to analysis included the volumes of these organs receiving more than 15, 30, 40, and 45 Gy (V15-V45) and their mean dose. Associations between DVH parameters or clinical factors and the incidence of grade 2 or higher chronic GI complications were evaluated. Results: Of the clinical factors, smoking and low body mass index (BMI) (<22) were significantly associated with grade 2 or higher chronic GI complications. Also, patients with chronic GI complications had significantly greater V15-V45 volumes and higher mean dose of the small bowel loops compared with those without GI complications. In contrast, no parameters for the large bowel loop or peritoneal cavity were significantly associated with GI complications. Results of the receiver operating characteristics (ROC) curve analysis led to the conclusion that V15-V45 of the small bowel loops has high accuracy for prediction of GI complications. Among these parameters, V40 gave the highest area under the ROC curve. Finally, multivariate analysis was performed with V40 of the small bowel loops and 2 other clinical parameters that were judged to be potential risk factors for chronic GI complications: BMI and smoking. Of these 3 parameters, V40 of the small bowel loops and smoking emerged as independent predictors of chronic GI complications. Conclusions: DVH parameters of the small bowel loops may serve as predictors of grade 2 or higher chronic GI complications after postoperative concurrent nedaplatin-based chemoradiation therapy for early-stage cervical cancer.

  10. Pan-European early switch/early discharge opportunities exist for hospitalized patients with methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections.

    PubMed

    Nathwani, D; Eckmann, C; Lawson, W; Stephens, J M; Macahilig, C; Solem, C T; Simoneau, D; Chambers, R; Li, J Z; Haider, S

    2014-10-01

    The objective of this study was to document pan-European real-world treatment patterns and healthcare resource use and estimate opportunities for early switch (ES) from intravenous (IV) to oral antibiotics and early discharge (ED) in hospitalized patients with methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections (cSSTIs). This retrospective observational medical chart review study enrolled 342 physicians across 12 European countries who collected data from 1542 patients with documented MRSA cSSTI who were hospitalized (July 2010 to June 2011) and discharged alive (by July 2011). Data included clinical characteristics and outcomes, hospital length of stay (LOS), MRSA-targeted IV and oral antibiotic use, and ES and ED eligibility according to literature-based and expert-validated criteria. The most frequent initial MRSA-active antibiotics were vancomycin (50.2%), linezolid (15.1%), clindamycin (10.8%), and teicoplanin (10.4%). Patients discharged with MRSA-active antibiotics (n = 480) were most frequently prescribed linezolid (42.1%) and clindamycin (19.8%). IV treatment duration (9.3 ± 6.5 vs. 14.6 ± 9.9 days; p <0.001) and hospital LOS (19.1 ± 12.9 vs. 21.0 ± 18.2 days; p 0.162) tended to be shorter for patients switched from IV to oral treatment than for patients who received IV treatment only. Of the patients, 33.6% met ES criteria and could have discontinued IV treatment 6.0 ± 5.5 days earlier, and 37.9% met ED criteria and could have been discharged 6.2 ± 8.2 days earlier. More than one-third of European patients hospitalized for MRSA cSSTI could be eligible for ES and ED, resulting in substantial reductions in IV days and bed-days, with potential savings of €2000 per ED-eligible patient. PMID:24673973

  11. Early experience using an online reporting system for interventional radiology procedure-related complications integrated with a digital dictation system.

    PubMed

    Gupta, Sanjay; Patel, Jay; McEnery, Kevin; Wallace, Michael J; Ahrar, Kamran; Suitor, Chuck; Hicks, Marshall E

    2011-08-01

    The absence of user-friendly systems for reporting complications is a major barrier to improving quality assurance (QA) programs in interventional radiology (IR) services. We describe the implementation of a QA application that is completely integrated with the radiology dictation system. We implemented an IR QA process as a module within the electronic medical record and radiologist dictation system applications used at our institution. After a radiologist completes a dictation, he or she must select from a drop-down list of complications before proceeding to the next case. Delayed QA events can be entered using the same applications. All complication entries are sent to a database, which is queried to run reports. During the study period, all the 20,034 interventional procedures were entered in the QA database, 1,144 complications were reported, 110 (9.6%) of which were classified as major. Although majority of the complications (996) were entered at the time of dictation, 148 complications (12.9%) were entered afterwards. All major complications were referred to the IR peer review committee, and 30 of these were discussed in the morbidity and mortality meetings. We studied post-lung-biopsy pneumothorax and chest tube rates and initiated a quality improvement process based on the results.The integration of the IR QA reporting system into the workflow process and the mandatory requirements for completion has the potential to minimize the work effort required to enter complication data, and improve participation in the QA process. PMID:20717701

  12. [A case of intrarenal hematoma: role of ultrasonography in the early diagnosis of a possible complication of anticoagulant therapy].

    PubMed

    Dugo, Mauro; La Torre, Ermanno; Farneti, Fabrizio; Caberlotto, Adriana; Pasi, Alessandra; Puggia, Riccarda; Gatti, Pierluigi; Maresca, Maria Cristina

    2012-01-01

    Uremia associated with anticoagulant therapy is a high risk factor for bleeding complications in patients undergoing hemodialysis. We report a case of intrarenal hematoma arising in a uremic patient treated with warfarin. The hematoma was rapidly diagnosed by ultrasonography of the abdomen and treated with embolization. Our experience confirms that the availability of an ultrasound facility within the renal unit allows better assessment of our patients, also in the management of the most fearsome and rare complications. Moreover, it strengthens the evidence that uremic patients are at high risk of bleeding complications when treated with oral anticoagulants. PMID:23117741

  13. Postoperative surgical complications after lung transplantation.

    PubMed

    de la Torre, M; Fernández, R; Fieira, E; González, D; Delgado, M; Méndez, L; Borro, J M

    2015-01-01

    This is a review article on the main postoperative complications after lung transplantation: airways complications, vascular complications, pleural complications, surgical wound complications, and abdominal complications. Incidence data, severity, and major management regimens are reported. Postoperative complications after lung transplantation result in a significantly increased morbidity and mortality, with early diagnosis and therapy being extremely important. PMID:25854134

  14. Early Complications Following Oesophagectomy for Cancer in Relation to Long-Term Healthcare Utilisation: A Prospective Population-Based Cohort Study

    PubMed Central

    Doorakkers, Eva; Konings, Peter; Mattsson, Fredrik; Lagergren, Jesper; Brusselaers, Nele

    2015-01-01

    Background Little is known about how early postoperative complications after oesophagectomy for cancer influence healthcare utilisation in the long-term. We hypothesised that these complications also increase healthcare utilisation long after the recovery period. Methods This was a prospective, nationwide Swedish population-based cohort study of patients who underwent curatively intended oesophagectomy for cancer in 2001-2005 and survived at least 1 year postoperatively (n = 390). Total days of in-hospitalisation, number of hospitalisations and number of visits to the outpatient clinic within 5 years of surgery were analysed using quasi-Poisson models with adjustment for patient, tumour and treatment characteristics and are expressed as incidence rate ratios (IRR) and 95% confidence intervals (CI). Results There was an increased in-hospitalisation period 1-5 years after surgery in patients with more than 1 complication (IRR 1.5, 95% CI 1.0-2.4). The IRR for the number of hospitalisations by number of complications was 1.1 (95% CI 0.7-1.6), and 1.2 (95% CI 0.9-1.6) for number of outpatient visits in patients with more than 1 complication. The IRR for in-hospitalisation period 1-5 years following oesophagectomy was 1.8 (95% CI 1.0-3.0) for patients with anastomotic insufficiency and 1.5 (95% CI 0.9-2.5) for patients with cardiovascular or cerebrovascular complications. We found no association with number of hospitalisations (IRR 1.2, 95% CI 0.7-2.0) or number of outpatient visits (IRR 1.3, 95% CI 0.9-1.7) after anastomotic insufficiency, or after cardiovascular or cerebrovascular complications (IRR 1.2, 95% CI 0.7-1.9) and (IRR 1.1, 95% CI 0.8-1.5) respectively. Conclusion This study showed an increased total in-hospitalisation period 1-5 years after oesophagectomy for cancer in patients with postoperative complications, particularly following anastomotic insufficiency. PMID:25768921

  15. Risk of neutropenic fever and early infectious complications after autologous peripheral blood stem cell transplantation for malignant diseases.

    PubMed

    Fujii, Keiko; Aoyama, Masako; Shinagawa, Katsuji; Matsuo, Keitaro; Takenaka, Katsuto; Ikeda, Kazuma; Kojima, Kensuke; Ishimaru, Fumihiko; Kiura, Katsuyuki; Ueoka, Hiroshi; Niiya, Kenji; Tanimoto, Mitsune; Harada, Mine

    2002-08-01

    Autologous peripheral blood stem cell transplantation (auto-PBSCT) has facilitated high-dose chemotherapy for the treatment of various types of malignancy, but the factors affecting the treatment outcome have not been well defined. We evaluated patients who underwent auto-PBSCT (46 patients with hematological malignancies and 39 with solid tumors) to elucidate the risks of background factors, including age, in association with infectious complications. In contrast to former reports, faster engraftment did not influence the incidence of documented infection or neutropenic fever, whereas high age (age > or = 50 years old) and delayed platelet recovery (> or = 18 days) were demonstrated to be positively involved. The odds ratio (OR) for documented infection in elderly patients was 4.94 (95% confidence interval, 1.22-15.8). Another risk factor of infection was the HD-ICE regimen (ifosfamide, carboplatin, etoposide) given to patients with solid tumors (OR, 8.00; 95% confidence interval, 1.61-39.7). In conclusion, we found that elderly patients and patients on the HD-ICE regimen have a higher risk of infectious complications even after auto-PBSCT. Although the clinical indications for auto-PBSCT can be extended to elderly patients, thorough precautions should be taken against infectious complications during the pre-engraftment phase. PMID:12215019

  16. EMR is not inferior to ESD for early Barrett’s and EGJ neoplasia: An extensive review on outcome, recurrence and complication rates

    PubMed Central

    Komeda, Yoriaki; Bruno, Marco; Koch, Arjun

    2014-01-01

    Background and study aims In recent years, it has been reported that early Barrett’s and esophagogastric junction (EGJ) neoplasia can be effectively and safely treated using endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD). Multiband mucosectomy (MBM) appears to be the safest EMR method. The aim of this systematic review is to assess the safety and efficacy of MBM compared with ESD for the treatment of early neoplasia in Barrett’s or at the EGJ. Methods A literature review of studies published up to May 2013 on EMR and ESD for early Barrett’s esophagus (BE) neoplasia and adenocarcinoma at the EGJ was performed through MEDLINE, EMBASE and the Cochrane Library. Results on outcome parameters such as number of curative resections, complications and procedure times are compared and reported. Results A total of 16 studies met the inclusion criteria for analysis in this study. There were no significant differences in recurrence rates when comparing EMR (10/380, 2.6?%) to ESD (1/333, 0.7?%) (OR 8.55; 95?%CI, 0.91?–?80.0, P?=?0.06). All recurrences after EMR were treated with additional endoscopic resection. The risks of delayed bleeding, perforation and stricture rates in both groups were similar. The procedure was considerably less time-consuming in the EMR group (mean time 36.7?min, 95?%CI, 34.5?–?38.9) than in the ESD group (mean time 83.3?min, 95?%CI, 57.4?–?109.2). Conclusions The MBM technique for EMR is as effective as ESD when comparing outcomes related to recurrence and complication rates for the treatment of early Barrett’s or EGJ neoplasia. The MBM technique is considerably less time-consuming.

  17. Discordance between MRI and bone scan findings in a child with acute complicated osteomyelitis: scintigraphic features that contribute to the early diagnosis.

    PubMed

    Mpalaris, V; Arsos, G; Iakovou, I; Dalpa, E; Karatzas, N

    2014-01-01

    Early diagnosis and prompt treatment of acute osteomyelitis are of paramount importance in children because they can prevent irreversible bone damage. Magnetic resonance imaging (MRI) with its superior spatial resolution and lack of ionizing radiation is routinely preferred over bone scan for this purpose. Increased blood flow, hyperemia and focally increased tracer uptake shown by "three phase" bone scan are the typical scintigraphic findings of acute osteomyelitis. In addition, diffuse uptake along the shaft of long bones and focal "cold" lesions are two special features that may be highly suggestive of infective periostitis, soft tissue sepsis and subperiosteal abscess formation, due to the loose attachment of periosteum to bone during childhood. We present a case of complicated osteomyelitis in a child with inconclusive MRI correctly diagnosed on the basis of these special scintigraphic findings resulting in treatment change from double i.v. Vancomycin--Ceftriaxone scheme to surgical intervention. PMID:23938190

  18. Development of early neutropenic fever, with or without bacterial infection, is still a significant complication after reduced-intensity stem cell transplantation.

    PubMed

    Hori, Akiko; Kami, Masahiro; Kim, Sung-Won; Chizuka, Aki; Kojima, Rie; Imataki, Osamu; Sakiyama, Michiyo; Hamaki, Tamae; Onishi, Yasushi; Usubuchi, Noriko; Kishi, Yukiko; Murashige, Naoko; Tajima, Kinuko; Miyakoshi, Shigesaburo; Heike, Yuji; Masuo, Shigeru; Taniguchi, Shuichi; Takaue, Yoichi

    2004-01-01

    Little information is available on the clinical characteristics of infectious complications that occur in the early period after reduced-intensity stem cell transplantation (RIST). We retrospectively investigated the clinical features of neutropenic fever and infectious episodes within 30 days after RIST in 76 patients who had received fluoroquinolones as part of their antibacterial prophylaxis. Preparative regimens included cladribine 0.66 mg/kg or fludarabine 180 mg/m2 plus busulfan 8 mg/kg. All but 1 patient survived 30 days after transplantation, and 75 patients (99%) became neutropenic within a median duration of 9 days. Neutropenic fever was observed in 29 patients (38%), and bacterial infection was confirmed in 15 (20%) of these, including bacteremia (n = 13), bacteremia plus pneumonia (n = 1), and urinary tract infection (n = 1). The causative organisms were gram-positive (n = 9) and gram-negative organisms (n = 7), with a mortality rate of 6%. Neither viral nor fungal infection was documented. Multivariate analysis showed that the presence of neutropenia at the initiation of preparative regimens was an independent risk factor for subsequent documented bacterial infections (P =.026; 95% confidence interval, 1.25-35.1). We conclude that neutropenic fever and bacteremia remain common complications in RIST. PMID:14752781

  19. Complications of nephrotic syndrome

    PubMed Central

    Park, Se Jin

    2011-01-01

    Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS. PMID:22087198

  20. [Hemangioma: complications].

    PubMed

    Casanova, D; Norat, F; Bardot, J; Magalon, G

    2006-01-01

    Hemangioma (HMG) is a benign tumour of the child generally evolving to spontaneous regression. Sometimes this evolution can become complicated in a more or less serious way according to its localization or of its importance. If local complications are, in the most of cases, without gravity, complications of a general nature like thrombopenia or cardiac failure may compromise the vital prognosis. There are in addition serious forms where, according to its localization or its importance, the HMG can compromise the aesthetic, or functional even vital outcome. PMID:16997443

  1. Amniotic fluid concentrations of alpha-fetoprotein (AFP) in early normal pregnancy, and pregnancy complicated by neural tube defects. A review of 18 months experience.

    PubMed

    Coltart, R M; Seller, M J; Singer, J D; Campbell, S

    1974-01-01

    Amniotic fluid concentrations of alpha-fetoprotein (AFP) in early normal pregnancy and pregnancy complicated by neural tube defects were investigated. The normal range of AFP values was determined from 163 samples obtained at 14-20 weeks of pregnancy. The relationship between AFP level and gestational age was represented by a linear regression (p less than .001). Regression lines for males and females differed significantly in position (p less than .01) but not in slope, the line for males 2.7 mcg/ml higher than that for females. No correlation was seen between maternal age and AFP level. 50 ''at risk'' cases, in whom there has been a history of previous anencephaly or spina bifida, were included in the noraml values. 6 of these patients had amniotic fluid AFP values outside the normal range and in 5 of the 6 cases, ultrasound examination of the fetus confirmed the diagnosis of an anencephalic type lesion and so termination was undertaken, All 5 fetuses had severe neural tube defects. The 6th fetus revealed an intact neural tube but clear-cut evidence of growth retardation and the placenta was small and infarcted. PMID:4143202

  2. Pregnancy Complications

    MedlinePLUS

    Home > Pregnancy > You're pregnant: Now what? Pregnancy This information in Spanish ( en español ) Pregnancy complications Health problems before pregnancy Pregnancy related problems Infections during pregnancy When to call the doctor ...

  3. Early-switch/early-discharge opportunities for hospitalized patients with methicillin-resistant Staphylococcus aureus complicated skin and soft tissue infections: proof of concept in the United Arab Emirates

    PubMed Central

    El Houfi, Ashraf; Javed, Nadeem; Solem, Caitlyn T; Macahilig, Cynthia; Stephens, Jennifer M; Raghubir, Nirvana; Chambers, Richard; Li, Jim Z; Haider, Seema

    2015-01-01

    Objectives To describe real-world treatment patterns and health care resource use and to estimate opportunities for early-switch (ES) from intravenous (IV) to oral (PO) antibiotics and early-discharge (ED) for patients hospitalized in the United Arab Emirates (UAE) with methicillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft tissue infections. Methods This retrospective observational medical chart review study enrolled physicians from four UAE sites to collect data for 24 patients with documented MRSA complicated skin and soft tissue infections, hospitalized between July 2010 and June 2011, and discharged alive by July 2011. Data include clinical characteristics and outcomes, hospital length of stay (LOS), MRSA-targeted IV and PO antibiotic use, and ES and ED eligibility using literature-based and expert-validated criteria. Results Five included patients (20.8%) were switched from IV to PO antibiotics while being inpatients. Actual length of MRSA-active treatment was 10.8±7.0 days, with 9.8±6.6 days of IV therapy. Patients were hospitalized for a mean 13.9±9.3 days. The most frequent initial MRSA-active therapies used were vancomycin (37.5%), linezolid (16.7%), and clindamycin (16.7%). Eight patients were discharged with MRSA-active antibiotics, with linezolid prescribed most frequently (n=3; 37.5%). Fifteen patients (62.5%) met ES criteria and potentially could have discontinued IV therapy 8.3±6.0 days sooner, and eight (33.3%) met ED criteria and potentially could have been discharged 10.9±5.8 days earlier. Conclusion While approximately one-fifth of patients were switched from IV to PO antibiotics in the UAE, there were clear opportunities for further optimization of health care resource use. Over half of UAE patients hospitalized for MRSA complicated skin and soft tissue infections could be eligible for ES, with one-third eligible for ED opportunities, resulting in substantial potential for reductions in IV days and bed days. PMID:26124673

  4. Neuromuscular complications of critical illness.

    PubMed

    Osias, Jules; Manno, Edward

    2014-10-01

    Neuromuscular sequelae are common in the critically ill. Critical illness polyneuropathy and critical illness myopathy are neuromuscular complications of sepsis or iatrogenic complications of treatments required in intensive care. This article discusses the diagnosis, treatment, and prognosis of these disorders based on a literature review. This review found that glycemic control, early mobilization, and judicious use of steroids and neuromuscular blocking agents are the primary approaches to reduce the incidence and severity of neuromuscular complications in affected patients. PMID:25257741

  5. generalization complicated

    E-print Network

    Hinton, Geoffrey E.

    on big datasets . If we have a big data set that needs a complicated model, the full Bayesian framework generalization. Is preprocessing cheating? . Its cheating if we use a carefully designed set of task­ specific. One set is sufficient. . For planes in 3­D, h=4 even though 4 co­planar points cannot be shattered

  6. Antibiotic treatment patterns across Europe in patients with complicated skin and soft-tissue infections due to meticillin-resistant Staphylococcus aureus: a plea for implementation of early switch and early discharge criteria.

    PubMed

    Eckmann, Christian; Lawson, Wendy; Nathwani, Dilip; Solem, Caitlyn T; Stephens, Jennifer M; Macahilig, Cynthia; Simoneau, Damien; Hajek, Petr; Charbonneau, Claudie; Chambers, Richard; Li, Jim Z; Haider, Seema

    2014-07-01

    This retrospective observational medical chart review aimed to describe country-specific variations across Europe in real-world meticillin-resistant Staphylococcus aureus (MRSA) complicated skin and soft-tissue infection (cSSTI) treatment patterns, antibiotic stewardship activity, and potential opportunities for early switch (ES) from intravenous (i.v.) to oral formulations and early discharge (ED) from hospital using standardised data collection and criteria and economic implications of these opportunities. Patients were randomly sampled from 12 countries (Austria, Czech Republic, France, Germany, Greece, Ireland, Italy, Poland, Portugal, Slovakia, Spain and the UK), aged ?18 years, with documented MRSA cSSTI, hospitalised between 1 July 2010 and 30 June 2011, discharged alive by 31 July 2011. Of 1502 patients, 1468 received MRSA-targeted therapy. Intravenous-to-oral switch rates ranged from 2.0% to 20.2%, i.v. length of therapy from 10.1 to 18.6 days and hospital length of stay (LoS) from 15.2 to 25.0 days across Europe. Of 341 sites, 82.9% had antibiotic steering committees, 23.7% had i.v.-to-oral switch antibiotic protocols and 12.9% had ED protocols for MRSA cSSTI. ES and ED eligibility ranged from 12.0% (Slovakia) to 56.3% (Greece) and from 10% (Slovakia) to 48.2% (Portugal), respectively. Potential cost savings per ED-eligible patient ranged from €414 (Slovakia) to €2703 (France). MRSA cSSTI treatment patterns varied widely across countries, but further reductions in i.v. therapy, hospital LoS and associated costs could be realised. These data provide insight into clinical practice patterns across diverse European healthcare systems and identify potential opportunities for local clinicians and policy-makers to improve clinical care and cost-effectiveness of this therapeutic area. PMID:24928311

  7. Leukotriene B4 enhances innate immune defense against the puerperal sepsis agent Streptococcus pyogenes

    PubMed Central

    Soares, Elyara M.; Mason, Katie L.; Rogers, Lisa M.; Serezani, Carlos H.; Faccioli, Lucia H.; Aronoff, David M.

    2012-01-01

    Puerperal sepsis is a leading cause of maternal mortality worldwide. Streptococcus pyogenes (Group A Streptococcus; GAS) is a major etiologic agent of severe postpartum sepsis yet little is known regarding the pathogenesis of these infections. Tissue macrophages provide innate defense against GAS and their actions are highly regulated. The intracellular second messenger cAMP can negatively regulate macrophage actions against GAS. Because leukotriene (LT) B4 has been shown to suppress intracellular cAMP in macrophages, we hypothesized that it could enhance innate defenses against GAS. We assessed the capacity of LTB4 to modulate anti-streptococcal actions of human macrophages, including placental and decidual macrophages and used a novel intrauterine infection model of GAS in mice lacking the 5-lipoxygenase (5LO) enzyme to determine the role of endogenous LTs in host defense against this pathogen. Animals lacking 5LO were significantly more vulnerable to intrauterine GAS infection than wild-type mice and showed enhanced dissemination of bacteria out of the uterus and a more robust inflammatory response compared to wild-type mice. Additionally, LTB4 reduced intracellular cAMP levels via the BLT1 receptor and was a potent stimulant of macrophage phagocytosis and NADPH oxidase-dependent intracellular killing of GAS. Importantly, interference was observed between the macrophage immunomodulatory actions of LTB4 and the cAMP-inducing lipid prostaglandin E2, suggesting that interplay between pro- and anti-inflammatory compounds may be important in vivo. This work underscores the potential for pharmacological targeting of lipid mediator signaling cascades in the treatment of invasive GAS infections. PMID:23325886

  8. Neurologic complications following pediatric renal transplantation.

    PubMed

    Ghosh, Partha S; Kwon, Charles; Klein, Melanie; Corder, Julie; Ghosh, Debabrata

    2014-06-01

    We reviewed neurologic complications after renal transplantation in children over a 20-year period. Neurologic complications were classified as early (within 3 months) and delayed (beyond 3 months). Of 115 children, 10 (8.7%) had complications. Early complications were found in 4.35% of patients: seizures in 4 (posterior reversible leukoencephalopathy syndrome due to immunosuppressant toxicity, sepsis/presumed meningitis, and indeterminate) and headaches in 1. One patient with seizures received levetiracetam for 6 months and 1 with headaches received amitriptyline prophylaxis. Late complications were noted in 4.35% of patients: seizures in 3 (posterior reversible leukoencephalopathy syndrome due to hypertension, hypertensive encephalopathy), headaches in 2, and tremors in 1. Two patients with seizures were treated with anti-epilepsy medications; 1 with migraine received cyproheptadine prophylaxis. Neurologic complications develop in children after renal transplantation. Seizures due to posterior reversible leukoencephalopathy syndrome were the commonest complication. Early detection and appropriate management of these complications is important. PMID:23752071

  9. Postoperative complications do not influence the pattern of early lung function recovery after lung resection for lung cancer in patients at risk

    PubMed Central

    2014-01-01

    Background The pattern and factors influencing the lung function recovery in the first postoperative days are still not fully elucidated, especially in patients at increased risk. Methods Prospective study on 60 patients at increased risk, who underwent a lung resection for primary lung cancer. Inclusion criteria: complete resection and one or more known risk factors in form of COPD, cardiovascular disorders, advanced age or other comorbidities. Previous myocardial infarction, myocardial revascularization or stenting, cardiac rhythm disorders, arterial hypertension and myocardiopathy determined the increased cardiac risk. The severity of COPD was graded according to GOLD criteria. The trend of the postoperative lung function recovery was assessed by performing spirometry with a portable spirometer. Results Cardiac comorbidity existed in 55%, mild and moderate COPD in 20% and 35% of patients respectively. Measured values of FVC% and FEV1% on postoperative days one, three and seven, showed continuous improvement, with significant difference between the days of measurement, especially between days three and seven. There was no difference in the trend of the lung function recovery between patients with and without postoperative complications. Whilst pO2 was decreasing during the first three days in a roughly parallel fashion in patients with respiratory, surgical complications and in patients without complications, a slight hypercapnia registered on the first postoperative day was gradually abolished in all groups except in patients with cardiac complications. Conclusion Extent of the lung resection and postoperative complications do not significantly influence the trend of the lung function recovery after lung resection for lung cancer. PMID:24884793

  10. Culture-independent pilot study of microbiota colonizing open fractures and association with severity, mechanism, location, and complication from presentation to early outpatient follow-up.

    PubMed

    Hannigan, Geoffrey D; Hodkinson, Brendan P; McGinnis, Kelly; Tyldsley, Amanda S; Anari, Jason B; Horan, Annamarie D; Grice, Elizabeth A; Mehta, Samir

    2014-04-01

    Precise identification of bacteria associated with post-injury infection, co-morbidities, and outcomes could have a tremendous impact in the management and treatment of open fractures. We characterized microbiota colonizing open fractures using culture-independent, high-throughput DNA sequencing of bacterial 16S ribosomal RNA genes, and analyzed those communities with respect to injury mechanism, severity, anatomical site, and infectious complications. Thirty subjects presenting to the Hospital of the University of Pennsylvania for acute care of open fractures were enrolled in a prospective cohort study. Microbiota was collected from wound center and adjacent skin upon presentation to the emergency department, intraoperatively, and at two outpatient follow-up visits at approximately 25 and 50 days following initial presentation. Bacterial community composition and diversity colonizing open fracture wounds became increasingly similar to adjacent skin microbiota with healing. Mechanism of injury, severity, complication, and location were all associated with various aspects of microbiota diversity and composition. The results of this pilot study demonstrate the diversity and dynamism of the open fracture microbiota, and their relationship to clinical variables. Validation of these preliminary findings in larger cohorts may lead to the identification of microbiome-based biomarkers of complication risk and/or to aid in management and treatment of open fractures. PMID:24395335

  11. Lateral Lumbar Interbody Fusion for the Correction of Spondylolisthesis and Adult Degenerative Scoliosis in High-Risk Patients: Early Radiographic Results and Complications

    PubMed Central

    Waddell, Brad; Briski, David; Qadir, Rabah; Godoy, Gustavo; Houston, Allison Howard; Rudman, Ernest; Zavatsky, Joseph

    2014-01-01

    Background Lateral lumbar interbody fusion (LLIF) is not associated with many of the complications seen in other interbody fusion techniques. This study used computed tomography (CT) scans, the radiographic gold standard, to assess interbody fusion rates achieved utilizing the LLIF technique in high-risk patients. Methods We performed a retrospective review of patients who underwent LLIF between January 2008 and July 2013. Forty-nine patients underwent nonstaged or staged LLIF on 119 levels with posterior correction and augmentation. Per protocol, patients received CT scans at their 1-year follow-up. Of the 49 patients, 21 patients with LLIF intervention on 54 levels met inclusion criteria. Two board-certified musculoskeletal radiologists and the senior surgeon (JZ) assessed fusion. Results Of the 21 patients, 6 patients had had previous lumbar surgery, and the cohort's comorbidities included osteoporosis, diabetes, obesity, and smoking, among others. Postoperative complications occurred in 12 (57.1%) patients and included anterior thigh pain and weakness in 6 patients, all of which resolved by 6 months. Two cases of proximal junctional kyphosis occurred, along with 1 case of hardware pullout. Two cases of abdominal atonia occurred. By CT scan assessment, each radiologist found fusion was achieved in 53 of 54 levels (98%). The radiologists' findings were in agreement with the senior surgeon. Conclusion Several studies have evaluated LLIF fusion and reported fusion rates between 88%-96%. Our results demonstrate high fusion rates using this technique, despite multiple comorbidities in the patient population. Spanning the ring apophysis with large LLIF cages along with supplemental posterior pedicle screw augmentation can enhance stability of the fusion segment and increase fusion rates. PMID:24688329

  12. Diagnostic Value of the Combined Measurement of Serum Hcy, Serum Cys C, and Urinary Microalbumin in Type 2 Diabetes Mellitus with Early Complicating Diabetic Nephropathy

    PubMed Central

    Wang, Tengkai; Wang, Qian; Wang, Zhimei; Xiao, Zuomin; Liu, Lunqin

    2013-01-01

    Diabetic nephropathy (DN) is a major cause of end-stage kidney disease, and therefore early diagnosis and intervention may help reverse renal damage. One hundred and sixty-eight patients with T2DM and 56 healthy volunteers (control group) were enrolled at Shandong University Qilu Hospital between April 2010 and October 2012. All subjects underwent blood sampling for sera homocysteine (Hcy) and cystatin C (Cys C) assays and a urine microalbumin test. The patients were divided into three groups according to the urine microalbumin excretion rate (UMAER): the simple DM group (SDM group, n = 51), the early-stage DN group (EDN group, n = 60), and the clinical DN and renal failure group (CDN group, n = 57). Correlation analysis was performed to examine the association between sera Hcy and Cys C levels with UMAER. Our findings showed that sera Hcy level, Cys C level, and UMAER increased significantly in the SDM group (P < 0.05, P < 0.01), the EDN group (P < 0.01), and the CDN group (P < 0.01) as compared with the control group. These three biochemical markers also increased significantly with DN progression (P < 0.01). Correlation analysis showed that sera Hcy and Cys C levels were positively correlated with UMAER (r = 0.702, P < 0.01; r = 0.873, P < 0.01). In conclusion, our results showed that sera Hcy and Cys C levels increased consistently with the development and progression of DN as indicated by UMAER. Sera Hcy and Cys C are sensitive biomarkers for the detection of early-stage DN and monitoring its progression. PMID:24159393

  13. Pregnancy Complications: Chlamydia

    MedlinePLUS

    ... in the community. Home > Pregnancy > Pregnancy Complications > Chlamydia Pregnancy complications Pregnancy complications may need special medical care. ... younger than 25. Can chlamydia cause problems during pregnancy? Yes. If you get it before or during ...

  14. Early Complication in Sickle Cell Anemia Children due to A(TA)nTAA Polymorphism at the Promoter of UGT1A1 Gene

    PubMed Central

    Chaouch, Leila; Talbi, Emna; Moumni, Imen; Ben Chaabene, Arij; Kalai, Miniar; Chaouachi, Dorra; Mallouli, Fethi; Ghanem, Abderraouf; Abbes, Salem

    2013-01-01

    Aim. To determine the implication of the polymorphism, namely, A(TA)nTAA of UGT1A1 in lithogenesis for the first time in Tunisia among sickle cell anemia (SCA) children patients. Material and Methods. Our study was performed in 2010 and it involved 76 subjects chosen as control group characterized with normal hemoglobin status and presence of cholelithiasis and 102 SCA pediatric patients among whom 52 have cholelithiasis. We analyzed the polymorphism A(TA)nTAA at the UGT1A1 promoter and the relationships between the various A(TA)nTAA genotypes and alleles and bilirubin levels and occurrence of cholelithiasis. Results and Discussion. The repartition of genotypes found according to serum bilirubin level shows a significant association between genotypes carrying variant (TA)7 and hyperbilirubinemia (P < 0.05). We demonstrated the association of two genotypes with gallstones formation among SCA children patients: (TA)7/(TA)7 and (TA)7/(TA)8 with P = 8.1 × 10?8 and P = 0.01, respectively. (TA)7 and (TA)8 allele variants act as a risk factor for early gallstones formation in SCA patients with P = 5.8 × 10?9 and P = 0.01, respectively. As for the control group only the genotype (TA)7/(TA)7 presented a risk factor for gallstones formation. Conclusion. The novelty of this report is that it is the first time that a similar study was made on the Tunisian children sickle cell population and that the results show a clear association of (TA)7 variant in early gallstones formation in Tunisian SCA children. Interestingly our findings highlighted the association of (TA)8 variant as well, which was not found in previous studies. PMID:24167350

  15. Early complication in Sickle Cell Anemia children due to A(TA)_n TAA polymorphism at the promoter of UGT1A1 gene.

    PubMed

    Chaouch, Leila; Talbi, Emna; Moumni, Imen; Ben Chaabene, Arij; Kalai, Miniar; Chaouachi, Dorra; Mallouli, Fethi; Ghanem, Abderraouf; Abbes, Salem

    2013-04-25

    AIM: To determine the implication of the polymorphism namely A(TA)nTAA of UGT1A1 in lithogenesis for the first time in Tunisia among sickle cell anemia (SCA) children patients. MATERIAL AND METHODS: Our study was performed in 2010 and it involved 76 subjects chosen as control group characterized with normal hemoglobin status and presence of cholelithiasis and 102 SCA pediatric patients among whom 52 have cholelithiasis. We analyzed the polymorphism A(TA)_{n} TAA at the UGT1A1 promoter and the relationships between the various A(TA)_{n} TAA genotypes and alleles and bilirubin levels and occurrence of cholelithiasis. RESULTS AND DISCUSSION: The repartition of genotypes found according to serum bilirubin level shows a significant association between genotypes carried variant (TA)_{7} and hyperbilirubinemia (p< 0.05). We demonstrated the association of two genotypes with gallstones formation among SCA children patients: (TA)_{7}/(TA)_{7} and (TA)_{7}/(TA)_{8} with p=8.1 × 10^{ - 8} and p=0.01 respectively. (TA)_{7} and (TA)_{8} allele variants act as a risk factor for early gallstones formation in SCA patients with p=5.8 × 10^{ -9} and p=0.01 respectively. As for the control group only the genotype (TA)_{7}/(TA)_{7} presented a risk factor for gallstones formation. CONCLUSION: The novelty of this report is that it is the first time that a similar study was made on the Tunisian children sickle cell population and that the results show a clear association of (TA)_{7} variant in early gallstones formation in Tunisian SCA children. Interestingly our findings highlighted the association of (TA)_{8} variant as well, which was not found in previous studies. PMID:23619273

  16. Complications of Tumor Ablation

    Microsoft Academic Search

    Lawrence Cheung; Tito Livraghi; Luigi Solbiati; Gerald D. Dodd; Eric vanSonnenberg

    Percutaneous and surgical ablation procedures are flourishing, in large part because of the relative paucity and the acceptability\\u000a of complications. However, serious and fatal complications have occurred, albeit rarely, with ablation. This chapter identifies\\u000a those complications, describes their underlying cause, and, when possible, discusses strategies to avoid them.

  17. Gestational vascular complications

    Microsoft Academic Search

    Arnon Samueloff

    2003-01-01

    Severe pregnancy complications, primarily severe pre-eclampsia, placental abruption, intrauterine growth restriction (IUGR) and intrauterine fetal death (IUFD) occur in about 1–5% of gestations. This rate is even higher in special medical situations. These pregnancy complications have been shown to increase maternal and fetal morbidity and mortality considerably. Severe pregnancy complications have also been shown to be associated with deficient uteroplacental

  18. Chronic complications of spinal cord injury

    PubMed Central

    Sezer, Nebahat; Akku?, Selami; U?urlu, Fatma Gülçin

    2015-01-01

    Spinal cord injury (SCI) is a serious medical condition that causes functional, psychological and socioeconomic disorder. Therefore, patients with SCI experience significant impairments in various aspects of their life. The goals of rehabilitation and other treatment approaches in SCI are to improve functional level, decrease secondary morbidity and enhance health-related quality of life. Acute and long-term secondary medical complications are common in patients with SCI. However, chronic complications especially further negatively impact on patients’ functional independence and quality of life. Therefore, prevention, early diagnosis and treatment of chronic secondary complications in patients with SCI is critical for limiting these complications, improving survival, community participation and health-related quality of life. The management of secondary chronic complications of SCI is also important for SCI specialists, families and caregivers as well as patients. In this paper, we review data about common secondary long-term complications after SCI, including respiratory complications, cardiovascular complications, urinary and bowel complications, spasticity, pain syndromes, pressure ulcers, osteoporosis and bone fractures. The purpose of this review is to provide an overview of risk factors, signs, symptoms, prevention and treatment approaches for secondary long-term complications in patients with SCI. PMID:25621208

  19. Imagerie des complications neuro-orthopédiques des traumatismes graves

    Microsoft Academic Search

    J. Ezra; F. Roffi; F. Eichwald; F. Colas; S. Mokhtari; C. Le Breton; D. Safa; F. Genet; D. Mompoint; C. Vallée; R.-Y. Carlier

    2010-01-01

    Cranial and spinal trauma are a frequent cause of disability in the general population. Post-traumatic paraplegia or quadriplegia or hemiplegia from vascular injury (CVA) can lead to early complications (respiratory, cardiovascular, urinary, cutaneous, infectious…) that may have an impact on the immediate prognosis. Neurologic and orthopedic complications occur later and further impair the quality of life of patients.Orthopedic complications include:

  20. Colonic stent-related complications and their management.

    PubMed

    Han, Seung-Hee; Lee, Jong Hoon

    2014-09-01

    Since its introduction in the early 1990s, the self-expandable metal stent (SEMS) has been increasingly used for the management of malignant colorectal obstruction, not only as a palliative method but also as a preoperative treatment in surgical candidates. However, more recently, concerns have been raised over stent complication rates. Early complications include pain, perforation, and rectal bleeding, and late complications include stent migration and stent obstruction. With the increasing use of SEMS for treatment, physicians need to be more aware of complications occurring after the placement of these stents. This review covers the technical considerations and management of complications after colonic stenting. PMID:25325000

  1. Complications of splenic tissue reimplantation.

    PubMed Central

    Tzoracoleftherakis, E.; Alivizatos, V.; Kalfarentzos, F.; Androulakis, J.

    1991-01-01

    Splenic tissue reimplantation employing the omental implantation technique was applied in 23 patients undergoing splenectomy for traumatic or iatrogenic splenic injury. Four complications were encountered after autotransplantation (17.4%). Two of these consisted of small bowel obstruction due to postoperative adhesions and were successfully managed by lysis of the adhesions. The other two complications were aseptic necrosis of the splenic transplants and were treated with ablation of the autolysed transplants. A case of abnormal splenic tissue reimplantation in a male patient with unsuspected myelofibrosis is also discussed. He underwent an emergency laparotomy for rupture of a subcapsular splenic haematoma. It is concluded that splenic tissue implantation in the greater omentum is associated with important early morbidity and this should be taken into account whenever application of the method is considered. Images Figure 1 PMID:2018325

  2. [Complications of surgical treatment of hypospadia].

    PubMed

    Romanov, D V; Korol'kova, I A

    2004-01-01

    127 new cases of hypospadia were treated in 1980-2002. A total of 348 operations including urethroplasty by Duplay and Cecil were made. 78 of the operations were followed by complications out of which 26 were corrected in the postoperative period and had no effect on the treatment results. The first stage of surgical correction of hypospadia (89 operations) brought complications in 13.48% cases. Recurrent distortion of the cavernous bodies was most typical complication at this stage. In most cases development of scarry deformation was due to inflammatory changes early after surgery. Derivatives of prednisolone proved effective in the treatment of hypertrophic scars. This complication correlated with skin plastic repair (longitudinal suturing or creation of oncoming triangular flaps) to correct the defect. The second stage of hypospadia surgery was urethroplasty made in 196 cases. It was accompanied with complications in 13.25 patients. Fistulas of newly-created urethra (11.73%) were the most typical and frequent complication. The number of postoperative complications varied greatly depending on the disease form and method of urethral reconstruction. Cecil urethroplasty brought complications in 7.94% cases. Efficacy of neurourethra creation by Duplay varied greatly depending on the length of the created neourethral portion and the number of local skin resources (8-33-83.33% complications). PMID:15199814

  3. Coagulation and placenta-mediated complications.

    PubMed

    Greer, Ian A; Aharon, Anat; Brenner, Benjamin; Gris, Jean-Christophe

    2014-10-01

    Pregnancy is a physiological hypercoagulable state, preparing the mother for the hemostatic challenge of delivery. However, this is associated with an increased risk of venous thrombosis and placenta-mediated complications, which present major challenges for mother and fetus. Although these conditions are heterogeneous in their pathophysiology, hereditary and acquired thrombophilia has been associated with recurrent pregnancy loss and gestational vascular complications, such as early-onset pre-eclampsia and placental abruption. Prevention of such placenta-mediated complications, which collectively complicate up to 15% of pregnancies, is a major issue for women's health. Prospective interventional studies stratified by current knowledge of pathophysiological mechanisms related to placental and systemic hemostatic alterations will impact on the management of pregnancies at risk of these complications. PMID:25386350

  4. [Complications of body piercing].

    PubMed

    Friedrich, L; Madrid, C; Odman-Jaques, M; Yersin, B; Carnon, P N

    2014-03-19

    The trend of body piercing has grown in popularity in the past decade within the general population and especially among young adults. Complications of body piercing include local inflammation and infections, but severe complications are also possible and largely underestimated. People are usually not aware of the risks before making a piercing, and their medical history, medication and comorbidities are largely neglected by the people who realise the piercing. This article presents a review of the complications that a primary care physician may observe, for a patient who wishes to make a piercing, or presents complications due to the implementation of such a device. PMID:24734366

  5. Extraintestinal Complications: Kidney Disorders

    MedlinePLUS

    ... kidney dialysis or transplantation may be required. Drug toxicity This is occasionally responsible for kidney complications, although toxicity issues generally resolve when the drug in question ...

  6. Complications in periorbital surgery.

    PubMed

    Terella, Adam M; Wang, Tom D; Kim, Michael M

    2013-02-01

    Comprehensive rejuvenation of the periorbital region commonly involves management of the brow, as well as the upper and lower eyelids. Browlifting, upper and lower blepharoplasty, fat transfer, and neuromodulators are frequently utilized with excellent results. However, surgery in this region can be fraught with potential complications ranging from a poor cosmetic outcome to orbital hematoma and vision loss. Although avoidance of complications is preferred, it is incumbent on the surgeon to have a detailed understanding of the pathophysiology, prevention, and management of these complications. The authors examine the more common complications of periorbital surgery. PMID:23426754

  7. Complications of rhinoplasty.

    PubMed

    Harsha, Brian C

    2009-02-01

    Rhinoplasty presents a unique set of challenges for the cosmetic surgeon. Complications may arise from inadequate diagnosis, errors in surgical technique, or variations in the patient's anatomy or healing response. Complications as a result of overly aggressive surgery may also have functional consequences and be harder to correct. PMID:19185797

  8. Anastomotic Complications after Esophagectomy

    Microsoft Academic Search

    T. Lerut; W. Coosemans; G. Decker; P. De Leyn; P. Nafteux; D. Van Raemdonck

    2002-01-01

    Anastomotic complications after esophagectomy continue to be a burden jeopardizing the quality of life and of swallowing. However, incidence, mortality and morbidity of anastomotic complications have substantially decreased in recent years. It seems that this is not so much related to the use of a particular conduit, approach or route for reconstruction, but rather related to refinement in anastomotic techniques

  9. [Complications in thyroid surgery].

    PubMed

    Lombardi, C P; Raffaelli, M; De Crea, C; Traini, E; Oragano, L; Sollazzi, L; Bellantone, R

    2007-10-01

    Thyroidectomy is one of the most frequently performed surgical procedure worldwide, even if the risks of lethal postoperative complications prevented its evolution and diffusion until the beginning of the XX century. At that time, T. Kocher described his meticulous technique, reporting excellent results in terms of mortality and morbidity. At present, mortality for this procedure approaches 0% and overall complication rate is less than 3%. Nonetheless, major complications of thyroidectomy (i.e. compressive hematoma, recurrent laryngeal nerve palsy and hypoparathyroidism) are still fearful complications and account for a significant percentage of medico-legal claims. Patients volume and surgical skill play an important role in reducing the risk of complications. Accurate knowledge of anatomy and pathophysiology, complications incidence and pathogenesis and a careful surgical performance are essential. In this review, post-thyroidectomy complications basing on literature analysis and personal experience are described. The main anatomical, technical and pathophysiological factors that help preventing post-thyroidectomy complications are analyzed, taking into proper account new technologies and the minimally invasive surgical procedures that influenced thyroid surgery during the last decade. PMID:17947950

  10. Complications of endoscopic neurosurgery

    Microsoft Academic Search

    Charles Teo; Salim Rahman; Frederick A. Boop; Bruce Cherny

    1996-01-01

    Neuroendoscopy is rapidly becoming an essential part of the neurosurgeon's repertoire. Currently, very few studies have identified the complications of this new technique, yet many have warned of the steep learning curve associated with its practice. We have reviewed the last 173 neuroendoscopic procedures performed by one surgeon and identified two distinct groups of complications: those that have clinically significant

  11. Amniocentesis and its complications.

    PubMed

    Anandakumar, C; Wong, Y C; Annapoorna, V; Arulkumaran, S; Chia, D; Bongso, A; Ratnam, S S

    1992-05-01

    This study was conducted in order to evaluate whether the performance of an experienced operator had any significant influence in reducing the incidence of complications in amniocentesis; 1,459 women had amniocentesis performed under ultrasound guidance; 1,324 were performed by experienced operators and 135 cases by less experienced operators. Complications like fetal loss, blood-stained amniotic fluid, culture failure, multiple needle puncture, leaking liquor, fetal trauma and error in results were compared in the 2 groups. This study demonstrated that amniocentesis performed by an experienced operator decreased the various complications associated with amniocentesis. PMID:1520214

  12. Complications following hepatectomy.

    PubMed

    Russell, Maria C

    2015-01-01

    As the number of liver resections in the United States has increased, operations are more commonly performed on older patients with multiple comorbidities. The advent of effective chemotherapy and techniques such as portal vein embolization, have compounded the number of increasingly complex resections taking up to 75% of healthy livers. Four potentially devastating complications of liver resection include postoperative hemorrhage, venous thromboembolism, bile leak, and post-hepatectomy liver failure. The risk factors and management of these complications are herein explored, stressing the importance of identifying preoperative factors that can decrease the risk for these potentially fatal complications. PMID:25444470

  13. Chickenpox (Varicella) Complications

    MedlinePLUS

    ... Related Links Medline Plus Healthfinder.gov Shingles Complications Language: English Español (Spanish) Recommend on Facebook Tweet Share Compartir ... Symptoms Related Links Medline Plus Healthfinder.gov Shingles Language: English Español (Spanish) File Formats Help: How do I ...

  14. Complications of Sinusitis

    MedlinePLUS

    ... complete loss of smell (anosmia) may occur with sinusitis. Causes of decreased and/or loss of sense ... improvement. Mucocele A mucocele is a complication of sinusitis caused by obstruction of drainage of mucous from ...

  15. [Complications of liposuction].

    PubMed

    Sattler, G; Eichner, S

    2013-03-01

    Liposuction is the most frequent aesthetic procedure worldwide for adipose tissue reduction and treatment of lipedema. It is being employed with increasing frequency. In 2010, in the USA more than 200.000 liposuctions were performed. Apart from aesthetic indications, liposuction also is suitable for treatment of benign adipose tissue diseases. This intervention is not a simple procedure but requires extensive knowledge and experience to prevent irreversible medical or aesthetic complications. Severe complications including necrotizing fasciitis, toxic shock syndrome, hemorrhage, perforation of inner organs und pulmonary embolism - some even with lethal outcome - occasionally have been reported. These complications were mostly due to inadequate hygiene measures, inappropriate patient selection, use of excessive local anesthesia during mega-liposuction (tumescent technique) and inadequate post-operative surveillance. The complication rate usually reflects a lack of medical experience as well as technical inadequacies. PMID:23494094

  16. Complications of TMJ surgery.

    PubMed

    Hoffman, David; Puig, Leann

    2015-02-01

    Temporomandibular joint (TMJ) surgery can be divided into 3 types of surgery: Arthroscopy, arthroplasty, and total joint replacement. The complications associated with these procedures increase with complexity. They all include injury to adjacent structures, infections, and bleeding problems. PMID:25483447

  17. Pertussis (Whooping Cough) Complications

    MedlinePLUS

    ... CDC Cancel Submit Search The CDC Pertussis (Whooping Cough) Note: Javascript is disabled or is not supported ... friendly Fact Sheet Pertussis Vaccination Pregnancy and Whooping Cough Clinicians Disease Specifics Treatment Clinical Features Clinical Complications ...

  18. Intestinal Complications of IBD

    MedlinePLUS

    ... Crohn’s disease and ulcerative colitis (collectively known as inflammatory bowel disease, or IBD) are generally classified as either local ... is chronic (of long duration) LOCAL COMPLICATIONS OF ULCERATIVE COLITIS PERFORATION (RUPTURE) OF THE BOWEL Intestinal perforation occurs ...

  19. Complications of Mumps

    MedlinePLUS

    ... and Resources MMWR Articles Outbreak Articles Related Links World Health Organization Medline Plus Complications of Mumps Language: English Español ( ... Action Coalition's website (www.vaccineinformation.org). Related Links World Health Organization Medline Plus ... Español (Spanish) File Formats ...

