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1

Association between Method of Delivery and Puerperal Infectious Complications in the Perinatal Database of Baden-Württemberg 1998–2001  

Microsoft Academic Search

The strongest argument against caesarean delivery relates to maternal complications. Evidence supporting this for elective operations is controversial. The perinatal database 1998–2001 of the German state of Baden-Württemberg was studied to assess the maternal obstetrical risk associated with caesarean delivery with regard to puerperal infectious complications. For statistical analysis the ?2 test, Fisher’s exact test, Mantel-Haenszel statistics and relative risks

E. Simoes; S. Kunz; F. W. Schmahl

2005-01-01

2

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

3

Early respiratory complications after liver transplantation  

PubMed Central

The poor clinical conditions associated with end-stage cirrhosis, pre-existing pulmonary abnormalities, and high comorbidity rates in patients with high Model for End-Stage Liver Disease scores are all well-recognized factors that increase the risk of pulmonary complications after orthotopic liver transplantation (OLT) surgery. Many intraoperative and postoperative events, such as fluid overload, massive transfusion of blood products, hemodynamic instability, unexpected coagulation abnormalities, renal dysfunction, and serious adverse effects of reperfusion syndrome, are other factors that predispose an individual to postoperative respiratory disorders. Despite advances in surgical techniques and anesthesiological management, the lung may still suffer throughout the perioperative period from various types of injury and ventilatory impairment, with different clinical outcomes. Pulmonary complications after OLT can be classified as infectious or non-infectious. Pleural effusion, atelectasis, pulmonary edema, respiratory distress syndrome, and pneumonia may contribute considerably to early morbidity and mortality in liver transplant patients. It is of paramount importance to accurately identify lung disorders because infectious pulmonary complications warrant speedy and aggressive treatment to prevent diffuse lung injury and the risk of evolution into multisystem organ failure. This review discusses the most common perioperative factors that predispose an individual to postoperative pulmonary complications and these complicationsearly clinical manifestations after OLT and influence on patient outcome. PMID:24409054

Feltracco, Paolo; Carollo, Cristiana; Barbieri, Stefania; Pettenuzzo, Tommaso; Ori, Carlo

2013-01-01

4

Early complications with the holmium laser  

NASA Astrophysics Data System (ADS)

The purpose of this study is to report early complications in our initial experience with the holmium laser in 133 patients. A retrospective study of patients undergoing endourological procedures with the holmium laser was performed. Complications included urinary tract infection (3), post-operative bradycardia (1), inverted T-waves (1), intractable flank pain (1), urinary retention (1), inability to access a lower pole calyx with a 365 micron fiber (9), stone migration (5), termination of procedure due to poor visualization (2). No ureteral perforations or strictures occurred. The holmium laser was capable of fragmenting all urinary calculi in this study. In our initial experience, the holmium laser is safe and effective in the treatment of genitourinary pathology. Use of laser fibers larger than 200 microns occasionally limit deflection into a lower pole or dependent calyx.

Beaghler, Marc A.; Stewart, Steven C.; Ruckle, Herbert C.; Poon, Michael W.

1997-05-01

5

Early Complications Following Cemented Modular Hip Hemiarthroplasty  

PubMed Central

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

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

2015-01-01

6

Cardiac arrest following acute puerperal uterine inversion.  

PubMed

Although uterine inversion is a potentially life-threatening complication of childbirth, there are only six case reports of cardiac arrest due to acute inversion to date. We report a successful outcome in a patient with sickle cell disease who had a witnessed cardiac arrest due to acute puerperal uterine inversion. Revival from cardiac arrest and resuscitation was followed by manual repositioning of the uterus. She gradually recovered from the acute kidney injury that developed as sequelae of the cardiac arrest and subsequent circulatory shock. Awareness of this rare complication and timely intervention is the key to a successful outcome in these patients. PMID:25694631

Nag, Deb Sanjay; Datta, Mamta Rath; Samaddar, Devi Prasad; Panigrahi, Binita

2015-01-01

7

Risk of puerperal and non-puerperal recurrence of illness following bipolar affective puerperal (post-partum) psychosis.  

PubMed

The clinical value of information on the risk of future psychiatric illness in women who have experienced puerperal (post-partum) psychosis has been limited by inconsistencies in terminology and nosology. Here we report rates of subsequent puerperal and non-puerperal episodes, in a well characterised sample of women diagnosed with clearly defined bipolar affective puerperal psychosis (n=103). Out of 54 women having further children, 31(57%; 95% CI 44-69) experienced an additional puerperal psychotic episode, and 64 of 103 women (62%; 95% CI 52-71) experienced a non-puerperal affective episode during the follow-up period (mean duration 9 years). A history of bipolar episodes prior to the puerperal psychosis did not predict risk following subsequent pregnancies, but positive family history of mental illness predicted shorter time to non-puerperal relapse. PMID:15738508

Robertson, Emma; Jones, Ian; Haque, Sayeed; Holder, Roger; Craddock, Nick

2005-03-01

8

Early postoperative complications in primary cleft lip and palate surgery  

Microsoft Academic Search

We studied the occurrence of early complications of cleft lip and palate surgery by the retrospective study of 132 consecutive cases (160 procedures) operated between three and six months of age. Three children presented with major complications within the immediate postoperative period. All were treated successfully. A local complication directly related to the operation occurred in 7.5% of the cases

A. DeMey; J. Vadoud-Seyedi; F. Demol; M. Govaerts

1997-01-01

9

Puerperal Group A Streptococcal Infections: A Case Series and Discussion  

PubMed Central

Puerperal group A streptococcal infections, a major postpartum killer during the late 19th and early 20th centuries, have become (fortunately) rare. We describe a cluster of 4 serious peripartum group A streptococcal infections occurring within the past five years at a single medical center. These cases were not epidemiologically linked and serve to illustrate the continuing risk of these potentially fulminant infections. PMID:23710192

Busowski, Mary T.; Lee, Melissa; Busowski, John D.; Akhter, Kauser; Wallace, Mark R.

2013-01-01

10

Early management of atrial fibrillation to prevent cardiovascular complications.  

PubMed

Atrial fibrillation (AF) is generally considered a progressive disease, typically evolving from paroxysmal through persistent to 'permanent' forms, a process attributed to electrical and structural remodelling related to both the underlying disease and AF itself. Medical treatment has yet to demonstrate clinical efficacy in preventing progression. Large clinical trials performed to date have failed to show benefit of rhythm control compared with rate control, but these trials primarily included patients at late stages in the disease process. One possible explanation is that intervention at only an early stage of progression may improve prognosis. Evolving observations about the progressive nature of AF, along with the occurrences of major complications such as strokes upon AF presentation, led to the notion that earlier and more active approaches to AF detection, rhythm-reversion, and maintenance of sinus rhythm may be a useful strategy in AF management. Approaches to early and sustained rhythm control include measures that prevent development of the AF substrate, earlier catheter ablation, and novel antiarrhythmic drugs. Improved classifications of AF mechanism, pathogenesis, and remodelling may be helpful to enable patient-specific pathophysiological diagnosis and therapy. Potential novel therapeutic options under development include microRNA-modulation, heatshock protein inducers, agents that influence Ca(2+) handling, vagal stimulators, and more aggressive mechanism-based ablation strategies. In this review, of research into the basis and management of AF in acute and early settings, it is proposed that progression from paroxysmal to persistent AF can be interrupted, with potentially favourable prognostic impact. PMID:24536084

Nattel, Stanley; Guasch, Eduard; Savelieva, Irina; Cosio, Francisco G; Valverde, Irene; Halperin, Jonathan L; Conroy, Jennifer M; Al-Khatib, Sana M; Hess, Paul L; Kirchhof, Paulus; De Bono, Joseph; Lip, Gregory Y H; Banerjee, Amitava; Ruskin, Jeremy; Blendea, Dan; Camm, A John

2014-06-01

11

Complications  

MedlinePLUS

... Complications Neuropathy Foot Complications DKA (Ketoacidosis) & Ketones Kidney Disease (Nephropathy) Gastroparesis Mental Health Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More ...

12

Coagulation factor VII R353Q polymorphism and the risk of puerperal cerebral venous thrombosis.  

PubMed

Puerperal cerebral venous thrombosis (CVT) is a relatively common form of stroke in young women in India. The blood coagulation factor VII (FVII) R353Q polymorphism increases the risk for venous thrombosis. Our aim was to investigate the association of FVII R353Q polymorphism with the risk of puerperal CVT. A total of 100 women with puerperal CVT and 102 age-matched women without postpartum complications were investigated. FVII R353Q genotypes were identified using restriction fragment length polymorphism analysis. Our results showed that the homozygous FVII 353QQ genotype was present in 9% and 8% of patients and controls, respectively; and 42% of patients and 31.4% of controls had the heterozygous 353RQ genotype (odds ratio = 1.55, 95% confidence interval = 0.89-2.70; p = 0.243). Our findings suggest that the FVII R353Q polymorphism is not associated with increased risk for CVT occurring during the puerperal period in Indian women. PMID:22136731

Kruthika-Vinod, T P; Nagaraja, Dindagur; Christopher, Rita

2012-01-01

13

The Effect of Surveillance and Appreciative Inquiry on Puerperal Infections: A Longitudinal Cohort Study in India  

PubMed Central

Objective To evaluate the effects of an intervention comprising surveillance and an organisational change called Appreciative Inquiry on puerperal infections in hospitals in Gujarat state, India. Methods This longitudinal cohort study with a control group was conducted over 16 months between 2010 and 2012. Women who delivered in six hospitals were followed-up. After a five month pre-intervention period, the intervention was introduced in three hospitals. Monthly incidence of puerperal infection was recorded throughout the study in all six hospitals. A chi-square test and logistic regression were used to examine for associations, trends and interactions between the intervention and control groups. Findings Of the 8,124 women followed up, puerperal infections were reported in 319 women (3.9%) over the course of the study. Puerperal sepsis/genital tract infections and urinary tract infections were the two most common puerperal infections. At the end of the study, infection incidence in the control group halved from 7.4% to 3.5%. Levels in the intervention group reduced proportionately even more, from 4.3% to 1.7%. A chi-square test for trend confirmed the reduction of infection in the intervention and control groups (p<0.0001) but the trends were not statistically different from one another. There was an overall reduction of infection by month (OR?=?0.94 95% CI 0.91–0.97). Risk factors like delivery type, complications or delivery attendant showed no association with infection. Conclusion Interruption of resource flows in the health system occurred during the intervention phase, which may have affected the findings. The incidence of infection fell in both control and intervention groups during the course of the study. It is not clear if appreciative inquiry contributed to the reductions observed. A number of practical and methodological limitations were faced. Trial Registration Controlled-Trials.com ISRCTN03513186 PMID:24498089

Hussein, Julia; Ramani, K. V.; Kanguru, Lovney; Patel, Kalpesh; Bell, Jacqueline; Patel, Purvi; Walker, Leighton; Mehta, Rajesh; Mavalankar, Dileep

2014-01-01

14

Reverse Total Shoulder Replacement: Intraoperative and Early Postoperative Complications  

PubMed Central

Reverse total shoulder arthroplasty is a treatment option for patients with symptomatic glenohumeral arthritis and a deficient rotator cuff. The reported complication rates vary from 0% to 68%. Given this variation, our purposes were to (1) determine the learning curve for the procedure, (2) identify complications and surgical pitfalls, and (3) compare our results with those of similar published series. We retrospectively reviewed 20 consecutive patients (mean age, 73 years; range, 45–88 years) who had reverse total shoulder arthroplasty by one surgeon, tabulating intraoperative and postoperative complications. Minimum followup was 3 months (average, 9 months; range, 3–21 months). The intraoperative complication rate for the first 10 patients was higher than that for the second 10 patients. There were 33 complications in 15 patients: 11 patients collectively had 22 intraoperative complications and eight patients collectively had 11 postoperative complications. At radiographic followup, 11 patients had scapular notching and nine patients had heterotopic ossification. Our complication rate was higher than published rates. Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18685908

Wierks, Carl; Skolasky, Richard L.; Ji, Jong Hun

2008-01-01

15

[The effect of early urologic complications on the prognosis of kidney transplantation].  

PubMed

The early urological complications of 200 patients receiving a kidney allograft between 1985 and 1987 were analyzed retrospectively. In the first 4 weeks after transplantation urological, complications were found in 25 cases (12.5%), with a portion of 74.1% ureteral fistulas. The treatment was conservatively in 4 cases and operatively in 21 patients (84%), in 3 cases a recurrent operation was necessary. After an urological complication the graft prognosis was diminished markedly and the letality was higher in comparison with uncomplicated cases. PMID:2672674

Konert, J; Heinrichs, H J; Eismann, R; Richter, M I; Lüthge, K D; Lang-Kopf, B

1989-07-01

16

Early postoperative complications in patients with Crohn's disease given and not given preoperative total parenteral nutrition  

PubMed Central

Objective The effect of preoperative total parenteral nutrition (TPN) on the rate of early (within 30 days) postoperative complications in patients with moderate to severe Crohn's disease (CD) was examined. Material and methods A series of 15 consecutive patients with CD (mean CD activity index score, 270) given preoperative TPN for 18–90 days (mean, 46 days) and undergoing bowel resection and primary anastomosis was compared with matching controls (105 patients) consecutively selected from all CD patients operated in Stockholm County during a preceding 20-year period without preoperative TPN. Results During the preoperative TPN, all the patients studied displayed clinical remission of CD as reflected in improvement in their general well-being, relief of abdominal pain, and abatement of fever and diarrhea. There was no significant early postoperative complication in the TPN-treated group, whereas there were 29 patients with early postoperative complications in the control group, which means a significantly higher rate of postoperative complications when preoperative TPN was not provided. During the preoperative TPN, some crucial variables increased such as the body weight, the serum concentrations of albumin and triiodothyronine reflecting improved nutritional state, whereas the serum concentration of haptoglobin and the white cell count decreased reflecting decreased inflammatory activity. Conclusions This study shows that preoperative TPN for at least 18 days may be recommended to be given to patients with moderate to severe CD until clinical remission is achieved in order to minimize the risk of early postoperative complications. PMID:22242614

Jacobson, Stefan

2012-01-01

17

Gastrointestinal complications after cardiac transplantation. Potential benefit of early diagnoses and prompt surgical intervention.  

PubMed

Acute gastrointestinal (GI) illnesses are unusual but potentially fatal complications following cardiac transplantation. A retrospective study was performed to analyze the frequency, etiology, and severity of GI complications and the potential impact of early diagnosis and prompt surgical intervention when appropriate. Between 1981 and July 1, 1988, 31 GI complications (pancreatic, 6; colonic, 6; gastroduodenal, 6; biliary, 5; esophageal, 3; appendiceal, 2; hernia, 2; and splenic, 1) occurred in 26 patients undergoing 32 cardiac transplants. Complications were most common (14 of 31 patients, 45%) within the first 30 days after transplantation. Seventeen GI complications were treated medically (2 deaths), 2 with elective surgery and 12 with emergent operations (3 deaths). The overall mortality rate was 16%. All patients who underwent emergent operations within 3 days of onset of symptoms survived; the mean interval of onset between symptoms and operation in the nonsurvivors was 10 +/- 3.8 days. We infer that among patients requiring urgent surgical intervention, successful outcome is enhanced by intense surveillance for early symptoms, prompt diagnostic evaluation, and early surgical intervention. PMID:2339915

Kirklin, J K; Holm, A; Aldrete, J S; White, C; Bourge, R C

1990-05-01

18

Early complications and endoleaks after endovascular abdominal aortic aneurysm repair: Report of a multicenter study  

Microsoft Academic Search

Objective: The aim of this study was the identification of risk factors for adverse events and the assessment of the early success rate in 1554 patients with abdominal aortic aneurysms (AAAs) who underwent treatment with endovascular technique between January 1994 and March 1999. For this purpose, the clinical and procedural data were correlated with observed complications and endoleaks. Methods: The

Jacob Buth; R. J. F. Laheij

2000-01-01

19

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

Microsoft Academic Search

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

P Gontero; PS Sidhu; GH Muir

2000-01-01

20

Early Process and Dropping Out From Short-Term Group Therapy for Complicated Grief  

Microsoft Academic Search

Early group process variables were investigated as predictors of dropping out for patients who participated in short-term group psychotherapy for complicated grief. Constructs assessed included affect, cohesion, group climate, and therapeutic alliance. Using logistic regression analyses, the authors investigated differences between dropouts and remainers at Sessions 1 and 4. Results indicated that after the 1st therapy session, imminent dropouts reported

Mary McCallum; William E. Piper; John S. Ogrodniczuk; Anthony S. Joyce

2002-01-01

21

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

PubMed Central

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

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

2015-01-01

22

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

PubMed Central

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

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

2015-01-01

23

A controlled trial of anti-tuberculosis chemotherapy in the early complicated pneumoconiosis of coalworkers  

PubMed Central

A controlled trial in coalminers under the age of 50 in South Wales with sputum-negative, early complicated pneumoconiosis was used to compare three regimes: (1) chemotherapy (rest in hospital and 1 g. streptomycin, 200 mg. INH, 10 g. PAS, for 3 months; then 200 mg. INH, 10 g. PAS for 9 months); (2) rest (in hospital for 3 months); and (3) a working group. The initial and three-year radiographs were assessed by two methods in 173 (96%) of the 180 men entering the trial. No beneficial effect of chemotherapy was demonstrated and this factor was not related to the completeness of the chemotherapy. The variation between individuals in the rate of progression and in the development of new shadows was unrelated to chest symptoms, smoking habits, initial erythrocyte sedimentation rate, or special features in the initial radiographs, so these did not provide any useful predictive characteristics. Those with an initial negative Mantoux (1 T.U.) showed significantly less progression than those with a positive Mantoux. The lack of benefit and the short- and long-term complications of chemotherapy (weight gain, reduction in ventilatory capacity, dyspepsia, and streptomycin toxicity) show that this treatment is contra-indicated in miners with early complicated pneumoconiosis without a positive sputum. That new shadows develop during chemotherapy adds to the evidence from other sources that tuberculosis is unlikely to be a major factor in the pathogenesis of complicated pneumoconiosis in this area. Mycobacterium peregrinum (Runyon group IV) was isolated in three cases. PMID:5795642

Ball, J. D.; Berry, G.; Clarke, W. G.; Gilson, J. C.; Thomas, J.; Exall, Catherine; Roberts, Marjorie

1969-01-01

24

Early complications of permanent pacemaker implantation: no difference between dual and single chamber systems  

Microsoft Academic Search

OBJECTIVE--To evaluate the incidence of intraoperative and early postoperative complications (up to two months after implant) of endocardial permanent pacemaker insertion in all patients under-going a first implant at a referral centre. METHODS--Prospective evaluation of all endocardial pacemaker implantation procedures performed from April 1992 to January 1994 carried out by completion of standard audit form at implant. Patients' demographic data,

R. K. Aggarwal; D. T. Connelly; S. G. Ray; J. Ball; R. G. Charles

1995-01-01

25

Risk Factors of Early Complications afterPancreaticoduodenectomy in 200 Consecutive Patients  

Microsoft Academic Search

Objective: To study the risk factors for early complications after pancreaticoduodenectomy\\u000a(PD). Methods: Two hundred patients undergoing PD at our hospital between December 1996 and\\u000aSeptember 2002 were reviewed retrospectively. Standard PD was performed on 176 cases, standard PD\\u000awith extended lymphadenectomy on 24 patients, whereas pylorus-preserving PD was not used. An end-toside\\u000acombined with mucosa-to-mucosa pancreaticojejunostomy was performed on

Qingbao CHENG; Baohua ZHANG; Xiangji LUO; Yongjie ZHANG; Xiaoqing JIANG; Bin YI; Wenlong YU; Mengchao WU; Baihe ZHANG

2005-01-01

26

Self-powered instrumented knee implant for early detection of postoperative complications.  

PubMed

In-vivo measurement of tibiofemoral forces transmitted through Total Knee Replacement (TKR) during normal walking allows the early detection of postoperative complications such as the tibiofemoral misalignment and soft-tissue imbalance. In addition, the in-vivo data can help to improve the design of TKR in order to reduce polyethylene wear and consequently to increase the lifespan of knee implant. A self-powered custom-designed tibial implant instrumented with four piezoceramics has been developed in order to detect the aforementioned complications by measuring the relative change in pressure center (COP) position for different levels of eccentric compressive loading. Moreover, the energy harvested by the piezoceramics can be used to power a transmission system located at the stem of knee implant to wirelessly transmit the in-vivo data outside the implant for further processing and display. PMID:21095807

Almouahed, Shaban; Gouriou, Manuel; Hamitouche, Chafiaa; Stindel, Eric; Roux, Christian

2010-01-01

27

Complications and the effect of varicocelectomy on semen analysis, fertility, early ejaculation and spontaneous abortion.  

PubMed

Varicocele is still an enigma. Its effects on semen analysis, fertility and, more recently, early ejaculation and spontaneous abortion in spouses are not yet fully understood. In this retrospective study, we evaluated these four parameters (semen analysis, fertility, early ejaculation and spontaneous abortion among spouses) in relation to varicocele and varicocelectomy during a 13-year period. A total of 1,711 patients with varicocele underwent varicocelectomy by high inguinal method (251 cases), subinguinal method (1,375 cases), scrotal method (34 cases), and subinguinal method with local anesthesia (38 cases). Our complication rate was acceptable. Sperm count, motility and morphology increased three months post operation in 55, 51, and 46%, respectively (P value 0.000, 0.000, and 0.015, respectively). Paternity was 56% after one year of post varicocelectomy follow-up. Only 7 out of 82 azoospermic men had sperm in their semen after varicocelectomy and only one of them with mild spermatogenic hypoplasia became a father. The spontaneous abortion rate in the spouses of respondents was 59%. Early ejaculation improved in 75% of the respondents. In conclusion, varicocelectomy does not improve sperm parameters in all men, but it improves pregnancy rate, early ejaculation, and scrotal pain. PMID:21060180

Shamsa, Ali; Nademi, M; Aqaee, M; Fard, A Nouraee; Molaei, Mahmood

2010-11-01

28

Suppression of puerperal lactation using jasmine flowers (Jasminum sambac).  

PubMed

The efficacy of jasmine flowers (Jasminum Sambac) applied to the breasts to suppress puerperal lactation was compared that of Bromocriptine. Effectiveness of both regimens was monitored by serum prolactin levels, clinical evaluation of the degree of breast engorgement and milk production and the analgesic intake. While both bromocriptine and jasmine flowers brought about a significant reduction in serum prolactin, the decrease was significantly greater with bromocriptine. However, clinical parameters such as breast engorgement, milk production and analgesic intake showed the 2 modes of therapy to be equally effective. The failure rates of the 2 regimens to suppress lactation were similar; however, rebound lactation occurred in a small proportion of women treated with bromocriptine. Jasmine flowers seem to be an effective and inexpensive method of suppressing puerperal lactation and can be used as an alternative in situations where cost and nonavailability restrict the use of bromocriptine. PMID:3214386

Shrivastav, P; George, K; Balasubramaniam, N; Jasper, M P; Thomas, M; Kanagasabhapathy, A S

1988-02-01

29

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

PubMed Central

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

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; Foŕ, Roberto; Alimena, Giuliana

2014-01-01

30

Early and late complications related to central venous catheters in hematological malignancies: a retrospective analysis of 1102 patients.  

PubMed

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

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; Foŕ, Roberto; Alimena, Giuliana

2014-01-01

31

Acute gastric remnant dilatation, a rare early complication of laparoscopic mini-gastric bypass.  

PubMed

Several thousands of laparoscopic mini-gastric bypass have been performed globally by a number of surgeons. There is growing evidence that mini-gastric bypass is a safe and effective procedure. We report a rare case of massive gastric remnant dilation in a 45-year-old man after laparoscopic mini-gastric bypass. Acute gastric dilatation is a surgical emergency. In our case, a triad of clinical suspicion, laboratory profile, and emergency radiologic investigation were essential for early diagnosis and management. Image-guided gastrostomy tube placement provides an effective decompression of the gastric remnant. A literature review revealed no previous reports of similar complications in mini-gastric bypass. PMID:24754886

Almulaifi, Abdullah M; Ser, Kong-Han; Lee, Wei-Jei

2014-05-01

32

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

NASA Astrophysics Data System (ADS)

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.

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

2006-02-01

33

Hypertensive phase and early complications after Ahmed glaucoma valve implantation with intraoperative subtenon triamcinolone acetonide  

PubMed Central

Objective To evaluate intraoperative subtenon triamcinolone acetonide (TA) as an adjunct to Ahmed glaucoma valve (AGV) implantation. Design Retrospective comparative case series. Participants Forty-two consecutive cases of uncontrolled glaucoma undergoing AGV implantation: 19 eyes receiving intraoperative subtenon TA and 23 eyes that did not receive TA. Methods A retrospective chart review was performed on consecutive pseudophakic adult patients with uncontrolled glaucoma undergoing AGV with and without intraoperative subtenon TA injection by a single surgeon. Clinical data were collected from 42 eyes and analyzed for the first 6 months after surgery. Main outcome measures Primary outcomes included intraocular pressure (IOP) and number of glaucoma medications prior to and after AGV implantation. The hypertensive phase (HP) was defined as an IOP measurement of greater than 21 mmHg (with or without medications) during the 6-month postoperative period that was not a result of tube obstruction, retraction, or malfunction. Postoperative complications and visual acuity were analyzed as secondary outcome measures. Results Five out of 19 (26%) TA cases and 12 out of 23 (52%) non-TA cases developed the HP (P=0.027). Mean IOP (14.2±4.6 in TA cases versus [vs] 14.7±5.0 mmHg in non-TA cases; P=0.78), and number of glaucoma medications needed (1.8±1.3 in TA cases vs 1.6±1.1 in the comparison group; P=0.65) were similar between both groups at 6 months. Although rates of serious complications did not differ between the groups (13% in the TA group vs 16% in the non-TA group), early tube erosion (n=1) and bacterial endophthalmitis (n=1) were noted with TA but not in the non-TA group. Conclusions Subtenon TA injection during AGV implantation may decrease the occurrence of the HP but does not alter the ultimate IOP outcome and may pose increased risk of serious complications within the first 6 months of surgery. PMID:25050061

Turalba, Angela V; Pasquale, Louis R

2014-01-01

34

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

PubMed

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

Neuman, Menahem

2008-01-01

35

Major early complications from diagnostic and therapeutic ERCP: a prospective multicenter study  

Microsoft Academic Search

Background: There is a lack of multicenter prospective studies on complications of diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP). Methods: We studied 2769 consecutive patients undergoing ERCP at nine centers in the Triveneto region of Italy over a 2-year period. Six centers performed ERCP on less than 200 patients per year (small centers). General and ERCP-specific major complications were predefined.

Silvano Loperfido; Giampaolo Angelini; Giorgio Benedetti; Fausto Chilovi; Franco Costan; Franco De Berardinis; Massimo De Bernardin; Andrea Ederle; Paolo Fina; Agostino Fratton

1998-01-01

36

The Association of Birth Complications and Externalizing Behavior in Early Adolescents: Direct and Mediating Effects  

ERIC Educational Resources Information Center

Prior studies have shown that birth complications interact with psychosocial risk factors in predisposing to increased externalizing behavior in childhood and criminal behavior in adulthood. However, little is known about the direct relationship between birth complications and externalizing behavior. Furthermore, the mechanism by which the birth…

Liu, Jianghong; Raine, Adrian; Wuerker, Anne; Venables, Peter H.; Mednick, Sarnoff

2009-01-01

37

Very early onset and severe complicated phenotype caused by a new spastic paraplegia 3A gene mutation.  

PubMed

Spastic paraplegia 3A is the second most common form of hereditary autosomal dominant spastic paraplegia. This form is mainly associated with an early age of onset and pure phenotype, although recently complicated forms were reported. We describe a patient carrying a new C>T P344S>CT mutation in exon 10 of the spastic paraplegia 3A gene with unusual, complicated, and extremely severe phenotype. At the last neurologic examination performed at 17 years of life, the patient disclosed spastic tetraparesis, sensorimotor axonal neuropathy, cognitive and cranial nerve impairment, mild pes cavus, and distal amyotrophy. PMID:22378671

Fusco, Carlo; Frattini, Daniele; Farnetti, Enrico; Nicoli, Davide; Casali, Bruno; Della Giustina, Elvio

2012-10-01

38

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

PubMed Central

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

2012-01-01

39

Insulin Resistance in Early Vs Late Nutrition and Complications of Sirs in Neurosurgical Intensive Care Unit (ICU)  

PubMed Central

Background: Systemic Inflammatory Response Syndrome (SIRS) is a common complication in neurosurgical diseases in Intensive Care Unit (ICU). Because of associated insulin resistance (IR) the ICU is in dilemma in which stage to start the nutrition to patients and what is the amount of Insulin Unit to control the hyperglycemia. Aim: to define the IR and to compare IR and amount of insulin among ICU patients in “Mother Theresa” University Hospital Center (MTUHC) in Tirana Albania. Methods: 154 patients with neurosurgical disease and SIRS complications were randomized in two groups: early nutrition 73 patients (47%) and late nutrition 81 (53%) and compared for a number of variables. Results: There was no statistical age and gender difference between the two groups (P>0.05). The amount of insulin units to control the level of glycemia (80-110 mg/dc) was 12.8±7 unit per day in early nutrition and 23.8 ±12.9 units in late nutrition group (p<0.01). No patient in early nutrition group but six (7.4%) patients in late nutrition group developed insulin resistance (p=0.03). Conclusions: the IR due to the infection complications is higher among late than early nutrition group. Therefore, we suggest that in neurosurgical ICU it would be better to start the nutrition within 72 hours. PMID:25870478

Pilika, Kliti; Roshi, Enver

2015-01-01

40

Treatment of Acute Puerperal Mastitis and Breast Abscess  

PubMed Central

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

Cantlie, Helene Bertrand

1988-01-01

41

The incidence of early post-operative complications following uvulopalatopharyngoplasty: identification of predictive risk factors  

PubMed Central

Objective Characterize complications following uvulopalatopharyngoplasty (UPPP) for obstructive sleep apnea. Study design Retrospective chart review. Subjects and methods Charts of patients undergoing UPPP at an academic teaching hospital from 1999 to 2005 were reviewed. Results 345 consecutive patients (248 inpatients; 97 outpatients) were studied. The most common post-operative complication in the entire study was oxyhemoglobin desaturation (12.8%). Three patients suffered major complications (airway obstruction, pulmonary edema, arrhythmia). Regarding complications limited to the post-anaesthetic care unit alone, only 8.2% of patients had oxyhemoglobin desaturation after discontinuation of oxygen supplementation. Inpatients requiring supplemental oxygen on the ward had significantly higher mean AHI (37.4 vs. 31.4; p=0.05) and BMI (32.3 kg/m2 vs. 28.9 kg/m2; p=0.004) than those who did not. Those inpatients who were obese (BMI > 30 kg/m2) with an AHI?22 were associated with an increased risk of requiring oxygen on the ward (odds ratio = 3.48, 95% CI = 1.56 – 7.78). Conclusion The incidence of post-UPPP complications is much lower than the literature has historically suggested. Selected patients should be able to safely undergo outpatient UPPP. Patients with higher AHI, higher BMI, or multiple comorbidities are at higher risk for postoperative complications and are most appropriate for overnight monitoring. PMID:23570393

2013-01-01

42

Preprocedural serum levels of C-reactive protein predict early complications and late restenosis after coronary angioplasty  

Microsoft Academic Search

OBJECTIVESWe sought to investigate whether early and late outcome after percutaneous transluminal coronary angioplasty (PTCA) could be predicted by baseline levels of acute-phase reactants.BACKGROUNDAlthough some risk factors for acute complications and restenosis have been identified, an accurate preprocedural risk stratification of patients undergoing PTCA is still lacking.METHODSLevels of C-reactive protein (CRP), serum amyloid A protein (SAA) and fibrinogen were measured

Antonino Buffon; Giovanna Liuzzo; Luigi M Biasucci; Patrizio Pasqualetti; Vito Ramazzotti; Antonio G Rebuzzi; Filippo Crea; Attilio Maseri

1999-01-01

43

Medical Complications of the Critically Ill Newborn: A Review for Early Intervention Professionals.  

ERIC Educational Resources Information Center

Provides early-intervention professionals with a basic familiarity and understanding of some of the newest technologies employed in the neonatal intensive care units for neonates with respiratory distress syndrome, persistent fetal circulation, retinopathy of prematurity, intraventricular hemorrhage, and periventricular leukomalacia. Early

McNab, Theresa C.; Blackman, James A.

1998-01-01

44

Early complications after low anterior resection for rectal cancer using the EEA TM stapling device  

Microsoft Academic Search

Complications following 178 low anterior resections for rectal carcinoma with the EEA autosuture device are reported prospectively.\\u000a The operative mortality was 2.8 percent. Clinical anastomotic leakage developed in 27 patients, but in none of the 30 patients\\u000a over 76 years of age. Two of the five hospital deaths were related to leakage. Long-term steroid treatment and previous pelvic\\u000a radiotherapy were

Henning Kold Antonsen; Ole Kronborg

1987-01-01

45

Familial liability, obstetric complications and childhood development abnormalities in early onset schizophrenia: a case control study  

Microsoft Academic Search

Background  Genetic and environmental risk factors and gene-environment interactions are linked to higher likelihood of developing schizophrenia\\u000a in accordance with the neurodevelopmental model of disease; little is known about risk factors and early development in early-onset\\u000a schizophrenia (EOS) and very early-onset schizophrenia (VEOS).\\u000a \\u000a \\u000a \\u000a \\u000a Methods  We present a case-control study of a sample of 21 patients with EOS\\/VEOS and a control group of

Francesco Margari; Maria G Petruzzelli; Paola A Lecce; Orlando Todarello; Andrea De Giacomo; Elisabetta Lucarelli; Domenico Martinelli; Lucia Margari

2011-01-01

46

Clinical assessment of peripheral perfusion to predict postoperative complications after major abdominal surgery early: a prospective observational study in adults  

PubMed Central

Introduction Altered peripheral perfusion is strongly associated with poor outcome in critically ill patients. We wanted to determine whether repeated assessments of peripheral perfusion during the days following surgery could help to early identify patients that are more likely to develop postoperative complications. Methods Haemodynamic measurements and peripheral perfusion parameters were collected one day prior to surgery, directly after surgery (D0) and on the first (D1), second (D2) and third (D3) postoperative days. Peripheral perfusion assessment consisted of capillary refill time (CRT), peripheral perfusion index (PPI) and forearm-to-fingertip skin temperature gradient (Tskin-diff). Generalized linear mixed models were used to predict severe complications within ten days after surgery based on Clavien-Dindo classification. Results We prospectively followed 137 consecutive patients, from among whom 111 were included in the analysis. Severe complications were observed in 19 patients (17.0%). Postoperatively, peripheral perfusion parameters were significantly altered in patients who subsequently developed severe complications compared to those who did not, and these parameters persisted over time. CRT was altered at D0, and PPI and Tskin-diff were altered on D1 and D2, respectively. Among the different peripheral perfusion parameters, the diagnostic accuracy in predicting severe postoperative complications was highest for CRT on D2 (area under the receiver operating characteristic curve = 0.91 (95% confidence interval (CI) = 0.83 to 0.92)) with a sensitivity of 0.79 (95% CI = 0.54 to 0.94) and a specificity of 0.93 (95% CI = 0.86 to 0.97). Generalized mixed-model analysis demonstrated that abnormal peripheral perfusion on D2 and D3 was an independent predictor of severe postoperative complications (D2 odds ratio (OR) = 8.4, 95% CI = 2.7 to 25.9; D2 OR = 6.4, 95% CI = 2.1 to 19.6). Conclusions In a group of patients assessed following major abdominal surgery, peripheral perfusion alterations were associated with the development of severe complications independently of systemic haemodynamics. Further research is needed to confirm these findings and to explore in more detail the effects of peripheral perfusion–targeted resuscitation following major abdominal surgery. PMID:24894892

2014-01-01

47

Translational Research Efforts in Biomarkers and Biology of Early Transplant-Related Complications  

PubMed Central

In the time since the first allogeneic hematopoietic stem cell transplantation (HSCT) was performed over 40 years ago, this life-saving procedure has been used increasingly for patients with hematologic, metabolic, and malignant diseases. Despite major advances in our understanding of the immunologic processes (both beneficial and injurious) that are associated with HSCT and improvements in supportive and critical care medicine, successful outcomes are still limited by several serious complications. As such, the establishment of effective therapeutic strategies for these complications will be crucial as increasing numbers of high-risk transplants are performed each year. The development of such approaches is fundamentally dependent upon a basic understanding of pathophysiologic mechanisms of disease and also on our ability to successfully translate these insights back to the bedside. This brief review will highlight breakthroughs in translational research endeavors that have paved the way for the development of novel strategies intended to change the standard of care and optimize outcomes for patients in whom allogeneic HSCT offers the only hope for a cure. PMID:21195297

Paczesny, Sophie; Diaz-Ricart, Maribel; Carerras, Enrique; Cooke, Kenneth R.

2015-01-01

48

Translational research efforts in biomarkers and biology of early transplant-related complications.  

PubMed

In the time since the first allogeneic hematopoietic stem cell transplantation (HSCT) was performed over 40 years ago, this life-saving procedure has been used increasingly for patients with hematologic, metabolic, and malignant diseases. Despite major advances in our understanding of the immunologic processes (both beneficial and injurious) that are associated with HSCT and improvements in supportive and critical care medicine, successful outcomes are still limited by several serious complications. As such, the establishment of effective therapeutic strategies for these complications will be crucial as increasing numbers of high-risk transplants are performed each year. The development of such approaches is fundamentally dependent upon a basic understanding of pathophysiologic mechanisms of disease and also on our ability to successfully translate these insights back to the bedside. This brief review will highlight breakthroughs in translational research endeavors that have paved the way for the development of novel strategies intended to change the standard of care and optimize outcomes for patients in whom allogeneic HSCT offers the only hope for a cure. PMID:21195297

Paczesny, Sophie; Diaz-Ricart, Maribel; Carreras, Enric; Carerras, Enrique; Cooke, Kenneth R

2011-01-01

49

Early increase of procalcitonin after cardiovascular surgery in patients with postoperative complications  

Microsoft Academic Search

Objective. Type and frequency of postoperative abnormalities were registered after cardiovascular surgery to evaluate the aetiology and diagnostic value of increased concentrations of procalcitonin (PCT) and C-reactive protein (CRP) during the early postoperative period. Design. Prospective, observational study. Patients. Two hundred and eight patients undergoing coronary artery bypass grafting or valve replacement requiring cardiopulmonary bypass were monitored for 7 days

M. Meisner; C. Rauschmayer; J. Schmidt; R. Feyrer; R. Cesnjevar; D. Bredle; K. Tschaikowsky

2002-01-01

50

Determinants of early case-fatality among stroke patients in Maputo, Mozambique and impact of in-hospital complications.  

PubMed

The burden of stroke is increasing in developing countries that struggle to manage it efficiently. We identified determinants of early case-fatality among stroke patients in Maputo, Mozambique, to assess the impact of in-hospital complications. Patients admitted to any hospital in Maputo with a new stroke event were prospectively registered (n = 651) according to the World Health Organization's STEPwise approach, in 2005-2006. We assessed the determinants of in-hospital and 28-day fatality, independently of age, gender and education, and computed population attributable fractions. In-hospital mortality was higher among patients with Glasgow score at admission ? 6 (more than fivefold) or needing cardiopulmonary resuscitation during hospitalization (approximately 2.5-fold). Pneumonia and deep vein thrombosis/other cardiovascular complications during hospitalization were responsible for 19.6% (95% confidence interval, 5.3 to 31.7) of ischaemic stroke and 15.9% (95% confidence interval, 5.8 to 24.9) of haemorrhagic stroke deaths until the 28th day. Ischaemic stroke patients with systolic blood pressure 160-200 mmHg had lower in-hospital mortality (relative risk = 0.32, 95% confidence interval, 0.13 to 0.78), and, for those with haemorrhagic events (haemorrhagic stroke), 28-day mortality was higher when systolic blood pressure was over 200 mmHg (hazard ratio = 3.42; 95% confidence interval, 1.02 to 11.51), compared with systolic blood pressure 121-140 mmHg. Regarding diastolic blood pressure, the risk was lowest at 121-150 mmHg for ischaemic stroke and at 61-90 mmHg for haemorrhagic stroke. Early case-fatality was mostly influenced by stroke severity and in-hospital complications. The allocation of resources to the latter may have a large impact on the reduction of the burden of stroke in this setting. PMID:23331721

Gomes, Joana; Damasceno, Albertino; Carrilho, Carla; Lobo, Vitória; Lopes, Hélder; Madede, Tavares; Pravinrai, Pius; Silva-Matos, Carla; Diogo, Domingos; Azevedo, Ana; Lunet, Nuno

2013-10-01

51

[Prevention and treatment of pulmonary complications in patients with combined injuries of the chest accompanied by shock in the early period of trauma].  

PubMed

Complications were noted in 83% of patients with an associated trauma of the chest. Bilateral pneumonia was the most frequent complication (57.7%), then were traumatic pulmonitis (15.9%) and total pulmonary edema (18%). The adequate anesthesia, liquidation of a disturbance of the chest carcass, timely elimination of hemo- and pneumothorax are thought to be the most effective measures of struggle against pulmonary complications in patients in the early period of the trauma disease. The complex treatment has given 1.5 times less amount of pulmonary complications. PMID:3727306

Shapot, Iu B; Vashetko, R V; Novikov, A S

1986-03-01

52

A rare case of tertiary syphilis complicated with aortic aneurysm in this era of early use of highly effective antibiotics  

PubMed Central

This 35-year-old man presented with history of hemoptysis and breathlessness on exertion of 3 months duration. Examination revealed feeble left radial, brachial and carotid pulses. Chest radiograph showed a superior mediastinal mass and contrast enhanced computed tomography chest showed a large aortic arch with mass and compression effects. Endosonographic examination was suggestive of aortic aneurysm. During further evaluation, serum Venereal Disease Research Laboratory test was found to be positive in titers of 1:32. Treponema pallidum hemagglutination test was performed and showed positive titers of 1:64. Neurosyphilis was ruled out by normal cerebrospinal fluid examination findings. Patient was treated with injectable benzathine penicillin and aortic aneurysm repair was planned. The authors present a rare case of tertiary syphilis complicated with aortic aneurysm in this era of early use of highly effective antibiotics. PMID:24958987

Vasudevan, Biju; Verma, Rajesh; Pragasam, Vijendran; Nema, Shekar

2014-01-01

53

Custom-made titanium cranioplasty: early and late complications of 151 cranioplasties and review of the literature.  

PubMed

A diverse range of techniques is available for reconstruction of full-thickness calvarial defects and the optimum substrate for cranioplasty remains unproven. During a 9-year period, 149 patients underwent insertion of 151 custom-made titanium cranioplasties using the same technique. Data relating to patient demographics, indication for cranioplasty, and site and size of the defect were collected from the clinical records. Patients were followed up in all cases for a mean of 1 year 2 months (range 7 days to 8 years 8 months). Early complications requiring intervention were experienced in 7% and included seroma, haematoma, and continued bleeding necessitating implant removal in one patient. One death occurred at 3 days post-operation due to haemorrhagic stroke. Late self-limiting complications such as seroma were experienced in 19% of patients, however complete failure requiring implant removal was seen in only 4% of cases. Infection was the cause of failure in all cases. A comprehensive literature review was carried out and data abstracted to compare reported failure rates in other techniques of full-thickness cranial reconstruction. This review shows that custom-made patient-specific titanium cranioplasties compare very favourably to the other published techniques and remain a tried and tested option for reconstruction of all sizes of full-thickness calvarial defect. PMID:25482456

Williams, L R; Fan, K F; Bentley, R P

2015-05-01

54

Risk factors for early and late biliary complications in pediatric liver transplantation.  

PubMed

BC are a common source of morbidity after pediatric LT. Knowledge about risk factors may help to reduce their incidence. Retrospective analysis of BC in 116 pediatric patients (123 LT) (single institution, 05/1990-12/2011, medium follow-up 7.9 yr). One-, five-, and 10-yr survival was 91.1%, no patient died of BC. Prevalence and risk factors for anastomotic and intrahepatic BC were examined. There were 29 BC in 123 LT (23.6%), with three main categories: 10 (8.1%) primary anastomotic strictures, eight (6.5%) anastomotic leaks, and three (2.4%) intrahepatic strictures. Significant risk factors for anastomotic leaks were total operation time (increase 1.26-fold) and early HAT (<30 days post-LT; increase 5.87-fold). Risk factor for primary anastomotic stricture was duct-to-duct choledochal anastomosis (increase 5.96-fold when compared to biliary-enteric anastomosis). Risk factors for intrahepatic strictures were donor age >48 yr (increase 1.09-fold) and MELD score >30 (increase 1.2-fold). To avoid morbidity from anastomotic BC in pediatric LT, the preferred biliary anastomosis appears to be biliary-enteric. Operation time should be kept to a minimum, and HAT must by all means be prevented. Children with a high MELD score or receiving livers from older donors are at increased risk for intrahepatic strictures. PMID:25263826

Lüthold, Samuel C; Kaseje, Neema; Jannot, Anne-Sophie; Mentha, Gilles; Majno, Pietro; Toso, Christian; Belli, Dominique C; McLin, Valérie A; Wildhaber, Barbara E

2014-12-01

55

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

PubMed Central

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

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

2011-01-01

56

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

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.

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

57

Mitogen-Activated Protein Kinase Cascade Is Involved in Endothelin1Induced Rat Puerperal Uterine Contraction  

Microsoft Academic Search

The regulation of mitogen-activated protein (MAP) kinase by en- dothelin-1 (ET-1) in cultured rat puerperal uterine myometrial cells was investigated. ET-1 caused the rapid stimulation of MAP kinase activity. ET-1-induced MAP kinase activation is neither extracellular Ca21- nor intracellular Ca21-dependent. ET-1 stimulation also led to an increase in phosphorylation of son-of-sevenless (SOS), and trans- fection of dominant negative SOS attenuated

AKIKO KIMURA; MASAHIDE OHMICHI; TAKASHI TAKEDA; HIROHISA KURACHI; HIROMASA IKEGAMI; KOJI KOIKE; KANJI MASUHARA; JUN HAYAKAWA; TOHRU KANZAKI; MAMORU KOBAYASHI; MASUO AKABANE; MASAKI INOUE; AKIRA MIYAKE; YUJI MURATA

1999-01-01

58

Non-puerperal complete uterine inversion caused by malignant mixed mullerian tumour of the uterus  

Microsoft Academic Search

Non-puerperal uterine inversion is an extremely rare entity, which many gynaecologists would never come across in their lifetime.\\u000a Diagnosis can be difficult. Our patient was a 91-year-old lady who presented with profuse vaginal bleeding. Hysteroscopy was\\u000a unsuccessful as the cervix was completely replaced by a friable growth. A total abdominal hysterectomy and bilateral salpingo-oophorectomy\\u000a was planned as a palliative measure

A. Sinha; D. Sinha; M. Aslam; M. N. Fitzgibbon

2007-01-01

59

Postoperative Infectious Complications in Our Early Experience With Holmium Laser Enucleation of the Prostate for Benign Prostatic Hyperplasia  

PubMed Central

Purpose The objective of this study was to retrospectively investigate postoperative infectious complications (PICs) in our early experience with holmium laser enucleation of the prostate (HoLEP) followed by mechanical morcellation for symptomatic benign prostatic hyperplasia. Materials and Methods A retrospective review was performed of the clinical data for 90 consecutive patients who underwent HoLEP at our institution between February 2008 and March 2011. All patients were evaluated for the emergence of PICs, including prophylactic antibiotic administration (PAA) and the influence of the kind or duration of PAA on PIC. The details of cases with PICs were also examined. Results The patients' mean age was 71 years (range, 50 to 95 years), and their mean prostate volume was 60 mL (range, 2 to 250 mL). There were 7 cases (7.78%) with PICs; in detail, 3 patients were diagnosed with prostatitis, 2 with pyelonephritis, and 2 with epididymitis. Three patients had positive urine cultures: 1 had Serratia marcescens/Proteus mirabilis, 1 had S. marcescens, and 1 had Klebsiella pneumonia; only one case had urological sepsis. Our statistical data showed no significant differences between 2 or fewer days and 3 or more days of PAA and PIC occurrence. There was also no significant effect on PIC occurrence of sulbactam/ampicillin compared with other antibiotics. Conclusions The results of this retrospective study showed that PIC occurrence did not depend on the duration or the kind of PAA. Further prospective study is necessary for the evaluation and establishment of prophylactic measures for PICs. PMID:23526729

Tanaka, Kazushi; Haraguchi, Takahiro; Yamamichi, Fukashi; Muramaki, Mototsugu; Miyake, Hideaki; Fujisawa, Masato

2013-01-01

60

Clinical, bacteriological, and histopathological study of toxic puerperal metritis in Iraqi buffalo.  

PubMed

Data were collected from 42 buffalo with toxic puerperal metritis in 2 large herds, with a history of dystocia, prolapse, and retained placenta. All buffalo were subjected to detailed clinical examination including external inspection, vaginoscopy, and transrectal palpation of the cervix, uterus, and ovaries. Swabs for bacteriology and biopsies for histopathology were collected from the uterine lumen from each cow. Character, odor, and estimation of polymorphonuclear cells of the vaginal mucus were scored. Blood samples were collected from cows for creatine kinase and aspartate amino-transferase measurement. The most predisposing factor causing toxic puerperal metritis was retained placenta (52.4%), and the most prevalent bacteria in uterine lumen were Escherichia coli, Arcanobacterium pyogenes, Staphylococcus aureus, and Fusobacterium necrophorum (18.5, 16.7, 13.0, and 9.3%, respectively). High levels of polymorphonuclear cells were observed in buffalo infected with A. pyogenes and gram-negative anaerobic bacteria (62.1 and 76.4%). A high prevalence of gram-negative anaerobes was isolated from uteri harboring A. pyogenes (13.0%). Buffalo with toxic puerperal metritis had significantly higher creatine kinase and aspartate aminotransferase activities than controls (499.2 +/- 23.9 and 208.3 +/- 11.3 vs. 242.7 +/- 12.9 and 166.8 +/- 11.5 U/L, respectively). In a conclusion, gram-negative anaerobes and other facultative pathogens including A. pyogenes were important pathogens that cause severe uterine inflammation. PMID:17881686

Azawi, O I; Omran, S N; Hadad, J J

2007-10-01

61

Protein Z G79A Polymorphism and Puerperal Cerebral Venous Thrombosis.  

PubMed

Protein Z (PZ), a cofactor for PZ-dependent protease inhibitor, is known to play an important role in inhibiting the coagulation cascade. The aim of the study was to investigate whether PZ G79A polymorphism is a risk factor for puerperal cerebral venous thrombosis (CVT). A total of 71 patients with puerperal CVT and 98 healthy controls were genotyped for PZ 79GA polymorphism by polymerase chain reaction-restriction fragment length polymorphism method. In patients, the genotype distribution for GG, GA, and AA genotypes was 22.5%, 43.7%, and 33.8%, and in controls, 25.5%, 40.8%, and 33.7%, respectively. The risk associated with carrying the mutant genotype (GA and AA) versus the wild GG genotype was found to be 1.11 (95% confidence interval: 0.52-2.35; P = .909). There was no significant difference in the clinical features of the patients with and without the polymorphism. We therefore conclude that PZ G79A polymorphism is not a risk factor for puerperal CVT in Indian women. PMID:24907135

Yadav, Dharmendrasinh Dhansingh; De, Tanima; Nagaraja, Dindagur; Christopher, Rita

2014-06-01

62

Rare complication of ventriculoperitoneal shunt. Early onset of distal catheter migration into scrotum in an adult male: Case report and literature review  

PubMed Central

Introduction The role of shunt placement is to divert cerebrospinal fluid from within the ventricles to an alternative location in the setting of hydrocephalus. One of the rare shunt complications is distal catheter migration, and various body sites have been reported, including the scrotum. Although cases of scrotal migration of distal catheter have been reported in pediatric patients, cases in adult patients are rare due to obliterated processus vaginalis. Furthermore, there has not been a case reported for scrotal migration in an adult at an early onset. Presentation of case 65-year-old male underwent shunt placement for normal-pressure hydrocephalus-like symptoms. On post-operative day seven patient developed right testicular edema, for which ultrasound was performed, revealing hydrocele along with the presence of distal catheter in the scrotum. On post-operative day nine patient underwent distal catheter trimming via laparoscopic approach with general surgery, with post-operative imaging showing satisfactory location of distal catheter in the peritoneal cavity. Discussion/Conclusion Early onset of distal catheter migration into scrotum in an adult male is a unique case, as most cases are reported in pediatric patients, and it is the first case reported in the English literature to have occurrence at an early onset during the peri-operative period. As our case demonstrates, early occurrence and detection of scrotal migration of the distal catheter prevent shunt malfunction. Prompt surgical management of catheter repositioning is therefore recommended to avoid the risk of further complications. PMID:25553524

Lee, Bryan S.; Vadera, Sumeet; Gonzalez-Martinez, Jorge A.

2014-01-01

63

Plasma factor VIII in non-puerperal cerebral venous thrombosis: a prospective case-control study.  

PubMed

Elevated plasma factor VIII (FVIII) is increasingly recognized as an independent risk factor for thrombotic diseases. Our aim was to evaluate the association of increased plasma FVIII with cerebral venous thrombosis (CVT). Forty eight patients with non-puerperal, aseptic CVT were recruited for the study along with 50 age- and gender-matched, healthy controls. Blood samples were collected 3 months after the thrombotic event in patients. Plasma FVIII and fibrinogen levels were measured by a functional clot-based assay. Mean plasma FVIII was significantly higher in patients when compared to controls (235.40 ± 94.5 vs.121.2 ± 28.3IU/dl, p<0.001). Absence of significant elevation of fibrinogen suggested that the increase in FVIII was not due to an acute phase reaction. Elevated FVIII (>170 IU/dl) was associated with >18-fold increase in the risk for non-puerperal CVT (adjusted OR: 18.754, 95% CI 10.2-203.0, p<0.001). Non-O blood groups were more prevalent in CVT patients. Mean FVIII levels were higher in subjects with non-O blood group as compared to those with O blood group (155.16 ± 46.05 vs. 129.09 ± 40.06 IU/dl, p<0.001). Multivariate analysis with logistic regression showed that only elevated FVIII, and not blood group, was significantly associated with CVT. Our study demonstrates that elevated FVIII is an independent risk factor for non-puerperal CVT in an Indian population. PMID:24560376

Anadure, Ravi K; Nagaraja, Dindagur; Christopher, Rita

2014-04-15

64

Comparison of Propofol and Ketamine versus Propofol and Fentanyl for Puerperal Sterilization, A Randomized Clinical Trial  

PubMed Central

Background: Puerperal sterilization requires a rapid recovery of the mother so that she can take care of her child. Propofol with fentanyl (PF) is an option, but is associated with intraoperative hypotension, respiratory depression and an unsatisfactory postoperative recovery profile. Propofol with ketamine (PK) appears to be an alternative in terms of haemodynamic stability and analgesia. Materials and Methods: This randomized clinical trial involved 60 patients who were scheduled to undergo puerperal sterilization, who belonged to American society of anaesthesiologists (ASA) physical status 1. Patients were randomly allocated to receive either ketamine – propofol infusion in a concentration of 8mg/ml each (group PK) or fentanyl 2?g/kg intravenously, followed by an infusion of propofol in a concentration of 8mg/ml (group PF). In both the groups, the infusion was started at 300ml/hr till patient lost consciousness. Subsequently, the rate was set at 1.5ml/kg/hr for group PF and at 0.75ml/kg/hr for group PK. After the initial 10 minutes, the infusion rate was reduced to 1ml/kg/hr for group PF and to 0.5ml/kg/hr for group PK. Blood pressure and saturation were the primary outcomes which were measured. Results: Patients from group PF recorded a significant drop in the systolic blood pressure from the 5th minute, in diastolic pressure from the 10th minute and transient oxygen desaturation, as compared to group PK. Patients in group PK had adequate surgical conditions and better recovery profiles in terms of pain and sedation. Conclusion: The combination of ketamine and propofol is a safe and possibly superior alternative to propofol – fentanyl combination in patients who undergo puerperal sterilization, in terms of haemodynamic stability and respiratory depression. PMID:24995191

Cherian, Anusha; Balachander, Hemavathi; Kumar C, Yashavantha

2014-01-01

65

Leflunomide increases the risk of early healing complications in patients with rheumatoid arthritis undergoing elective orthopedic surgery  

Microsoft Academic Search

The aim of this object is to study whether treatment with biological or leflunomide increases the risk of wound-healing complications after elective orthopedic surgery. Between March 2002 and September 2003, 201 patients participated in this study with the following inclusion criteria: (a) Rheumatoid arthritis (RA) or psoriatic arthritis (psA), (b) therapy with: MTX, leflunomide, etanercept, infliximab, adalimumab, anakinra, (c) undergoing

Martin Fuerst; Henrike Möhl; Kerstin Baumgärtel; Wolfgang Rüther

2006-01-01

66

Appendicostomy in Preschool Children with Anorectal Malformation: Successful Early Bowel Management with a High Frequency of Minor Complications  

PubMed Central

Aim. The aim of this study is to evaluate postoperatively bowel symptoms of antegrade colon enema through appendicostomies in preschool children with anorectal malformation (ARM). Method. 164 children with ARM operated on with posterior sagittal anorectal plasty were included. The malformations were classified according to Krickenbeck classification. Seventeen children in preschool age had an appendicostomy. The bowel symptoms according to the Krickenbeck follow-up were analysed pre- and postoperatively. All complications were registered. A questionnaire on the use of the appendicostomy was answered. Results. The median age (range) at the time of the appendicostomy was 4 (1–6) years. The observation time was 5 (0.5–14) years. The main indications for appendicostomy were incontinence and noncompliance to rectal enemas. Postoperatively there was a significant decrease in soiling and constipation (P < 0.001). The total complication rate was 43% with infections (29%), stenosis (12%), and retrograde leakage (0). The median time required for giving enema in the appendicostomy was 45 minutes (range: 15–120) once a day varying from 2 times/week to 3 times/day. And: complications are less frequent than in older children. Conclusion. Appendicostomy in preschool children with ARM is a way to achieve fecal cleanness before school start. The infection rate was high, but other complications are less frequent than in older children. PMID:24175287

Granéli, Christina; Salö, Martin; Arnbjörnsson, Einar

2013-01-01

67

Non Puerperal Uterine Inversion in A Young Female- A Case Report  

PubMed Central

We report a case of 28-year-old, primipara who presented with complaints of mass descending per vaginum along with excessive bleeding and foul smelling vaginal discharge for the past six months. Clinical examination revealed an inverted uterus, cervix and vagina with a large submucosal fundal fibroid. A diagnosis of non-puerperal uterine inversion was made. Surgical management included vaginal myomectomy with repositioning of the uterus using an abdomino-vaginal approach and a successful outcome. Histopathology confirmed the diagnosis of leiomyoma. Hence, we conclude that uterus-sparing surgery should be considered in young females desirous for future pregnancy until the final pathology is known. PMID:25386493

Samal, Sunil Kumar; Pallavee, P; Ghose, Seetesh

2014-01-01

68

Is photodynamic therapy a selective treatment? Analysis of local complications after endoscopic photodynamic therapy of early stage tumors of gastrointestinal, tracheobronchial, and urinary tracts  

NASA Astrophysics Data System (ADS)

Selectivity is the most emphasized advantage of photodynamic therapy (PDT). However, at drug and light doses used for clinical applications, response from normal tissue surrounding the tumor reduces the real selectivity of the drug-light system and increases the surface of the area responding to the treatment. It is now evident that light irradiation of a sensitized patient produces damage at a various degree not only in the tumor but also in non-neoplastic tissues included in the field of irradiation. We report our experience in endoscopic PDT of early stage tumors in tracheobronchial, gastrointestinal and urinary tracts, describing early and late local complications caused by the damage of normal tissues adjacent to the tumors and included in the field of light irradiation. Among 44 patients treated, local complications, attributable to a poor selectivity of the modality, occurred in 6 patients (14%). In particular, the rate of local complications was 9% in patients treated for esophageal tumors, 14% in patients with gastric tumors, 9% in patients with tracheobronchial tumors, and 67% in bladder cancer patients. Clinical pictures as well as endoscopic findings at various intervals from treatment showed that mucositis is a common event following endoscopic PDT. It causes exudation and significant tissue inflammatory response, whose consequences are different in the various organs treated. Photoradiation must be, as much as possible, limited to the malignant area.

Spinelli, Pasquale; Dal Fante, Marco; Mancini, Andrea

1995-03-01

69

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

PubMed Central

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

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

2015-01-01

70

Early Appropriate Parenteral Antimicrobial Treatment of Complicated Skin and Soft Tissue Infections Caused by Methicillin-Resistant Staphylococcus aureus  

Microsoft Academic Search

Background: Complicated skin and soft tissue infections (cSSTIs) are a major clinical problem, in part because of the increasing resistance of infecting bacteria to our current antibiotic therapies. Prompt appropriate treat- ment of infections in hospitalized patients reduces the mortality rate. Furthermore, appropriate and timely an- tibiotic therapy improves outcomes for cSSTIs caused by methicillin-resistant Staphylococcus aureus (MRSA). This review

Lena M. Napolitano

2008-01-01

71

Effect of soil-plant-animal mineral interactions in the genesis of puerperal haemoglobinuria in dairy animals  

E-print Network

Effect of soil-plant-animal mineral interactions in the genesis of puerperal haemoglobinuria. The present study was conducted to monitor the mineral alterations in plasma vis-a-vis their relationship with mineral status of soils and plants in disease prone areas of the Punjab State. Blood samples from clinical

Paris-Sud XI, Université de

72

An unusual presentation of a submucous leiomyoma accounting to a non-puerperal uterine inversion: A case report  

PubMed Central

Non-puerperal uterine inversion is an extremely rare gynaecological event that is usually associated with uterine tumours such as submucous or cervical leiomyomas. In this report, we describe a case of uterine inversion due to a large submucous leiomyoma in a 42-year-old multiparous and obese Caucasian woman. PMID:24592087

Atalay, Mehmet Aral; Demir, Bilge Çetinkaya; Solak, Ne?e; Atalay, Fatma Oz; Küçükkömürcü, ?akir

2013-01-01

73

Determination of ceftiofur derivatives in serum, endometrial tissue, and lochia in puerperal dairy cows with fever or acute puerperal metritis after subcutaneous administration of ceftiofur crystalline free acid.  