  20. Complications of Otitis Media

    Microsoft Academic Search

    T. Metin Önerci

    \\u000a The complications of acute or chronic middle ear diseases still carry a very high mortality rate if not treated properly,\\u000a although the incidence of complications has been decreasing significantly after the introduction of antibiotics. The infection\\u000a may spread to neighboring structures either by bone erosion or preformed pathways. Facial nerve paralysis due to chronic otitis\\u000a media with cholesteatoma requires urgent

  1. Central nervous system complications after liver transplantation.

    PubMed

    Kim, Jeong-Min; Jung, Keun-Hwa; Lee, Soon-Tae; Chu, Kon; Roh, Jae-Kyu

    2015-08-01

    We investigated the diversity of central nervous system complications after liver transplantation in terms of clinical manifestations and temporal course. Liver transplantation is a lifesaving option for end stage liver disease patients but post-transplantation neurologic complications can hamper recovery. Between 1 January 2001 and 31 December 2010, patients who had undergone liver transplantation at a single tertiary university hospital were included. We reviewed their medical records and brain imaging data and classified central nervous system complications into four categories including vascular, metabolic, infectious and neoplastic. The onset of central nervous system complications was grouped into five post-transplantation intervals including acute (within 1month), early subacute (1-3months), late subacute (3-12months), chronic (1-3years), and long-term (after 3years). During follow-up, 65 of 791 patients (8.2%) experienced central nervous system complications, with 30 occurring within 1month after transplantation. Vascular etiology was the most common (27 patients; 41.5%), followed by metabolic (23; 35.4%), infectious (nine patients; 13.8%), and neoplastic (six patients). Metabolic encephalopathy with altered consciousness was the most common etiology during the acute period, followed by vascular disorders. An initial focal neurologic deficit was detected in vascular and neoplastic complications, whereas metabolic and infectious etiologies presented with non-focal symptoms. Our study shows that the etiology of central nervous system complications after liver transplantation changes over time, and initial symptoms can help to predict etiology. PMID:26100156

  2. Subcutaneous Immunization with Inactivated Bacterial Components and Purified Protein of Escherichia coli, Fusobacterium necrophorum and Trueperella pyogenes Prevents Puerperal Metritis in Holstein Dairy Cows

    PubMed Central

    Machado, Vinícius Silva; Bicalho, Marcela Luccas de Souza; Meira Junior, Enoch Brandão de Souza; Rossi, Rodolfo; Ribeiro, Bruno Leonardo; Lima, Svetlana; Santos, Thiago; Kussler, Arieli; Foditsch, Carla; Ganda, Erika Korzune; Oikonomou, Georgios; Cheong, Soon Hon; Gilbert, Robert Owen; Bicalho, Rodrigo Carvalho

    2014-01-01

    In this study we evaluate the efficacy of five vaccine formulations containing different combinations of proteins (FimH; leukotoxin, LKT; and pyolysin, PLO) and/or inactivated whole cells (Escherichia coli, Fusobacterium necrophorum, and Trueperella pyogenes) in preventing postpartum uterine diseases. Inactivated whole cells were produced using two genetically distinct strains of each bacterial species (E. coli, F. necrophorum, and T. pyogenes). FimH and PLO subunits were produced using recombinant protein expression, and LKT was recovered from culturing a wild F. necrophorum strain. Three subcutaneous vaccines were formulated: Vaccine 1 was composed of inactivated bacterial whole cells and proteins; Vaccine 2 was composed of proteins only; and Vaccine 3 was composed of inactivated bacterial whole cells only. Two intravaginal vaccines were formulated: Vaccine 4 was composed of inactivated bacterial whole cells and proteins; and Vaccine 5 was composed of PLO and LKT. To evaluate vaccine efficacy, a randomized clinical trial was conducted at a commercial dairy farm; 371 spring heifers were allocated randomly into one of six different treatments groups: control, Vaccine 1, Vaccine 2, Vaccine 3, Vaccine 4 and Vaccine 5. Late pregnant heifers assigned to one of the vaccine groups were each vaccinated twice: at 230 and 260 days of pregnancy. When vaccines were evaluated grouped as subcutaneous and intravaginal, the subcutaneous ones were found to significantly reduce the incidence of puerperal metritis. Additionally, subcutaneous vaccination significantly reduced rectal temperature at 6±1 days in milk. Reproduction was improved for cows that received subcutaneous vaccines. In general, vaccination induced a significant increase in serum IgG titers against all antigens, with subcutaneous vaccination again being more effective. In conclusion, subcutaneous vaccination with inactivated bacterial components and/or protein subunits of E. coli, F. necrophorum and T. pyogenes can prevent puerperal metritis during the first lactation of dairy cows, leading to improved reproduction. PMID:24638139

  3. Complications of hip fractures: A review

    PubMed Central

    Carpintero, Pedro; Caeiro, Jose Ramón; Carpintero, Rocío; Morales, Angela; Silva, Samuel; Mesa, Manuel

    2014-01-01

    Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections (alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum -a major contributor to fracture healing- in the femoral neck. In extracapsular fractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients. PMID:25232517

  4. Complications of body piercing.

    PubMed

    Meltzer, Donna I

    2005-11-15

    The trend of body piercing at sites other than the earlobe has grown in popularity in the past decade. The tongue, lips, nose, eyebrows, nipples, navel, and genitals may be pierced. Complications of body piercing include local and systemic infections, poor cosmesis, and foreign body rejection. Swelling and tooth fracture are common problems after tongue piercing. Minor infections, allergic contact dermatitis, keloid formation, and traumatic tearing may occur after piercing of the earlobe. "High" ear piercing through the ear cartilage is associated with more serious infections and disfigurement. Fluoroquinolone antibiotics are advised for treatment of auricular perichondritis because of their antipseudomonal activity. Many complications from piercing are body-site-specific or related to the piercing technique used. Navel, nipple, and genital piercings often have prolonged healing times. Family physicians should be prepared to address complications of body piercing and provide accurate information to patients. PMID:16342832

  5. Complications in laparoscopic surgery.

    PubMed

    Niebuhr, H; Nahrstedt, U; Hollmann, S; Rückert, K

    1995-01-01

    Over the last few years, laparoscopic surgery has gained widespread acceptance in surgical practice. The indications range has expanded extraordinarily in that time. Some of the practiced procedures are already considered the gold standard, while others are still on the way there. The fascinating technique and results notwithstanding, a number of risks, mistakes, and complications are possible in both the initial and the advanced states. We present our experience from 2118 laparoscopic operations performed between February 1991 to March 1995, focusing on the intraoperative complications (Tables 1, 2). PMID:21400429

  6. Complications of cosmetic tattoos.

    PubMed

    De Cuyper, Christa

    2015-01-01

    Cosmetic tattoos, which are better known as permanent make-up, have become popular in the last decades. This same procedure can be used to camouflage pathological skin conditions, to mask scars and to complete the aesthetic results of plastic and reconstructive surgeries. The risks and complications of tattooing procedures include infections and allergic reactions. Scarring can occur. Fanning and fading of the colorants and dissatisfaction with colour and shape are not unusual. Different lasers can offer solutions for the removal of unwanted cosmetic tattoos, but complications due to the laser treatment, such as paradoxical darkening and scarring, can arise. PMID:25833626

  7. Neurological complications of Schistosoma infection.

    PubMed

    Carod-Artal, Francisco Javier

    2008-02-01

    Schistosomiasis is a parasitic disease caused by blood flukes of the genus Schistosoma. Currently more than 200 million people worldwide are affected. Neuroschistosomiasis constitutes a severe presentation of the disease. Neurological symptoms result from the inflammatory response of the host to egg deposition in the brain and spinal cord. Neurological complications of cerebral schistosomiasis include delirium, loss of consciousness, seizures, dysphasia, visual field impairment, focal motor deficits and ataxia. Cerebral and cerebellar tumour-like neuroschistosomiasis can present with increased intracranial pressure, headache, nausea and vomiting, and seizures. Myelopathy (acute transverse myelitis and subacute myeloradiculopathy) is the most common neurological complication of Schistosoma mansoni infection. Schistosomal myelopathy tends to occur early after infection and is more likely to be symptomatic than cerebral schistosomiasis. The conus medullaris and cauda equina are the most common sites of involvement. Severe schistosomal myelopathy can provoke a complete flaccid paraplegia with areflexia, sphincter dysfunction and sensory disturbances. Schistosomicidal drugs, steroids and surgery are the currently available treatments for neuroschistosomiasis. Rehabilitation and multidisciplinary team care are needed in severely disabled patients. PMID:17905371

  8. Complicated Gallstones after Laparoscopic Sleeve Gastrectomy

    PubMed Central

    Sioka, Eleni; Zacharoulis, Dimitris; Zachari, Eleni; Katsogridaki, Georgia; Tzovaras, George

    2014-01-01

    Background. The natural history of gallstone formation after laparoscopic sleeve gastrectomy (LSG), the incidence of symptomatic gallstones, and timing of cholecystectomy are not well established. Methods. A retrospective review of prospectively collected database of 150 patients that underwent LSG was reviewed. Results. Preoperatively, gallbladder disease was identified in 32 of the patients (23.2%). Postoperatively, eight of 138 patients (5.8%) became symptomatic. Namely, three of 23 patients (13%) who had evident cholelithiasis preoperatively developed complicated cholelithiasis. From the cohort of patients without preoperative cholelithiasis, five of 106 patients (4.7%) experienced complicated gallstones after LSG. Total cumulative incidence of complicated gallstones was 4.7% (95% CI: 1.3–8.1%). The gallbladder disease-free survival rate was 92.2% at 2 years. No patient underwent cholecystectomy earlier than 9 months or later than 23 months indicating the post-LSG effect. Conclusion. A significant proportion of bariatric patients compared to the general population became symptomatic and soon developed complications after LSG, thus early cholecystectomy is warranted. Routine concomitant cholecystectomy could be considered because the proportion of patients who developed complications especially those with potentially significant morbidities is high and the time to develop complications is short and because of the real technical difficulties during subsequent cholecystectomy. PMID:25105023

  9. Tetanus: Symptoms and Complications

    MedlinePLUS

    ... materials (aspiration pneumonia) Breathing difficulty, possibly leading to death (10-20% of cases are fatal) Â Top of Page Related Page Symptoms/Complications for Clinicians Related Links Tetanus Vaccination Maternal and Neonatal Tetanus Elimination File Formats Help: How do I ...

  10. Complicating Visual Culture

    ERIC Educational Resources Information Center

    Daiello, Vicki; Hathaway, Kevin; Rhoades, Mindi; Walker, Sydney

    2006-01-01

    Arguing for complicating the study of visual culture, as advocated by James Elkins, this article explicates and explores Lacanian psychoanalytic theory and pedagogy in view of its implications for art education practice. Subjectivity, a concept of import for addressing student identity and the visual, steers the discussion informed by pedagogical…

  11. Interpreting Dream Complications.

    ERIC Educational Resources Information Center

    Gollub, Dan

    1984-01-01

    Explains different complications, i.e., emotional behavior, speech, and symbolism, suggesting that emotional behavior in dreams is either genuine or opposite from emotional reality. Dream speech delineates boundaries between the conscious and unconscious. Symbolism in dreams presents abstract concepts visually. (BH)

  12. Treatment of complicated grief

    PubMed Central

    Rosner, Rita; Pfoh, Gabriele; Kotou?ová, Michaela

    2011-01-01

    Following the death of a loved one, a small group of grievers develop an abnormal grieving style, termed complicated or prolonged grief. In the effort to establish complicated grief as a disorder in DSM and ICD, several attempts have been made over the past two decades to establish symptom criteria for this form of grieving. Complicated grief is different from depression and PTSD yet often comorbid with other psychological disorders. Meta-analyses of grief interventions show small to medium effect sizes, with only few studies yielding large effect sizes. In this article, an integrative cognitive behavioral treatment manual for complicated grief disorder (CG-CBT) of 25 individual sessions is described. Three treatment phases, each entailing several treatment strategies, allow patients to stabilize, explore, and confront the most painful aspects of the loss, and finally to integrate and transform their grief. Core aspects are cognitive restructuring and confrontation. Special attention is given to practical exercises. This article includes the case report of a woman whose daughter committed suicide. PMID:22893810

  13. [Complications of hypospadias repairs].

    PubMed

    Soave, A; Riechardt, S; Engel, O; Rink, M; Fisch, M

    2014-07-01

    Hypospadias is the most common congenital abnormality of the lower urinary tract affecting one of 300 male newborns. More than 300 different surgical hypospadias repair techniques have been described. Currently, tubularized incised plate and meatal advancement and glansplasty integrated repair are the preferred techniques for distal hypospadias, whereas two-staged procedures are most frequently used in proximal forms. Success rates are high in the hands of dedicated surgeons, although studies on long-term results are sparse. The most frequent complications of hypospadias repairs include urethrocutaneous fistulas, meatal stenosis, and urethral strictures. Urological follow-up into puberty is warranted, as well as further studies with standardized reporting of long-term results and complications. PMID:25023236

  14. Bereavement and Complicated Grief

    PubMed Central

    Ghesquiere, Angela; Glickman, Kim

    2013-01-01

    Bereavement is a common experience in adults age 60 and older. Loss of a loved one usually leads to acute grief characterized by yearning and longing, decreased interest in ongoing activities, and frequent thoughts of the deceased. For most, acute grief naturally evolves into a state of integrated grief, where the bereaved is able to reengage with everyday activities and find interest or pleasure. About 7% of bereaved older adults, however, will develop the mental health condition of Complicated Grief (CG). In CG, the movement from acute to integrated grief is derailed, and grief symptoms remain severe and impairing. This article reviews recent publications on the diagnosis of CG, risk factors for the condition, and evidenced-based treatments for CG. Greater attention to complicated grief detection and treatment in older adults is needed. PMID:24068457

  15. [Complications of rhinosinusitis].

    PubMed

    Grevers, G; Klemens, A

    2002-10-31

    Rhinogenous complications may manifest in the region of the orbits, bone or soft parts of the wall of the frontal sinus, or endocranially. With regard to orbital complications, a differentiation is made between edema, periostitis, subperiosteal abscess and phlegmon--depending on severity and extent. A possible sequela of frontal sinusitis may be osteomyelitis. If the frontal bone is involved, there is a danger that the infection may spread to the endocranium via medullary spaces and blood vessels. The diagnostic basis for deciding appropriate treatment is CT or MRI. While orbital edema and periostitis usually respond to conservative treatment, subperiosteal abscess, orbital phlegmon and abscess of the brain require immediate operative treatment under antibiotic cover. The treatment of choice for osteomyelitis of the frontal bone is the liberal removal of affected bone, also under antibiotic cover. PMID:12494596

  16. Neurologic Complications of Sarcoma

    Microsoft Academic Search

    Santosh Kesari; Lara J. Kunschner

    Sarcomas are a heterogeneous group of tumors that rarely involve the nervous system. Neurologic effects of sarcoma are more\\u000a often due to tumors outside of the central nervous system. However, as long-term survival rates in childhood sarcoma improves,\\u000a reports of late neurologic complications have increased. With recent advances in treating local sarcomas with targeted molecular\\u000a therapies, the incidence of late

  17. Complications of allergic rhinitis.

    PubMed

    Settipane, R A

    1999-01-01

    With unfortunate high frequency, clinicians consider allergic rhinitis to be more of a nuisance than an illness. When in fact, allergic rhinitis is not only a very common disease process, affecting up to a cumulative frequency of 42% of the U.S. population by age 40, but can lead to significant short-term and long-term medical complications. Poorly controlled symptoms of allergic rhinitis may contribute to sleep loss, secondary daytime fatigue, learning impairment, decreased overall cognitive functioning, decreased long-term productivity and decreased quality of life. Additionally, poorly controlled allergic rhinitis may also contribute to the development of other related disease processes including acute and chronic sinusitis, recurrence of nasal polyps, otitis media/otitis media with effusion, hearing impairment, abnormal craniofacial development, sleep apnea and related complications, aggravation of underlying asthma, and increased propensity to develop asthma. Treatment of allergic rhinitis with sedating antihistamine therapy may result in negative neuropsychiatric effects that contribute to some of these complications. Sedating antihistamines may also be dangerous to use in certain other settings such as driving or operating potentially dangerous machinery. In contrast nonsedating antihistamines have been demonstrated to result in improved performance in allergic rhinitis. PMID:10476318

  18. Pleuropulmonary complications of pancreatitis

    PubMed Central

    Kaye, Michael D.

    1968-01-01

    Pancreatitis, in common with many other upper abdominal diseases, often leads to pleuropulmonary complications. Radiological evidence of pleuropulmonary abnormality was found in 55% of 58 cases examined retrospectively. The majority of such abnormalities are not specific for pancreatitis; but a particular category of pleural effusions, rich in pancreatic enzymes, is a notable exception. A patient with this type of effusion, complicated by a spontaneous bronchopleural fistula and then by an empyema, is reported. The literature relating to pancreatic enzyme-rich pleural effusions (pathognomonic of pancreatitis) is reviewed. Of several possible mechanisms involved in pathogenesis, transdiaphragmatic lymphatic transfer of pancreatic enzymes, intrapleural rupture of mediastinal extensions of pseudocysts, and diaphragmatic perforation are the most important. The measurement of pleural fluid amylase, at present little employed in this country, has considerable diagnostic value. Enzyme-rich effusions are more commonly left-sided, are often blood-stained, are frequently associated with pancreatic pseudocysts, and—if long standing—may be complicated by a bronchopleural fistula. Images PMID:4872925

  19. [Respiratory complications after transfusion].

    PubMed

    Bernasinski, M; Mertes, P-M; Carlier, M; Dupont, H; Girard, M; Gette, S; Just, B; Malinovsky, J-M

    2014-05-01

    Respiratory complications of blood transfusion have several possible causes. Transfusion-Associated Circulatory Overload (TACO) is often the first mentioned. Transfusion-Related Acute Lung Injury (TRALI), better defined since the consensus conference of Toronto in 2004, is rarely mentioned. French incidence is low. Non-hemolytic febrile reactions, allergies, infections and pulmonary embolism are also reported. The objective of this work was to determine the statistical importance of the different respiratory complications of blood transfusion. This work was conducted retrospectively on transfusion accidents in six health centers in Champagne-Ardenne, reported to Hemovigilance between 2000 and 2009 and having respiratory symptoms. The analysis of data was conducted by an expert committee. Eighty-three cases of respiratory complications are found (316,864 blood products). We have counted 26 TACO, 12 TRALI (only 6 cases were identified in the original investigation of Hemovigilance), 18 non-hemolytic febrile reactions, 16 cases of allergies, 5 transfusions transmitted bacterial infections and 2 pulmonary embolisms. Six new TRALI were diagnosed previously labeled TACO for 2 of them, allergy and infection in 2 other cases and diagnosis considered unknown for the last 2. Our study found an incidence of TRALI 2 times higher than that reported previously. Interpretation of the data by a multidisciplinary committee amended 20% of diagnoses. This study shows the imperfections of our system for reporting accidents of blood transfusion when a single observer analyses the medical records. PMID:24814817

  20. Surgical complications of ascariasis.

    PubMed

    Ochoa, B

    1991-01-01

    Over the past 25 years (1963-1988), a total of 311 children under 12 years of age were admitted to the Pediatric Surgical Service of the San Vicente de Paúl University Hospital, Medellín, Colombia, with complications resulting from infection with Entamoeba histolytica or Ascaris lumbricoides. In this group, the abdominal complications produced by ascariasis numbered 145, and included intestinal obstruction (n = 107), perforation of the appendix (n = 10), and migration of the parasite to the biliary tree or to the peritoneal cavity (n = 28). Evaluation of the living conditions of a significant subgroup of our patients confirms that intestinal parasitism is an endemic condition prevailing in nations that exhibit deep social and economic imbalance, where large sectors of the population remain deprived of the basic services of education, health, housing, and recreation. Massive infestation in children may give rise to grave complications that demand expert surgical care. Third World surgeons practicing in general hospitals that take care of patients of low economic capacity are usually familiar with the diagnosis and management of this pathology; surgeons who practice in the industrialized nations will only occasionally face such problems. The greater mobility of today's societies and the rather massive migrations that take place in current times have resulted in an increasing incidence of these entities in the hospital populations of the large urban centers of these nations. It is for the surgeons practicing in such centers that the information presented herein may be of greater value. PMID:2031358

  1. Nasal tip complications.

    PubMed

    Davis, Richard E

    2012-06-01

    As cosmetic nasal surgery becomes increasingly more popular worldwide, postoperative nasal tip deformities have also become far more prevalent. Owing to the cosmetic prominence of the nose and to the functional importance of the nasal airway, postsurgical nasal tip deformities often result in debilitating emotional and physiological consequences. However, contemporary principles of cosmetic and functional nasal surgery, when applied expertly, will typically prevent such complications and will simultaneously permit a natural, attractive, and well-functioning nose. This article explores the mechanisms leading to common iatrogenic deformities of the nasal tip and provides alternative techniques for the safe and effective modification of nasal tip contour. PMID:22723230

  2. Technical note: Intraobserver, interobserver, and test-retest reliabilities of an assessment of vaginal discharge from cows with and without acute puerperal metritis.

    PubMed

    Sannmann, I; Heuwieser, W

    2015-08-01

    Acute puerperal metritis (APM) in dairy cows is a common disease occurring in the first 10 d after calving. According to a widely accepted definition, the diagnosis is primarily based on body temperature and sensorial assessment of vaginal discharge. The scope of this study was to evaluate the reliability for color, smell, and viscosity of vaginal discharge from healthy cows and cows with APM. Fifteen investigators evaluated 6 vaginal discharge samples 10 times. Subsequently, the investigators rated the health status of the cows and the diagnostic value of color, smell, and viscosity. In a final questionnaire, the investigators estimated their ability to diagnose APM correctly and the influence of experience. Reliability was tested using Cohen's kappa (?). Our study revealed slight to moderate reliabilities concerning the assessment of vaginal discharge. Overall interobserver reliability for color, smell, and viscosity was ?=0.15, 0.27, and 0.44, respectively. Overall intraobserver reliability for color, smell, and viscosity was ?=0.35, 0.39, and 0.6, respectively. By means of a questionnaire, overall personal expertise to detect cows suffering from APM correctly as such was estimated to be 59%, whereas the diagnostic value of a combination of color, smell, and viscosity to detect cows with APM correctly was estimated to be 91.1% perfect. We found a discrepancy between reliability and the personal perception of diagnostic value. Our study shows that the sensorial assessment of color, smell, and viscosity of vaginal discharge in cows postpartum is subjective. PMID:26026759

  3. Complications in periocular rejuvenation.

    PubMed

    Mack, William P

    2010-08-01

    Thorough preoperative evaluation with meticulous surgical planning to achieve facial aesthetic balance between the forehead, eyelids, and midface is imperative to avoid or decrease potential functional and/or cosmetic complications in cosmetic periocular surgery. Before performing surgery, the physician should be aware of the patient's history of dry eyes, previous facial trauma, previous injection of Botox Cosmetic, history of previous laser-assisted in situ keratomileusis, and past facial surgery. A full evaluation should be performed on the upper eyelid/brow region to assess for the presence of brow ptosis, brow/eyelid asymmetry, dermatochalasis/pseudodermatochalasis, eyelid ptosis, and deep superior sulcus. On the lower eyelid/cheek examination, special attention should be directed to the diagnosis of underlying negative vector, dry eyes, prominent eyes, lower lid retraction, ectropion, lateral canthal dystopia, lower eyelid laxity, scleral show, and lagophthalmos, with a rejuvenation goal that focuses on obtaining a youthful fullness through repositioning and reinforcing efforts to avoid the negative effects of hollowness. Intraoperative and postoperative medical and surgical management of cosmetic periocular surgery complications focus on decreasing the risk of postoperative ptosis, lagophthalmos, lid retraction, and lid asymmetry, with special attention to limiting the risk of visual loss secondary to orbital hemorrhage. PMID:20659676

  4. Complications associated with equine arthroscopy.

    PubMed

    Goodrich, Laurie R; McIlwraith, C Wayne

    2008-12-01

    Arthroscopic complications are infrequent but when they occur can cause significant morbidity in the equine patient. This article reviews intraoperative and postoperative complications along with ways to avoid them. Additionally, therapeutic methods of managing these complications also are discussed. PMID:19203702

  5. Les complications des hémangiomes

    Microsoft Academic Search

    D. Casanova; F. Norat; J. Bardot; G. Magalon

    2006-01-01

    Hemangioma (HMG) is a benign tumour of the child generally evolving to spontaneous regression. Sometimes this evolution can become complicated in a more or less serious way according to its localization or of its importance. If local complications are, in the most of cases, without gravity, complications of a general nature like thrombopenia or cardiac failure may compromise the vital

  6. Procedural Changes to Decrease Complications in Laparoscopic Gastric Bypass

    PubMed Central

    Beitner, Melissa; Luo, Yuying

    2015-01-01

    Background and Objectives: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a complex procedure performed in a patient population with significant medical comorbidities. Evaluation and modification of surgical techniques can minimize the complications associated with the lengthy learning curve for this procedure. The purpose of this study was to evaluate a single surgeon's decade-long experience with LRYGB, to determine whether complications decreased with experience and surgical modifications improved perioperative outcomes. Methods: A retrospective review of all procedures performed by a fellowship-trained surgeon (MK) from December 1, 2000, to October 31, 2013, identified patients who underwent LRYGB. We evaluated perioperative outcomes in 1117 patients and examined the impact of modification of surgical techniques on complications. The patients were divided into 4 groups: cases 1–100 (group 1), cases 101–400 (group 2), cases 401–700 (group 3), and cases 701-1117 (group 4). Results: Operating time decreased significantly after the initial 100 cases, from 179.1 minutes for group 1 to 122.1 minutes for group 4. With experience, early complication rates improved from 25.0% to 5.0%, but the rates of early reoperation increased from 1.0% to 2.2% over the 4 case groups. Late complication and reoperation rates increased from 4.0% to 10.5%. However, rates of bleeding, early stricture, internal hernia, and wound infection all decreased after the modification of surgical techniques. Conclusions: Operating time and early complication rates decreased with operative experience, but late complication and early and late reoperation rates increased. However, after modifications of surgical technique, common complications of LRYGB decreased to rates lower than those reported in several gastric bypass case series in the literature. The findings in this study will be helpful to fellow bariatric surgeons who are refining their strategies for reducing morbidity related to LRGYB. PMID:25848188

  7. Zebrafish sex: a complicated affair

    PubMed Central

    Liew, Woei Chang

    2014-01-01

    In this review, we provide a detailed overview of studies on the elusive sex determination (SD) and gonad differentiation mechanisms of zebrafish (Danio rerio). We show that the data obtained from most studies are compatible with polygenic sex determination (PSD), where the decision is made by the allelic combinations of several loci. These loci are typically dispersed throughout the genome, but in some teleost species a few of them might be located on a preferential pair of (sex) chromosomes. The PSD system has a much higher level of variation of SD genotypes both at the level of gametes and the sexual genotype of individuals, than that of the chromosomal sex determination systems. The early sexual development of zebrafish males is a complicated process, as they first develop a ‘juvenile ovary’, that later undergoes a transformation to give way to a testis. To date, three major developmental pathways were shown to be involved with gonad differentiation through the modulation of programmed cell death. In our opinion, there are more pathways participating in the regulation of zebrafish gonad differentiation/transformation. Introduction of additional powerful large-scale genomic approaches into the analysis of zebrafish reproduction will result in further deepening of our knowledge as well as identification of additional pathways and genes associated with these processes in the near future. PMID:24148942

  8. Postoperative pulmonary complications updating.

    PubMed

    Langeron, O; Carreira, S; le Saché, F; Raux, M

    2014-01-01

    Postoperative pulmonary complications (PPCs) are a major contributor to the overall risk of surgery. PPCs affect the length of hospital stay and are associated with a higher in-hospital mortality. PPCs are even the leading cause of death either in cardiothoracic surgery but also in non-cardiothoracic surgery. Thus, reliable PPCs risk stratification tools are the key issue of clinical decision making in the perioperative period. When the risk is clearly identified related to the patient according the ARISCAT score and/or the type of surgery (mainly thoracic and abdominal), low-cost preemptive interventions improve outcomes and new strategies can be developed to prevent this risk. The EuSOS, PERISCOPE and IMPROVE studies demonstrated this care optimization by risk identification first, then risk stratification and new care (multifaceted) strategies implementation allowing a decrease in PPCs mortality by optimizing the clinical path of the patient and the care resources. PMID:25168300

  9. [Diabetic macrovascular complications].

    PubMed

    Yamagishi, Sho-ichi

    2015-03-01

    Reactive derivatives from non-enzymatic glucose-protein condensation reactions, as well as lipids and nucleic acids exposed to reducing sugars, form a heterogeneous group of irreversible adducts called "advanced glycation end products(AGEs)". The formation and accumulation of AGEs have been known to progress at an accelerated rate under diabetes. There is accumulating evidence that AGEs and their receptor (RAGE) interaction elicits oxidative stress generation and subsequently evokes inflammatory and thrombogenic reactions, thereby being involved in vascular complications in diabetes. We, along with others, have recently found that pigment epithelium-derived factor(PEDF), a glycoprotein that belongs to the superfamily of serine protease inhibitors, has neuroprotective, anti-angiogenic, anti-oxidative, and anti-inflammatory properties both in cell culture and animal models. In this review, we discuss the role of AGE-RAGE axis in diabetic macroangiopathy and its therapeutic intervention by PEDF. PMID:25812377

  10. Pulmonary complications of AIDS: radiologic features. [AIDS

    SciTech Connect

    Cohen, B.A.; Pomeranz, S.; Rabinowitz, J.G.; Rosen, M.J.; Train, J.S.; Norton, K.I.; Mendelson, D.S.

    1984-07-01

    Fifty-two patients with pulmonary complications of acquired immunodeficiency syndrome (AIDS) were studied over a 3-year period. The vast majority of the patients were homosexual; however, a significant number were intravenous drug abusers. Thirteen different organisms were noted, of which Pneumocystis carinii was by far the most common. Five patients had neoplasia. Most patients had initial abnormal chest films; however, eight patients subsequently shown to have Pneumocystis carinii pneumonia had normal chest films. A significant overlap in chest radiographic findings was noted among patients with different or multiple organisms. Lung biopsy should be an early consideration for all patients with a clinical history consistent with the pulmonary complications of AIDS. Of the 52 patients, 41 had died by the time this report was completed.

  11. Radiologist's perspective for the Meckel's diverticulum and its complications.

    PubMed

    Kotha, V K; Khandelwal, A; Saboo, S S; Shanbhogue, A K P; Virmani, V; Marginean, E C; Menias, C O

    2014-05-01

    The Meckel's diverticulum is the commonest congenital anomaly of the gastrointestinal tract, often presenting with complications such as gastrointestinal bleeding, intussusception, bowel obstruction and diverticulitis, which are often misdiagnosed. Imaging plays an important role in the early diagnosis and characterization of these conditions and is very helpful in decision making. The Meckel's diverticulum and its complications have myriad presentations and appearances on various imaging modalities. Thus, sound knowledge of the anatomy, embryology, clinical presentation, imaging characteristics and complications is crucial to the practice of abdominal imaging. We present a review of the literature and current radiological practices in the diagnosis and management of the Meckel's diverticulum and its various complications with special emphasis on the imaging of various complications, mimickers and pathological correlation. PMID:24611767

  12. Radiologist's perspective for the Meckel's diverticulum and its complications

    PubMed Central

    Kotha, V K; Saboo, S S; Shanbhogue, A K P; Virmani, V; Marginean, E C; Menias, C O

    2014-01-01

    The Meckel's diverticulum is the commonest congenital anomaly of the gastrointestinal tract, often presenting with complications such as gastrointestinal bleeding, intussusception, bowel obstruction and diverticulitis, which are often misdiagnosed. Imaging plays an important role in the early diagnosis and characterization of these conditions and is very helpful in decision making. The Meckel's diverticulum and its complications have myriad presentations and appearances on various imaging modalities. Thus, sound knowledge of the anatomy, embryology, clinical presentation, imaging characteristics and complications is crucial to the practice of abdominal imaging. We present a review of the literature and current radiological practices in the diagnosis and management of the Meckel's diverticulum and its various complications with special emphasis on the imaging of various complications, mimickers and pathological correlation. PMID:24611767

  13. [Neurological complication of influenza infections].

    PubMed

    Brydak, Lidia B

    2002-01-01

    The aim of this study was to present neurological complications of influenza infections. Infections caused by influenza viruses can be very serious and may lead even to death resulted from the post-infectious complications. The most often occurring complications are pneumonia, bronchitis, bronchiolitis, myocarditis and otitis media. The other group is neurological post-influenza complications, including dementia, epileptic disorders, cerebrovascular disease, febrile convulsions, toxic encephalopathy, encephalitis, meningitis, subarachnoid hemorrhages, lethargic encephalitis, psychosis or increase in the number of cases of Parkinson's disease. The first way of prevention of influenza is vaccination that results in healthy, social and economic benefits. PMID:12194226

  14. Complications of groin hernia repair: their prevention and management.

    PubMed

    Gaines, R D

    1978-03-01

    An estimated overall complication rate of approximately ten percent is found in the half million patients who annually undergo groin hernia repair in the United States. Certain features in the operative technique are emphasized which should prevent many of these complications.Intraoperative complications during the groin hernia repair are primarily hemorrhage and injury to the vas deferens, the three nerves in the area, the vascular supply of the testis, and the abdominal and pelvic viscera. Miscellaneous intraoperative complications relate to problems associated with the repair of massive hernias, missed hernia, and the loss of strangulated bowel into the abdominal cavity.Early postoperative complications may be either systemic or local with cardiac and respiratory conditions comprising the former group. The early local complications are primarily wound problems of infection, hematoma formation, and scrotal swelling involving the skin and testis. High ligation in excision of the sac in all hernias, repair of the defect in the plane of its occurrence, and suture of fascia to fascia in the same plane without tension are the basic tenets of inguinal hernia repair which should result in a low incidence of recurrence.The most effective prophylactic measures necessary for the prevention of complications considered are a thorough knowledge of inguinofemoral anatomy, mature surgical judgment, and meticulous surgical technique. PMID:691083

  15. Bone and metabolic complications of urinary diversions.

    PubMed

    Cano Megías, Marta; Muñoz Delgado, Eva Golmayo

    2015-02-01

    Hyperchloremic metabolic acidosis is a complication of urinary diversion using ileum or colon. Its prevalence ranges from 25% and 46% depending on the procedure used and renal function of the patient. It is a consequence of intestinal fluid and electrolyte exchange between intestinal mucosa and urine. The main mechanism is absorption of ammonium and chloride from urine. Long-term chronic metabolic acidosis in these patients may lead to impaired bone metabolism and osteomalacia. Regular monitoring of pH, chlorine, bicarbonate, and calcium-phosphorus metabolism is therefore essential for early diagnosis and treatment. PMID:25481805

  16. Female circumcision and obstetric complications

    Microsoft Academic Search

    U. Larsen; F. E. Okonofua

    2002-01-01

    Objectives: To examine whether complications at delivery are associated with female circumcision. Method: One thousand eight hundred and fifty-one women seeking family planning or antenatal care in three south-west Nigerian hospitals were interviewed and had a medical exam. The prevalence of complications at delivery for uncircumcised women and circumcised women with type 1 (partial or total removal of the clitoris)

  17. Intracranial complications of acute mastoiditis

    Microsoft Academic Search

    Cynthia Go; Joseph M Bernstein; Andrew L de Jong; Marcelle Sulek; Ellen M Friedman

    2000-01-01

    Objective: Oral antibiotic use may have changed the incidence and microbiology of otitic intracranial complications. We reviewed cases of acute mastoiditis to document: (1) incidence of intracranial complications; (2) risk factors; and (3) identify pathologic organisms. Methods: A retrospective study of children at a tertiary care children's hospital with acute mastoiditis from July, 1986 through June, 1998. Results: 118 children

  18. Major Depression and Complicated Grief

    MedlinePLUS

    ... bereavement The grief process Major depression and complicated grief Coping with loss Helping someone who is grieving Grief ... References Previous Topic The grief process Next Topic Coping with loss Major depression and complicated grief Depression It’s common for people to have sadness, ...

  19. Septoplasty complications: avoidance and management.

    PubMed

    Bloom, Jason D; Kaplan, Seth E; Bleier, Benjamin S; Goldstein, Stephen A

    2009-06-01

    Nasal obstruction from a deviated septum is one of the more frequent complaints bringing patients into an otolaryngology office. Despite the significant number of septoplasties performed each year, complications after this procedure are relatively uncommon. Most complications result from inadequate surgical planning or poor technique and often can be prevented. Surgeons should discuss these risks with patients before surgery as part of the informed consent process. This article reviews how complications of septoplasty can occur, compromising the functional and aesthetic aspects of a patient's life, and how attention to detail can reduce the risk for these complications. The septoplasty surgeon must be aware of all the possible complications that may arise so as to convey the benefits and risks of surgery effectively to prospective patients. PMID:19486742

  20. Complications of abdominoplasty after weight loss as a result of bariatric surgery or dieting/postpregnancy.

    PubMed

    Staalesen, Trude; Olsén, Monika Fagevik; Elander, Anna

    2012-12-01

    It is well known that the risk of complications after abdominal contouring surgery is high. Sparse data in published reports exist, suggesting that complication rates are higher in postbariatric patients compared with patients who have lost weight by dieting. The aim of this study was to analyse the incidence of complications after abdominoplasty in postbariatric patients compared with in patients who have not had weight loss surgery. The aim was also to identify predictive factors associated with the development of postoperative complications. This study retrospectively analysed 190 consecutive patients operated on with abdominoplasty due to abdominal tissue excess from January 2006 to December 2008 at Sahlgrenska University Hospital. Variables analysed were sex, age, max body mass index (BMI), delta BMI (max BMI minus preoperative BMI), preoperative BMI, method of weight reduction, resection weight, and complications. The early complication rates were significantly higher in postbariatric patients (48%) than in patients who had not had weight loss surgery (29%). Resection weight was significantly higher for patients with early local complications compared with patients without early local complications. Max BMI, delta BMI, or preoperative BMI had no influence on the incidence of complications. In conclusion, this study confirms in a fairly large sample that the complication rate after abdominoplasty seems to be higher in postbariatric patients compared with patients who have not had weight loss surgery. However, no predictive factors could be identified explaining these differences. Further studies need to be conducted to identify predictive factors for the occurrence of complications after abdominal contouring surgery. PMID:23088637

  1. Neurological complications of cardiac surgery.

    PubMed

    McDonagh, David L; Berger, Miles; Mathew, Joseph P; Graffagnino, Carmelo; Milano, Carmelo A; Newman, Mark F

    2014-05-01

    As increasing numbers of elderly people undergo cardiac surgery, neurologists are frequently called upon to assess patients with neurological complications from the procedure. Some complications mandate acute intervention, whereas others need longer term observation and management. A large amount of published literature exists about these complications and guidance on best practice is constantly changing. Similarly, despite technological advances in surgical intervention and modifications in surgical technique to make cardiac procedures safer, these advances often create new avenues for neurological injury. Accordingly, rapid and precise neurological assessment and therapeutic intervention rests on a solid understanding of the evidence base and procedural variables. PMID:24703207

  2. Cancer in an ileoanal reservoir: a new late complication?

    Microsoft Academic Search

    H Stern; S Walfisch; B Mullen; R McLeod; Z Cohen

    1990-01-01

    The functional success rate of the ileoanal reservoir procedure for ulcerative colitis is quite high. Despite the few early and late complications described there is now wide-spread acceptance of this procedure in the management of ulcerative colitis. We report a patient who developed an adenocarcinoma in the rectal cuff four years after having a pelvic pouch procedure. This new late

  3. Defective implantation and placentation: laying the blueprint for pregnancy complications

    Microsoft Academic Search

    Errol R Norwitz

    2006-01-01

    Normal implantation and placentation is critical for pregnancy success. Many pregnancy-related complications that present late in gestation (such as pre-eclampsia and preterm labour) appear to have their origins early in pregnancy with abnormalities in implantation and placental development. Implantation is characterized by invasion of the maternal tissues of the uterus by fetal trophoblast, and the degree to which trophoblast invades

  4. Defective implantation and placentation: laying the blueprint for pregnancy complications

    Microsoft Academic Search

    Errol R Norwitz

    2007-01-01

    Normal implantation and placentation is critical for pregnancy success. Many pregnancy-related complications that present late in gestation (such as pre-eclampsia and preterm labour) appear to have their origins early in pregnancy with abnormalities in implantation and placental development. Implantation is characterized by invasion of the maternal tissues of the uterus by fetal trophoblast, and the degree to which trophoblast invades

  5. Complications and reoperations in stapled anopexy: learning by doing

    Microsoft Academic Search

    Johannes Jongen; Jens-Uwe Bock; Hans-Günter Peleikis; Anne Eberstein; Karin Pfister

    2006-01-01

    Although stapled anopexy for second and third degree hemorrhoids has been widely used since 1998, there are limited long-term data available. We performed an analysis of a prospectively accrued data set of all patients undergoing stapled anopexy in our practice from 1998 through August 2003. Patients were specifically assessed for early and late complications and long-term reoperation rates for anorectal

  6. Perioperative Complications: The First 140 Polypropylene Pubovaginal Slings

    Microsoft Academic Search

    KATHLEEN C. KOBASHI; FRED E. GOVIER

    2003-01-01

    PurposeTwo widely used tensionless mid urethral slings currently available are the SPARC polypropylene sling (American Medical Systems, Minneapolis, Minnesota) and the TVT (tensionless vaginal tape, Ethicon, New Brunswick, New Jersey). As with the TVT system, the SPARC has been suggested as an outpatient procedure. We present the early complications of our first 140 slings, based on which we recommend that

  7. Neurological Complications of Lyme Disease

    MedlinePLUS

    ... the National Institutes of Health (NIH), also support research on Lyme disease. NIH Patient Recruitment for Neurological Complications of Lyme Disease Clinical Trials At NIH Clinical Center Throughout the U.S. ...

  8. BCG vaccination in SCID patients: complications, risks and vaccination policies

    PubMed Central

    Marciano, Beatriz E; Huang, Chiung-Yu; Joshi, Gyan; Rezaei, Nima; Carvalho, Beatriz Costa; Allwood, Zoe; Ikinciogullari, Aydan; Reda, Shereen M; Gennery, Andrew; Thon, Vojtech; Espinosa-Rosales, Francisco; Al-Herz, Waleed; Porras, Oscar; Shcherbina, Anna; Szaflarska, Anna; Kiliç, ?ebnem; Franco, Jose L; Raccio, Andrea C Gómez; Roxo-Jr, Persio; Esteves, Isabel; Galal, Nermeen; Grumach, Anete Sevciovic; Al-Tamemi, Salem; Yildiran, Alisan; Orellana, Julio C; Yamada, Masafumi; Morio, Tomohiro; Liberatore, Diana; Ohtsuka, Yoshitoshi; Lau, Yu-Lung; Nishikomori, Ryuta; Torres-Lozano, Carlos; Mazzucchelli, Juliana TL; Vilela, Maria MS; Tavares, Fabiola S; Cunha, Luciana; Pinto, Jorge A; Espinosa-Padilla, Sara E; Hernandez-Nieto, Leticia; Elfeky, Reem A; Ariga, Tadashi; Toshio, Heike; Dogu, Figen; Cipe, Funda; Formankova, Renata; Nuñez-Nuñez, M Enriqueta; Bezrodnik, Liliana; Marques, Jose Gonçalo; Pereira, María I; Listello, Viviana; Slatter, Mary A; Nademi, Zohreh; Kowalczyk, Danuta; Fleisher, Thomas A.; Davies, Graham; Neven, Bénédicte; Rosenzweig, Sergio D

    2014-01-01

    Background SCID is a syndrome characterized by profound T cell deficiency. BCG vaccine is contraindicated in SCID patients. Because most countries encourage BCG vaccination at birth, a high percent of SCID patients are vaccinated before their immune defect is detected. Objectives To describe the complications and risks associated with BCG vaccination in SCID patients. Methods An extensive standardized questionnaire evaluating complications, therapeutics, and outcome regarding BCG in patients diagnosed with SCID was widely distributed. Summary statistics and association analysis was performed. Results Data on 349 BCG vaccinated SCID patients from 28 centers in 17 countries was analyzed. Fifty-one percent of the patients developed BCG complications, 34% disseminated and 17% localized (a 33,000 and 400 fold increase, respectively, over the general population). Patients receiving early vaccination (? 1 month) showed an increased prevalence of complications (p=0.006) and death due to BCG complications (p<0.0001). The odds of experiencing complications among patients with T cells ? 250/uL at diagnosis was 2.1 times higher (95% CI, 1.4-3.4; p = 0.001) than among those with T cells > 250/uL. BCG complications were reported in 2/78 patients who received anti-mycobacterial therapy while asymptomatic and no deaths due to BCG complications occurred in this group. In contrast 46 BCG-associated deaths were reported among 160 patients treated with anti-mycobacterial therapy for a symptomatic BCG infection (p<0.0001). Conclusions BCG vaccine has a very high rate of complications in SCID patients, which increase morbidity and mortality rates. Until safer and more efficient anti-tuberculosis vaccines become available, delay in BCG vaccination should be considered to protect highly vulnerable populations from preventable complications. PMID:24679470

  9. [Complications and peculiarities of anesthesia in abdominal delivery].

    PubMed

    Balich, E Ia

    1993-01-01

    Analysis of the reasons responsible for complications of anesthesia in abdominal delivery has shown that such complications are most frequent before fetus extraction. They are: poorly corrected hypo- or hypertension and tachycardia; damages of major vessels, pleura and lungs upon central vein puncture; severe hypoxia in difficult or abortive intubations with mouth, larynx, pharynx, trachea and esophagus injuries; regurgitation and development of aspiration pneumonia (Mendelson syndrome); toxic and allergic reactions to psychopharmacological, narcotic and local anesthetic agents; signs of laryngobronchiolospasm; complications during suture of the uterus and abdominal cavity when main anesthesia is performed (hypotonic bleeding with the onset of ARDS, hemodynamic disturbances due to microembolism of the pulmonary artery branches upon active contractions of the uterus caused by uterotonics, side effects of myorelaxants); complications in the early postoperative period (prolonged apnea, the onset of acute cardiopulmonary and hepatic failure). PMID:7943866

  10. Biliary Complications of Pancreatic Necrosis.

    PubMed

    Chaudhary, Adarsh; Sachdev, Ajay; Negi, Sanjay

    2001-01-01

    Pancreatic necrosis has the potential to cause avariety of locoregional complications (1). This isbecause of the propensity of the necrotic tissue tospread far beyond the confines of the pancreas. Theproximity of the biliary tract to the pancreas makesit particularly vulnerable to damage by the inflammatory process, and though likely, there are only isolated case reports of involvement of the biliarytract through the necrotic process (2-5). This papershares our experience in managing six patients withbiliary complications of pancreatic necrosis. PMID:12754382

  11. Neurologic Complications in Percutaneous Nephrolithotomy

    PubMed Central

    Basiri, Abbas; Soltani, Mohammad Hossein; Kamranmanesh, Mohammadreza; Tabibi, Ali; Mohsen Ziaee, Seyed Amir; Nouralizadeh, Akbar; Sharifiaghdas, Farzaneh; Poorzamani, Mahtab; Gharaei, Babak; Ozhand, Ardalan; Lashay, Alireza; Ahanian, Ali; Aminsharifi, Alireza; Sichani, Mehrdad Mohammadi; Asl-Zare, Mohammad; Ali Beigi, Faramarz Mohammad; Najjaran, Vahid; Abedinzadeh, Mehdi

    2013-01-01

    Purpose Percutaneous nephrolithotomy (PCNL) has been the preferred procedure for the removal of large renal stones in Iran since 1990. Recently, we encountered a series of devastating neurologic complications during PCNL, including paraplegia and hemiplegia. There are several reports of neurologic complications following PCNL owing to paradoxical air emboli, but there are no reports of paraplegia following PCNL. Materials and Methods We retrospectively reviewed the medical records of patients who had undergone PCNL in 13 different endourologic centers and retrieved data related to neurologic complications after PCNL, including coma, paraplegia, hemiplegia, and quadriplegia. Results The total number of PCNL procedures in these 13 centers was 30,666. Among these procedures, 11 cases were complicated by neurologic events, and four of these cases experienced paraplegia. All events happened with the patient in the prone position with the use of general anesthesia and in the presence of air injection. There were no reports of neurologic complications in PCNL procedures performed with the patient under general anesthesia and in the prone position and with contrast injection. Conclusions It can be assumed that using room air to opacify the collecting system played a major role in the occurrence of these complications. Likewise, the prone position and general anesthesia may predispose to these events in the presence of air injection. PMID:23526482

  12. Complications of Minimally Invasive Cosmetic Procedures: Prevention and Management

    PubMed Central

    Levy, Lauren L; Emer, Jason J

    2012-01-01

    Over the past decade, facial rejuvenation procedures to circumvent traditional surgery have become increasingly popular. Office-based, minimally invasive procedures can promote a youthful appearance with minimal downtime and low risk of complications. Injectable botulinum toxin (BoNT), soft-tissue fillers, and chemical peels are among the most popular non-invasive rejuvenation procedures, and each has unique applications for improving facial aesthetics. Despite the simplicity and reliability of office-based procedures, complications can occur even with an astute and experienced injector. The goal of any procedure is to perform it properly and safely; thus, early recognition of complications when they do occur is paramount in dictating prevention of long-term sequelae. The most common complications from BoNT and soft-tissue filler injection are bruising, erythema and pain. With chemical peels, it is not uncommon to have erythema, irritation and burning. Fortunately, these side effects are normally transient and have simple remedies. More serious complications include muscle paralysis from BoNT, granuloma formation from soft-tissue filler placement and scarring from chemical peels. Thankfully, these complications are rare and can be avoided with excellent procedure technique, knowledge of facial anatomy, proper patient selection, and appropriate pre- and post-skin care. This article reviews complications of office-based, minimally invasive procedures, with emphasis on prevention and management. Practitioners providing these treatments should be well versed in this subject matter in order to deliver the highest quality care. PMID:23060707

  13. [Prevention of respiratory complications after abdominal surgery].

    PubMed

    Rezaiguia, S; Jayr, C

    1996-01-01

    Abdominal surgery, especially upper abdominal surgical procedures are known to adversely affect pulmonary function. Pulmonary complications are the most frequent cause of postoperative morbidity and mortality. This review article aimed to analyse the incidence and risk factors for postoperative pulmonary morbidity and their prevention. The most important means for preoperative assessment is the clinical examination; pulmonary function tests (spirometry) are not reliably predictive for postoperative pulmonary complications. Age, type of surgical procedure, smoking and nutritional state have all been identified as potential predictors for postoperative complications. However, usually there is not enough preoperative time available to obtain beneficial effects of stopping smoking and improvement of nutritional state. In patients with COPD, a preoperative multidisciplinary evaluation including the primary care physician, pulmonologist/intensivist, anesthesiologist and surgeon is required. Consensus as to preoperative physiologic state, therapeutic preparation, and postoperative management is essential. Simple spirometry and arterial blood gas analysis are indicated in patients exhibiting symptoms of obstructive airway disease. There are no values that contra-indicate an essential surgical procedure. Smoking should stop at least 8 weeks preoperatively. Preoperative therapy for elective surgery with antibiotics, beta2-agonist, or anticholinergic bronchodilator aerosols, as well as training in cough and lung expansion techniques should begin at least 24 to 48 hours preoperatively. Postoperative therapy should be continued for 3 to 5 days. Usually, anaesthesia is responsible for early complications, whereas surgical procedures are often associated with delayed morbidity. Laparoscopic procedures are recommended, as postoperative morbidity and hospital stay seem reduced in patients without COPD. Regional anaesthesia is given as having less adverse effects on pulmonary function than general anaesthesia. However, for unknown reasons these benefits are not associated with a decrease in postoperative respiratory complications. Moreover, the quality or the type of postoperative analgesia does not influence postoperative respiratory morbidity. Postoperatively, oxygen administration increases SaO2, but cannot abolish desaturation due to obstructive apnea. The various techniques of physiotherapy (chest physiotherapy, incentive spirometry, continuous positive airway pressure breathing) seem to be equivalent in efficacy; but intermittent positive pressure breathing has no advantages, compared with the other treatments and could even be deleterious. Chest physiotherapy and incentive spirometry are the most practical methods available for decreasing secretion contents of airways, whereas continuous positive airway pressure breathing is efficient on atelectasis. In stage II or III COPD patients, admission in a intensive therapy unit and prolonged mechanical ventilation may be required. PMID:9033757

  14. Neurologic Complications in Infective Endocarditis

    PubMed Central

    Morris, Nicholas A.; Matiello, Marcelo; Samuels, Martin A.

    2014-01-01

    Neurologic complications of infective endocarditis (IE) are common and frequently life threatening. Neurologic events are not always obvious. The prediction and management of neurologic complications of IE are not easily approached algorithmically, and the impact they have on timing and ability to surgically repair or replace the affected valve often requires a painstaking evaluation and joint effort across multiple medical disciplines in order to achieve the best possible outcome. Although specific recommendations are always tailored to the individual patient, there are some guiding principles that can be used to help direct the decision-making process. Herein, we review the pathophysiology, epidemiology, manifestations, and diagnosis of neurological complications of IE and further consider the impact they have on clinical decision making. PMID:25360207

  15. [Complications after cosmetic iris implantation].

    PubMed

    Jonsson, N J; Sahlmüller, M C; Ruokonen, P C; Torun, N; Rieck, P

    2011-05-01

    We report the case of a 37-year-old patient with ocular complications associated with the implantation of cosmetic iris implants. Implantation of silicone iris implants for the purpose of changing iris colour has been performed since 2004. Diaphragms are implanted in the anterior chamber. Up to now only little information exists about side effects of this method. In the literature severe ocular complications shortly after cosmetic iris implantation are reported in single cases. In our case 5 months after surgery optic nerve damage caused by elevated intraocular pressure (IOP) was diagnosed. Nuclear opacity of both lenses and a decreased number of corneal endothelial cells were observed at the first visit. Because of recurrent IOP elevation despite maximum antiglaucoma therapy, explantation of the iris implants was required. Damage to the trabecular meshwork, opacity of the lenses as well as the reduced number of endothelial cells are permanent and will probably lead to further complications like corneal decompensation and progressing glaucoma. PMID:21344246

  16. [Early complications with colon esophageal substitution for children via retrosternal].

    PubMed

    Chávez-Aguilar, Antonio Heliodoro; Silva-Báez, Héctor; Sánchez-Rodríguez, Yamid Brajin; Esparza-Ponce, Carlos; Zatarain-Ontiveros, Miguel Ángel; Barrera de León, Juan Carlos

    2015-01-01

    Objetivo: Describir las complicaciones tempranas de la sustitución esofágica con colon en niños. Material y métodos: Estudio transversal descriptivo realizado entre los años 2005 y 2011 en pacientes pediátricos con diagnóstico de ingesta de álcali, atresia esofágica o lesión esofágica traumática manejadas con sustitución esofágica con colon por vía retroesternal. Se realizó un análisis estadístico descriptivo con SPSS 20.0. Resultados: Se realizaron 19 sustituciones esofágicas; la media de edad de los niños fue de 7 (4-15) años; hubo 13 (68%) pacientes masculinos y 6 (31%) femeninos. El diagnóstico inicial fue: ingesta de cáustico en 13 (68%) pacientes y atresia esofágica tipo III en 6 (32%). De las 6 atresias esofágicas, en 4 (66%) hubo dehiscencia de plastia; en 1 (17%), atresia tipo long-gap, y en 1 (17%), perforación esofágica por dilataciones. El segmento de colon utilizado fue transverso en 8 (42%) casos, transverso/descendente en 7 (36%), ascendente/transverso en 3 (15%) y descendente en 1 (5%). Las complicaciones tempranas fueron: neumotórax en 1 (5%) caso, neumonía en 3 (15%), sepsis en 3 (15%), oclusión intestinal por bridas en 2 (10%), invaginación intestinal en 1 (5%) y fístula cervical en 3 (15%). Hubo una defunción por sepsis (5%) a los cuatro días posquirúrgicos. Conclusiones: La sustitución de esófago con colon por vía retroesternal es una buena alternativa de reemplazo esofágico; las complicaciones tempranas más frecuentes son: fístula cervical, neumonía y sepsis. PMID:26089268

  17. Caregiving, bereavement and complicated grief

    PubMed Central

    Boerner, Kathrin; Schulz, Richard

    2010-01-01

    Most deaths are preceded by chronic illness and disability and the provision of support by family caregivers. The purpose of this article is to describe how the caregiving experience affects bereavement, with an emphasis on the relationship between challenging caregiving situations and difficult grieving processes – often referred to as `complicated grief'. The article starts with a brief summary of the general literature on caregiving and bereavement. It then defines complicated grief and discusses why some caregivers may struggle with the death of their loved one. Finally, it offers practical suggestions for what professionals can do to help caregivers both before and after the death has occurred. PMID:20463850

  18. Caregiving, bereavement and complicated grief.

    PubMed

    Boerner, Kathrin; Schulz, Richard

    2009-12-01

    Most deaths are preceded by chronic illness and disability and the provision of support by family caregivers. The purpose of this article is to describe how the caregiving experience affects bereavement, with an emphasis on the relationship between challenging caregiving situations and difficult grieving processes - often referred to as `complicated grief'. The article starts with a brief summary of the general literature on caregiving and bereavement. It then defines complicated grief and discusses why some caregivers may struggle with the death of their loved one. Finally, it offers practical suggestions for what professionals can do to help caregivers both before and after the death has occurred. PMID:20463850

  19. Complicated grief in late life

    PubMed Central

    Miller, Mark D.

    2012-01-01

    Complicated grief (CG) is a syndrome that affects 10% to 20% of grievers regardless of age, although proportionally more will face the death of loved ones in late life, CG is characterized by preoccupying and disabling symptoms that can persist for decades such as an inability to accept the death, intense yearning or avoidance, frequent reveries, deep sadness, crying, somatic distress, social withdrawal, and suicidal ideation. This syndrome is distinct from major depression and post-traumatic stress disorder, but CG maybe comorbid with each. This communication will focus on the impact of CG in late life (over age 60) and will include a case vignette for illustrating complicated grief therapy. PMID:22754292

  20. Augmentation cystoplasty: Contemporary indications, techniques and complications

    PubMed Central

    Veeratterapillay, Rajan; Thorpe, Andrew C.; Harding, Chris

    2013-01-01

    Augmentation cystoplasty (AC) has traditionally been used in the treatment of the low capacity, poorly compliant or refractory overactive bladder (OAB). The use of intravesical botulinum toxin and sacral neuromodulation in detrusor overactivity has reduced the number of AC performed for this indication. However, AC remains important in the pediatric and renal transplant setting and still remains a viable option for refractory OAB. Advances in surgical technique have seen the development of both laparoscopic and robotic augmentation cystoplasty. A variety of intestinal segments can be used although ileocystoplasty remains the most common performed procedure. Early complications include thromboembolism and mortality, whereas long-term problems include metabolic disturbance, bacteriuria, urinary tract stones, incontinence, perforation, the need for intermittent self-catheterization and carcinoma. This article examines the contemporary indications, published results and possible future directions for augmentation cystoplasty. PMID:24235795

  1. Pleural procedural complications: prevention and management

    PubMed Central

    Psallidas, Ioannis; Wrightson, John M.; Hallifax, Robert J.; Rahman, Najib M.