PubMed

Acute puerperal metritis (APM) is one of the most common diseases during the puerperal period. Systemic administration of ceftiofur for 5 consecutive days has been shown to be effective for treatment of APM. The objective of this study was to determine concentrations of ceftiofur derivatives in serum, endometrial tissue, and lochia of cows with fever postpartum or APM 4 to 6d after treatment with a single subcutaneous dose of 6.6 mg of ceftiofur crystalline free acid (CCFA)/kg of estimated BW at the base of the ear. In the first experiment, samples from CCFA-treated cows with fever postpartum or APM (n=42) were taken on d 4, 5, or 6 after treatment. Concentrations of ceftiofur derivatives were quantified using an HPLC assay. Concentrations of active ceftiofur metabolite desfuroylceftiofuracetamide (DCA) were greatest at d 4 after treatment with CCFA in all samples, but they were considerably lower than the concentrations of DCA in healthy postpartum cows treated with the same dose of CCFA. The concentrations of DCA in serum, endometrial tissue, and lochia were affected by odor of vaginal discharge before treatment with CCFA. Mean concentrations of DCA could be detected above the reported minimal drug concentrations (minimum inhibitory concentrations, MIC) required to inhibit relevant pathogens such as Escherichia coli and Arcanobacterium pyogenes in serum on all days and in endometrial tissue and lochia only on d 4 in CCFA-treated cows with fetid vaginal discharge before treatment. In the second experiment, samples from CCFA-treated cows with APM (n=8) were taken on d 0 (before treatment) and d 4, 5, and 6 after treatment. Mean concentrations of DCA in serum and lochia were similar on d 4 to 6 in both laboratories. Furthermore, determined concentrations of DCA from both laboratories were correlated for serum and lochia. Mean concentrations of DCA could be detected above the reported MIC in serum and lochia only on d 4. Our 2 experiments demonstrated that in postpartum cows with fever postpartum or APM concentrations above the MIC for relevant bacteria (>0.5 ?g/mL or >0.5 ?g/g) of DCA could be sustained only for 4 (serum: 15/17; endometrial tissue: 2/17; lochia: 1/16) to 5d (serum: 10/13; endometrial tissue: 1/13; lochia: 2/12) after a single treatment with CCFA only in a certain proportion of cows. Overall, our data provide first pharmacological evidence that a single subcutaneous administration of 6.6g of CCFA/kg of BW might not be sufficient to efficaciously treat APM in postpartum dairy cows. PMID:23261383

von Krueger, X; Scherpenisse, P; Roiger, S; Heuwieser, W

2013-02-01

74

Early assessment of heart rate variability is predictive of in-hospital death and major complications after acute myocardial infarction  

Microsoft Academic Search

Background: Depressed heart rate variability at acute myocardial infarction discharge is associated with poor long-term prognosis. However, its early (<48 h) predictive value has not been extensively investigated. Aim of this Multicenter Italian Study was to investigate, during acute myocardial infarction, in-hospital prognostic value of heart rate variability and its short-term evolution. Methods: Twenty-four hour ECG monitoring was prospectively obtained

Clara Carpeggiani; Antonio L'Abbate; Patrizia Landi; Claudio Michelassi; Mauro Raciti; Alberto Macerata; Michele Emdin

2004-01-01

75

Pregnancy Complications  

MedlinePLUS

... Emergency Preparedness and Response Pregnant Women and Flu Pregnancy Complications On this Page Before Pregnancy During Pregnancy ... to decrease the risk of pregnancy complications. Before Pregnancy Make sure to talk to your doctor about ...

76

[Acute respiratory distress syndrome complicating an acute chest syndrome: potential benefit of early combination of exchange transfusion and prone positioning].  

PubMed

We report the case of an 8-year-old sickle cell anemia child admitted for acute respiratory failure complicating acute chest syndrome. Because of threatening respiratory failure, tracheal intubation was performed immediately after ICU admission. The patient met the criteria for ARDS with a PaO2/FiO2 ratio of 94mmHg. An exchange transfusion was performed immediately after admission. HbS fraction failed from 69 % to 30 %. Fluid resuscitation with crystalloids and continuous norepinephrine infusion was needed because of arterial hypotension. Due to persistent severe hypoxemia with PaO2/FiO2 ratio below 100, the patient was placed in prone positioning 16hours after admission, for a total duration of 14hours. A second 12-hour session of prone positioning was performed 41h after admission and PaO2/FiO2 ratio reached 300mmHg after. Treatment also included transfusion of two red-cell pack on day 1 and 2 after admission in order to maintain hemoglobin level above 8g/dL, and a daily folic acid supplementation. The control of hyperthermia was achieved by a systematic parenteral administration of paracetamol. Cefotaxime and erythromycine were continued until day 7 despite the negative results of all bacteriological samples. The outcome was favorable from day 3 and the patient met the criteria for extubation on day 5. A first attempt of extubation was performed on day 5, but re-intubation was required because of laryngeal edema. Steroids were given for 48h and the patient was successfully extubated on day 7. She was discharged from the ICU on day 8, and from the hospital on day 12. We discuss the various treatments available for the management of acute chest syndrome and their actual relevance in acute respiratory distress syndrome in the absence of strong evidence-based guidelines in pediatric ARDS. PMID:25458459

Dusacre, J-A; Pons, B; Piednoir, P; Soubirou, J-F; Thiery, G

2014-12-01

77

Uterus Preserving Reposition of Non-Puerperal Uterine Inversion under Laparoscope: A Case Report and Literature Review.  

PubMed

Non-puerperal uterine inversion is a rare clinical condition. Surgical procedures described in literature were mostly repositioning of the uterus followed by hysterectomy and laparotomy. In this paper, we reported a case of successful uterus preserving reposition of non-puerperal uterine inversion under laparoscopy. The patient, a 34-year-old, was presented with irregular vaginal bleeding with a mass protruding. On laparoscopy, the anterior wall of the uterus was opened longitudinally to release the thick ring of cervical tissue. The uterus was then repositioned and the anterior wall of the uterus was closed by stitches with two layers. Antibiotics was used for 6 days to prevent infection. The patient recovered well and retrieved menstruation 1 month after surgery. © 2015 S. Karger AG, Basel. PMID:25634558

Zhang, Xuyin; Sun, Li; Chen, Xiaojun; Hua, Keqin

2015-01-01

78

Pregnancy Complications  

MedlinePLUS

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

79

Ocular complications of diabetes mellitus  

PubMed Central

Diabetes mellitus (DM) is a important health problem that induces ernestful complications and it causes significant morbidity owing to specific microvascular complications such as, retinopathy, nephropathy and neuropathy, and macrovascular complications such as, ischaemic heart disease, and peripheral vasculopathy. It can affect children, young people and adults and is becoming more common. Ocular complications associated with DM are progressive and rapidly becoming the world’s most significant cause of morbidity and are preventable with early detection and timely treatment. This review provides an overview of five main ocular complications associated with DM, diabetic retinopathy and papillopathy, cataract, glaucoma, and ocular surface diseases. PMID:25685281

Sayin, Nihat; Kara, Necip; Pekel, Gökhan

2015-01-01

80

Comparative Microbial Analysis of Paired Amniotic Fluid and Cord Blood from Pregnancies Complicated by Preterm Birth and Early-Onset Neonatal Sepsis  

PubMed Central

Background 16S rRNA-based genomic analyses have revolutionized our understanding of infectious diseases. Many cases which were recognized as “idiopathic” are now known to have an infectious etiology. Here, we present a proof-of-concept study to examine the microbial link between intra-amniotic infection (IAI) and early-onset neonatal sepsis (EONS). Results Using culture independent methods, we analyzed paired amniotic fluid (AF) and cord blood (CB) samples from 36 singleton pregnancies complicated by preterm birth (PTB), IAI, and/or EONS. PTB cases were grouped as 1) Group 1– neonatal blood culture-positive EONS (n?=?6). 2) Group 2– neonatal blood culture-negative presumed EONS with positive IAI (n?=?16). 3) Group 3– neonatal blood culture-negative presumed EONS with no IAI (n?=?7); 4) Group 4– no EONS or IAI (n?=?7). In addition, samples from term healthy deliveries (n?=?8) served as technical controls. A total of 31 species (15 non-redundant) were identified in AF, of which only 1/3 were cultivated. Significantly fewer microorganisms were detected in CB, with a total of 18 species (7 non-redundant) identified, of which only 2 (Escherichia coli, Streptococcus agalactiae) were cultivated. Of those, Bergeyella, Fusobacterium nucleatum, and Sneathia sanguinegens had not been detected in EONS before. The novel species identified in AF by PCR include Peptoniphilus harei and Lachnospiraceae sp. The majority (72%) of CB species were also detected in the matching AF, with E. coli and F. nucleatum as the most prevalent. The 16S rRNA sequences of paired AF and CB were 99.9–100% identical, while no identical sequences were found between different pregnancies. Conclusions Previously unrecognized, uncultivated or difficult-to-cultivate species are implicated in EONS. Microbial species in paired AF and CB likely share the same infectious origin. Given its prevalence in EONS, F. nucleatum should be placed on the same importance scale as E. coli. PMID:23437088

Wang, Xiaowei; Buhimschi, Catalin S.; Temoin, Stephanie; Bhandari, Vineet; Han, Yiping W.; Buhimschi, Irina A.

2013-01-01

81

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

PubMed Central

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

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

2012-01-01

82

Introduction Complications  

E-print Network

Rapidity Gaps Between Jets Matthew Beckingham DIS 2002, Cracow 30 April ­ 4 May 2002 Contents: . Introduction . Complications and Gap Definition . Models . Dijet Cross sections . Gap Fractions #12; Rapidity Gaps Between Jets, Matthew Beckingham Rapidity Gaps Between Jets Dh t g e e' x p x g w jet jet P

83

[Orbital complications of sinusitis].  

PubMed

Orbital complications categorised by Chandler are emergency. They need early diagnosis and agresive treatment. Stage and origin of orbital complications are identified by rhinoendoscopy, ophtalmologic examination and CT of orbite and paranasal sinuses. Periorbital cellulitis and early stage of orbital cellulitis can be treated conservatively with i. v. antibiotics. Monitoring of laboratory parameters and ophtalmologic symptoms is mandatory. Lack of improvement or worsening of symptoms within 24-48 hours and advanced stages of orbital complications are indicated for surgery. The purpose of the study is to evaluate epidemiology, clinical features and management of sinogenic orbital complications. Retrospective data of 8 patients with suspicion of orbital complication admited to hospital from 2008 to 2013 were evaluated. Patients were analyzed in terms of gender, age, CT findings, microbiology, clinical features, stage and treatment. Male and female were afected in rate 1,66:1. Most of patients were young adult in 3rd. and 4th. decade of life (62,5 %). Acute and chronic sinusitis were cause of orbital complication in the same rate. The most common origin of orbital complication was ethmoiditis (62,5 %), than maxillary (25 %) and frontal (12,5 %) sinusitis. Polysinusitis with affection of ethmoidal, maxillary and frontal sinuses (75 %) was usual CT finding. Staphylococcus epidermidis and Staphylococcus aureus were etiological agens in half of cases. Periorbital oedema (100 %), proptosis, chemosis (50 %), diplopia and glaucoma (12,5 %) were observed. Based on examinations, diagnosis of periorbital oedema/preseptal cellulitis was made in 3 (37,5 %), orbital cellulitis in 3 (37,5 %) and subperiosteal abscess in 2 cases (25 %). All patients underwent combined therapy - i. v. antibiotics and surgery within 24 hours. Eradication of disease from ostiomeatal complex (OMC), drainage of affected sinuses and drainage of subperiosteal abscess were done via fuctional endonasal endoscopic surgery (FEES). In case of superior subperiosteal abscess, combined endonasal and external approach (external orbitotomy) was needed. Combined therapy facilitated quick improvement of local and systematic symptoms. Average time of hospitalisation was 7 days. Early diagnosis and agresive combined therapy prevent loss of vision and life threatening complications. PMID:25640234

Šucha?, M; Hor?ák, M; Kaliarik, L; Krempaská, S; Koštialová, T; Kova?, J

2014-12-01

84

Diagnosis of acute puerperal metritis by electronic nose device analysis of vaginal discharge in dairy cows.  

PubMed

The objective of this study was to estimate the diagnostic accuracy of an electronic nose device using vaginal discharge samples to diagnose acute puerperal metritis (APM) in dairy cows. Uterine fluid was sampled manually with a gloved hand and under sterile conditions for electronic nose device analysis (day in milk (DIM) 2, 5, and 10) and bacteriologic examination (DIM 5), respectively, and on additional days, if APM was diagnosed during the daily clinical examinations. A dataset containing samples from 70 cows was used to create a model and to validate the APM status predicted by this model, respectively. Half of the dataset (n = 35; 14 healthy and 21 metritic cows) was provided with information regarding the APM diagnosis and contained all three measurements (DIM 2, 5, and 10) for each cow and was used as a training set whereas the second half was blinded (n = 35; 14 healthy and 21 metritic cows) and contained only the samples collected on DIM 5 of each cow and was used to validate the created prediction model. A receiver operating characteristic curve was calculated using the prediction results of the validation test. The best observed sensitivity was 100% with specificity of 91.6% when using a threshold value of 0.3. The calculated P-value for the receiver operating characteristic curve was less than 0.01. Overall, Escherichia coli was isolated in eight of 28 (28.6%) and 22 of 42 (52.4%) samples collected from healthy and metritic cows, respectively. Trueperella pyogenes and Fusobacterium necrophorum were isolated in 14 and six of 28 (50.0% and 21.4%) and 17 and 16 of 42 (40.5% and 38.1%) samples collected from healthy and metritic cows, respectively. The prevalence of Escherichia coli and Trueperella pyogenes was similar in the samples obtained from metritic cows used for the training set and the validation test. The results are promising especially because of the objective nature of the measurements obtained by the electronic nose device. PMID:24746098

Burfeind, O; Bruins, M; Bos, A; Sannmann, I; Voigtsberger, R; Heuwieser, W

2014-07-01

85

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

PubMed Central

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

2014-01-01

86

Hypoglycemia: The neglected complication  

PubMed Central

Hypoglycemia is an important complication of glucose-lowering therapy in patients with diabetes mellitus. Attempts made at intensive glycemic control invariably increases the risk of hypoglycemia. A six-fold increase in deaths due to diabetes has been attributed to patients experiencing severe hypoglycemia in comparison to those not experiencing severe hypoglycemia Repeated episodes of hypoglycemia can lead to impairment of the counter-regulatory system with the potential for development of hypoglycemia unawareness. The short- and long-term complications of diabetes related hypoglycemia include precipitation of acute cerebrovascular disease, myocardial infarction, neurocognitive dysfunction, retinal cell death and loss of vision in addition to health-related quality of life issues pertaining to sleep, driving, employment, recreational activities involving exercise and travel. There is an urgent need to examine the clinical spectrum and burden of hypoglycemia so that adequate control measures can be implemented against this neglected life-threatening complication. Early recognition of hypoglycemia risk factors, self-monitoring of blood glucose, selection of appropriate treatment regimens with minimal or no risk of hypoglycemia and appropriate educational programs for healthcare professionals and patients with diabetes are the major ways forward to maintain good glycemic control, minimize the risk of hypoglycemia and thereby prevent long-term complications. PMID:24083163

Kalra, Sanjay; Mukherjee, Jagat Jyoti; Venkataraman, Subramanium; Bantwal, Ganapathi; Shaikh, Shehla; Saboo, Banshi; Das, Ashok Kumar; Ramachandran, Ambady

2013-01-01

87

Benzoyl-L-arginine methyl ester (BAME)-esterase activity in human plasma during the gravidic-puerperal cycle.  

PubMed

Benzoyl-L-arginine methyl ester (BAME)-esterase activity of plasma was measured in women going through the gravidic-puerperal cycle and compared with plasma of non-pregnant women. Plasma from women in the 36th to 40th week of pregnancy hydrolyzes BAME two times more rapidly than that from non-pregnant women. During pregnancy, BAME-esterase activity in plasma increases progressively up to the 40th week, decreases during labor, and after delivery reaches the same level as in non-pregnant women. The BAME-esterase activity of plasma was affected by the storage temperature, with differences demonstrable between -20 and -4 C and between pregnant and non-pregnant women. PMID:754510

Salles Meirelles, R

1977-01-01

88

Puerperal Mastitis: a Reproductive Event of Importance Affecting Anti-Mucin Antibody Levels and Ovarian Cancer Risk  

PubMed Central

Purpose Test the hypothesis that puerperal mastitis may alter immunity related to the mucin (MUC) family of glycoproteins and lower risk for ovarian cancer. Methods In two case-control studies conducted in New England between 1998–2008, we examined the association between self-reported mastitis and ovarian cancer in 1,483 women with epithelial ovarian cancer and 1,578 controls. IgG1 antibodies against (MUC1) CA15.3 and (MUC16) CA125 were measured using electrochemiluminescence assays in a subset of controls (n=200). Preoperative CA125 was recorded in 649 cases. The association between ovarian cancer and mastitis was assessed using unconditional logistic regression to calculate adjusted odds ratios, OR, and 95% confidence intervals (CI). Associations between mastitis and anti-CA15.3 and anti-CA125 antibodies and preoperative CA125 levels were evaluated using adjusted linear regression models. Results Prior mastitis was associated with a significantly lower risk for ovarian cancer: OR (and 95% CI) of 0.67 (0.48, 0.94) adjusted for parity, breastfeeding, and other potential confounders. The association was strongest with 2 or more episodes of mastitis; and risk declined progressively with increasing number of children and episodes of mastitis. Among controls, prior mastitis was associated with significantly higher anti-CA15.3 and anti-CA125 antibody levels and, among cases, with significantly lower preoperative CA125 levels. Conclusion Puerperal that mastitis may produce long-lasting anti-mucin antibodies that may lower the risk for ovarian cancer, plausibly through enhanced immune surveillance. Studying immune reactions related to MUC1 and MUC16 in the 10–20% of breastfeeding women who develop mastitis may suggest ways to duplicate its effects through vaccines based on both antigens. PMID:23925696

Cramer, Daniel W.; Williams, Kristina; Vitonis, Allison F.; Yamamoto, Hidemi S.; Stuebe, Alison; Welch, William R.; Titus, Linda; Fichorova, Raina N.

2013-01-01

89

Proinflammatory cytokines and their role in the development of major transplant-related complications in the early phase after allogeneic bone marrow transplantation  

Microsoft Academic Search

Serum levels of interleukin-6 (IL-6), interleukin-8 (IL-8) and tumor necrosis factor (TNF)-alpha were frequently measured during the first 30 days after allogeneic bone marrow transplantation (BMT) in 84 consecutive adult patients. Major transplant-related complications (MTCs) occurred in 33% of cases and included veno-occlusive liver disease, idiopathic pneumonia syndrome, severe endothelial leakage syndrome and >grade II acute graft-versus-host disease. Compared with

R Schots; L Kaufman; I Van Riet; T Ben Othman; M De Waele; B Van Camp; C Demanet

2003-01-01

90

Pregnancy Complications: Gonorrhea  

MedlinePLUS

... in the community. Home > Pregnancy > Pregnancy Complications > Gonorrhea Pregnancy complications Pregnancy complications may need special medical care. ... the United States. Can gonorrhea cause complications during pregnancy and for your baby? Yes. Gonorrhea can lead ...

91

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

PubMed Central

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

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

2014-01-01

92

Pregnancy Complications/Health Problems Complication Explanation  

E-print Network

1 Pregnancy Complications/Health Problems Complication Explanation Preterm Labor Labor that starts and uterine tenderness. Gestational Diabetes Pregnancy induced high blood sugar. Diabetes that begins in pregnancy and goes away after delivery. Preeclampsia (hypertension) Pregnancy induced high blood pressure

Stromswold, Karin

93

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

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

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

2013-01-01

94

Pregnancy Complications: Syphilis  

MedlinePLUS

... in the community. Home > Pregnancy > Pregnancy Complications > Syphilis Pregnancy complications Pregnancy complications may need special medical care. ... syphilis each year. Can syphilis cause problems during pregnancy and for your baby? Yes. You can pass ...

95

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 ...

96

Pregnancy Complications: HELLP Syndrome  

MedlinePLUS

... the community. Home > Pregnancy > Pregnancy Complications > HELLP syndrome Pregnancy complications Pregnancy complications may need special medical care. ... to get pregnant again. Are gallstones common during pregnancy? Not common, but they do happen. Elevated hormones ...

97

Complications of Endovascular Repair of Abdominal Aortic Aneurysms: A Review  

SciTech Connect

The endovascular procedure for repair of abdominal aortic aneurysms has had an enormous impact on the treatment of this challenging disease. Complications, however, do occur and it is important to have a thorough understanding of the array of complications and appropriate management strategies. In this review of endovascular complications, we describe early and late complications paying particular attention to preventive, treatment and surveillance strategies.

Katzen, Barry T. [Baptist Cardiac and Vascular Institute, Baptist Health Systems, Department of Interventional Radiology, Florida (United States)], E-mail: barryk@baptisthealth.net; MacLean, Alexandra A. [New York Hospital-Queens, Department of Surgery (United States)

2006-12-15

98

[Complications of permanent cardiac pacing].  

PubMed

The implantation of a pacemaker is an everyday medical procedure. New indications are under evaluation. However, it should be recalled that this is a surgical intervention with implantation of a prosthesis with possible complications. This should, therefore, be a considered decision. There are early complications which occur in the first 6 weeks after implantation. Their incidence is underestimated (up to 7%) as is their seriousness. There are late complications. Some are responsible for pacemaker dysfunction, the risk of which is proportional to the dependence of the patient on permanent cardiac pacing. The migration of a pacing catheter or the fracture of an Accufix catheter expose the patient to much greater risk. Venous complications are overlooked as they are usually asymptomatic. The superior vena cava syndrome is, however, a serious complication of cardiac pacing. Two recent studies (MOST and DAVID) underline the deleterious haemodynamic effects of unnecessary right ventricular pacing. This right ventricular pacing may have a pro-arrhythmic effect on the ventricles and be responsible for sudden death. It may also cause atrial arrhythmia even if atrio-ventricular synchronisation is preserved. Infectious complications are also under-reported, partially because of the difficulty of diagnosis. They may be life-threatening and require extraction of the implanted material. In conclusion, it is wrong to think that even if a patient does not benefit from his implanted device this cannot have deleterious consequences. Pacemakers should be adjusted especially to avoid inappropriate right ventricular stimulation. PMID:15272521

Klug, D; Marquié, C; Lacroix, D; Kacet, S

2003-12-01

99

Bilateral Compartment Syndrome Complicating Prolonged Lithotomy Position  

Microsoft Academic Search

Summary A case of bilateral compartment syndrome after prolonged Lloyd-Davies lithotomy position is described. The diagnosis was made early, despite effective extradural bupivacaine- fentanyl analgesia. The aetiology, diagnosis, pathology and treatment of compartment syn- drome are described. Complications of the syndrome may be life-threatening and perma- nently disabling. The anaesthetist should be aware of the potential complications of the operative

J. TUCKEY

1997-01-01

100

[Surgical complications in kidney transplantation].  

PubMed

Kidney transplantation has become the treatment of choice for patients with end stage renal disease since it offers an excellent quality of life. Moreover, the economic impact is considerable, particularly beyond the first year. Indeed, the annual cost of a successful renal transplantation is ten fold lower than haemodialysis. But surgical complications remain one of our main concerns. Surgical complications are various. They may be non-specific as haematomas, incision-induced hernias and wound infections. They may also be directly related to the procedure as vascular thrombosis and urinary fistula in the early postoperative period or arterial stenosis and ureteral obstruction in the late post-operative period. The accurate diagnosis and the appropriate management of these complications are the most important tasks for the surgical team. This review is based upon our experience in kidney transplantation and upon the medical published data. PMID:18457318

Karam, G; Maillet, F; Braud, G; Battisti, S; Hétet, J F; Glémain, P; Le Normand, L; Bouchot, O; Rigaud, J

2007-12-01

101

Severe complications of herpes zoster.  

PubMed

The usual presentation of herpes zoster is as a self-limiting vesicular rash, often accompanied by post-herpetic neuralgia (PHN), its most common complication. However, herpes zoster can give rise to other complications, many of which have unusual presentations and serious sequelae. The incidence and burden of many of these less common complications are poorly understood. Ocular complications of ophthalmic zoster are relatively frequent but, with early antiviral therapy, need not be sight-threatening. Delayed contralateral hemiparesis is a rare complication of ophthalmic zoster that may present as stroke, temporally remote from the zoster episode. Ramsay Hunt syndrome is caused by reactivation of varicella zoster virus (VZV) involving the facial nerve; facial paralysis, ear pain and vesicles in the ear are diagnostic. Facial paralysis in the absence of vesicles may indicate zoster sine herpete, which can be mistaken for Bell's palsy. Herpetic facial palsies may respond to combination therapy with an antiviral plus steroid, but further research is needed to determine the benefit of such treatments. PMID:17939894

Volpi, Antonio

2007-09-01

102

Determination of ceftiofur derivatives in serum, endometrial tissue, and lochia in puerperal dairy cows after subcutaneous administration of ceftiofur crystalline free acid.  

PubMed

Puerperal uterine infections are often associated with decreased reproductive performance in dairy cows. Routine treatment protocols include the systemic administration of antibiotics. Antibiotic drugs, however, should be administered daily over at least 5 d. The objective of this study was to determine concentrations of ceftiofur derivatives in serum, endometrial tissue, and lochia after subcutaneous administration of ceftiofur crystalline free acid in 6 clinically healthy puerperal dairy cows with normal parturition. Samples were taken immediately before treatment, 2 h after, and then every 24 h over a 7-d period. Concentrations of ceftiofur derivatives were quantified using an HPLC assay. In serum and endometrial tissue, ceftiofur derivatives could be detected above the reported minimum drug concentrations required to inhibit relevant pathogens such as Escherichia coli and Arcanobacterium pyogenes over a 7-d period. Concentrations of desfuroylceftiofuracetamide at 5 d after administration of ceftiofur crystalline free acid were 1.21±0.61 ?g/mL in serum, 0.86±0.61 ?g/mg in endometrial tissue, and 0.96±1.15 ?g/mL in lochia. In lochia, mean concentrations of ceftiofur derivatives also remained above the minimal inhibitory concentration of relevant pathogens, but showed greater variations between cows. PMID:21183038

Witte, T S; Iwersen, M; Kaufmann, T; Scherpenisse, P; Bergwerff, A A; Heuwieser, W

2011-01-01

103

Thromboembolic complications of thyroid storm  

PubMed Central

Summary Thyroid storm is a rare but potentially life-threatening complication of hyperthyroidism. Early recognition and prompt treatment are essential. Atrial fibrillation can occur in up to 40% of patients with thyroid storm. Studies have shown that hyperthyroidism increases the risk of thromboembolic events. There is no consensus with regard to the initiation of anticoagulation for atrial fibrillation in severe thyrotoxicosis. Anticoagulation is not routinely initiated if the risk is low on a CHADS2 score; however, this should be considered in patients with thyroid storm or severe thyrotoxicosis with impending storm irrespective of the CHADS2 risk, as it appears to increase the risk of thromboembolic episodes. Herein, we describe a case of thyroid storm complicated by massive pulmonary embolism. Learning points Diagnosis of thyroid storm is based on clinical findings. Early recognition and prompt treatment could lead to a favourable outcome.Hypercoagulable state is a recognised complication of thyrotoxicosis.Atrial fibrillation is strongly associated with hyperthyroidism and thyroid storm.Anticoagulation should be considered for patients with severe thyrotoxicosis and atrial fibrillation irrespective of the CHADS2 score.Patients with severe thyrotoxicosis and clinical evidence of thrombosis should be immediately anticoagulated until hyperthyroidism is under control. PMID:24683480

Min, T; Benjamin, S; Cozma, L

2014-01-01

104

Cavernous sinus thrombophlebitis complicating sinusitis  

PubMed Central

Background Thrombophlebitis of the cavernous sinus is a rare but serious disease that most often affects young adults and children. It is associated with significant morbidity or mortality and is often related to local infections of the head. The diagnosis is based on clinical findings and is confirmed by imaging. Case Report: We report the case of a 17-year-old male with a history of recurrent sinusitis, who presented general signs of infection, orbital symptoms, and meningeal involvement. CT and MRI showed thrombosis of the cavernous sinus associated with cerebral ischemic damage. The therapeutic management included empiric antibiotic therapy, drainage of an orbital collection, and anticoagulation. The patient died later secondary to septic shock. Conclusions: Although thrombophlebitis of the cavernous sinus is increasingly rare, it remains a lethal complication of sinusitis, and mortality is still high. The course of this disease can be dramatic due to infectious or vascular neurological complications. Early diagnosis and appropriate treatment are crucial. PMID:23826444

Berdai, Adnane Mohamed; Shimi, Abdelkarim; Khatouf, Mohammed

2013-01-01

105

Complications of Mumps  

MedlinePLUS

... Answers Disease Description Physical Findings and Complications Case Reporting Exposure and Response Prevention and Control in Healthcare Settings Background Acceptable Presumptive Evidence of ...

106

[Complications in acute pancreatitis].  

PubMed

Acute pancreatitis is discussed from the point of view her complications. The survey of local, organ and system complication is demonstrated, and the Atlanta classification is recalled. The complications are demonstrated at the mild acute pancreatitis and also at the severe acute pancreatitis. The complications are demonstrated on the own group of patients (period 1995-1997). Severe respiratory failure came later, but the letality was high. The renale or hepatorenale failure came formerly and equally as DIC were combined with practically absolutely letality. PMID:10084859

Krska, Z; Pesková, M; Sváb, J; Výborný, J

1998-12-01

107

Instrumentation related complications in spine surgery.  

PubMed

Spinal instrumentation constructs are frequently necessary for the surgical management of patients with variable spinal pathology. However, surgical complications may appear. These should be detected early and managed to achieve recovery and good functional outcome for the patient. This article provides an in-depth analysis of the most common instrumentation-related complications of spine surgery as well as a diagnostic plan and treatment options for the management of these challenging entities once they occur. PMID:23662657

Ballas, Efstathios; Mavrogenis, Andreas F; Karamanis, Eirineos; Mimidis, George; Tolis, Konstantinos; Soultanis, Konstantinos; Papagelopoulos, Panayiotis J

2012-01-01

108

Coagulation and placenta-mediated complications.  

PubMed

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

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

2014-10-01

109

Coagulation and Placenta-Mediated Complications  

PubMed Central

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

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

2014-01-01

110

Complications of ovariohysterectomy and orchiectomy in companion animals.  

PubMed

Complications following elective spay or neuter procedures are particularly feared by new graduates. However, even the most experienced surgeons may encounter surgical or postoperative complications. At best, complications associated with elective procedures can harm the doctor-client relationship. At worst, these can present legal and financial problems. Veterinary surgeons should be aware of the potential complications associated with elective sterilization, these should be communicated to the client, and there should be a clear plan for action when a complication occurs. This article reviews the reported complications encountered in elective sterilization surgery in companion animals, with a special focus on early detection and prevention. PMID:21889699

Adin, Christopher A

2011-09-01

111

Complications in percutaneous nephrolithotomy.  

PubMed

Percutaneous nephrolithotomy (PCNL) is generally considered a safe technique offering the highest stone-free rates after the first treatment as compared to the other minimal invasive lithotripsy techniques. Still, serious complications although rare should be expected following this percutaneous procedure. In this work, the most common and important complications associated with PCNL are being reviewed focusing on the perioperative risk factors, current management, and preventing measures that need to be taken to reduce their incidence. In addition, complication reporting is being criticized given the absence of a universal consensus on PCNL complications description. Complications such as perioperative bleeding, urine leak from nephrocutaneous fistula, pelvicalyceal system injury, and pain are individually graded as complications by various authors and are responsible for a significant variation in the reported overall PCNL complication rate, rendering comparison of morbidity between studies almost impossible. Due to the latter, a universally accepted grading system specialized for the assessment of PCNL-related complications and standardized for each variation of PCNL technique is deemed necessary. PMID:25218854

Kyriazis, Iason; Panagopoulos, Vasilios; Kallidonis, Panagiotis; Ozsoy, Mehmet; Vasilas, Marinos; Liatsikos, Evangelos

2014-09-14

112

[Complications in pediatric anesthesia].  

PubMed

As in adult anesthesia, morbidity and mortality could be significantly reduced in pediatric anesthesia in recent decades. This fact cannot conceal the fact that the incidence of anesthetic complications in children is still much more common than in adults and sometimes with a severe outcome. Newborns and infants in particular but also children with emergency interventions and severe comorbidities are at increased risk of potential complications. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. In addition to the systematic prevention of complications in pediatric anesthesia, it is important to quickly recognize disturbances of homeostasis and treat them promptly and appropriately. In addition to the expertise of the performing anesthesia team, the institutional structure in particular can improve quality and safety in pediatric anesthesia. PMID:25004872

Becke, K

2014-07-01

113

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

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

Machado, Vinícius Silva; Bicalho, Marcela Luccas de Souza; Meira Junior, Enoch Brandăo 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

114

Spontaneous iliopsoas muscle haematoma as a complication of anticoagulation in acute cerebral venous thrombosis: to stop or not to stop (the anticoagulation)?  

PubMed

Spontaneous iliopsoas muscle haematoma is an infrequent complication of anticoagulation, potentially causing neurological dysfunction through compression of the femoral nerve or lumbar plexus. The authors report the case of a puerperal woman admitted for an extensive cerebral venous thrombosis. Anticoagulation was started, with clinical improvement. The patient later reported low back pain irradiating to the right thigh and developed neurological impairment consistent with lumbar plexus dysfunction. A pelvic CT scan revealed a right iliopsoas muscle haematoma. Considering the risk of anticoagulation suspension, a conservative approach was chosen, with maintenance of anticoagulation. Clinical and functional improvement occurred, with mild right hip and knee flexion paresis as sequelae. Anticoagulation complications are challenging, especially when interruption of anticoagulation may threaten vital and functional outcomes. Therefore, a careful evaluation is essential, since no clinical guidelines are available. In this case, continuing anticoagulation provided a good functional outcome. PMID:25750219

Fernandes, Carina; Pereira, Pedro; Rodrigues, Miguel

2015-01-01

115

Management of complicated duodenal diverticula.  

PubMed

The duodenum is the second most common location of intestinal diverticula after the colon. Duodenal diverticulum (DD) is usually located in the second portion of the duodenum (D2), close to the papilla. Most duodenal diverticula are extraluminal and acquired rather than congenital; more rare is the congenital, intraluminal diverticulum. DD is usually asymptomatic and discovered incidentally, but can become symptomatic in 1% to 5% of cases when complicated by gastroduodenal, biliary and/or pancreatic obstruction, by perforation or by hemorrhage. Endoscopic treatment is the most common first-line treatment for biliopancreatic complications caused by juxtapapillary diverticula and also for bleeding. Conservative treatment of perforated DD based on fasting and broad-spectrum antibiotics may be offered in some selected cases when diagnosis is made early in stable patients, or in elderly patients with comorbidities who are poor operative candidates. Surgical treatment is currently reserved for failure of endoscopic or conservative treatment. The main postoperative complication of diverticulectomy is duodenal leak or fistula, which carries up to a 30% mortality rate. PMID:23810155

Oukachbi, N; Brouzes, S

2013-06-01

116

Gastrointestinal complications of diabetes mellitus  

PubMed Central

Diabetes mellitus affects virtually every organ system in the body and the degree of organ involvement depends on the duration and severity of the disease, and other co-morbidities. Gastrointestinal (GI) involvement can present with esophageal dysmotility, gastro-esophageal reflux disease (GERD), gastroparesis, enteropathy, non alcoholic fatty liver disease (NAFLD) and glycogenic hepatopathy. Severity of GERD is inversely related to glycemic control and management is with prokinetics and proton pump inhibitors. Diabetic gastroparesis manifests as early satiety, bloating, vomiting, abdominal pain and erratic glycemic control. Gastric emptying scintigraphy is considered the gold standard test for diagnosis. Management includes dietary modifications, maintaining euglycemia, prokinetics, endoscopic and surgical treatments. Diabetic enteropathy is also common and management involves glycemic control and symptomatic measures. NAFLD is considered a hepatic manifestation of metabolic syndrome and treatment is mainly lifestyle measures, with diabetes and dyslipidemia management when coexistent. Glycogenic hepatopathy is a manifestation of poorly controlled type 1 diabetes and is managed by prompt insulin treatment. Though GI complications of diabetes are relatively common, awareness about its manifestations and treatment options are low among physicians. Optimal management of GI complications is important for appropriate metabolic control of diabetes and improvement in quality of life of the patient. This review is an update on the GI complications of diabetes, their pathophysiology, diagnostic evaluation and management. PMID:23772273

Krishnan, Babu; Babu, Shithu; Walker, Jessica; Walker, Adrian B; Pappachan, Joseph M

2013-01-01

117

HIV and the Risk of Direct Obstetric Complications: A Systematic Review and Meta-Analysis  

PubMed Central

Background Women of reproductive age in parts of sub-Saharan Africa are faced both with high levels of HIV and the threat of dying from the direct complications of pregnancy. Clinicians practicing in such settings have reported a high incidence of direct obstetric complications among HIV-infected women, but the evidence supporting this is unclear. The aim of this systematic review is to establish whether HIV-infected women are at increased risk of direct obstetric complications. Methods and findings Studies comparing the frequency of obstetric haemorrhage, hypertensive disorders of pregnancy, dystocia and intrauterine infections in HIV-infected and uninfected women were identified. Summary estimates of the odds ratio (OR) for the association between HIV and each obstetric complication were calculated through meta-analyses. In total, 44 studies were included providing 66 data sets; 17 on haemorrhage, 19 on hypertensive disorders, five on dystocia and 25 on intrauterine infections. Meta-analysis of the OR from studies including vaginal deliveries indicated that HIV-infected women had over three times the risk of a puerperal sepsis compared with HIV-uninfected women [pooled OR: 3.43, 95% confidence interval (CI): 2.00–5.85]; this figure increased to nearly six amongst studies only including women who delivered by caesarean (pooled OR: 5.81, 95% CI: 2.42–13.97). For other obstetric complications the evidence was weak and inconsistent. Conclusions The higher risk of intrauterine infections in HIV-infected pregnant and postpartum women may require targeted strategies involving the prophylactic use of antibiotics during labour. However, as the huge excess of pregnancy-related mortality in HIV-infected women is unlikely to be due to a higher risk of direct obstetric complications, reducing this mortality will require non obstetric interventions involving access to ART in both pregnant and non-pregnant women. PMID:24124458

Calvert, Clara; Ronsmans, Carine

2013-01-01

118

Complications following hepatectomy.  

PubMed

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

Russell, Maria C

2015-01-01

119

Postoperative surgical complications of lymphadenohysterocolpectomy  

PubMed Central

Rationale The current standard surgical treatment for the cervix and uterine cancer is the radical hysterectomy (lymphadenohysterocolpectomy). This has the risk of intraoperative accidents and postoperative associated morbidity. Objective The purpose of this article is the evaluation and quantification of the associated complications in comparison to the postoperative morbidity which resulted after different types of radical hysterectomy. Methods and results Patients were divided according to the type of surgery performed as follows: for cervical cancer – group A- 37 classic radical hysterectomies Class III Piver - Rutledge -Smith ( PRS ), group B -208 modified radical hysterectomies Class II PRS and for uterine cancer- group C -79 extended hysterectomies with pelvic lymphadenectomy from which 17 patients with paraaortic lymphnode biopsy . All patients performed preoperative radiotherapy and 88 of them associated radiosensitization. Discussion Early complications were intra-abdominal bleeding ( 2.7% Class III PRS vs 0.48% Class II PRS), supra-aponeurotic hematoma ( 5.4% III vs 2.4% II) , dynamic ileus (2.7% III vs 0.96% II) and uro - genital fistulas (5.4% III vs 0.96% II).The late complications were the bladder dysfunction (21.6% III vs 16.35% II) , lower limb lymphedema (13.5% III vs 11.5% II), urethral strictures (10.8% III vs 4.8% II) , incisional hernias ( 8.1% III vs 7.2% II), persistent pelvic pain (18.91% III vs 7.7% II), bowel obstruction (5.4% III vs 1.4% II) and deterioration of sexual function (83.3% III vs 53.8% II). PRS class II radical hysterectomy is associated with fewer complications than PRS class III radical hysterectomy , except for the complications of lymphadenectomy . A new method that might reduce these complications is a selective lymphadenectomy represented by sentinel node biopsy . In conclusion PRS class II radical hysterectomy associated with neoadjuvant radiotherapy is a therapeutic option for the incipient stages of cervical cancer. Abbreviations: PRS- Piver Rutledge-Smith, II- class II, III- class III PMID:24653760

Marin, F; Ple?ca, M; Bordea, CI; Voinea, SC; Burl?nescu, I; Ichim, E; Jianu, CG; Nicol?escu, RR; Teodosie, MP; Maher, K; Blidaru, A

2014-01-01

120

Pertussis (Whooping Cough) Complications  

MedlinePLUS

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

121

Complications of Circumcision  

PubMed Central

In the United States, circumcision is a commonly performed procedure. It is a relatively safe procedure with a low overall complication rate. Most complications are minor and can be managed easily. Though uncommon, complications of circumcision do represent a significant percentage of cases seen by pediatric urologists. Often they require surgical correction that results in a significant cost to the health care system. Severe complications are quite rare, but death has been reported as a result in some cases. A thorough and complete preoperative evaluation, focusing on bleeding history and birth history, is imperative. Proper selection of patients based on age and anatomic considerations as well as proper sterile surgical technique are critical to prevent future circumcision-related adverse events. PMID:22235177

Krill, Aaron J.; Palmer, Lane S.; Palmer, Jeffrey S.

2011-01-01

122

Intestinal Complications of IBD  

MedlinePLUS

... is chronic (of long duration) LOCAL COMPLICATIONS OF ULCERATIVE COLITIS PERFORATION (RUPTURE) OF THE BOWEL Intestinal perforation occurs ... CANCER About 5% to 8% of people with ulcerative colitis will develop colorectal cancer within 20 years after ...

123

[Complicated mesenteric ischaemia].  

PubMed

Acute mesenteric ischaemia is a serious condition associated with high morbidity and mortality. Atherosclerosis is one of the most frequent etiologic factors. This case report presents a patient suffering from acute mesenteric ischaemia complicated by acute lower limb ischaemia and post-ischaemic stenosis of the ileum. Such a patient requires a multidisciplinary, comprehensive, and, in some cases, phased approach to solve complications brought about especially by generalized atherosclerosis. PMID:25472564

Volák, S; Orhalmi, J; Dušek, T; Ferko, A

2014-12-01

124

Pulmonary Complications of Cirrhosis  

Microsoft Academic Search

Pulmonary vascular complications of liver disease comprise two distinct clinical entities: hepatopulmonary syndrome (HPS—microvascular\\u000a dilatation and angiogenesis) and portopulmonary hypertension (POPH—vasoconstriction and remodeling in resistance vessels).\\u000a These complications occur in similar pathophysiologic environments and may share pathogenic mechanisms. HPS is found in 15%\\u000a to 30% of patients with cirrhosis and its presence increases mortality and the risks of liver transplantation,

Rajan Kochar; Moises I. Nevah Rubin; Michael B. Fallon

2011-01-01

125

On complicity theory  

Microsoft Academic Search

The received account of whistleblowing, developed over the last quarter century, is identified with the work of Norman Bowie\\u000a and Richard DeGeorge. Michael Davis has detailed three anomalies for the received view: the paradoxes of burden, missing harm\\u000a and failure. In addition, he has proposed an alternative account of whistleblowing, viz., the Complicity Theory. This paper\\u000a examines the Complicity Theory.

A. David Kline

2006-01-01

126

On complicity theory.  

PubMed

The received account of whistleblowing, developed over the last quarter century, is identified with the work of Norman Bowie and Richard DeGeorge. Michael Davis has detailed three anomalies for the received view: the paradoxes of burden, missing harm and failure. In addition, he has proposed an alternative account of whistleblowing, viz., the Complicity Theory. This paper examines the Complicity Theory. The supposed anomalies rest on misunderstandings of the received view or misreadings of model cases of whistleblowing, for example, the Challenger disaster and the Ford Pinto. Nevertheless, the Complicity Theory is important for as in science the contrast with alternative competing accounts often helps us better understand the received view. Several aspects of the received view are reviewed and strengthened through comparison with Complicity Theory, including why whistleblowing needs moral justification. Complicity Theory is also critiqued. The fundamental failure of Complicity Theory is its failure to explain why government and the public encourage and protect whistleblowers despite the possibility of considerable harm to the relevant company in reputation, lost jobs, and lost shareholder value. PMID:16609713

Kline, A David

2006-04-01

127

[Type 2 diabetes complications].  

PubMed

People with type 2 diabetes are at increased risk of many complications, which are mainly due to complex and interconnected mechanisms such as hyperglycemia, insulino-resistance, low-grade inflammation and accelerated atherogenesis. Cardi-cerebrovascular disease are frequently associated to type 2 diabetes and may become life threatening, particularly coronaropathy, stroke and heart failure. Their clinical picture are sometimes atypical and silencious for a long time. Type 2 diabetes must be considered as an independent cardiovascular risk factor. Nephropathy is frequent in type 2 diabetes but has a mixed origin. Now it is the highest cause of end-stage renal disease. Better metabolic and blood pressure control and an improved management of microalbuminuria are able to slowdown the course of the disease. Retinopathy which is paradoxically slightly progressive must however be screened and treated in these rather old patients which are globally at high ophthalmologic risk. Diabetic foot is a severe complication secondary to microangiopathy, microangiopathy and neuropathy. It may be considered as a super-complication of several complications. Its screening must be done on a routine basis. Some cancer may be considered as an emerging complication of type 2 diabetes as well as cognitive decline, sleep apnea syndrome, mood disorders and bone metabolism impairments. Most of the type 2 diabetes complications may be prevented by a strategy combining a systematic screening and multi-interventional therapies. PMID:23528336

Schlienger, Jean-Louis

2013-05-01

128

Management of complications after rotator cuff surgery.  

PubMed

Rotator cuff repair (RCR) is a common procedure performed by orthopedic surgeons via arthroscopic, open, or mini-open techniques. While this surgery is considered to be of low morbidity, several potential complications can arise either intraoperatively or during the postoperative time period. Some of these complications are related to the surgical approach (arthroscopic or open), while others are patient dependent. Many of these complications can be managed through nonoperative means; however, early recognition and timely treatment is essential in limiting the long-term sequela and improving patient outcome. There are several different ways to classify complications after RCR repair: timing, severity, preventability, whether or not the pathology is intra- or extra-articular, and the type of treatment necessary. It is essential that the surgeon is cognizant of the etiology contributing to the failed RCR surgery in order to provide timely and proper management. PMID:25532916

Parada, Stephen A; Dilisio, Matthew F; Kennedy, Colin D

2015-03-01

129

Percutaneous Ablation for Small Renal Masses—Complications  

PubMed Central

Although percutaneous ablation of small renal masses is generally safe, interventional radiologists should be aware of the various complications that may arise from the procedure. Renal hemorrhage is the most common significant complication. Additional less common but serious complications include injury to or stenosis of the ureter or ureteropelvic junction, infection/abscess, sensory or motor nerve injury, pneumothorax, needle tract seeding, and skin burn. Most complications may be treated conservatively or with minimal therapy. Several techniques are available to minimize the risk of these complications, and patients should be appropriately monitored for early detection of complications. In the event of a serious complication, prompt treatment should be provided. This article reviews the most common and most important complications associated with percutaneous ablation of small renal masses. PMID:24596439

Kurup, A. Nicholas

2014-01-01

130

Neurological complications of porphyria.  

PubMed

The aim of this study was to evaluate and describe the importance of neurological complications in patients with a confirmed diagnosis of porphyria. Clinical details are presented for a cohort of 14 patients who presented with one of four categories of symptoms: seizures, polyneuropathy, transient sensory-motor symptoms and cognitive or behavioural abnormalities. Ascertainment of porphyria was often incidental and in many patients neurological complications preceded the definitive biochemical diagnosis. Porphyria is a group of diseases whose clinical picture is often complex and heterogeneous, but neurological complications are not uncommon. When indicated, differential diagnosis of neurological signs and symptoms should include porphyria, as the incidence of the disease is probably underestimated. Part of the clinical picture can be transient and it is often initially disregarded. A family history and recurrence of otherwise unexplained neurological symptoms should alert the clinician to a possible diagnosis of porphyria for patients with neurological presentations. PMID:18187328

Solinas, C; Vajda, F J E

2008-03-01

131

Osteoarticular complications of brucellosis.  

PubMed Central

Two hundred and sixty three patients with a diagnosis of brucellosis between January 1984 and December 1987 were studied prospectively. Sixty five patients (25%) developed osteoarticular complications. These patients had a more prolonged course than those with no complications. Spondylitis in 38 (58%) and sacroiliitis in 29 (45%) were the most prevalent. There were no significant laboratory, serological, or bacteriological differences between patients with and without osteoarticular complications. At diagnosis 47 patients (72%) showed radiographic abnormalities, commonly in axial sites but rarely in peripheral sites. Radionuclide bone scan was positive with no radiographic abnormalities in 17 (26%) of cases. Fifty seven patients received medical treatment alone, 51 (89%) being cured with a single course of treatment. Treatment failed or there was a relapse in six patients (11%), of whom five had spondylitis. Eight of the 65 patients (12%), all of whom had spondylitis and paravertebral or epidural abscesses, also required surgical treatment. Images PMID:1994863

Colmenero, J D; Reguera, J M; Fernández-Nebro, A; Cabrera-Franquelo, F

1991-01-01

132

Complications of laparoscopic pyeloplasty  

Microsoft Academic Search

Objectives  With the development of new video-endoscopic techniques like endopyelotomy, laparoscopy and retroperitoneoscopy the treatment\\u000a of UPJO has become less invasive. The complications and learning curve of laparoscopic pyeloplasty are presented together\\u000a with recommendations for adequate management.\\u000a \\u000a \\u000a \\u000a Materials and methods  Based on the personal experience with 189 cases of retroperitoneoscopic pyeloplasty, a literature review (PubMed) was performed\\u000a focussing on complication and success

Jens J. Rassweiler; Dogu Teber; Thomas Frede

2008-01-01

133

Complicated necrotizing otitis externa.  

PubMed

Necrotizing (malignant) otitis externa (NOE) is a rare and invasive infection originating in the external acoustic meatus seen most commonly in diabetes and other immunocompromised states. After a protracted course, disease can smolder and extend into the mastoid, skull base, dural sinuses, and intracranially. We present a case of NOE complicated by mastoiditis, dural sinus thrombosis, and Bezold's abscess in an uncontrolled diabetic presenting with a prolonged course of facial nerve palsy. We stress the importance of maintaining a high index of clinical suspicion for NOE in diabetic patients and offering timely, aggressive treatment to mitigate its complications. PMID:23927998

Nawas, Mariam T; Daruwalla, Vistasp J; Spirer, David; Micco, Alan G; Nemeth, Alexander J

2013-01-01

134

Complications of hip fractures: A review  

PubMed Central

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

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

2014-01-01

135

Treatment of complicated grief  

PubMed Central

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

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

2011-01-01

136

Complications of cyclosporin therapy  

Microsoft Academic Search

Cyclosporin (CsA) therapy has improved the outcome of allotransplants. Because of a relatively selective action on T lymphocytes, CsA therapy causes fewer immunosuppressive complications of infection or malignancy compared to previous chemical agents, which were relatively nonspecific in their spectrum of action on lymphoid versus nonlymphoid cells. Gastrointestinal complaints after oral administration and vasomotor reactions after intravenous administration represent pharmacologic

Barry D. Kahan; Stuart M. Flechner; Marc I. Lorber; Chris Jensen; Debbie Golden; Charles T. Van Buren

1986-01-01

137

Pregnancy Complications in PCOS  

Microsoft Academic Search

A higher prevalence of several complications of pregnancy in women with polycystic ovary syndrome (PCOS), compared with healthy\\u000a mothers with no PCOS, has been described. These include an increased prevalence of spontaneous miscarriage, gestational diabetes,\\u000a pre-eclamptic toxaemia and pregnancy-induced hypertension (PIH) and the birth of small-for-gestational-age (SGA) babies.

Roy Homburg

138

Symptomatic Nephrolithiasis Complicating Pregnancy  

E-print Network

Objective: To review our experiences with diagnosis and management of symptomatic nephrolithiasis complicating pregnancy and to ascertain the efficacy of renal sonography for initial diagnosis compared with plain x-rays or singleshot intravenous pyelography. Methods: Perinatal outcomes were evaluated for all pregnant women admitted to Parkland Hospital for nephrolithiasis

139

Neurological Complications of AIDS  

MedlinePLUS

Neurological Complications of AIDS Fact Sheet Feature Federal domestic HIV/AIDS information and resources can be found at www.AIDS.gov See a ... Where can I get more information? What is AIDS? AIDS (acquired immune deficiency syndrome) is a condition ...

140

Predictors of complicated grief  

Microsoft Academic Search

This study examined whether process variables predict an outcome of complicated grief. A turbulent and prolonged grief was predicted to occur after the death of a spouse in subjects who had self-blame, used the deceased for an extension of self, had ambivalence toward the deceased, or overcontrolled emotional responses. Ninety subjects were examined at 6, 14, and 25 months after

Mardi Horowitz; Constance Milbrath; George A. Bonanno; Nigel Field; Charles Stinson; Are Holen

1998-01-01

141

Successful Surgical Treatment of Cardiac Complication of Graves Disease  

PubMed Central

Cardiac complications such as arrhythmia and heart failure are common in Graves disease. Early detection and proper treatment of hyperthyroidism are important because cardiac complications are reported to be reversible if the thyroid function is normalized by medical treatment. We report here a case of cardiac complication of Graves disease that was too late to reverse with medical treatment and required surgical treatment. PMID:25207231

Min, Jooncheol; Kim, Woong-Han; Jang, Woo Sung; Choi, Eun Seok; Cho, Sungkyu; Choi, Kwang Ho

2014-01-01

142

[Complications of refractive excimer laser surgery].  

PubMed

In surface ablation, haze is the most frequent complication. After LASIK, microkeratome-related complications are rare today and usually resolve without sequelae, provided no ablation was done. Postoperative flap complications such as flap slippage usually occur during the first few days after surgery and should be treated as early whenever present. Interface complications are a new diagnostic entity as the interface between flap and stroma presents a space where fluid or cells can accumulate. Diffuse lamellar keratitis usually occurs within the first few postoperative days and should be treated aggressively to avoid scarring. Epithelial ingrowth is another rare complication usually requiring treatment. Corneal hydrops with fluid accumulation in the interface is a very rare but important phenomenon related to steroid-induced glaucoma but presenting with false low tonometry readings. Corneal ectasia is extremely rare and in most cases related to thin stromal beds. However, its pathogenesis is not yet completely understood, and it may occur in "normal" eyes, too. Dry eye syndrome is the most frequent complication after LASIK. It is usually benign but may cause significant visual impairment in rare cases. PMID:16465507

Knorz, M C

2006-03-01

143

Laparoscopic Myomectomy: Technique, Complications, and Ultrasound Scan Evaluations  

Microsoft Academic Search

Study ObjectiveTo evaluate the feasibility, limits, and complications of laparoscopic myomectomy, assess time to full recovery, and evaluate uterine wound healing by ultrasound in the early postoperative period.

S. Landi; R. Zaccoletti; L. Ferrari; L. Minelli

2001-01-01

144

Obstetrical Complications and Violent Delinquency: Testing Two Developmental Pathways.  

ERIC Educational Resources Information Center

Assessed interaction between obstetrical complications and early family adversity in predicting violent behavior during childhood and adolescence among 849 boys from low SES areas. Found that elevated scores on scale of obstetrical complications (preeclampsia, umbilical cord prolapse, induced labor) increased risk of being violent at 6 and 17…

Arseneault, Louise; Tremblay, Richard E.; Boulerice, Bernard; Saucier, Jean-Francois

2002-01-01

145

Motor complications in Parkinson disease: Clinical manifestations and management  

Microsoft Academic Search

Long-term dopaminomimetic therapy, not limited to levodopa, is complicated by the emergence of variations of motor response in a majority of Parkinson disease (PD) patients. These variations can occur in different forms, as early wearing off during the initial stage of motor complications, dyskinesias in the intermediate stage, and complex fluctuations in the advanced stage. Considered to be a major

Roongroj Bhidayasiri; Daniel D. Truong

2008-01-01

146

Drug complications in outpatients  

Microsoft Academic Search

OBJECTIVE: Outpatient drug complications have not been well studied. We sought to assess the incidence and characteristics of outpatient\\u000a drug complications, identify their clinical and nonclinical correlates, and evaluate their impact on patient satisfaction.\\u000a \\u000a \\u000a DESIGN: Retrospective chart reviews and patient surveys.\\u000a \\u000a \\u000a \\u000a \\u000a SETTING: Eleven Boston-area ambulatory clinics.\\u000a \\u000a \\u000a \\u000a \\u000a PATIENTS: We randomly selected 2,248 outpatients, 20 to 75 years old.\\u000a \\u000a \\u000a \\u000a \\u000a MEASUREMENTS AND MAIN

Tejal K. Gandhi; Helen R. Burstin; E. Francis Cook; Ann L. Puopolo; Jennifer S. Haas; Troyen A. Brennan; David W. Bates

2000-01-01

147

Bereavement and Complicated Grief  

PubMed Central

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

Ghesquiere, Angela; Glickman, Kim

2013-01-01

148

Neuromuscular complications in HIV  

Microsoft Academic Search

HIV affects many organs of the body, including the nervous system. As a result, a series of neurologic complications have\\u000a created challenges for scientists and clinicians alike. Among these, HIV-associated neuropathy and myopathy may occur at all\\u000a stages of the disease process. Of the neuropathies, distal symmetrical polyneuropathy is the most common form. The pathogenesis\\u000a of primary HIV neuropathy is

Susama Verma; Elena Micsa; Lydia Estanislao; David Simpson

2004-01-01

149

Complications of Robotic Prostatectomy  

Microsoft Academic Search

\\u000a Robotic prostatectomy has now become the most common surgical procedure for the treatment of prostate cancer in the United\\u000a States. In 2008, over 70,000 robotic prostatectomies were performed worldwide (Intuitive Surgical). While there are no randomized\\u000a trials that compare outcomes of open and laparoscopic prostatectomy, it is commonly assumed that minimally invasive surgery\\u000a is associated with less morbidity and complications

Akshay Bhandari; Mani Menon

150

Vascular complications in the diabetic pregnancy.  

PubMed

Long-standing hyperglycemia frequently leads to vasculopathy. Microvascular disease is characterized by retinopathy and nephropathy, while macrovascular involvement can affect coronary arteries. Diabetic autonomic neuropathy, when present, is generally associated with retinal and/or renal involvement. Early identification of these diabetic complications allows appropriate counseling and early treatment. Among women with diabetic vasculopathy, nephropathy, chronic hypertension, preeclampsia, preterm delivery, and fetal growth restriction are frequently observed. Furthermore, women with impaired renal function in early pregnancy have increased risk of long-term deterioration of glomerular filtration rate. Proliferative retinopathy can progress during pregnancy and 1 year after delivery, but long-term effects are not likely to occur. When coronary artery disease or gastroparesis diabeticorum are present, excessive maternal and fetal morbidity is observed. When modern management is synchronized with early medical care, favorable maternal and perinatal outcomes can be expected. PMID:25732848

Leguizamón, Gustavo; Trigubo, Denise; Pereira, Juan Ignacio; Vera, María Fernanda; Fernández, José Alberto

2015-04-01

151

A review of sonographic evaluation of renal transplant complications.  

PubMed

In this article, we present an overview of renal transplantation with its complications and discuss the abilities and limitations of ultrasound in evaluating these complications. We included renal transplants performed at our institution between 1993 and 2006 and gathered data on more than 1,000 patients who developed graft dysfunction. We analyzed the ultrasound findings in different posttransplant complications and compared our findings with those in published literature. We present this review article that elaborates and categorizes various transplant complications from an ultrasound perspective. Based on imaging evaluation, the complications of renal transplantation can be divided into four major categories: peri-renal, renal parenchymal, renal collecting system, and renal vascular complications. Common complications included acute tubular necrosis, graft rejection, drug nephrotoxicity, hematoma, lymphocele, urinoma, hydronephrosis, and vascular complications. Ultrasound has a key role in identification and management of most of these complications. However, some parenchymal complications may only be diagnosed on renal biopsy. Ultrasound is a very powerful screening tool to assess renal transplant dysfunction and has a primary role in early diagnosis and management of structural and vascular complications, which may need surgical intervention to save the graft. PMID:18295078

Irshad, Abid; Ackerman, Susan; Sosnouski, David; Anis, Munazza; Chavin, Kenneth; Baliga, Prabhaker

2008-01-01

152

Acute abdominal complications following hip surgery.  