    2015-01-01

    Pleural disease is common with a rising case frequency. Many of these patients will be symptomatic and require diagnostic and/or therapeutic procedures. Patients with pleural disease present to a number of different medical specialties, and an equally broad range of clinicians are therefore required to have practical knowledge of these procedures. There is often underestimation of the morbidity and mortality associated with pleural interventions, even those regarded as being relatively straightforward, with potentially significant implications for processes relating to patient safety and informed consent. The advent of thoracic ultrasound (TUS) has had a major influence on patient safety and the number of physicians with the necessary skill set to perform pleural procedures. As the variety and complexity of pleural interventions increases, there is increasing recognition that early specialist input can reduce the risk of complications and number of procedures a patient requires. This review looks at the means by which complications of pleural procedures arise, along with how they can be managed or ideally prevented.

  2. Surgical complications of Ascaris lumbricoides in children

    PubMed Central

    Ramareddy, Raghu S.; Alladi, Anand; Siddapa, O. S.; Deepti, V; Akthar, Tanveer; Mamata, B.

    2012-01-01

    Aim: To report the surgical complications of Ascaris lumbricoides infestation in children. Materials and Methods: This is a retrospective study and cases of intestinal ascariasis managed conservatively were excluded. Results: Sixteen children presented with Ascariasis sequelae, which included ileal volvulus (n=5), perforations (n=4), intussusception (n=1), biliary ascariasis (n-1) and impacted multiple worm boluses (n=5). Plain abdominal radiographs showed pneumoperitoneum (3), cigar bundle appearance (3) and multiple air and fluid levels (13). Sonography showed floating worms with free fluid (2), sluggish peristalsis and moderate free fluid (7) and intestinal worm bolus (11). The surgical procedures included milking of worms (in all), bowel resection (6), closure of perforation (3) and manual reduction of intussusception (1). Biliary ascariasis was managed conservatively and the progress monitored with sonography. There were 3 deaths all of whom had intestinal volvulus, bowel necrosis and toxemia. Conclusion: Sonography can be helpful in diagnosing the presence of worms, its complications and in evaluating response to treatment. Early surgical intervention in those with worm bolus, peritonism, and volvulus may salvage bowel and reduce mortality. PMID:22869977

  3. Causes and managements of postoperative complications after degenerative scoliosis treatments with internal fixation

    PubMed Central

    Yang, Yong-Hong; Zheng, Jie; Lou, Shu-Liang

    2014-01-01

    Objective: To investigate the causes and managements of early postoperative complications of degenerative scoliosis (DS) treated with internal pedicle screw fixation. Methods: From Jan 2000 to Apr 2013, 325 DS patients treated with internal pedicle screw fixation in our hospital were retrospectively involved. The categories, causes, managements and outcomes of early postoperative complications were statistically analyzed. Results: Early postoperative complications occurred in 10.76% of the patients including 16 cases of lower limb numb or pain, 6 cases of decreased lower limb sensitivity and motor functions, which accounted for 62.86% of all complications, followed by incision infections (4/35, 11.43%) and rare cases of cerebrospinal fluid leakage, cardiac and renal inadequacy, urinary system and pulmonary infections. The incidence of overall complications (19.79%, p = 0.001) and nerve injuries (11.46%, p = 0.000) were significantly higher in long-segment than in short-segment fixations. Improper screw implanting, over correction of scoliosis and insufficient blood supply of the spinal cord during operation were risk factors for early postoperative complications and most of them were cured by anti-infection medication, incision dressing change, nerve nourishment, adjusting the screws and anti-osteoporosis treatments within 6 months after surgery. Only three cases with severe nerve injury did not improve until the 6 months postoperative follow-up. Conclusions: Most of the postoperative complications in our DS patients disappeared within 6 months after surgery and more than half of complications were nerve injuries. PMID:25550945

  4. Caregiving, bereavement and complicated grief

    Microsoft Academic Search

    Kathrin Boerner; Richard Schulz

    2009-01-01

    Most deaths are preceded by chronic illness and disability and the provision of support by family caregivers. The purpose of this article is to describe how the caregiving experience affects bereavement, with an emphasis on the relationship between challenging caregiving situations and difficult grieving processes - often referred to as ‘complicated grief’. The article starts with a brief summary of

  5. Constraints complicate centrifugal compressor depressurization

    SciTech Connect

    Key, B. (Hoover and Keith Inc., Houston, TX (United States)); Colbert, F.L. (Paragon Engineering Services Inc., Houston, TX (United States))

    1993-05-10

    Blowdown of a centrifugal compressor is complicated by process constraints that might require slowing the depressurization rate and by mechanical constraints for which a faster rate might be preferred. The paper describes design constraints such as gas leaks; thrust-bearing overload; system constraints; flare extinguishing; heat levels; and pressure drop.

  6. Caesarean section: techniques and complications

    Microsoft Academic Search

    Andrew Simm; Darly Mathew

    2008-01-01

    One-fifth of deliveries in England and Wales are undertaken by caesarean section. The procedure has changed very little over the years, although evidence-based refinements have resulted in reduced morbidity; research continues in adapting techniques to improve safety further. Preoperative preparation involving anaesthetists and radiologists if complications are anticipated has contributed to improved outcome. Good surgical training is paramount, particularly because

  7. Surgical complications of amyloid disease.

    PubMed Central

    O'Doherty, D. P.; Neoptolemos, J. P.; Bouch, D. C.; Wood, K. F.

    1987-01-01

    The case of a man with primary systemic amyloidosis without myelomatosis and long-term survival is described. The patient has had major surgical complications from large amyloid deposits in the colon, dorsal spine and peritoneal cavity. The patient remains well 14 years after diagnosis. Images Figure 1 Figure 2 Figure 3 Figure 4 PMID:3684836

  8. Fetal complications of obstetric cholestasis

    Microsoft Academic Search

    RICHARD REID; K J Ivey; R H Rencoret; B Storey

    1976-01-01

    Among 56 pregnancies complicated by obstetric cholestasis five intrauterine deaths and one neonatal death occurred between 33 and 39 weeks, and a further six infants required urgent delivery for intrapartum asphyxia. Eighteen spontaneous premature deliveries occurred. Five mothers required specific treatment for unexplained postpartum haemorrhage. Cholestasis of pregnancy is therefore not a condition benign to the fetus, and it may

  9. Cutaneous vasculitis complicating coeliac disease

    Microsoft Academic Search

    S Meyers; S Dikman; H Spiera; N Schultz; H D Janowitz

    1981-01-01

    A 38 year old female, with chronic uncontrolled coeliac disease, presented with the rare complication of cutaneous leucocytoclastic vasculitis. Detailed study failed to identify any cause for the vasculitis, other than the underlying coeliac disease. Haematuria and proteinuria with mesangial nephritis were also demonstrated on renal biopsy with electron microscopic study. It is speculated that exogenous or endogenous antigens permeated

  10. Neurological Complications of VZV Reactivation

    PubMed Central

    Nagel, Maria A.

    2014-01-01

    Purpose of the review Varicella zoster virus (VZV) reactivation results in zoster, which may be complicated by postherpetic neuralgia, myelitis, meningoencephalitis and VZV vasculopathy. This review highlights the clinical features, laboratory abnormalities, imaging changes and optimal treatment of each of those conditions. Because all of these neurological disorders produced by VZV reactivation can occur in the absence of rash, the virological tests proving that VZV caused disease are discussed. Recent findings After primary infection, VZV becomes latent in ganglionic neurons along the entire neuraxis. With a decline in VZV-specific cell-mediated immunity, VZV reactivates from ganglia and travels anterograde to the skin to cause zoster, which is often complicated by postherpetic neuralgia. VZV can also travel retrograde to produce meningoencephaltis, myelitis and stroke. When these complications occur without rash, VZV-induced disease can be diagnosed by detection of VZV DNA or anti-VZV antibody in CSF and treated with intravenous acyclovir. Summary Awareness of the expanding spectrum of neurological complications caused by VZV reactivation with and without rash will improve diagnosis and treatment. PMID:24792344

  11. The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Study at 30 Years: Overview

    PubMed Central

    Nathan, David M.

    2014-01-01

    OBJECTIVE The Diabetes Control and Complications Trial (DCCT) was designed to test the glucose hypothesis and determine whether the complications of type 1 diabetes (T1DM) could be prevented or delayed. The Epidemiology of Diabetes Interventions and Complications (EDIC) observational follow-up determined the durability of the DCCT effects on the more-advanced stages of diabetes complications including cardiovascular disease (CVD). RESEARCH DESIGN AND METHODS The DCCT (1982–1993) was a controlled clinical trial in 1,441 subjects with T1DM comparing intensive therapy (INT), aimed at achieving levels of glycemia as close to the nondiabetic range as safely possible, with conventional therapy (CON), which aimed to maintain safe asymptomatic glucose control. INT utilized three or more daily insulin injections or insulin pump therapy guided by self-monitored glucose. EDIC (1994–present) is an observational study of the DCCT cohort. RESULTS The DCCT followed >99% of the cohort for a mean of 6.5 years and demonstrated a 35–76% reduction in the early stages of microvascular disease with INT, with a median HbA1c of 7%, compared with CONV, with a median HbA1c of 9%. The major adverse effect of INT was a threefold increased risk of hypoglycemia, which was not associated with a decline in cognitive function or quality of life. EDIC showed a durable effect of initial assigned therapies despite a loss of the glycemic separation (metabolic memory) and demonstrated that the reduction in early-stage complications during the DCCT translated into substantial reductions in severe complications and CVD. CONCLUSIONS DCCT/EDIC has demonstrated the effectiveness of INT in reducing the long-term complications of T1DM and improving the prospects for a healthy life span. PMID:24356592

  12. [Renal biopsy: procedures, contraindications, complications].

    PubMed

    Lefaucheur, Carmen; Nochy, Dominique; Bariety, Jean

    2009-07-01

    Renal biopsy plays a central role in the investigational approach of the nephrologist. The technique has significantly improved over the past two decades as a result of the introduction of ultrasonography and automated-gun biopsy devices. Percutaneous renal biopsy has become a relatively safe procedure with life-threatening complications occurring in less than 0.1% of biopsies in recent reports. However, percutaneous kidney biopsy is not without risk. Overt complications occurring in up to 13% of the cases, and 6 to 7% of complications were considered major, needing for an intervention such as transfusion of blood product or invasive procedure (radiographic or surgical). Major complications were apparent in more than 90% of patients by 24 hours. In situations in which the potential benefit of obtaining renal histology outweighs the risks of the procedure, transjugular kidney biopsy or surgical biopsy offers an attractive alternative. At present, we have no definite predictive indicators of postbiopsy bleeding complication, with the exception of age, gender, advanced renal insufficiency and the baseline partial thromboplastin time. Bleeding time is not significantly predictive and has been reported to have substantial limitations as a screening test. The use of the PFA-100 may replace the bleeding time and is now considered as a more valuable screening test for prebiopsy identification and management of patients with impaired haemostasis. Four groups of patients benefit from the findings of renal biopsy: those with a nephrotic syndrome, those with a renal disease in a context of systemic disorder, those with acute renal failure and those with a renal transplant. Some patients with non-nephrotic proteinuria, hematuria and chronic renal failure may also benefit from the procedure. PMID:19345174

  13. Complications of chronic suppurative otitis media: a retrospective review.

    PubMed

    Yorganc?lar, E; Yildirim, M; Gun, R; Bakir, S; Tekin, R; Gocmez, C; Meric, F; Topcu, I

    2013-01-01

    The purpose of this study was to review our patients with complications of chronic suppurative otitis media (CSOM) and compare with literature. This retrospective study was performed over 10 years in our tertiary referral university hospital. During this period 4,630 patients with CSOM were admitted to the department and 906 patients underwent a surgery. From the records of the 4,630 patients, 121 patients (2.6%) with complications were identified. Of the 906 CSOM patients that underwent a surgery, 511 had cholesteatoma, and 395 had granulation and/or polyp tissue. Ninety-four of 511 (18.4%) patients with cholesteatoma and 27 of 395 (6.8%) patients with granulation and/or polyp tissue had a complication. Of the 121 complicated CSOM patients, 57 extracranial (47.1%) and 37 intracranial (30.6%). Multiple combined complications were occurred in 27 (22.3%) patients. The mastoid abscess was the commonest extracranial complication (28.3%); it was followed by labyrinthitis (9%), facial nerve paralysis (8.4%), and Bezold's abscess (1.3%). The most common intracranial complication was lateral sinus thrombophlebitis (19.5%), followed by perisigmoid sinus abscess (13.5%), meningitis (9%), brain abscess (6.5%), and extradural abscess (4.5%). Most frequent intraoperative finding of complicated CSOM patients was cholesteatoma, with the exception of patients with facial nerve paralysis. There was no mortality in any of our patients. The additional morbidities were recorded in 25 patients (20.6%). In this study, we emphasize the importance of an accurate and early diagnosis, followed by adequate surgical therapy and a multidisciplinary approach. PMID:22249835

  14. Hematologic effects and complications of snake envenoming.

    PubMed

    Berling, Ingrid; Isbister, Geoffrey K

    2015-04-01

    Hematologic abnormalities are the most common effects of snake envenoming globally. Venom-induced consumption coagulopathy (VICC) is the commonest and most important. Other hematologic abnormalities are an anticoagulant coagulopathy and thrombotic microangiopathy. Venom-induced consumption coagulopathy is a venom-induced activation of the clotting pathway by procoagulant toxins, resulting in clotting factor consumption and coagulopathy. The type of procoagulant toxin differs between snakes and can activate prothrombin, factor X, and factor V or consume fibrinogen. The most useful investigation in VICC is a prothrombin time/international normalized ratio. The d-dimer may assist in early diagnosis, but fibrinogen levels often add little in the clinical setting. Bedside investigations would be ideal, but point-of-care testing international normalized ratio and whole blood clotting tests have been shown to be unreliable in VICC. The major complication of VICC is hemorrhage, including intracranial hemorrhage which is often fatal. The role of antivenom in VICC is controversial and may only be beneficial for some types of snakes including Echis spp where the duration of abnormal clotting is reduced from more than a week to 24 to 48 hours. In contrast, antivenom does not appear to speed the recovery of VICC in Australian snake envenoming. Other treatments for VICC include factor replacement, observation and prevention of trauma, and heparin. An Australian study showed that fresh-frozen plasma speeds recovery of VICC, but early use may increase consumption. There is no evidence to support heparin. PMID:25556574

  15. Impact of medical therapies on inflammatory bowel disease complication rate.

    PubMed

    Reenaers, Catherine; Belaiche, Jacques; Louis, Edouard

    2012-08-01

    Crohn's disease and ulcerative colitis are progressive diseases associated with a high risk of complications over time including strictures, fistulae, perianal complications, surgery, and colorectal cancer. Changing the natural history and avoiding evolution to a disabling disease should be the main goal of treatment. In recent studies, mucosal healing has been associated with longer-term remission and fewer complications. Conventional therapies with immunosuppressive drugs are able to induce mucosal healing in a minority of cases but their impact on disease progression appears modest. Higher rates of mucosal healing can be achieved with anti-tumor necrosis factor therapies that reduce the risk of relapse, surgery and hospitalization, and are associated with perianal fistulae closure. These drugs might be able to change the natural history of the disease mainly when introduced early in the course of the disease. Treatment strategy in inflammatory bowel diseases should thus be tailored according to the risk that each patient could develop disabling disease. PMID:22876033

  16. Delayed presentation of traumatic diaphragmatic rupture with complicated cholecystitis

    PubMed Central

    Chun, Jae Min

    2013-01-01

    The right-sided diaphragmatic rupture is often clinically occulted due to buffering effects of the liver and thus, erroneous diagnosis of such rupture may result in life-threatening conditions. A 44-year-old female who had a history of car accident in 2006 was admitted to our hospital for pleuritic pain. On the chest computed tomography, she was diagnosed with diaphragmatic rupture accompanied by herniation of hypertrophic left liver with complicated cholecystitis and we carried out cholecystectomy, reduction of the liver, pleural drainage, and primary closure of the diaphragm via thoracic approaches. Our case is presented in three unique aspects: herniation of left hemiliver, hypertrophic liver herniated up to the 4th rib level, and combination of complicated cholecystitis. Although the diagnosis of right-sided diaphragmatic rupture can be challenging for the surgeon, an early diagnosis can prevent further complications on the clinical presentation.

  17. Cardiovascular Complications in CKD Patients: Role of Oxidative Stress

    PubMed Central

    Gosmanova, Elvira O.; Le, Ngoc-Anh

    2011-01-01

    Starting with the early stages, patients with chronic kidney disease (CKD) experience higher burden of cardiovascular disease (CVD). Moreover, CVD complications are the major cause of mortality in CKD patients as compared with complications from chronic kidney failure. While traditional CVD risk factors, including diabetes, hypertension, hyperlipidemia, obesity, physical inactivity, may be more prevalent among CKD patients, these factors seem to underestimate the accelerated cardiovascular disease in the CKD population. Search for additional biomarkers that could explain the enhanced CVD risk in CKD patients has gained increasing importance. Although it is unlikely that any single nontraditional risk factor would fully account for the increased CVD risk in individuals with CKD, oxidative stress appears to play a central role in the development and progression of CVD and its complications. We will review the data that support the contribution of oxidative stress in the pathogenesis of CVD in patients with chronic kidney failure. PMID:21253517

  18. Mesenteric malperfusion complicated with type A acute aortic dissection.

    PubMed

    Takagi, H; Watanabe, T; Umemoto, T

    2015-10-01

    Type A acute aortic dissection (AAAD), involving the ascending aorta, is one of life-threatening disorders. Emergent surgery, such as graft replacement of the aortic root, ascending aorta, aortic arch, or these combinations, is routinely performed to avoid sudden death due to free rupture, cardiac tamponade, or coronary obstruction. Even though appropriate surgery is immediately completed, however, operative mortality remains high, between 15% and 30%. Furthermore, mesenteric malperfusion, bringing about enteric ischemia, occurs unusually in AAAD with far and away higher mortality. In the present article, we reviewed contemporary evidence regarding incidence, mortality, and treatment of mesenteric malperfusion complicated with AAAD. The incidence and early mortality rate of mesenteric malperfusion complicated with AAAD was 4% and 68%, respectively. Patients with mesenteric malperfusion had a 9.7-fold risk of mortality relative to those without it. Evidence regarding optimal treatment of mesenteric malperfusion complicated with AAAD is very limited. PMID:25077517

  19. Complications of acute otitis media in children

    Microsoft Academic Search

    Kimmo Leskinen

    2005-01-01

    The clinical picture and the treatment of acute otitis media (AOM) and its complications have changed during the past decades.\\u000a The availability of antibiotics has decreased the incidence of complications of AOM significantly. The treatment of complications\\u000a of AOM is conservative in most cases. Mastoidectomy is needed when abscess-forming mastoiditis or intracranial complications\\u000a develop. Although intratemporal and intracranial complications of

  20. Avoiding complications in patellofemoral surgery.

    PubMed

    Harrison, Ryan K; Magnussen, Robert A; Flanigan, David C

    2013-06-01

    The diagnosis and treatment of patellofemoral disorders can challenge even the experienced orthopedic surgeon. Differential diagnosis is broad and multiple anatomic abnormalities must be taken into account in order to manage care. The majority of patients with patellofemoral disorders can be treated successfully nonoperatively. When nonoperative management fails, and in the carefully selected patient, a variety of surgical options exist based on the anatomic pathology involved, but each brings its own potential for complication. We discuss several of the surgical treatment options that are available to the orthopedic surgeon for the treatment of patellofemoral disorders, including lateral retinacular release, medial soft-tissue reconstructive procedures, and bony procedures (including trochleoplasty and tibial tubercle osteotomy. We describe potential complications of each procedure and what the orthopedic surgeon can do to avoid them. PMID:23649160

  1. Complications of Laparoscopic Donor Nephrectomy

    Microsoft Academic Search

    Alexei Wedmid; Michael A. Palese

    \\u000a “Laparoscopic donor nephrectomy is a unique surgical procedure due to the fact that the surgeon is operating on a healthy\\u000a individual in order to benefit another patient he or she is unlikely managing, with a potential for complications ensuing\\u000a in both the donor and the recipient patients. Overall surgical technique, anatomic considerations, and perioperative management\\u000a remain important for minimizing the

  2. Eczema herpeticum complicating Parthenium dermatitis.

    PubMed

    Prabhakar, Ajith C; Dogra, Sunil; Handa, Sanjeev

    2005-06-01

    Parthenium dermatitis is one of the most common causes of airborne contact dermatitis in India. Eczema herpeticum has been reported in association with various eczematous conditions, including Parthenium dermatitis. We report a case of eczema herpeticum in association with Parthenium dermatitis. Because Parthenium dermatitis is a common condition in this region, one should be aware of this complication so that appropriate treatment is not delayed. PMID:16036117

  3. Oral complications in cancer patients

    SciTech Connect

    Carl, W.

    1983-02-01

    Ionizing radiation used in treating the head and neck area produces oral side effects such as mucositis, salivary changes, trismus and radiation caries. Sequelae of cancer chemotherapy often include oral stomatitis, myelosuppression and immunosuppression. Infections of dental origin in compromised patients are potentially lethal. Specific programs to eliminate dental pathology before radiation and chemotherapy, and to maintain oral hygiene during and after therapy, will minimize these complications.

  4. Neurologic complications after liver transplantation

    PubMed Central

    Živkovi?, Saša A

    2013-01-01

    Neurologic complications are relatively common after solid organ transplantation and affect 15%-30% of liver transplant recipients. Etiology is often related to immunosuppressant neurotoxicity and opportunistic infections. Most common complications include seizures and encephalopathy, and occurrence of central pontine myelinolysis is relatively specific for liver transplant recipients. Delayed allograft function may precipitate hepatic encephalopathy and neurotoxicity of calcineurin inhibitors typically manifests with tremor, headaches and encephalopathy. Reduction of neurotoxic immunosuppressants or conversion to an alternative medication usually result in clinical improvement. Standard preventive and diagnostic protocols have helped to reduce the prevalence of opportunistic central nervous system (CNS) infections, but viral and fungal CNS infections still affect 1% of liver transplant recipients, and the morbidity and mortality in the affected patients remain fairly high. Critical illness myopathy may also affect up to 7% of liver transplant recipients. Liver insufficiency is also associated with various neurologic disorders which may improve or resolve after successful liver transplantation. Accurate diagnosis and timely intervention are essential to improve outcomes, while advances in clinical management and extended post-transplant survival are increasingly shifting the focus to chronic post-transplant complications which are often encountered in a community hospital and an outpatient setting. PMID:24023979

  5. A Rare Complication of Adjustable Gastric Banding:Wernicke's Encephalopathy

    Microsoft Academic Search

    Alp Bozbora; Halil Coskun; Selcuk Özarmagan; Yesin Erbil; Nese Özbey; Yusef Orhan

    2000-01-01

    Background:Wernicke'sencephalopathy is an uncommon complication seen after morbid obesity surgery. Neurological and cardiac\\u000a symptoms can occur. Early and adequate replacement of thiamin is crucial. Methods: A patient, who was operated by adjustable\\u000a silicone gastric banding had severe vomiting 1 week after the operation. Physical examination showed no abnormalities except\\u000a neurological signs consisting of ataxia, disorientation and diplopia. All radiological and

  6. Anterior cruciate ligament reconstruction complicated by pyoderma gangrenosum.

    PubMed

    Bagouri, E; Smith, Jon; Geutjens, G

    2012-11-01

    We report a case of pyoderma gangrenosum as a complication of an anterior cruciate ligament reconstruction in a patient with inflammatory bowel disease, which was misdiagnosed initially as a post-operative wound infection. An early dermatology opinion and skin biopsy should be considered in cases of suspected infection where thorough surgical debridement and antimicrobial therapy has failed to improve the clinical picture. PMID:23131219

  7. Distal tibia fractures: management and complications of 101 cases.

    PubMed

    Joveniaux, Pierre; Ohl, Xavier; Harisboure, Alain; Berrichi, Aboubekr; Labatut, Ludovic; Simon, Patrick; Mainard, Didier; Vix, Nicolas; Dehoux, Emile

    2010-04-01

    Distal tibia fractures are complex injuries with a high complication rate. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Between 2002 and 2004, 104 patients were admitted for 105 distal tibia fractures. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12-46). Internal fixation, external fixation, limited internal fixation (K-wires or screws), intramedullary nailing and conservative treatment were used. Outcome parameters included occurrence of complications, radiographic analysis, evaluation of the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and measures of the ankle range of motion. The average functional score was 76 points (range, 30-100 points), and complications occurred in 30 patients. Predictive factors of poor results were fracture severity, complications, malunion and the use of external fixation. We believe that external fixation must be reserved for trauma with severe skin injury, as a temporary solution in a two-staged protocol. For other cases, we recommend ORIF with early mobilisation. PMID:19554328

  8. [Special surgical complications in chronic inflammatory bowel diseases].

    PubMed

    Kroesen, A J

    2015-04-01

    After colorectal and anorectal interventions for chronic inflammatory bowel diseases, specific complications can occur.In Crohn's disease these complications mainly occur after proctocolectomy. Pelvic sepsis can be prevented by omentoplasty with fixation inside the pelvis. A persisting sepsis of the sacral cavity can be treated primarily by dissection of the anal sphincter which ensures better drainage. In cases of chronic sacral sepsis, transposition of the gracilis muscle is a further effective option. Early recurrence of a transsphincteric anal fistula should be treated by reinsertion of a silicon seton drainage.Complications after restorative proctocolectomy are frequent and manifold (35%). The main acute complications are anastomotic leakage and pelvic sepsis. Therapy consists of transperineal drainage of the abscess with simultaneous transanal drainage. Late complications due to technical and septic reasons are still a relevant problem even 36 years after introduction of this operative technique. A consistent approach with detailed diagnostic and surgical therapy results in a 75% rescue rate of ileoanal pouches. PMID:25693779

  9. Clinical experience with hyaluronic acid-filler complications.

    PubMed

    Park, Tae-Hwan; Seo, Sang-Won; Kim, June-Kyu; Chang, Choong-Hyun

    2011-07-01

    Hyaluronic acid (HA) fillers have become the material of choice for soft-tissue augmentation. HA fillers are longer lasting, less immunogenic and can be broken down by hyaluronidase. These advantages make HA fillers the most common of the temporary fillers on the market. However, early and delayed complications, ranging from minor to severe, can occur following HA-filler injection. We evaluated and treated 28 cases of HA-filler-related complications that were referred to our hospital over a period of 5 years from July 2004 to October 2009. Twenty-eight patients were included in our study; 82.1% of the patients were female and 17.9% were male. Complications were roughly classified as nodular masses, inflammation, tissue necrosis and dyspigmentation. Affected locations, in descending order of frequency, were the perioral area, forehead, including glabella, nose, nasolabial fold, mentum, including marionette wrinkles, cheek area and periocular wrinkles. The most disastrous complication was alar rim necrosis following injection of the nasolabial fold. We propose two 'danger zones' that are particularly vulnerable to tissue necrosis following filler injection: the glabella and nasal ala. Although there is no definite treatment modality for the correction of HA-filler complications, we have managed them with various available treatment modalities aimed at minimising patient morbidity. PMID:21310674

  10. Complications after ileal pouch-anal anastomosis in Korean patients with ulcerative colitis

    PubMed Central

    Ryoo, Seung-Bum; Oh, Heung-Kwon; Han, Eon Chul; Ha, Heon-Kyun; Moon, Sang Hui; Choe, Eun Kyung; Park, Kyu Joo

    2014-01-01

    AIM: To investigate the outcomes of treatments for complications after ileal pouch-anal anastomosis (IPAA) in Korean patients with ulcerative colitis. METHODS: Between March 1998 and February 2013, 72 patients (28 male and 44 female, median age 43.0 years ± 14.0 years) underwent total proctocolectomy with IPAA. The study cohort was registered prospectively and analyzed retrospectively. Patient characteristics, medical management histories, operative findings, pathology reports and postoperative clinical courses, including early postoperative and late complications and their treatments, were reviewed from a medical record system. All of the ileal pouches were J-pouch and were performed with either the double-stapling technique (n = 69) or a hand-sewn (n = 3) technique. RESULTS: Thirty-one (43.1%) patients had early complications, with 12 (16.7%) patients with complications related to the pouch. Pouch bleeding, pelvic abscesses and anastomosis ruptures were managed conservatively. Patients with pelvic abscesses were treated with surgical drainage. Twenty-seven (38.0%) patients had late complications during the follow-up period (82.5 ± 50.8 mo), with 21 (29.6%) patients with complications related to the pouch. Treatment for pouchitis included antibiotics or anti-inflammatory drugs. Pouch-vaginal fistulas, perianal abscesses or fistulas and anastomosis strictures were treated surgically. Pouch failure developed in two patients (2.8%). Analyses showed that an emergency operation was a significant risk factor for early pouch-related complications compared to elective procedures (55.6% vs 11.1%, P < 0.05). Pouchitis was related to early (35.3%) and the other late pouch-related complications (41.2%) (P < 0.05). The complications did not have an effect on pouch failure nor pouch function. CONCLUSION: The complications following IPAA can be treated successfully. Favorable long-term outcomes were achieved with a lower pouch failure rate than reported in Western patients. PMID:24966620

  11. Perioperative thrombotic complications in liver transplantation

    PubMed Central

    Feltracco, Paolo; Barbieri, Stefania; Cillo, Umberto; Zanus, Giacomo; Senzolo, Marco; Ori, Carlo

    2015-01-01

    Although the perioperative bleeding complications and the major side effects of blood transfusion have always been the primary concern in liver transplantation (OLT), the possible cohesion of an underestimated intrinsic hypercoagulative state during and after the transplant procedure may pose a major threat to both patient and graft survival. Thromboembolism during OLT is characterized not only by a complex aetiology, but also by unpredictable onset and evolution of the disease. The initiation of a procoagulant process may be triggered by various factors, such as inflammation, venous stasis, ischemia-reperfusion injury, vascular clamping, anatomical and technical abnormalities, genetic factors, deficiency of profibrinolytic activity, and platelet activation. The involvement of the arterial system, intracardiac thrombosis, pulmonary emboli, portal vein thrombosis, and deep vein thrombosis, are among the most serious thrombotic events in the perioperative period. The rapid detection of occlusive vascular events is of paramount importance as it heavily influences the prognosis, particularly when these events occur intraoperatively or early after OLT. Regardless of the lack of studies and guidelines on anticoagulant prophylaxis in this setting, many institutions recommend such an approach especially in the subset of patients at high risk. However, the decision of when, how and in what doses to use the various chemical anticoagulants is still a difficult task, since there is no common consensus, even for high-risk cases. The risk of postoperative thromboembolism causing severe hemodynamic events, or even loss of graft function, must be weighed and compared with the risk of an important bleeding. In this article we briefly review the risk factors and the possible predictors of major thrombotic complications occurring in the perioperative period, as well as their incidence and clinical features. Moreover, the indications to pharmacological prophylaxis and the current treatment strategies are also summarized. PMID:26185371

  12. Risks of complication following thyroidectomy

    Microsoft Academic Search

    Mark R. Burge; Tanja-Maria Zeise; Michael W. Johnsen; Martin J. Conway; Clifford R. Qualls

    1998-01-01

    OBJECTIVE: Because hypoparathyroidism is a serious complication of thyroidectomy, we attempted to elucidate factors determining the\\u000a risk of this postoperative outcome.\\u000a \\u000a \\u000a SETTING: Four tertiary care hospitals in Albuquerque, New Mexico.\\u000a \\u000a \\u000a \\u000a \\u000a PATIENTS: A retrospective study of 142 patients who underwent total or subtotal thyroidectomy between 1988 and 1995.\\u000a \\u000a \\u000a \\u000a \\u000a MEASUREMENTS AND MAIN RESULTS: Permanent hypoparathyroidism was defined as hypocalcemic symptoms plus a

  13. Vaccinia necrosum complicating immunoblastic sarcoma.

    PubMed

    Turkel, S B; Overturf, G D

    1977-07-01

    A 59-year-old man is presented who had immunoblastic lymphadenopathy which evolved over a three-year period into immunoblastic sarcoma. His course was complicated by vaccinia necrosum, which necessitated prolonged therapy with Marboran and vaccinia-immune globulin. The persistence of virus was documented at autopsy by positive viral culture and ultra-structural examination. This case illustrates the potential hazards of administration of live viral vaccines to an immune compromised host presumed to be in remission and suggests that the continued activity of viral infection may signal the unsuspected persistence of underlying disease. PMID:880554

  14. Automatic Monitoring Of Complicated Systems

    NASA Technical Reports Server (NTRS)

    Schwuttke, Ursula M.

    1990-01-01

    Collection of computer programs developed for expert computer system performing complicated, tedious, and repetitive portions of analysis of telemetry data from spacecraft. Provides nonstop, accurate surveillance of incoming data, also frees operators to concentrate their expertise on unexpected abnormal operating conditions. When unable to explain discrepancies with certainty resulting from data out of synchronization or other falso-alarm conditions, triggers alarm devices to request assistance from designated individuals. Concept useful in such terrestrial systems as production lines, power-distribution networks, chemical processes, large airplanes, and other assemblies of interdependent equipment.

  15. Pulmonary complications of inflammatory myopathy.

    PubMed

    Miller, Shelly A; Glassberg, Marilyn K; Ascherman, Dana P

    2015-05-01

    Pulmonary complications cause significant morbidity and mortality in the idiopathic inflammatory myopathies. Advances in biomarker discovery have facilitated clinical phenotyping, allowing investigators to better define at-risk patient subsets and to potentially gauge disease activity. This serologic characterization has complemented more traditional assessment tools. Pharmacologic management continues to rely on the use of corticosteroids, often in combination with additional immunosuppressive agents. The rarity of myositis-associated interstitial lung disease and lack of controlled trials have limited analyses of treatment efficacy, mandating the development of standardized outcome measures and improvement of data sharing between disciplines. PMID:25836641

  16. [Cardiovascular complications of alpha interferon].

    PubMed

    Le Corguillé, Monika; Pochmalicki, Gilbert; Eugène, Claude

    2007-12-01

    Interferon-alpha is a biological response modifier with antiviral and tumoral effect that is used in the treatment of chronic viral hepatitis. Cardiovascular complications occurred in clinical trials of interferon. The most common presentations of cardio toxicity were cardiac arrhythmia, dilated cardiomyopathy, atrial extrasystole and symptoms of ischemic heart disease, including myocardial infarction and other effects less common and dangerous: low-level conduction impairment or reversible hypertension. The physiopathology of this cardiotoxicity remains unknown, but rigorous cardiological monitoring of all patients receiving this treatment seems necessary. PMID:18176361

  17. Oral Complications of HIV Disease

    PubMed Central

    Leao, Jair C.; Ribeiro, Camila M. B.; Carvalho, Alessandra A. T.; Frezzini, Cristina; Porter, Stephen

    2009-01-01

    Oral lesions are among the early signs of HIV infection and can predict its progression to acquired immunodeficiency syndrome (AIDS). A better understanding of the oral manifestations of AIDS in both adults and children has implications for all health care professionals. The knowledge of such alterations would allow for early recognition of HIV-infected patients. The present paper reviews epidemiology, relevant aspects of HIV infection related to the mouth in both adults and children, as well as current trends in antiretroviral therapy and its connection with orofacial manifestations related to AIDS. PMID:19488613

  18. Complications of herpes zoster in cancer patients.

    PubMed

    Tran, Trung N; Ray, G Thomas; Horberg, Michael A; Yawn, Barbara P; Castillo, Adrienne L; Saddier, Patricia; Habel, Laurel A

    2014-07-01

    Cancer patients tend to have a higher incidence of herpes zoster (HZ), but little is known about their risk of HZ complications. We conducted a retrospective study of 424 newly diagnosed hematologic (HM, n = 140) and solid tumor malignancy (STM, n = 284) patients who developed HZ between January 2001 and December 2006 to measure the frequency and identify risk factors of HZ complications. Patients were adult members of Kaiser Permanente Northern California. HZ diagnosis and complications were confirmed by medical chart review. HM patients with HZ tended to have more HZ complications than STM patients (34% vs 23%, p = 0.02), largely due to more frequent non-pain complications. On multivariate analysis, older age and being male were associated with a higher risk of HZ complications in HM patients; more advanced cancer stage was associated with HZ complications in STM patients. HZ complications are frequent and can present extra disease burden in cancer patients who develop HZ. PMID:24796470

  19. Spinal cord dysfunction complicating meningococcal meningitis

    Microsoft Academic Search

    J. Khan; I. Altafullah; M. Ishaq

    1990-01-01

    A 29 year old male developed paraplegia during the acute phase of meningococcal meningitis. Possible mechanisms for this unusual complication are discussed and the literature regarding spinal cord complications of pyogenic meningitis is reviewed.

  20. Managing Complications of Diabetes in Later Life

    MedlinePLUS

    ... previous page Related Topics Diabetes Related Documents PDF Living with Diabetes Download PDF Managing Complications of Diabetes in Later Life Download Join our e-newsletter! Resources Managing Complications ...

  1. Epigenetic phenomena linked to diabetic complications

    Microsoft Academic Search

    Luciano Pirola; Aneta Balcerczyk; Jun Okabe; Assam El-Osta

    2010-01-01

    Diabetes mellitus (type 1 and type 2) and the complications associated with this condition are an urgent public health problem, as the incidence of diabetes mellitus is steadily increasing. Environmental factors, such as diet and exposure to hyperglycemia, contribute to the etiology of diabetes mellitus and its associated microvascular and macrovascular complications. These vascular complications are the main cause of

  2. Hemoglobin and Hematocrit Levels in the Prediction of Complicated Crohn's Disease Behavior – A Cohort Study

    PubMed Central

    Rieder, Florian; Paul, Gisela; Schnoy, Elisabeth; Schleder, Stephan; Wolf, Alexandra; Kamm, Florian; Dirmeier, Andrea; Strauch, Ulrike; Obermeier, Florian; Lopez, Rocio; Achkar, Jean-Paul; Rogler, Gerhard; Klebl, Frank

    2014-01-01

    Background Markers that predict the occurrence of a complicated disease behavior in patients with Crohn's disease (CD) can permit a more aggressive therapeutic regimen for patients at risk. The aim of this cohort study was to test the blood levels of hemoglobin (Hgb) and hematocrit (Hct) for the prediction of complicated CD behavior and CD related surgery in an adult patient population. Methods Blood samples of 62 CD patients of the German Inflammatory Bowel Disease-network “Kompetenznetz CED” were tested for the levels of Hgb and Hct prior to the occurrence of complicated disease behavior or CD related surgery. The relation of these markers and clinical events was studied using Kaplan-Meier survival analysis and adjusted COX-proportional hazard regression models. Results The median follow-up time was 55.8 months. Of the 62 CD patients without any previous complication or surgery 34% developed a complication and/or underwent CD related surgery. Low Hgb or Hct levels were independent predictors of a shorter time to occurrence of the first complication or CD related surgery. This was true for early as well as late occurring complications. Stable low Hgb or Hct during serial follow-up measurements had a higher frequency of complications compared to patients with a stable normal Hgb or Hct, respectively. Conclusions Determination of Hgb or Hct in complication and surgery naïve CD patients might serve as an additional tool for the prediction of complicated disease behavior. PMID:25116048

  3. Risk factors for postoperative respiratory complications in adult liver transplant recipients.

    PubMed

    Pirat, A; Ozgur, S; Torgay, A; Candan, S; Zeynelo?lu, P; Arslan, G

    2004-01-01

    To determine the types and the incidence of as well as risk factors for early postoperative (<30 days) respiratory complications in adult liver transplant (LT) recipients, we reviewed The data of 44 consecutive adult LT recipients who received their grafts from January 1995 through December 2002. The data included demographic features; primary diagnosis; number of intraoperative transfusions; preoperative and postoperative laboratory values; intraoperative and postoperative characteristics; and early postoperative (<30 days) mortality. Pulmonary atelectasis, pleural effusion, pneumonia, respiratory failure, and pulmonary edema were the respiratory complications investigated. Twenty-six patients (59.1%) developed at least one respiratory complication during the early postoperative period. The most frequent complication was pleural effusion (n = 18, 40.9%), followed by atelectasis (n = 13, 29.5%), pneumonia (n = 10, 22.7%), acute respiratory failure (n = 5, 11.4%), pulmonary edema (n = 3, 6.8%), and pneumothorax (n = 2, 4.5%). Compared to the patients who did not develop these problems, the affected cohort was significantly older (27 +/- 12 years vs 36 +/- 14 years, respectively; P =.039) and required more intraoperative transfusions (P =.005). Among the overall mortality rate of 15.9%, patients who developed pneumonia showed a significantly higher mortality (40.0% vs 8.8%, respectively; P =.037). Pleural effusion, atelectasis, and pneumonia are the main respriatory complications that occur in adult LT recipients. Patient age and intraoperative transfusion requirements are important predictors of early postoperative complications. Pneumonia is associated with a poor prognosis in this patient group. PMID:15013351

  4. Single incision laparoscopic cholecystectomy: A review on the complications

    PubMed Central

    Fransen, Sofie; Stassen, L.; Bouvy, N.

    2012-01-01

    BACKGROUND: The aim of this study was to establish the incidence of postoperative complications after single incision laparoscopic cholecystectomy. MATERIALS AND METHODS: A literature search was performed using the PubMed database. Search terms included single incision laparoscopic cholecystectomy, single port cholecystectomy, minimal invasive laparoscopic cholecystectomy, nearly scarless cholecystectomy and complications. RESULTS: A total of 38 articles meeting the selection criteria were reviewed. A total of 1180 patients were selected to undergo single incision laparoscopic cholecystectomy. Introduction of extra ports was necessary in 4% of the patients. Conversion to open cholecystectomy was required in 0.4% of the patients. Laparoscopic cholangiography was attempted in 4% of the patients. The incidence of major complications requiring surgical intervention or ERCP with stenting was 1.7%. The mortality rate was zero. CONCLUSION: Although the number of complications after single incision laparoscopic cholecystectomy seems favourable, it is too early to conclude that single incision laparoscopic cholecystectomy is a safe procedure. Large randomised controlled trials will be necessary to further establish its safety. PMID:22303080

  5. Maternal serum soluble HLA-G in complicated pregnancies.

    PubMed

    B?y?k, Ismail

    2014-03-01

    Preeclampsia, intrauterine growth retardation (IUGR), oligohydramnios, abortus, preterm birth and premature rupture of the membranes (PROM) are significant complications of pregnancy. Insufficient trophoblastic invasion plays an important role in the pathophysiology of pregnancy complications. Soluble human leukocyte antigen-gestation (HLA-G)1/G5 is a molecule associated with trophoblast invasion. When pregnancy complications are predicted early, strategies to prevent these complications can be implemented. The aim of this study was to investigate the relationship between first trimester maternal serum soluble HLA-G1/G5 levels and high-risk pregnancies. A total of 232 pregnant women were followed prospectively. Maternal blood samples were collected for determination of soluble HLA-G1/G5 levels at 11-14 weeks, during which routine serum free beta human chorionic gonadotropin (?hCG) and pregnancy associated plasma protein-A (PAPP-A) level determinations in addition to nuchal translucency (NT) measurements for Down's syndrome screening were done during 20-22 weeks gestation. The subjects were classified into normal pregnancy, preeclampsia, oligohydramnios, IUGR, preterm birth and PROM groups. First trimester maternal serum soluble HLA-G1/G5 levels were not significantly different between the groups. First trimester soluble HLA-G1/G5 did not predict high-risk pregnancies. Studies with larger number of cases are need to confirm our findings. PMID:23795671

  6. Cardiovascular complications of chronic renal failure - an updated review.

    PubMed

    Roy, G C; Sutradhar, S R; Barua, U K; Datta, N C; Debnath, C R; Hoque, M M; Hossain, A S; Haider, M S; Das, M

    2012-07-01

    Chronic kidney disease (CKD) is a worldwide public health problem. Cardiovascular disease (CVD) is frequently associated with CKD, which is important because individuals with CKD are more likely to die from CVD than to develop kidney failure. CVD in CKD is treatable and potentially preventable and CKD appears to be a risk factor for CVD. In order of incidence and frequency systemic hypertension, left ventricular failure, congestive cardiac failure, ischemic heart disease, anaemic heart failure, rhythm disturbances, pericarditis with or without effusion, cardiac tamponade, uraemic cardiomyopathy are various cardiovascular complications encountered in patients with chronic renal failure. A patient may present with one or more complications of cardiovascular system. The survival rate and prognosis to a great extent depends on proper management of these complications. Use of regular dialysis and renal transplant has changed the death pattern in developed countries but it is still a major problem in developing country. The aim of this article is early detection of CKD and proper management of it thereby preventing the major cardiovascular complications. PMID:22828566

  7. [Does delayed fracture fixation within the upper extremity influence the rate of complications?].

    PubMed

    Grys, G; Or?owski, J

    1999-01-01

    A series of 42 patients operated on due to humeral shaft fracture and 67 patients with forearm bones shaft fracture were analyzed clinically and statistically. The type of fracture was related to the time span between injury and surgery and number of complications. Complications were divided into two groups--early ones (skin necrosis, infection) and late ones (fixation failure, delayed union, pseudoarthrosis). Injury to surgery time span was divided into for sections: less than 10 h, 10-24 h, 24 h-10 d and above 10 days. Early and late complications prevailed in patients operated within 24 hours from injury (87% of all complications). Eleven patients with humeral fracture had fair or poor result; 8 of them were operated within 24 hours from injury. Among 18 patients with fair and poor results after forearm fracture 13 were operated on within 24 hours from injury. PMID:10676012

  8. Rare vascular perforation complicating radial approach to percutaneous coronary angioplasty.

    PubMed

    Farooqi, Fahad; Alexander, John; Sarma, Aditya

    2013-01-01

    A transradial arterial approach to coronary angiography and percutaneous coronary intervention has become increasingly embraced by cardiologists as it is associated with decreased vascular complications and allows early mobilisation of patients when compared with transfemoral arterial access. Major vascular complication post-transradial access is uncommon. We describe a very rare case of perforation of the costocervical trunk (a branch of the right subclavian artery at the site of the thoracic inlet) presenting shortly after percutaneous transradial coronary intervention. The resulting rapidly expanding cervical haematoma caused airway compromise necessitating emergent intubation in the catheter laboratory recovery area. Transfemoral catheter coil embolisation of the feeder artery was successful in obliterating blood flow to the perforated vessel with eventual resolution of the neck haematoma. PMID:23362057

  9. Complications and management of breast enhancement using hyaluronic acid.

    PubMed

    Ishii, Hidenori; Sakata, Kazuaki

    2014-01-01

    The authors report on their experience with using hyaluronic acid of non-animal origin manufactured using commercially available technology (Macrolane, Q-Med AB, Sweden) for breast enhancement in 4000 women treated since 2004 and describe the most common complications and their successful treatment. On average, 30 mL to 40 mL of Macrolane was injected into each breast. Of 274 women who returned to the clinic during 2007, <10% experienced local adverse events (eg, gel dislocation, Macrolane nodules and rare cases of infection). There were no serious systemic events and treatment was well tolerated. To prevent local complications, such as infection, an aseptic injection technique was required and early treatment of adverse events is recommended. While only small volumes of Macrolane were injected, it is comparatively easy and safe to perform breast enhancement of up to one cup size to correct asymmetry between breasts and to create fullness in the upper portion of the breast. PMID:25332644

  10. Ophthalmological complications of the hypertriglyceridaemias.

    PubMed

    Winder, A F; Dodson, P M; Galton, D J

    1980-04-01

    Hypertriglyceridaemia is an inappropriate elevation in plasma of chylomicrons, very low density lipoprotein, or both, functioning in the transport of exogenous and endogenous neutral fat respectively (lewis, 1976; Miller, 1979). The elevation may be due to rare genetically-determined defects or to a specific imbalance between triglyceride production and utilization, either secondary to or accentuated by other metabolic disturbances such as obesity or diabetes mellitus. Various surveys indicate that some degree of hypertriglyceridaemia affects more than 10 per cent of the adult population, with a male preponderance and a reduced expression during childhood (Lewis, 1976). Ophthalmological complications of hypertriglyceridaemia include eruptive and other forms of xanthomata including xanthelasmata, corneal arcus, lipaemia retinalis, effects on retinal blood flow, and lipid emboli affecting vision. The clinical features overlap those of hypercholesterolaemia and these features may lead to initial presentation and diagnosis of either disorder. Recognition of the underlying disorder is important since with treatment the incidence of major cardiovascular and other problems such as pancreatitis may be reduced, and with familial disorders other affected members may then be sought. PMID:6943819

  11. [The pathogenesis of postvaccinal complications].

    PubMed

    Huber, H C

    1981-03-19

    Paraspecific reactions to vaccines are -- induction of autoimmune mechanisms, -- immunosuppression, -- induction of inflammation (i.e. "reactogenicity"). These undesirable side effects of vaccination are important factors in pathogenesis of postvaccinal complications. Using the model of experimental vaccinia virus infection the paraspecific reactions could be demonstrated in several animal species. Cell mediated hypersensitivity to brain tissue antigen and basic encephalitogenic protein occurred following vaccinia infection in guinea pigs. In infected rabbits humoral anti-brain antibodies could be detected. The immune response to sheep erythrocytes in mice was tested by determining the number of plaque forming cells in the spleen after specific immunization. Vaccinia virus injected prior to or simultaneously with immunization strongly reduced the number of plaque forming cells in the spleen. The reactogenicity of bacterial and viral vaccines could be determined by means of a simple hemolytic plaque assay in mice. This assay represents the degree of enzymatic lysosomal activity of macrophages. The methods described might be useful to test the innocuity and tolerance of new vaccines. PMID:6112195

  12. [Neurologic Complications in HPV Vaccination].

    PubMed

    Ikeda, Shu-Ichi

    2015-07-01

    A relatively high incidence of chronic limb pain, frequently complicated by violent, tremulous involuntary movements, has been noted in Japanese girls following human papillomavirus vaccination. The average incubation period after the first dose of the vaccine was 5.47 ± 5.00 months. Frequent manifestations included headaches, general fatigue, coldness of the feet, limb pain, and weakness. The skin temperature of the girls with limb symptoms was slightly lower in the fingers and moderately lower in the toes. Digital plethysmograms revealed a reduced peak of the waves, especially in the toes. Limb symptoms of the affected girls were compatible with the diagnostic criteria for complex regional pain syndrome. The Schellong test identified a significant number of patients with orthostatic hypotension and a few with postural orthostatic tachycardia syndrome. Electron-microscopic examinations of the intradermal nerves showed an abnormal pathology in the unmyelinated fibers in two of the three girls examined. The symptoms observed in this study can be explained by abnormal peripheral sympathetic responses. The most common previous diagnosis in the patients was psychosomatic disease. Recently, delayed manifestation of cognitive dysfunction in the post-vaccinated girls has attracted attention. The symptoms include memory loss and difficulty in reading textbooks and/or calculation. PMID:26160812

  13. International NeuroAIDS: prospects of HIV1 associated neurological complications

    Microsoft Academic Search

    J Roberto TRUJILLO; Gilberto JARAMILLO-RANGEL; Marta ORTEGA-MARTINEZ; Augusto C PENALVA de OLIVEIRA; Jose E VIDAL; Joseph BRYANT; Robert C GALLO

    2005-01-01

    Neurological complications associated with HIV-1\\/AIDS are being recognized with a high frequency that parallels the increased number of AIDS cases. The early infiltration by HIV-1 into the nervous system can cause primary and\\/or secondary neurological complications. The most common neurocognitive disorder is AIDS Dementia Complex (ADC). In developing countries of Asia the three most opportunistic infections are tuberculosis (TB), cryptococcosis,

  14. Risk factors for complications after bowel surgery in Korean patients with Crohn's disease

    PubMed Central

    Yang, Song Soo; Yoon, Yong Sik; Yoon, Sang Nam; Lim, Seok-Byung; Kim, Jin Cheon

    2012-01-01

    Purpose To assess the incidence and factors predictive of early postoperative complications in Korean patients who undergo surgery for Crohn's disease (CD). Methods We retrospectively assessed 350 patients (246 males, 104 females; mean age, 30 ± 9 years) who underwent surgery for primary or recurrent CD at Asan Medical Center between January 1991 and May 2010. The incidence and predictive factors of early postoperative complications were analyzed by both univariate and multivariate analyses. Results Of the 350 patients, 81 patients (23.1%) developed postoperative complications, the most common being septic complications (54 patients), including 19 cases of wound infection. Thirty patients (8.6%) required re-operations, and only one patient died. Multivariate analysis showed that four factors were independently associated with a high risk of early postoperative complications; preoperative moderate to severe anemia (hematocrit concentration <30%; odds ratio [OR], 3.1; 95% confidence interval [CI], 1.6 to 5.9), hypoalbuminemia (serum albumin level <3.0 g/dL; OR, 2.6; 95% CI, 1.4 to 4.7), emergency surgery (OR, 4.0; 95% CI, 1.5 to 10.6), and covering stoma (OR, 2.6; 95% CI, 1.3 to 5.4). Correction of preoperative moderate to severe anemia and hypoalbuminemia decreased the incidence of postoperative complications. Mean hospital stay was significantly longer in patients with than without postoperative complications (31.3 ± 27.2 days vs. 10.3 ± 3.8 days, P < 0.001). Conclusion Preoperative anemia, low albumin level, emergency surgery, and covering stoma significantly increased the risk of early postoperative complications in patients with CD. Correcting preoperatively deficient nutritional factors may reduce postoperative morbidities. PMID:22977760

  15. Gastrointestinal complications of systemic sclerosis

    PubMed Central

    Tian, Xin-Ping; Zhang, Xuan

    2013-01-01

    Systemic sclerosis is an autoimmune disease characterized by progressive skin thickening and tightness. Pulmonary interstitial fibrosis and kidney damage are the most important indicators for mortality; however, the gastrointestinal tract is the most commonly damaged system. Virtually all parts of the gastrointestinal (GI) tract can be involved, although the esophagus is the most frequently reported. The mechanisms that cause such extensive damage are generally unclear, but vascular changes, immunological abnormalities, excessive accumulation of collagen in the submucosa, smooth muscle atrophy and neuropathy may participate because these are the most common histological findings in biopsies and autopsies. Most patients with GI tract involvement complain about dyspepsia, nausea, vomiting, abdominal bloating/distension, and fecal incontinence. These symptoms are generally mild during the early stage of the disease and are likely ignored by physicians. As the disease becomes more advanced, however, patient quality of life is markedly influenced, whereby malnutrition and shortened survival are the usual consequences. The diagnosis for systemic sclerosis is based on manometry measurements and an endoscopy examination. Supportive and symptomatic treatment is the main therapeutic strategy; however, an early diagnosis is critical for successful management. PMID:24222949

  16. Extravascular complications following abdominal organ transplantation.

    PubMed

    Low, G; Jaremko, J L; Lomas, D J

    2015-08-01

    A variety of transplants have been performed in the abdomen including liver, kidney, pancreas and islet, bowel, and multivisceral transplants. Imaging plays an important role in graft surveillance particularly to exclude post-transplant complications. When complications occur, therapeutic image-guided interventions are invaluable as these may be graft-saving and even life-saving. Vascular complications following transplantation have been extensively reported in recent reviews. The focus of this review is to discuss post-transplant complications that are primarily extravascular in location. This includes biliary, urological, intestinal, malignancy, infections, and miscellaneous complications. Familiarity with the imaging appearances of these complications is helpful for radiologists as accurate diagnosis and expedient treatment has an impact on graft and patient survival. PMID:25979853

  17. Complications of arthroscopic surgery of the hip

    PubMed Central

    Papavasiliou, A. V.; Bardakos, N. V.