PubMed

Hip surgeries are some of the most common and successful orthopedic procedures. Although rarely, abdominal complications do occur and are associated with unfavorable outcomes.We aimed to identify and describe the severe abdominal complications that appear in patients under-going elective or traumatic hip surgery. A four year retrospective electronic database research identified 408 elective primary hip replacements,51 hip revisions and 1040 intra and extracapsular proximal femur fractures. Out of these, three males and 4 females between 64 - 84 years old were identified to have developed acute abdominal complications: perforated acute ulcer (3),acute cholecystitis (2), volvulus (1), toxic megacolon with peritonitis (1) and acute colonic pseudo-obstruction (1).Complications debuted 3 - 10 days after index orthopedic surgery. Acute perioperative abdominal complications are rarely encountered during orthopedic surgery. When these do occur, they do so almost exclusively in patients with hippathology, comorbidities and most often lead to life threatening situations. We thus emphasize the need for early identification and appropriate management by both orthopedic and general surgery doctors in order to improve patient safety. PMID:24742414

Deleanu, B; Prejbeanu, R; Vermesan, D; Haragus, H; Icma, I; Predescu, V

2014-01-01

153

Epigenetic phenomena linked to diabetic complications.  

PubMed

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 the morbidity and mortality burden of diabetes mellitus. The DCCT-EDIC and UKPDS epidemiological studies correlated poor glycemic control with the development of vascular complications in patients with type 1 or type 2 diabetes mellitus. The findings of these studies suggest that early exposure to hyperglycemia predisposes individuals to the development of diabetic complications, a phenomenon referred to as metabolic memory or the legacy effect. The first experimental evidence for metabolic memory was reported >20 years ago and the underlying molecular mechanisms are currently being characterized. Interestingly, transient exposure to hyperglycemia results in long-lasting epigenetic modifications that lead to changes in chromatin structure and gene expression, which mediate these persistent metabolic characteristics. PMID:21045787

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

2010-12-01

154

Focus on treatment complications and optimal management surgery  

PubMed Central

Thoracic surgery comprises major procedures which may be challenging, not only from a technical point of view but also regarding anesthetic and postoperative management. Complications are common occurrences which are also related to the comorbidity of the patients. After major lung resections pulmonary and pleural complications are often encountered. In this overview more surgically related complications are discussed, focusing on postpneumonectomy pulmonary edema, thromboembolic disease including pulmonary embolism, prolonged air leak, lobar torsion, persistent pleural space, empyema and bronchopleural fistula. Prevention, timely recognition, and early adequate treatment are key points as complications initially considered to be minor, may suddenly turn into life-threatening events. To this end multidisciplinary cooperation is necessary. Preoperative smoking cessation, adequate pain control, attention to nutritional status, incentive spirometry and early mobilization are important factors to reduce the incidence of postoperative complications.

Hendriks, Jeroen M.; Lauwers, Patrick

2014-01-01

155

Fungal pulmonary complications.  

PubMed

With AIDS has come a new level of T-cell immunosuppression, beyond that previously seen. The impact of the HIV pandemic on the field of fungal infections includes a major increase in the number of serious fungal infections, an increase in the severity of those infections, and even some entirely new manifestations of fungal illness. In this article fungal pulmonary complications of AIDS are discussed. T-cell opportunists including Cryptococcus neoformans and the endemic mycoses are the most important pathogens. Phagocyte opportunists, including Aspergillus species and agents of mucormycosis, are less important. PMID:9016374

Davies, S F; Sarosi, G A

1996-12-01

156

[Postoperative complications and management of filtration surgery].  

PubMed

Of the filtering procedures employed, trabeculectomy is the one most frequently used for surgical therapy in primary open angle glaucoma patients. Intra- and postoperative complications must be detected promptly and treated adequately. Many complications arise within the first weeks, such as bleb scaring, decreased flow beneath the scleral flap, extensive filtration with choroidal detachment and anterior chamber narrowing. Fibrin reaction, corneal dellen, iris prolapse, conjunctival leakage and ciliary body detachment are seen more rarely. With prophylactic pre- and perioperative application of antibiotics, wound infections are rare and the risk of endophthalmitis following trabeculectomy remains small. Careful surgical planning requires special consideration of the conjunctiva and provides the basis for long-term success as long as intensive follow-up treatment is ensured. The success of trabeculectomy depends on the preoperative, intraoperative as well as postoperative condition and in particular on bleb development. Early detection of postoperative complications, especially in terms of early scaring in the bleb area, enables implementation of adequate therapeutic measures, such as needling procedures and early bleb revision. Close patient monitoring substantially increases long-term success rates. PMID:19908048

Jonescu-Cuypers, C P; Seitz, B

2009-11-01

157

Complications in periocular rejuvenation.  

PubMed

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

Mack, William P

2010-08-01

158

Complications Related to Gastric Endoscopic Submucosal Dissection and Their Managements  

PubMed Central

Endoscopic submucosal dissection (ESD) for early gastric cancer is a well-established procedure with the advantage of resection in an en bloc fashion, regardless of the size, shape, coexisting ulcer, and location of the lesion. However, gastric ESD is a more difficult and meticulous technique, and also requires a longer procedure time, than conventional endoscopic mucosal resection. These factors naturally increase the risk of various complications. The two most common complications accompanying gastric ESD are bleeding and perforation. These complications are known to occur both intraoperatively and postoperatively. However, there are other rare but serious complications related to gastric ESD, including aspiration pneumonia, stenosis, venous thromboembolism, and air embolism. Endoscopists should have sufficient knowledge about such complications and be prepared to deal with them appropriately, as successful management of complications is necessary for the successful completion of the entire ESD procedure. PMID:25324997

Saito, Itaru; Tsuji, Yosuke; Sakaguchi, Yoshiki; Niimi, Keiko; Ono, Satoshi; Kodashima, Shinya; Yamamichi, Nobutake; Koike, Kazuhiko

2014-01-01

159

Complicated bile duct stones.  

PubMed

Common bile duct stones (CBDSs) are solid deposits that can either form within the gallbladder or migrate to the common bile duct (CBD), or form de novo in the biliary tree. In the USA around 15% of the population have gallstones and of these, 3% present with symptoms annually. Because of this, there have been major advancements in the management of gallstones and related conditions. Management is based on the patient's risk profile; young and healthy patients are likely to be recommended for surgery and elderly patients with comorbidities are usually recommended for endoscopic procedures. Imaging of gallstones has advanced in the last 30 years with endoscopic retrograde cholangiopancreatography evolving from a diagnostic to a therapeutic procedure in removing CBDSs. We present a complicated case of a patient with a CBDS and periampullary diverticulum and discuss the techniques used to diagnose and remove the stone from the biliary system. PMID:23946532

Roy, Ashwin; Martin, Derrick

2013-01-01

160

[Diabetic macrovascular complications].  

PubMed

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

Yamagishi, Sho-ichi

2015-03-01

161

LASIK Interface Complications: Etiology, Management, & Outcomes  

PubMed Central

The anatomy of the LASIK interface allows for a variety of potential complications to arise, unique etiologies with overlapping clinical presentations. Primary interface complications include infectious keratitis, diffuse lamellar keratitis (DLK), central toxic keratopathy (CTK), pressure-induced stromal keratopathy (PISK), and epithelial ingrowth. Infectious keratitis is most commonly caused by Methicill in resistant S. aureus (early onset) or atypical Mycobacterium (late onset) postoperatively, and immediate treatment includes flap lift and irrigation, cultures, and initiation of broad-spectrum topical antibiotics, with possible flap amputation for recalcitrant cases. DLK is a white blood cell infiltrate that appears within the first 5 days postoperatively and is acutely responsive to aggressive topical and oral steroid use in the early stages but may require flap lift and irrigation to prevent flap necrosis if inflammation worsens. In contrast, PISK is caused by acute steroid response and resolves only with cessation of steroid use and IOP lowering. Without appropriate therapy PISK can result in severe optic nerve damage. CTK mimics stage 4 DLK but occurs early in the postoperative period is non-inflammatory. Observation is the only effective treatment, and flap lift is usually not warranted. Epithelial ingrowth is easily distinguishable from other interface complications and may be self-limited or require flap lift to treat irregular astigmatism and prevent flap melt. Differentiating between interface entities is critical to rapid appropriate diagnosis, treatment, and ultimate visual outcome. While initial presentations may overlap significantly, the conditions can be readily distinguished with close follow-up and most complications can resolve without significant visual sequelae when treated appropriately. PMID:22869235

Randleman, J. Bradley; Shah, Rupa D.

2014-01-01

162

Documented complications of staple hemorrhoidopexy: a systematic review.  

PubMed

A systematic review addressing reported complications of stapled hemorrhoidopexy was conducted. Articles were identified via searching OVID and MEDLINE between July 2011 and October 2013. Limitations were placed on the search criteria with articles published from 1998 to 2013 being included in this review. No language restrictions were placed on the search, however foreign language articles were not translated. Two reviewers independently screened the abstracts for relevance and their suitability for inclusion. Data extraction was conducted by both reviewers and entered and analyzed in Microsoft Excel. The search identified 784 articles and 78 of these were suitable for inclusion in the review. A total of 14,232 patients underwent a stapled hemorrhoidopexy in this review. Overall complication rates of stapled hemorrhoidopexy ranged from 3.3%-81% with 5 mortalities documented. Early and late complications were defined individually with overall data suggesting that early complications ranged from 2.3%-58.9% and late complications ranged from 2.5%-80%. Complications unique to the procedure were identified and rates recorded. Both early and late complications unique to stapled hemorrhoidopexy were identified and assessed. PMID:25594639

Porrett, Liesel J; Porrett, Jemma K; Ho, Yik-Hong

2015-01-01

163

Procedural Changes to Decrease Complications in Laparoscopic Gastric Bypass  

PubMed Central

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.

Beitner, Melissa; Luo, Yuying

2015-01-01

164

COMPLICATIONS OF TATTOOING  

PubMed Central

Pathologic consequence of tattooing is relatively rare, but in light of the great number of persons in military service, where tattooing seems to be popular, consideration of the complications seems worth while. Four unusual cases of patients with cutaneous lesions in tattoos are reported. One patient had Boeck's sarcoid, in which the cutaneous eruption was limited solely to the tattooed areas on the body and involved all the various colors of the tattoo. The cutaneous eruption was only a single manifestation of generalized sarcoidosis. Another patient had secondary syphilis with the cutaneous lesions involving multi-colored tattoos, including the red areas. These tattoos were applied in Hawaii, and presumably the red dye was not the usual cinnabar (mercuric sulfide). As a general rule, the cutaneous lesions of secondary syphilis do not involve the red areas because of the treponomicidal action of mercuric sulfide. In the third case the characteristic eruption of discoid lupus erythematosus was present. It began over the red areas of a tattoo on the patient's forearm. It has been stated that mercuric sulfide is a photo-sensitizing agent, and it is believed that this explains the localization of the eruption in this case. The fourth patient had eruption, caused by mercury sensitivity, in an area of tattoo. The eruption was noted soon after the tattooing was done, and it persisted for seven years. PMID:14905289

Lubeck, Glenn; Epstein, Ervin

1952-01-01

165

Hematologic Complications of Pregnancy  

PubMed Central

Pregnancy induces a number of physiologic changes that affect the hematologic indices, either directly or indirectly. Recognizing and treating hematologic disorders that occur during pregnancy is difficult owing to the paucity of evidence available to guide consultants. This paper specifically reviews the diagnosis and management of benign hematologic disorders occurring during pregnancy. Anemia secondary to iron deficiency is the most frequent hematologic complication and is easily treated with oral iron formulations,; however care must be taken not to miss other causes of anemia, such as sickle cell disease. Thrombocytopenia is also a common reason for consulting the hematologist and distinguishing gestational thrombocytopenia from immune thrombocytopenia (ITP), preeclampsia, HELLP syndrome, or thrombotic thrombocytopenic purpura (TTP) is essential since the treatment differs widely. Occasionally the management of mother and infant involves the expeditious recognition of neonatal alloimmune thrombocytopenia (NAIT), a condition that is responsible for severe life-threatening bleeding of the newborn. Additionally, inherited and acquired bleeding disorders affect pregnant women disproportionately and often require careful monitoring of coagulation parameters in order to prevent bleeding in the puerperium. Finally, venous thromboembolism (VTE) during pregnancy is still largely responsible for mortality during pregnancy and the diagnosis, treatment options and guidelines for prevention of VTE during pregnancy are explored. PMID:23953339

Townsley, Danielle M.

2013-01-01

166

A clinical study comparing BIVAP saline vaporization of the prostate with bipolar TURP in patients with prostate volume 30 to 80 mL: Early complications, physiological changes and postoperative follow-up outcomes  

PubMed Central

Introduction: We compare BIVAP saline vaporization of the prostate with bipolar transurethral resection of the prostate (TURP) in the treatment of benign prostatic hyperplasia. Methods: In total, we included 86 patients treated with BIVAP (n = 44) and bipolar TURP (n = 42). The inclusion criteria were maximum urinary flow rate (Qmax) ?10 mL/s, International Prostate Symptom Score (IPSS) ?16, and prostate volume measured with transrectal ultrasound scan between 30 and 80 mL. Serum electrolyte, hemoglobin, and hematocrit levels were determined preoperatively and postoperatively. All patients were evaluated at the postoperative first and third months and the IPSS score, post-void residual urinary volume (PVR), Qmax, and average urinary flow rate (Qave) were compared. Statistical analyses were performed using SPSS 16.0 program and statistical significance was set at p < 0.05. Results: Preoperative demographic characteristics were similar in the 2 groups. The mean operation time was significantly higher (p = 0.02) and hospitalization time was significantly lower (p = 0.04) in the BIVAP group when compared to the bipolar TURP group. There was no significant difference between 2 groups in terms of preoperative and postoperative serum electrolyte, hemoglobin and hematocrit levels. Postoperative complication rates were similar in the 2 groups. The only exception was the rate of severe dysuria, which was significantly higher in the BIVAP group. No statistical difference was noted between the groups in terms of postoperative follow-up results. Conclusion: Bipolar TURP is a safe and highly effective technique which can be used in the surgical treatment of benign prostatic obstruction with minimal side effects. BIVAP saline vaporization of the prostate seems to be a potential alternative to bipolar TURP with shorter hospitalization time. PMID:25132894

Aydogdu, Ozgu; Karakose, Ayhan; Atesci, Yusuf Ziya

2014-01-01

167

Neurosurgical complications after intranasal ethmoidectomy.  

PubMed Central

Intranasal ethmoidectomy is a common otolaryngological procedure. Despite the potential for serious intracranial complications, there is a paucity of reports describing the neurosurgical complications of the procedure. Two patients with intracranial complications of intranasal ethmoidectomy, and the relevant medical literature, are reviewed. The anatomy of the ethmoid air cells and their relation to the intracranial cavity are described. The importance of definitive, emergent repair with attention to the potential for vascular injury is discussed. PMID:1865214

Toselli, R M; dePapp, A; Harbaugh, R E; Saunders, R L

1991-01-01

168

Motor complications in Parkinson's disease.  

PubMed

Management of motor complications in advanced Parkinson's disease (PD) can be challenging. The main complications are inadequate dopaminergic tone ("off" time and dose failures) and excess dopaminergic tone (dyskinesia). These motor complications increase as PD progresses. Changing the dose and timing of L-dopa is the main strategy for both scenarios. Reducing "off" time can also be achieved by the addition of adjunctive therapies (dopamine agonists, catechol-O-methyl transferase inhibitors, and monoamine oxidase-B inhibitors). Dyskinesia can improve with amantadine and possibly several other medications. Surgical interventions such as lesioning and deep brain stimulation are considered when pharmacological strategies for motor complications are not satisfactory. PMID:22035028

Ondo, William G

2011-01-01

169

Pulmonary Complications of Drug Abuse  

PubMed Central

Complications resulting from drug abuse more frequently affect the lung than any other organ. The spectrum of pulmonary complications associated with drug abuse is wide. The current practice of using mixtures of drugs is mainly responsible for the increase in pulmonary complications. The chief complications observed in a series of 241 drug abuse patients were aspiration pneumonitis (12.9 percent), pulmonary edema (10.0 percent), and pneumonia (7.5 percent). ImagesFigure 1.Figure 2.Figure 3.Figure 4.Figure 5.Figure 6.Figure 7.Figure 8.Figure 9.Figure 10. PMID:4812215

Gottlieb, Leon S.; Boylen, Thomas C.

1974-01-01

170

[Recurrent, atypical uterine prolapse after the end of early puerperium in a cow of the German black pied breed (clinical case report)].  

PubMed

A case of a recurrent incomplete uterine prolapse in a two year-old cow of the German Black Pied breed delivered into the clinic at the 16th day after parturition is described. An inversio uteri that possibly relapsed very soon following reposition of an uterine prolapse post partum is presumably the reason of the prolapsus uteri beyond the early puerperal period. The prolapsed left uterine horn was enclosed tightly by the cervix. Due to severe inflammatory changes a reduction was not practicable. PMID:3424358

Graf, A; Ahlers, D

1987-01-01

171

Avoiding and treating dermal filler complications.  

PubMed

All fillers are associated with the risk of both early and late complications. Early side effects such as swelling, redness, and bruising occur after intradermal or subdermal injections. The patient has to be aware of and accept these risks. Adverse events that last longer than 2 weeks can be attributable to technical shortcomings (e.g., too superficial an implantation of a long-lasting filler substance). Such adverse events can be treated with intradermal 5-fluorouracil, steroid injections, vascular lasers, or intense pulsed light, and later with dermabrasion or shaving. Late adverse events also include immunologic phenomena such as late-onset allergy and nonallergic foreign body granuloma. Both react well to intralesional steroid injections, which often have to be repeated to establish the right dose. Surgical excisions shall remain the last option and are indicated for hard lumps in the lips and visible hard nodules or hard granuloma in the subcutaneous fat. PMID:16936549

Lemperle, Gottfried; Rullan, Peter P; Gauthier-Hazan, Nelly

2006-09-01

172

Adult tibial shaft fractures – different patterns, various treatments and complications  

PubMed Central

Summary Background Tibial Fractures constitute a large number of emergency operations in most trauma centers. There are different approaches for tibial fractures. To our knowledge, there is insufficient evidence to consider post-operative complications in relation to both surgical methods and the types of fractures. Our purpose is to report our experience regarding the efficacy and complications associated with diverse surgical methods of different patterns of tibial shaft fractures in adults. Material/Methods We studied 387 adult patients. The patients’ information was registered from the charts and after examination. The methods used were intramedullary interlocking nails, simple intramedullary rods, plating and external fixation. Early and late complications were recorded and by applying the DELPHI method different treatments were compared. Finally, the safest mode of treatment is proposed. Results In the intramedullary interlocking nails method the most noticeable complication was delayed union and the highest rate of complications was seen in open oblique fractures. In the simple intramedullary rods method the most frequent complication was pain, and in the with butterfly fractures the complications were the most. In the plating method the most frequent complication was pain, and most of the complications were seen in open comminuted fractures. Finally, in the external fixation method the most frequent complication was non-union and complications were the highest in the patients with oblique, comminuted and segmented fractures. Conclusions The proposed method to treat transverse, oblique and butterfly fractures is simple intramedullary rods; whereas intramedullary interlocking nails is the better method for comminuted, segmented and spiral fractures. PMID:22037743

Madadi, Firooz; Eajazi, Alireza; Madadi, Firoozeh; Besheli, Laleh Daftari; Sadeghian, Reza; Lari, Mehdi Nasri

2011-01-01

173

[The diabetic foot: the Cinderella of complications].  

PubMed

The problems of the diabetic foot in general are badly known by patients as well as caregivers. They represent yet a major health problem. Recall that if the ulcers are treated early and adequately, they will heal in 70 to 90% of cases. "The diabetic foot" encompasses the whole of the anomalies of the function and/or of the structure of the foot, linked directly or indirectly to hyperglycaemia. The involvement of nerves, arteries and infection can concentrate on the foot that is also called the "crossroads of complications". These various complications are reviewed in detail. The neuropathy mainly sensitive with the diminution or even the disappearance of the sensitivity to pain and its modes of detection as well as this awful and poorly known complication that is the Charcot foot. The arteriopathy sub-diagnosed and yet very frequent, its modes of detection and its treatment. The difficulties of diagnosis of infection, another serious danger for the foot, its classification and treatment. The care of the wounds whose size and depth are too often under-estimated, their classification of important prognostic value. The care of the diabetic foot wounds too often treated as "classic" wounds forgetting those topics mentioned above will be described focusing on their specific characteristics which are debridement and above all offloading. The importance of the primary and secondary prevention will be highlighted. PMID:21089420

Dumont, I

2010-09-01

174

Ocular Complications of Leprosy in Yemen  

PubMed Central

Objectives: This study was conducted to identify the main ocular- and vision-threatening complications of leprosy in Yemen. Methods: This is a cross-sectional observational study which took place from February to July 2010. Leprosy patients attending the Skin and Venereal Diseases Hospital in the City of Light in Taiz, Yemen, who consented to participate in the study, were enrolled. Detailed demographic and medical histories were taken and clinical examination findings were recorded. A detailed eye examination, including visual acuity (VA), slit-lamp, and fundus examinations, was conducted on each patient by a qualified ophthalmologist. Results: A total of 192 patients (180 male, 12 female, with a male to female ratio of 15:1) were included in the study. The majority of the patients (157; 81.8%) were over 40 years. Over two-thirds of the patients (129; 67.2%) had had leprosy for more than 20 years. Ocular complications were found in 97% of cases; 150 (39.1%) of the patients’ eyes had at least one pathology. Eyelid involvement was the most common problem observed in 102 (26.5%) patients. Half of the eyes (192; 50%) had a VA of <6/60. The main cause of blindness among these patients was corneal opacity detected in 69 out of 192 patients (35.9%). Conclusion: Ocular complications are frequent among leprosy patients in Yemen. They are true vision-threatening lesions. It is important to prevent these lesions through early diagnosis and adequate treatment. PMID:23275842

Salem, Raga A. A.

2012-01-01

175

Management and complications of stomas.  

PubMed

Stomas are created for a wide range of indications such as temporary protection of a high-risk anastomosis, diversion of sepsis, or permanent relief of obstructed defecation or incontinence. Yet this seemingly benign procedure is associated with an overall complication rate of up to 70%. Therefore, surgeons caring for patients with gastrointestinal diseases must be proficient not only with stoma creation but also with managing postoperative stoma-related complications. This article reviews the common complications associated with ostomy creation and strategies for their management. PMID:23177069

Bafford, Andrea C; Irani, Jennifer L

2013-02-01

176

Traumatic abdominal hernia complicated by necrotizing fasciitis.  

PubMed

Necrotizing fasciitis is a critical illness involving skin and soft tissues, which may develop after blunt abdominal trauma causing abdominal wall hernia and representing a great challenge for physicians. A 52-year-old man was brought to the emergency department after a road accident, presenting blunt abdominal trauma with a large non-reducible mass in the lower-right abdomen. A first, CT showed abdominal hernia without signs of complication. Three hours after ICU admission, he developed hemodynamic instability. Therefore, a new CT scan was requested, showing signs of hernia complication. He was moved to the operating room where a complete transversal section of an ileal loop was identified. Five hours after surgery, he presented a new episode of hemodynamic instability with signs of skin and soft tissue infection. Due to the high clinical suspicion of necrotizing fasciitis development, wide debridement was performed. Following traumatic abdominal wall hernia (TAWH), patients can present unsuspected injuries in abdominal organs. Helical CT can be falsely negative in the early moments, leading to misdiagnosis. Necrotizing fasciitis is a potentially fatal infection and, consequently, resuscitation measures, wide-spectrum antibiotics, and early surgical debridement are required. This type of fasciitis can develop after blunt abdominal trauma following wall hernia without skin disruption. PMID:25541927

Martínez-Pérez, Aleix; Garrigós-Ortega, Gonzalo; Gómez-Abril, Segundo Ángel; Martí-Martínez, Eva; Torres-Sánchez, Teresa

2014-11-01

177

Obturator Nerve Injury: An Infrequent Complication of TOT Procedure  

PubMed Central

Transvaginal mid-urethral slings have become the most preferred surgical treatment option for female stress urinary incontinence. However, various complications have been reported for these operations occurring especially during penetration of the retropubic space. It can negatively affect patient's quality of life. Early treatment increases the chance of complete normalization of the functions. In this case report we presented a case of obturator nerve damage that was diagnosed and treated at early stage after TOT operation. PMID:25343052

Aydogmus, S.; Kelekci, S.; Aydogmus, H.; Ekmekci, E.; Secil, Y.; Ture, S.

2014-01-01

178

Obturator Nerve Injury: An Infrequent Complication of TOT Procedure.  

PubMed

Transvaginal mid-urethral slings have become the most preferred surgical treatment option for female stress urinary incontinence. However, various complications have been reported for these operations occurring especially during penetration of the retropubic space. It can negatively affect patient's quality of life. Early treatment increases the chance of complete normalization of the functions. In this case report we presented a case of obturator nerve damage that was diagnosed and treated at early stage after TOT operation. PMID:25343052

Aydogmus, S; Kelekci, S; Aydogmus, H; Ekmekci, E; Secil, Y; Ture, S

2014-01-01

179

Complications of radial head prostheses.  

PubMed

Radial head prostheses are indicated for treatment of complex radial head fractures not amenable for fixation. After the initial experience with silastic implants, metallic or pyrocarbon arthroplasty have been used for 20 years. Little is known about complications related to these implants. Main complications are related to loosening whether they are cemented or not cemented. Hypotheses have been proposed like inadequate stem design, insufficient cement technique, stress shielding, and foreign body reactions secondary to polyethylene wear. Pain and stiffness are other common complications often related to oversized radial head component or overstuffing of the joint with excessive lengthening of the radius. Instability can be another complication in the context of more complex trauma with lateral collateral ligament complex lesion and coronoid fracture. Fixation of the coronoid fracture, reinsertion of the lateral collateral ligament complex, and the use of monobloc radial head prosthesis are recommended to stabilize the joint. Finally, osteoarthritis is common with follow-up. PMID:25655903

Delclaux, Stéphanie; Lebon, Julie; Faraud, Amélie; Toulemonde, Julien; Bonnevialle, Nicolas; Coulet, Bertrand; Mansat, Pierre

2015-05-01

180

Role of biomarkers in management of complications after cardiac surgery.  

PubMed

The use of cardiopulmonary bypass distinguishes cardiac surgery from other types of surgery. It introduces some serious postoperative complications, such as acute organ dysfunction of the brain, heart, kidney, lungs and infection, which cause significant morbidity and mortality. Prevention and control of these complications are critical in the evolution of cardiac surgery and in the successful outcomes of most operations. Early detection of these complications are clinically important, because many therapeutic interventions are available to prevent these deadly effects today. Many biomarkers have emerged over the past years, which provided superior diagnostic and prognostic information. Some specific biomarkers that can reflect organ dysfunction, may be useful for early detection, diagnostic assessment, risk stratification of these complications, even monitoring the patient's response to therapy. Our expectation is that a cardiac surgery-associated monitoring system should be constructed with multiple biomarkers, which are specific for different postoperative complications. Such system may help physicians and anesthetist to tailor perioperative management, considering individual pathogenesis and prognosis. In this review, we will summarize the newly identified cardiac surgery-associated biomarkers, and discuss their values in diagnosis and prognosis of some serious complications. PMID:24658063

Zhang, B; Liang, J; Zhang, Z

2014-03-24

181

Effect of intrauterine infusion of an organic-certified product on uterine health, survival, and fertility of dairy cows with toxic puerperal metritis.  

PubMed

The objective was to evaluate the effect of intrauterine infusion of an organic certified product (Optimum UterFlush, Van Beek Natural Science, Orange City, IA) on uterine health, survival, and fertility of cows affected with toxic puerperal metritis (TPM) in an organic dairy farm. Cows with TPM were defined as having an abnormally enlarged uterus and a fetid watery red-brown vaginal discharge, associated with systemic illness and fever (rectal temperature ?39.5°C), within 12 d postpartum. Cows diagnosed with TPM (n=220; study d 0) were blocked by parity (1 and ?2) and randomly assigned into 1 of 2 intrauterine treatments applied every other day for a total of 3 applications: (1) control (CON)=200mL of povidone iodine diluted in 2L of distilled water (n=113); (2) Optimum UterFlush (UF)=3.75mL diluted in 117mL of distilled water (n=107). All enrolled cows received hypertonic saline solution (500mL 7.2% i.v.), dextrose (500mL 50% i.v.), and oral aspirin (5 boluses/d). Outcome variables for treatment efficacy included fever and presence of fetid vaginal discharge at study d 6 and 14, survival at study d 6 and 14 and at 30 and 100 DIM, and reproductive performance. Control variables were parity, BCS at enrollment, calving season, and milk yield. Occurrence of fever at d 6 and 14 was not different between the 2 treatment groups. Presence of fetid vaginal discharge at d 6 and 14 was lower in cows treated with UF compared with cows in the CON group (10.7 vs. 28% and 1.1 vs. 9.1%). The odds (95% confidence interval) for survival and remaining in the farm at study d 6 and 14 and at 30 and 100 DIM for cows in the UF treatment were 4.67 (1.38-15.8), 2.77 (1.25-6.10), 3.13 (1.22-8.02), and 2.82 (1.38-5.71) times the odds of cows in the CON group, respectively. The odds of AI until 150 DIM and the interval from calving to first AI were not different between the 2 treatments. However, pregnancy was affected by treatment; the odds (95% confidence interval) of pregnancy at the first AI, 150 DIM, and 300 DIM for cows treated with UF were 2.15 (1.05-4.40), 1.81 (1.04-3.15), and 1.92 (1.09-3.38) times the odds of cows in the CON group, respectively. Days to pregnancy were similar in both treatment groups, but the number of artificial inseminations per pregnancy were different (2.69 vs. 2.02 for cows in the CON and UF treatments). Results indicate that cows with TPM administered intrauterine infusion of Optimum UterFlush had higher odds of recovering and improved reproductive performance compared with cows treated with povidone iodine. PMID:25771053

Pinedo, P J; Velez, J S; Bothe, H; Merchan, D; Pińeiro, J M; Risco, C A

2015-05-01

182

[Postoperative complications in plastic surgery].  

PubMed

Plastic surgery covers a broad spectrum of diseases and conditions in the areas of reconstructive surgery, hand, burn and aesthetic surgery. Besides acquired defects or malformations an increasing number of patients are being treated for surgical or multimodal complications. In a considerable number of patients plastic and reconstructive surgery remains the only therapeutic alternative after other therapy has failed. Therefore complication management in plastic surgery is of utmost importance for a successful outcome. In addition patient expectations in the results of plastic surgery as a discipline of invention and problem solving are steadily increasing. This challenge is reflected in clinical patient management by intensive research in tissue engineering and regenerative medicine. Patients in plastic surgery are recruited from all age groups of either gender, involving traumatic and oncologic as well as congenital and aesthetic disorders. The demographics of aging, multimorbidity and obesity pose new challenges to plastic surgery. Although age over 70 years is not an independent risk factor per se for complications in plastic surgery, e.g. for complex free flap transfer, medical problems are present at a higher rate, which is to be expected in this age group. Risk factors such as alcoholism and coronary heart diseases seem to be independent predictors of perioperative complications. Therefore older patients can also benefit from plastic surgery and recurrent operations by the corresponding risk and complication management. Complication management necessitates careful patient selection, estimation of operative risks and patient-adapted selection of procedures. In addition to expertise in plastic surgery a thorough knowledge of non-surgical and surgical back-up procedures for technical incidents as well as vascular circulatory and wound healing disorders is required to deal successfully with complications in plastic surgery. This article presents these specific aspects of postoperative complication management in plastic surgery. PMID:19669715

Vogt, P M

2009-09-01

183

Unusual Complications of Quinalphos Poisoning  

PubMed Central

This 40-year-old man was treated for suicidal quinalphos 25%EC consumption. He developed intermediate syndrome with normal response to repetitive nerve stimulation, pancreatitis with high enzyme elevations, and normal computed tomography and excreted black, brown, and orange urine sequentially over the first nine days of hospitalization. The last complication has not been previously reported with any organophosphate compound. He finally succumbed to complication of ventilator associated pneumonia related septic shock and ventricular tachycardia. PMID:23762661

Viswanathan, Stalin

2013-01-01

184

Pulmonary complications of mechanical ventilation.  

PubMed

Although life-saving, mechanical ventilation may be associated with many complications, including consequences of positive intrathoracic pressure, the many aspects of volutrauma, and adverse effects of intubation and tracheostomy. Optimal ventilatory care requires implementing mechanical ventilation with attention to minimizing adverse hemodynamic effects, averting volutrauma, and effecting freedom from mechanical ventilation as quickly as possible so as to minimize the risk of airway complications. PMID:10386254

Sandur, S; Stoller, J K

1999-06-01

185

Medical complications of drug abuse.  

PubMed

Because we do not fully understand the cause of drug abuse, we do not currently have specific therapy for the abuse phenomenon. It is likely that those patients who abuse drugs are not a homogeneous treatment group. The patients seen most frequently because of medical complications probably represent only a small percentage of the total number of drug abusers. The medical complications of drug abuse affect almost all organ systems, and may result acutely from overdose or may not become apparent until after prolonged or recurrent use. Special emphasis has been placed on recognizing the key points of the physical examination in the overdose setting and in the drug-abusing patient that will give clues as to the nature and degree of the drug abuse. It is not clear whether drug abuse causes behavioral problems or vice versa. Physicians need to develop the medical expertise necessary to care for patients with drug abuse problems. Special attention is called to new drug abuse problems: complications associated with phencyclidine, amyl nitrate, and layman's remedies; acute and pulmonary complications; rhabdomyolysis; the brown heroin syndrome; and methylphenidate abuse. Although each of these complications has individual importance, a high incidence of alcohol use and smoking further compromises the general health of drug-abusing patients. Treating all of the medical complications of drugs must be viewed as only the beginning of a therapeutic attempt to restore these patients to a more physically and emotionally healthy life. PMID:371359

Becker, C E

1979-01-01

186

Advanced glycation endproducts: what is their relevance to diabetic complications?  

Microsoft Academic Search

Glycation is a major cause of spontaneous damage to proteins in physiological systems. This is exacerbated in diabetes as a consequence of the increase in glucose and other saccharides derivatives in plasma and at the sites of vascular complications. Protein damage by the formation of early glycation adducts is limited to lysine side chain and N-terminal amino groups whereas later

N. Ahmed; P. J. Thornalley

2007-01-01

187

Complications following dislocations of the proximal interphalangeal joint.  

PubMed

Dorsal fracture-dislocations of the proximal interphalangeal joint are challenging injuries to treat and are associated with many complications. The determination of stability is crucial to appropriate management. Stable injuries can usually be treated nonsurgically, whereas unstable injuries typically require surgical stabilization. Many surgical techniques have been used, including extension block pinning, volar plate arthroplasty, open reduction and internal fixation, external fixation, and hemihamate autografting. Because stiffness and flexion contracture are frequent complications, every effort should be made to initiate early motion while maintaining concentric reduction. Other complications include redislocation, chronic swelling, swan neck and coronal plane deformities, and pin tract infections. Assessing injury characteristics, including chronicity, the percentage of articular surface fractured, and the degree of comminution, and understanding complications will help in determining the most appropriate treatment. Chronic dislocations and those injuries in which painful arthritis develops can be successfully treated with salvage procedures, including arthroplasty and arthrodesis. PMID:24720300

Mangelson, John J; Stern, Peter J; Abzug, Joshua M; Chang, James; Osterman, A Lee

2014-01-01

188

Complications of endoscopic sinus surgery in a residency training program.  

PubMed

Endoscopic sinus surgery (ESS) is now taught in most otolaryngology residency programs in the United States. However, this is technically challenging surgery and concerns exist regarding patient safety early in the surgeon's learning curve. The authors reviewed 193 cases of ESS performed by residents, under faculty supervision at our program, between 1987 and 1992. Sixty-seven percent of patients underwent bilateral anterior ethmoidectomy, 40% had bilateral total ethmoidectomy, and 44% had bilateral middle turbinate reduction. The overall complication rate was 22% and included one major complication. Synechiae accounted for 50% of minor complications. There was no correlation between middle or inferior turbinate reduction and the formation of synechiae. Posterior ethmoidectomy was not associated with a significant increase in complications. We conclude that ESS can be safely performed by otolaryngology residents in carefully structured and supervised training programs. PMID:7564829

Kinsella, J B; Calhoun, K H; Bradfield, J J; Hokanson, J A; Bailey, B J

1995-10-01

189

Management of the complications of BPH/BOO  

PubMed Central

Most men will develop histological BPH if they live long enough. Approximately, half will develop benign prostatic enlargement (BPE) and about half of these will get BOO with high bladder pressures and low flow, this in turn leads to detrusor wall hypertrophy. Many of these men will only have lower urinary tract symptoms (LUTS) but a significant number will also suffer the other complications of BPH. These include urinary retention (acute and chronic), haematuria, urinary tract infection, bladder stones, bladder wall damage, renal dysfunction, incontinence and erectile dysfunction. Recognition of the complications of BPH/BOO early allows more effective management of these complications. This is particularly important for the more serious urinary infections and also for high-pressure chronic retention (HPCR). Complications of LUTS/BPH are very rare in clinical trials because of their strict inclusion and exclusion criteria but are more common in real life practice. PMID:24744522

Speakman, Mark J.; Cheng, Xi

2014-01-01

190

Complications after volar locking plate fixation of distal radius fractures.  

PubMed

Volar locking plates are an increasingly popular treatment for distal radius fractures. We reviewed complications observed after volar locking plate fixation in a busy teaching hospital. The purpose of the study was to assess whether complication rates after volar locking plate use in general, routine trauma practice were higher than published literature from expert users. A retrospective review was carried out of patients treated with a volar locking plate between January 2009 and December 2010. The series included 206 procedures in 204 patients (77 males and 127 females) with mean age of 55 years (range 16-94). Surgery was performed by 18 different consultant surgeons and 11 registrars. A total of 22 complications were observed in 20 patients with an overall complication rate of 9.7%. Seven (3.4%) patients developed tendon problems including four (1.9%) tendon ruptures. Four (1.9%) patients required re-operation for metalwork problems; four patients developed complex regional pain syndrome (CRPS). Three fracture reduction problems were noted. A total of 16 further operations were carried out for complications. The overall complication rate was low even when surgery was done by many surgeons, suggesting that this is a safe and reproducible technique. This study provides information which can be used to counsel patients about risks, including those of tendon and metalwork problems. This allows patients to make an informed decision. Surgeons must have specific strategies to avoid these complications and remain vigilant so that these can be identified and managed early. PMID:24176679

Johnson, N A; Cutler, L; Dias, J J; Ullah, A S; Wildin, C J; Bhowal, B

2014-03-01

191

Complications of Minimally Invasive Cosmetic Procedures: Prevention and Management  

PubMed Central

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

Levy, Lauren L; Emer, Jason J

2012-01-01

192

Urological surgery in elderly patients: results and complications  

PubMed Central

Purpose Owing to the large aging population, a growing number of elderly patients are undergoing surgical treatment. Surgical procedures in elderly patients are associated with a higher risk of complications. The aim of this study was to evaluate the efficacy and safety of urological surgeries in old patients. Methods The authors carried out a retrospective study, evaluating results and early postoperative complications in patients aged 75 years and older. The cohort of patients included 221 patients who underwent surgical procedures in the department of urology between January 2011 and December 2012. The average age of patients was 78. The results and complications were categorized based on the type of surgery performed, and the Dindo–Clavien scale. Results The median follow-up was 18 months. All surgeries for malignant tumors were performed successfully with no residual disease. Totally, 48 (22%) complications were recorded. The most serious were as follows: one patient (<0.5%) died; and four (<2%) patients underwent reoperation. The most common complications involved infection, mainly sepsis and surgical site infections. Other complications included mild respiratory insufficiency, delirium, bleeding, etc. Conclusion Surgeries in elderly patients were effective and safe. The cornerstone of safety is careful preparation and treatment of comorbidities. Complications occurred mainly as a result of emergency procedures during emergency procedures and in major surgeries such as cystectomy and nephrectomy. The standard use of low molecular-weight heparin caused no incidence of thromboembolic disease. PMID:25673978

Brodak, Milos; Tomasek, Jan; Pacovsky, Jaroslav; Holub, Lukas; Husek, Petr

2015-01-01

193

Pulmonary complications in hematopoietic SCT: a prospective study.  

PubMed

Pulmonary complications are common and often lethal in hematopoietic SCT recipients. The objective of this prospective interventional study was to evaluate the etiology, diagnostic procedures, risk factors and outcome of pulmonary complications in a cohort of hematopoietic SCT recipients followed up for 1 year. For patients suffering from a pulmonary complication, a diagnostic algorithm that included non-invasive and bronchoscopic procedures was performed. We identified 73 pulmonary complications in 169 patients: 50 (68%) were pneumonias; 21 (29%) were non-infectious complications and 2 (3%) were undiagnosed. Viruses (particularly Rhinovirus) and bacteria (particularly P. aeruginosa) (28 and 26%, respectively) were the most common causes of pneumonia. A specific diagnosis was obtained in 83% of the cases. A non-invasive test gave a specific diagnosis in 59% of the episodes. The diagnostic yield of bronchoscopy was 67 and 78% in pulmonary infections. Early bronchoscopy (?5 days) had higher diagnostic yield than late bronchoscopy (78 vs 23%; P=0.02) for pulmonary infections. Overall mortality was 22 and 32% of all fatalities were due to pulmonary complications. Pulmonary complications are common and constitute an independent risk factor for mortality, stressing the importance of an appropriate clinical management. PMID:25046219

Lucena, C M; Torres, A; Rovira, M; Marcos, M A; de la Bellacasa, J P; Sánchez, M; Domingo, R; Gabarrus, A; Mensa, J; Agustí, C

2014-10-01

194

POSTOPERATIVE COMPLICATIONS IN THE ONCOLOGY DOG PATIENT  

Microsoft Academic Search

Summary Objective: to investigate post0operative complications in the dogs' oncology patients Design : retrospective study of the 211 canines with cancer. Intervention: curative, palliative, or cytoreductive surgery. Results: after 211 oncology surgery 17 per cent complications were assessed; wound complication (30.5%), excessive pain (25%), hypothermia (22%), and sinus tachycardia (11%) of the total complications. Conclusion: common complications registered after the

C. IGNA; A. SALA; LARISA SCHUSZLER; M. SAB?U; C. LUCA

2009-01-01

195

[Psoriasis: development and fatal complications].  

PubMed

In a retrospective study we tried to evaluate the number of severe psoriasis with a lethal outcome observed in France in a 20-year period from 1965 to 1985. Among 992 psoriatic in-patients on care during this period in the Dermatology Clinic of Strasbourg, 7 died of different complications directly related to the skin disease or its therapy; 39 further cases could be gathered through different departments of dermatology of France. Patients who died had generalized psoriasis (13 cases), psoriatic erythroderma (15 cases) and generalized pustular psoriasis (18 cases); 18 (39 p. 100) also had psoriatic polyarthritis. Circumstances leading to death (table I) were metabolic disorders, related to erythroderma in most cases, non-specific complications (infections, amyloidosis) or complications of specific treatments (methotrexate, etretinate, corticosteroids, mechlorethamine). A comprehensive review of the literature over a century showed that only 72 lethal psoriasis cases have been reported: this rather low number may be due to the fact that some rare pathologies, such as visceral amyloidosis (12 cases) (table III) and fatal complications of methotrexate therapy (38 cases) (table V), paradoxically are more often published than non-specific complications occurring in severe psoriasis, such as cardiovascular failure or cachexy in erythrodermic patients. However, the review of the literature shows, as our own inquiry, the poor prognosis of generalized pustular forms and of psoriasis-associated polyarthropathies: among 42 lethal cases where enough data were available, 23 (55 p. 100) had psoriatic polyarthritis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2048897

Roth, P E; Grosshans, E; Bergoend, H

1991-01-01

196

Epidemiology of Diabetes Interventions and Complications (EDIC)  

PubMed Central

OBJECTIVE The Diabetes Control and Complications Trial (DCCT) demonstrated the powerful impact of glycemic control on the early manifestations of microvascular complications. Contemporary prospective data on the evolution of macrovascular and late microvascular complications of type 1 diabetes are limited. The Epidemiology of Diabetes Interventions and Complications (EDIC) study is a multicenter, longitudinal, observational study designed to use the well-characterized DCCT cohort of >1,400 patients to determine the long-term effects of prior separation of glycemic levels on micro- and macrovascular outcomes. RESEARCH DESIGN AND METHODS Using a standardized annual history and physical examination, 28 EDIC clinical centers that were DCCT clinics will follow the EDIC cohort for 10 years. Annual evaluation also includes resting electrocardiogram, Doppler ultrasound measurements of ankle/arm blood pressure, and screening for nephropathy. At regular intervals, a timed 4-h urine is collected, lipid profiles are obtained, and stereoscopic fundus photographs are taken. In addition, dual B-mode Doppler ultrasound scans of the common and internal carotid arteries will be performed at years 1 and 6 and at study end. RESULTS Written informed consent was obtained from 96% of the DCCT subjects. The participants, compared with nonparticipants, tended to have better glycemic control at the completion of the DCCT and were more likely to have their diabetes care provided by DCCT personnel. The EDIC baseline measurement stratified by sex delineates multiple cardiovascular disease risk factor differences such as age (older in men), waist-to-hip ratio (higher in men), HDL cholesterol (lower in men), hypertension (more prevalent in men), and maximum intimal-medial thickness of common and internal carotid arteries (thicker in men). Of the original conventional treatment group, 69% have changed to continuous subcutaneous insulin infusion or multiple daily injections. Although the mean HbA1c difference between the intensive and conventional treatment groups narrowed at EDIC years 1 and 2, HbA1c remained significantly lower in the intensive group. Of all expected clinic visits, 95% were completed, and the quality of EDIC data is very similar to that observed in the DCCT. CONCLUSIONS Although obvious problems exist in extended follow-up studies of completed clinical trials, these are balanced by the value of continued systematic observation of the DCCT cohort. In contrast to other epidemiologic studies, EDIC will provide 1) definitive data on type 1 as distinct from type 2 diabetes; 2) reliance on prospective rather than on cross-sectional analysis; 3) long-term follow-up in a large population; 4) consistent use of objective, reliable measures of outcomes and glycemia; and 5) observation of patients from before the onset of complications. PMID:10333910

2009-01-01

197

Fasting: The History, Pathophysiology and Complications  

PubMed Central

An appreciation of the physiology of fasting is essential to the understanding of therapeutic dietary interventions and the effect of food deprivation in various diseases. The practice of prolonged fasting for political or religious purposes is increasing, and a physician is likely to encounter such circumstances. Early in fasting weight loss is rapid, averaging 0.9 kg per day during the first week and slowing to 0.3 kg per day by the third week; early rapid weight loss is primarily due to negative sodium balance. Metabolically, early fasting is characterized by a high rate of gluconeogenesis with amino acids as the primary substrates. As fasting continues, progressive ketosis develops due to the mobilization and oxidation of fatty acids. As ketone levels rise they replace glucose as the primary energy source in the central nervous system, thereby decreasing the need for gluconeogenesis and sparing protein catabolism. Several hormonal changes occur during fasting, including a fall in insulin and T3 levels and a rise in glucagon and reverse T3 levels. Most studies of fasting have used obese persons and results may not always apply to lean persons. Medical complications seen in fasting include gout and urate nephrolithiasis, postural hypotension and cardiac arrhythmias. ImagesFigure 4. PMID:6758355

Kerndt, Peter R.; Naughton, James L.; Driscoll, Charles E.; Loxterkamp, David A.

1982-01-01

198

Neurologic Complications in Infective Endocarditis  

PubMed Central

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

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

2014-01-01

199

[Complications of extracorporeal shockwave lithotripsy].  

PubMed

The authors reviewed treatments performed worldwide using extracorporeal shock wave lithotripsy since its introduction in West Germany in 1980 to determine the efficacy of this treatment modality and its potential risks. The prevention of complications related to patients or shock wave energy are discussed, as well as the cardiovascular complications related to immersion, prevention of lesions to nearby organs, treatment of ESWL-induced bleeding, treatment of post-ESWL ureteral obstruction, prevention and treatment of infection, and long-term biological effects. Currently, less than 5% of patients are excluded from treatment with ESWL due to technical reasons or increased risk of periprocedural complications. Patients with cardiac pacemakers have been treated safely. Calcifications of the ipsilateral renal artery or aorta are considered only relative contraindications. However, certain technical limitations exist; i.e., the Dornier HM-3 cannot support patients weighing more than 135 kg., and patient height is also a limiting factor. There is an impressively low incidence of complications related to the energy of the shock wave. The severity and extent of damage are dose- and pressure-dependent. The potential for induction of cardiac arrhythmias secondary to the shock wave exists; however, effective prevention is achieved by coupling the shock wave discharge to the electrocardiogram. Complications of immersion are also extremely rare and can be avoided by careful preoperative evaluation. Damage to nearby organs such as pulmonary, gastric, duodenal or colonic contusions, constitute a very infrequent complication. Elevations of liver enzymes have also been noted post-lithotripsy. However, all these changes were transient and had no significant clinical consequences. Management of post-ESWL ureteral obstruction is by endourological procedures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2699550

Fuchs, G J; David, R D; Fuchs, A M

1989-01-01

200

Venous complications of pancreatitis: a review.  

PubMed

Pancreatitis is notorious to cause vascular complications. While arterial complications include pseudoaneurysm formation with a propensity to bleed, venous complications can be quite myriad. Venous involvement in pancreatitis often presents with thrombosis. From time to time case reports and series of unusual venous complications associated with pancreatitis have, however, been described. In this article, we review multitudinous venous complications in the setting of pancreatitis and propose a system to classify pancreatitis associated venous complications. PMID:25640778

Aswani, Yashant; Hira, Priya

2015-01-01

201

Caregiving, bereavement and complicated grief.  

PubMed

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

Boerner, Kathrin; Schulz, Richard

2009-12-01

202

Surgical Complications of Gynecologic Surgery  

PubMed Central

Complications of gynecological surgery are considerable and when reviewed in detail are almost frightening. There is no substitute for experience and intimate knowledge of the intricate pelvic structures in health and disease. Anyone who is active in the field is sooner or later going to experience some difficulty whether it be due to his miscalculation or to innate conditions in the patient which are beyond his/her control. It is the responsibility of the pelvic surgeon to recognize the complication and apply proper corrective measures. The patient should not be given false hopes of sure success nor should she be deprived of whatever hope for success does exist. PMID:572875

Weekes, Leroy R.; Gandhi, Shobhana Anil; Gandhi, Anil Krishnakumar

1977-01-01

203

Managing complications in cirrhotic patients  

PubMed Central

Liver cirrhosis is a serious and potentially life-threatening condition. This life-threatening condition usually arises from complications of cirrhosis. While variceal bleeding is the most acute and probably best studied, several other complications of liver cirrhosis are more insidious in their onset but nevertheless more important for the long-term management and outcome of these patients. This review summarizes the topics discussed during the UEG-EASL Hepatology postgraduate course of the United European Gastroenterology Week 2013 and discusses emergency surgical conditions in cirrhotic patients, the management of hepatic encephalopathy, ascites and hepatorenal syndrome, coagulation disorders, and liver cancer. PMID:25653862

Angeli, Paolo; Cordoba, Juan; Farges, Oliver; Valla, Dominique

2015-01-01

204

Gastrointestinal complications of mycosis fungoides.  

PubMed Central

Mycosis fungoides (MF) is an uncommon T-cell lymphoma which characteristically involves the skin. Two patients with MF are described who developed fatal complications secondary to involvement of the gastrointestinal tract. One developed malabsorption due to small intestinal involvement; the other had a massive haemorrhage from an ulcerated nodule of tumour in the stomach. The potential for extracutaneous spread is discussed, and it is emphasized that bowel infiltration should be considered in any patient with MF who develops gastrointestinal symptoms or complications. Images Figure 1. Figure 2. Figure 3. Figure 4. Figure 5. Figure 6. Figure 7. PMID:6737393

Slater, D N; Bleehen, S S; Beck, S

1984-01-01

205

Medical complications after subarachnoid hemorrhage.  

PubMed

The prevention and management of medical complications are important for improving outcomes after subarachnoid hemorrhage (SAH). Fever, anemia requiring transfusion, hyperglycemia, hyponatremia, pneumonia, hypertension, and neurogenic cardiopulmonary dysfunction occur frequently after SAH. There is increasing evidence that acute hypoxia and extremes of blood pressure can exacerbate brain injury during the acute phase of bleeding. There are promising strategies to minimize these complications. Randomized controlled trials are needed to evaluate the risks and benefits of these and other medical management strategies after SAH. PMID:20380973

Wartenberg, Katja E; Mayer, Stephan A

2010-04-01

206

Thromboembolic complications in arthroscopic surgery.  

PubMed

Venous thromboembolism (VTE) is a relatively rare complication of arthroscopic surgery but has the potential to cause significant morbidity and even mortality. VTE has been reported after shoulder and knee arthroscopy prompting controversial guidelines to be proposed. More limited studies are available regarding hip and ankle arthroscopy and 1 case of deep venous thrombosis in the contralateral leg status after hip arthroscopy exists. No reports have been published regarding VTE after elbow or wrist arthroscopy to these authors' knowledge. In this article, a systematic review of the literature was conducted to analyze the incidence, treatment, and prevention of thromboembolic complications in arthroscopy. PMID:23649153

Greene, Joseph W; Deshmukh, Ajit J; Cushner, Fred D

2013-06-01

207

Acute Pancreatitis Complicating Severe Dengue  

PubMed Central

Dengue is an arthropod borne viral infection endemic in tropical and subtropical continent. Severe dengue is life threatening. Various atypical presentations of dengue have been documented. But we present a rare and fatal complication of severe dengue in form of acute pancreatitis. A 27-year-old male had presented with severe dengue in decompensated shock and with pain in abdomen due to pancreatitis. The pathogenesis of acute pancreatitis in dengue is not clearly understood, but various mechanisms are postulated. The awareness and timely recognition of this complication is very important for proper management. PMID:24926168

Jain, Vishakha; Gupta, OP; Rao, Tarun; Rao, Siddharth

2014-01-01

208

Diabetic retinopathy - ocular complications of diabetes mellitus  

PubMed Central

In industrialized nations diabetic retinopathy is the most frequent microvascular complication of diabetes mellitus and the most common cause of blindness in the working-age population. In the next 15 years, the number of patients suffering from diabetes mellitus is expected to increase significantly. By the year 2030, about 440 million people in the age-group 20-79 years are estimated to be suffering from diabetes mellitus worldwide (prevalence 7.7%), while in 2010 there were 285 million people with diabetes mellitus (prevalence 6.4%). This accounts for an increase in patients with diabetes in industrialized nations by 20% and in developing countries by 69% until the year 2030. Due to the expected rise in diabetic patients, the need for ophthalmic care of patients (i.e., exams and treatments) will also increase and represents a challenge for eye-care providers. Development of optimized screening programs, which respect available resources of the ophthalmic infrastructure, will become even more important. Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy. Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels. Additionally, regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy. In this way, the risk of blindness can considerably be reduced. In advanced stages of diabetic retinopathy, pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment. In recent years, the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema. PMID:25897358

Nentwich, Martin M; Ulbig, Michael W

2015-01-01

209

Traumatic tympanic membrane perforations: complications and management.  

PubMed

There is great diversity in the methods of treating traumatic perforations of the tympanic membrane. To elucidate the controversy, we present a long-term follow-up study of 37 patients. On the basis of our present study and available relevant data in the literature, we emphasize that early surgical intervention of a traumatic myringeal perforation is not indicated, as most of these perforations (an average of 88%) do heal spontaneously without complications. However, we stress the importance of performing a meticulous auditory and vestibular examination with close follow-up and repeat audiograms in all patients with acute traumatic myringoruptures to provide enough information for diagnosis of a major perilymph leak that would warrant operation. Myringeal perforations or major conductive hearing losses persisting 3 months after injury warrant tympanotomy and appropriate reconstruction. PMID:2676466

Kristensen, S; Juul, A; Gammelgaard, N P; Rasmussen, O R

1989-07-01

210

CARDIAC COMPLICATIONS OF CHEMOTHERAPY: ROLE OF IMAGING  

PubMed Central

Opinion Statement New advances in cancer diagnosis and treatment have increased survival rates in patients with cancer. In parallel with the increase in the number of cancer survivors is an increasing prevalence of cardiac complications from cancer treatment. Chemotherapy-induced cardiac dysfunction is a major contributor to adverse morbidity and mortality rates in cancer patients. Evidence suggests that both clinical symptoms and the traditional left ventricular ejection fraction (LVEF) may lack sensitivity as measures of cardiotoxicity. The early identification of subclinical LV dysfunction is becoming increasingly important, as this may allow cancer patients and their physicians to make informed decisions about therapeutic options. The features of echocardiography make it a useful tool in the diagnosis and monitoring of cardiotoxicity. This review will examine the role of cardiac imaging in detecting cardiotoxicity, focusing primarily on the conventional and more recent echocardiographic approaches for assessing subclinical cardiotoxicity. PMID:24519487

Tan, Timothy C.; Scherrer-Crosbie, Marielle

2014-01-01

211

Prevention of the Musculoskeletal Complications of Hemophilia  

PubMed Central

Hemophilia is an inherited disorder of clotting factor deficiencies resulting in musculoskeletal bleeding, including hemarthroses, leading to musculoskeletal complications. The articular problems of hemophiliac patients begin in infancy. These include: recurrent hemarthroses, chronic synovitis, flexion deformities, hypertrophy of the growth epiphyses, damage to the articular cartilage, and hemophilic arthropathy. The most commonly affected joints are the ankle, the knee, and the elbow. Hematologic prophylactic treatment from ages 2 to 18 years could avoid the development of hemophilic arthropathy if the concentration of the patient's deficient factor is prevented from falling below 1% of normal. Hemarthroses can be prevented by the administration of clotting factor concentrates (prophylaxis). However, high costs and the need for venous access devices in younger children continue to complicate recommendations for universal prophylaxis. Prevention of joint arthropathy needs to focus on prevention of hemarthroses through prophylaxis, identifying early joint disease through the optimal use of cost-effective imaging modalities and the validation of serological markers of joint arthropathy. Screening for effects on bone health and optimal management of pain to improve quality of life are, likewise, important issues. Major hemarthrosis and chronic hemophilic synovitis should be treated aggressively to prevent hemophilic arthropathy. PMID:22778972

Rodriguez-Merchan, E. C.

2012-01-01

212

Radiation therapy: posterior segment complications.  

PubMed

Therapeutic radiation to the posterior segment of the eye is a common option for posterior segment tumors. Such tumors are often malignant, but sometimes, benign neoplasms are treated with ionizing radiation. Also, non-neoplastic intraocular lesions like wet age-related macular degeneration may be treated with radiotherapy. Orbital disease, both neoplastic lesions like optic nerve sheath meningioma and non-neoplastic entities like Graves' ophthalmopathy may be treated with radiotherapy and this may include radiation of the optic nerve and posterior segment of the eye. Occasionally, radiotherapy of extraocular malignant disease, involving, e.g. the paranasal sinuses, may cause significant radiation damage to the eye. Complications after radiation to the posterior segment of the eye are largely related to the radiation dose to the posterior segment. The amount of irradiated volume of normal tissue and fractionation are also important for the development of radiation complications to the posterior segment. Radiation retinopathy is the most common complication of the posterior segment, but radiation optic neuropathy also occurs frequently. Radiation scleral necrosis is less frequent probably due to the radioresistance of the scleral collagen. These complications have the potential to cause blindness (radiation retinopathy and optic neuropathy) or enucleation of the eye (scleral necrosis). Although numerous treatments have been advocated, management of radiation-induced damage remains controversial. Efficacy for any treatment still needs to be proven and, if possible, the best option by far is to minimize radiation changes to normal tissue. PMID:23989132

Seregard, Stefan; Pelayes, David E; Singh, Arun D

2013-01-01

213

Manufacturing Complicated Shells And Liners  

NASA Technical Reports Server (NTRS)

Explosive forming, wax filling, and any one of welding, diffusion bonding, or brazing used in method of manufacturing large, complicated shell-and-liner vessels or structures. Method conceived for manufacture of film-cooled rocket nozzles but applicable to joining large coaxial shells and liners in general.

Sobol, Paul J.; Faucher, Joseph E.

1993-01-01

214

Simple Models of Complicated Rheology  

Microsoft Academic Search

Various non-newtonian materials, ranging from polymers to slurries and pastes, exhibit complicated rheology (flow behavior) in the nonlinear regime. In particular, there are materials whose response to steady stress is unsteady flow or vice versa: in recent years, spontaneous oscillations, chaotic dynamics, and what is effectively turbulence at zero Reynolds number, have all been seen. In this talk I will

Michael Cates

2002-01-01

215

Complications of Central Venous Catheterisation  

PubMed Central

Central venous catheterisation (CVC) is a common bedside invasive procedure done in medical practice. Even though it is a safe procedure when done with ultrasound guidance, difficulties and complications do occur even in experienced hands. Here, we describe the difficulties encountered in the form of the breakage of the guidewire while inserting a CVC in a patient with sickle cell disease. PMID:22087404

Tawfic, Qutaiba A.; Bhakta, Pradipta; Burad, Jyoti; Mishra, Pragyandipta; Kausalya, Rajini

2011-01-01

216

Neurologic complications of myocardial infarction.  