    2012-01-01

    Over recent years hip arthroscopic surgery has evolved into one of the most rapidly expanding fields in orthopaedic surgery. Complications are largely transient and incidences between 0.5% and 6.4% have been reported. However, major complications can and do occur. This article analyses the reported complications and makes recommendations based on the literature review and personal experience on how to minimise them. PMID:23610683

  18. Complications associated with transobturator sling procedures

    Microsoft Academic Search

    Sarah Hamilton Boyles; Renee Edwards; William Gregory; Amanda Clark

    2007-01-01

    This study aims to determine the complications associated with trans-obturator slings as reported to a national database.\\u000a We required “MAUDE”, a database that collects reports of complications associated with medical devices and which is maintained\\u000a by the Food and Drug Administration. We searched for complications associated with three different, commercially available\\u000a trans-obturator slings. We then tabulated the results by type

  19. Frequent Hemodialysis Fistula Infectious Complications

    PubMed Central

    Lok, Charmaine E.; Sontrop, Jessica M.; Faratro, Rose; Chan, Christopher T.; Zimmerman, Deborah Lynn

    2014-01-01

    Background Few studies have examined if infectious arteriovenous access complications vary with the cannulation technique and whether this is modified by dialysis frequency. We compared the infection rate between fistulas cannulated using buttonhole versus stepladder techniques for patients treated with short daily (SDH) or nocturnal hemodialysis at home (NHD). We also compared patients receiving conventional intermittent hemodialysis (CIHD) using stepladder cannulation. Methods Data were prospectively collected from 631 patients dialyzed with a fistula from 2001 to 2010 (Toronto and Ottawa, Canada). We compared the person-time incidence rate of bacteremia and local fistula infections using the exact binomial test. Results Forty-six (7.3%) patients received SDH (?5 sessions/week, 2-4 h/session), 128 (20.3%) NHD (?4 sessions/week, ?5 h/session) and 457 (72%) CIHD (3 sessions/week, ?4 h/session). Fifty percent of SDH and 72% of NHD patients used the buttonhole technique. There were 39 buttonhole-related bacteremias (rate: 0.196/1,000 fistula days) and at least 2 local buttonhole site infections. Staphylococcus aureus accounted for 85% of the bacteremias. There were 5 (13%) infection-related hospitalizations and 3 (10%) serious metastatic infections, including fistula loss. In comparison, there was 1 possible fistula-related infection in CIHD during follow-up (rate: 0.002/1,000 fistula days). Conclusions The rate of buttonhole-related infections was high among patients on frequent hemodialysis and more than 50 times greater than that among patients on CIHD with the stepladder technique. Most bacteremias were due to S. aureus – with serious consequences. The risks and benefits of buttonhole cannulation require individual consideration with careful monitoring, prophylaxis and management. PMID:25473405

  20. Fournier's gangrene complicating ulcerative pancolitis.

    PubMed

    Katsanos, Konstantinos H; Ignatiadou, Eleftheria; Sarandi, Maria; Godevenos, Dimitrios; Asproudis, Ioannis; Fatouros, Michael; Tsianos, Epameinondas V

    2010-06-01

    Fournier gangrene is a very rare and a rapidly progressing, polymicrobial necrotizing faciitis or myonecrosis of the perineal, perianal and genital regions, with a high mortality rate. Infection is associated with superficial traum, urological and colorectal diseases and operations. The most commonly found bacteria are Escherichia coli followed by Bacteroides and streptococcal species. Diabetes mellitus, alcoholism, and immunosuppression are perpetuating co-factors. Fournier's gangrene complicating inflammatory bowel disease has been reported in three patients so far, two with Crohn's disease. A 78-year-old man diagnosed with ulcerative pancolitis was referred for fever, and painful perianal and scrotal swelling after perianal surgery for a horseshoe-type perianal abscess. Since bowel disease diagnosis, patient was on mesalazine and achieved long-term remission. Perianal abscess occurred suddenly one week before perianal surgery without any evidence of pre-existing fistula or other abnormalities. Physical examination showed extensive edema and crepitus of perineum and genitalia and patient had symptoms of significant toxicity. The diagnosis of Fournier's gangrene was made and patient underwent emergency surgery with extensive surgical debridement of the scrotal and perianal area and Hartman procedure with a diverting colostomy. In addition, patient started on therapy with mesalazine 3gr, methylprednisolone 16 mg, parenteral nutrition and broad spectrum of antibiotics. Two days after the first operation the patient needed a second operation for perianal debridement. On the fourth day, blood cultures showed E. coli. Patient had an uneventful recovery and was discharged after 34 days of hospitalization. On follow up, disease review is scheduled and colostomy closure is planned. PMID:21122507

  1. [Complications of double J ureteral stents].

    PubMed

    el Khader, K

    1996-01-01

    The double J ureteral stents have become an integral part of the urological armentarium. They allow good urinary drainage from kidney to the bladder and usually are safe and well tolerated. However, different complications may occur with short or long-term use of indwelling stents. These complications have varied from minor side effects such as hematuria, dysuria, frequency, flank and suprapubic pain to major complications such as vesico-ureteric reflux, migration, encrustation, urinary infection, stent fracture, necrosis and ureteroarterial fistula. Mostly of complications require removal of the indwelling catheter. PMID:9091568

  2. Video-assisted thoracic surgery complications

    PubMed Central

    Kozak, Józef

    2014-01-01

    Video-assisted thoracic surgery (VATS) is a miniinvasive technique commonly applied worldwide. Indications for VATS are very broad and include the diagnosis of mediastinal, lung and pleural diseases, as well as large resection procedures such as pneumonectomy. The most frequent complication is prolonged postoperative air leak. The other significant complications are bleeding, infections, postoperative pain and recurrence at the port site. Different complications of VATS procedures can occur with variable frequency in various diseases. Despite the large number of their types, such complications are rare and can be avoided through the proper selection of patients and an appropriate surgical technique. PMID:25561984

  3. Management of complications after total shoulder arthroplasty.

    PubMed

    Eichinger, Josef K; Galvin, Joseph W

    2015-03-01

    The outcomes of total shoulder arthroplasty (TSA) for painful arthritis of the glenohumeral joint are excellent with significant improvement in pain and function. Increased use of total shoulder arthroplasty over the past decade has led to identification of common complications. Although the complication rate is low, accurate and timely diagnosis, appropriate management, and implementation of methods for prevention are critical to a successful long-term outcome. The most common complications include infection, glenoid and humeral component loosening, rotator cuff tear, periprosthetic fracture, and neurologic injury. The purpose of this review is to outline the best practices for diagnosing, managing, and preventing these complications. PMID:25672497

  4. Managing complications II: conduit failure and conduit airway fistulas.

    PubMed

    Meyerson, Shari L; Mehta, Christopher K

    2014-05-01

    Conduit failure and conduit airway fistula are rare complications after esophagectomy, however they can be catastrophic resulting in high mortality. Survivors can expect a prolonged hospital course with multiple interventions and an extended period of time prior to being able to resume oral nutrition. High index of suspicion can aid in early diagnosis. Conduit failure usually requires a period of proximal esophageal diversion and staged reconstruction. Conduit airway fistulas may be amenable to endoscopic repair but this has a high failure rate and many patients will require surgical repair with closure of the fistula and interposition of vascularized tissue to minimize recurrence. PMID:24876943

  5. Spinal Instrumentation With A Low Complication Rate

    Microsoft Academic Search

    Scott A Shapiro; William Snyder

    1997-01-01

    BackgroundSpinal instrumentation has become an increasing part of the armamentarium of neurosurgery and neurosurgical training. For noncontroversial indications for spine fusion the arthrodesis rate seems to be better. For both noncontroversial and controversial indications, the reported complication rate with spinal instrumentation tends to be greater than that with noninstrumented spine surgeries. These reported complications include a 2–3% neurologic injury rate,

  6. Complications of Breast-cancer Radiotherapy

    Microsoft Academic Search

    E. Senkus-Konefka; J. Jassem

    2006-01-01

    Although the beneficial effect of postoperative radiotherapy for breast cancer is well documented, this treatment may be related to a number of complications, which may affect patient quality of life and possibly survival. Among significant long-term irradiation sequelae are cardiac and lung damage, lymphoedema, brachial plexopathy, impaired shoulder mobility and second malignancies. The risk of these complications, particularly high with

  7. Complications in brief: Anterior cruciate ligament reconstruction.

    PubMed

    Tjoumakaris, Fotios Paul; Herz-Brown, Amy L; Bowers, Andrea L; Legath-Bowers, Andrea; Sennett, Brian J; Bernstein, Joseph

    2012-02-01

    When performing reconstruction of the ACL, the major complications that can arise include missed concomitant injuries, tunnel malposition, patellar fracture, knee stiffness, and infection. We review the complications that can occur as a result of errors made before, during, and after surgery. PMID:22086506

  8. [Myocardial infarction as complication of acute pancreatitis].

    PubMed

    Asfalou, I; Miftah, F; Kendoussi, M; Raissouni, M; Benyass, A; Moustaghfir, A; Zbir, E; Hda, A; Hamani, A

    2011-01-01

    We report a case of an acute pancreatitis complicated by myocardial infarction with normal coronary arteries on angiography. This observation presents a double interest. First, it illustrates unusual forms of coronary disease represented by the non-atherosclerotic infarction. On the other hand, it shows that the multiple visceral damage associated with acute pancreatitis can include myocardial infarction which complications aggravate prognosis. PMID:21232905

  9. Complications with Outpatient Angiography and Interventional Procedures

    SciTech Connect

    Young, Noel; Chi, Ka-Kit; Ajaka, Joe; McKay, Lesa; O'Neill, Diane; Wong, Kai Ping [Department of Radiology, Westmead Hospital, Westmead, Sydney, NWS, 2145 (Australia)

    2002-03-15

    Purpose: To prospectively identify the complications, and rates of complication, in outpatient angiography and interventional procedures. Methods: There were 1050 consecutive patients, 646 men and 404 women, aged 17-89 years, with a total of 1239 procedures studied in a 2-year period, 1997 to 1999. Results: There were 560 cases of aorto-femoral angiography,resulting in 124 complications (22%), with pain or hematoma in 110.There were 206 cases of neck and cerebral angiography, resulting in 51 complications (25%), with pain and hematoma in 34, transient ischemic attack in 2 and cerebrovascular accident in 1. There were 197 interfentional procedures, with 177 being balloon dilatations, resulting in 68 complications (35%), with 2 having hematomas and 1 having hematoma/abscess requiring active treatment. There were 276 cases having various 'other' procedures (e.g., renal angiography),resulting in 65 complications (24%), with pain and hematoma in 61. No procedure-related death occurred. Eighteen cases (1.5%) had significant complications, with contrast allergy in eight. Conclusion: Outpatient angiography and intervention are relatively safe, with low significant complication rates.

  10. Tube Thoracostomy: Complications and Its Management

    PubMed Central

    Kesieme, Emeka B.; Dongo, Andrew; Ezemba, Ndubueze; Irekpita, Eshiobo; Jebbin, Nze; Kesieme, Chinenye

    2012-01-01

    Background. Tube thoracostomy is widely used throughout the medical, surgical, and critical care specialities. It is generally used to drain pleural collections either as elective or emergency. Complications resulting from tube thoracostomy can occasionally be life threatening. Aim. To present an update on the complications and management of complications of tube thoracostomy. Methods. A review of the publications obtained from Medline search, medical libraries, and Google on tube thoracostomy and its complications was done. Results. Tube thoracostomy is a common surgical procedure which can be performed by either the blunt dissection technique or the trocar technique. Complication rates are increased by the trocar technique. These complications have been broadly classified as either technical or infective. Technical causes include tube malposition, blocked drain, chest drain dislodgement, reexpansion pulmonary edema, subcutaneous emphysema, nerve injuries, cardiac and vascular injuries, oesophageal injuries, residual/postextubation pneumothorax, fistulae, tumor recurrence at insertion site, herniation through the site of thoracostomy, chylothorax, and cardiac dysrhythmias. Infective complications include empyema and surgical site infection. Conclusion. Tube thoracostomy, though commonly performed is not without risk. Blunt dissection technique has lower risk of complications and is hence recommended. PMID:22028963

  11. Neurological complications in obstetric regional anaesthesia

    Microsoft Academic Search

    C. C. Loo; G. Dahlgren; L. Irestedt

    2000-01-01

    Neurological complications after obstetric central neural blocks are rare events. Although central neural blockade does cause neurological complications, there must be awareness that neurological deficits may either develop spontaneously (e.g. epidural abscess\\/haematoma) or as a result of the labour and delivery process (maternal obstetric palsies). We have attempted to review as completely as possible the published survey and case reports

  12. Complications of regional anesthesia for ophthalmic surgery.

    PubMed Central

    McGoldrick, K. E.

    1993-01-01

    Ocular regional anesthesia can be accomplished with either a peribulbar or retrobulbar approach. Each has advantages and disadvantages. Complications can be vision-threatening or life-threatening. Positioning the eye in neutral gaze when retrobulbar block is executed and using a needle no longer than 31 mm are effective strategies to reduce the incidence of serious complications. PMID:7825345

  13. Major orbital complications of endoscopic sinus surgery

    Microsoft Academic Search

    C Rene; G E Rose; R Lenthall; I Moseley

    2001-01-01

    BACKGROUNDThe paranasal sinuses are intimately related to the orbit and consequently sinus disease or surgery may cause severe orbital complications. Complications are rare but can result in serious morbidity, the most devastating of which is severe visual loss.METHODSA retrospective review was undertaken of four cases of severe orbital trauma during endoscopic sinus surgery.RESULTSAll the cases suffered medial rectus damage, one

  14. Pancreatic transplantation: Radiologic evaluation of vascular complications

    Microsoft Academic Search

    J. F. Snider; D. W. Hunter; C. C. Kuni; W. R. Castaneda-Zuniga; J. G. Letourneau

    1991-01-01

    Transplantation of the pancreas is an increasingly common therapeutic option for preventing or delaying complications of type I diabetes mellitus. The authors studied the relative roles of various radiologic examinations in diagnosing vascular complications in these grafts including arterial and venous thrombosis, stenosis, and anastomotic leak (the most common vascular factors that necessitate pancreatectomy of the transplant), as defined with

  15. Management of complications of flexor tendon injuries.

    PubMed

    Pulos, Nicholas; Bozentka, David J

    2015-05-01

    Innovations in operative techniques, biomaterials, and rehabilitation protocols have improved outcomes after treatment of flexor tendon injuries. However, despite these advances, treatment of flexor tendon injuries remains challenging. The purpose of this review is to highlight the complications of flexor tendon injuries and review the management of these complications. PMID:25934203

  16. Strategies to reduce treatment costs of peristomal skin complications.

    PubMed

    Martins, Lina; Tavernelli, Kathy; Sansom, Wendy; Dahl, Kirsten; Claessens, Ineke; Porrett, Terri; Andersen, Birgitte Dissing

    Peristomal skin complications (PSCs) are common and troublesome and the consequences are substantial both for the patient and from a health-economic viewpoint. The purpose of this article is to demonstrate that early detection and treatment of PSCs, combined with the use of a correctly fitted and appropriate pouching system, can reduce treatment costs-in the UK, it is estimated to save £28.1m annually. A model for cost estimation of PSCs and a real-life global data set of people with stomas are used for the calculations. A high priority should be given to ensuring resources are available to provide education, guidance and assistance to people with a stoma. This would support increased awareness of the first signs of PSCs and enable self-management at an early stage. PMID:23249795

  17. Complications and Continuation of Intrauterine Device Use Among Commercially Insured Teenagers

    PubMed Central

    Berenson, Abbey B.; Tan, Alai; Hirth, Jacqueline M.; Wilkinson, Gregg S.

    2014-01-01

    Objective Many U.S. providers remain reluctant to prescribe intrauterine devices (IUDs) to teenagers due to concerns about serious complications. This study examined whether 15–19 year-old IUD users were more likely to experience complications, failure, or early discontinuation than adult users aged 20–24 and 25–44 years and whether there were differences in between users of levonorgestrel-releasing intrauterine systems and copper IUDs. Methods A retrospective cohort study was conducted using health insurance claims obtained from a private insurance company of 90,489 women who had an IUD inserted between 2002 and 2009. Logistic regression models were used to estimate the odds of experiencing complications, method failure, or early discontinuation within 12 months of insertion by age group and type of IUD inserted. Results Serious complications, including ectopic pregnancy and pelvic inflammatory disease, occurred in less than 1% of patients regardless of age or IUD type. Women aged 15–19 years were more likely than those aged 25–44 years to have a claim for dysmenorrhea OR=1.4, CI=1.1, 1.6), amenorrhea (OR=1.3, CI=1.1, 1.5), or normal pregnancy (OR=1.4, CI=1.1, 1.8). Overall, early discontinuation did not differ between teenagers and women aged 25–44 years (13% vs. 11%, p>.05). However, use of the levonorgestrel-releasing intrauterine system was associated with fewer complications and less early discontinuation than the copper IUD in all age groups. Conclusions The IUD is as appropriate for teenagers to use as it is for older women, with serious complications occurring infrequently in all groups. The levonorgestrel-releasing intrauterine system may be a better choice than copper IUD due to lower odds of complications, discontinuation, and failure. PMID:23635730

  18. Common post-operative complications in children

    PubMed Central

    Pawar, Dilip

    2012-01-01

    The exact incidence of common post-operative complications in children is not known. Most common one is post-operative nausea and vomiting followed by respiratory complications leading to hypoxia. Cardiac complications are less in children without associated congenital cardiac anomaly. Post-operative shivering, agitation and delirium are seen more often in children anaesthetised with newer inhalational agents like sevoflurane and desflurane. Urinary retention in the post-operative period could be influenced by anaesthetic drugs and regional blocks. The purpose of this article is to review the literature and present to the postgraduate students comprehensive information about the current understanding and practice pattern on various common complications in the post-operative period. Extensive literature was searched with key words of various complications from Pubmed, Google scholar and specific journal, namely paediatric anaesthesia. The relevant articles, review article meta-analysis and editorials were the primary source of information for this article. PMID:23293390

  19. Common post-operative complications in children.

    PubMed

    Pawar, Dilip

    2012-09-01

    The exact incidence of common post-operative complications in children is not known. Most common one is post-operative nausea and vomiting followed by respiratory complications leading to hypoxia. Cardiac complications are less in children without associated congenital cardiac anomaly. Post-operative shivering, agitation and delirium are seen more often in children anaesthetised with newer inhalational agents like sevoflurane and desflurane. Urinary retention in the post-operative period could be influenced by anaesthetic drugs and regional blocks. The purpose of this article is to review the literature and present to the postgraduate students comprehensive information about the current understanding and practice pattern on various common complications in the post-operative period. Extensive literature was searched with key words of various complications from Pubmed, Google scholar and specific journal, namely paediatric anaesthesia. The relevant articles, review article meta-analysis and editorials were the primary source of information for this article. PMID:23293390

  20. Ocular Complications of Inflammatory Bowel Disease

    PubMed Central

    Mady, Rana; Grover, Will; Butrus, Salim

    2015-01-01

    Though inflammatory bowel disease (IBD) has a specific predilection for the intestinal tract, it is a systemic inflammatory disorder affecting multiple organs, including the eye. Ocular complications directly related to IBD are categorized as primary and secondary. Primary complications are usually temporally associated with IBD exacerbations and tend to resolve with systemic treatment of the intestinal inflammation. These include keratopathy, episcleritis, and scleritis. Secondary complications arise from primary complications. Examples include cataract formation due to treatment with corticosteroids, scleromalacia due to scleritis, and dry eye due to hypovitaminosis A following gut resection. Some ocular manifestations of IBD can lead to significant visual morbidity and temporally associated complications can also be a herald of disease control. Furthermore, ocular manifestations of IBD can occasionally manifest before the usual intestinal manifestations, leading to an earlier diagnosis. Thus, it is important to understand the clinical presentation of possible ocular manifestations in order to initiate appropriate treatment and to help prevent significant visual morbidity. PMID:25879056

  1. Cardiogenic shock complicating acute myocardial infarction--a review.

    PubMed

    Dubey, Laxman; Sharma, Sanjib; Gautam, Mani; Gautam, Samir; Guruprasad, Sogunuru; Subramanyam, Gangapatnam

    2011-12-01

    Cardiogenic shock is characterized by inadequate tissue perfusion due to cardiac dysfunction and is the leading cause of death in patients hospitalized with acute myocardial infarction. Mortality from cardiogenic shock still remains high. The development of cardiogenic shock is rarely unexpected; most patients who develop cardiogenic shock do so within 48 hrs of admission, with only 10% shocked on arrival. Mortality rate is exceedingly high and reaches 70-80% in those treated conservatively. Early revascularization is the cornerstone treatment of acute myocardial infarction complicated by cardiogenic shock. According to the guidelines, revascularization is effective up to 36 hours after the onset of cardiogenic shock and performed within 18 hours after the diagnosis of cardiogenic shock. Primary percutaneous coronary intervention is the most efficient therapy to restore coronary flow in the infarct-related artery. However, invasive strategy in a developing country like ours is not only costly but also technically demanding. We present a case of acute myocardial infarction complicated with cardiogenic shock that underwent primary percutaneous coronary intervention and also review the incidence, pathophysiology, management and outcome of cardiogenic shock complicating acute myocardial infarction. PMID:22299378

  2. Nutrition in the management of cirrhosis and its neurological complications.

    PubMed

    Bémeur, Chantal; Butterworth, Roger F

    2014-06-01

    Malnutrition is a common feature of chronic liver diseases that is often associated with a poor prognosis including worsening of clinical outcome, neuropsychiatric complications as well as outcome following liver transplantation. Nutritional assessment in patients with cirrhosis is challenging owing to confounding factors related to liver failure. The objectives of nutritional intervention in cirrhotic patients are the support of liver regeneration, the prevention or correction of specific nutritional deficiencies and the prevention and/or treatment of the complications of liver disease per se and of liver transplantation. Nutritional recommendations target the optimal supply of adequate substrates related to requirements linked to energy, protein, carbohydrates, lipids, vitamins and minerals. Some issues relating to malnutrition in chronic liver disease remain to be addressed including the development of an appropriate well-validated nutritional assessment tool, the identification of mechanistic targets or therapy for sarcopenia, the development of nutritional recommendations for obese cirrhotic patients and liver-transplant recipients and the elucidation of the roles of vitamin A hepatotoxicity, as well as the impact of deficiencies in riboflavin and zinc on clinical outcomes. Early identification and treatment of malnutrition in chronic liver disease has the potential to lead to better disease outcome as well as prevention of the complications of chronic liver disease and improved transplant outcomes. PMID:25755550

  3. Urologic Considerations and Complications in Kidney Transplant Recipients.

    PubMed

    Di Carlo, Heather N; Darras, Frank S

    2015-07-01

    Urologic considerations during the kidney transplantation process, starting with initial recipient evaluation and continuing through the post-transplant, long-term follow-up, are critical for minimizing urologic complications and improving graft survival. Appropriate, targeted, preoperative urologic evaluation of the recipient allows for an optimized urinary tract to accept the graft, whereas post-transplant urologic follow-up and monitoring decrease the risk of graft lost secondary to a urologic cause, particularly in patients with a urologic reason for their kidney failure and in those patients with concomitant urologic diagnoses. Urologic complications comprise the second most common adverse post-transplant event, occurring in 2.5% to 14% of patients and are associated with high morbidity, graft loss, and mortality. Early and late urologic complications, including hematuria, hematoma, lymphocele, urine leak, ureteral stricture, nephrolithiasis, and vesicoureteral reflux, and their causes and treatment options are explored. A multidisciplinary team approach to kidney transplantation, including transplant surgery, urology, and nephrology, optimizes outcomes and graft survival. Although the current role of the urologist in kidney transplantation varies greatly by institution, appropriate consultation, participation, and monitoring in select patients is essential. PMID:26088075

  4. A Rare Complication of Radiofrequency Tonsil Ablation: Horner Syndrome

    PubMed Central

    Ozbay, Isa; Yildirim, Nadir; Zeybek Sivas, Zuhal; Canbaz Kabay, Sibel

    2015-01-01

    Chronic tonsillitis is a common disease, and several different surgical techniques are used to treat this condition. In recent years, techniques such as radiofrequency ablation and coblation have been commonly used for tonsil surgery. In this report, we present the cases of two pediatric patients who developed ptosis, miosis, and enophthalmos (Horner syndrome) after radiofrequency ablation for tonsil reduction and discuss the technique of radiofrequency ablation of the tonsils. In the early postoperative period, miosis and ptosis were observed on the right side in one patient and on the left side in the other patient. Both patients were treated with 1?mg/kg/day methylprednisolone, which were tapered by halving the dose every 3 days. Miosis and ptosis improved after treatment in both patients. Along with the case presentation, we discuss the effectiveness and complications of radiofrequency ablation of the tonsils. These unusual complications of tonsil ablation may help ENT physicians who do not yet have a preferred surgical technique for tonsillectomy to make an informed decision. Limited data are available about the possible complications of radiofrequency ablation of the tonsils. The present report contributes to the literature on this topic.

  5. Complications After Open Distal Clavicle Excision

    PubMed Central

    Chronopoulos, Efstathis; Gill, Harpreet S.; Freehill, Michael T.; Petersen, Steve A.

    2008-01-01

    Isolated distal clavicle excision performed as an open procedure has been considered safe and, in the literature, has been considered the standard for comparison with arthroscopic distal clavicle excisions. However, we noticed isolated open distal clavicle excision was associated with a number of complications. We therefore raised two questions about the complication rate in a cohort of our patients who had undergone this procedure: (1) What was the complication rate and how did it compare to that in the existing literature on this subject? and (2) Were the complications in our cohort similar to those previously reported? We studied 42 patients who underwent an isolated distal clavicle excision between 1992 and 2003. There were 27 complications (64%), which was substantially higher than rates previously reported. Complications in our cohort not previously reported included continued acromioclavicular joint tenderness and scar hypertrophy. Our study suggests complications after open distal clavicle excisions may be more frequent than and may differ from previously reported rates and types. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18264853

  6. Epidemiology of Intratemporal Complications of Otitis Media

    PubMed Central

    Maranhão, André; Andrade, José; Godofredo, Valéria; Matos, Rafaela; Penido, Norma

    2014-01-01

    Introduction?Despite the advent of antibiotics and immunizations in the last century, complications of otitis media remain quite frequent, have high morbidity and mortality rates, and pose a challenge to the otorhinolaryngologist. Objective?To establish the annual incidence of intratemporal complications of otitis media and prospectively evaluate patients via an analysis of epidemiologic and clinical aspects. Methods?Prospective, observational study. Between February 2010 and January 2011, patients admitted to a tertiary care, university-based otology practice with diagnosis of otitis media and an associated intratemporal complication (ITC) were included in the study. The following data were evaluated: age, sex, type of ITC, treatment, imaging tests findings, type and degree of hearing loss, and clinical outcome. The overall incidence of all complications and of each complication individually was determined. Results?A total of 1,816 patients were diagnosed with otitis media. For 592 (33%) individuals, the diagnosis was chronic otitis media; for 1,224 (67%), the diagnosis was acute otitis media. ITCs of otitis media were diagnosed in 15 patients; thus, the annual incidence of intratemporal complications was 0.8%. We identified 19 ITC diagnoses in 15 patients (3 patients had more than one diagnosis). Labyrinthine fistulae were diagnosed in 7 (36.8%) individuals, mastoiditis in 5 (26.3%), facial palsy in 4 (21.1%), and labyrinthitis in 3 (15.8%). Conclusion?The incidence of intratemporal complications in Brazil remains significant when compared with developed countries. Chronic otitis media with cholesteatoma is the most frequent etiology of intratemporal complications. Labyrinthine fistula is the most common intratemporal complication. PMID:25992087

  7. Epidemiology of intratemporal complications of otitis media.

    PubMed

    Maranhão, André; Andrade, José; Godofredo, Valéria; Matos, Rafaela; Penido, Norma

    2014-04-01

    Introduction?Despite the advent of antibiotics and immunizations in the last century, complications of otitis media remain quite frequent, have high morbidity and mortality rates, and pose a challenge to the otorhinolaryngologist. Objective?To establish the annual incidence of intratemporal complications of otitis media and prospectively evaluate patients via an analysis of epidemiologic and clinical aspects. Methods?Prospective, observational study. Between February 2010 and January 2011, patients admitted to a tertiary care, university-based otology practice with diagnosis of otitis media and an associated intratemporal complication (ITC) were included in the study. The following data were evaluated: age, sex, type of ITC, treatment, imaging tests findings, type and degree of hearing loss, and clinical outcome. The overall incidence of all complications and of each complication individually was determined. Results?A total of 1,816 patients were diagnosed with otitis media. For 592 (33%) individuals, the diagnosis was chronic otitis media; for 1,224 (67%), the diagnosis was acute otitis media. ITCs of otitis media were diagnosed in 15 patients; thus, the annual incidence of intratemporal complications was 0.8%. We identified 19 ITC diagnoses in 15 patients (3 patients had more than one diagnosis). Labyrinthine fistulae were diagnosed in 7 (36.8%) individuals, mastoiditis in 5 (26.3%), facial palsy in 4 (21.1%), and labyrinthitis in 3 (15.8%). Conclusion?The incidence of intratemporal complications in Brazil remains significant when compared with developed countries. Chronic otitis media with cholesteatoma is the most frequent etiology of intratemporal complications. Labyrinthine fistula is the most common intratemporal complication. PMID:25992087

  8. Total parenteral nutrition-related gastroenterological complications.

    PubMed

    Guglielmi, F W; Boggio-Bertinet, D; Federico, A; Forte, G B; Guglielmi, A; Loguercio, C; Mazzuoli, S; Merli, M; Palmo, A; Panella, C; Pironi, L; Francavilla, A

    2006-09-01

    Total parenteral nutrition is a life saving therapy for patients with chronic gastrointestinal failure, being an effective method for supplying energy and nutrients when oral or enteral feeding is impossible or contraindicated. Clinical epidemiological data indicate that total parenteral nutrition may be associated with a variety of problems. Herein we reviewed data on the gastroenterological tract regarding: (i) total parenteral nutrition-related hepatobiliary complications; and (ii) total parenteral nutrition-related intestinal complications. In the first group, complications may vary from mildly elevated liver enzyme values to steatosis, steatohepatitis, cholestasis, fibrosis and cirrhosis. In particular, total parenteral nutrition is considered to be an absolute risk factor for the development of biliary sludge and gallstones and is often associated with hepatic steatosis and intrahepatic cholestasis. In general, the incidence of total parenteral nutrition-related hepatobiliary complications has been reported to be very high, ranging from 20 to 75% in adults. All these hepatobiliary complications are more likely to occur after long-term total parenteral nutrition, but they seem to be less frequent, and/or less severe in patients who are also receiving oral feeding. In addition, end-stage liver disease has been described in approximately 15-20% of patients receiving prolonged total parenteral nutrition. Total parenteral nutrition-related intestinal complications have not yet been adequately defined and described. Epidemiological studies intended to define the incidence of these complications, are still ongoing. Recent papers confirm that in both animals and humans, total parenteral nutrition-related intestinal complications are induced by the lack of enteral stimulation and are characterised by changes in the structure and function of the gut. Preventive suggestions and therapies for both these gastroenterological complications are reviewed and reported in the present review. PMID:16766237

  9. Complications of otitis media in Indigenous and non-Indigenous children.

    PubMed

    O'Connor, Tony E; Perry, Christopher F; Lannigan, Francis J

    2009-11-01

    In Australia, three to five children die each year because of otitis media complications, and 15 children will suffer permanent hearing loss each year as a result of otitis media. Extracranial complications occur most commonly, and include mastoiditis, cholesteatoma and otitis media with perforation. Intracranial complications are less common, and include meningitis, brain abscess and lateral sinus thrombosis. In Australia, approximately 60% of extracranial and intracranial complications of otitis media occur in children. The contrasting rates of childhood otitis media among Indigenous and non-Indigenous children have implications for the frequency and types of complications occurring in both groups. Otitis media with effusion and acute otitis media predominate among non-Indigenous children, whereas chronic suppurative otitis media (CSOM) occurs most commonly among Indigenous children. The incidence of mastoiditis in Australia is low by international standards (2/100,000 children), but cholesteatoma rates among Indigenous children in Australia are higher than previously estimated (up to 10% in CSOM). A high rate of chronic tympanic membrane perforation occurs among Indigenous children, estimated to be as high as 80%. Intracranial complications of otitis media are uncommon, but are potentially life-threatening and are more likely to occur among Indigenous than non-Indigenous children. Reduced access to medical care, lower socioeconomic status and remote living conditions mean that levels of early childhood hearing loss among Indigenous children are likely to be underestimated. This has implications for early childhood speech and language development and education. PMID:19883359

  10. Identifying children at particular risk of long-term diabetes complications.

    PubMed

    Gallego, Patrica H; Wiltshire, Esko; Donaghue, Kim C

    2007-10-01

    Formerly a 'taboo' subject, long-term complications are now being increasingly discussed with the family by the health-care team. Identifying potential predictors and establishing early intervention can change the course of these complications in the young patient with diabetes. Although the most recognized risk factor is glycaemic exposure, the development of diabetes complications is likely to result from an interaction between genetic and environmental factors. Other major environmental risk factors are hypertension, smoking, higher body mass index and lipid disorders. This article will concentrate on specific paediatric aspects, including the impact of puberty; endothelial dysfunction and genetic susceptibility. Endothelial function assessed by flow-mediated dilatation is a non-invasive method that has been suitable for use in children and adolescents. In type 1 diabetes mellitus children, endothelium dysfunction has been documented among patients with short diabetes duration and has been correlated to folate status, triglyceride and low-density lipoprotein cholesterol levels. Studies in the paediatric population have also revealed an association of diabetes complications with genetic variants in the renin-angiotensin system, polyol pathway, lipid oxidation and folate metabolism. Currently, achieving the best glycaemic control remains the gold standard for prevention of long-term diabetes complications in the clinical context. However, recent identification of genetic markers and development of research tools that predict long-term complications might have a potential role as instruments in assessing the effectiveness of intervention in the early course of the disease. PMID:17727384

  11. Complications of Intravesical Bacillus Calmette-Guérin

    PubMed Central

    Macleod, Liam C.; Ngo, Tin C.; Gonzalgo, Mark L.

    2014-01-01

    Intravesical Bacillus Calmette-Guérin (BCG) is an important treatment for the management of non-muscle invasive bladder cancer because of its proven efficacy and favourable safety profile. The most common complications associated with BCG treatment are relatively minor. They include urinary frequency, cystitis, fever, and hematuria. Although serious complications are rare, patients can develop severe, life-threatening sepsis with disseminated mycobacterial infection. We report a rare case of periurethral diverticulum formation after intravesical BCG and review the literature on the potential complications of this treatment modality. PMID:25210559

  12. Mechanical complications of acute myocardial infarction.

    PubMed

    Kutty, Ramesh S; Jones, Nicola; Moorjani, Narain

    2013-11-01

    Acute myocardial infarction (AMI) can result in ischemic, mechanical, arrhythmic, embolic, or inflammatory complications. The development of mechanical complications following AMI is associated with a significantly reduced short-term and long-term survival. Since the introduction of primary percutaneous coronary intervention as the principal reperfusion strategy following acute ST-elevation myocardial infarction, the incidence of mechanical complications, including rupture of the left ventricular free wall, papillary muscle, and ventricular septum, has reduced significantly to less than 1%. Despite high operative mortality, the lack of an effective medical alternative makes surgical repair the mainstay of current management for these patients. PMID:24188218

  13. Pulmonary effects and complications of snakebites.

    PubMed

    Gnanathasan, Ariaranee; Rodrigo, Chaturaka

    2014-11-01

    This review is on the pulmonary complications of snakebites, which can have fatal consequences. We identified three common themes as reported in the literature regarding envenomation: generalized neuromuscular paralysis affecting airway and respiratory muscles, pulmonary edema, and pulmonary hemorrhages or thrombosis due to coagulopathy. Respiratory paralysis and pulmonary edema can be due to either elapid or viper bites, whereas pulmonary complications of coagulopathy are exclusively reported with viper bites. The evidence for each complication, timeline of appearance, response to treatment, and details of pathophysiology are discussed. PMID:25367476

  14. Extraintestinal complications of inflammatory bowel disease

    Microsoft Academic Search

    Ad A. van Bodegraven; Ben A. C. Dijkmans; Paul Lips; Tom J. Stoof; A. Salvador Peña; Stephan G. M. Meuwissen

    2001-01-01

    Opinion statement  \\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Extraintestinal complications of inflammatory bowel disease (IBD) are often secondary to the underlying disease. Therefore,\\u000a the first priority is to get active IBD into remission with medications, since surgery for IBD is not indicated for the treatment\\u000a of extraintestinal complications.\\u000a \\u000a \\u000a \\u000a \\u000a – \\u000a \\u000a Symptoms of extraintestinal complications usually can be treated with simple agents; the treatment of patients with

  15. Divergent Gene Expression Responses to Complicated Grief and Non-complicated Grief

    PubMed Central

    Irwin, Michael R.; Arevalo, Jesusa M. G.; Cole, Steven W.

    2014-01-01

    The “widowhood effect” (i.e., morbidity/mortality in recently bereaved spouses) may be related to changes in immune function, but little is known about the impact of bereavement on gene transcription in immune cells. This study examined how Complicated Grief and Non-complicated Grief responses to bereavement differentially affect leukocyte gene expression. Genome-wide transcriptional profiling and bioinformatic analyses were completed on 63 older adults. Thirty-six of them had lost their spouse/partner on average 2 years ago, and 27 were nonbereaved, married controls. Twelve of the bereaved participants met criteria for Complicated Grief. Compared to nonbereaved controls, bereavement (both Complicated Grief and Non-complicated Grief) was associated with upregulated expression of genes involved in general immunologic activation and a selective downregulation of genes involved in B lymphocyte responses. However, Complicated Grief and Non-complicated Grief differed markedly in their expression of Type I interferon-related transcripts, with Non-complicated Grief subjects showing substantial upregulation relative to nonbereaved controls and Complicated Grief subjects showing substantial downregulation. Bereavement significantly modulates immune function gene expression. The magnitude of bereavement-related distress (i.e., Complicated Grief vs. Non-complicated Grief) is linked to differential patterns of transcription factor activation and gene expression involved in innate antiviral responses. These findings provide a molecular framework for understanding the health effects of bereavement, as well as new insights into the particular gene modules that are most sensitive to the individual's psychological response to loss. PMID:24380850

  16. Divergent gene expression responses to complicated grief and non-complicated grief.

    PubMed

    O'Connor, Mary-Frances; Schultze-Florey, Christian R; Irwin, Michael R; Arevalo, Jesusa M G; Cole, Steven W

    2014-03-01

    The "widowhood effect" (i.e., morbidity/mortality in recently bereaved spouses) may be related to changes in immune function, but little is known about the impact of bereavement on gene transcription in immune cells. This study examined how Complicated Grief and Non-complicated Grief responses to bereavement differentially affect leukocyte gene expression. Genome-wide transcriptional profiling and bioinformatic analyses were completed on 63 older adults. Thirty-six of them had lost their spouse/partner on average 2years ago, and 27 were nonbereaved, married controls. Twelve of the bereaved participants met criteria for Complicated Grief. Compared to nonbereaved controls, bereavement (both Complicated Grief and Non-complicated Grief) was associated with upregulated expression of genes involved in general immunologic activation and a selective downregulation of genes involved in B lymphocyte responses. However, Complicated Grief and Non-complicated Grief differed markedly in their expression of Type I interferon-related transcripts, with Non-complicated Grief subjects showing substantial upregulation relative to nonbereaved controls and Complicated Grief subjects showing substantial downregulation. Bereavement significantly modulates immune function gene expression. The magnitude of bereavement-related distress (i.e., Complicated Grief vs. Non-complicated Grief) is linked to differential patterns of transcription factor activation and gene expression involved in innate antiviral responses. These findings provide a molecular framework for understanding the health effects of bereavement, as well as new insights into the particular gene modules that are most sensitive to the individual's psychological response to loss. PMID:24380850

  17. Molecular targets of diabetic vascular complications and potential new drugs.

    PubMed

    Da Ros, Roberto; Assaloni, Roberta; Ceriello, Antonio

    2005-06-01

    In diabetes, oxidative stress plays a key role in the pathogenesis of vascular complications, and an early step of such damage is considered to be the development of an endothelial dysfunction. Hyperglycemia directly promotes an endothelial dysfunction inducing process of overproduction of superoxide and consequently peroxynitrite, that damages DNA and activates the nuclear enzyme poly(ADP-ribose) polymerase. This process, depleting NAD+, slowing glycolsis, ATP formation and electron transport, results in acute endothelial dysfunction in diabetic blood vessels and contributes to the development of diabetic complications. These new findings may explain why classical antioxidants, like vitamin E, that work scavenging already formed toxic oxidation products, have failed to show beneficial effects on diabetic complications, and suggest new and attractive "causal" antioxidant therapy. New, low molecular mass compounds that act as SOD or catalase mimetics or L-propionyl-carnitine and lipoic acid, that work as intracellular superoxide scavengers, improving mitochondrial function and reducing DNA damage, may be good candidates for such strategy, and preliminary studies support this hypothesis. This "causal" therapy would also be associated with other promising tools such as LY 333531, PJ34 and FP15, which block protein kinase beta isoform, poly(ADP-ribose) polymerase and peroxynitrite, respectively. It is now evident that, statins, ACE inhibitors, AT-1 blockers, calcium channel blockers and thiazolidinediones have a strong intracellular antioxidant activity, and it has been suggested that many of their beneficial ancillary effects are due to this property. This preventive activity against oxidative stress generation can justify a large utilization and association of this compounds for preventing complications in diabetic patients where antioxidant defences have been shown to be defective. PMID:16026269

  18. Brain sonography in African infants with complicated sporadic bacterial meningitis

    PubMed Central

    Eze, Kenneth C.; Enukegwu, Sam U.; Odike, Angela I.

    2013-01-01

    Background: To determine the structural findings in brain sonography of African infants with complicated sporadic bacterial meningitis. Materials and Methods: Retrospective assessment of medical records of patients who underwent brain sonography on account of complicated bacterial meningitis. The brain sonography was carried out over a 4-year period (between September 15, 2004 and September 14, 2008). Result: A total of 86 infants were studied (40 boys and 46 girls in a ratio of 1:1.1); more than 70% of the patients were aged below 6 months. Presenting complaint included convulsion with fever in 34 (39.53%), persistent fever 20 (23.26%), bulging fontanelles 8 (9.30%), coma 7 (8.14%) and sepsis with convulsion 6 (6.98%), among others. Patients’ place of previous treatment included specialist hospitals 33 (38.37%), private hospitals 21 (24.42%), herbal home centres 12 (13.95%), nursing homes 8 (9.30%), patent medicine stores 7 (8.14%) and other non-doctor attended clinics 5 (5.81%) infants. The sonographic findings included hydrocephalus 36 (41.86%), cerebral infarction 12 (13.95%), encephalocoele 9 (10.49%) and intracerebral abscess 7 (8.14%) infants. Cerebritis 5 (5.81%), intracerebral hemorrhage 3 (3.49%), porocephalic cysts 2 (2.33%), cerebral oedema 2 (2.33%), intraventricular haemorrhage 1 (1.16%) and subdural collection 1 (1.16%) infants; 8 patients (9.30%) had normal findings. Conclusion: Hydrocephalus, cerebral infarction and intracerebral abscess were the most common complications elicited by sonography in this study. Early and adequate treatment with antibiotics in patients with persistent fever and convulsion with fever will reduce the complications of meningitis and its long-term neurological sequelae. PMID:24403710

  19. Acute Kidney Injury Complicated Epstein-Barr Virus Infection in Infancy

    PubMed Central

    Ozgurhan, Gamze; Ozcetin, Mustafa; Vehapoglu, Aysel; Karakaya, Zeynep; Aygun, Fatih

    2015-01-01

    Infectious mononucleosis is an acute lymphoproliferative disorder caused by the Epstein-Barr virus (EBV) and seen most commonly in children and young adults. Clinical presentation of the disease is characterized by fever, tonsillopharyngitis, lymphadenopathy, and hepatosplenomegaly, whereas serological findings of this benign disorder include positive heterophilic antibody formation (transient increase in heterophilic antibodies) and prominence of hematological lymphocytosis of more than 10% of atypical lymphocytes. An EBV infection is usually asymptomatic in childhood, but acute kidney injury can be a rare complication during its course. Most cases recover from the disease completely. Early recognition of EBV infection and estimation of its complication are important for its prognosis. In light of previous literature, we discuss the case evaluated as an EBV infection complicated by acute kidney injury in early childhood and results of tubulointerstitial nephritis shown on a renal biopsy that was later diagnosed as an EBV infection by serological examination.

  20. From Pre-Clinical Studies to Clinical Trials: Generation of Novel Therapies for Pregnancy Complications

    PubMed Central

    Cottrell, Elizabeth C.; Sibley, Colin P.

    2015-01-01

    Complications of pregnancy represent a significant disease burden, with both immediate and lasting consequences for mother and baby. Two key pregnancy complications, fetal growth restriction (FGR) and preeclampsia (PE), together affect around 10%–15% of all pregnancies worldwide. Despite this high incidence, there are currently no therapies available to treat these pregnancy disorders. Early delivery remains the only intervention to reduce the risk of severe maternal complications and/or stillbirth of the baby; however early delivery itself is associated with increased risk of neonatal mortality and morbidity. As such, there is a pressing need to develop new and effective treatments that can prevent or treat FGR and PE. Animal models have been essential in identifying and screening potential new therapies in this field. In this review, we address recent progress that has been made in developing therapeutic strategies for pregnancy disorders, some of which are now entering clinical trials. PMID:26062129

  1. Risk factors for postoperative respiratory complications in adult liver transplant recipients

    Microsoft Academic Search

    A Pirat; S Özgur; A Torgay; S Candan; P Zeynelo?lu; G Arslan

    2004-01-01

    To determine the types and the incidence of as well as risk factors for early postoperative (<30 days) respiratory complications in adult liver transplant (LT) recipients, we reviewed The data of 44 consecutive adult LT recipients who received their grafts from January 1995 through December 2002. The data included demographic features; primary diagnosis; number of intraoperative transfusions; preoperative and postoperative

  2. [The surgery of laparoceles. The postoperative complications].

    PubMed

    Garavello, A; Tuccimei, U; Sadighi, A; Belardi, A; Remedi, M; Antonellis, D

    1997-05-01

    The use of prosthetic meshes in incisional hernias repairs is now very attractive, particularly for wide fascial defects; nevertheless the presence of a foreign body and placement technique may be responsible for complications sometimes leading to failure. To evaluate technical problems and complications in incisional hernia surgery the authors reviewed their 5 year experience in 70 patients; 39 mesh repairs and 31 direct sutures of the abdominal wall were performed. Local complications (fistulas, wound hematoma or infections) were more frequent in the former group; PTFE meshes showed a lower resistance to infections, particularly in diabetics, and in three patients partial or total removal was mandatory. Prosthetic meshes showed a marked reduction of recurrences in incisional hernia surgery, but their use leads to more local complications than direct repair; the authors believe that mesh placement must be evaluated for every single patient and not used as a routine procedure. PMID:9297143

  3. [Complications of laparoscopic cholecystectomy. Free intraperitoneal calculi].

    PubMed

    Schroeyers, P; Mansvelt, B; Bertrand, C; de Neve de Roden, A

    1994-01-01

    With the use of laparoscopic cholecystectomy, increasing numbers of gallstones are being left in the peritoneal cavity. To our knowledge, the rarely cause complications. We present two cases with stone spillage after laparoscopic cholecystectomy, with a different outcome. PMID:7864541

  4. Pulmonary hypertension complicating connective tissue disease.

    PubMed

    Lynch, Joseph P; Belperio, John A; Saggar, Rajeev; Fishbein, Michael C; Saggar, Rajan

    2013-10-01

    Pulmonary hypertension (PH) may complicate connective tissue disease (CTD), particularly systemic sclerosis (SSc, scleroderma), and markedly increases mortality. More than 70% of cases of PH complicating CTD occur in SSc, which is the major focus of this article. Pulmonary complications (i.e., interstitial lung disease [ILD] and PH) are the leading causes of scleroderma-related deaths. "Isolated" PH (i.e., without ILD) complicates SSc in 7.5 to 20% of cases; secondary PH may also occur in patients with SSc-associated ILD. Several clinical markers and specific autoantibody profiles have been associated with PH in SSc. The role of PH-specific therapy is controversial, as prognosis and responsiveness to therapy are worse in SSc-associated PH compared with idiopathic pulmonary arterial hypertension. We discuss medical therapies for CTD-associated PH and the role of lung transplantation for patients failing medical therapy. PMID:24037627

  5. Predicting vascular complications in percutaneous coronary interventions

    Microsoft Academic Search

    Winthrop D Piper; David J Malenka; Thomas J Ryan; Samuel J Shubrooks; Gerald T O’Connor; John F Robb; Karen L Farrell; Mary S Corliss; Michael J Hearne; Mirle A Kellett; Matthew W Watkins; William A Bradley; Bruce D Hettleman; Theodore M Silver; Paul D McGrath; John R O’Mears; David E Wennberg

    2003-01-01

    ObjectivesUsing a large, current, regional registry of percutaneous coronary interventions (PCI), we identified risk factors for postprocedure vascular complications and developed a scoring system to estimate individual patient risk.

  6. Neurological complications of beta-thalassemia.

    PubMed

    Nemtsas, P; Arnaoutoglou, M; Perifanis, V; Koutsouraki, E; Orologas, A

    2015-08-01

    The thalassemias are the most common single gene disorder in the world. Over the last years, several reports have demonstrated neurological complications in beta-thalassemia patients. In most cases, these complications remained subclinical and were detected only during neuropsychological, neurophysiological, or neuroimaging evaluation. Cognitive impairment, abnormal findings on evoked potentials, complications due to extramedullary hematopoiesis, cerebrovascular disease, and peripheral neuropathy comprise the broad spectrum of neurological involvement. Chronic hypoxia, iron overload, desferrioxamine neurotoxicity, and bone marrow expansion are implicated, but sufficient explanatory evidence is lacking and development of biomarkers is needed. This review summarizes current knowledge of the neurological complications. As life expectancy for beta-thalassemia patients increases, we support the use of neurophysiological, neuropsychological, or neuroimaging monitoring, enabling the evaluation of neural pathway impairment, to achieve appropriate management and as a result a better quality of life for this patient group. PMID:25903043

  7. Cardiac Complications in Acute Ischemic Stroke

    E-print Network

    2011-01-01

    of cardiac function and complications with AIS. EmergencyAIS patients. 50,51 Regarding structural systolic functionAIS (ie, the ischemic penumbra) intrinsic autoregulation of the vasculature is lost, rendering cerebral blood ?ow directly dependent on cardiac function.

  8. [Ischemic testicular necrosis following vasectomy: rare and typical complications of an outpatient procedure].

    PubMed

    Rolfes, N; Lümmen, G

    2011-10-01

    Taking the clinical case of a patient who developed unilateral testicular necrosis following vasectomy as a starting point, the early and late complications of this procedure are described based on a literature review.In the USA 7% of all men undergo vasectomy, as compared to 2% in Germany. Early postoperative complications include bleeding/hematoma (0.5-18%), infection (0.3-32.9%), epididymitis (0.4-6.1%), granuloma (0.07-90%), and rare complications such as vas deferens abscess, vesicular gland abscess, vasovenous fistula, testicular necrosis, arteriovenous fistula, pulmonary embolism, endocarditis, scrotal skin necrosis and Fournier's disease which mostly have been reported in the form of case reports. Late complications are chronic pain (0.5-18%), pain during sex (2.9%), hydrocele (0-4%) as well as spermatocele (1.6%). There is a failure rate of 4.3-16% as concluded from the number of patients with nonmotile sperm in the post-vasectomy semen analysis. The postoperative paternity rate is 0-4%.Bilateral vasectomy is a secure way of contraception; perioperative and late complications are on an average rare, however, with a range up to 90%. In individual cases severe complications occur, which should be detected at an early stage. Therefore a close follow-up should be maintained after this outpatient procedure. One should ask for risk factors of endocarditis or thrombosis preoperatively. The patient should be informed of the possible loss of a testicle because of the severity of this complication. Postoperative semen analysis is obligatory. PMID:21845426

  9. Complications in pediatric cochlear implant surgery

    Microsoft Academic Search

    H.-G. Kempf; K. Johann; T. Lenarz

    1999-01-01

    In a retrospective analysis we evaluated the intra- and postoperative complications in children who underwent cochlear implantation\\u000a between 1984 and 1993 at the Medizinische Hochschule Hannover. The data and records of 366 children were collected and analyzed.\\u000a Relevant parameters were major complications such as significant infection, intraoperative bleeding, facial nerve injury,\\u000a implant loss and device failure, as well as lesser

  10. Complications and therapy after subarachnoid haemorrhage

    Microsoft Academic Search

    S. M. Dorhout Mees

    2012-01-01

    Subarachnoid haemorrhage (SAH) is a subset of stroke with a poor prognosis, up to 40% of patients die. Besides the impact of the initial haemorrhage, several neurological and systemic complications contribute to a poor clinical outcome.\\u000a\\u000aThe first part of this thesis describes several complications after SAH. It is well known that SAH patients often have hyperglycaemia, and in chapter

  11. Irreversible neurologic complications of metrizamide myelography.

    PubMed

    Meador, K; Hamilton, W J; El Gammal, T A; Demetropoulos, K C; Nichols, F T

    1984-06-01

    Metrizamide, a major contrast agent for myelographic procedures, has rarely been reported to cause irreversible neurologic complications. The major transient neurologic alterations include neuropsychological reactions, generalized tonic-clonic seizures, and headaches. Two cases of irreversible spinal neurologic deficits resulting from metrizamide myelography are reported, and the factors that may increase the risks of complications in metrizamide myelographic studies are discussed, including preexisting dehydration, patient positioning, and the concentration of contrast agent. PMID:6539448

  12. Management of orbital complications due to rhinosinusitis

    Microsoft Academic Search

    V. Siedek; A. Kremer; C. S. Betz; U. Tschiesner; A. Berghaus; A. Leunig

    2010-01-01

    Emergencies in sinusitis are in 60–75% orbital complications defined by blepharedema (stage I), periostitis (stage II), subperiostal\\u000a abscesses (SPA) (stage III) and orbital cellulites (stage IV). Ophthalmic complications such as diplopia, exophthalmia and\\u000a reduced visual acuity are seen in stages III and IV. There is a consensus for primary conservative treatment in stage I or\\u000a II and until recently for

  13. Complications of Intrathecal Baclofen Pumps in Children

    Microsoft Academic Search

    Judith L. Gooch; Wende A. Oberg; Barbara Grams; Lorrie A. Ward; Marion L. Walker

    2003-01-01

    Intrathecal baclofen is increasingly being used to manage severe spasticity in children. Although substantial tone reduction with this treatment has been documented, complications also occur. In this study, we describe the device- and major non-device-related complications in a group of 100 consecutive children and young adults who received 117 intrathecal baclofen pumps for the management of severe spasticity. Twenty-four patients

  14. Complications of anterior compartment vaginal surgery

    Microsoft Academic Search

    Eric S. Rovner

    2007-01-01

    Many complications can be associated with anterior compartment surgery of the vagina. With the integration of synthetic materials\\u000a into the surgical armamentarium for the repair of stress urinary incontinence in the form of midurethral slings, and for the\\u000a repair of vaginal prolapse as a primary procedure or to augment an existing repair, the spectrum of complications related\\u000a to this type

  15. Vascular ring complicates accidental button battery ingestion.

    PubMed

    Mercer, Ronald W; Schwartz, Matthew C; Stephany, Joshua; Donnelly, Lane F; Franciosi, James P; Epelman, Monica

    2015-01-01

    Button battery ingestion can lead to dangerous complications, including vasculoesophageal fistula formation. The presence of a vascular ring may complicate battery ingestion if the battery lodges at the level of the ring and its important vascular structures. We report a 4-year-old boy with trisomy 21 who was diagnosed with a vascular ring at the time of button battery ingestion and died 9 days after presentation due to massive upper gastrointestinal bleeding from esophageal erosion and vasculoesophageal fistula formation. PMID:25662210

  16. Cervical plate fracture: a rare complication

    PubMed Central

    Veli, Citisli; Muhammet, Ibrahimoglu; Serkan, Civlan; Murat, Kocaoglu

    2015-01-01

    In traumatic and degenerative diseases cervical fusion with anterior cervical plate are commonly used. The increase in the use of cervical plate segment level is also increased risk of developing complications. This case report shows that the increase in the use of cervical plate segment level and also the complications in cervical spinal instrumentation, short-segment cervical plate rare case reported to be broken.

  17. Policy Paper: The Predictive Validity of Early Childhood Variables.

    ERIC Educational Resources Information Center

    Apling, Richard; Bryk, Anthony

    Some early childhood variables are examined to evaluate their predictive validity. The selection of children needing early childhood Title I services is complicated by the lack of criteria for defining who is educationally disadvantaged and the special problems of early childhood testing and measurement. The study used re-analysis of longitudinal…

  18. Imaging of complications in liver transplantation.

    PubMed

    Nghiem, H V; Tran, K; Winter, T C; Schmiedl, U P; Althaus, S J; Patel, N H; Freeny, P C

    1996-07-01

    Hepatic transplantations are being performed with increasing frequency, leading to greater demand for accurate evaluation of related complications. Ultrasonography (US) is the primary screening technique for detection of vascular complications of hepatic transplantation: angiography is used to confirm the US findings or when the US study is suboptimal. Hepatic artery thrombosis, the most common (as high as 42% of pediatric cases; 4%-12% of adult cases) and important vascular complication, may be associated with bilomas, infarcts, or abscesses at gray-scale US and absence of proper hepatic and intrahepatic arterial flow at Doppler analysis. Hepatic artery stenosis (seen in 11% of cases) is suspected if a focal accelerated velocity of greater than 2-3 m/sec with turbulence is seen at or distal to the stenosis or if a tardus parvus pattern of intrahepatic arterial flow is seen. In cases of inferior vena cava thrombosis and stenosis, US may show echogenic thrombus or obvious narrowing, with a substantially increased flow velocity through the stenosis or reversal of flow in the hepatic veins. Biliary complications occur relatively often (13%-25% of cases) after liver transplantation; bile leakage and biliary stricture, the most common biliary complications, are seen as a fluid collection and a stricture, respectively. Although acute rejection is one of the most serious complications affecting graft survival, it cannot be reliably detected with available diagnostic tests or radiologic methods. PMID:8835974

  19. Complications related to pubic hair removal

    PubMed Central

    DEMARIA, Andrea L.; FLORES, Marissa; HIRTH, Jacqueline M.; BERENSON, Abbey B.

    2014-01-01

    Objectives We investigated the prevalence and correlates of complications related to pubic hair removal among a diverse clinical sample of women attending a public clinic. Study Design Women (aged 16 to 40 years) who received care from April to June 2012 at two publicly funded clinics completed an anonymous, self-administered questionnaire (n=369). After excluding women with missing data, analyses were conducted on 333 women. Additional measures were retrieved through a medical chart review. Chi-square and multivariable logistic regression were used to analyze participant characteristics, pubic hair removal behaviors, and complications related to pubic hair removal. Results Most women (87%) admitted to current removal of at least some pubic hair, while the remainder responded that they had removed pubic hair in the past. Under or normal weight women were more likely to report total pubic hair removal than overweight or obese women. The majority (60%) had experienced at least one health complication due to removal, of which the most common were epidermal abrasion and ingrown hairs. Black and Hispanic women were less likely than white women to report complications. Overweight or obese women were almost twice as likely to report a complication and almost 3 times as likely if they were also total removers. Only 4% had seen a healthcare provider for a complication related to hair removal and only 4% discussed safe removal practices with their doctor. Conclusions Minor complications commonly occur as a result of pubic hair removal. Gynecological visits could provide a safe environment for women to discuss pubic hair removal practices. PMID:24486227

  20. Complications following Tension-Free Vaginal Tapes: Accurate Diagnosis and Complications Management

    PubMed Central

    Kociszewski, J.; Kolben, S.; Barski, D.; Viereck, V.; Barcz, E.

    2015-01-01

    The sling procedures are the gold standard for SUI treatment. They are highly effective but not free from complications. The most common adverse effect for the surgery with the implant insertion is: overactive bladder occurring de novo after the surgery, voiding dysfunctions, urine retention, and unsatisfactory treatment outcome. The most important question that arises after 20 years of sling procedures is how to manage the complications and what can be offered to complicated patients. The above review summarises the ultrasound findings in complicated cases and shows the scheme of management of the clinical problems concerning the tape location in suburethral region. PMID:25973423

  1. Acute complications of spinal cord injuries

    PubMed Central

    Hagen, Ellen Merete

    2015-01-01

    The aim of this paper is to give an overview of acute complications of spinal cord injury (SCI). Along with motor and sensory deficits, instabilities of the cardiovascular, thermoregulatory and broncho-pulmonary system are common after a SCI. Disturbances of the urinary and gastrointestinal systems are typical as well as sexual dysfunction. Frequent complications of cervical and high thoracic SCI are neurogenic shock, bradyarrhythmias, hypotension, ectopic beats, abnormal temperature control and disturbance of sweating, vasodilatation and autonomic dysreflexia. Autonomic dysreflexia is an abrupt, uncontrolled sympathetic response, elicited by stimuli below the level of injury. The symptoms may be mild like skin rash or slight headache, but can cause severe hypertension, cerebral haemorrhage and death. All personnel caring for the patient should be able to recognize the symptoms and be able to intervene promptly. Disturbance of respiratory function are frequent in tetraplegia and a primary cause of both short and long-term morbidity and mortality is pulmonary complications. Due to physical inactivity and altered haemostasis, patients with SCI have a higher risk of venous thromboembolism and pressure ulcers. Spasticity and pain are frequent complications which need to be addressed. The psychological stress associated with SCI may lead to anxiety and depression. Knowledge of possible complications during the acute phase is important because they may be life threatening and/ or may lead to prolonged rehabilitation. PMID:25621207

  2. Acute complications of spinal cord injuries.

    PubMed

    Hagen, Ellen Merete

    2015-01-18

    The aim of this paper is to give an overview of acute complications of spinal cord injury (SCI). Along with motor and sensory deficits, instabilities of the cardiovascular, thermoregulatory and broncho-pulmonary system are common after a SCI. Disturbances of the urinary and gastrointestinal systems are typical as well as sexual dysfunction. Frequent complications of cervical and high thoracic SCI are neurogenic shock, bradyarrhythmias, hypotension, ectopic beats, abnormal temperature control and disturbance of sweating, vasodilatation and autonomic dysreflexia. Autonomic dysreflexia is an abrupt, uncontrolled sympathetic response, elicited by stimuli below the level of injury. The symptoms may be mild like skin rash or slight headache, but can cause severe hypertension, cerebral haemorrhage and death. All personnel caring for the patient should be able to recognize the symptoms and be able to intervene promptly. Disturbance of respiratory function are frequent in tetraplegia and a primary cause of both short and long-term morbidity and mortality is pulmonary complications. Due to physical inactivity and altered haemostasis, patients with SCI have a higher risk of venous thromboembolism and pressure ulcers. Spasticity and pain are frequent complications which need to be addressed. The psychological stress associated with SCI may lead to anxiety and depression. Knowledge of possible complications during the acute phase is important because they may be life threatening and/ or may lead to prolonged rehabilitation. PMID:25621207

  3. The cost of diabetes chronic complications among Iranian people with type 2 diabetes mellitus

    PubMed Central

    2014-01-01

    Background To evaluate the cost of diabetes related micro- and macrovascular complications in Iranian people with type 2 diabetes mellitus. Methods In routine clinical practice, people with type 2 diabetes mellitus were assessed for 10 years at a diabetes care center. The type of medications and clinical data were extracted from patients’ documents. Mortality rate and the incidence of micro- and macrovascular complications recorded in patients’ documents were analyzed. Cost analysis was comprised of 1) para clinic costs as well as laboratory, medications, clinical visits and nonmedical costs 2) inpatient costs as well as hospital admission costs, disability, and mortality costs. Results From 1562 people with type 2 diabetes mellitus, a total of 1000 patients with mean duration disease of 11.2 years, who had completed information in their documents, were studied. All people were free from complications at baseline. Mean cumulative incidence of diabetes-related complications over 10 years were 10.9?±?3.5%, 8.0?±?3.1%, 4.6?±?1.7%, 9.1?±?3.6% and 2.3?±?0.9% for peripheral neuropathy and diabetic foot ulcer, nephropathy, ophthalmic complications, cardiovascular disease and death, respectively. People with better glycemic control had less complication and also related expenditures. Average para clinic cost per patient was 393.6?±?47.8 and average inpatient cost per patient was 1520.7?±?104.5 USD. Conclusions Our findings demonstrate considerable incidence of diabetes chronic complications and also high health care expenditure for related complications among our patients. As the number of people with diabetes continues to rise, early detection of the disease and implementation of timely and appropriate therapeutic strategies could decrease the burden of diabetes chronic complications and also huge related expenditures. PMID:24593991

  4. Oral Complications of Chemotherapy and Head/Neck Radiation (PDQ)

    MedlinePLUS

    ... Radiation (PDQ®) General Information About Oral Complications Key Points Oral complications are common in cancer patients, especially ... and malnutrition . Oral Complications and Their Causes Key Points Cancer treatment can cause mouth and throat problems. ...

  5. Pathogenesis of diabetic cerebral vascular disease complication

    PubMed Central

    Xu, Ren-Shi

    2015-01-01

    Diabetes mellitus is one of the most potent independent risk factors for the development of diabetic cerebral vascular disease (CVD). Many evidences suggested that hyperglycemia caused excess free fatty acids, the loss of endothelium-derived nitric oxide, insulin resistance, the prothrombotic state, endothelial dysfunction, the abnormal release of endothelial vasoactivators, vascular smooth muscle dysfunction, oxidative stress, and the downregulation of miRs participated in vessel generation and recovery as well as the balance of endotheliocytes. In turn, these abnormalities, mainly via phosphatidylinositol 3 kinase, mitogen-activated protein kinase, polyol, hexosamine, protein kinase C activation, and increased generation of advanced glycosylation end products pathway, play an important role in inducing diabetic CVD complication. A deeper comprehension of pathogenesis producing diabetic CVD could offer base for developing new therapeutic ways preventing diabetic CVD complications, therefore, in the paper we mainly reviewed present information about the possible pathogenesis of diabetic CVD complication. PMID:25685278

  6. Penile skin necrosis - complication following selfcircumcision.

    PubMed

    Sagar, Jayesh; Sagar, Bethani; Shah, Dharmendra K

    2005-07-01

    Circumcision is one of the commonest operations performed throughout the world for ritual, traditional or medical reasons. Self-circumcision may lead to disastrous complications. There have been reports of the complications following use of the constricting devices for improved sexual performance and for auto-erotic intentions, but cases of self-circumcision leading to complications such as necrosis of the penile skin and strangulation of the penis are very rarely reported. This case represents penile skin necrosis in a 55-year-old white English man following an attempt at self-circumcision with a medically unapproved plastic device available in the market. He recovered after surgical debridement and treatment with antibiotics. PMID:16884600

  7. Complications of body sculpture: prevention and treatment.

    PubMed

    Toledo, Luiz S; Mauad, Raul

    2006-01-01

    In many countries, lipoplasty is the most frequently performed aesthetic procedure. It has been promoted as a safe, easy-to-learn, outpatient procedure. Although plastic surgeons have developed safety measures to perform the technique, there are serious risks, including death at a rate of 1/5000 procedures. Life-threatening complications include pulmonary embolism, hemorrhage, perforation, infection, lidocaine toxicity, epinephrine toxicity, third space fluid shifts, and fat embolism syndrome. Aesthetic complications include undercorrection (insufficient fat removal), overcorrection (excess fat removal), irregular fat removal with palpable and visible irregularities, edema, hematoma, seroma, local infection, cutaneous slough, hyperpigmentation, vasculopathies, and permanent color changes in the skin. In this article we present methods to prevent and, when possible, treat these complications. PMID:16427969

  8. Vaginal Evisceration: An Unexpected Complication of Conization

    PubMed Central

    Ghassani, Ali; Andre, Benoit; Simon-Toulza, Caroline; Tanguy le Gac, Yann; Martinez, Alejandra; Vidal, Fabien

    2014-01-01

    Background. Large loop excision of the transformation zone (LLETZ) is routinely performed for the management of high grade intracervical neoplasia (CIN). Several uncommon complications have been described, including postoperative peritonitis, pseudoaneurysm of uterine artery, and bowel fistula. We report a unique case of postoperative vaginal evisceration and the subsequent management. Case. A 73-years-old woman underwent LLETZ for high grade CIN. On postoperative day 3, she was admitted for small bowel evisceration through the vagina. Surgical management was based on combined laparoscopic and transvaginal approach and consisted in bowel inspection and reinstatement, peritoneal washing, and dehiscence repair. Conclusions. Vaginal evisceration is a rare but potentially serious complication of pelvic surgery. This case report is to make clinicians aware of such complication following LLETZ and its management. PMID:25506010

  9. Complications of Blepharoplasty: Prevention and Management

    PubMed Central

    Oestreicher, James; Mehta, Sonul

    2012-01-01

    Blepharoplasty is an operation to modify the contour and configuration of the eyelids in order to restore a more youthful appearance. The surgery involves removing redundant skin, fat, and muscle. In addition, supporting structures such as canthal tendons are tightened. Other conditions such as ptosis, brow ptosis, entropion, ectropion, or eyelid retraction may also need to be corrected at the time a blepharoplasty is performed to ensure the best functional and aesthetic result. Due to the complexity and intricate nature of eyelid anatomy, complications do exist. In addition to a thorough pre operative assessment and meticulous surgical planning, understanding the etiology of complications is key to prevention. Finally, management of complications is just as important as surgical technique. PMID:22655191

  10. Late-Presenting Complications After Splenic Trauma

    PubMed Central

    Freiwald, Sandra

    2010-01-01

    Since the 1970s, the management of blunt splenic trauma has evolved from almost exclusive surgical management to selective use of nonsurgical management in hemodynamically stable patients. Understanding of the spleen's immunologic importance in protection against overwhelming postsplenectomy infection led to development first of surgical techniques for splenic salvage and later to protocols for nonsurgical management of adults with blunt splenic injury. The evolution of nonsurgical management has resulted in new patterns of postsplenic trauma complications. This article describes a pancreatic pseudocyst, one of several described delayed complications of nonsurgical management of blunt splenic trauma. Along with missed splenic injury and delayed rupture, the development of a splenic pseudocyst represents challenges for any multidisciplinary team involved in trauma care. Detection and management of these complications is discussed, as is postsplenectomy vaccination and return to activity. PMID:20740116

  11. Ophthalmic complications associated with orthognathic surgery.

    PubMed

    Lanigan, D T; Romanchuk, K; Olson, C K

    1993-05-01

    Ophthalmic complications are rare following maxillary osteotomies. Potential complications include a decrease in visual acuity, extraocular muscle dysfunction, neuroparalytic keratitis, and nasolacrimal problems involving both an increase or a decrease in tearing. Ophthalmic injuries appear to be primarily mediated through indirect injuries to neurovascular structures occurring from traction, compression, or contrecoup injuries from forces transmitted during the pterygomaxillary dysjunction using an osteotome or from fractures extending to the base of the skull or orbit associated with the pterygomaxillary dysjunction or the maxillary downfracture. A review of the literature of previous ophthalmic complications as well as eight new cases are reported. The possible etiologic basis for these injuries is discussed in detail as well as treatment possibilities when appropriate. PMID:8478755

  12. Complications when augmenting the posterior maxilla.

    PubMed

    Fugazzotto, Paul; Melnick, Philip R; Al-Sabbagh, Mohanad

    2015-01-01

    The maxillary posterior edentulous region presents a challenge when planning for restoring missing teeth with a dental implant. The available bone in such cases is often not dense and not adequate for the placement of a properly sized implant because of maxillary sinus pneumatization and alveolar bone loss. Maxillary sinus lift is a predictable procedure to provide adequate bone height for the purpose of implant placement. However, complications are encountered during or after the execution of the sinus lift procedure. In this article, the prevention and management of maxillary sinus complications are discussed. PMID:25434561

  13. Musculoskeletal complications of neuromuscular disease in children.

    PubMed

    Driscoll, Sherilyn W; Skinner, Joline

    2008-02-01

    A wide variety of neuromuscular diseases affect children, including central nervous system disorders such as cerebral palsy and spinal cord injury; motor neuron disorders such as spinal muscular atrophy; peripheral nerve disorders such as Charcot-Marie-Tooth disease; neuromuscular junction disorders such as congenital myasthenia gravis; and muscle fiber disorders such as Duchenne's muscular dystrophy. Although the origins and clinical syndromes vary significantly, outcomes related to musculoskeletal complications are often shared. The most frequently encountered musculoskeletal complications of neuromuscular disorders in children are scoliosis, bony rotational deformities, and hip dysplasia. Management is often challenging to those who work with children who have neuromuscular disorders. PMID:18194756

  14. Emphysematous cystitis: an unreported complication after pancreaticoduodenectomy.

    PubMed

    Dumitrascu, T; Preda, Emi; Ionescu, M

    2015-01-01

    Pancreaticoduodenectomy was associated with an increased morbidity, and septic complications are the primary cause of death in these patients. However, severe sepsis, caused by a postoperative urinary tract infection, is uncommon. It is presented the case of a 72 years old man, with a pylorus-preserving pancreaticoduodenectomy for an ampullary adenocarcinoma. Postoperatively, the patient developed a chyle leak, and a severe urinary tract infection (i.e., emphysematous cystitis), with septic shock. The diagnosis, management and outcome are discussed. In conclusion, emphysematous cystitis is a potentially life-threatening complication, which may occur due to the postoperative immunodepression after pancreaticoduodenectomy. PMID:25970961

  15. Complicated otitis media and its implications.

    PubMed

    Leibovitz, Eugene

    2008-12-23

    Complicated otitis media (OM) is a common paediatric problem and includes two major entities: persistent acute OM (AOM) and recurrent AOM (R-AOM). Double-tympanocentesis studies comparing the microbiology of initial and recurrent episodes of AOM have demonstrated that most recurrent episodes occurring within 1 month after antibiotic therapy are new infections, not true bacteriological relapses. These findings have highlighted the importance of bacteriological eradication in the prevention of subsequent R-AOM episodes. The seven-valent pneumococcal conjugate vaccine (PCV7) targets Streptococcus pneumoniae, one of the main AOM pathogens, and data on the impact of PCV7 on complications of AOM, such as mastoiditis, are presented. PMID:19094932

  16. Complications of hand fractures and their prevention.

    PubMed

    Markiewitz, Andrew D

    2013-11-01

    Regardless of the clinician's technical skill, the results of hand fracture treatment may not be optimal. Tissue planes are damaged by the initial trauma, and surgical approaches to restore bony anatomy or develop tendon gliding further violate them with scarring producing adhesions and motion deficits. Close communication with therapists may help reduce complications. Identification and prompt treatment of these complications may allow improved function. However, repeat surgery may be necessary to improve the results. It is critical to work with the patient to match expectations and to minimize frustration of both the patient and the surgeon. PMID:24209957

  17. Anterior ankle arthroscopy: indications, pitfalls, and complications.

    PubMed

    Epstein, David M; Black, Brandee S; Sherman, Seth L

    2015-03-01

    Anterior ankle arthroscopy is a useful, minimally invasive technique for diagnosing and treating ankle conditions. Arthroscopic treatment offers the benefit of decreased surgical morbidity, less postoperative pain, and earlier return to activities. Indications for anterior ankle arthroscopy continue to expand, including ankle instability, impingement, management of osteochondritis dissecans, synovectomy, and loose body removal. Anterior ankle arthroscopy has its own set of inherent risks and complications. Surgeons can decrease the risk of complications through mastery of ankle anatomy and biomechanics, and by careful preoperative planning and meticulous surgical technique. PMID:25726482

  18. Transjugular intrahepatic portosystemic shunts and portal hypertension-related complications.

    PubMed

    Siramolpiwat, Sith

    2014-12-01

    Portal hypertension (PH) plays an important role in the natural history of cirrhosis, and is associated with several clinical consequences. The introduction of transjugular intrahepatic portosystemic shunts (TIPS) in the 1980s has been regarded as a major technical advance in the management of the PH-related complications. At present, polytetrafluoroethylene-covered stents are the preferred option over traditional bare metal stents. TIPS is currently indicated as a salvage therapy in patients with bleeding esophageal varices who fail standard treatment. Recently, applying TIPS early (within 72 h after admission) has been shown to be an effective and life-saving treatment in those with high-risk variceal bleeding. In addition, TIPS is recommended as the second-line treatment for secondary prophylaxis. For bleeding gastric varices, applying TIPS was able to achieve hemostasis in more than 90% of patients. More trials are needed to clarify the efficacy of TIPS compared with other treatment modalities, including cyanoacrylate injection and balloon retrograde transvenous obliteration of gastric varices. TIPS should also be considered in bleeding ectopic varices and refractory portal hypertensive gastropathy. In patients with refractory ascites, there is growing evidence that TIPS not only results in better control of ascites, but also improves long-term survival in appropriately selected candidates. In addition, TIPS is a promising treatment for refractory hepatic hydrothorax. However, the role of TIPS in the treatment of hepatorenal and hepatopulmonary syndrome is not well defined. The advantage of TIPS is offset by a risk of developing hepatic encephalopathy, the most relevant post-procedural complication. Emerging data are addressing the determination the optimal time and patient selection for TIPS placement aiming at improving long-term treatment outcome. This review is aimed at summarizing the published data regarding the application of TIPS in the management of complications related to PH. PMID:25493012

  19. Masters Scholarship Opportunities: Diagnostic Markers for Diabetic Complications

    E-print Network

    Hickman, Mark

    Masters Scholarship Opportunities: Diagnostic Markers for Diabetic Complications We are recruiting aimed at developing a novel biomedical test for diabetics at risk of developing further complications

  20. Encapsulating peritoneal sclerosis as a late complication of peritoneal dialysis

    PubMed Central

    Oran, Ebru; Seyit, Hakan; Besleyici, Canan; Ünsal, Abdulkadir; Al??, Halil

    2015-01-01

    Introduction Encapsulating peritoneal sclerosis (EPS) is a rare cause of intestinal obstruction which is characterized by fibrotic encapsulation of the bowel. Although its pathogenesis is still not clear, many etiological factors have been stated. Presentation of case In this report, we present a 26-year old woman with peritoneal dialysis related EPS. Because of the unresolving intestinal obstructive symptoms, she underwent surgical intervention in which the thick dense whitish membranous sac was excised from the surrounding intestine along with adhesiolysis. She recovered uneventfully. She is symptom-free on the eight months of follow-up. Discussion EPS should be born in mind as a complication of the long term peritoneal dialysis in patients with progressive obstructive ileus and recurrent peritonitis. Its treatment either medically or surgically varies depending on the stage of this entity. Conclusion Early identification of EPS is important in order to achieve better prognosis.

  1. Complications from Stereotactic Body Radiotherapy for Lung Cancer

    PubMed Central

    Kang, Kylie H.; Okoye, Christian C.; Patel, Ravi B.; Siva, Shankar; Biswas, Tithi; Ellis, Rodney J.; Yao, Min; Machtay, Mitchell; Lo, Simon S.

    2015-01-01

    Stereotactic body radiotherapy (SBRT) has become a standard treatment option for early stage, node negative non-small cell lung cancer (NSCLC) in patients who are either medically inoperable or refuse surgical resection. SBRT has high local control rates and a favorable toxicity profile relative to other surgical and non-surgical approaches. Given the excellent tumor control rates and increasing utilization of SBRT, recent efforts have focused on limiting toxicity while expanding treatment to increasingly complex patients. We review toxicities from SBRT for lung cancer, including central airway, esophageal, vascular (e.g., aorta), lung parenchyma (e.g., radiation pneumonitis), and chest wall toxicities, as well as radiation-induced neuropathies (e.g., brachial plexus, vagus nerve and recurrent laryngeal nerve). We summarize patient-related, tumor-related, dosimetric characteristics of these toxicities, review published dose constraints, and propose strategies to reduce such complications. PMID:26083933

  2. Complications from Stereotactic Body Radiotherapy for Lung Cancer.

    PubMed

    Kang, Kylie H; Okoye, Christian C; Patel, Ravi B; Siva, Shankar; Biswas, Tithi; Ellis, Rodney J; Yao, Min; Machtay, Mitchell; Lo, Simon S

    2015-01-01

    Stereotactic body radiotherapy (SBRT) has become a standard treatment option for early stage, node negative non-small cell lung cancer (NSCLC) in patients who are either medically inoperable or refuse surgical resection. SBRT has high local control rates and a favorable toxicity profile relative to other surgical and non-surgical approaches. Given the excellent tumor control rates and increasing utilization of SBRT, recent efforts have focused on limiting toxicity while expanding treatment to increasingly complex patients. We review toxicities from SBRT for lung cancer, including central airway, esophageal, vascular (e.g., aorta), lung parenchyma (e.g., radiation pneumonitis), and chest wall toxicities, as well as radiation-induced neuropathies (e.g., brachial plexus, vagus nerve and recurrent laryngeal nerve). We summarize patient-related, tumor-related, dosimetric characteristics of these toxicities, review published dose constraints, and propose strategies to reduce such complications. PMID:26083933

  3. Pylephlebitis: a rare complication of an intra-abdominal infection

    PubMed Central

    Wong, Katherine; Weisman, David S.; Patrice, Kelly-Ann

    2013-01-01

    Pylephlebitis is defined as an inflamed thrombosis of the portal vein. It is a rare complication of an intra-abdominal infection, and the diagnosis is often missed due to its nonspecific clinical presentation. Symptoms may include abdominal pain, fever, chills, fatigue, nausea, and vomiting. It is important to consider this differential when a patient presents with signs of abdominal sepsis since it has a high mortality rate and is often diagnosed postmortem. Pylephlebitis can be diagnosed via abdominal ultrasound or CT demonstrating a thrombus in the portal vein, and it must be treated early and aggressively with broad-spectrum antibiotics. We are presenting a case of pylephlebitis as well as discussing the diagnosis and treatment of this potentially lethal condition. PMID:23882407

  4. Complicating Complicity: Aiding and Abetting Causing Death by Dangerous Driving in R v Martin

    Microsoft Academic Search

    Sally Cunningham

    2011-01-01

    The law of complicity, particularly relating to joint enterprise liability, appears to becoming more and more complicated. Cases on secondary liability for murder in the Court of Appeal demonstrate that this area of law is difficult to interpret and to apply. Even more complex is the question of how to apply these cases to offences other than murder. This case

  5. Orthopedic surgery and its complication in systemic lupus erythematosus

    PubMed Central

    Mak, Anselm

    2014-01-01

    Systemic lupus erythematosus (SLE) is a multi-systemic immune-complex mediated autoimmune condition which chiefly affects women during their prime year. While the management of the condition falls into the specialty of internal medicine, patients with SLE often present with signs and symptoms pertaining to the territory of orthopedic surgery such as tendon rupture, carpal tunnel syndrome, osteonecrosis, osteoporotic fracture and infection including septic arthritis, osteomyelitis and spondylodiscitis. While these orthopedic-related conditions are often debilitating in patients with SLE which necessitate management by orthopedic specialists, a high index of suspicion is necessary in diagnosing these conditions early because lupus patients with potentially severe orthopedic conditions such as osteomyelitis frequently present with mild symptoms and subtle signs such as low grade fever, mild hip pain and back tenderness. Additionally, even if these orthopedic conditions can be recognized, complications as a result of surgical procedures are indeed not uncommon. SLE per se and its various associated pharmacological treatments may pose lupus patients to certain surgical risks if they are not properly attended to and managed prior to, during and after surgery. Concerted effort of management and effective communication among orthopedic specialists and rheumatologists play an integral part in enhancing favorable outcome and reduction in postoperative complications for patients with SLE through thorough pre-operative evaluation, careful peri-operative monitoring and treatment, as well as judicious postoperative care. PMID:24653977

  6. Acute spinal subdural hematoma complicating lumbar decompressive surgery

    PubMed Central

    Chang, Kok Chun; Samartzis, Dino; Luk, Keith D.K.; Cheung, Kenneth M.C.; Wong, Yat-Wa

    2012-01-01

    Study design:?A case report. Objective:?To report a rare case of acute spinal subdural hematoma (SSH) complicating lumbar spine surgery, its characteristic presenting symptoms, diagnostic imaging, possible cause, and pitfall in management. Methods:?A 59-year-old woman with lumbar spinal instability and stenosis underwent laminectomy and decompression at L3–L5 with instrumentation and fusion from L3–S1. Results:?Immediately following surgery, the patient presented with incapacitating pain of both lower extremities from the mid-thigh downward, which was not relieved by narcotic analgesia and was disproportional to surgical trauma. Left ankle and great toes weakness was detected at postoperative day 2 and deteriorated on day 6. Magnetic resonance imaging was performed urgently and revealed a characteristic SSH with thecal sac compression at the level of L2, proximal to the laminectomy. Emergency decompression and evacuation of the hematoma was performed. The patient had partial recovery 6 weeks postoperatively. Conclusion:?Acute SSH is a rare complication of lumbar spine surgery. This diagnosis must be considered when severe leg pain, unresolved with analgesia and disproportional to surgical trauma, with neurological deterioration occurring after lumbar spine surgery. Magnetic resonance imaging is the imaging modality of choice to assist in the differential diagnosis of an SSH. Early surgical decompression is necessary for optimal neurological recovery. PMID:23236307

  7. Protein O-GlcNAcylation in diabetes and diabetic complications

    PubMed Central

    Ma, Junfeng; Hart, Gerald W

    2014-01-01

    The post-translational modification of serine and threonine residues of proteins by O-linked ?-N-acetylglucosamine (O-GlcNAc) is highly ubiquitous, dynamic and inducible. Protein O-GlcNAcylation serves as a key regulator of critical biological processes including transcription, translation, proteasomal degradation, signal transduction and apoptosis. Increased O-GlcNAcylation is directly linked to insulin resistance and to hyperglycemia-induced glucose toxicity, two hallmarks of diabetes and diabetic complications. In this review, we briefly summarize what is known about protein O-GlcNAcylation and nutrient metabolism, as well as discuss the commonly used tools to probe changes of O-GlcNAcylation in cultured cells and in animal models. We then focus on some key proteins modified by O-GlcNAc, which play crucial roles in the etiology and progression of diabetes and diabetic complications. Proteomic approaches are also highlighted to provide a system view of protein O-GlcNAcylation. Finally, we discuss how aberrant O-GlcNAcylation on certain proteins may be exploited to develop methods for the early diagnosis of pre-diabetes and/or diabetes. PMID:23992419

  8. Gastrointestinal Complications of Laparoscopic/Robot-Assisted Urologic Surgery and a Review of the Literature

    PubMed Central

    Karadag, Mert Ali; Cecen, Kursat; Demir, Aslan; Bagcioglu, Murat; Kocaaslan, Ramazan; Kadioglu, Teoman Cem

    2015-01-01

    Gastrointestinal injuries that occur during or after laparoscopic and robot-assisted surgery are serious side effects that affect patient outcome. In this review, we attempt to highlight the identification, incidence and management of gastrointestinal and visceral complications of laparoscopic and robot-assisted surgery. A search of Medline and PubMed databases was performed using the following terms: gastrointestinal complications of laparoscopy, laparoscopic, kidney and robotic surgery. A total of 1,072 papers related to the subject were analyzed. Forty-six of these papers were included in the present review. These papers reported high numbers of participants and had a high level of evidence. Gastrointestinal complications during laparoscopic and robot-assisted surgery are rare, but similar, and can occur at any time between access and closure. Despite their infrequency, these complications can result in mortality. The early recognition and management of gastrointestinal complications is very important. Unrecognized or delayed identification of gastrointestinal complications may cause sepsis and death. PMID:25699115

  9. Percutaneous Lung Biopsy: Technique, Efficacy, and Complications

    PubMed Central

    Winokur, Ronald S.; Pua, Bradley B.; Sullivan, Brian W.; Madoff, David C.

    2013-01-01

    Computed tomography-guided percutaneous needle biopsy of the lung is an indispensable tool in the evaluation of pulmonary abnormalities due to its high diagnostic accuracy in the detection of malignancy. Percutaneous biopsy in the lung plays a critical role in obtaining pathologic proof of malignancy, guiding staging and planning treatment. This article reviews biopsy techniques and their related efficacy and complications. PMID:24436527

  10. Rare complications of pediatric diabetic ketoacidosis.

    PubMed

    Bialo, Shara R; Agrawal, Sungeeta; Boney, Charlotte M; Quintos, Jose Bernardo

    2015-02-15

    The incidence of type 1 diabetes (T1D) among youth is steadily increasing across the world. Up to a third of pediatric patients with T1D present with diabetic ketoacidosis, a diagnosis that continues to be the leading cause of death in this population. Cerebral edema is the most common rare complication of diabetic ketoacidosis in children. Accordingly, treatment and outcome measures of cerebral edema are vastly researched and the pathophysiology is recently the subject of much debate. Nevertheless, cerebral edema is not the only sequela of diabetic ketoacidosis that warrants close monitoring. The medical literature details various other complications in children with diabetic ketoacidosis, including hypercoagulability leading to stroke and deep vein thrombosis, rhabdomyolysis, pulmonary and gastrointestinal complications, and long-term memory dysfunction. We review the pathophysiology, reported cases, management, and outcomes of each of these rare complications in children. As the incidence of T1D continues to rise, practitioners will care for an increasing number of pediatric patients with diabetic ketoacidosis and should be aware of the various systems that may be affected in both the acute and chronic setting. PMID:25685287

  11. Fournier gangrene: rare complication of rectal cancer

    PubMed Central

    Ossibi, Pierlesky Elion; Souiki, Tarik; Majdoub, Karim Ibn; Toughrai, Imane; Laalim, Said Ait; Mazaz, Khalid; Tenkorang, Somuah; Farih, My Hassan

    2015-01-01

    Fournier's Gangrene is a rare complication of rectal cancer. Its discovery is often delayed. It's incidence is about 0.3/100 000 populations in Western countries. We report a patient with peritoneal perforation of rectal cancer revealed by scrotal and perineal necrotizing fasciitis.

  12. Topical Review: Neurologic Complications of Immunization

    Microsoft Academic Search

    James F. Bale

    2004-01-01

    In the United States and many other developed countries, active immunization of children has virtually eliminated poliomyelitis, measles, rubella, tetanus, and other diseases, such as disease due to Haemophilus influenzae type b. Individual vaccines can produce systemic or neurologic reactions ranging from minor events, such as pain and erythema at the injection site, to major complications, such as seizures, shock,

  13. Acute transverse myelopathy complicating systemic lupus erythematosus.

    PubMed Central

    Propper, D J; Bucknall, R C

    1989-01-01

    A sixteen year old girl with systemic lupus erythematosus developed acute transverse myelopathy. She was treated with high dose steroids, cyclophosphamide, and plasma exchange and regained partial neurological function. Previous descriptions of transverse myelopathy complicating systemic lupus erythematosus are reviewed, with particular reference to the efficacy of high dose steroid treatment. PMID:2662918

  14. Prevention of infectious complications in pediatric HSCT

    Microsoft Academic Search

    J Styczynski; L Gil

    2008-01-01

    Infectious complications constitute a major cause of morbidity and mortality in pediatric and adult patients undergoing hematopoietic SCT (HSCT). Current guidelines and recommendations for prevention of infections in children after HSCT are presented in this mini review. The paper is based on evidence-based recommendations rated by the strength of the recommendation and the quality of the supporting evidence. Prophylaxis strategy

  15. Complications of Hemorrhagic Stroke in Children

    Microsoft Academic Search

    Robin P. Humphreys

    1992-01-01

    The complications of hemorrhagic stroke in children begin first with one’s failure to establish the correct diagnosis or from the lack of knowledge of attendant phenomena and second, from those events which occur before, during or because of the treatment provided for specific lesions. The fundamental principles of history gathering, clinical evaluation and appropriate neuroimaging will direct safe, uncomplicated patient

  16. Risks for Complicated Grief in Family Caregivers

    Microsoft Academic Search

    Angela Ghesquiere; Yamile M. Martí Haidar; M. Katherine Shear

    2011-01-01

    Complicated Grief (CG) is a recently recognized disorder experienced by the bereaved and characterized by intense distress that interferes with functioning. Estimates indicate that about 20 % of bereaved individuals may develop CG. Family caregivers of those who are chronically ill may face unique risks for CG, such as pre-death stressors associated with caregiving. In this article, existing literature on

  17. Prévention des complications respiratoires après chirurgie abdominale

    Microsoft Academic Search

    S Rezaiguia; C Jayr

    1996-01-01

    Abdominal surgery, especially upper abdominal surgical procedures are known to adversely affect pulmonary function. Pulmonary complications are the most frequent cause of postoperative morbidity and mortality. This review article aimed to analyse the incidence and risk factors for postoperative pulmonary morbidity and their prevention. The most important means for preoperative assessment is the clinical examination; pulmonary function tests (spirometry) are

  18. Extracranial complications of chronic suppurative otitis media.

    PubMed

    Hossain, M M; Kundu, S C; Haque, M R; Shamsuzzaman, A K; Khan, M K; Halder, K K

    2006-01-01

    The aim of this study was to find out the pattern of extracranial complications of CSOM cases who attended to the department of ENTD, Mymensingh Medical College Hospital during the period from July'1999 to June' 2001. Different types of extracranial complications of CSOM were presented here. A total of 100 cases, diagnosed clinically and radiologically were included in the study of which 66 were male and 34 were female giving a male to female ratio of 1.94 : 1 (p < 0.05). Majority cases (53) were in the age group of 11- 20 years followed by the age group of below 10 years where there were 30 cases. Majority (64) cases came from low socio-economic class. The number of different types of extracranial complications of CSOM were as follows: mastoid abscess 57, discharging sinuses 28, purulent labyrinthitis 07, Bezold's abscess 04, fascial nerve paralysis 03 and zygomatic abscess 01. In all cases of CSOM Cholesteatoma were detected. In 14 cases, Cholesteatoma were associated with granulation tissue/polyp. Modified radical mastoidectomy were performed in all cases. On analyzing the findings of the present study it was observed that mastoid abscess were the predominant extracranial complications of CSOM, affecting mostly the male population of 11 - 20 years age group coming from low socio-economic class. PMID:16467754

  19. CT of pregnancy-related complications.

    PubMed

    Menias, Christine O; Elsayes, Khaled M; Peterson, Christine M; Huete, Alvaro; Gratz, Brett I; Bhalla, Sanjeev

    2007-03-01

    During pregnancy, the risk of radiation exposure to the fetus is increased so that more than the usual benefit is necessary to justify computed tomography (CT; or other radiation exposure) than in non-pregnant patients. In the setting of a life-threatening illness, CT may be indicated to assess for potentially fatal complications such as hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome. After delivery, patients rarely develop serious problems requiring radiologic evaluation. When indicated, however, CT may be invaluable in making the diagnosis or determining the severity of peri- and post-partum complications, including uterine perforation, hemorrhage, endometritis, thrombophlebitis, and abscess formation. At times, CT may be the first to uncover conditions, such as post-partum cardiomyopathy, and heart failure, which are usually diagnosed by other modalities but may explain the symptoms for which the study was ordered. In some centers, CT pulmonary angiography represents the standard of care to diagnose pulmonary thromboembolism. In this article, we illustrate the spectrum of peri-partum and post-partum complications on CT to familiarize the radiologist with the CT features of these potentially life-threatening pregnancy-related complications. PMID:17216173

  20. Endoscopic complications—avoidance and management

    Microsoft Academic Search

    Jacques Devière; Daniel Blero

    2012-01-01

    The frequency of endoscopic complications is likely to rise owing to the increased number of indications for therapeutic procedures and also to the increased complexity of endoscopic techniques. Informed patient consent should be obtained as part of the procedure. Prevention of endoscopic adverse events is based on knowledge of the relevant risk factors and their mechanisms of occurrence. Thus, suitable

  1. Complications of radiofrequency coagulation of liver tumours

    Microsoft Academic Search

    S. Mulier; P. Mulier; Y. Ni; Y. Miao; B. Dupas; G. Marchal; I. De Wever; L. Michel

    2002-01-01

    Background: Radiofrequency coagulation (RFC) is being promoted as a novel technique with a low morbidity rate in the treatment of liver tumours. The purpose of this study was to assess critically the complication rates of RFC in centres with both large and limited initial experience, and to establish causes and possible means of prevention and treatment. Methods: This is an

  2. Coronary Artery Vasospasm Complicating Acute Myocarditis

    PubMed Central

    Ferguson, David W.; Farwell, Allan P.; Bradley, William A.; Rollings, Robert C.

    1988-01-01

    A 17-year-old boy had a 2-day prodrome of fever and mild sore throat followed by 2 episodes of severe anginal chest discomfort and substantial transient ST-segment elevations in the anterior leads of the electrocardiogram. A subsequent evaluation showed the 2 episodes were most likely coronary vasospasm complicating acute viral myocarditis. Images PMID:3176473

  3. Rare complications of pediatric diabetic ketoacidosis

    PubMed Central

    Bialo, Shara R; Agrawal, Sungeeta; Boney, Charlotte M; Quintos, Jose Bernardo

    2015-01-01

    The incidence of type 1 diabetes (T1D) among youth is steadily increasing across the world. Up to a third of pediatric patients with T1D present with diabetic ketoacidosis, a diagnosis that continues to be the leading cause of death in this population. Cerebral edema is the most common rare complication of diabetic ketoacidosis in children. Accordingly, treatment and outcome measures of cerebral edema are vastly researched and the pathophysiology is recently the subject of much debate. Nevertheless, cerebral edema is not the only sequela of diabetic ketoacidosis that warrants close monitoring. The medical literature details various other complications in children with diabetic ketoacidosis, including hypercoagulability leading to stroke and deep vein thrombosis, rhabdomyolysis, pulmonary and gastrointestinal complications, and long-term memory dysfunction. We review the pathophysiology, reported cases, management, and outcomes of each of these rare complications in children. As the incidence of T1D continues to rise, practitioners will care for an increasing number of pediatric patients with diabetic ketoacidosis and should be aware of the various systems that may be affected in both the acute and chronic setting. PMID:25685287

  4. Appendiceal actinomycosis complicated by multiple hepatic abscesses.

    PubMed

    Hernigou, J; Dugué, L; Maftouh, A; Balian, C; Charlier, A

    2013-12-01

    We report the case of a patient with appendicitis due to actinomycosis, complicated by multiple liver abscesses. Definitive diagnosis was based on histopathologic examination of the resected appendix. Accurate identification of the pathogen led to curative antibiotic therapy of the liver abscesses. PMID:24113262

  5. On the Approximation of Complicated Dynamical Behavior

    E-print Network

    On the Approximation of Complicated Dynamical Behavior Michael Dellnitz and Oliver Junge techniques for the numerical approximation of compli- cated dynamical behavior. In particular, we develop numerical methods which allow to approximate SBR-measures as well as (almost) cyclic behavior of a dynamical

  6. Portal vein thrombosis complicating endoscopic variceal sclerotherapy

    Microsoft Academic Search

    Jacob Korula; Albert Yellin; Gary C. Kanel; Peter Nichols

    1991-01-01

    Summary Portal vein thrombosis occurred in a patient who bled from gastric varices that developed after obliteration of esophageal varices by endoscopic sclerotherapy. This complication was recognized only at surgery when thrombectomy and endovenectomy preceded the successful placement of an end-to-side portocaval shunt. At histopathology, the presence of an amorphous, eosinophilic material staining negatively for fibrin and similar to sclerosant

  7. Cardiovascular complications of pediatric chronic kidney disease

    PubMed Central

    2006-01-01

    Cardiovascular disease (CVD) mortality is a leading cause of death in adult chronic kidney disease (CKD), with exceptionally high rates in young adults, according to the Task Force on Cardiovascular Disease. Recent data indicate that cardiovascular complications are already present in children with CKD. This review summarizes the current literature on cardiac risk factors, mortality and morbidity in children with CKD. PMID:17120060

  8. Management of Complications of Prostate Cancer Treatment

    PubMed Central

    Michaelson, M. Dror; Cotter, Shane E.; Gargollo, Patricio C.; Zietman, Anthony L.; Dahl, Douglas M.; Smith, Matthew R.

    2010-01-01

    Prostate cancer is the most commonly diagnosed noncutaneous cancer in men in the United States. Treatment of men with prostate cancer commonly involves surgical, radiation, or hormone therapy. Most men with prostate cancer live for many years after diagnosis and may never suffer morbidity or mortality attributable to prostate cancer. The short-term and long-term adverse consequences of therapy are, therefore, of great importance. Adverse effects of radical prostatectomy include immediate postoperative complications and long-term urinary and sexual complications. External beam or interstitial radiation therapy in men with localized prostate cancer may lead to urinary, gastrointestinal, and sexual complications. Improvements in surgical and radiation techniques have reduced the incidence of many of these complications. Hormone treatment typically consists of androgen deprivation therapy, and consequences of such therapy may include vasomotor flushing, anemia, and bone density loss. Numerous clinical trials have studied the role of bone antiresorptive therapy for prevention of bone density loss and fractures. Other long-term consequences of androgen deprivation therapy may include adverse body composition changes and increased risk of insulin resistance, diabetes, and cardiovascular disease. Ongoing and planned clinical trials will continue to address strategies to prevent treatment-related side effects and improve quality of life for men with prostate cancer. PMID:18502900

  9. Congenital Thrombophilia Associated to Obstetric Complications

    Microsoft Academic Search

    Cynthia Villarreal; Gerardo García-Aguirre; Carmen Hernández; Olynka Vega; José R. Borbolla; María T. Collados

    2002-01-01

    During pregnancy there are hemostatic changes that result in a hypercoagulable state and can have thrombotic consequences. This condition can be aggravated in women who are carriers of congenital thrombophilic factors. This thrombotic tendency can manifest as thrombotic lesions in the placenta with compromise of utero-placental circulation, which are common characteristics present in obstetric complications, such as preeclampsia\\/eclampsia, miscarriage, fetal

  10. Lymphatic Leak Complicating Central Venous Catheter Insertion

    Microsoft Academic Search

    Alex M. Barnacle; Tricia M. Kleidon

    2005-01-01

    Many of the risks associated with central venous access are well recognized. We report a case of inadvertent lymphatic disruption during the insertion of a tunneled central venous catheter in a patient with raised left and right atrial pressures and severe pulmonary hypertension, which led to significant hemodynamic instability. To our knowledge, this rare complication is previously unreported.

  11. Recognition and prevention of barium enema complications.

    PubMed

    Williams, S M; Harned, R K

    1991-01-01

    The barium enema is a safe and accurate diagnostic study of the colon but, in rare cases, complications may result. Many of these can be prevented by proper equipment and careful attention to technique. When a complication does occur, prompt recognition and management is vital in decreasing morbidity and mortality. Perforation of the bowel is the most frequent serious complication, occurring in approximately 0.02% to 0.04% of patients. Rarely the colon may burst due to excessive transmural pressure alone. However, a colon weakened by iatrogenic trauma or disease is more likely to perforate during an enema than is a normal healthy bowel. Injury to the rectal mucosa or anal canal due to the enema tip or retention balloon is probably the most common traumatic cause of barium enema perforation. Inflation of a retention balloon within a stricture, neoplasm, inflamed rectum, or colostomy stoma is particularly hazardous. Recent deep biopsy or polypectomy with electrocautery makes the bowel more vulnerable to rupture. The tensile strength of the bowel wall is impaired in elderly patients, patients receiving long-term steroid therapy, and in disease states including neoplasm, diverticulitis, inflammatory bowel disease, and ischemia. Intraperitoneal perforation leads to a severe, acute peritonitis with intravascular volume depletion. The ensuing shock may be rapidly fatal. Prompt fluid replacement and laparotomy are essential. If the patient survives the initial shock and sepsis, later complications caused by dense intraperitoneal adhesions may develop. Extraperitoneal perforation is usually less catastrophic but may result in pain, sepsis, cellulitis, abscess, rectal stricture, or fistula. Intramural extravasation often forms a persistent submucosal barium granuloma which may ulcerate or be mistaken for a neoplasm. The most dramatic complication of barium enema is venous intravasation of barium. Fortunately, this is quite rare as it may be immediately lethal. Most cases have been attributed to trauma from the enema tip or retention balloon, mucosal inflammation, or misplacement of the tip in the vagina. Bacteremia has been found in as many as 23% of patients following barium enema and, in rare cases, may cause symptomatic septicemia. Other less common complications include barium impaction, water intoxication, allergic reactions, and cardiac arrhythmias. Preparatory laxatives and cleansing enemas have been implicated in some instances of dehydration, rectal trauma, water intoxication, and perforation. Careful review of the indications for examination, previous radiographs, and clinical history will identify many of the patients at greater risk for complications so that appropriate precautions may be observed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:1889235

  12. Milk transfer of phenoxymethylpenicillin during puerperal mastitis.

    PubMed Central

    Matheson, I; Samseth, M; Løberg, R; Faegri, A; Prentice, A

    1988-01-01

    1 The milk excretion of phenoxymethylpenicillin (PMP) was studied from both breasts in patients with mastitis (n = 12) and healthy volunteers (controls, n = 4) to investigate the hypothesis that milk transfer of PMP is higher in mastitic than in non-mastitic breasts. 2 Patients were included according to clinical symptoms of mastitis. Milk (and serum from controls) were sampled 0, 1, 2, 3, 4, 6 and 8 h after a single oral dose of 1320 mg PMP. Penicillin concentrations in milk and serum were measured by an agar diffusion technique. 3 Maximum milk concentrations (Cmax) of PMP in patients were higher (P less than 0.05) in mastitic than in non-mastitic breasts. The latter concentrations were higher (P less than 0.05) than those in breast milk from healthy controls. In milk from the mastitis patients (both breasts) the Cmax was reached after 2 h with a subsequent rapid decline in concentration. In milk from the healthy controls the PMP concentration reached a plateau after 4 h. The area under the milk concentration vs time curve (AUC0-8h) was not different for mastitic vs non-mastitic breast milk in patients nor for mastitic vs control breast milk. This can be explained by higher rates of appearance and disappearance of PMP in the breast milk of mastitis patients compared with healthy controls. In mastitic breast milk there was a moderate (P less than 0.01) increase in sodium and albumin compared with non-mastitic milk. However, milk potassium, glucose and lactose values were within normal limits.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3130891

  13. Medicine and abortion law: complicating the reforming profession.

    PubMed

    McGuinness, Sheelagh; Thomson, Michael

    2015-01-01

    The complicated intra-professional rivalries that have contributed to the current contours of abortion law and service provision have been subject to limited academic engagement. In this article, we address this gap. We examine how the competing interests of different specialisms played out in abortion law reform from the early twentieth-century, through to the enactment of the Abortion Act 1967, and the formation of the structures of abortion provision in the early 1970s. We demonstrate how professional interests significantly shaped the landscape of abortion law in England, Scotland, and Wales. Our analysis addresses two distinct and yet related fields where professional interests were negotiated or asserted in the journey to law reform. Both debates align with earlier analysis that has linked abortion law reform with the market development of the medical profession. We argue that these two axes of debate, both dominated by professional interests, interacted to help shape law's treatment of abortion, and continue to influence the provision of abortion services today. PMID:25995361

  14. Right atrial tamponade complicating cardiac operation: clinical, hemodynamic, and scintigraphic correlates

    SciTech Connect

    Bateman, T.; Gray, R.; Chaux, A.; Lee, M.; De Robertis, M.; Berman, D.; Matloff, J.

    1982-09-01

    Persistent bleeding into the pericardial space in the early hours after cardiac operation not uncommonly results in cardiac tamponade. Single chamber tamponade also might be expected, since in this setting the pericardium frequently contains firm blood clots localized to the area of active bleeding. However, this complication has received very little attention in the surgical literature. We are therefore providing documentation that isolated right atrial tamponade can occur as a complication of cardiac operation and that there exists a potential for misdiagnosis and hence incorrect treatment of this condition. Right atrial tamponade may be recognized by a combination of low cardiac output, low blood pressure, prominent neck veins, right atrial pressure in excess of pulmonary capillary wedge pressure and right ventricular end-diastolic pressure, and a poor response to plasma volume expansion. Findings on chest roentgenogram and gated wall motion scintigraphy may be highly suggestive. This review should serve to increase awareness of this complication and to provide some helpful diagnostic clues.

  15. Frequency of Peripherally Inserted Central Catheter Complications in Children

    PubMed Central

    BARRIER, ANGELA; WILLIAMS, DEREK J.; CONNELLY, MEGAN; CREECH, C. BUDDY

    2012-01-01

    This study examined the frequency and types of complications with PICCs placed in immunocompetent pediatric patients for parenteral antimicrobial therapy. It also sought to determine risk factors associated with those complications. Complications occurred at a frequency of 19.3/1000 PICC days, and greater than 30% of PICCs developed at least one complication. Risk factors for complication include double lumen PICCs, PICCs placed in the femoral vein, younger age, and greater number of daily doses. PMID:22189533

  16. [Haemocholecyst: a rare complication of anticoagulant treatment].