PubMed

Cardiac disease, in particular coronary artery disease, is the leading cause of mortality in developed nations. Strokes can complicate cardiac disease - either as result of left ventricular dysfunction and associated thrombus formation or of therapy for the cardiac disease. Antiplatelet drugs and anticoagulants routinely used to treat cardiac disease increase the risk for hemorrhagic stroke. PMID:24365291

Haque, Moneera N; Dieter, Robert S

2014-01-01

217

Complications of intraoperative radiation therapy  

Microsoft Academic Search

The authors have studied the severe complications occurring after treatment with intraoperative radiation therapy (IORT) in patients with locally advanced carcinoma of the rectum. Four groups of patients were compared: Group 1 (80 patients) had treatment with surgery alone for mobile and resectable tumors; Group 2 (23 patients) had treatment with high dose preoperative irradiation followed by surgical resection for

Joel E. Tepper; Leonard L. Gunderson; Erica Orlow; Alfred M. Cohen; Stephen E. Hedberg; William U. Shipley; Peter H. Blitzer; Tyvin Rich

1984-01-01

218

Anaesthetic complications in plastic surgery.  

PubMed

Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients' experience and surgical outcome. PMID:24501480

Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T

2013-05-01

219

A Rare Complication of Septorhinoplasty  

PubMed Central

Summary: Septoplasty and septorhinoplasty are common procedures. A 28-year-old woman underwent the procedure and presented postoperatively with headache and vomiting and had developed a large pneumocephalus. We describe the case in detail and analyze the possible causes and ways to prevent such a complication. PMID:25587507

2014-01-01

220

Anaesthetic complications in plastic surgery  

PubMed Central

Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients’ experience and surgical outcome. PMID:24501480

Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T.

2013-01-01

221

Major Depression and Complicated Grief  

MedlinePLUS

... grief process Next Topic Coping with loss Major depression and complicated grief Depression It’s common for people to have sadness, pain, ... might be getting worse—going into a major depression. About 1 in 5 bereaved people will develop ...

222

Complications of mediastinal neural tumours  

PubMed Central

Thirty-two mediastinal neural tumours were seen in the East Anglian Regional Thoracic Surgical Unit at Cambridge between October 1952 and July 1970. The descending order of frequency was neurofibroma, ganglioneuroma, neurilemmoma, neurofibrosarcoma, and neuroblastoma. The literature relating to these tumours is reviewed and the pathological and clinical complications encountered in this series and in the literature are described. PMID:4327710

Parish, Christopher

1971-01-01

223

Constraints complicate centrifugal compressor depressurization  

SciTech Connect

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.

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

1993-05-10

224

Complications of immobilization and bed rest. Part 2: Other complications.  

PubMed Central

Prolonged immobilization affects almost every organ system. Respiratory complications include decreased ventilation, atelectasis, and pneumonia. Decreased basal metabolic rate, increased diuresis, natriuresis, and nitrogen and calcium depletion affect metabolism. Genitourinary problems include renal stones and more frequent urinary tract infections. Glucose intolerance, anorexia, constipation, and pressure sores might develop. Central nervous system changes could affect balance and coordination and lead to increasing dependence on caregivers. Images Figure 1 PMID:8324412

Teasell, R.; Dittmer, D. K.

1993-01-01

225

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

PubMed Central

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

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

2014-01-01

226

Complications of chronic liver disease.  

PubMed

Children with chronic liver disease (CLD) need a head to toe approach and an early suspicion of multi organ involvement. Nutritional assessment and management is the cornerstone of management. Consider immune dysfunction in everyday treatment decisions. Consider early heart-lung-brain involvement in transplant evaluation. PMID:22521556

Tsouka, Alexandra; McLin, Valérie A

2012-06-01

227

Complications of surgery for radiotherapy skin damage  

Microsoft Academic Search

Complications of modern surgery for radiotherapy skin damage reviewed in 28 patients who had 42 operations. Thin split-thickness skin grafts for ulcer treatment had a 100 percent complication rate, defined as the need for further surgery. Local flaps, whether delayed or not, also had a high rate of complications. Myocutaneous flaps for ulcers had a 43 percent complication rate, with

Ross Rudolph

1982-01-01

228

Suicide bereavement and complicated grief  

PubMed Central

Losing a loved to suicide is one is one of life's most painful experiences. The feelings of loss, sadness, and loneliness experienced after any death of a loved one are often magnified in suicide survivors by feelings of quilt, confusion, rejection, shame, anger, and the effects of stigma and trauma. Furthermore, survivors of suicide loss are at higher risk of developing major depression, post-traumatic stress disorder, and suicidal behaviors, as well as a prolonged form of grief called complicated grief. Added to the burden is the substantial stigma, which can keep survivors away from much needed support and healing resources. Thus, survivors may require unique supportive measures and targeted treatment to cope with their loss. After a brief description of the epidemiology and circumstances of suicide, we review the current state of research on suicide bereavement, complicated grief in suicide survivors, and grief treatment for survivors of suicide. PMID:22754290

Tal Young, Ilanit; Iglewicz, Alana; Glorioso, Danielle; Lanouette, Nicole; Seay, Kathryn; Ilapakurti, Manjusha; Zisook, Sidney

2012-01-01

229

Neurologic Complications of Lung Cancer  

Microsoft Academic Search

Lung cancer frequently causes neurological complications from direct and indirect effects. Brain metastases occur in 41% of\\u000a patients with non-small cell lung cancer and 35% with small cell lung cancer at autopsy. Presenting symptoms can be quite\\u000a protean. MRI continues to be the gold standard of detecting metastases. Biopsy or resection should be considered for patients\\u000a with a single lesion,

Suriya A. Jeyapalan; Anand Mahadevan

230

Hemorrhagic complications in dermatologic surgery  

PubMed Central

The ability to recognize, manage, and, most importantly, prevent hemorrhagic complications is critical to performing dermatologic procedures that have safe and high quality outcomes. This article reviews the preoperative, intraoperative, and postoperative factors and patient dynamics that are central to preventing such an adverse outcome. Specifically, the role that anticoagulants and antiplatelet agents, hypertension, and other medical conditions play in the development of postoperative hemorrhage are discussed. In addition, this article provides practical guidelines on managing bleeding during and after surgery. PMID:22515669

Bunick, Christopher G.; Aasi, Sumaira Z.

2014-01-01

231

Intestinal complications of Behçet's disease.  

PubMed

We report a case of a young female patient with long-standing oral and genital Behçet's disease (BD), who presented with progressive severe colonic inflammation and perforation, requiring multiple laparotomies. The case had ultimately a favourable outcome despite posing a number of diagnostic and therapeutic challenges. Intestinal complications, although rare, should be considered as important differential diagnoses in patients with BD presenting with abdominal pain, and is a difficult-to-prove differential diagnosis to Crohn's disease. PMID:23917369

Kovacs, D Botond; Ray, Dipak K; Dasgupta, Kaushik; Borowski, David W

2013-01-01

232

Complications of Laparoscopic Donor Nephrectomy  

Microsoft Academic Search

\\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

Alexei Wedmid; Michael A. Palese

233

Hematologic Complications of Alternative Remedies  

Microsoft Academic Search

The use of alternative therapies increased dramatically over the last decade with a wide variety of methods and interventions.\\u000a Dietary supplements are a very common form of alternative therapy used by healthy people as well as patients with serious\\u000a health problems.The use of these untested, unregulated therapies may carry inherent risks. Hematologic complications are known\\u000a side effects of these remedies

Abdul Rahman Jazieh; Maisaa Khalil

2001-01-01

234

Unusual complications of incisional hernia.  

PubMed

Incisional hernia represents a breakdown or loss of continuity of a fascial closure. These hernias are of particular concern not only for the high recurrence rates among them but also for the challenges that follow their repair. It is known to occur in 11-23% of laparotomies. This paper presents two unusual complications of incisional hernia managed by the authors. One ruptured incisional hernia with evisceration of gut and a case of incarcerated gravid uterus in a woman in labour. The case records of the two patients with unusual complications of incisional hernia were pooled and presented to highlight the clinical presentation and management options of this condition. The patient with ruptured hernia and eviscerated gut presented immediately and was resuscitated and the hernia repaired with polypropylene mesh. The patient with incarcerated uterus had caesarean section and mesh repair of the hernia. Incisional hernia can present with unusual complications. The management is very challenging. Good knowledge and skills are required to deal with this condition. PMID:25506498

Emegoakor, Cd; Dike, Ei; Emegoakor, Fc

2014-11-01

235

Unusual Complications of Incisional Hernia  

PubMed Central

Incisional hernia represents a breakdown or loss of continuity of a fascial closure. These hernias are of particular concern not only for the high recurrence rates among them but also for the challenges that follow their repair. It is known to occur in 11-23% of laparotomies. This paper presents two unusual complications of incisional hernia managed by the authors. One ruptured incisional hernia with evisceration of gut and a case of incarcerated gravid uterus in a woman in labour. The case records of the two patients with unusual complications of incisional hernia were pooled and presented to highlight the clinical presentation and management options of this condition. The patient with ruptured hernia and eviscerated gut presented immediately and was resuscitated and the hernia repaired with polypropylene mesh. The patient with incarcerated uterus had caesarean section and mesh repair of the hernia. Incisional hernia can present with unusual complications. The management is very challenging. Good knowledge and skills are required to deal with this condition. PMID:25506498

Emegoakor, CD; Dike, EI; Emegoakor, FC

2014-01-01

236

Imaging of complications from hematopoietic stem cell transplant  

PubMed Central

Stem cell transplant has been the focus of clinical research for a long time given its potential to treat several incurable diseases like hematological malignancies, diabetes mellitus, and neuro-degenerative disorders like Parkinson disease. Hematopoietic stem cell transplantation (HSCT) is the oldest and most widely used technique of stem cell transplant. HSCT has not only been used to treat hematological disorders including hematological malignancies, but has also been found useful in treamtent of genetic, immunological, and solid tumors like neuroblastoma, lymphoma, and germ cell tumors. In spite of the rapid advances in stem cell technology, success rate with this technique has not been universal and many complications have also been seen with this form of therapy. The key to a successful HSCT therapy lies in early diagnosis and effective management of complications associated with this treatment. Our article aims to review the role of imaging in diagnosis and management of stem cell transplant complications associated with HSCT. PMID:25489126

Pandey, Tarun; Maximin, Suresh; Bhargava, Puneet

2014-01-01

237

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

Microsoft Academic Search

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

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

2000-01-01

238

Reflection on a pregnancy complicated by obstetric cholestasis.  

PubMed

Gemma Steele, a midwife, shares her personal reflection on her first pregnancy which was complicated by obstetric cholestasis. Gemma gives insight as to how debilitating it can be suffering from this condition and highlights that a woman can be diagnosed as early as six-eight weeks gestation. For this reflection, Gemma used Gibbs' reflective cycle (Gibbs 1988) to help explore the experience and guide the reflective process (Bulman 2008). PMID:23252070

Steele, Gemma

2012-10-01

239

Management of Complications After Tension-Free Midurethral Slings  

PubMed Central

Since their introduction in 1996, tension-free midurethral slings (MUS) have been proven to have long-term efficacy and safety. They are considered the gold standard treatment of female stress urinary incontinence, especially in cases that are associated with urethral hypermobility. However, they are not free of complications and, although rare, some of these complications can be challenging for both patients and physicians. Some complications occur intraoperatively, whereas others appear in the early or late postoperative period. There is less controversy in the diagnosis and treatment of complications such as vaginal extrusion or urinary system erosion, whereas de novo voiding problems are at best not completely understood. Voiding dysfunction after MUS placement may vary in a wide range from urinary frequency or urgency to retention and is usually attributed to the obstructive or irritative effect of the sling. However, present urodynamic criteria for the diagnosis of female infravesical obstruction are not satisfactory, and the best management policy for de novo voiding dysfunction remains controversial. In the majority of cases, the diagnosis of obstruction leading to a urethral release surgery depends on a combination of several clinical findings. The timing of urethral release surgery varies depending on the preferences of the surgeon, and the outcome of this surgery is not always predictable. The purpose of this review was to assess the diagnosis and management of the immediate, short-term, and long-term complications of MUS in light of the current literature in an attempt to determine the best management policy. PMID:24175037

Çetinel, Bülent

2013-01-01

240

Complications of anterior cruciate ligament reconstruction: MR imaging.  

PubMed

Arthroscopic reconstruction of the anterior cruciate ligament (ACL) using autografts or allografts is being performed with increasing frequency, particularly in young athletes. Although the procedure is generally well tolerated, with good success rates, early and late complications have been documented. As clinical manifestations of graft complications are often non-specific and plain radiographs cannot directly visualize the graft and the adjacent soft tissues, MR imaging has a definite role in the diagnosis of complications after ACL reconstruction and may direct subsequent therapeutic management. Our purpose is to review the normal MR imaging of the ACL graft and present the MR imaging findings of a wide spectrum of complications after ACL reconstruction, such as graft impingement, graft rupture, cystic degeneration of the graft, postoperative infection of the knee, diffuse and localized (i.e., cyclops lesion) arthrofibrosis, and associated donor site abnormalities. Awareness of the MR imaging findings of complications as well as the normal appearances of the normal ACL graft is essential for correct interpretation. PMID:12695835

Papakonstantinou, Olympia; Chung, Christine B; Chanchairujira, Kullanuch; Resnick, Donald L

2003-05-01

241

Infrared Thermal Imaging for Automated Detection of Diabetic Foot Complications  

PubMed Central

Background Although thermal imaging can be a valuable technology in the prevention and management of diabetic foot disease, it is not yet widely used in clinical practice. Technological advancement in infrared imaging increases its application range. The aim was to explore the first steps in the applicability of high-resolution infrared thermal imaging for noninvasive automated detection of signs of diabetic foot disease. Methods The plantar foot surfaces of 15 diabetes patients were imaged with an infrared camera (resolution, 1.2 mm/pixel): 5 patients had no visible signs of foot complications, 5 patients had local complications (e.g., abundant callus or neuropathic ulcer), and 5 patients had diffuse complications (e.g., Charcot foot, infected ulcer, or critical ischemia). Foot temperature was calculated as mean temperature across pixels for the whole foot and for specified regions of interest (ROIs). Results No differences in mean temperature >1.5 °C between the ipsilateral and the contralateral foot were found in patients without complications. In patients with local complications, mean temperatures of the ipsilateral and the contralateral foot were similar, but temperature at the ROI was >2 °C higher compared with the corresponding region in the contralateral foot and to the mean of the whole ipsilateral foot. In patients with diffuse complications, mean temperature differences of >3 °C between ipsilateral and contralateral foot were found. Conclusions With an algorithm based on parameters that can be captured and analyzed with a high-resolution infrared camera and a computer, it is possible to detect signs of diabetic foot disease and to discriminate between no, local, or diffuse diabetic foot complications. As such, an intelligent telemedicine monitoring system for noninvasive automated detection of signs of diabetic foot disease is one step closer. Future studies are essential to confirm and extend these promising early findings. PMID:24124937

van Netten, Jaap J.; van Baal, Jeff G.; Liu, Chanjuan; van der Heijden, Ferdi; Bus, Sicco A.

2013-01-01

242

Neurological complications of coeliac disease  

PubMed Central

A variety of neurological disorders have been reported in association with coeliac disease including epilepsy, ataxia, neuropathy, and myelopathy. The nature of this association is unclear and whether a specific neurological complication occurs in coeliac disease remains unproved. Malabsorption may lead to vitamin and trace element deficiencies. Therefore, patients who develop neurological dysfunction should be carefully screened for these. However, malabsorption does not satisfactorily explain the pathophysiology and clinical course of many of the associated neurological disorders. Other mechanisms proposed include altered autoimmunity, heredity, and gluten toxicity. This review attempts to summarise the literature and suggests directions for future research. PMID:12151653

Pengiran, T; Wills, A; Holmes, G

2002-01-01

243

Cutaneous vasculitis complicating coeliac disease.  

PubMed Central

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 the abnormal small bowel mucosa leading to formation of circulating immune complexes. Subsequent tissue deposition of these complexes then resulted in vasculitis and nephritis. The skin lesions cleared completely after treatment with a strict gluten free diet. Images Fig. 1 Fig. 2 PMID:7461477

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

1981-01-01

244

Unusual costochondral bone graft complication.  

PubMed

In hemifacial microsomia, patients with severely hypoplastic mandibles (Pruzansky type III) require replacement of the ramus and condyle unit. Common complications of this procedure include graft fracture and overgrowth of the graft. An uncommon case of osteolysis of the costochondral graft with osteitis of the middle cranial fossa is reported herein. To our knowledge, no such case has been reported in the literature previously. The aim of this report is to present the only known case and to discuss the contributing factors. PMID:23972557

Tabchouri, Nathalie; Kadlub, Natacha; Diner, Patrick A; Picard, Arnaud

2013-11-01

245

[Neurological complications in cancer patients].  

PubMed

Neurological symptoms in cancer patients have a great impact on quality of life and need an interdisciplinary approach. They lead to significant impairment in activities of daily living (gait disorders, dizziness), a loss of patients independency (vegetative disturbances, wheel-chair dependency) and interfere with social activities (ban of driving in case of epilepsy). In this article we describe three main and serious neurological problems in the context of oncological patients. These are chemotherapy-induced polyneuropathy, malignant spinal cord compression and epileptic seizures. Our aim is to increase the awareness of neurological complications in cancer patients to improve patients care. PMID:25146945

Hundsberger, Thomas; Roth, Patrick; Roelcke, Ulrich

2014-08-20

246

Management of postoperative complications: anemia.  

PubMed

Anemia is extremely common following hip fracture. Consistent data from randomized trials show that transfusion of less blood, with a transfusion threshold around 8 g/dL hemoglobin concentration, is preferable to a traditional threshold of 10 g/dL. Adoption of a lower threshold leads to at least equivalent clinical outcomes, with much less exposure to transfusion costs and risks. The most common complication of transfusion is circulatory overload. Future research may elucidate the optimal transfusion threshold for these elderly patients and address the specific needs of subgroups of patients, including those with acute coronary syndrome or chronic kidney disease. PMID:24721367

Willett, Laura Rees; Carson, Jeffrey L

2014-05-01

247

Psychosocial Complications of Coronary Artery Disease  

PubMed Central

Background: Cardiovascular diseases are the leading causes of death around the world. The coronary artery disease (CAD) is one of the most common diseases in this category, which can be the trigger to various psychosocial complications. We believe that inadequate attention has been paid to this issue. Objectives: The purpose of the present study was to explore the psychosocial complications of CAD from the Iranian patients’ perspective. Patients and Methods: A qualitative design based on the content analysis approach was used to collect the data and analyze the perspective of 18 Iranian patients suffered from CAD, chosen by a purposeful sampling strategy. Semi-structured interviews were held in order to collect the data. Sampling was continued until the data saturation. The data were analyzed using qualitative content analysis approach by MAXQUDA 2010 software. Results: This study revealed the theme of the patients’ challenges with CAD. This theme consisted of: "primary challenges," including doubting early diagnosis and treatment, and feeling being different from others; "psychological issues," including preoccupation, fear of death and surgical intervention, recurrence stress , anxiety and depression; "problems of life," including financial problems, work-related problems, and family-related problems; and "sociocultural issues," including change in perspective of people towards the patient, and cultural issues. Conclusions: Although the management of physical problems in patients with CAD is important, psychosocial effects of this disease is more important. Thus, health care personnel should pay ample attention to identify and resolve psychosocial problems of these patients. Results of this study can be used to empower these patients. PMID:25068057

Karimi-Moonaghi, Hossein; Mojalli, Mohammad; Khosravan, Shahla

2014-01-01

248

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

PubMed Central

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

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

2014-01-01

249

Arterial pseudoaneurysms complicating pancreatitis: literature review.  

PubMed

Arterial pseudoaneurysm formation of visceral arteries as a vascular complication of pancreatitis, either acute or chronic, is an uncommon phenomenon. This review article discusses the incidence, pathophysiology, imaging, treatment strategies, and prognosis of mesenteric pseudoaneurysms complicating pancreatitis. PMID:25279846

Verde, Franco; Fishman, Elliot K; Johnson, Pamela T

2015-01-01

250

Managing Complications of Diabetes in Later Life  

MedlinePLUS

... Download PDF Managing Complications of Diabetes in Later Life Download Join our e-newsletter! Resources Managing Complications of Diabetes in Later Life Tools and Tips Printer-friendly PDF Click here ...

251

Imaging of duodenal diverticula and their complications.  

PubMed

Duodenal diverticula are common and are often incidentally found during routine imaging. Complications can occur but few require surgical intervention. We present a review of duodenal diverticula and their complications. PMID:22085659

Bittle, Michelle M; Gunn, Martin L; Gross, Joel A; Rohrmann, Charles A

2012-01-01

252

Complications of transplantation. Part 1: renal transplants.  

PubMed

Vascular complications after solid-organ transplantation are not uncommon and may lead to graft dysfunction and ultimately graft loss. A thorough understanding of the surgical anatomy, etiologies, and types of vascular complications, their presentation, and the options for management are important for managing these complex patients. This article reviews the basic surgical anatomy, vascular complications, and endovascular management options of vascular complications in patients with renal transplants. PMID:24562321

Khaja, Minhaj S; Matsumoto, Alan H; Saad, Wael E

2014-10-01

253

Complicated Grief Reactions in Children and Adolescents  

Microsoft Academic Search

An understanding of complicated grief in youth is incomplete, because the full range of observed, theorized, and studied symptoms and reactions has not yet been examined in different age groups. Until recently, scales to assess complicated grief in youth were based on adult constructs of complicated grief and did not include many of the symptoms and reactions proposed for posttrauma

Kathleen Nader; Alison Salloum

2011-01-01

254

PERIFOVEAL VITREOUS DETACHMENT AND ITS MACULAR COMPLICATIONS  

PubMed Central

Purpose To evaluate the vitreoretinal relationship in eyes with idiopathic macular disorders putatively caused by vitreomacular traction associated with early stages of age-related posterior vitreous detachment (PVD). Methods Retrospective observational case series of 43 eyes of 40 patients diagnosed with one of several idiopathic vitreomacular conditions. Included patients had no biomicroscopic evidence for complete PVD on presentation and underwent a specific clinical assessment of the vitreoretinal relationship. Affected eyes were evaluated with slit-lamp biomicroscopy, B-scan ultrasonography, optical coherence tomography, and/or intraoperative examination of the posterior hyaloid. Results By one or more examination techniques, 41 (95.3%) of the 43 study eyes had evidence of vitreous detachment from the perifoveal macular region and the remaining two eyes had complete PVD. When measurable, the size of the vitreomacular adhesion varied by diagnosis. Of 31 eyes with perifoveal vitreous detachment seen in follow-up, only three (9.7%) showed progression to complete PVD over an average preoperative or total follow-up period of 30.0 months (range, 2 to 237 months). Surgical or spontaneous separation of the residual vitreomacular adhesion in 16 eyes was followed in 15 (93.8%) by partial or complete resolution of the symptoms and signs of macular traction. Conclusions Age-related PVD appears to be an insidious, chronic event that begins in the perifoveal macula and evolves over a prolonged period of time prior to vitreopapillary separation. Though usually asymptomatic, its early (perifoveal) stages may be complicated by one of several macular pathologies, determined in part by the size of the residual vitreomacular adhesion. PMID:17057817

Johnson, Mark W

2005-01-01

255

Neurologic complications of vascular surgery.  

PubMed

Technological advances in the management of cardiovascular disorders have resulted in an expansion of eligibility criteria for treatment, as well as an increased demand for improved outcomes. Neurologic complications after coronary artery bypass surgery, particularly stroke and cognitive dysfunction, substantially increase mortality, strain health care resources, and reduce the clinical effectiveness of the procedure. Carotid endarterectomy can be both the optimum stroke preventative strategy as well as a cause of stroke. The trend toward minimally invasive endovascular procedures, which has provided non-surgical options for both coronary and cerebral vascular occlusive lesions, is slowly being compared to conventional surgical and medical therapies. The identification of risk factors and mechanisms of adverse cerebral outcomes of these myriad vascular procedures is essential in improving their clinical effectiveness and patient applicability. PMID:9421538

Sila, C A

1998-02-01

256

Neurologic complications of lightning injuries.  

PubMed Central

Over the past ten years, we have cared for 13 patients who suffered serious neurologic complications after being struck by lightning. The spectrum of neurologic lesions includes the entire neuraxis from the cerebral hemispheres to the peripheral nerves. We describe these various neurologic disorders with regard to the site of the lesion, severity of the deficit, and the outcome. Damage to the nervous system can be a serious problem for patients struck by lightning. Fatalities are associated with hypoxic encephalopathy in patients who suffered cardiac arrests. Patients with spinal cord lesions are likely to have permanent sequelae and paralysis. New technology for detecting lightning with wideband magnetic direction finders is useful in establishing lightning-flash densities in each state. Florida and the Gulf Coast states have the highest densities. Colorado and the Rocky Mountain states have the next highest. Images PMID:7785254

Cherington, M; Yarnell, P R; London, S F

1995-01-01

257

Cesarean delivery: counseling issues and complication management.  

PubMed

Nearly one-third of all deliveries in the United States are cesarean deliveries. Compared with spontaneous vaginal delivery, cesarean delivery is associated with increased maternal and neonatal morbidity and mortality. Interventions that decrease the chance of a cesarean delivery include avoiding non-medically indicated induction of labor, avoiding amniotomy, and having a doula present. In North America, the most common reasons for cesarean delivery include elective repeat cesarean delivery, dystocia or failure to progress, malpresentation, and fetal heart rate tracings that suggest fetal distress. Post-cesarean delivery complications include pain, endomyometritis, wound separation/infection, urinary tract infection, gastrointestinal problems, deep venous thrombosis, and septic thrombophlebitis. Women with no risk factors for deep venous thrombosis other than the postpartum state and the operative delivery do not require thromboembolism prophylaxis other than early ambulation. A pregnant woman's decision to attempt a trial of labor after cesarean delivery or have a planned repeat cesarean delivery involves a balancing of maternal and neonatal risks, as well as personal preference after counseling by her physician. Approximately 75% of attempted trials of labor after cesarean delivery are successful. Provision of advanced maternity care practices by family physicians, including serving as primary surgeons for cesarean deliveries, is consistent with the goals of the patient-centered medical home. PMID:25822271

Quinlan, Jeffrey D; Murphy, Neil J

2015-02-01

258

[Vascular complications in infectious endocarditis. Apropos of 86 cases].  

PubMed

During a 20 year period, 285 patients were hospitalised for infectious endocarditis (IE) in the Department of Cardiology of the Ernest-Conseil Hospital in Tunis and 86 of them, i.e. 30%, developed a vascular complication (VC). Among these 86 patients, there were a total of 108 lesions, including 52 neurological complications, 14 peripheral acute ischemic syndromes, 16 peripheral arterial aneurysms, 9 aortic aneurysms, 7 pulmonary embolisms, 6 splenic infarctions and 4 coronary lesions. The mortality in this patient group proved to be slightly greater than in the series as a whole, in particular concerning patients with multiple lesions and those with an artificial valve. No prognostic difference was seen between patients with a VC of aneurysmal type and of ischemic type, but the presentation and severity of lesions was very variable. The vascular complication was a presenting feature of IE in almost 40% of cases. The organism found most often was the streptococcus, above all in ischemic type IE as well as in the total patient group. Similarly, the preferential site was aortic, above all for aneurysmal type IE. Ultrasonography revealed a higher incidence of vegetations in this series of patients, above all in ischemic type VC, but anatomical studies have shown this to be an investigation of moderate sensitivity and poor specificity, poorly correlated from a prognostic standpoint with the risk of embolism. The conclusion of the study is above all the need to prevent such complications: embolic complications by early antibiotic treatment and valve replacement and aneurysmal complications by methodical routine angiographic evaluation and appropriate treatment. PMID:1610094

Beard, T; Hannachi, N; Meddeb, I; Derbel, F; Ben Ismail, M; Bernadet, P

1992-03-01

259

Failure to thrive in infants with complicated facial hemangiomas.  

PubMed

We have observed that some children with facial hemangiomas of infancy have feeding difficulties coincident with periods of failure to thrive. We evaluated the early oral sensory and feeding experiences of four children with facial hemangiomas through medical record review and parental surveys to investigate their contribution to the patients' failure to thrive. All children with feeding irregularities experienced some degree of oral sensory impairment and required early oral sensory intervention, but there were varying reports of difficulty or delay in the development of oral feeding. The nature of these difficulties is discussed. Infants with complicated facial hemangiomas with perioral and airway involvement may be at higher risk for feeding and oral sensory problems. We recommend close monitoring for failure to thrive and early evaluation by speech or occupational therapists. PMID:21950618

Thomas, Meghan W; Burkhart, Craig N; Vaghani, Sapna P; Morrell, Dean S; Wagner, Annette M

2012-01-01

260

Distal Femoral Complications Following Antegrade Intramedullary Nail Placement  

PubMed Central

While antegrade nailing for proximal and diaphyseal femur fractures is a commonly utilized fixation method with benefits including early mobilization and high rates of fracture union, both intraoperative and postoperative complications may occur. Intraoperative errors include leg length discrepancy, anterior cortical perforation, malreduction of the fracture, and neurovascular injury, and postoperative complications include nonunion, malunion, infection, and hardware failure. This case series reviews complications affecting the distal femur after intramedullary nailing including fracture surrounding a distal femoral interlocking screw (Case #1), nonunion after dynamization with nail penetration into the knee joint (Case #2), and anterior cortical perforation (Case #3). Prevention of intraoperative and postoperative complications surrounding intramedullary nailing requires careful study of the femoral anatomy and nail design specifications (radius of curvature), consideration of the necessity of distal interlocking screws, the need for close radiographic follow-up after nail placement with X-rays of the entire length of the nail, and awareness of possible nail penetration into the knee joint after dynamization. PMID:25874066

Fantry, Amanda J.; Elia, Gregory; Vopat, Bryan G.; Daniels, Alan H.

2015-01-01

261

Bleeding complications in laparoscopic cholecystectomy: Incidence, mechanisms, prevention and management  

PubMed Central

BACKGROUND: Laparoscopic cholecystectomy (LC) has established itself firmly as the ‘gold standard’ for the treatment of gallstone disease, but it can, at times, be associated with significant morbidity and mortality. Existing literature has focused almost exclusively on the biliary complications of this procedure, but other complications such as significant haemorrhage can also be encountered, with an immediate mortality if not recognized and treated in a timely manner. MATERIALS AND METHODS: Publications in English language literature that have reported the complication of bleeding during or after the performance of LC were identified and accessed. The results thus obtained were tabulated and analyzed to get a true picture of this complication, its mechanism and preventive measures. RESULTS: Bleeding has been reported to occur with an incidence of up to nearly 10% in various series, and can occur at any time during LC (during trocar insertion, dissection technique or slippage of clips/ ligatures) or in the postoperative period. It can range from minor haematomas to life-threatening injuries to major intra-abdominal vessels (such as aorta, vena cava and iliacs). CONCLUSION: Good surgical technique, awareness and early recognition and management of such cases are keys to success when dealing with this problem. PMID:20877476

Kaushik, Robin

2010-01-01

262

Fatal and other major complications of endoscopic sinus surgery.  