    PubMed

    Mikou, M M; Mouaffak, Y; Benyacob, A; Mosaddek, A; Faroudy, M; Ababou, A; Lazreq, C; Sbihi, A

    2004-07-01

    We report a case of a 50-year-old woman, taking antivitamin K for double mitro-aortic valvular replacement, having presented a clinical picture of acute cholecystitis with marked hypotension. The radiological and biologic exams showed a deep hypocoagulability, vesicular gallstones, a haemoperitoneum and retroperitoneal haematoma. After correction of biological anomalies, the patient was operated. The gallbladder was distended containing large clots and four stones without any evidence of perforation. One of the gallstones led to cystic duct obstruction. Haemocholecyst is a rare complication of anticoagulant therapy, which may occur in the setting of gallbladder stones. The usual complication was the vesicular perforation. In spite of its rarity, haemocholecyst should be suspected when an anticoagulant treated patient presents symptoms of acute cholecystis with or without haemorrhagic shock. PMID:15324963

  17. Neurocritical care complications of pregnancy and puerperum.

    PubMed

    Frontera, Jennifer A; Ahmed, Wamda

    2014-12-01

    Neurocritical care complications of pregnancy and puerperum such as preeclampsia/eclampsia, hemolysis, elevated liver enzymes, low platelets syndrome, thrombotic thrombocytopenic purpura, seizures, ischemic and hemorrhagic stroke, postpartum angiopathy, cerebral sinus thrombosis, amniotic fluid emboli, choriocarcinoma, and acute fatty liver of pregnancy are rare but can be devastating. These conditions can present a challenge to physicians because pregnancy is a unique physiologic state, most therapeutic options available in the intensive care unit were not studied in pregnant patients, and in many situations, physicians need to deliver care to both the mother and the fetus, simultaneously. Timely recognition and management of critical neurologic complications of pregnancy/puerperum can be life saving for both the mother and fetus. PMID:25123793

  18. [Lipedema complicated with lymphedema and chyloderma].

    PubMed

    Ignjatovi?, M; Jevti?, M; Cerovi?, S

    2000-01-01

    Lipedema never reveals clinical picture of extreme lymphedema-elephantiasis, and skin signs and complications have not been observed. Aim of this paper is to present a case of lipedema with the initial lymphedema in which, after one episode of lymphangiitis and cellulitis, came to the rapid development of lymphedema followed by chyloderma. During the local treatment of extreme chyloderma with excessive exudation, semiocclusive synthetic dressings have been used for moist wound healing. The treatment was completed after 20 weeks with total epithelizsation, without maceration and irritation, without additional spreading of the chyloderma field, without wound infections, with fast and full relief of the pain. Lipedem with extreme lymphedema can be followed by skin complications of lymphedema like chylodermia. PMID:11039316

  19. [Neurological complications of inflammatory bowel disease].

    PubMed

    Bermejo, Pedro Emilio; Burgos, Aurora

    2008-05-10

    Although ulcerative colitis and Crohn's disease have traditionally been considered to be inflammatory diseases limited to the gastrointestinal tract, it has been shown that both pathologies are frequently accompanied by various extraintestinal disorders. There is an increasing evidence that they may also manifest in the nervous system, including the peripheral and the central parts. Although some of these neurological complications have been known for a long time, such as cerebrovascular disease, vasculitis and autoinmune processes including neuropathies and cerebral demyelination, others have been recently described. With the exception of some of this complications such as the thromboembolism, evidence for a casual relationship relies merely on single case reports or case series. In this article, we try to review the existing evidence on neurological manifestations of both variants of inflammatory bowel disease. PMID:18501131

  20. Extracorporeal membrane oxygenation-hemostatic complications.

    PubMed

    Murphy, Deirdre A; Hockings, Lisen E; Andrews, Robert K; Aubron, Cecile; Gardiner, Elizabeth E; Pellegrino, Vincent A; Davis, Amanda K

    2015-04-01

    The use of extracorporeal membrane oxygenation (ECMO) support for cardiac and respiratory failure has increased in recent years. Improvements in ECMO oxygenator and pump technologies have aided this increase in utilization. Additionally, reports of successful outcomes in supporting patients with respiratory failure during the 2009 H1N1 pandemic and reports of ECMO during cardiopulmonary resuscitation have led to increased uptake of ECMO. Patients requiring ECMO are a heterogenous group of critically ill patients with cardiac and respiratory failure. Bleeding and thrombotic complications remain a leading cause of morbidity and mortality in patients on ECMO. In this review, we describe the mechanisms and management of hemostatic, thrombotic and hemolytic complications during ECMO support. PMID:25595476

  1. Blind loop: rare but important surgical complication

    PubMed Central

    2014-01-01

    Background Surgical complications worldwide are dreaded by both patients and physicians alike. They represent significant and serious morbidity and mortality, and contribute substantially to increased costs of healthcare. Case presentation Our Case Report describes a 65yo Caucasian man with an extensive operative history for Crohn’s disease, including 4 laparotomies with small bowel resections to ameliorate small bowel obstructions. He presented with signs and symptoms of a chronic draining sinus, but was found to have a Blind Loop of bowel. This finding is believed to be the result of a surgical complication. Conclusion While the Case Reports discusses this particular patient presentation, the paper defines, describes and offers treatment strategies for Enterocutaneous Fistulas (ECF). We offer aim to add Blind Loop to the differential diagnosis when presented with a patient with signs and symptoms of ECF. PMID:25176257

  2. [Hypercalcemia complicating BCG lymphadenitis: case report].

    PubMed

    Kojmane, W; Chaouki, S; Souilmi, F Z; Atmani, S; Idrissi, M; Bouharrou, A; Hida, M

    2015-03-01

    One of the side effects of the BCG vaccine is a local infection that may spread to the regional lymph nodes causing lymphadenitis, which can resolve spontaneously without treatment. We report the case of an immunocompetent infant who developed lymphadenitis after administration of the BCG vaccine, complicated with persistent symptomatic hypercalcemia in spite of the usual treatment including corticotherapy. Antituberculous treatment was necessary to reduce this hypercalcemia. PMID:25636213

  3. Incidence of complications following laparoscopic hernioplasty

    Microsoft Academic Search

    E. H. Phillips; M. Arregui; B. J. Carroll; J. Corbitt; W. B. Crafton; M. J. Fallas; C. Filipi; R. J. Fitzgibbons; M. J. Franklin; B. McKernan; D. Olsen; A. Ortega; J. H. Payne; J. Peters; R. Rodriguez; P. Rosette; L. Schultz; A. Seid; R. Sewell; R. Smoot; F. Toy; R. Waddell; S. Watson

    1995-01-01

    Smaller individual series on the outcome of laparoscopic hernioplasty techniques have been reported. This study reports on the complications of 3,229 laparoscopic hernia repairs performed by the authors in 2,559 patients. The TAPP (transabdominal preperitoneal) technique was the most frequently performed: 1,944 (60%). The totally preperitoneal technique was performed 578 (18%) times. The IPOM (intraperitoneal onlay mesh) repair was performed

  4. Limy Bile Syndrome Complicated with Primary Hyperparathyroidism

    PubMed Central

    Koca, Yavuz Savas; Koca, Tugba; Barut, Ibrahim

    2015-01-01

    Limy bile is a relatively rare condition, in which a radiopaque material is visible in the gallbladder on plain radiography or computerized tomography. Cases of complicated hyperparathyroidism are extremely rare. We report a patient with right upper quadrant and epigastric pain and extremity weakness in whom abdominal tomography showed limy bile in the gallbladder and laboratory values showed high levels of serum calcium and parathormone. PMID:25821626

  5. Management of complication from temporal bone fractures

    Microsoft Academic Search

    Cvorovic Ljiljana; Milan B. Jovanovic; Marko Markovic; Zoran Milutinovic; M. Strbac

    The objective of the study is to review clinical findings and outcomes in patients with temporal bone fractures, and to show\\u000a an incidence and management of complications. It is the retrospective clinical study and the study took place at tertiary\\u000a referral center. Fifty-two patients with temporal bone fractures. Data were collected from patients’ charts and clinical review.\\u000a Patients were classified

  6. Deep enteroscopy - indications, diagnostic yield and complications

    PubMed Central

    Moeschler, Oliver; Mueller, Michael Karl

    2015-01-01

    Since its introduction in 2001 capsule endoscopy opened up the small bowel for diagnostic approaches followed by double balloon enteroscopy which enabled the endoscopic community to perform therapeutic interventions in the whole small intestine. In this review the scientific developments related to indications, diagnostic yield and complications of the last years between the competing devices double ballon enteroscopy, single balloon enteroscopy and spiral enteroscopy are illustrated. PMID:25663758

  7. Complications of aortic atherosclerosis: Atheroemboli and thromboemboli

    Microsoft Academic Search

    Theresa A. Molisse; Paul A. Tunick; Itzhak Kronzon

    2007-01-01

    Opinion statement  Patients with severe aortic atherosclerosis are at high risk for stroke and other embolic complications. Therapy to prevent\\u000a emboli from aortic plaque is not yet established. Therefore, patients with atherosclerosis or risk factors for embolic disease\\u000a should be identified and treated aggressively. Aspirin, smoking cessation, and control of blood pressure and glucose are important.\\u000a Retrospective data in patients with

  8. [Uretero(reno)scopy: management of complications].

    PubMed

    Knoll, T; Wendt-Nordahl, G

    2014-05-01

    Rigid and flexible uretero(reno)scopy (URS) are safe and effective methods in interventional calculus therapy. Complications are rare and can be avoided in advance in many cases. In ureteroliths, URS has in many cases replaced extracorporeal shock wave lithotripsy (ESWL) as the method of first choice. However, it is important to describe in detail the advantages and disadvantages as well as the risks of the procedure to the patient. PMID:24727994

  9. Abdominal Aortic Aneurysm Complicated by Intestinal Malrotation

    PubMed Central

    Okazaki, Jin; Ishida, Masaru; Kodama, Akio; Mii, Shinsuke

    2015-01-01

    Intestinal malrotation (IM) is an anomaly of fetal intestinal rotation that usually presents in the first month of life; it is rare for malrotaion to present in adulthood. Furthermore, the presentation of IM in conjunction with Abdominal aortic aneurysm is extremely rare and may require consideration with respect to the surgical approach and exposure of the abdominal aorta. We herein report a case of an abdominal aortic aneurysm complicated by intestinal malrotation. PMID:25848429

  10. Uses, limitations, and complications of endobronchial ultrasound.

    PubMed

    Jalil, Bilal A; Yasufuku, Kazuhiro; Khan, Amir Maqbul

    2015-07-01

    Endobronchial ultrasound (EBUS) plays a pivotal role in the minimally invasive staging of non-small cell lung cancer. The role of EBUS is progressively expanding to include the evaluation of peribronchial lesions, pulmonary nodules, and other mediastinal abnormalities. Recently, EBUS has assisted in the diagnosis of many other disease entities, including malignancies and various infections such as tuberculosis and sarcoidosis. This article reviews the indications and contraindications of EBUS, with emphasis on the technique and complications encountered during the procedure. PMID:26130878

  11. Uses, limitations, and complications of endobronchial ultrasound

    PubMed Central

    Jalil, Bilal A.; Yasufuku, Kazuhiro

    2015-01-01

    Endobronchial ultrasound (EBUS) plays a pivotal role in the minimally invasive staging of non–small cell lung cancer. The role of EBUS is progressively expanding to include the evaluation of peribronchial lesions, pulmonary nodules, and other mediastinal abnormalities. Recently, EBUS has assisted in the diagnosis of many other disease entities, including malignancies and various infections such as tuberculosis and sarcoidosis. This article reviews the indications and contraindications of EBUS, with emphasis on the technique and complications encountered during the procedure. PMID:26130878

  12. Metabolic Complications of Polycystic Ovary Syndrome

    Microsoft Academic Search

    Tracy L. Setji; Ann J. Brown

    Polycystic ovary syndrome (PCOS) affects 4–7% of reproductive-aged women and is associated with serious metabolic complications\\u000a including type 2 diabetes. Forty percent of affected women have impaired glucose tolerance or type 2 diabetes by the age of\\u000a forty. Evaluation of women with PCOS includes metabolic risk assessment and counseling on the prevention of diabetes through\\u000a lifestyle therapies such as diet,

  13. Cardiovascular complications of pediatric chronic kidney disease

    Microsoft Academic Search

    Mark M. Mitsnefes

    2008-01-01

    Cardiovascular disease (CVD) mortality is a leading cause of death in adult chronic kidney disease (CKD), with exceptionally\\u000a high rates in young adults, according to the Task Force on Cardiovascular Disease. Recent data indicate that cardiovascular\\u000a complications are already present in children with CKD. This review summarizes the current literature on cardiac risk factors,\\u000a mortality and morbidity in children with

  14. [Antibiotic treatment of complicated urinary tract infections].

    PubMed

    Peters, H J

    1995-06-01

    The diagnosis of an urinary tract infection (UTI) is proved by the identification of a significant leucocyturia and bacteriuria of the mid-stream urine analysis in men and catheter urine in women. A diagnostical localisation is possible by the case history as well as clinical, sonographical and laboratory tests (leucocytes, CRP) to classify into a cystitis and infection of the parenchyma, respectively an uncomplicated or complicated UTI. Untreated complicated urinary tract infections have a bad prognosis. The therapy consists of bed rest, normalization of the urinary flow, a specific antibiotic therapy corresponding to the antibiotic sensitivity pattern and the administration of a prostaglandin-synthesis-inhibitor. Every physician should choose one of the many antibiotics and must get acquainted with the pharmacokinetics and side-effects. In severe acute infections, a calculated antibiotic therapy in certain combinations is necessary until the bacteriological findings are known. Corresponding to the spectrum of bacteria in complicated UTI, one should select a fluoro-chinolone, a broad-spectrum penicilline in combination with a beta-lactamase-inhibitor, a cephalosporine of the second and third generation with a relative stability against beta-lactamase as well as an aminoglycoside. Reserve-antibiotics for special indications are for example, cefsulodine. Less effective than the drugs mentioned above is cotrimoxazole, which was favourized before. In complicated UTI, the older gyrase-inhibitors like nalidixic acid, pipemidic acid, cinoxacin and nitrofurantoin are not longer indicated. There is only one indication for the application of doxycyclin: the treatment of bacterial prostatitis. A lower dosage of antibiotics and a drug therapy of 7-10 days are sufficient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7668016

  15. Nasolacrimal polyurethane stent: Complications with CT correlation

    Microsoft Academic Search

    Isabel T. Pinto; Laura Paul; Carlos Grande

    1998-01-01

    Purpose: To evaluate initial results in patients with epiphora secondary to obstruction of the nasolacrimal duct treated by placement\\u000a of a polyurethane stent, and to discuss the technical problems and complications arising during the procedure, with visualization\\u000a of the anatomy of the drainage apparatus using computed tomography (CT).\\u000a \\u000a \\u000a Methods: We inserted 20 polyurethane Song stents under fluoroscopic guidance after dacryocystography

  16. Unusual Bilateral Paramolars Associated with Clinical Complications

    PubMed Central

    Sulabha, A. N.; Sameer, C.

    2015-01-01

    Paramolars are rare supernumerary structures of maxillofacial complex that occur buccally or lingually near the molar row. Predominantly these occur singly; bilateral presentation is very rare. This paper reports two unusual bilateral presentations of paramolars with clinical complication and its management. One of the cases in the present paper also documents the cooccurrence of bilateral paramolars and microdontia of single tooth and one of its paramolars presented with multilobed crown with an anomalous buccal tubercle.

  17. [Use of Permacol in complicated incisional hernia].

    PubMed

    Armellino, Mariano Fortunato; De Stefano, Guglielmo; Scardi, Francesco; Forner, Anna Lucia; Ambrosino, Francesco; Bellotti, Roberto; Robustelli, Umberto; De Stefano, Giovanni

    2006-01-01

    Polypropylene mesh repair is the gold standard for primary inguinal hernia and incisional hernia. Wound infection and small bowel fistulas are contraindications to polypropylene mesh repair. In addition, synthetic meshes are known to cause severe peritoneal adhesions and enteric fistulas if located close to the bowel. Porcine intestinal submucosa has been used successfully in experimental studies in dogs and rats to repair large abdominal wall defects. A new porcine dermal collagen graft has been used in man for groin hernia repair, incisional hernia repair and other surgical procedures without complications. We describe 6 cases of complicated incisional hernia operated in emergency using porcine dermal collagen grafts. In one woman the incisional hernia was associated with an enterovaginal fistula. Three cases presented severe wound infections, two of which related to a previous polypropylene mesh repair, while another had an irreducible recurrent incisional hernia and one woman presented complete evisceration. None of the patients had postoperative or porcine-graft-related complications. Over a follow-up period of 3-24 months we have had no recurrence or wound infection. The results of these few cases confirm the safety and efficacy of the porcine dermal collagen mesh also in incisional hernia repair. PMID:17069192

  18. Update on complications in pediatric anesthesia

    PubMed Central

    De Francisci, Giovanni; Papasidero, Angela Elisa; Spinazzola, Giorgia; Galante, Dario; Caruselli, Marco; Pedrotti, Dino; Caso, Antonio; Lambo, Massimo; Melchionda, Matteo; Faticato, Maria Grazia

    2013-01-01

    Complications in pediatric anesthesia can happen, even in our modern hospitals with the most advanced equipment and skilled anesthesiologists. It is important, albeit in a tranquil and reassuring way, to inform parents of the possibility of complications and, in general, of the anesthetic risks. This is especially imperative when speaking to the parents of children who will be operated on for minor procedures: in our experience, they tend to think that the anesthesia will be a light anesthesia without risks. Often the surgeons tell them that the operation is very simple without stressing the fact that it will be done under general anesthesia which is identical to the one we give for major operations. Different is the scenario for the parents of children who are affected by malignant neoplasms: in these cases they already know that the illness is serious. They have this tremendous burden and we choose not to add another one by discussing anesthetic risks, so we usually go along with the examination of the child without bringing up the possibility of complications, unless there is some specific problem such as a mediastinal mass. PMID:23667731

  19. Intracranial complications of otitis media: In retrospect

    Microsoft Academic Search

    V. B. Modak; V. R. Chavan; V. R. Borade; D. P. Kotnis; S. J. Jaiswal

    2005-01-01

    Objective  Evaluating intracranial complications of otitis media.\\u000a \\u000a \\u000a \\u000a Design  An Evaluative study of 106 cases of intracranial complications secondary to otitis media.\\u000a \\u000a \\u000a \\u000a Intervention  Diagnosis is based on history, clinical exam (general, systemic and ENT), investigations hemogram, X-ray mastoid CT scan brain\\u000a and mastoid.\\u000a \\u000a \\u000a \\u000a Treatment  \\u000a \\u000a \\u000a \\u000a 1. \\u000a \\u000a Medical management:\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a a. \\u000a \\u000a IV Higher Antibiotics.\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a 2. \\u000a \\u000a Surgery for complicating pathology:\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a a. \\u000a \\u000a Pus (in Abscesses)-bram canula aspiration.\\u000a \\u000a \\u000a \\u000a \\u000a b. \\u000a \\u000a Lateral

  20. Complex dynamics in learning complicated games

    E-print Network

    Tobias Galla; J. Doyne Farmer

    2011-09-20

    Game theory is the standard tool used to model strategic interactions in evolutionary biology and social science. Traditional game theory studies the equilibria of simple games. But is traditional game theory applicable if the game is complicated, and if not, what is? We investigate this question here, defining a complicated game as one with many possible moves, and therefore many possible payoffs conditional on those moves. We investigate two-person games in which the players learn based on experience. By generating games at random we show that under some circumstances the strategies of the two players converge to fixed points, but under others they follow limit cycles or chaotic attractors. The dimension of the chaotic attractors can be very high, implying that the dynamics of the strategies are effectively random. In the chaotic regime the payoffs fluctuate intermittently, showing bursts of rapid change punctuated by periods of quiescence, similar to what is observed in fluid turbulence and financial markets. Our results suggest that such intermittency is a highly generic phenomenon, and that there is a large parameter regime for which complicated strategic interactions generate inherently unpredictable behavior that is best described in the language of dynamical systems theory

  1. [Thyroid surgery (356 cases): risks and complications].

    PubMed

    Benzarti, S; Miled, I; Bassoumi, T; Ben Mrad, B; Akkari, K; Bacha, O; Chebbi, M K

    2002-01-01

    The purpose of this study was to evaluate the risks and complication rate of thyroid surgery. The authors present a retrospective study of 356 patients surgically treated for thyroid nodules, between 1987 and 1998, at the military hospital of Tunis. The patients were categorised into 3 groups: group I: 238 solitary thyroid nodules (66.8%); group II: 92 multinodular goitres (25.8%) included 12 retrosternal goitres (3.37%) and group III: 26 cases of Basedow's disease (7.4%). Patients benefitted from unilateral surgery in 72% of cases and from bilateral surgery (total or subtotal thyroidectomy) in the remaining 28% of cases. Malignancy was found in 34 cases (9.5%). The complications observed were haemorrhage (0.56% of cases), unilateral post operative recurrent laryngeal palsy (1.12% of cases), and permanent hypoparathyroidism in 0.81% of cases. Experienced surgeons and the use of a meticulous surgical technique can reduce the incidence of post operative complications in thyroid surgery. PMID:12200998

  2. Pancreatic transplantation: Radiologic evaluation of vascular complications

    SciTech Connect

    Snider, J.F.; Hunter, D.W.; Kuni, C.C.; Castaneda-Zuniga, W.R.; Letourneau, J.G. (Univ. of Minnesota Hospital and Clinic, Minneapolis (USA))

    1991-03-01

    Transplantation of the pancreas is an increasingly common therapeutic option for preventing or delaying complications of type I diabetes mellitus. The authors studied the relative roles of various radiologic examinations in diagnosing vascular complications in these grafts including arterial and venous thrombosis, stenosis, and anastomotic leak (the most common vascular factors that necessitate pancreatectomy of the transplant), as defined with pathologic or arteriographic data. The results of 78 scintigraphic flow studies, 40 abdominal and pelvic computed tomographic (CT) scans, 27 sonograms, and eight color Doppler studies were evaluated in 52 patients who received a total of 27 cadaveric and 26 living-donor grafts over a 12-year period. These results were correlated with the data from 45 gross and microscopic pathologic studies and 37 arteriograms to determine their relative value in enabling detection of graft thrombosis and other vascular complications. Scintigraphy, CT, sonography, and color Doppler were all sensitive in detection of generalized graft abnormalities but lacked specificity in defining the underlying etiologic factors.

  3. Advances in the epidemiology, pathogenesis, and management of Cushing's syndrome complications.

    PubMed

    Arnaldi, G; Mancini, T; Tirabassi, G; Trementino, L; Boscaro, M

    2012-04-01

    Cushing's syndrome (CS) is a clinical condition resulting from chronic exposure to glucocorticoid excess. As a consequence, hypercortisolism contributes significantly to the early development of systemic disorders by direct and/or indirect effects. Complications such as obesity, hypertension, diabetes, dyslipidemia, and hypercoagulability cause premature atherosclerosis and increase cardiovascular mortality. Impairment of the skeletal system is a relevant cause of morbidity and disability in these patients especially due to the high prevalence of vertebral fractures. In addition, muscle weakness, emotional lability, depression, and impairment of quality of life are very common. Clinical management of these patients is complex and should be particularly careful in identifying global cardiovascular risks and aim at controlling all complications. Although the primary goal in the prevention and treatment of complications is the correction of hypercortisolism, treatment does not completely eliminate these comorbidities. Given that cardiovascular risk and fracture risk can persist after cure, early detection of each morbidity could prevent the development of irreversible damage. In this review we present the various complications of CS and their pathogenetic mechanisms. We also suggest the clinical management of these patients based on our extensive clinical experience and on the available literature. PMID:22652826

  4. [Importance of biologically active components and plants in the prevention of complications of diabetes mellitus].

    PubMed

    Savickiene, Nijole; Dagilyte, Audrone; Lukosius, Audronis; Zitkevicius, Virgilijus

    2002-01-01

    Diabetes complications, especially late (chronic) ones, are the main reasons of invalidity and early mortality. The most threatening diabetes complications are vascular and metabolic complications (diabetic neuropathy, angiopathy, cataract, glaucoma, optic neuropathy, retinopathy, diabetic nephropathy). Good diabetes control is very important, because in early stages these changes are reversible. In order to decrease the number of diabetes complications and to postpone their development, the use of biologic active components and plants is recommended. The most important biologic active substances for this purpose are vitamins and minerals, proteins, polysaccharides, lectins, saponins and flavonoids. According the scientific data, the mostly used plants are: Ginkgo biloba, Allium sativum, Silybum marianum, Panax Ginseng, Carica papaya, Vaccinium myrtillus, Phaseolus vulgaris. Some of them are proposed for treatment of symptoms related to venous and lymphatic vessel insufficiency, for the prophylaxis and treatment of liver damage caused by metabolic toxins, in chronic degenerative liver conditions, for the therapy of digestive disorders, to increase in the unspecific way the resistance of the organism to various environmental influences, and to stabilize membranes through antioxidant and radical scavenging actions. PMID:12532704

  5. Early-Stage Dementia Diagnosis and Care

    Microsoft Academic Search

    Victor G. Valcour; Patricia L. Blanchette

    2012-01-01

    Dementia caused by Alzheimer's disease and other factors is taking a tremendous toll on elders and their families. According to the author however, if the disease is diagnosed and treated early, many patients can avoid or delay secondary medical and social complications.

  6. Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases

    PubMed Central

    Xiao, Jiantao; Lei, Jun; He, Leye; Yin, Guangming

    2015-01-01

    Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC.

  7. Renal calculus complicated with squamous cell carcinoma of renal pelvis: Report of two cases.

    PubMed

    Xiao, Jiantao; Lei, Jun; He, Leye; Yin, Guangming

    2015-01-01

    Longstanding renal calculus is a risk factor of squamous cell carcinoma (SCC) of the renal pelvis. It is highly aggressive and usually diagnosed at advanced stages with a poor prognosis. We present two cases of kidney stone complications with renal pelvic SCC. These two patients had a radical nephrectomy and the dissected tissues were renal pelvic SCC. Our cases further emphasize that renal pelvic SCC should be considered in patients with longstanding renal calculus. These cases contribute greatly to an early diagnosis and early treatment, both of which will significantly minimize the damage of, and markedly improve the prognosis of, renal pelvic SCC. PMID:26029303

  8. Retroperitoneoscopic donor nephrectomy: donor outcome and complication rate in comparison with three different techniques

    Microsoft Academic Search

    Robin Ruszat; Tullio Sulser; Michael Dickenmann; Thomas Wolff; Lorenz Gürke; Thomas Eugster; Igor Langer; Peter Vogelbach; Jürg Steiger; Thomas C. Gasser; Christian G. Stief; Alexander Bachmann

    2006-01-01

    Four surgical techniques for living donor nephrectomy were analyzed retrospectively in terms of perioperative outcome and\\u000a early complication rate. A total of 182 donor nephrectomies including 69 open (OLDN), 14 fully laparoscopic (LDN), 34 hand-assisted\\u000a laparoscopic (HLDN) and 65 retroperitoneoscopic (RLDN) nephrectomies were analyzed. There was a significant difference in\\u000a mean operating time (OPT) between the OLDN (160 min) and RLDN

  9. Successful Management of Hemorrhagic Complications during Onyx-18 Embolization of Cerebral Arteriovenous Malformations.

    PubMed

    Liu, L; Li, Y; Yang, X; He, H; Wu, Z

    2010-12-01

    The most frequent and devastating complication of the endovascular treatment of cerebral AVMs is hemorrhage. This report describes three patients with cerebral AVM who encountered bleeding during Onyx-18 embolization. The bleeding was discovered promptly during the procedure and hemorrhage quickly prevented using Onyx-18. All three patients recovered without any new neurological symptoms. Early detection and prevention of bleeding are very important during interventional procedures to avoid craniotomy and improve the prognosis of patients. PMID:24148732

  10. Hepatic myelopathy: an unusual neurological complication of chronic liver disease presenting as quadriparesis

    PubMed Central

    Kori, Prakash; Sahu, Ritesh; Jaiswal, Anupam; Shukla, Rakesh

    2013-01-01

    Hepatic myelopathy is a rare neurological complication of chronic liver disease, which is usually seen in adults, presenting as pure motor spastic paraparesis. It is almost always associated with portosystemic shunts and hepatic decompensation. We report a rare case of a young adult man presenting as rapidly progressive spastic quadriparesis because of hepatic myelopathy and associated spontaneous splenorenal shunt and early hepatic decompensation. PMID:23749858

  11. Complications of radiofrequency ablation of hepatic tumors: Frequency and risk factors

    PubMed Central

    Fonseca, Alexandre Zanchenko; Santin, Stephanie; Gomes, Luiz Guilherme Lisboa; Waisberg, Jaques; Ribeiro Jr., Marcelo Augusto Fontenelle

    2014-01-01

    Radiofrequency ablation (RFA) has become an important option in the therapy of primary and secondary hepatic tumors. Surgical resection is still the best treatment option, but only a few of these patients are candidates for surgery: multilobar disease, insufficient liver reserve that will lead to liver failure after resection, extra-hepatic disease, proximity to major bile ducts and vessels, and co-morbidities. RFA has a low mortality and morbidity rate and is considered to be safe. Thus, complications occur and vary widely in the literature. Complications are caused by thermal damage, direct needle injury, infection and the patient’s co-morbidities. Tumor type, type of approach, number of lesions, tumor localization, underlying hepatic disease, the physician’s experience, associated hepatic resection and lesion size have been described as factors significantly associated with complications. The physician in charge should promptly recognize high-risk patients more susceptible to complications, perform a close post procedure follow-up and manage them early and adequately if they occur. We aim to describe complications from RFA of hepatic tumors and their risk factors, as well as a few techniques to avoid them. This way, others can decrease their morbidity rates with better outcomes. PMID:24672640

  12. Cross-sectional imaging of common and unusual complications after endoscopic retrograde cholangiopancreatography.

    PubMed

    Tonolini, Massimo; Pagani, Alessandra; Bianco, Roberto

    2015-06-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is currently a primarily therapeutic procedure that is extensively employed to treat several biliopancreatic disorders. Although widely considered a safe procedure, ERCP is associated with a non-negligible morbidity and occasional mortality. Due to the number and complexity of operative ERCPs performed, radiologists are increasingly faced with urgent requests for investigation of suspected post-procedural complications, which often have similar clinical and laboratory manifestations. This pictorial essay reviews the usual post-procedural CT findings, the clinical features and imaging appearances of common and unusual post-ERCP occurrences including interstitial oedematous and necrotising acute pancreatitis, haemorrhages, retroperitoneal and intraperitoneal duodenal perforations, infections and stent-related complications. Emphasis is placed on the pivotal role of multidetector CT, which is warranted after complex or prolonged ERCP procedures as it represents the most effective modality to detect and grade ERCP-related complications and to monitor nonsurgically treated patients. Timely diagnosis and optimal management require a combination of clinical and laboratory data with imaging appearances; therefore, this article aims to provide an increased familiarity with interpretation of early post-ERCP studies, particularly to triage those occurrences that require interventional or surgical treatment. In selected patients MRI allows imaging pancreatitis and abnormal collections without the use of ionising radiation. Teaching Points • Endoscopic retrograde cholangiopancreatography (ERCP) allows treating many biliopancreatic disorders.• Due to the number and complexity of procedures, post-ERCP complications are increasingly encountered.• Main complications include acute pancreatitis, haemorrhages, duodenal perforation and infections.• Diagnosis and management of complications rely on combined clinical, laboratory and imaging data.• Multidetector CT is most effective to diagnose, categorise and monitor post-ERCP complications. PMID:25716101

  13. Neurologic complications of influenza A(H1N1)pdm09

    PubMed Central

    Khandaker, Gulam; Zurynski, Yvonne; Buttery, Jim; Marshall, Helen; Richmond, Peter C.; Dale, Russell C.; Royle, Jenny; Gold, Michael; Snelling, Tom; Whitehead, Bruce; Jones, Cheryl; Heron, Leon; McCaskill, Mary; Macartney, Kristine; Elliott, Elizabeth J.

    2012-01-01

    Objective: We sought to determine the range and extent of neurologic complications due to pandemic influenza A (H1N1) 2009 infection (pH1N1?09) in children hospitalized with influenza. Methods: Active hospital-based surveillance in 6 Australian tertiary pediatric referral centers between June 1 and September 30, 2009, for children aged <15 years with laboratory-confirmed pH1N1?09. Results: A total of 506 children with pH1N1?09 were hospitalized, of whom 49 (9.7%) had neurologic complications; median age 4.8 years (range 0.5–12.6 years) compared with 3.7 years (0.01–14.9 years) in those without complications. Approximately one-half (55.1%) of the children with neurologic complications had preexisting medical conditions, and 42.8% had preexisting neurologic conditions. On presentation, only 36.7% had the triad of cough, fever, and coryza/runny nose, whereas 38.7% had only 1 or no respiratory symptoms. Seizure was the most common neurologic complication (7.5%). Others included encephalitis/encephalopathy (1.4%), confusion/disorientation (1.0%), loss of consciousness (1.0%), and paralysis/Guillain-Barré syndrome (0.4%). A total of 30.6% needed intensive care unit (ICU) admission, 24.5% required mechanical ventilation, and 2 (4.1%) died. The mean length of stay in hospital was 6.5 days (median 3 days) and mean ICU stay was 4.4 days (median 1.5 days). Conclusions: Neurologic complications are relatively common among children admitted with influenza, and can be life-threatening. The lack of specific treatment for influenza-related neurologic complications underlines the importance of early diagnosis, use of antivirals, and universal influenza vaccination in children. Clinicians should consider influenza in children with neurologic symptoms even with a paucity of respiratory symptoms. PMID:22993280

  14. Use of intraoperative indocyanin-green angiography to minimize wound healing complications in abdominal wall reconstruction.

    PubMed

    Patel, Ketan M; Bhanot, Parag; Franklin, Brenton; Albino, Frank; Nahabedian, Maurice Y

    2013-12-01

    Complication rates following abdominal wall reconstruction (AWR) remain high. Early complications are related to skin necrosis and delayed healing, whereas late complications are related to recurrence. When concomitant body contouring procedures are performed, complication rates can be further increased. It is hypothesised that fluorescent angiography using indocyanin green (ICG) can identify poorly perfused tissues and thus reduce the incidence of delayed healing. A retrospective review was conducted of all patients who underwent AWR with concomitant panniculectomy from 2007-2012. Intraoperative ICG angiography with the SPY system (LifeCell Corp.) was used to determine the amount of resection for body contouring in patients who underwent reconstruction in a cohort of patients. SPY-Q was used to assess relative perfusion of analysed areas. Preoperative, postoperative, and operative details were analyzed. Seventeen patients met inclusion criteria, 12 patients were included in the non-ICG cohort, while five patients were included in the ICG cohorts. Wound-healing complications occurred in 5/12 (42%) patients in the non-ICG cohort vs 1/5 (20%) of the ICG cohorts. A description of the sole patient with complications in the ICG cohort is illustrated. Operative debridement and wound infection development occurred more frequently in the non-ICG cohort compared with the ICG cohort (17%, 17% vs 0%, 0%, respectively). Average time to wound healing was 41.1 days. Intraoperative ICG angiography can accurately detect perfusion abnormalities and can decrease wound healing related complications in complex hernia repair with concomitant panniculectomy. Assessing and ensuring skin viability can decrease the need for operative debridement. PMID:23596988

  15. Nasolacrimal Polyurethane Stent: Complications with CT Correlation

    SciTech Connect

    Pinto, Isabel T.; Paul, Laura; Grande, Carlos [Department of Radiology, Hospital Universitario de Getafe, Ctra. de Toledo, km 12.5, E-28905 Getafe, Madrid (Spain)

    1998-11-15

    Purpose: To evaluate initial results in patients with epiphora secondary to obstruction of the nasolacrimal duct treated by placement of a polyurethane stent, and to discuss the technical problems and complications arising during the procedure, with visualization of the anatomy of the drainage apparatus using computed tomography (CT). Methods: We inserted 20 polyurethane Song stents under fluoroscopic guidance after dacryocystography in 19 patients with grade 3-4 epiphora caused by idiopathic obstruction of the nasolacrimal duct. CT scans were obtained following stent placement in all patients. Results: We focus on the technical problems and complications that arose during these procedures. During negotiation of the guidewire past the obstruction at the level of the junction of the duct with the lacrimal sac, the guidewire created a false passage in a posterior suborbital direction in two cases and towards the posterior midline in another. In all cases the guidewire was withdrawn and reinserted through the proper anatomic route without further difficulty or complications. In two cases the stent was improperly positioned wholly or partially outside the nasolacrimal system (one medially, one posteriorly). In one case the stent was removed and reinserted; in the other it remains in place and functional. CT was performed in all these cases to ensure proper anatomic alignment and determine what had gone wrong. The epiphora was completely resolved in 13 cases and partially relieved in four; there were three cases of stent obstruction. Epistaxis of short duration (1 hr) occurred in seven patients and headache in one. Conclusions: Treatment of epiphora with polyurethane stents is a technique that is well tolerated by patients and achieves a high success rate, yet problems in placement may be encountered. Though no major consequences for patients are involved, cognizance of such difficulties is important to avoid incorrect positioning of stents.

  16. It’s more complicated than that

    PubMed Central

    Rycroft-Malone, Jo

    2015-01-01

    In this commentary the findings from a systematic review that concluded there is no compelling evidence to suggest that implementing complicated, multi-faceted interventions is more effective than simple, single component interventions to changing healthcare professional’s behaviour are considered through the lens of Harvey and Kitson’s editorial. Whilst an appealing conclusion, it is one that hides a myriad of complexities. These include issues concerning how best to tailor interventions and how best to evaluate such efforts. These are complex issues that do not have simple solutions.

  17. [An unusual case of "complicated" adrenal hemorrhage].

    PubMed

    Gallina, M R; Roncati, D; Grassino, E; Tomao, R; Ferrero, F

    2013-08-01

    This case report concerns a newborn with bilateral adrenal massive hemorrhage complicated by inferior cava vein thrombosis, hypertension and encephalopathy to elaborate diagnostic and therapeutic problem of neonatal thromboembolic events. Increasing of risk population (extreme prematurity), improvement of imaging, laboratory and neonatologist care enhanced in recent years the diagnosis of this group of diseases. Even if literature about this subject is poor, we remark the significant effort of neonatologist to revise and update neonatal guidelines and the relevance of the institution of the National Registry of Neonatal Thrombosis (RITI). PMID:24051977

  18. An Unusual Complication of a Colonic Wallstent

    SciTech Connect

    Low, Deborah E.; Panto, Philip N. [Kings Mill Hospital, Department of Radiology (United Kingdom); Hastings, Andrew G. [Kings Mill Hospital, Department of Pathology (United Kingdom); Nigam, Keshav [Kings Mill Hospital, Department of Surgery (United Kingdom)

    2004-08-15

    We report a case of delayed perforation of normal colonic wall by the wire tips of an enteral Wallstent, which had successfully been used to treat a malignant obstruction of the sigmoid colon. Perforation occurred 5 days following insertion and despite surgery, resulted in fatality. Though perforation at the tumor site is a recognized complication during or following colonic stent placement, it is rare for the ends of the stent to perforate through nondiseased bowel wall. The site of the obstructing lesion and thus the position of the stent on a bend in the colon may be a contributory factor.

  19. Risks for complicated grief in family caregivers.

    PubMed

    Ghesquiere, Angela; Haidar, Yamile M Martí; Shear, M Katherine

    2011-01-01

    Complicated grief (CG) is a recently recognized disorder experienced by the bereaved and characterized by intense distress that interferes with functioning. Estimates indicate that about 20 % of bereaved individuals may develop CG. Family caregivers of those who are chronically ill may face unique risks for CG, such as pre-death stressors associated with caregiving. In this article, existing literature on CG in family caregivers is reviewed to identify pre-bereavement risk factors for the disorder. Implications for practice are also discussed, including both preventive interventions that could be instituted before the ill person's death and therapeutic techniques for treating CG after the death. PMID:21895438

  20. Broncho-pleuropericardial fistula complicating staphylococcal sepsis

    PubMed Central

    Arab, Abeer A.; Kattan, Maan A.; Alyafi, Walid A.; Alhashemi, Jamal A.

    2011-01-01

    This is a rare case of broncho-pleuropericardial fistula in a 12-year-old female who presented with fever, painful joint swelling, and pleural and pericardial effusion secondary to disseminated methicillin-sensitive Staphylococcus aureus infection. The pleural and pericardial effusion were drained, however, air leak was observed from both tubes and was synchronous with mechanical inspiration. A broncho-pleuropericardial fistula was suspected and confirmed with computed tomography. This case report demonstrated that disseminated S. aureus bacteremia could result in broncho-pleuropericardial fistula. The ability of disseminated staphylococcal infection to produce pnemopericardium should be added to the list of other complications associated with disseminated staphylococcal sepsis. PMID:22144936

  1. Vascular Complications of Pancreatitis: Imaging and Intervention

    SciTech Connect

    Kirby, John M., E-mail: johnkirby@ireland.com; Vora, Parag; Midia, Mehran; Rawlinson, John [McMaster University Medical Center (Canada)

    2008-09-15

    The objective of this study was to highlight technical challenges and potential pitfalls of diagnostic imaging, intervention, and postintervention follow-up of vascular complications of pancreatitis. Diagnostic and interventional radiology imaging from patients with pancreatitis from 2002 to 2006 was reviewed. We conclude that biphasic CT is the diagnostic modality of choice. Catheter angiography may (still) be required to diagnose small pseudoaneurysms. Endovascular coiling is the treatment of choice for pseudoaneurysms. Close clinical follow-up is required, as patients may rebleed/develop aneurysms elsewhere.

  2. [Severe cardiovascular complications relating to Gemeprost therapy].

    PubMed

    Lauer, M; Berentelg, J

    2000-01-01

    The use of gemeprost vaginal pessaries is generally thought to be a method with little complications used for cervical softening within the first two trimesters of pregnancy. Though in our hospital two cases presented with severe cardiovascular reactions, to be attributed to the effect of prostaglandins. The first patient experienced a severe cardiogenic shock due to vasospasm several hours after primary administration of gemeprost vaginal pessaries and a cerebral stroke some hours later. The second patient suffered of a myocardial infarction ensuing from coronary spasm. PMID:10904996

  3. Prognostic Significance of Complications after Laparoscopic Colectomy for Colon Cancer

    PubMed Central

    Xia, Xiang; Wu, Weidong; Zhang, Kundong; Cen, Gang; Jiang, Tao; Cao, Jun; Huang, Kejian; Huang, Chen; Qiu, Zhengjun

    2014-01-01

    Aims This study sought to evaluate the prognostic significance of postoperative complications for colon cancer patients undergoing laparoscopic surgery. Methods From May 2006 to May 2009, a total 224 patients who underwent laparoscopic curative resection (R0) for colon cancer were included in our retrospective study. Postoperative complications were evaluated according to a standardized grading system. The main outcome measurements of our study were overall survival (OS) and relapse-free survival (RFS), which were then compared between the no complication and complication groups. Univariate and multivariate analysis were used to assess the correlation between complications and prognosis. Results Fifty-nine postoperative complications occurred in 43 patients. The overall morbidity rate was 26.3%. The 5-year OS in the complication group was 41.4% compared with 78.5% in the no complication group (P<0.001). The cumulative incidence of relapse was also more aggressive in patients with complications (5-year RFS: complication group 40.9% vs. no complication group 82.1%, P<0.001). Multivariate analysis identified complications as a significant factor increasing the risk for both OS (RR 2.737; 95% CI 1.512–4.952; P?=?0.001) and RFS (RR 4.247; 95% CI 2.291–7.876; P<0.001). Conclusion Postoperative complications could pose a significant adverse impact not only on OS but also on RFS in patients with colon cancer even when laparoscopic R0 resection is available. PMID:25299478

  4. Early Cottons

    E-print Network

    Bennett, R. L. (Robert Love)

    1904-01-01

    TEXAS AGRICULTURAL EXPERIMENT STATIONS BULLETIN No. 75 COTTON INVESTIGATIONS OF THE BUREAU OF PLANT INDUSTRY, U. S. DEPARTMENT OF AGRICULTURE AND THE TEXAS EXPERIMENT STATION EARLY COTTONS POSTOFFICE: COLLEGE STATION, BRAZOS COUNTY, TEXAS... ........................... F. R. MARSHALL. .Animal Husbandry EDWARD C. GREEN, B. S.. ................. .Assistant Horticultt~rist .................................. G. S. FRAPS. .Associate Chemist R. L. BENNETT. ................................ .Cotton Specialist 0. M...

  5. Early Math.

    ERIC Educational Resources Information Center

    Van Nuys, Ute Elisabeth

    1986-01-01

    Presents reviews of the following mathematics software designed to teach young children counting, number recognition, visual discrimination, matching, addition, and subtraction skills; Stickybear Numbers, Learning with Leeper, Getting Ready to Read and Add, Counting Parade, Early Games for Young Children, Charlie Brown's 1,2,3's, Let's Go Fishing,…

  6. Oral complications of cancer therapies. Oral complications in the pediatric population

    SciTech Connect

    Leggott, P.J. (Univ. of California, San Francisco (USA))

    1990-01-01

    A number of acute oral complications may be associated with cancer therapy in children, but the extent and duration of these complications, and the most effective management techniques. have not been well described. The few studies differ in design, making comparisons difficult. Well-controlled, prospective clinical studies are needed to define the most effective strategies for the management of acute oral complications in children. However, it is clear that dental intervention prior to cancer therapy is an important factor in the optimal preparation of the patient. During cancer therapy, intensive supervised oral preventive protocols appear to be of benefit to the child's oral health, overall comfort, and well-being. Furthermore, the prevention of oral infection may significantly reduce the morbidity associated with cancer therapy. Long-term preventive oral care may help prevent dental disease and infection in medically compromised children and contribute to improving the quality of life. 41 references.

  7. Cardiac Complications in Acute Ischemic Stroke

    PubMed Central

    Wira, Charles R; Rivers, Emanuel; Martinez-Capolino, Cynthia; Silver, Brian; Iyer, Gayathri; Sherwin, Robert; Lewandowski, Christopher

    2011-01-01

    Introduction To characterize cardiac complications in acute ischemic stroke (AIS) patients admitted from an urban emergency department (ED). Methods Retrospective cross-sectional study evaluating AIS patients admitted from the ED within 24 hours of symptom onset who also had an echocardiogram performed within 72 hours of admission. Results Two hundred AIS patients were identified with an overall in-hospital mortality rate of 8% (n = 16). In our cohort, 57 (28.5%) of 200 had an ejection fraction less than 50%, 35 (20.4%) of 171 had ischemic changes on electrocardiogram (ECG), 18 (10.5%) of 171 presented in active atrial fibrillation, 21 (13.0%) of 161 had serum troponin elevation, and 2 (1.1%) of 184 survivors had potentially lethal arrhythmias on telemetry monitoring. Subgroup analysis revealed higher in-hospital mortality rates among those with systolic dysfunction (15.8% versus 4.9%; P = 0.0180), troponin elevation (38.1% versus 3.4%; P < 0.0001), atrial fibrillation on ECG (33.3% versus 3.8%; P = 0.0003), and ischemic changes on ECG (17.1% versus 6.1%; P = 0.0398) compared with those without. Conclusion A proportion of AIS patients may have cardiac complications. Systolic dysfunction, troponin elevation, atrial fibrillation, or ischemic changes on ECG may be associated with higher in-hospital mortality rates. These findings support the adjunctive role of cardiac-monitoring strategies in the acute presentation of AIS. PMID:22224130

  8. External ventricular drains: Management and complications

    PubMed Central

    Muralidharan, Rajanandini

    2015-01-01

    Background: Insertion of an External Ventricular Drain (EVD) is arguably one of the most common and important lifesaving procedures in neurologic intensive care unit. Various forms of acute brain injury benefit from the continuous intracranial pressure (ICP) monitoring and cerebrospinal fluid (CSF) diversion provided by an EVD. After insertion, EVD monitoring, maintenance and troubleshooting essentially become a nursing responsibility. Methods: Articles pertaining to EVD placement, management, and complications were identified from PubMed electronic database. Results: Typically placed at the bedside by a neurosurgeon or neurointensivist using surface landmarks under emergent conditions, this procedure has the ability to drain blood and CSF to mitigate intracranial hypertension, continuously monitor intracranial pressure, and instill medications. Nursing should ensure proper zeroing, placement, sterility, and integrity of the EVD collecting system. ICP waveform analysis and close monitoring of CSF drainage are extremely important and can affect clinical outcomes of patients. In some institutions, nursing may also be responsible for CSF sampling and catheter irrigation. Conclusion: Maintenance, troubleshooting, and monitoring for EVD associated complications has essentially become a nursing responsibility. Accurate and accountable nursing care may have the ability to portend better outcomes in patients requiring CSF drainage.

  9. Complications of HIV disease and antiretroviral therapy.

    PubMed

    Luetkemeyer, Anne F; Havlir, Diane V; Currier, Judith S

    2012-01-01

    Studies on the efficacy of and drug interactions with the hepatitis C virus (HCV) direct-acting antivirals (DAAs) in HCV/ HIV coinfection were a highlight of the 2012 Conference on Retroviruses and Opportunistic Infections. The addition of an HCV protease inhibitor (PI) to pegylated interferon alfa/ribavirin increased HCV cure rates by 30% to 35% in HCV genotype 1 treatment-naive HIV-coinfected patients, an increase similar to that observed in HIV-uninfected HCV-infected patients. Drug interactions with antiretrovirals can be complex, and DAAs are recommended for use only with antiretroviral drugs for which pharmacokinetic data are available. Further drug interaction and clinical data are needed to ensure the safe coadminstration of DAAs with antiretroviral therapy. The conference placed continued emphasis on pathogenesis, management, and prevention of the long-term complications of HIV disease and its therapies, including cardiovascular disease, lipodystrophy, renal disease, alterations in bone metabolism, and vitamin D deficiency, along with a growing focus on biomarkers to predict development of end-organ disease. HIV has increasingly been recognized as a disease of accelerated aging, manifested by increased progression of vascular disease, cellular markers of aging, and a heightened risk of certain non-AIDS-defining malignancies. This year's conference also highlighted data on diagnosis, prevention, and complications of tuberculosis coinfection as well as the treatment and prevention of coinfections that are common with HIV, including cryptococcal meningitis, influenza, and varicella zoster. PMID:22710907

  10. Management of post-hepatectomy complications

    PubMed Central

    Jin, Shan; Fu, Quan; Wuyun, Gerile; Wuyun, Tu

    2013-01-01

    Hepatic resection had an impressive growth over time. It has been widely performed for the treatment of various liver diseases, such as malignant tumors, benign tumors, calculi in the intrahepatic ducts, hydatid disease, and abscesses. Management of hepatic resection is challenging. Despite technical advances and high experience of liver resection of specialized centers, it is still burdened by relatively high rates of postoperative morbidity and mortality. Especially, complex resections are being increasingly performed in high risk and older patient population. Operation on the liver is especially challenging because of its unique anatomic architecture and because of its vital functions. Common post-hepatectomy complications include venous catheter-related infection, pleural effusion, incisional infection, pulmonary atelectasis or infection, ascites, subphrenic infection, urinary tract infection, intraperitoneal hemorrhage, gastrointestinal tract bleeding, biliary tract hemorrhage, coagulation disorders, bile leakage, and liver failure. These problems are closely related to surgical manipulations, anesthesia, preoperative evaluation and preparation, and postoperative observation and management. The safety profile of hepatectomy probably can be improved if the surgeons and medical staff involved have comprehensive knowledge of the expected complications and expertise in their management. This review article focuses on the major postoperative issues after hepatic resection and presents the current management. PMID:24307791

  11. Repair of Infrapopliteal Postembolectomy Complications with Variant Embolization Techniques

    SciTech Connect

    Del Grande, Filippo [Institute of Diagnostic Radiology, University Hospital, Raemistrasee 100, CH-8091 Zuerich (Switzerland); Cassina, Paolo C. [Department of Surgery, University Hospital, Raemistrasee 100, CH-8091 Zuerich (Switzerland); Leu, Anders J. [Division of Angiology, University Hospital, Raemistrasee 100, CH-8091 Zuerich (Switzerland); Pfammatter, Thomas [Institute of Diagnostic Radiology, University Hospital, Raemistrasee 100, CH-8091 Zuerich (Switzerland)

    2001-07-15

    Infrapopliteal pseudoaneurysms and arteriovenous fistulae are known complications of Fogarty balloon embolectomy. Management of these complications in two patients with associated critical foot ischemia by modified interventional embolization techniques is described.

  12. Multiple sclerosis: a complicated picture of autoimmunity

    Microsoft Academic Search

    Roland Martin; Henry F McFarland

    2007-01-01

    Understanding of autoimmune diseases, including multiple sclerosis, has expanded considerably in recent years. New insights have been provided by not only animal models but also studies of patients, often in conjunction with experimental therapies. It is accepted that autoimmune T cells mediate the early steps of new multiple sclerosis lesions, and although uncertainties remain about the specific targets of autoreactive

  13. Managing complications I: leaks, strictures, emptying, reflux, chylothorax

    PubMed Central

    2014-01-01

    Esophagectomy can be used to treat several esophageal diseases; it is most commonly used for treatment of esophageal cancer. Esophagectomy is a major procedure that may result in various complications. This article reviews only the important complications resulting from esophageal resection, which are anastomotic complications after esophageal reconstruction (leakage and stricture), delayed emptying or dumping syndrome, reflux, and chylothorax. PMID:24876942

  14. Complications associated with arthroscopic rotator cuff repair: a literature review.

    PubMed

    Randelli, P; Spennacchio, P; Ragone, V; Arrigoni, P; Casella, A; Cabitza, P

    2012-06-01

    The aim of this literature review was to report complications associated with arthroscopic rotator cuff repair (RCR). A computerized search of articles published between 200 and 2009 was performed using MEDLINE and PubMed. We included clinical studies (Level 1-4): (a) investigating patients with rotator cuff tears, managed by a completely arthroscopic RCR technique; (b) reported data about complications. Data about arthroscopic-assisted techniques were excluded. Articles that meet criteria inclusion were analytically examined. Complications were classified into general complications and specific complications related to arthroscopic RCR. We found 414 complications in 2,890 patients; most of them were specific complications related to arthroscopic RCR. Re-rupture was the most frequently encountered complication: re-tear rate ranged between 11.4 and 94%. Stiffness and hardware-related complications were observed in 74 and 12 patients, respectively. Eleven less common complications were also reported: 5 neurovascular, 3 septic, 2 thromboembolic events, and 1 anesthesiological complication. This review stated that arthroscopic RCR is a low-risk surgical procedure. Anatomical failure of the repair is the most common complication encountered in the literature. PMID:22205384

  15. Complications of Living Donor Hepatic Lobectomy—A Comprehensive Report

    PubMed Central

    Abecassis, M. M.; Fisher, R. A.; Olthoff, K. M.; Freise, C. E.; Rodrigo, D. R.; Samstein, B.; Kam, I.; Merion, R. M.

    2013-01-01

    A wider application of living donor liver transplantation is limited by donor morbidity concerns. An observational cohort of 760 living donors accepted for surgery and enrolled in the Adult-to-Adult Living Donor Liver Transplantation cohort study provides a comprehensive assessment of incidence, severity and natural history of living liver donation (LLD) complications. Donor morbidity (assessed by 29 specific complications), predictors, time from donation to complications and time from complication onset to resolution were measured outcomes over a 12-year period. Out of the 760 donor procedures, 20 were aborted and 740 were completed. Forty percent of donors had complications (557 complications among 296 donors), mostly Clavien grades 1 and 2. Most severe counted by complication category; grade 1 (minor, n = 232); grade 2 (possibly life-threatening, n = 269); grade 3 (residual disability, n = 5) and grade 4 (leading to death, n = 3). Hernias (7%) and psychological complications (3%) occurred >1 year postdonation. Complications risk increased with transfusion requirement, intraoperative hypotension and predonation serum bilirubin, but did not decline with the increased center experience with LLD. The probability of complication resolution within 1 year was overall 95%, but only 75% for hernias and 42% for psychological complications. This report comprehensively quantifies LLD complication risk and should inform decision making by potential donors and their caregivers. PMID:22335782

  16. Prevalence of risk factors for diabetic foot complications

    Microsoft Academic Search

    Fatma Al-Maskari; Mohammed El-Sadig

    2007-01-01

    BACKGROUND: Foot complications are common in diabetic patients and are considered one of the most expensive diabetes (DM) complications to treat. The aim of this study was to determine the prevalence and risk factors for foot complications among diabetic patients in Al-Ain district, United Arab Emirates (UAE). METHODS: The study was part of a general cross-sectional survey carried out to

  17. Evaluation of hospital inpatient complications: a planning approach

    Microsoft Academic Search

    Ronald J Lagoe; Gert P Westert

    2010-01-01

    BACKGROUND: Hospital inpatient complications are one of a number of adverse health care outcomes. Reducing complications has been identified as an approach to improving care and saving resources as part of the health care reform efforts in the United States. An objective of this study was to describe the Potentially Preventable Complications software developed as a tool for evaluating hospital

  18. Surgical and Nonsurgical Complications of a Pig to Baboon Heterotopic Heart Transplantation Model

    PubMed Central

    Corcoran, P.C.; Horvath, K.A.; Singh, A.K.; Hoyt, R.F.; Thomas, M.L.; Eckhaus, M.A.; Mohiuddin, M.M.

    2010-01-01

    A modified immunosuppressive regimen, developed at the National Institutes of Health, has been employed in a large animal model of heterotopic cardiac xenotransplantation. Graft survival has been prolonged, but despite this, our recipients have succumbed to various surgical or nonsurgical complications. Herein, we have described different complications and management strategies. The most common complication was hyperco-agulability (HC) after transplantation, causing thrombosis of both small and large vasculature, ultimately leading to graft loss. While managing this complication we discovered that there was a delicate balance between HC and consumptive coagulopathy (CC). CC encountered in some recipient baboons was not able to be reversed by stopping anticoagulation and administering multiple blood transfusions. Some complications had iatrogenic components. To monitor the animals, a solid state left ventricular telemetry probe was placed directly into the transplanted heart via the apex. Induction of hypocoagulable states by continuous heparin infusion led to uncontrollable intra-abdominal bleeding in 1 baboon from this apical site. This occurrence necessitated securing the probe more tightly with multiple purse strings and 4-quadrant pledgeted stay sutures. One instance of cardiac rupture originated from a lateral wall infarction site. Earlier studies have shown infections to be uniformly fatal in this transplant model. However, owing to the telemetry placement, infections were identified early by temperature spikes that were treated promptly with antibiotics. We had several cases of wound dehiscence due to recipients picking at the sutures. These complications were promptly resolved by either re-approximating the wound or finding distractions for the baboon. A few of the most common problems we faced in our earlier experiments were related to the jacket, tether, and infusion pumps. It was difficult to keep the jackets on some baboons and the tether had to be modified several times before we assured long-term success. Infusion catheter replacement resulted in transplant heart venous obstruction and thrombosis from a right common femoral venous line. Homeostatic perturbations such as HC and CC and baboon-induced wound complications comprised most complications. Major bleeding and death due to telemetry implantation and infarct rupture occurred in 2 baboons. Despite the variety of complications, we achieved significant graft prolongation in this model. PMID:20692430

  19. Pancreatic Neoplasms in Pregnancy: Diagnosis, Complications, and Management

    PubMed Central

    Boyd, Casey A.; Benarroch-Gampel, Jaime; Kilic, Gokhan; Kruse, Edward J.; Weber, Sharon M.; Riall, Taylor S.

    2012-01-01

    BACKGROUND Neoplasms of the pancreas during pregnancy are rare, with less than 25 cases of benign and malignant tumors reported in the literature. METHODS We present three unique cases of pancreatic tumors occurring during pregnancy—one mucinous cystic neoplasm and two adenocarcinomas. We review the literature regarding pancreatic neoplasms during pregnancy and discuss the diagnosis, complications, and management of these tumors. RESULTS MRI and ultrasound are the imaging modalities of choice in pregnancy. In patients with benign or premalignant tumors, surgical resection may be postponed until the second trimester. In symptomatic patients, or if there is a concern for intrauterine growth restriction (IUGR), urgent surgical intervention should be performed. With malignant tumors, the benefit of delaying surgery must be balanced with the risk of maternal disease progression. Termination of the pregnancy should be discussed when a malignant tumor is diagnosed during the first trimester. Pancreatic tumors diagnosed during the third trimester may be resected after delivery. If malignant, early delivery of the fetus and subsequent maternal operation can be considered at appropriate fetal maturity. CONCLUSION When these tumors occur during pregnancy, they present a diagnostic and treatment dilemma, with variation in treatment based on gestational age and patient preference. PMID:22160782

  20. Treatment of severe acute pancreatitis and its complications

    PubMed Central

    Zerem, Enver

    2014-01-01

    Severe acute pancreatitis (SAP), which is the most serious type of this disorder, is associated with high morbidity and mortality. SAP runs a biphasic course. During the first 1-2 wk, a pro-inflammatory response results in systemic inflammatory response syndrome (SIRS). If the SIRS is severe, it can lead to early multisystem organ failure (MOF). After the first 1-2 wk, a transition from a pro-inflammatory response to an anti-inflammatory response occurs; during this transition, the patient is at risk for intestinal flora translocation and the development of secondary infection of the necrotic tissue, which can result in sepsis and late MOF. Many recommendations have been made regarding SAP management and its complications. However, despite the reduction in overall mortality in the last decade, SAP is still associated with high mortality. In the majority of cases, sterile necrosis should be managed conservatively, whereas in infected necrotizing pancreatitis, the infected non-vital solid tissue should be removed to control the sepsis. Intervention should be delayed for as long as possible to allow better demarcation and liquefaction of the necrosis. Currently, the step-up approach (delay, drain, and debride) may be considered as the reference standard intervention for this disorder. PMID:25320523

  1. Hyperperfusion syndrome after MCA embolectomy – a rare complication?

    PubMed Central

    Backhaus, Roland; Boy, Sandra; Fuchs, Kornelius; Ulrich, Bogdahn; Schuierer, Gerhard; Schlachetzki, Felix

    2013-01-01

    Patient: Female, 78 Final Diagnosis: Cerebral hyperperfusion syndrome Symptoms: — Medication: — Clinical Procedure: Endovascular embolectomy Specialty: Neurology Objective: Unknown ethiology Background: Cerebral hyperperfusion syndrome (cHS) is a well known but rare complication after carotid endarterectomy, carotid angioplasty with stenting, and stenting of intracranial arterial stenosis. The clinical presentation may vary from acute onset of focal oedema (stroke-like presentation) and intracerbral hemorrhage to delayed (>24h hours after the procedure) presentation with seizures, focal motor weakness, or late intracerebral hemorrhage. The incidence of cHS after carotid endarterectomy ranges from 0–3% and defined as an increase of the ipsilateral cerebral blood flow up to 40% over baseline in ultrasound. Case Report: We present a case of a 78-year-old woman with an acute ischemic stroke due to left side middle cerebral artery territory with right sided hemiparesis and aphasia (NIHSS 16). After systemic thrombolysis embolectomy using a retractable stent (Solitaire® device) was performed and resulted in complete and successful recanalization of MCA including its branches about 210 minutes after symptom onset but, partial dislocation of thrombotic material into the anterior cerebral artery (ACA). Conclusions: Cerebral hyperperfusion syndrome should be considered in patients with clinical deterioration after successful recanalisation and the early diagnosis and treatment may be important for neurological outcome after endovascular embolectomy PMID:24340127

  2. Portomesenteric venous gas: A late complication of pneumatosis intestinalis

    PubMed Central

    Faraj, W.; Srinivasan, P.; El Nounou, G.; Abou El Naaj, A.; Khalife, M.; Doughan, Samer; Haydar, A.

    2014-01-01

    Background The pneumatosis intestinalis is an entity with multiple aetiologies and may be associated with a fatal outcome when present on plain radiographs. When associated with the presence of portomesenteric venous gas (PMVG) it is typically the result of bowel ischaemia. Methods and results We are presenting a case of a 43 year old male who presented with a two days history of haematemesis, generalised abdominal pain and distension. Computed tomography (CT) scan revealed a gross amount of air within the portal venous system and small bowel dilatation to the level of distal ileum was also seen with associated pneumatosis intestinalis. Emergency laparotomy was conducted which demonstrated a simple band adhesion resulting in bowel ischaemia. The patient was making a good post-operative recovery complicated only by sub-therapeutic treatment of schizophrenia. Conclusion The presence of gas within the portal venous system and PI in adults can indicate severe life-threatening disease. This requires early surgical intervention in those patients with a clinical suspicion of bowel ischaemia, and with radiological signs. This may avoid significant mortality. PMID:25545710

  3. Toxic epidermal necrolysis and neutropaenia: complications of omeprazole.

    PubMed

    Thakor, Avnesh S; Burke, Ailbhe; Handfield-Jones, Susan; Sinha, Ayush; Palmer, Mike; Burns, Alys

    2009-08-01

    Worldwide, proton pump inhibitors (PPI) are one of the most frequently prescribed drugs; however, up to 70% of patients taking these drugs have no appropriate indication. Although PPI are relatively well tolerated, they are not free from side-effects and several life-threatening complications are associated with them. In the present report, a 43-year-old woman presented to her general practitioner with an erythematous rash over her face and chest, having been started on omeprazole for chronic abdominal bloating. Over the next 24 h she became increasingly unwell and was admitted to hospital with shortness of breath, pyrexia and the rash spreading over her back, arms and legs. Vesicles had now started to appear within the erythematous regions over her upper body and within 24 h the rash became confluent and desquamative, spreading to involve her entire body. A diagnosis of toxic epidermal necrolysis (TEN) was made. Despite supportive treatment within a critical care setting, she became neutropaenic and her skin loss became more extensive, resulting in 95% epidermal detachment. This case highlights that TEN is a life-threatening condition associated with a high incidence of morbidity and mortality. Optimal management requires early diagnosis and transfer to a specialized unit. Clinicians need to be aware that PPI are not free from side-effects and that their routine prescription should be strongly discouraged. PMID:19659985

  4. [Cosmetic blepharoplasty complicated by necrotizing periorbital fasciitis: a case report].

    PubMed

    Laouar, K; Ruban, J-M; Baggio, E; Dupeyron, G

    2012-06-01

    Necrotizing periorbital or palpebro-orbital fasciitis represents a unique anatomical site for necrotizing fasciitis, which is an extremely rare and very severe, potentially devastating bacterial infection, rapidly leading to facial necrosis with loss of vision and even death of the patient from toxic shock. In this paper, we report a case of necrotizing periorbital fasciitis as a complication of cosmetic lower eyelid blepharoplasty. Necrotizing fasciitis most often affects the upper and lower limbs, the trunk and the perineal area. It is rarely observed in the facial region due to the rich blood supply in this area. The most commonly implicated pathogen is group A, ?-hemolytic "pyogenic"Streptococcus, either alone or in combination with other bacteria, such as staphylococcus or pseudomonas. Mortality varies according to the series and anatomical site. The mortality rate for necrotizing fasciitis is approximately 28 %. It is slightly lower in the periorbital area (15 %). Risk factors for death include alcoholism, diabetes mellitus, immunocompromise, hematologic or pulmonary diseases, and the identity of the causative agent (group A Streptococcus), although approximately 50 % of patients have no predisposing conditions. Management of periorbital necrotizing fasciitis is based on early detection of initial symptoms and on aggressive multidisciplinary treatment including surgical debridement of necrotic areas and antibiotic coverage. The timeliness of treatment and the multidisciplinary approach are considered to be the two essential factors in influencing the mortality and morbidity of this condition. PMID:22633216

  5. Predictive Value of C-Reactive Protein for Major Complications after Major Abdominal Surgery: A Systematic Review and Pooled-Analysis

    PubMed Central

    Cuesta, Miguel A.; Berkhof, Johannes; Jansma, Elise P.; van der Peet, Donald L.

    2015-01-01

    Background Early diagnosis and treatment of complications after major abdominal surgery can decrease associated morbidity and mortality. Postoperative CRP levels have shown a strong correlation with complications. Aim of this systematic review and pooled-analysis was to assess postoperative values of CRP as a marker for major complications and construct a prediction model. Study design A systematic review was performed for CRP levels as a predictor for complications after major abdominal surgery (MAS). Raw data was obtained from seven studies, including 1427 patients. A logit regression model assessed the probability of major complications as a function of CRP levels on the third postoperative day. Two practical cut-offs are proposed: an optimal cut-off for safe discharge in a fast track protocol and another for early identification of patients with increased risk for major complications. Results A prediction model was calculated for major complications as a function of CRP levels on the third postoperative day. Based on the model several cut-offs for CRP are proposed. For instance, a two cut-off system may be applied, consisting of a safe discharge criterion with CRP levels below 75 mg/L, with a negative predictive value of 97.2%. A second cut-off is set at 215 mg/L (probability 20%) and serves as a predictor of complications, indicating additional CT-scan imaging. Conclusions The present study provides insight in the interpretation of CRP levels after major abdominal surgery, proposing a prediction model for major complications as a function of CRP on postoperative day 3. Cut-offs for CRP may be implemented for safe early-discharge in a fast-track protocol and, secondly as a threshold for additional examinations, such as CT-scan imaging, even in absence of clinical signs, to confirm or exclude major complications. The prediction model allows for setting a cut-off at the discretion of individual surgeons or surgical departments. PMID:26177542

  6. Rattlesnake bite complications in 19 children.

    PubMed

    Cruz, N S; Alvarez, R G

    1994-02-01

    The Western diamondback rattlesnake, Crotalus atrox, is responsible for the majority of snakebites in Sonora, Mexico. We report 19 cases of children who were attacked by these snakes. Most of the rattlesnake attacks occurred in rural areas during the summer. The children's ages ranged from one to 15 years. The lower extremities, especially the legs, were most often bitten. The signs and symptoms presented by these patients included: pain, edema, limitation of motion, ecchymosis, bleeding and necrosis in the area of the bite, epistaxis, hematuria, and vomiting. Hospital treatment included: parenteral electrolyte solutions, antivenom serum, antibiotics, tetanus toxoid, blood transfusions, hydrocortisone, heparin, and peritoneal dialysis. In one case a fasciotomy was necessary. The observed complications on envenomations included: hemolysis, local necrosis, coagulation disorders, paresthesia, somnolence, and acute renal failure. One death occurred from disseminated intravascular coagulation. PMID:8177804

  7. Pulmonary complications of abdominal wall defects.

    PubMed

    Panitch, Howard B

    2015-01-01

    The abdominal wall is an integral component of the chest wall. Defects in the ventral abdominal wall alter respiratory mechanics and can impair diaphragm function. Congenital abdominal wall defects also are associated with abnormalities in lung growth and development that lead to pulmonary hypoplasia, pulmonary hypertension, and alterations in thoracic cage formation. Although infants with ventral abdominal wall defects can experience life-threatening pulmonary complications, older children typically experience a more benign respiratory course. Studies of lung and chest wall function in older children and adolescents with congenital abdominal wall defects are few; such investigations could provide strategies for improved respiratory performance, avoidance of respiratory morbidity, and enhanced exercise ability for these children. PMID:25458796

  8. Gaucher disease: haematological presentations and complications.

    PubMed

    Thomas, Alison S; Mehta, Atul; Hughes, Derralynn A

    2014-05-01

    Gaucher disease (GD) is an autosomal recessive lysosomal storage disease, caused by deficiency of the enzyme glucocerebrosidase, required for the degradation of glycosphingolipids. Clinical manifestations include hepatosplenomegaly, thrombocytopenia, bone disease and a bleeding diathesis, frequently resulting in presentation to haematologists. Historically managed by splenectomy, transfusions and orthopaedic surgery, the development of specific therapy in the form of intravenous enzyme replacement therapy in the 1990s has resulted in dramatic improvements in haematological and visceral disease. Recognition of complications, including multiple myeloma and Parkinson disease, has challenged the traditional macrophage-centric view of the pathophysiology of this disorder. The pathways by which enzyme deficiency results in the clinical manifestations of this disorder are poorly understood; altered inflammatory cytokine profiles, bioactive sphingolipid derivatives and alterations in the bone marrow microenvironment have been implicated. Further elucidating these pathways will serve to advance our understanding not only of GD, but of associated disorders. PMID:24588457

  9. Steroids: Pharmacology, Complications, and Practice Delivery Issues

    PubMed Central

    Ericson-Neilsen, William; Kaye, Alan David

    2014-01-01

    Background Since their identification nearly 80 years ago, steroids have played a prominent role in the treatment of many disease states. Many of the clinical roles of steroids are related to their potent antiinflammatory and immune-modulating properties. Methods This review summarizes the basic pharmacology, complications, and practice delivery issues regarding steroids. Results Clinically relevant side effects of steroids are common and problematic. Side effects can occur at a wide range of doses and vary depending on the route of administration. The full spectrum of side effects can be present even in patients taking low doses. Conclusions Practitioners must be aware that these drugs might exacerbate a preexisting condition or present a new medical condition. Knowledge of the clinical implications of prescribing these agents is critical. PMID:24940130

  10. Petroclival meningiomas: surgical management and common complications.

    PubMed

    Tahara, Adriana; de Santana, Pedro Augustto; Calfat Maldaun, Marcos Vinicius; Panagopoulos, Alexandros Theodoros; da Silva, Arnaldo Neves; Zicarelli, Carlos A; Pires de Aguiar, Paulo Henrique

    2009-05-01

    Petroclival meningiomas are technically challenging lesions. They have a tendency to grow slowly, involve cranial nerves and compress the brainstem and basilar artery, pushing them to the opposite side. Their natural history is marked by clinical deterioration and fatal outcome. They were once considered inoperable lesions; decades ago, mortality rates were higher than 50%. The authors describe 15 petroclival meningiomas treated surgically between 1995 and 2007. The main approaches used were combined anterior petrosectomy and retrosigmoid (3 cases), retrosigmoid (8 cases), and pre-sigmoid and subtemporal (4 cases). The mortality rate was 13.5% due to surgical bed hematoma and brain ischemia. The post-operative complications were hydrocephalus in 2 cases, cerebrospinal fluid leak in 2 cases and infection of surgical flap in one case. Limiting factors for surgical removal are tumor consistency, encasement of brainstem perforators and pre-operative clinical status. PMID:19318254

  11. DNA viral infections complicating lung transplantation.

    PubMed

    Clark, Nina M; Lynch, Joseph P; Sayah, David; Belperio, John A; Fishbein, Michael C; Weigt, S Samuel

    2013-06-01

    DNA viruses with potential to cause complications after lung transplantation include the human Herpesviridae family consisting of cytomegalovirus (CMV), herpes simplex virus 1 and 2 (HSV-1, -2), varicella-zoster virus (VZV), human herpesvirus 6, 7, and 8 (HHV-6, -7, -8), and Epstein-Barr virus (EBV); the Polyomaviridae family consisting of BK virus and JC virus; and the Adenoviridae family consisting of more than 50 adenovirus subtypes. This is a diverse group of viruses with equally diverse immediate and long-term impacts on allograft function and clinical outcomes following lung transplantation. This article discusses the individual pathogens, their epidemiology and clinical manifestations, as well as treatment and preventive strategies in this era of antiviral treatment regimens. PMID:23821512

  12. Intracranial venous thrombosis complicating oral contraception

    PubMed Central

    Dindar, F.; Platts, M. E.

    1974-01-01

    Four days after the onset of a severe headache a 22-year-old woman who had been taking oral contraceptives for less than three weeks had a convulsion, followed by right hemiparesis. Other focal neurologic signs and evidence of raised intracranial pressure appeared, and she became comatose on the seventh day. A left craniotomy revealed extensive cerebral venous thrombosis. She died the next day. On postmortem examination extensive thrombosis of the superior sagittal sinus and draining cerebral veins, and multiple areas of cerebral hemorrhage and hemorrhagic infarction were seen. Some of the superficial cerebral veins showed focal necrosis of their walls, and the lateral lacunae of the superior sagittal sinus contained proliferating endothelial cells. The adrenal veins were also thrombosed. The significance of these findings is discussed. The literature on cerebrovascular complications of oral contraception, particularly cerebral venous thrombosis, is reviewed. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5FIG. 6 PMID:4413961

  13. Mycobacterium chelonae infection: a complication of tattooing.

    PubMed

    Sergeant, A; Conaglen, P; Laurenson, I F; Claxton, P; Mathers, M E; Kavanagh, G M; Tidman, M J

    2013-03-01

    We describe an outbreak of Mycobacterium chelonae infection in four young immunocompetent patients who were tattooed by the same artist. All had been previously tattooed without complication, but following the latest tattooing session, they all developed a very similar papular eruption confined to skin that had been newly coloured light grey. On histological examination of the eruption, granulomatous inflammation with microabscess formation was seen, in association with the tattoo pigment. Skin cultures grown under optimal conditions grew M. chelonae, sensitive to clarithromycin, from one patient. M. chelonae was also cultured from the contents and nozzle of an opened bottle of light-grey ink from the tattoo parlour frequented by the patients. Dermatologists should consider mycobacterial infection in patients who develop inflammatory changes within a new tattoo. PMID:22831709

  14. [Cardiopulmonary complications in sickle cell anemia].

    PubMed

    Rojas-Jiménez, Sara; Lopera-Valle, Johan; Yabur-Espítia, Mirna

    2013-01-01

    Sickle cell anemia, considered the most prevalent genetic disease among African Americans, is a disease with autosomal recessive inheritance pattern, characterized by the production of hemoglobin S. This abnormal protein polymerizes and facilitates the formation of fibrillar aggregates that alters the erythrocyte morphology. The stiffness of the red blood cells hinders the adequate transit across microcirculation, leading to hemolysis and increased blood viscosity, which ease thrombogenesis and vascular occlusion, resulting in tissue ischemia and microinfarcts. This disease has a high rate of morbidity and mortality, especially in the first three years of life, when a rapid diagnosis and appropriate treatment are essential. Cardiovascular complications such as heart failure and pulmonary hypertension may develop independently, and each one contributes to increased mortality, being the combination of both risk factors, an important aggravating factor for prognosis and a determinant indicator of mortality. PMID:24215682

  15. Immunological and neuroimaging biomarkers of complicated grief

    PubMed Central

    O'Connor, Mary-Frances

    2012-01-01

    Complicated grief (CG) is a disorder marked by intense and persistent yearning for the deceased, in addition to other criteria. The present article reviews what is known about the immunologic and neuroimaging biomarkers of both acute grief and CG, Attachment theory and cognitive stress theory are reviewed as they pertain to bereavement, as is the biopsychosocial model of CG. Reduced immune cell function has been replicated in a variety of bereaved populations. The regional brain activation to grief cues frequently includes the dorsal anterior cingulate cortex and insula, and also the posterior cingulate cortex. Using theory to point to future research directions, we may eventually learn which biomarkers are helpful in predicting CG, and its treatment. PMID:22754286

  16. Incidents and Complications of Permanent Venous Central Access Systems: A Series of 1,460 Cases

    PubMed Central

    El Ouazni, Mohammed; Arsalane, Adil; El Oueriachi, Fayçal; Mansouri, Hamid; Kabiri, El Hassane

    2014-01-01

    Background Implanted venous access devices or permanent central venous access systems (PCVASs) are routinely used in oncologic patients. Complications can occur during the implantation or use of such devices. We describe such complications of the PCVAS and their management. Methods Our retrospective study included 1,460 cases in which PCVAS was implanted in the 11 years between January 2002 and January 2013, including 810 women and 650 men with an average age of 45.2 years. We used polyurethane or silicone catheters. The site of insertion and the surgical or percutaneous procedure were selected on the basis of clinical data and disease information. The subclavian and cephalic veins were our most common sites of insertion. Results About 1,100 cases (75%) underwent surgery by training surgeons and 360 patients by expert surgeons. Perioperative incidents occurred in 33% and 12% of these patients, respectively. Incidents (28%) included technical difficulties (n=64), a subcutaneous hematoma (n=37), pneumothoraces (n=15), and an intrapleural catheter (n=1). Complications in the short and medium term were present in 14.2% of the cases. Distortion and rupture of the catheter (n=5) were noted in the costoclavicular area (pinch-off syndrome). There were 5 cases of catheter migration into the jugular vein (n=1), superior vena cava (n=1), and heart cavities (n=3). No patient died of PCVAS insertion or complication. Conclusion PCVAS complications should be diagnosed early and treated with probable removal of this material for preventing any life-threatening outcome associated with complicated PVCAS. PMID:24782960

  17. Perioperative Complications of Robot-Assisted Laparoscopic Surgery Using Three Robotic Arms at a Single Institution

    PubMed Central

    Yim, Ga Won; Kim, Sang Wun; Nam, Eun Ji; Kim, Sunghoon

    2015-01-01

    Purpose The aim of this study was to evaluate perioperative complications of robot-assisted laparoscopic surgery in gynecology. Materials and Methods Patients who underwent elective robot-assisted laparoscopic surgery between February 2006 and December 2013 were identified. Robotic procedures were performed using the da Vinci robotic system. Patient demographic data and operative outcomes were prospectively collected in a computerized database and extracted for this study. Results Two hundred and ninety eight patients were identified during the study period. One case was converted to conventional laparoscopy due to mechanical failure of the robot system before the procedure and excluded from review. The median age and body mass index of patients were 48 years and 23.0 kg/m2, respectively. The majority (n=130, 43.6%) of operative procedures was radical hysterectomy, followed by endometrial cancer staging (n=112, 37.6%), total hysterectomy (n=39, 13.1%), and myomectomy (n=17, 5.7%). The median operative time, estimated blood loss, and postoperative hospital stay were 208.5 min, 184.8 mL, and 8.9 days, respectively. The overall complication rate was 18.8% and that for only oncologic cases was 16.1%. Intraoperative complications (n=5, 1.7%) consisted of three vessel injuries, one bowel content leakage during an appendectomy during endometrial cancer staging and one case of bladder injury during radical hysterectomy. Early and late postoperative complications were 14.4% and 2.7%, respectively. Five patients (1.7%) experienced grade 3 complications according to Clavien-Dindo classification and therefore needed further intervention. Conclusion Robot-assisted laparoscopic surgery is a feasible approach in gynecology with acceptable complications. PMID:25683998

  18. Complications and management in Descemet's stripping endothelial keratoplasty: Analysis of consecutive 430 cases

    PubMed Central

    Basak, Samar K; Basak, Soham

    2014-01-01

    Purpose: To analyze the complications and their managements in Descemet's stripping endothelial keratoplasty (DSEK) in consecutive 430 cases by single surgeon in a tertiary eye hospital. Materials and Methods: 430 eyes of 366 patients with endothelial dysfunctions scheduled for DSEK, were analyzed retrospectively. In all cases donor dissection was performed manually, and ‘Taco’ insertion and unfolding technique was used. Intra-operative and postoperative complications with their managements and outcomes were reviewed retrospectively. Periodic endothelial cell density was analyzed for each patient till the last visit. Follow-up period was between 3 to 60 months (mean 18.7 months). Results: 13 (3.0%) eyes had operative complications during donor dissection and 16 (3.7%) had during recipient procedure. In 7 (1.6%) eyes, donor lenticule was replaced with a new one during the surgery. In early postoperative period, 21 (4.9%) eyes had donor dislocation and 12 (2.8%) eyes had air-induced pupillary block; and they were managed immediately. 2 cases had primary graft failure and in 1 case had postoperative bacterial endophthalmitis requiring evisceration. In late postoperative period, 48 (11.3%) eyes had secondary glaucoma and 14 (3.3%) eyes had late secondary graft failure. Endothelial rejection occurred in 5 (1.2%) cases. Mean endothelial cell loss was 19.7% after 3 months and 54.2% after 5 years. Total graft failure in this series was 31 (7.2%) and in 17 cases re-DSEK was performed successfully. Conclusions: Both operative and postoperative complications do occur in DSEK. Most of these complications can be managed by medical or appropriate surgical means. Some of the complications can be avoided and reduced with experience. PMID:24008797

  19. Radiofrequency Catheter Ablation: Indications and Complications

    Microsoft Academic Search

    A. M. Dubin; G. F. Van Hare

    2000-01-01

    .   Radiofrequency catheter ablation was first described in pediatric patients in the early 1990s. Since then, multiple advances\\u000a in the technology and understanding of radiofrequency ablation have allowed this technique to blossom into one of the most\\u000a powerful therapeutic tools available to the pediatric electrophysiologist. This treatment has, in the majority of cases, replaced\\u000a arrhythmia surgery as the definitive cure

  20. Respiratory Complications from Acute Corrosive Poisonings in Adults

    PubMed Central

    Chibishev, Andon A.; Simonovska, Natasa; Bozinovska, Cvetanka; Pereska, Zanina; Smokovski, Ivica; Glasnovic, Marija

    2014-01-01

    Introduction: Acute corrosive poisonings are caused by ingestion of corrosive chemicals which are most commonly used as household agents. Intoxications with these kind of agents produce numerous and severe post-corrosive complications of the upper gastrointestinal tract. On the other hand, our experience showed that corrosive agents may also cause injuries of the respiratory system, which makes the treatment very hard and additionally complicates the severe clinical condition of the patient. Objective: The aim of the study is to show the incidence of respiratory complications in acute corrosive poisonings, the need of various clinical investigations and also the treatment and final outcome of these kind of poisoning. Methods: We retrospectively analyzed clinical records of 415 patients hospitalized and treated at the University clinic for toxicology and urgent internal medicine, in Skopje, Republic of Macedonia, in the period between 2007 and 2011. The protocol consisted of methods for analyzing the systemic complications, with an accent on the post-corrosive respiratory complications. Results: From the total number of patients even 98 (23.61%) exhibited systemic complications, from which 51 (52.04%) are respiratory complications. The majority of patients are female (n=40, 78.43%) and the most common complication is pneumonia (n=47). The youngest patient in this study was 14 and the oldest was 87 years old. Conclusion: Besides the gastrointestinal complications in the acute corrosive poisonings respiratory complications are also very often. They complicate the clinical state of patient and very often lead to fatal endings. PMID:24944527

  1. Survey and management of anaesthesia related complications in PACU

    PubMed Central

    Faraj, Jafar H.; Vegesna, A.R.R.; Mudali, I.N.; Khairay, M.A.; Nissar, Shaikh; Alfarhan, Muna; Sabir, Kareema; El-imam, Fawkia; Anto, Lucy; Go, Teofila

    2012-01-01

    It is the first prospective study about anaesthesia related postoperative complications conducted in Hamad General Hospital. Total 1128 adult patients admitted to the Post Anaesthesia Care Unit (PACU) during a period of three months were surveyed for anaesthesia related complications. Documented complications were found in 48 patients i.e. 4.25% of patients' population. The types of complications were related to the respiratory system, cardiovascular system, nausea/vomiting and body temperature in this descending order. Most of the complications happened to healthy ASA I and II patients. Factors that play major role in determining the immediate postoperative complications were the ASA status, the level of anaesthesia seniority attending the patient, the urgency and the nature of procedure. We tried to find other factors that may influence complications in addition, discussed below. PMID:25003043

  2. Unusual long-term complication of polyalkylimide hydrogel manifesting as nasal septal abscess.

    PubMed

    Chang, Chul; Lee, Sun Bin

    2015-05-01

    Bio-Alcamid is a new synthetic polyacrylic hydrogel that contains alkylimide-amide groups and pyrogen-free water (96%) and has gained widespread use in cosmetic and reconstructive practice since being awarded a Conformite European certificate in 2001.According to the research on the efficacy and safety of the long-acting filler Bio-Alcamid in the early phases of development, Bio-Alcamid is nearly nontoxic and nonallergenic and has long in vivo persistence. It has been widely used because of its superior durability compared with short-acting fillers.Many published studies have examined only early-phase postoperative inflammatory responses. More recently, however, complications with delayed onsets ranging from several months to several years, such as inflammation and filler migration, have been emerging. Given the rapidly increasing application of long-term fillers, an increased incidence of complications is expected, and increasing awareness of its correct use and complication treatments is needed.To address this problem, we reviewed the safety of long-acting fillers on the basis of a rare case of surgical incision and drainage of a nasal septal abscess that developed in a patient 2 years after Bio-Alcamid was injected into the nasal region. PMID:25974816

  3. Unreported complication of Bravo pH capsule dislodged into the pyriform sinus

    PubMed Central

    Kumar, Akash; Kramer, Elisabeth; Chokhavatia, Sita

    2015-01-01

    We report an unexpected, previously unreported complication of Bravo pH capsule dislodgement. During Bravo pH testing of a 44-year-old man with gastroesophageal reflux disease, we were unable to endoscopically visualize the capsule attached to the esophageal wall after deployment. After multiple attempts to detect the capsule, it was visualized in the left pyriform sinus. As there was significant risk for pulmonary dislodgement, ENT and pulmonary physicians were immediately consulted to review options for safe removal. Ultimately, ENT successfully retrieved the capsule with a foreign body removal forceps. The Bravo pH test is generally a well-tolerated diagnostic tool used to confirm the presence of abnormal esophageal acid reflux. While few complications have been reported, technical difficulties can occur, including poor data reception, misplacement, and early dislodgement. Rarely, more serious complications can occur, ranging from esophageal wall trauma to capsule aspiration. Gastroenterologists performing this procedure should be aware of the low, but non-trivial, risk of complications. PMID:25992198

  4. Actinomycotic sinus of the buccal mucosa: a rare complication of cheek dimple creation.

    PubMed

    AbdullGaffar, Badr; Ghandoor, Khalid; Ahli, Qassim

    2014-11-01

    Even though actinomyces are common oral commensals, actinomycosis is an uncommon oral infection. Cheek dimple creation is a common surgical procedure with rare complications. Bacterial infection with abscess formation and foreign body reaction were reported. We report a rare example-and, to our knowledge, the first-of oral actinomycosis after cheek dimple creation. A young woman complained of a chronic tender nodule of the right buccal mucosa with pus discharge after surgery for cheek dimple creation. Histologic examination showed a sinus tract with actinomyces microorganisms. This complication can be mimicked by other oral or dental sinus-forming lesions, can be chronic and insidious, and could therefore clinically be missed or mistreated. This might delay the diagnosis and cause scarring and disfigurement. The treatment of choice is early recognition and complete surgical excision to avoid irreversible complications and prevent recurrence. Awareness of this potential complication by aesthetic surgeons, oral clinicians, and dentists is important. Patients' adherence to preventive measures and plastic surgeons' application of inclusion criteria and contraindications, as well as their choice of best technique per patient, should help minimize such a problem in a simple and safe aesthetic procedure. LEVEL OF EVIDENCE 5: PMID:24973339

  5. Risk of cardiovascular, cardiac and arrhythmic complications in patients with non-alcoholic fatty liver disease

    PubMed Central

    Ballestri, Stefano; Lonardo, Amedeo; Bonapace, Stefano; Byrne, Christopher D; Loria, Paola; Targher, Giovanni

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) has emerged as a public health problem of epidemic proportions worldwide. Accumulating clinical and epidemiological evidence indicates that NAFLD is not only associated with liver-related morbidity and mortality but also with an increased risk of coronary heart disease (CHD), abnormalities of cardiac function and structure (e.g., left ventricular dysfunction and hypertrophy, and heart failure), valvular heart disease (e.g., aortic valve sclerosis) and arrhythmias (e.g., atrial fibrillation). Experimental evidence suggests that NAFLD itself, especially in its more severe forms, exacerbates systemic/hepatic insulin resistance, causes atherogenic dyslipidemia, and releases a variety of pro-inflammatory, pro-coagulant and pro-fibrogenic mediators that may play important roles in the pathophysiology of cardiac and arrhythmic complications. Collectively, these findings suggest that patients with NAFLD may benefit from more intensive surveillance and early treatment interventions to decrease the risk for CHD and other cardiac/arrhythmic complications. The purpose of this clinical review is to summarize the rapidly expanding body of evidence that supports a strong association between NAFLD and cardiovascular, cardiac and arrhythmic complications, to briefly examine the putative biological mechanisms underlying this association, and to discuss some of the current treatment options that may influence both NAFLD and its related cardiac and arrhythmic complications. PMID:24587651

  6. Water-soluble vitamin deficiencies in complicated peptic ulcer patients soon after ulcer onset in Japan.

    PubMed

    Miyake, Kazumasa; Akimoto, Teppei; Kusakabe, Makoto; Sato, Wataru; Yamada, Akiyoshi; Yamawaki, Hiroshi; Kodaka, Yasuhiro; Shinpuku, Mayumi; Nagoya, Hiroyuki; Shindo, Tomotaka; Ueki, Nobue; Kusunoki, Masafumi; Kawagoe, Tetsuro; Futagami, Seiji; Tsukui, Taku; Sakamoto, Choitsu

    2013-01-01

    We investigated over time whether contemporary Japanese patients with complicated peptic ulcers have any water-soluble vitamin deficiencies soon after the onset of the complicated peptic ulcers. In this prospective cohort study, fasting serum levels of water-soluble vitamins (vitamins B1, B2, B6, B12, C, and folic acid) and homocysteine were measured at 3 time points (at admission, hospital discharge, and 3 mo after hospital discharge). Among the 20 patients who were enrolled in the study, 10 consecutive patients who completed measurements at all 3 time points were analyzed. The proportion of patients in whom any of the serum water-soluble vitamins that we examined were deficient was as high as 80% at admission, and remained at 70% at discharge. The proportion of patients with vitamin B6 deficiency was significantly higher at admission and discharge (50% and 60%, respectively, p<0.05) than at 3 mo after discharge (10%). In conclusion, most patients with complicated peptic ulcers may have a deficiency of one or more water-soluble vitamins in the early phase of the disease after the onset of ulcer complications, even in a contemporary Japanese population. PMID:24477246

  7. Unreported complication of Bravo pH capsule dislodged into the pyriform sinus.

    PubMed

    Kumar, Akash; Kramer, Elisabeth; Chokhavatia, Sita

    2015-05-16

    We report an unexpected, previously unreported complication of Bravo pH capsule dislodgement. During Bravo pH testing of a 44-year-old man with gastroesophageal reflux disease, we were unable to endoscopically visualize the capsule attached to the esophageal wall after deployment. After multiple attempts to detect the capsule, it was visualized in the left pyriform sinus. As there was significant risk for pulmonary dislodgement, ENT and pulmonary physicians were immediately consulted to review options for safe removal. Ultimately, ENT successfully retrieved the capsule with a foreign body removal forceps. The Bravo pH test is generally a well-tolerated diagnostic tool used to confirm the presence of abnormal esophageal acid reflux. While few complications have been reported, technical difficulties can occur, including poor data reception, misplacement, and early dislodgement. Rarely, more serious complications can occur, ranging from esophageal wall trauma to capsule aspiration. Gastroenterologists performing this procedure should be aware of the low, but non-trivial, risk of complications. PMID:25992198

  8. Secondary frozen shoulder following septic arthritis – An unusual complication of magnetic resonance arthrogram

    PubMed Central

    Rajeev, Aysha; Andronic, Adrian; Mohamed, Abdalla; Newby, Mike; Chakravathy, Jagannath

    2015-01-01

    Introduction Magnetic resonance (MR) arthrogram is a commonly used investigation tool to detect various pathologies in the shoulder. The complications following this procedure is minor and rare. Septic arthritis is one of the rare complications which can develop after MR arthrogram. We report a case of secondary frozen shoulder after MR arthrogram induced septic arthritis. Presentation of case A young, fit and well female patient underwent MR arthrogram to detect any labral tears. Two days following the procedure, she developed signs and symptoms suggestive of septic arthritis of the shoulder. The patient underwent repeated arthroscopic debridement and washout. The organisms isolated was Staphylococcus epidermidis. She was treated with six weeks of intravenous antibiotics. The patient developed stiffness of the shoulder due to secondary frozen shoulder which was treated with arthroscopic capsular release with good functional outcomes at three months. Discussion MR arthrogram is a rare cause of septic arthritis of the shoulder. The common method introducing the organisms is from the skin flora or contaminated arthrogram trays. The treatment is repeated arthroscopic washouts and six weeks of appropriate intravenous antibiotics. Residual pain, stiffness and chondrolysis are common sequelae of septic arthritis. Conclusion Septic arthritis is a recognised and rare complication of MR arthrogram. Early and prompt diagnosis with arthroscopic washout and debridement combined with intravenous antibiotics helps to eradicate the infection. Secondary frozen shoulder is a late complication of sepsis in the joint. PMID:25884758

  9. Complications in the Treatment of Intracranial Aneurysms with Silk Stents: an Analysis of 30 Consecutive Patients

    PubMed Central

    Cirillo, L.; Leonardi, M.; Dall’olio, M.; Princiotta, C.; Stafa, A.; Simonetti, L.; Toni, F.; Agati, R.

    2012-01-01

    Summary Flow-diverting stents (Silk and PED) have radically changed the approach to intracranial aneurysm treatment from the use of endosaccular materials to use of an extraaneurysmal endoluminal device. However, much debate surrounds the most appropriate indications for the use of FD stents and the problems raised by several possible complications. We analysed our technical difficulties and the early (less than ten days after treatment) and late complications encountered in 30 aneurysms treated comprising 13 giant lesions, 12 large, five with maximum diameters <10 mm and one blister-like aneurysm. In our experience the primary indications for the use of FD stents can be the symptomatic intracavernous giant aneurysms. Although the extracavernous carotid siphon aneurysms have major risk of bleeding, FD stents are indicated clearly explaining the risks to the patient in case of severe mass effect. There is a very complex assessment for aneurysms of the vertebrobasilar circulation. PMID:23217636

  10. Life-Threatening Complication of Percutaneous Transthoracic Fine-Needle Aspiration Biopsy: Systemic Arterial Air Embolism

    PubMed Central

    Olgun, Deniz Cebi; Samanci, Cesur; Ergin, Ayse Seda; Akman, Canan

    2015-01-01

    Computed tomography-guided percutaneous transthoracic fine-needle aspiration biopsy of lung lesions is a well known diagnostic technique. Nevertheless, it has some complications; such as pneumothorax, intraparenchymal hemorrhage and hemoptysis, which are not rare. Air embolism is one of the rare but potentially fetal complications of this procedure. Herein, we report the case of a 69-year-old male, in which case of systemic air embolism developed after the performance of lung biopsy. Early diagnosis and prompt oxygen therapy is crucial for patient’s survival so careful reviewing of the obtained computed tomography images during the biopsy may prevent a missing systemic air embolism and provide an adequate therapy. PMID:25745350

  11. Cerebrovascular complications in pediatric intensive care unit

    PubMed Central

    Sachdev, Anil; Sharma, Rachna; Gupta, Dhiren

    2010-01-01

    Cerebrovascular complications are being frequently recognized in the pediatric intensive care unit in the recent few years. The epidemiology and risk factors for pediatric stroke are different from that of the adults. The incidence of ischemic stroke is almost slightly more than that of hemorrhagic stroke. The list of diagnostic causes is increasing with the availability of newer imaging modalities and laboratory tests. The diagnostic work up depends on the age of the child and the rapidity of presentation. Magnetic resonance imaging, computerized tomography and arteriography and venography are the mainstay of diagnosis and to differentiate between ischemic and hemorrhagic events. Very sophisticated molecular diagnostic tests are required in a very few patients. There are very few pediatric studies on the management of stroke. General supportive management is as important as the specific treatment. Most of the treatment guidelines and suggestions are extrapolated from the adult studies. Few guidelines are available for the use of anticoagulants and thrombolytic agents in pediatric patients. So, our objective was to review the available literature on the childhood stroke and to provide an insight into the subject for the pediatricians and critical care providers. PMID:21253346

  12. Thromboembolic complications in inflammatory bowel disease.

    PubMed

    Kohoutova, Darina; Moravkova, Paula; Kruzliak, Peter; Bures, Jan

    2015-05-01

    Patients with inflammatory bowel disease (IBD) have a 1.5-3.5-fold higher risk of thromboembolism when compared to the non-IBD population and the risk is much more prominent at the time of a flare. Arterial thromboembolism (ischemic stroke, focal white matter ischemia, cardiac ischemia, peripheral vascular disease and mesenteric ischemia) and venous thromboembolism (deep vein thrombosis and pulmonary embolism, cerebral venous sinus thrombosis, retinal, hepatic, portal and mesenteric vein thromboses) belong to the group of underestimated extraintestinal complications in IBD patients, which are associated with a high morbidity and mortality rate (the overall mortality is as high as 25 % per episode). Thromboembolism occurs in younger patients compared to the non-IBD population and has a high recurrence rate. Multiple risk factors are involved in the etiopathogenesis, but the acquired ones play the key role. Congenital alterations do not occur more frequently in IBD patients when compared to the non-IBD population. Standardized guidelines for the prophylaxis of thromboembolism in IBD patients are urgently needed and these should be respected in clinical practice to avoid preventable morbidity and mortality. PMID:25115840

  13. Catheter-related complications of cancer therapy.

    PubMed

    Greene, J N

    1996-06-01

    Although the management of CVC-related infection appears complex and at times the literature seems to be contradictory, simple guidelines can direct the clinician in a stepwise fashion. Knowledge of the pathogenesis of each organism and the immune status of the host is crucial to decide whether catheter removal or retention is indicated. For example, in general, GNB bacteremia does not immediately prompt catheter removal in a neutropenic patient but does in a nonneutropenic host because of the gastrointestinal source of the former and a primary catheter source in the latter. In summary, as more CVCs are inserted in patients undergoing chemotherapeutic, antimicrobial, transfusional, and nutritional supportive care, novel approaches to prevention and treatment of the associated infectious complications inherent with such devices are needed. A multifaceted approach from impregnated catheters to local catheter-site antisepsis was reviewed. We may find, however, that as simple handwashing between patients is crucial to infection control, so too is a trained catheter-care team using total barrier precautions and ensuring proper local catheter maintenance critical to preventing CVC-related infections. PMID:8803621

  14. Pulmonary complications of smoked substance abuse.

    PubMed Central

    Tashkin, D P

    1990-01-01

    After tobacco, marijuana is the most widely smoked substance in our society. Studies conducted within the past 15 years in animals, isolated tissues, and humans indicate that marijuana smoke can injure the lungs. Habitual smoking of marijuana has been shown to be associated with chronic respiratory tract symptoms, an increased frequency of acute bronchitic episodes, extensive tracheobronchial epithelial disease, and abnormalities in the structure and function of alveolar macrophages, key cells in the lungs' immune defense system. In addition, the available evidence strongly suggests that regularly smoking marijuana may predispose to the development of cancer of the respiratory tract. "Crack" smoking has become increasingly prevalent in our society, especially among habitual smokers of marijuana. New evidence is emerging implicating smoked cocaine as a cause of acute respiratory tract symptoms, lung dysfunction, and, in some cases, serious, life-threatening acute lung injury. A strong physician message to users of marijuana, cocaine, or both concerning the harmful effects of these smoked substances on the lungs and other organs may persuade some of them, especially those with drug-related respiratory complications, to quit smoking. PMID:2190420

  15. Adamantiades-Behcet's disease-complicated gastroenteropathy.

    PubMed

    Wu, Qing-Jun; Zhang, Feng-Chun; Zhang, Xuan

    2012-02-21

    Adamantiades-Behcet's disease (ABD) is a chronic, relapsing, systemic vasculitis of unknown etiology. It is more prevalent in populations along the ancient Silk Road from Eastern Asia to the Mediterranean Basin, and most frequently affects young adults between the second and fourth decades of life. ABD-complicated gastroenteropathy is a significant cause of morbidity and mortality, with abdominal pain as the most common symptom. The ileocecal region is affected predominantly, with ulcerations that may lead to penetration and/or perforation, whereas other parts of the gastrointestinal system including the esophagus and stomach can also be affected. Endoscopy is useful to locate the site and extent of the lesions, and tissue biopsy is often warranted to examine the histopathology that is often suggestive of underlying vasculitis of small veins/venules or, alternatively in some cases, nonspecific inflammation. Bowel wall thickening is the most common finding on computed tomography scan. Treatment is largely empirical since well-controlled studies are difficult to conduct due to the heterogeneity of the disease, and the unpredictable course with exacerbation and remission. Corticosteroids with or without other immunosuppressive drugs, such as cyclophosphamide, azathioprine, sulfasalazine, tumor necrosis factor ? antagonist or thalidomide should be applied before surgery, except in emergency. PMID:22363131

  16. Linking uric acid metabolism to diabetic complications

    PubMed Central

    Kushiyama, Akifumi; Tanaka, Kentaro; Hara, Shigeko; Kawazu, Shoji

    2014-01-01

    Hyperuricemia have been thought to be caused by the ingestion of large amounts of purines, and prevention or treatment of hyperuricemia has intended to prevent gout. Xanthine dehydrogenase/xanthine oxidase (XDH/XO) is rate-limiting enzyme of uric acid generation, and allopurinol was developed as a uric acid (UA) generation inhibitor in the 1950s and has been routinely used for gout prevention since then. Serum UA levels are an important risk factor of disease progression for various diseases, including those related to lifestyle. Recently, other UA generation inhibitors such as febuxostat and topiroxostat were launched. The emergence of these novel medications has promoted new research in the field. Lifestyle-related diseases, such as metabolic syndrome or type 2 diabetes mellitus, often have a common pathological foundation. As such, hyperuricemia is often present among these patients. Many in vitro and animal studies have implicated inflammation and oxidative stress in UA metabolism and vascular injury because XDH/XO act as one of the major source of reactive oxygen species Many studies on UA levels and associated diseases implicate involvement of UA generation in disease onset and/or progression. Interventional studies for UA generation, not UA excretion revealed XDH/XO can be the therapeutic target for vascular injury and renal dysfunction. In this review, the relationship between UA metabolism and diabetic complications is highlighted. PMID:25512781

  17. Linking uric acid metabolism to diabetic complications.

    PubMed

    Kushiyama, Akifumi; Tanaka, Kentaro; Hara, Shigeko; Kawazu, Shoji

    2014-12-15

    Hyperuricemia have been thought to be caused by the ingestion of large amounts of purines, and prevention or treatment of hyperuricemia has intended to prevent gout. Xanthine dehydrogenase/xanthine oxidase (XDH/XO) is rate-limiting enzyme of uric acid generation, and allopurinol was developed as a uric acid (UA) generation inhibitor in the 1950s and has been routinely used for gout prevention since then. Serum UA levels are an important risk factor of disease progression for various diseases, including those related to lifestyle. Recently, other UA generation inhibitors such as febuxostat and topiroxostat were launched. The emergence of these novel medications has promoted new research in the field. Lifestyle-related diseases, such as metabolic syndrome or type 2 diabetes mellitus, often have a common pathological foundation. As such, hyperuricemia is often present among these patients. Many in vitro and animal studies have implicated inflammation and oxidative stress in UA metabolism and vascular injury because XDH/XO act as one of the major source of reactive oxygen species Many studies on UA levels and associated diseases implicate involvement of UA generation in disease onset and/or progression. Interventional studies for UA generation, not UA excretion revealed XDH/XO can be the therapeutic target for vascular injury and renal dysfunction. In this review, the relationship between UA metabolism and diabetic complications is highlighted. PMID:25512781

  18. Volvulus complicating jejunal diverticulosis: A case report

    PubMed Central

    Igwe, P.O.; Ray-Offor, E.; Allison, A.B.; Alufohai, E.F.

    2015-01-01

    Introduction Diverticular disease is uncommon among Africans though increasing number of cases is now being reported, mainly of colonic diverticulosis. This condition afflicts all parts of the gastrointestinal tract but commonly the colon. Jejunal diverticula are rare, usually asymptomatic but may lead to an acute abdomen. Case presentation A 68 year old female trader, who was referred from a peripheral center with insidious onset of severe colicky, generalized abdominal pain, repeated vomiting of recently ingested meal, no hematemesis. There was constipation and abdominal distension. The working diagnosis was dynamic intestinal obstruction of small bowel origin. She had emergency exploratory laparotomy following resuscitation. The findings were: volvulus of the jejunum and multiple jejunal diverticula. A resection of 80 cm of the jejunum with most of the diverticula involved in the torsion was done with an end-to-end anastomosis of the jejunum. Her out-patient follow-up has been uneventful. Discussion Jejunal diverticular disease is rare in Africa. Our patient presented with small bowel obstruction due to volvulus. Other complications are discussed. Conclusion Intestinal obstruction from diverticular disease is not always of colonic origin. It can occur in the jejunum. PMID:25728670

  19. Community-acquired Pneumonia and its Complications.

    PubMed

    Qin, Qiang; Shen, Kun-Ling

    2015-08-01

    Community-acquired pneumonia (CAP) remains a major cause of morbidity and mortality worldwide in developing and developed countries, and its incidence is highest among children less than 5-y-old. Over the last five years, several international and local guidelines have been updated with new evidence concerning the epidemiology, etiology, pathogenesis, treatment and prevention of pediatric CAP, but there are still several major problems that need to be standardised. The aim of this review is to consider the available data concerning the termination, epidemiology, microbiology and pathogenesis, clinical features, diagnosis and differential diagnosis, treatment, and complications of pediatric CAP. There still are many unanswered questions concerning the management of CAP, including its definition, the difficulty to identify its etiological agents, the emergence of drug, and the lack of introduction of vaccines against respiratory pathogens in developing countries. More research is required in various areas (including therapy of atypical agents), and further efforts are needed to increase vaccination in order to reduce the incidence of the disease. PMID:25976616

  20. Neurologic complications of sickle cell disease.

    PubMed

    Venkataraman, Akila; Adams, Robert J

    2014-01-01

    Sickle cell disease (SCD) is a group of genetic blood disorders that vary in severity, but the most severe forms, primarily homozygous sickle cell anemia, are associated with neurologic complications. Over the last 90 years it has become established that some patients will develop severe arterial disease of the intracranial brain arteries and suffer brain infarction. Smaller infarctions and brain atrophy may also be seen and over time there appear to be negative cognitive effects in some patients, with or without abnormal brain imaging. Focal mononeuropathies and pneumococcal meningitis are also more common in these patients. Brain infarction in children can largely be prevented screening children beginning at age 2 years and instituting regular blood transfusion when the Doppler indicates high stroke risk (>200cm/sec). Iron overload and the uncertain duration of transfusion are disadvantages but overall this approach, tested in a randomized clinical trial, reduced first stroke by over 90%. Secondary stroke prevention has not been subjected to a randomized controlled trial except for one recently stopped comparison of regular transfusions compared to hydroxuyrea (results favored transfusion). The usual stroke prevention agents (such as aspirin or warfarin) have not been rigorously tested. Magnetic resonance imaging and positron emission tomography give evidence of subtle and sometimes overt brain injury due to stroke in many adults, but a preventive strategy for adults with SCD has not been developed. Bone marrow transplantation is the only cure, but some non-neurologic symptoms can be controlled in adults with hydroxuyrea. PMID:24365368

  1. Anatomical and functional outcomes after Densiron 68 heavy silicone oil tamponade for complicated retinal detachment in Chinese eyes

    PubMed Central

    Liu, Fang; Li, Hui; Feng, Le; Wang, Fang

    2014-01-01

    AIM To evaluate the safety and efficacy of Densiron 68 heavy silicone oil (HSO) tamponade for complicated retinal detachment (RD) in Chinese eyes. METHODS Twenty-one eyes of 21 patients with complicated RD were included in this retrospective study. All patients underwent pars plana vitrectomy with an internal tamponade using Densiron 68 HSO. Anatomical and functional results and complications were evaluated, including retinal status, visual acuity (VA), intraocular pressure (IOP), intraocular inflammation, lens opacity, and HSO emulsification. RESULTS All the patients were followed up for 3mo to 1y (5.8±1.16mo). Retinal reattachment was achieved in 19 of 21 patients (90.5%). VA improved in 18 of 21 patients (85.7%), from 1.93 logMAR (±0.48) to 1.52 logMAR (±0.45) (P=0.001). Postoperative complications included early dispersion of HSO in 7 eyes (38.8%), cataract in 10 of 18 phakic eyes (55.5%), moderate postoperative inflammation reaction in 10 eyes (47.6%), and elevated IOP in 5 eyes (23.8%), all of which were controlled by medication or by surgery. CONCLUSION High anatomical and functional success rates can be achieved with primary vitrectomy for complicated RD by using Densiron 68 HSO; however, it should not be ignored that Densiron 68 HSO can cause some complications in the eye. PMID:24967193

  2. Rapidly progressing subperiosteal orbital abscess: an unexpected complication of a group-A streptococcal pharyngitis in a healthy young patient

    PubMed Central

    2012-01-01

    Introduction Complications associated to group-A streptococcal pharyingitis include non-suppurative complications such as acute rheumatic fever and glomerulonephritis and suppurative complications such as peritonsillar or retropharyngeal abscess, sinusitis, mastoiditis, otitis media, meningitis, brain abscess, or thrombosis of the intracranial venous sinuses. Case presentation We described a case of a 15-year-old patient with a history of acute pharyngodinia early followed by improvise fever and a progressive formation of a diffuse orbital edema, corneal hyperaemia, diplopia and severe decrease of visual acuity. The patient was surgically treated with functional endoscopic sinus surgery (FESS) after the response of a maxillofacial computed tomography scans that showed a pansinusitis complicated by a left orbital cellulites. Numerous colonies of Streptococcus pyogenes were found in the samples of pus and an antibiotic therapy with meropenem was initiated on the basis of the sensitivity test to antibiotics. The patient was finally discharged with diagnosis of left orbital cellulites with periorbital abscess, endophtalmitis and acute pansinusitis as a consequence of streptococcal pharyngitis. Conclusion The case highlights the possible unusual complication of a group-A streptococcal pharyingitis in a immunocompetent child and the needing of a prompt surgical and medical approach toward the maxillofacial complications associated to the infection. PMID:23067784

  3. Real Money: Complications and Hospital Costs in Trauma Patients

    PubMed Central

    Hemmila, Mark R.; Jakubus, Jill L.; Maggio, Paul M.; Wahl, Wendy L.; Dimick, Justin B.; Campbell, Darrell A.; Taheri, Paul A.

    2008-01-01

    Background Major postoperative complications are associated with a substantial increase in hospital costs. Trauma patients are known to have a higher rate of complications than the general surgery population. We sought to utilize the National Surgical Quality Improvement Program (NSQIP) methodology to evaluate hospital costs, length of stay, and payment associated with complications in trauma patients. Study Design Using NSQIP principles, patient data were collected on 512 adult patients admitted to the trauma service for > 24 hours at a Level 1 trauma center (2004–2005). Patients were placed in one of three groups: no complications (none), ? 1 minor complication (minor, e.g., urinary tract infection), or ? 1 major complication (major, e.g., pneumonia). Total hospital charges, costs, payment, and length of stay associated with each complication group were determined from a cost accounting database. Multiple regression was used to determine the costs of each type of complication after adjusting for differences in age, gender, new injury severity score (nISS), Glasgow coma scale score (GCS), maximum head abbreviated injury scale (AIS), and first emergency department systolic blood pressure. Results 330 (64%) patients had no complications, 53 (10%) had ? 1 minor complication, and 129 (25%) had ? 1 major complication. Median hospital charges increased from $33,833 (none) to $81,936 (minor) and $150,885 (major). The mean contribution to margin per day was similar for the no complication and minor complication groups ($994 vs $1,115, p=0.7). Despite higher costs, the patients in the major complication group generated a higher mean contribution to margin per day when compared to the no complication group ($2,168, p<0.001). The attributable increase in median total hospital costs when adjusted for confounding variables was $19,915 for the minor complication group (p<0.001), and $40,555 for the major complication group (p<0.001). Conclusion Understanding the costs associated with traumatic injury provides a window for assessing the potential cost reductions associated with improved quality care. To optimize system benefits, payers and providers should develop integrated reimbursement methodologies which align incentives to provide quality care. PMID:18656640

  4. Clinically defined chemotherapy-associated bowel syndrome predicts severe complications and death in cancer patients

    PubMed Central

    Vehreschild, Maria J.G.T.; Meißner, Arne M.K.; Cornely, Oliver Andreas; Maschmeyer, Georg; Neumann, Silke; von Lilienfeld-Toal, Marie; Karthaus, Meinholf; Wattad, Mohammed; Staib, Peter; Hellmich, Martin; Christ, Hildegard; Vehreschild, Jörg Janne

    2011-01-01

    Background Neutropenic patients are at risk of abdominal complications and yet the incidence and impact of these complications on patients’ morbidity and mortality have not been sufficiently evaluated. We aimed to assess a clinical rule for early detection of abdominal complications leading to death or transfer to intensive care in patients with chemotherapy-associated neutropenia. Design and Methods This observational multicenter study was carried out in seven German hematology-oncology departments. For inclusion, neutropenia of at least 5 consecutive days was required. Risk factors for “transfer to intensive care” and “death” were assessed by backward-stepwise binary logistic regression analyses. Chemotherapy-associated bowel syndrome was defined as a combination of fever (T ?37.8 °C) and abdominal pain and/or lack of bowel movement for 72 hours or more. Five hundred and twenty-one neutropenic episodes were documented in 359 patients. Results The incidence of chemotherapy-associated bowel syndrome was 126/359 (35%) in first episodes of neutropenia. Transfer to intensive care occurred in 41/359 (11%) and death occurred in 17/359 (5%) first episodes. Chemotherapy-associated bowel syndrome and duration of neutropenia were identified as risk factors for transfer to intensive care (P<0.001; OR 4.753; 95% CI 2.297–9.833, and P=0.003; OR 1.061/d; 95% CI 1.021–1.103). Chemotherapy-associated bowel syndrome and mitoxantrone administration were identified as risk factors for death (P=0.005; OR 4.611; 95% CI 1.573–13.515 and P=0.026; OR 3.628; 95% CI 1.169–11.256). Conclusions The occurrence of chemotherapy-associated bowel syndrome has a significant impact on patients’ outcome. In future interventional clinical trials, this definition might be used as a selection criterion for early treatment of patients at risk of severe complications. PMID:21859736

  5. Potential Risks and Complications of Injectable Alloplastic Facial Fillers

    Microsoft Academic Search

    Melvin A. Shiffman

    \\u000a All injectable alloplastic facial fillers have potential risks and complications. Indiscriminate use of fillers without knowledge\\u000a of the possible risks and complications, their diagnosis, and their treatment is a disservice to the patient. Patients should\\u000a be forewarned of all of the possible risks and complications of any dermal filler being planned to be used. The author discusses\\u000a each of the

  6. Long-term complications associated with permanent dermal fillers.

    PubMed

    Kunjur, Jayanth; Witherow, Helen

    2013-12-01

    We report a case series of patients with serious long-term complications associated with the injection of permanent dermal fillers. Although such complications are relatively rare, the consequences are potentially life-long, and the psychological and medical effects can often have a profound impact on the patient. The continued routine offering of these treatments will require doctors to communicate effectively with patients about the nature of the complications and the probability of risk compared with alternative treatments. PMID:23962591

  7. Complications of anterior cruciate ligament reconstruction: graft issues.

    PubMed

    Matava, Matthew J

    2006-01-01

    Anterior cruciate ligament reconstruction has become one of the most common arthroscopic procedures performed on the knee. Complications from this reconstructive surgery, although uncommon, can be devastating to the overall function of the knee. Several strategies exist to avoid potential complications related specifically to graft harvest and implantation, and to complications related to the bone-patellar tendon-bone and hamstring autografts, and patellar tendon allograft, the most common grafts currently used. PMID:16958483

  8. Obstetric Complications in Adults with ADHD: A Retrospective Cohort Study

    Microsoft Academic Search

    Marios Adamou; Anna Russell; Parmjt Sanghera

    Obstetric complications have been associated with a number of mental disorders. In this study, we investigate how obstetric\\u000a complications relate with clinically significant determinants of adult attention deficit hyperactivity disorder (ADHD), such\\u000a as gender, age of diagnosis, psychiatric co morbidity, severity of symptomatology and general functioning. Presence of obstetric\\u000a complications as reported in the psychiatric history of 64 patients in

  9. Descending necrotizing mediastinitis as a complication of odontogenic infection

    PubMed Central

    Diamantis, S.; Giannakopoulos, H.; Chou, J.; Foote, J.

    2011-01-01

    Descending necrotizing mediastinitis (DNM) is a serious, life threatening complication that can occur from a common odontogenic infection. Even with advancements in antibiotics, diagnostic imaging, and surgical management, the mortality rate remains between 20 and 40%. It is imperative that the practitioner taking care of patients with odontogenic infections be sensitized to this potentially fatal complication. We report the successful management of a case of mediastinitis complicating an odontogenic infection in a 39-year-old male.

  10. Nonthrombotic complications related to central vascular access devices.

    PubMed

    Ast, Daniel; Ast, Travis

    2014-01-01

    Central vascular access devices (CVADs) provide reliable access for a variety of infusion therapies both in hospital and nonhospital settings. CVAD complications that are not identified and resolved can lead to a delay in therapy or the loss of vascular access. Rapid and accurate identification of complications is essential for obtaining expected treatment outcomes. This article will describe various nonthrombotic CVAD complications as well as identification and appropriate interventions used to manage these events. PMID:25191818

  11. Treatments of medical complications of anorexia nervosa and bulimia nervosa.

    PubMed

    Mehler, Philip S; Krantz, Mori J; Sachs, Katherine V

    2015-01-01

    Inherent to anorexia nervosa and bulimia nervosa are a plethora of medical complications which correlate with the severity of weight loss or the frequency and mode of purging. Yet, the encouraging fact is that most of these medical complications are treatable and reversible with definitive care and cessation of the eating-disordered behaviours. Herein, these treatments are described for both the medical complications of anorexia nervosa and those which are a result of bulimia nervosa. PMID:25874112

  12. Vascular complications of prosthetic inter-vertebral discs

    Microsoft Academic Search

    Kevin J. Daly; E. Raymond S. Ross; Heather Norris; Charles N. McCollum

    2006-01-01

    Five consecutive cases of prosthetic inter-vertebral disc displacement with severe vascular complications on revisional surgery\\u000a are described. The objective of this case report is to warn spinal surgeons that major vascular complications are likely with\\u000a anterior displacement of inter-vertebral discs. We have not been able to find a previous report on vascular complications\\u000a associated with anterior displacement of prosthetic inter-vertebral

  13. Internal jugular vein thrombosis presenting as a painful neck mass due to a spontaneous dislocated subclavian port catheter as long-term complication: a case report.

    PubMed

    Binnebösel, Marcel; Grommes, Jochen; Junge, Karsten; Göbner, Sonja; Schumpelick, Volker; Truong, Son

    2009-01-01

    Central venous access devices are extensively used for long-term chemotherapy and parenteral nutrition. However, there are some possible immediate, early, and late complications related to the implantation technique, care, and maintenance. We present the uncommon occurrence of a thrombosis of the internal jugular vein due to a spontaneous migration of a Port-A-Cath catheter into the ipsilateral internal jugular vein as a delayed complication of a central venous access catheter implanted for chemotherapy delivery. A review of the literature is given, and the factors responsible for this unusual complication will be discussed. PMID:19830037

  14. Complicated grief associated with Hurricane Katrina

    PubMed Central

    Shear, M. Katherine; McLaughlin, Katie A.; Ghesquiere, Angela; Gruber, Michael J.; Sampson, Nancy A.; Kessler, Ronald C.

    2011-01-01

    Background Although losses are important consequences of disasters, few epidemiological studies of disasters have assessed complicated grief (CG) and none assessed CG associated with losses other than death of loved one. Methods Data come from the baseline survey of the Hurricane Katrina Community Advisory Group (CAG), a representative sample of 3,088 residents of the areas directly affected by Hurricane Katrina. A brief screen for CG was included containing four items consistent with the proposed DSM 5 criteria for a diagnosis of bereavement-related adjustment disorder. Results 58.5% of respondents reported a significant hurricane-related loss: Most-severe losses were 29.0% tangible, 9.5% interpersonal, 8.1% intangible, 4.2% work-financial, and 3.7% death of loved one. 26.1% of respondents with significant loss had possible CG and 7.0% moderate-severe CG. Death of loved one was associated with the highest conditional probability of moderate-severe CG (18.5%, compared to 1.1–10.5% conditional probabilities for other losses) but accounted for only 16.5% of moderate-severe CG due to its comparatively low prevalence. Most moderate-severe CG was due to tangible (52.9%) or interpersonal (24.0%) losses. Significant predictors of CG were mostly unique to either bereavement (racial-ethnic minority status, social support) or other losses (pre-hurricane history of psychopathology, social competence.). Conclusions Non-bereavement losses accounted for the vast majority of hurricane-related possible CG despite risk of CG being much higher in response to bereavement than to other losses. This result argues for expansion of research on CG beyond bereavement and alerts clinicians to the need to address post-disaster grief associated with a wide range of losses. PMID:21796740

  15. Multiple Myeloma: Cast Nephropathy, VTE, and Neurologic Complications

    PubMed Central

    Sullivan, Ellen; Smith, Lisa C.; Falco, Angela M.

    2013-01-01

    Multiple myeloma accounts for approximately 1% of neoplastic diseases and 13% of hematologic cancers. Complications often associated with MM include neurologic and hematologic issues, infections, renal insufficiency, and bone involvement. It is crucial for advanced practice professionals caring for myeloma patients to assess patients accurately, be keenly aware of possible associated complications, and be familiar with appropriate interventions to prevent further injury. This article will provide an overview of MM-related renal insufficiency, with a focus on cast nephropathy, venous thromboembolism, and neurologic complications along with various causes and treatment options; a future article will address additional complications associated with MM. PMID:25031979

  16. A Simple But Effective Evolutionary Algorithm for Complicated Optimization Problems

    E-print Network

    Xu, Y.G.

    A simple but effective evolutionary algorithm is proposed in this paper for solving complicated optimization problems. The new algorithm presents two hybridization operations incorporated with the conventional genetic ...

  17. Thoracic complications of illicit drug use: an organ system approach.

    PubMed

    Gotway, Michael B; Marder, Shelley R; Hanks, Douglas K; Leung, Jessica W T; Dawn, Samuel K; Gean, Alisa D; Reddy, Gautham P; Araoz, Philip A; Webb, W Richard

    2002-10-01

    Illicit drug use constitutes a major health problem and may be associated with various thoracic complications. These complications vary depending on the specific drug used and the route of administration. Commonly abused drugs that may play a role in causing thoracic disease include cocaine, opiates, and methamphetamine derivatives. Intravenously abused oral medications may contain filler agents that may be responsible for disease. Thoracic complications may be categorized as pulmonary, pleural, mediastinal, cardiovascular, and chest wall complications. Pulmonary complications of drug abuse include pneumonia, cardiogenic edema, acute lung injury, pulmonary hemorrhage, and aspiration pneumonia. Filler agents such as talc may result in panacinar emphysema or high-attenuation upper-lobe conglomerate masses. The primary pleural complication of illicit drug use is pneumothorax. Mediastinal and cardiovascular complications of illicit drug use include pneumomediastinum, cardiomyopathy, myocardial infarction, aortic dissection, and injection-related pseudoaneurysms. Chest wall complications include diskitis and vertebral osteomyelitis, epidural abscess, necrotizing fasciitis, costochondritis, and septic arthritis. Categorization of thoracic complications of illicit drug use may facilitate understanding of these disorders and allow accurate diagnosis. PMID:12376606

  18. Complications of Medium Depth and Deep Chemical Peels

    PubMed Central

    Nikalji, Nanma; Godse, Kiran; Sakhiya, Jagdish; Patil, Sharmila; Nadkarni, Nitin

    2012-01-01

    Superficial and medium depth peels are dynamic tools when used as part of office procedures for treatment of acne, pigmentation disorders, and photo-aging. Results and complications are generally related to the depth of wounding, with deeper peels providing more marked results and higher incidence of complications. Complications are also more likely with darker skin types, certain peeling agents, and sun exposure. They can range from minor irritations, uneven pigmentation to permanent scarring. In very rare cases, complications can be life-threatening. PMID:23378707

  19. Risk of Complications in Spine Surgery: A Prospective Study

    PubMed Central

    Reis, Rodolfo Casimiro; de Oliveira, Matheus Fernandes; Rotta, José Marcus; Botelho, Ricardo Vieira

    2015-01-01

    Purpose : Complications are the chief concern of patients and physicians when considering spine surgery. The authors seek to assess the incidence of complications in patients undergoing spine surgery and identify risk factors for their occurrence. Methods : Prospective study of patients undergoing spine surgery from 1 February 2013 to 1 February 2014. Epidemiological characteristics and complications during the surgical hospitalization were recorded and analyzed. Results : The sample comprised 95 patients (mean age, 59 years). Overall, 23% of patients were obese (BMI =30). The mean BMI was 25.9. Approximately 53% of patients had comorbidities. Complications occurred in 23% of cases; surgical site infections were the most common (9%). There were no significant differences between patients who did and did not develop complications in terms of age (60.6 vs 59.9 years, p = 0.71), sex (56% female vs 54% female, p = 0.59), BMI (26.6 vs 27.2, p = 0.40), or presence of comorbidities (52% vs 52.8%, p = 0.87). The risk of complications was higher among patients submitted to spine instrumentation than those submitted to non-instrumented surgery (33% vs 22%), p=0.8. Conclusion : Just over one-quarter of patients in the sample developed complications. In this study, age, BMI, comorbidities were not associated with increased risk of complications after spine surgery. The use of instrumentation increased the absolute risk of complications. PMID:25674185

  20. Local complications in dental implant surgery: prevention and treatment

    PubMed Central

    ANNIBALI, S.; RIPARI, M.; LA MONACA, G.; TONOLI, F.; CRISTALLI, M.P.

    2008-01-01

    SUMMARY There are many detailed articles regarding accidents and local complications in dental implantation. Comparison of the data they report is not always easy because different criteria have been followed in the various classifications and there is confusion between the terms accident and complication. The aim of this paper is to propose a classification that considers the timing of the events and makes a distinction between the two terms. Accidents are events that occur during surgery and complications are all the pathological conditions that appear postoperatively. The proper diagnostic procedures and surgical techniques for complications prevention and treatment are also described. PMID:23285333

  1. Early markers of the renal complications of insulin dependent diabetes mellitus

    Microsoft Academic Search

    D M Gibb; D Dunger; M Levin; V Shah; C Smith; T M Barratt

    1989-01-01

    We investigated the associations between albuminuria, metabolic control, glomerular filtration, blood pressure, and platelet function in children with insulin dependent diabetes mellitus. The geometric mean (95% tolerance levels) albumin excretion (expressed as the geometric mean albumin to creatinine ratio on two overnight urine collections (UA\\/UC], in 60 diabetic children was 0.72 (0.80-6.9) mg\\/mmol, significantly greater than in 45 normal children

  2. C-reactive protein is an early predictor of septic complications after elective colorectal surgery

    E-print Network

    Paris-Sud XI, Université de

    surgery Pablo Ortega-Deballon1 , MD, PhD, François Radais1 , MD, Olivier Facy1 , MD, Philippe d'Athis2-Pierre Favre1 , MD, FACS, Patrick Rat1 , MD 1 Department of Digestive, Thoracic and Oncologic Surgery, published in "World Journal of Surgery 2010;34(4):808-14" DOI : 10.1007/s00268-009-0367-x #12;2 Abstract

  3. Early complications of the modified Lapidus procedure for hallux valgus treatment in adults

    Microsoft Academic Search

    A. Metzdorf; J. K. Strehle

    2001-01-01

    Thirty-four (32%) of 106 patients with hallux valgus were treated with reorientation arthrodesis of the first metatarsocuneiform joint (the Lapidus procedure) between July 1996 and June 1998. Thirty patients with 34 operated feet were evaluated retrospectively with a mean follow-up of 14 months. The preoperative hallux valgus angle averaged 35° (range 20–55°), the intermetatarsal 14.5° (range 8–20°). The corresponding postoperative

  4. Takotsubo Cardiomyopathy as an Early Complication of Drug-Induced Suicide Attempt

    PubMed Central

    Romanò, Massimo; Zorzoli, Federica; Bertona, Roberta; Villani, Rosvaldo

    2013-01-01

    Takotsubo cardiomyopathy typically presents in menopausal women following episodes of intense physical or mental stress. To our knowledge, the literature contains only two documented cases of Takotsubo cardiomyopathy arising following a suicide attempt, neither of which involved pharmaceutical poisoning. Here, however, we document the case of a young male patient with borderline personality disorder and a clinical and angiographic presentation compatible with Takotsubo cardiomyopathy arising following a suicide attempt by voluntary drug intoxication (risperidone, barbiturates, and benzodiazepine). The potential pathophysiological mechanisms behind this unusual clinical picture are discussed. PMID:24327812

  5. Performing Women’s Speech in Early Modern Drama: Troubling Silence, Complicating Voice 

    E-print Network

    Van Note, Beverly Marshall

    2012-10-19

    considerably flatten the contours of the historical patterns discernable in women’s lifewriting. As a result, female spectators may have experienced greater cognitive dissonance in reaction to the portrayals of women by boy actors. In spite of this, however...

  6. Major reconstruction for periacetabular metastasis: early complications and outcome following surgical treatment in 40 hips.

    PubMed

    Kunisada, T; Choong, P F

    2000-12-01

    We performed 40 total hip arthroplasties with pelvic reconstruction in 37 patients with metastatic periacetabular tumor. 3 patients underwent bilateral periacetabular reconstructive surgery and 2 of these had bilateral procedures at the single operation. There were 8 Harrington class I, 7 class II, and 25 class III lesions. A modified Harrington procedure was employed. All patients showed improvements in hip pain, analgesic use, ambulation and mobility postoperatively. 1 prosthetic dislocation occurred after a fall at home 2 months following surgery. 2 patients had pulmonary emboli during the femoral procedure, 1 of whom died during surgery. There were no prosthetic loosenings. Preoperative CT and/or MRI are important for the study of metastatic involvement of acetabular bone. Durability of reconstruction requires appropriate use of acetabular mesh, Steinmann pins, acetabular reinforcement rings and long-stem femoral prostheses. Careful patient selection may improve quality of life. A sequential bilateral procedure should be considered for some patients. PMID:11145385

  7. Clinical Management of Patients Presenting with Non-Adjustable Gastric Band (NAGB) Complications

    PubMed Central

    Balogh, Julius; Vizhul, Andrey; Dunkin, Brian J.; Tariq, Nabil; Sherman, Vadim

    2014-01-01

    Background: A number of bariatric surgical procedures have been developed to manage morbid obesity and related co-morbidities. The non-adjustable gastric band (NAGB) was one such procedure that created restriction to food intake by gastric segmentation. Benefits of the procedure included a low risk of perioperative complications and substantial early weight loss. Unfortunately, the long term results of NAGB include a high incidence of complications and failure to maintain weight loss. The purpose of this study was to examine the presentation, workup, and treatment of patients presenting with complications following NAGB placement. Methods: A retrospective review of the diagnosis and management of 11 patients who presented with complications related to NAGB placement. Results: All patients presented with some degree of proximal gastric outlet obstruction. The majority of patients (8/11) presented with vomiting as the main complaint. Other complaints included intolerance to solids, liquids, and reflux. Only 2/11 patients presented with weight loss since undergoing NAGB placement, while the remainder had weight regain to their pre-NAGB level and above. Depending on clinical presentation, desire for additional weight loss and co-morbid conditions, patients underwent a variety of treatments. This included NAGB removal (endoscopic, laparo-endoscopic, and laparoscopic) as well as conversion to another bariatric procedure (sleeve gastrectomy, Roux-en-Y gastric bypass). Conclusion: Patients with NAGB complications present with symptoms related to a proximal gastric outlet obstruction, related to constriction imposed by the band. This may result in severe food and liquid intolerance and subsequent weight loss, but more likely results in maladaptive eating and subsequent weight gain. Optimal therapy involves removal of the NAGB. Laparoscopic conversion to another bariatric procedure, optimally a Roux-en-Y gastric bypass, is warranted to treat morbid obesity and associated co-morbidities. PMID:24910561

  8. Nodding syndrome in Ugandan children—clinical features, brain imaging and complications: a case series

    PubMed Central

    Idro, Richard; Opoka, Robert Opika; Aanyu, Hellen T; Kakooza-Mwesige, Angelina; Piloya-Were, Theresa; Namusoke, Hanifa; Musoke, Sarah Bonita; Nalugya, Joyce; Bangirana, Paul; Mwaka, Amos Deogratius; White, Steven; Chong, Kling; Atai-Omoruto, Anne D; Mworozi, Edison; Nankunda, Jolly; Kiguli, Sarah; Aceng, Jane Ruth; Tumwine, James K

    2013-01-01

    Objectives Nodding syndrome is a devastating neurological disorder of uncertain aetiology affecting children in Africa. There is no diagnostic test, and risk factors and symptoms that would allow early diagnosis are poorly documented. This study aimed to describe the clinical, electrophysiological and brain imaging (MRI) features and complications of nodding syndrome in Ugandan children. Design Case series. Participants 22 children with nodding syndrome brought to Mulago National Referral Hospital for assessment. Outcome measures Clinical features, physical and functional disabilities, EEG and brain MRI findings and a staging system with a progressive development of symptoms and complications. Results The median age of symptom onset was 6 (range 4–10) years and median duration of symptoms was 8.5 (range 2–11) years. 16 of 22 families reported multiple affected children. Physical manifestations and complications included stunting, wasting, lip changes and gross physical deformities. The bone age was delayed by 2 (range 1–6) years. There was peripheral muscle wasting and progressive generalised wasting. Four children had nodding as the only seizure type; 18 in addition had myoclonic, absence and/or generalised tonic–clonic seizures developing 1–3?years after the onset of illness. Psychiatric manifestations included wandering, aggression, depression and disordered perception. Cognitive assessment in three children demonstrated profound impairment. The EEG was abnormal in all, suggesting symptomatic generalised epilepsy in the majority. There were different degrees of cortical and cerebellar atrophy on brain MRI, but no hippocampal changes. Five stages with worsening physical, EEG and brain imaging features were identified: a prodrome, the development of head nodding and cognitive decline, other seizure types, multiple complications and severe disability. Conclusions Nodding syndrome is a neurological disorder that may be characterised as probably symptomatic generalised epilepsy. Clinical manifestations and complications develop in stages which might be useful in defining treatment and rehabilitation. Studies of risk factors, pathogenesis, management and outcome are urgently needed. PMID:23645924

  9. ?-cell Failure as a Complication of Diabetes

    PubMed Central

    Chang-Chen, KJ; Mullur, R; Bernal-Mizrachi, E

    2015-01-01

    Type 2 diabetes mellitus is a complex disease characterized by ?-cell failure in the setting of insulin resistance. In early stages of the disease, pancreatic ?-cells adapt to insulin resistance by increasing mass and function. As nutrient excess persists, hyperglycemia and elevated free fatty acids negatively impact ?-cell function. This happens by numerous mechanisms, including the generation of reactive oxygen species, alterations in metabolic pathways, increases in intracellular calcium and the activation of endoplasmic reticulum stress. These processes adversely affect ?-cells by impairing insulin secretion, decreasing insulin gene expression and ultimately causing apoptosis. In this review, we will first discuss the regulation of ?-cell mass during normal conditions. Then, we will discuss the mechanisms of ?-cell failure, including glucotoxicity, lipotoxicity and endoplasmic reticulum stress. Further research into mechanisms will reveal the key modulators of ?-cell failure and thus identify possible novel therapeutic targets. PMID:18777097

  10. Complications Following Endoscopic Retrograde Cholangiopancreatography: Minimal Invasive Surgical Recommendations

    PubMed Central

    Koc, Bora; Bircan, Huseyin Yuce; Adas, Gokhan; Kemik, Ozgur; Akcakaya, Adem; Yavuz, Alpaslan; Karahan, Servet

    2014-01-01

    Background ERCP has a complication rate ranging between 4% and 16% such as post-ERCP pancreatitis, hemorrhage, cholangitis and perforation. Perforation rate was reported as 0.08% to 1% and mortality rate up to 1.5%. Besides, injury related death rate is 16% to 18%. In this study we aimed to present a retrospective review of our experience with post ERCP-related perforations, reveal the type of injuries and management recommendations with the minimally invasive approaches. Methods Medical records of 28 patients treated for ERCP-related perforations in Okmeydani Training and Research Hospital between March 2007 and March 2013 were reviewed retrospectively. Patient age, gender, comorbidities, ERCP indication, ERCP findings and details were analyzed. All previous and current clinical history, laboratory and radiological findings were used to assess the evaluation of perforations. Results Between March 2007 and March 2013, 2972 ERCPs were performed, 28 (0.94%) of which resulted in ERCP-related perforations. 10 of them were men (35.8%) and 18 women (64.2%). Mean age was 53.36±14.12 years with a range of 28 to 78 years. 14 (50%) patients were managed conservatively, while 14 (50%) were managed surgically. In 6 patients, laparoscopic exploration was performed due to the failure of non-surgical management. In 6 of the patients that ERCP-related perforation was suspected during or within 2 hours after ERCP, underwent to surgery primarily. There were two mortalities. The mean length of hospitalization stay was 10.46±2.83 days. The overall mortality rate was 7.1%. Conclusion Successful management of ERCP-related perforation requires immediate diagnosis and early decision to decide whether to manage conservatively or surgically. Although traditionally conventional surgical approaches have been suggested for the treatment of perforations, laparoscopic techniques may be used in well-chosen cases especially in type II, III and IV perforations. PMID:25426633

  11. Thrombotic complications in patients with PMM2-CDG.

    PubMed

    Linssen, M; Mohamed, M; Wevers, R A; Lefeber, D J; Morava, E

    2013-05-01

    Many proteins regulating coagulation, including factor IX, factor XI, Antithrombin-III, Protein C and Protein S are deficient or decreased in activity in congenital disorders of glycosylation (CDG). Because of the imbalance of coagulation and anticoagulation factors, some patients develop acute vascular events, such as thrombosis. Identifying patients with increased risk for thrombotic events could prevent serious complications and even mortality. We performed a systematic review on patients diagnosed with the most common CDG form; PMM2-CDG, reported between 1990 and 2012 in medical literature. We also evaluated our PMM2-CDG patient-cohort of 15 patients. In total, based on the availability of comprehensive clinical descriptions, 100 patients were included in the study. Patients with and without thrombotic events were compared based on the alterations of the following glycosylated coagulation and anticoagulation factors: Antithrombin-III, Protein C, Protein S, factors IX and XI. We also assessed the global hemostasis, family history and provoking events. In the group of 100 PMM2-CDG patients 14 had suffered a venous or arterial thrombotic event. Low activity of several anticoagulation factors correlated with thrombotic events. Relatively high factor IX and XI activities were not associated with thrombosis. Prolonged PT and aPTT did not seem to protect against thrombosis in patients. Surgical procedures were frequently associated with thrombotic events. Based on the association of thrombosis and surgery in PMM2-CDG we advise to avoid elective surgical procedures in PMM2-CDG patients. Easily preventable risk factors like immobility should be treated with regular physiotherapy. We suggest a yearly follow-up for Antithrombin-III and Protein C levels and parent education for early thrombotic signs in CDG. PMID:23499581

  12. Novel use of skin substitute as rescue therapy in complicated giant exomphalos.

    PubMed

    Almond, Sarah L; Goyal, Anju; Jesudason, Edwin C; Graham, Kenneth E; Richard, Bruce; Selby, Andrew; Losty, Paul D

    2006-03-01

    Giant exomphalos can be successfully managed using conservative or surgical techniques. However, if treatment is complicated by sepsis, early skin cover of the defect becomes necessary. Options include split skin grafting, but in the presence of ongoing infection the risk of graft failure is high and limited skin is available for regrafting. We describe the novel use of a skin substitute (Integra Artificial Skin, Integra Life Sciences Corporation, Plainsboro, NJ) as an alternative to primary grafting in the management of infected giant exomphalos. PMID:16516606

  13. An Unusual Complication of the Ventricular Septal Defect Closure by Device: Late Right Aortic Cusp Perforation.

    PubMed

    Topcuoglu, M Sah; Atalay, Atakan; Gocen, Ugur; Guzel, Yasin; Basturk, Yuksel; Demir, Fadli

    2015-07-01

    Aortic regurgitation (AR) is a rare complication of transcatheter closure of perimembranous ventricular septal defects (pmVSD). It results from iatrogenic pinching of the aortic valve by the VSD occluder or perforation by the catheter. It is usually detected during control echocardiography (ECHO). The current study reports the first case of a late AR, which resulted from late right coronary cusp perforation by the VSD occluder. The current manuscript discusses the possible causes of late cusp erosion due to occluder, advantages of early operation in such cases, and an alternative treatment method where the occluder removal is not possible at the operation. PMID:25937396

  14. Hepatic allograft salvage with early doppler ultrasound diagnosis of acute vena cava thrombosis

    Microsoft Academic Search

    H. Bertani; A. D. Pinna; F. Di Benedetto; C. Quintini; C. Miller; E. Villa

    2004-01-01

    Postoperative inferior vena cava obstruction is an uncommon complication after liver transplantation. Outflow obstruction, if not rapidly corrected, can lead to graft failure and the patient’s death. We report a case in which Doppler ultrasound showed the thrombus inside the vessel, excluding extrahepatic causes of venous outflow obstruction, and permitted early surgical correction of the complication without graft loss.

  15. High incidence and spontaneous resolution of mastoid effusion after craniotomy on early postoperative magnetic resonance images

    Microsoft Academic Search

    T. Watanabe; N. Saito; N. Sato; A. Takahashi; H. Fujimaki; M. Tosaka; T. Sasaki

    2003-01-01

    Mastoid effusion is a poorly understood complication after craniotomy. The incidence and severity of postoperative mastoid effusion were retrospectively examined on postoperative magnetic resonance (MR) images to assess any association with craniotomy procedures, time course, and neuro-otological complications. We evaluated the early postoperative MR images (within 4 days of craniotomy) and medical records of 74 patients who underwent 77 operations for

  16. Use of present-on-admission indicators for complications after total knee arthroplasty: an analysis of Medicare administrative data

    PubMed Central

    Cram, Peter; Bozic, Kevin; Lu, Xin; Li, Yue

    2015-01-01

    Administrative data are commonly used to evaluate total joint arthroplasty, but analyses have historically been limited by the inability to capture which conditions were present-on-admission (POA). In 2007 Medicare began allowing hospitals to submit POA information. We used Medicare Part A data from 2008-2009 to examine POA coding for three common complications (pulmonary embolism [PE], hemorrhage/hematoma, and infection) for primary and revision total knee arthroplasty (TKA). POA information was complete for 60%-75% of complications. There was no evidence that higher TKA volume hospitals or major teaching hospitals were more likely to accurately code POA data. The percentage of complications coded as POA ranged from 6.4% (PE during index admission for primary TKA) to 68.8% (infection during index admission for revision TKA). Early experience suggests that POA coding can significantly enhance the value of Medicare data for evaluating TKA outcomes. PMID:24530205

  17. Long-term complications related to the modified Indiana pouch

    Microsoft Academic Search

    Daniel G Holmes; J. Brantley Thrasher; Gerald Y Park; Deborah C Kueker; John W Weigel

    2002-01-01

    ObjectivesTo describe a single-institution, single-surgeon experience with 125 modified Indiana pouches performed during a period of 14 years and their long-term complications. The modified Indiana pouch is a widely accepted and often used form of continent urinary diversion. Few studies have established the long-term complication rates associated with the procedure.

  18. Repair of hypospadias complications using the tubularized, incised plate urethroplasty

    Microsoft Academic Search

    Chih-Chang Luo; Jer-Nan Lin

    1999-01-01

    Background\\/Purpose: Secondary procedures to correct complications after hypospadias repair remain challenging especially for “hypospadias cripples”. The tubularized, incised plate urethroplasty was first introduced by Snodgrass for the repair of primary hypospadias in 1993. The authors used this procedure to correct the complications after hypospadias repair in patients who had no abundant local skin flaps to be used for a neourethra.Methods:

  19. Complications associated with prone positioning in elective spinal surgery

    PubMed Central

    DePasse, J Mason; Palumbo, Mark A; Haque, Maahir; Eberson, Craig P; Daniels, Alan H

    2015-01-01

    Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity. Although many of these complications remain uncommon, the range of possible morbidities is wide and includes multiple organ systems. Perioperative visual loss (POVL) is a well described, but uncommon complication that may occur due to ischemia to the optic nerve, retina, or cerebral cortex. Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery. Peripheral nerve injuries, such as those caused by prolonged traction to the brachial plexus, are more commonly encountered postoperative events. Myocutaneous complications including pressure ulcers and compartment syndrome may also occur after prone positioning, albeit rarely. Other uncommon positioning complications such as tongue swelling resulting in airway compromise, femoral artery ischemia, and avascular necrosis of the femoral head have also been reported. Many of these are well-understood and largely avoidable through thoughtful attention to detail. Other complications, such as POVL, remain incompletely understood and thus more difficult to predict or prevent. Here, the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity. PMID:25893178

  20. Can avoidance of complications lead to biased healthcare decisions?

    Microsoft Academic Search

    Jennifer Amsterlaw; Brian J. Zikmund-Fisher; Angela Fagerlin; Peter A. Ubel

    2006-01-01

    Imagine that you have just received a colon cancer diagnosis and need to choose between two different surgical treatments. One surgery, the ``complicated surgery,'' has a lower mortality rate (16\\\\% vs.\\\\ 20\\\\%) but compared to the other surgery, the ``uncomplicated surgery,'' also carries an additional 1\\\\% risk of each of four serious complications: colostomy, chronic diarrhea, wound infection, or an

  1. Understanding and preventing complications in repairing rotator cuff tears.

    PubMed

    Osti, Leonardo; Papalia, Rocco; Del Buono, Angelo; Denaro, Vincenzo; Maffulli, Nicola

    2012-01-01

    Repair of rotator cuff tears is a common procedure. Prior to approaching this surgery, it should be realized that each surgical step can lead to complications, including those related to positioning and anaesthesia. Stiffness, infection and failure of repair are the more frequent complications reported. PMID:21986055

  2. Upper Limb Ischemic Gangrene as a Complication of Hemodialysis Access

    PubMed Central

    Cawich, Shamir O.; Mohammed, Emil; Mencia, Marlon

    2015-01-01

    Upper limb ischemia is a well-recognized complication of dialysis access creation but progression to gangrene is uncommon. We report a case of upper limb ischemic gangrene and discuss the lessons learned during the management of this case. Clinicians must be vigilant for this complication and they should be reminded that it requires urgent management to prevent tissue loss. PMID:25810944

  3. Abdominal complications of chemotherapy: findings at computed tomography.

    PubMed

    Liu, Yueyi I; Jha, Priyanka; Wang, Zhen J; Yeh, Benjamin M; Poder, Liina; Westphalen, Antonio C; Coakley, Fergus V

    2012-01-01

    Modern chemotherapy may result in an array of complications that can produce computed tomography (CT) findings in the hepatobiliary, gastrointestinal and urinary systems. This article describes the CT findings that may be seen in abdominal complications of contemporary chemotherapy. Knowledge of the varying CT appearances that can be encountered may facilitate both diagnosis and management in such cases. PMID:22226444

  4. Complications obstétricales dans la schizophrénie : étude comparative en population tunisienne

    Microsoft Academic Search

    A. Mechri; A. Mrad; S. Mokni; N. Gaddour; M. Letaif; L. Gaha

    2008-01-01

    The neurodevelopmental hypothesis in schizophrenia argues that this disorder may be a result of abnormal brain development due to genetic risk and or to environmental injury such as those due to obstetric complications. Very few studies from emerging countries have been published concerning obstetric complications in schizophrenia. However, meteorological, demographic and health factors in most of these countries are different

  5. [COMPLICATED AMOEBIC APENDICITIS.REPORT OF A CASE

    PubMed

    Casavilca Zambrano, Sandro; Gomez Anchante, Victor; Cisneros Gallegos, Eduardo

    2000-01-01

    We report a case of acute abdomen that is operated with the presumptive diagnosis of complicated acute appendicitis. In the histologic examination we make the diagnosis of complicated amoebic appendicitis. We discuss clinical manifestations and histopathologic findings of this unusual presentation of amoebic infection. PMID:12140591

  6. Gastric Wall Dissection as a Complication of Percutaneous Gastrostomy

    SciTech Connect

    Reimer, Wolfgang; Farres, Maria Teresa; Lammer, Johannes [Department of Radiology, Division of Angiography and Interventional Radiology, University of Vienna, AKH, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    1996-04-15

    A percutaneous gastrostomy (PG) was complicated by gastric wall dissection and partial tube malposition. It occurred after tangential puncture along the greater curvature of the stomach which was performed in order to avoid an enlarged left lobe of the liver. To prevent this complication we recommend not using hydrophilic guidewires during PG.

  7. Relation of anthropometric and dynamometric variables to serious postoperative complications

    Microsoft Academic Search

    A M Klidjian; K J Foster; R M Kammerling; A Cooper; S J Karran

    1980-01-01

    Prediction of serious postoperative complications by using standard anthropometric and biochemical nutritional variables was attempted in 225 patients admitted for major abdominal surgery. In 102 of the patients hand-grip dynamometry was also measured, and this proved the most sensitive test, predicting complications in 48 of the 55 patients (87%) who developed them (p < 0.001). Arm muscle circumference and forearm

  8. Complicated malaria: a rare presentation of Plasmodium ovale.

    PubMed

    Tomar, Laxmikant Ramkumarsingh; Giri, Subhash; Bauddh, Nitesh Kumar; Jhamb, Rajat

    2015-04-01

    Malaria has emerged as a major public health problem worldwide. Complications are commonly seen in Plasmodium falciparum (P. falciparum) and Plasmodium vivax (P. vivax) infection, but due to Plasmodium ovale (P. ovale) infection is rarely described in literature. Here we report a case of severe disease due to P. ovale infection complicated with jaundice, thrombocytopenia, hypotension and acute renal failure. PMID:25672340

  9. Apoptosis in the placenta of pregnancies complicated with IUGR

    Microsoft Academic Search

    C. T Erel; B Dane; Z Calay; S Kaleli; K Aydinli

    2001-01-01

    Objective: In this study we have investigated the presence of apoptosis in the placental tissue of pregnancies complicated with intra-uterine growth restriction (IUGR). Method: Placental samples were obtained from 22 normal third trimester pregnancies and 20 pregnancies complicated with IUGR. The criteria for fetal growth impairment were clinical evidence of sub-optimal growth, ultrasonographic demonstration of deviation from normal percentiles of

  10. Study of Factors That Affect Complications After Renal Transplantation

    Microsoft Academic Search

    G. De Jesús-Gómez; E. A. Santiago-Delp??n; Z. González-Caraballo; L. Morales-Otero

    2006-01-01

    There are no multifactorial studies of complications after renal transplant in the Hispanic population. The objective of this study was to identify which factors are associated with the development of complications after renal transplantation. This retrospective study was performed on all patients transplanted in the Puerto Rico Transplant Program during 2002. Independent variables included preoperative albumin, white blood cell (WBC)

  11. Continuing Bonds and Reconstructing Meaning: Mitigating Complications in Bereavement

    Microsoft Academic Search

    Robert A. Neimeyer; Scott A. Baldwin; James Gillies

    2006-01-01

    Drawing on attachment theory and constructivist conceptualizations of bereavement, the authors assessed the relation between continuing bonds coping and meaning reconstruction following the death of a loved one and complicated grief symptomatology. Five hundred six young adults in the first two years of bereavement from a variety of losses completed the Inventory of Complicated Grief along with measures of the

  12. Advanced pediatric mastoiditis with and without intracranial complications

    Microsoft Academic Search

    Jose P. Zevallos; Jeffrey T. Vrabec; Robert A. Williamson; Carla Giannoni; Deidre Larrier; Marcelle Sulek; Ellen M. Friedman; John S. Oghalai

    2009-01-01

    Objectives\\/Hypothesis: Recently, several groups have noticed an increase in cases of advanced pediatric mastoiditis and intracranial complications. The objective of this study was to review the bacteri- ology of advanced mastoiditis in pediatric patients, with the hypothesis that a difference in bacteriology might explain the development of an intracranial complication. Study Design: Retrospective chart review. Methods: All pediatric patients with

  13. Complications of acute otitis media in children in southern Finland

    Microsoft Academic Search

    Kimmo Leskinen; Jussi Jero

    2004-01-01

    Background: The incidence of intratemporal and intracranial complications of acute otitis media (AOM) has decreased and the need for operative treatment is declined in developed countries during the antibiotic era. Objectives: To establish the clinical picture, diagnostic procedures, outcome and current treatment of pediatric patients with intratemporal and intracranial complications of AOM. Methods: A retrospective chart review with a sent

  14. Complications encountered in the treatment of pilon fractures.

    PubMed

    McFerran, M A; Smith, S W; Boulas, H J; Schwartz, H S

    1992-01-01

    A total of 52 tibial plafond (pilon) fractures in 51 patients were retrospectively reviewed from the years 1985-1990 to define the rate of complications encountered during their management. All fractures were managed under faculty supervision at a level I trauma center and its two affiliated institutions. The follow-up period was scrutinized to determine whether or not a complicating event occurred. Major local complications, termed events, were defined as those requiring unplanned surgery due to infection, wound breakdown with subsequent flap coverage, and failure of fixation or fracture healing. Reduction accuracy and final clinical results were not specifically examined. There were 14 (27%) type I, 17 (33%) type II, and 21 (40%) type III Ruedi-Allgower fracture types. The majority (79%) of the fractures were closed and 89% were treated by open reduction and internal fixation. The overall local complication rate was 54%. A total of 21 (40%) pilon fractures (six type I, six type II, and nine type III) had major local complicating events requiring 77 additional operations. Patient follow-up time ranged from 1 week (the occurrence of a major local complication) to 200 weeks (no complication), with a mean of 67 weeks. Kaplan-Meier survivorship (K-M) analysis was utilized to statistically estimate the complication rate in this patient population accounting for the occurrence of censored events. The K-M-determined event rate was 42 +/- 7%. Ten (of 21) pilon fractures had events by 3 weeks, while only two occurred beyond 40 weeks. PMID:1602341

  15. Risk Factors for Complications and Morbidity After Radical Retropubic Prostatectomy

    Microsoft Academic Search

    Ozdal Dillioglugil; Bryan D. Leibman; Neville S. Leibman; Michael W. Kattan; Alejandro L. Rosas; Peter T. Scardino

    1997-01-01

    PurposeWith recognition of the efficacy of surgical therapy for prostate cancer, there has been a marked increase in the number of radical prostatectomies performed, and substantial changes in surgical technique and perioperative management have decreased the morbidity of this procedure. We assessed the rate of perioperative complications with time and the risk factors for these complications, particularly age, operative time

  16. Open versus Laparoscopic Appendectomy in Children: A Comparison of Complications

    PubMed Central

    Fakhari, Mitra; Rauhofer, Ursula; Felberbauer, Franz Xaver; Rebhandl, Winfried; Horcher, Ernst

    2000-01-01

    Although between 4% and 20% of all appendectomies in adults are performed laparoscopically, this procedure is rarely done in the pediatric age group because of the substantially more difficult technique, the expected risks and suspected higher rate of complications. In a prospective study of 500 consecutive appendectomies, we tried to assess the actual rate of complications of each operative approach. We included 362 conventional and 138 laparoscopic appendectomies, the median age of the patients was 10.8 years. The mortality was 0 in both groups. We observed 89 minor and 11 major complications. All major complications (wound infections needing re-operation under general anesthesia, intra-abdominal abscesses, ileus due to adhesions and a case of renal insufficiency because of glomerulonephritis) occurred in the conventional group (n=11, ie, 3% of 362 open appendectomies). Seventy-two minor complications were seen in the same group (20%). In the laparoscopic group, there were 17 (13%) minor complications and no severe complications. This difference was statistically significant. We conclude that in children laparoscopic appendectomy does not carry a greater risk of intra- or postoperative complications and can therefore safely be established as a standard procedure. PMID:10917118

  17. Complications associated with prone positioning in elective spinal surgery.

    PubMed

    DePasse, J Mason; Palumbo, Mark A; Haque, Maahir; Eberson, Craig P; Daniels, Alan H

    2015-04-18

    Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity. Although many of these complications remain uncommon, the range of possible morbidities is wide and includes multiple organ systems. Perioperative visual loss (POVL) is a well described, but uncommon complication that may occur due to ischemia to the optic nerve, retina, or cerebral cortex. Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery. Peripheral nerve injuries, such as those caused by prolonged traction to the brachial plexus, are more commonly encountered postoperative events. Myocutaneous complications including pressure ulcers and compartment syndrome may also occur after prone positioning, albeit rarely. Other uncommon positioning complications such as tongue swelling resulting in airway compromise, femoral artery ischemia, and avascular necrosis of the femoral head have also been reported. Many of these are well-understood and largely avoidable through thoughtful attention to detail. Other complications, such as POVL, remain incompletely understood and thus more difficult to predict or prevent. Here, the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity. PMID:25893178

  18. Amniotic fluid insulin and C-peptide as predictive markers for fetal macrosomia, birth injuries, and delivery complications?

    PubMed Central

    Stein, Roland Gregor; Meinusch, Malgorzata; Diessner, Joachim; Dietl, Johannes; Hönig, Arnd; Zollner, Ursula

    2014-01-01

    Background Gestational diabetes mellitus (GDM) occurs in 3–5% of all pregnancies. GDM increases both maternal and fetal risks, causes fetal macrosomia, and hence increases the rates of caesarean sections and delivery complications such as shoulder dystocia. An early predictive marker and consequent early treatment could be beneficial, so amniotic fluid insulin and C-peptide have been examined in several studies. Increased amniotic fluid insulin in early amniocentesis between the 14th and 20th gestational week predicted a later GDM. A potential direct association with fetal macrosomia remains to be determined. Material/Methods This retrospective study investigated amniotic fluid insulin/C-peptide from amniocenteses between 14 and 20 weeks of gestation in correlation with fetal birth weight, type of delivery, and complications. To focus on effects of fetal hyperinsulinism apart from therapeutic confounders, we included patients who did not participate in GDM screening. Insulin and C-peptide were measured in 144 samples of frozen amniotic fluid. Birth weight, type of delivery, complications, and birth injuries were noted. Results Birth weights ranged from 760 g to 4410 g with a mean weight of 3424 g at an average of 40 weeks gestation. The mean amniotic fluid insulin was 4.36 ?U/ml and the mean C-peptide concentration was 0.076 ng/ml. There was no correlation between amniotic fluid insulin or C peptide and birth weight, type of delivery, complications, and birth injuries. Conclusions Amniotic fluid insulin and C-peptide are unsuitable as predictive marker for fetal macrosomia, type of delivery, complications, or birth injuries. PMID:24423633

  19. Cardiovascular complications in inflammatory bowel disease.

    PubMed

    Schicho, Rudolf; Marsche, Gunther; Storr, Martin

    2015-01-01

    Over the past years, a growing number of studies have indicated that patients suffering from inflammatory bowel disease (IBD) have an increased risk of developing cardiovascular disease. Both are chronic inflammatory diseases and share certain pathophysiological mechanisms that may influence each other. High levels of cytokines, C-reactive protein (CRP), and homocysteine in IBD patients may lead to endothelial dysfunction, an early sign of atherosclerosis. IBD patients, in general, do not show the typical risk factors for cardiovascular disease but changes in lipid profiles similar to the ones seen in cardiovascular events have been reported recently. Higher levels of coagulation factors frequently occur in IBD which may predispose to arterial thromboembolic events. Finally, the gut itself may have an impact on atherogenesis during IBD through its microbiota. Microbial products are released from the inflamed mucosa into the circulation through a leaky barrier. The induced rise in proinflammatory cytokines could contribute to endothelial damage, artherosclerosis and cardiovascular events. Although large retrospective studies favor a link between IBD and cardiovascular diseases, the mechanisms behind still remain to be determined. PMID:25642719

  20. C-reactive protein levels predict postoperative septic complications.

    PubMed

    Mustard, R A; Bohnen, J M; Haseeb, S; Kasina, R

    1987-01-01

    We studied 108 patients undergoing clean-contaminated and dirty surgical procedures to determine whether daily C-reactive protein (CRP) measurements for 14 days postoperatively could predict the occurrence of septic complications prior to clinical diagnosis. Diagnostic criteria for septic complications and positive CRP response were defined in advance of the study. The CRP assays were carried out using an automated laser nephelometer system after the patient's discharge from the hospital. Forty-six septic complications were diagnosed in 40 patients. These complications consisted of wound infection (23), urinary tract infection (11), pneumonia (six), upper respiratory tract infection (three), intra-abdominal abscess (one), and other (two). The CRP testing was found to have a positive predictive value of 69% and a negative predictive value of 78%. We conclude that serial CRP measurements may be a valuable adjunct to surgical care in patients at high risk of postoperative septic complications. PMID:3800652