PubMed

Endoscopic sinus surgery has become an acceptable technique for the treatment of chronic sinus disease. This report analyzes five complications which came to my attention. Two cases were orbital:1 bilateral blindness due to damage of the optic nerves, and 1 damage of medial rectus muscle. The other 3 cases were intracranial:two cribriform plate damage with frontal lobe injury and hematoma, and 1 damage of the anterior cerebral artery, resulting in death. This rather novel technique, especially when used by less-experienced surgeons, has major complications similar to what has been reported with the traditional intranasal sphenoethmoidectomy. Knowledge of anatomy, good training, and meticulous surgical technique are very important. Endoscopic sinus surgery in patients with extensive pathology should be used with caution, especially if general anesthesia is selected or if excessive bleeding occurs. It would be beneficial to otolaryngologists to have previous experience in the traditional technique before adopting endoscopic sinus surgery to their armamentarium. Even then, major complications may occur in the hands of very experienced surgeons. Early recognition and proper management of these complications are of utmost importance in order to minimize disability or prevent death. PMID:1895848

Maniglia, A J

1991-04-01

263

[Neurosurgical complications of purulent meningitis in the tropical zone].  

PubMed

Our retrospective study concerned 35 cases of surgical complications related to bacterial meningitis in 16 adults and 19 children. The mean age was 28 years for adults (15-56 years), and 6 months for children (1-12 months). Portal of entry for meningitis was found in 12 cases (35%): 8 sinusitis and 4 otitis. Delay to appearance of complications was 4.5 days, and to diagnosis confirmation 9 days with CT scan (17 cases), and transfontanellar ultrasonography (19 cases). The complications were: hydrocephalus, 19 cases (54%), brain empyemas, 7 cases (20%), abscesses, 10 cases (28.5%), ventriculitis, 2 cases (6%). Twenty-two bacteria were isolated from the CSF: Streptococcus pneumoniae (15 cases), Haemophilus influenzae (5 cases), Neisseria meningitidis (1 case), and Escherichia coli (1 case). Fourteen patients underwent neurosurgical treatment based on aspiration in case of suppuration and external drainage in case of hydrocephalus. The associated medical treatment was antibiotics combining third-generation cephalosporins, fluoroquinolone, and metronidazol, with a mean duration of 12 days. Recovery rate was 89%, letality 11%, and after effect rate were 33%. Our results confirm the low frequency of neurosurgical complications related to bacterial meningitis, but it emphasizes the role of an early CT-scan for diagnosis and prognosis. PMID:10567962

Eholie, S P; Boni, N; Aoussi, E; Konan, A; Orega, M; Koffi Adonis, L; Ba Zeze, V; Bissagnene, E; Kadio, A

1999-09-01

264

Distal femoral complications following antegrade intramedullary nail placement.  

PubMed

While antegrade nailing for proximal and diaphyseal femur fractures is a commonly utilized fixation method with benefits including early mobilization and high rates of fracture union, both intraoperative and postoperative complications may occur. Intraoperative errors include leg length discrepancy, anterior cortical perforation, malreduction of the fracture, and neurovascular injury, and postoperative complications include nonunion, malunion, infection, and hardware failure. This case series reviews complications affecting the distal femur after intramedullary nailing including fracture surrounding a distal femoral interlocking screw (Case #1), nonunion after dynamization with nail penetration into the knee joint (Case #2), and anterior cortical perforation (Case #3). Prevention of intraoperative and postoperative complications surrounding intramedullary nailing requires careful study of the femoral anatomy and nail design specifications (radius of curvature), consideration of the necessity of distal interlocking screws, the need for close radiographic follow-up after nail placement with X-rays of the entire length of the nail, and awareness of possible nail penetration into the knee joint after dynamization. PMID:25874066

Fantry, Amanda J; Elia, Gregory; Vopat, Bryan G; Daniels, Alan H

2015-03-01

265

Neurological complications of vascular access.  

PubMed

Neurological problems are common in patients undergoing haemodialysis. Over 60% of patients will suffer from symptoms of underlying polyneuropathy due to uraemia or diabetes. Others will have subclinical disease demonstrable by nerve conduction studies.Nerve injury following haemodialysis access surgery is underreported. However, sensory nerve lesions are probably common after most vascular access procedures but are rarely debilitating.Nerve compression syndromes such as carpal tunnel and ulnar compression syndromes are common, especially in patients who have been on dialysis for some years and at least some of these are related to or exacerbated by the access. Recognition is essential as they are eminently treatable by decompression surgery. Tourniquet use appears to be safe for carpal tunnel or ulnar nerve decompression surgery.Ischaemic monomelic neuropathy (IMN) is rare but follows a period of ischaemia during or as a result of access surgery, most commonly to construct a brachial arteriovenous fistula or graft. It is characterised by intense pain, out of proportion to any ischaemia, involves all of the upper limb nerves and may progress to involve the motor nerves eventually resulting in a useless clawed hand. It requires prompt treatment of any residual ischaemia after access creation, if necessary by access ligation, as in the established syndrome, like the even rarer complication of reflex sympathetic dystrophy, it is very difficult to offer any useful treatment other than symptomatic relief and physiotherapy. PMID:25751556

Gibbons, Christopher P

2015-03-01

266

Neurological complications in Fabry disease.  

PubMed

In Fabry disease, deficiency of ?-galactosidase A results in the accumulation of glycosphingolipids in body fluids and tissues including corneas, blood vessels, kidneys and also structures of the central and peripheral nervous system. Many patients show cardiovascular and cerebrovascular dysfunction. Cerebrovascular dysfunction is particularly associated with a high risk of strokes and of mortality even at a young age. The prevalence and severity of cerebrovascular complications increase with patients'age. Clinical data as well as histologic and neurophysiologic studies showed predominantly small fiber dysfunction in patients with Fabry disease. We recently performed quantitative sensory testing in patients with Fabry disease and found reduced cold and heat-pain detection thresholds, while nerve conduction velocities were only mildly reduced. From our findings, we concluded that small fiber dysfunction is more prominent than large fiber dysfunction in Fabry patients. Clinically, small fiber dysfunction contributes to recurrent episodes of burning and lancinating pain and paresthesias in the distal extremities. Such episodes can be typically triggered by changes of the environmental temperature, particularly by warming. Moreover, dysfunction of small thinly-myelinated and unmyelianated nerve fibers accounts for altered sympathetic and parasympathetic modulation. Sympathetic dysfunction explains the hypohidrosis and a subsequent poor exercise and heat tolerance. Enzyme replacement therapy (ERT) with recombinant human ?-galactosidase A is available. We could demonstrate improvement of small fiber neuropathy and neuropathic pain after 18-23 months of ERT, which probably resulted from glycosphingolipid clearing from perineurial cells, axons and Schwann cells or from blood vessels supplying the nerves. PMID:21211673

Dütsch, M; Hilz, M J

2010-12-01

267

Thermal stress and diabetic complications  

NASA Astrophysics Data System (ADS)

Activities of erythrocyte aldose reductase were compared in 34 normal subjects, 45 diabetic patients, and nine young men following immersion in water at 25, 39, and 42° C. Mean basal enzyme activity was 1.11 (SEM 0.12) U/g Hb and 2.07 (SEM 0.14) U/g Hb in normal controls and diabetic patients, respectively ( P<0.0001). Activities of the enzyme showed a good correlation with hemaglobin A1 (HbA1) concentrations ( P<0.01) but not with fasting plasma glucose concentrations. After immersion at 42° C for 10 min, enzyme activity was increased by 37.6% ( P<0.01); however, the activity decreased by 52.2% ( P<0.005) after immersion for 10 min at 39° C and by 47.0% ( P<0.05) at 25° C. These changes suggest that heat stress might aggravate diabetic complications, and body exposure to hot environmental conditions is not recommended for diabetic patients.

Ohtsuka, Yoshinori; Yabunaka, Noriyuki; Watanabe, Ichiro; Noro, Hiroshi; Fujisawa, Hiroyuki; Agishi, Yuko

1995-06-01

268

Cognitive functioning in complicated grief.  

PubMed

Complicated grief (CG) is increasingly recognized as a debilitating outcome of bereavement. Given the intensity of the stressor, its chronicity, and its association with depression, it is important to know the impact CG may have on cognitive functioning. This exploratory and descriptive study examined global and domain-specific cognitive functioning in a help-seeking sample of individuals with CG (n = 335) compared to a separately ascertained control sample (n = 250). Cognitive functioning was assessed using the Montreal Cognitive Assessment (MoCA). Controlling for age, sex and education effects, CG participants had lower total MoCA, visuospatial and attention scores relative to control participants. The two groups did not differ significantly in the domains of executive function, language, memory or orientation. Age, sex, and education accounted for much of the variance in MoCA scores, while CG severity and chronicity accounted for a very small percentage of MoCA score variance. Major depression was not a significant predictor of MoCA scores. This study is consistent with previous work demonstrating lower attention and global cognitive performance in individuals with CG compared to control participants. This study newly identifies the visuospatial domain as a target for future studies investigating cognitive functioning in CG. PMID:25088285

Hall, Charles A; Reynolds, Charles F; Butters, Meryl; Zisook, Sidney; Simon, Naomi; Corey-Bloom, Jody; Lebowitz, Barry D; Begley, Amy; Mauro, Christine; Shear, M Katherine

2014-11-01

269

Neurologic complications of craniovertebral dislocation.  

PubMed

Craniovertebral dislocation is uncommon, but its diagnosis is important taking into account the potential severity of the neurologic complications. A number of causes are known; the most common are Down syndrome, rheumatoid arthritis, Paget's disease, other metabolic bone diseases, and craniocervical trauma. Down's syndrome is a relatively common clinical condition but craniovertebral subluxation is only observed in a small percentage of patients. About half of all cervical spine injuries affect the atlanto-occipital region and C2 vertebra. In rheumatoid arthritis, craniocervical dislocation occurs in up to 40% of patients with severe disease. In Paget's disease, involvement of the craniovertebral region occurs in about 30% of all cases. The clinical neurologic syndrome is characterized by local pain, features of upper spinal cord and medullary compression, positive Lhermitte phenomenon, syncope associated with neck flexion, vertebral artery obstruction or dissection leading to stroke, and asymmetrical lower cranial nerve palsies. Neuroimaging is essential to confirm the clinical diagnosis and to categorize severity. The treatment of this disorder is usually surgical, but traction and external immobilization is relevant in some cases. Specific conditions may require additional treatments such as radiotherapy, antibiotics, or chemotherapy. PMID:24365311

de Carvalho, Mamede; Swash, Michael

2014-01-01

270

Gastrointestinal complications of systemic sclerosis.  

PubMed

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

Tian, Xin-Ping; Zhang, Xuan

2013-11-01

271

Post-liver Transplant Biliary Complications  

PubMed Central

Biliary tract complications remain a common source of morbidity and mortality in liver transplant (LT) recipients with an estimated incidence of 5–30% after orthotopic LT and a mortality rate of up to 10%. Biliary complications after LT may be related to various factors including hepatic artery thrombosis or stenosis, ischemia reperfusion injury, immunologic injury, infections, donor pool, and technical issues which include imperfect anastomosis and T-tube-related complications. Management of the detected biliary complications includes nonsurgical and surgical methods. A majority of these post transplant biliary complications can be treated with endoscopic retrograde cholangiography. If unsuccessful, a percutaneous intervention or surgery may be required. In this article, we review the incidence, clinical presentation, and management of the main types of biliary complications.

Atwal, Tegpal; Pastrana, Mariel; Sandhu, Bimaljit

2012-01-01

272

Femoral arteriovenous fistula: a complication of temporary hemodialysis catheter placement.  

PubMed

The femoral vein is increasingly being used as a temporary route for dual-lumen hemodialysis catheter placement because it is thought to be safer than the internal jugular or subclavian vein sites. However, several factors preclude the wider use of indwelling femoral catheters for hemodialysis, including interference with ambulation and concern over bleeding, infection, and deep thrombosis. Herein we describe a case of right superficial femoral arteriovenous fistula as a complication of the insertion of a dual-lumen hemodialysis catheter into the right femoral vein. The arteriovenous fistula was successfully managed with surgical vascular repair. From this experience, we emphasize that it is important for physicians and nursing staff treating patients with indwelling central catheters to exercise vigilance to allow early detection and treatment of these potentially serious, albeit rare, complications. PMID:16807814

Kuramochi, Gen; Ohara, Nobumasa; Hasegawa, Shin; Moro, Hisanaga

2006-01-01

273

Complications of arthroscopic surgery of the hip  

PubMed Central

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

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

2012-01-01

274

Frequent Hemodialysis Fistula Infectious Complications  

PubMed Central

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

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

2014-01-01

275

[Respiratory complications after oesophagectomy for cancer].  

PubMed

Surgery is the cornerstone of treatment for resectable tumours of the oesophagus. Recent advances of surgical techniques and anaesthesiology have led to a substantial decrease in mortality and morbidity. Respiratory complications affect about 30% of patients after oesophagectomy and 80% of these complications occur within the first five days. Respiratory complications include sputum retention, pneumonia and ARDS. They are the major cause of morbidity and mortality after oesophageal resection and numerous studies have identified the factors associated with these complications. The mechanisms are not very different from those observed after pulmonary resection. Nevertheless, there is an important lack of definition, and evaluation of the incidence is particularly difficult. Furthermore, respiratory complications are related to many factors. Careful medical history, physical examination and pulmonary function testing help to identify the risk factors and provide strategies to reduce the risk of pulmonary complications. Standardized postoperative management and a better understanding of the pathogenesis of pulmonary complications are necessary to reduce hospital mortality. This article discusses preoperative, intraoperative, and postoperative factors affecting respiratory complications and strategies to reduce the incidence of these complications after oesophagectomy. PMID:18772826

D'journo, X-B; Michelet, P; Avaro, J-P; Trousse, D; Giudicelli, R; Fuentes, P; Doddoli, C; Thomas, P

2008-06-01

276

Video-assisted thoracic surgery complications  

PubMed Central

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

Kozak, Józef

2014-01-01

277

Radiological diagnosis of dialysis-associated complications.  

PubMed

In daily clinical practice, the radiologist in the context of diagnosis often faces dialysis-associated complications. The complications are numerous and range from infections, catheter dysfunctions, haematomas, cardiovascular diseases, digital ischaemia, and pseudoaneurysms to shunt stenosis. In this pictorial essay, we take a close look at the imaging diagnostics of the most common complications in dialysis patients. Teaching Points • The occurrence of venous stenosis in haemodialysis patients is up to 41 %. • Catheters usually have a fibrin sheath that can be rinsed but not aspirated. • The steal phenomenon occurs in 75-90 % of patients with a shunt system. • Arterial pseudoaneurysms can cause a number of complications. PMID:25095722

Zandieh, Shahin; Muin, Dina; Bernt, Reinhard; Krenn-List, Petra; Mirzaei, Siroos; Haller, Joerg

2014-10-01

278

Image-guided chemoport insertion by interventional radiologists: A single-center experience on periprocedural complications  

PubMed Central

Purpose: To report our early experience in image-guided chemoport insertions by interventional radiologists. Materials and Methods: This was a cross-sectional study conducted in a tertiary center with 161 chemoport insertions done from June 2008 to June 2010. The chemoports were inserted either at the angiography suite or at the mobile operation theater unit. Ninety percent of the chemoports had right internal jugular vein (IJV) as the entry site. Other entry sites included the left IJV, subclavian veins and the inferior vena cava. Immediate and early complications were recorded. All insertions were performed under image guidance with the aid of ultrasound and fluoroscopy. Results: The technical success rate was 99.4%. In terms of immediate complications, there were only two cases of arterial puncture that resolved with local compression. No pneumothorax or air embolism was documented. Twenty-six early complications were recorded. The most common early complication was catheter blockage (12/161; 7.4%), followed by catheter-related infection (9/161; 5.6%). Other complications were catheter malposition, venous thrombosis and catheter dislodgement or leak. A total of 11 (6.8%) chemoports had to be removed within 30 days; most of them were due to infections that failed to respond to systemic antibiotic therapy. In terms of place of procedure, there were no significant differences in complication rates between the angiography suite and the mobile operation theater unit. Conclusion: Image-guided chemoport insertion by interventional radiologist gives low periprocedural complication rates. Using right IJV as the entry site, the image guidance gives good success rate with least complication. PMID:24082475

Yaacob, Yazmin; Nguyen, Dang V; Mohamed, Zahiah; Ralib, A Razali A; Zakaria, Rozman; Muda, Sobri

2013-01-01

279

Otolaryngological complications of occipitocervical injury.  

PubMed

Occipitocervical injuries are rare, accounting for 15% of all fatal spinal trauma. In patients who survive the initial incident, early detection and appropriate management is vital to avoid significant neurological disability and mortality. We present the case of a patient with neck trauma who was initially cleared of spinal injuries in the emergency department but who later developed acute hearing loss. We describe how the investigation of the hearing loss led to the detection of this devastating injury and report its successful management. Patients with persistent neck pain following trauma, particularly in the presence of degenerative spinal disease, should have cervical spine computed tomography to exclude occipitocervical injuries and other occult injuries. PMID:25350165

Qureishi, A; Khan, T; Johnston, M; Bommireddy, R; Klezl, Z

2014-11-01

280

Current State of Art Management for Vascular Complications after Liver Transplantation  

PubMed Central

Vascular complications by compromising the blood flow to the allograft can have significant and sometimes life-threating consequences for the patient. High level of suspicion and aggressive utilization of diagnostic modalities can lead to early diagnosis and salvage of the allograft. This review will summarize the current trends in the management of vascular complications after liver transplantation. Current trends show an increase in the utilization of endovascular interventions initially to address vascular complications after liver transplantation. Operative repair still has its major role, especially if endovascular procedures fail. PMID:25093059

Hejazi Kenari, S. Kamran; Zimmerman, Asha; Eslami, Mohammad; F. Saidi, Reza

2014-01-01

281

Brachial artery pseudoaneurysm: a rare complication after haemodialysis therapy.  

PubMed

Haemodialysis patients carry a high risk of pseudoaneurysm due to inadvertent puncture of the brachial artery during venous cannulation for haemodialysis. Signs and symptoms are pulsatile mass and a systolic murmur. Complications are rupture, infection, haemorrhage, distal arterial insufficiency, venous thrombosis and neuropathy. Early diagnosis is essential to plan adequate treatment. Doppler US and angiography usually confirm the lesion accurately. Ultrasound guided compression, percutaneous injection of thrombin, endovascular covered stent exclusion, aneurysmectomy and surgical repair are different treatment options. We report clinical and radiological findings and treatment strategies in four dialysed patients who developed brachial artery pseudoaneurysms. PMID:15906913

Yildirim, S; Nursal, T Zafer; Yildirim, T; Tarim, A; Caliskan, K

2005-04-01

282

Acute acalculous cholecystitis: a rare complication of snake bite.  

PubMed

Snake bite is an environmental and occupational hazard in many tropical and subtropical countries. It demands a high level of knowledge and skill in managing the envenomation syndrome. Herein, we describe a rare case of acute acalculous cholecystitis (AAC) that developed in a 36-year-old man after an Indian cobra (Naja naja) bite in the absence of any other predisposing factors for AAC. The probable mechanisms for the occurrence of AAC have been highlighted. Recognizing the possibility of such a complication after envenomation will definitely aid in early diagnosis and, subsequently, a better outcome. PMID:23473791

Senthilkumaran, Subramanian; Menezes, Ritesh G; Pant, Sadip; Thirumalaikolundusubramanian, Ponniah

2013-09-01

283

Tube Thoracostomy: Complications and Its Management  

PubMed Central

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

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

2012-01-01

284

Complications associated with limited macular translocation  

Microsoft Academic Search

PURPOSE: To report the ocular complications associated with the limited macular translocation procedure.METHODS: Retrospective review of 153 consecutive eyes of 151 patients that had the limited macular translocation procedure for subfoveal choroidal neovascularization between April 1996 and February 1999. The major study variables investigated included the incidence of specific ocular complications and their impact on visual acuity at 3 months

Gildo Y Fujii; Dante J Pieramici; Mark S Humayun; Andrew P Schachat; Sandra M Reynolds; Michele Melia; Eugene De Juan

2000-01-01

285

Acute postoperative complications of hypospadias repair  

PubMed Central

Purpose Complications in hypospadias surgery are higher than other reconstructive procedures. The incidence of complications can be reduced if proper preventive measures are taken. The review aims to highlight incidences, causes, and preventive measures of acute complications of hypospadias repair. Materials and Methods Literature reports were reviewed in Pubmed by giving the key word acute complications of hypospadias repair, wound infection, wound dehiscence, flap necrosis, edema, penile torsion, urethral fistula, bleeding and hematoma and urethral stents problems. Summaries of all articles were reviewed with full text of relevant article and results were analyzed. Results Besides mentioning the complications of hypospadias repair in individual articles on the subject, we did not come across any separate article on this subject in the published English literature. Fistula is the commonest complication followed by edema and penile torsion. Conclusions Most acute complications can be prevented with adherence to principles of plastic and microsurgery, meticulous preoperative planning, and judicious postoperative care. Deviation from these principles may lead to disaster and even failure of the repair. The aim in hypospadias surgery should be following these principles and bring down the complication rates < 5% in distal hypospadias and < 10% in proximal hypospadias. PMID:19468404

Bhat, Amilal; Mandal, Arup Kumar

2008-01-01

286

Computerized assessment of complications after colorectal surgery  

Microsoft Academic Search

PURPOSE: Historically, complication rates after colorectal surgery have been stratified by disease process, type of operation, or anesthesia risk derived after an intensive review of the medical record. Newer computer applications purport to shorten this process and predict the probability of postoperative complications by distinguishing them from comorbidities that are commingled on uniform discharge codes. We analyzed CaduCIS™ software, which

Khawaja Azimuddin; Lester Rosen; James F. Reed III

2001-01-01

287

Pancreatic transplantation: Radiologic evaluation of vascular complications  

Microsoft Academic Search

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

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

1991-01-01

288

Complications of regional anesthesia for ophthalmic surgery.  

PubMed Central

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

McGoldrick, K. E.

1993-01-01

289

Ocular Complications of Inflammatory Bowel Disease  

PubMed Central

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.

Mady, Rana; Grover, Will; Butrus, Salim

2015-01-01

290

Complications of surgery for radiotherapy skin damage  

SciTech Connect

Complications of modern surgery for radiotherapy skin damage reviewed in 28 patients who had 42 operations. Thin split-thickness skin grafts for ulcer treatment had a 100 percent complication rate, defined as the need for further surgery. Local flaps, whether delayed or not, also had a high rate of complications. Myocutaneous flaps for ulcers had a 43 percent complication rate, with viable flaps lifting off radiated wound beds. Only myocutaneous flaps for breast reconstruction and omental flaps with skin grafts and Marlex mesh had no complications. The deeper tissue penetration of modern radiotherapy techniques may make skin grafts and flaps less useful. In reconstruction of radiation ulcers, omental flaps and myocutaneous flaps are especially useful, particularly if the radiation damage can be fully excised. The pull of gravity appears detrimental to myocutaneous flap healing and, if possible, should be avoided by flap design.

Rudolph, R.

1982-08-01

291

Complications and Continuation of Intrauterine Device Use Among Commercially Insured Teenagers  

PubMed Central

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

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

2014-01-01

292

Nutrition in the Management of Cirrhosis and its Neurological Complications  

PubMed Central

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

Bémeur, Chantal; Butterworth, Roger F.

2013-01-01

293

Thyroid Storm Complicated by Bicytopenia and Disseminated Intravascular Coagulation  

PubMed Central

Patient: Male, 23 Final Diagnosis: Thyroid storm Symptoms: Delirium • diarrhea • fever • hypertension • hyperventilation • tachycardia • weight loss Medication: — Clinical Procedure: — Specialty: Endocrinology and Metabolic Objective: Unusual clinical course Background: The clinical presentation of thyroid storm includes fever, tachycardia, hypertension, and neurological abnormalities. It is a serious condition with a high mortality rate. Furthermore, some other complications affect the clinical course of thyroid storm. Although it is reported that prognosis is poor when thyroid storm is complicated by disseminated intravascular coagulation syndrome (DIC) and leukopenia, reports of such cases are rare. Case Report: A 23-year-old man presented with delirium, high pyrexia, diarrhea, and weight loss of 18 kg over 2 months. According to the criteria of Burch and Wartofsky, he was diagnosed with thyroid storm on the basis of his symptom-complex and laboratory data that confirmed the presence of hyperthyroidism. Investigations also found leukopenia, thrombocytopenia, and disseminated intravascular coagulation, all of which are very rare complications of thyroid storm. We successfully treated him with combined therapy including anti-thyroid medication, despite leukopenia. Conclusions: Early diagnosis and treatment are essential in ensuring a good outcome for patients with this rare combination of medical problems. PMID:25072662

Tokushima, Yoshinori; Sakanishi, Yuta; Nagae, Kou; Tokushima, Midori; Tago, Masaki; Tomonaga, Motosuke; Yoshioka, Tsuneaki; Hyakutake, Masaki; Sugioka, Takashi; Yamashita, Shu-ichi

2014-01-01

294

Microvascular Complications in Adolescents with Type 1 Diabetes Mellitus  

PubMed Central

Objective: Screening of complications is an important part of diabetes care. The aim of this study was to investigate diabetic complications and related risk factors in adolescents with type 1 diabetes mellitus (T1DM). Methods: This cross-sectional study was conducted on type 1 diabetics who were over 11 years of age or had a diabetes duration of 2 years and included 155 adolescents with T1DM (67 male, 88 female). The mean age of the patients was 14.4±2.1 years. Mean diabetes duration was 6.3±2.9 years. The patients were screened for diabetic nephropathy, retinopathy and peripheral neuropathy. Results: Mean glycosylated hemoglobin (HbA1c) level of the study group was 8.4%. The frequency of microalbuminuria and peripheral neuropathy were 16.1% and 0.6%, respectively. None of the patients had diabetic retinopathy. Dyslipidemia and hypertension rates were 30.3% and 12.3%, respectively. Risk factors associated with microalbuminuria were hypertension, higher HbA1c levels, longer diabetes duration and dyslipidemia. Conclusion: Early diagnosis and treatment of hypertension and dyslipidemia as well as achieving a better metabolic control are important in prevention or postponement of complications in patients with T1DM. Yearly screening for diabetic nephropathy should be started 2 years after the onset of the diabetes. Conflict of interest:None declared. PMID:24072081

Demirel, Fatma; Tepe, Derya; Kara, Özlem; Esen, ?hsan

2013-01-01

295

Nutrition in the management of cirrhosis and its neurological complications.  

PubMed

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

Bémeur, Chantal; Butterworth, Roger F

2014-06-01

296

Biomarkers of vascular complications in type 2 diabetes.  

PubMed

People with T2D are at substantially increased risk of developing severe complications, (coronary heart disease, stroke, retinopathy and nephropathy). Clinicians have an important responsibility to identify those patients who, because they are at high risk, will benefit more from a preventive program or intensified therapy. However, due to the limited accuracy of the predictive tests, and limited effectiveness of preventive measures, clinicians and their patients show a suboptimal compliance to such programs. An improved risk assessment will positively impact cost/benefit ratios, opening the door for new intervention. Research involving human genetic or genomic information becomes increasingly powerful and, in conjunction with other novel biomarkers, together with personal or health data, will offer new tools for harnessing risk factors underlying complex (multi-factorial) diseases such as T2D and its complications. Altogether, there is a rationale to develop early biomarkers with improved predictive value for vascular complications of T2D by integrating patients' genetic information with traditional and emerging biomarkers. PMID:25468145

Tremblay, Johanne; Hamet, Pavel

2015-03-01

297

Complications and failure of airway management.  

PubMed

Airway management complications causing temporary patient harm are common, but serious injury is rare. Because most airways are easy, most complications occur in easy airways: these complications can and do lead to harm and death. Because these events are rare, most of our learning comes from large litigation and critical incident databases that help identify patterns and areas where care can be improved: but both have limitations. The recent 4th National Audit Project of the Royal College of Anaesthetists and Difficult Airway Society provides important detailed information and our best estimates of the incidence of major airway complications. A significant proportion of airway complications occur in Intensive Care Units and Emergency Departments, and these more frequently cause patient harm/death and are associated with suboptimal care. Hypoxia is the commonest cause of airway-related deaths. Obesity markedly increases risk of airway complications. Pulmonary aspiration remains the leading cause of airway-related anaesthetic deaths, most cases having identifiable risk factors. Unrecognized oesophageal intubation is not of only historical interest and is entirely avoidable. All airway management techniques fail and prediction scores are rather poor, so many failures are unanticipated. Avoidance of airway complications requires institutional and individual preparedness, careful assessment, good planning and judgement, good communication and teamwork, knowledge and use of a range of techniques and devices, and a willingness to stop performing techniques when they are failing. Analysis of major airway complications identifies areas where practice is suboptimal; research to improve understanding, prevention, and management of such complications remains an anaesthetic priority. PMID:23242753

Cook, T M; MacDougall-Davis, S R

2012-12-01

298

Complications and Outcomes of Primary Phacotrabeculectomy with Mitomycin C in a Multi-Ethnic Asian Population  

PubMed Central

Purpose To determine the occurrence of intraoperative and postoperative complications up to three years after primary phacotrabeculectomy with intraoperative use of Mitomycin C (MMC) in primary open angle (POAG) and primary angle closure glaucoma (PACG) patients, and the effect of postoperative complications on surgical outcome. Methods Retrospective review of 160 consecutive patients with POAG (n = 105) and PACG (n = 55), who underwent primary phacotrabeculectomy with MMC at the National University Hospital, Singapore, from January 1, 2008 to December 31, 2010. Data was collected using a standardized form that included patient demographic information, ocular characteristics and postoperative complications, including hypotony (defined as intraocular pressure < 6 mmHg), shallow anterior chamber (AC) and hyphema. Results The mean age ± standard deviation (SD) of patients was 68.2 ± 8.2 years. No patient lost light perception during duration of follow-up. 77% of the postoperative complications occurred within the first month only. The commonest complications were hypotony (n = 41, 25.6%), hyphema (n = 16, 10.0%) and shallow AC (n = 16, 10.0%). Five patients (3.1%) required reoperation for their complications. Early hypotony (defined as hypotony < 30 days postoperatively) was an independent risk factor for surgical failure (hazard ratio [HR], 5.1; 95% CI, 1.6–16.2; p = 0.01). Hypotony with another complication was also a risk factor for surgical failure (p < 0.02). Conclusions Hypotony, hyphema and shallow AC were the commonest postoperative complications in POAG and PACG patients after phacotrabeculectomy with MMC. Most complications were transient and self-limiting. Early hypotony within the first month was a significant risk factor for surgical failure. PMID:25775362

Sng, Chelvin; Aquino, Maria C.; Chew, Paul

2015-01-01

299

Pulmonary effects and complications of snakebites.  

PubMed

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

Gnanathasan, Ariaranee; Rodrigo, Chaturaka

2014-11-01

300

Infectious complications in patients with liver cirrhosis.  

PubMed

Liver cirrhosis is the end stage of any chronic liver disease. Complications occurring in patients with liver cirrhosis may be specific to this pathology and to gastroenterology (upper gastrointestinal bleeding, hepatic encephalopathy) or may interfere with other specialties (hepatorenal syndrome, spontaneous bacterial peritonitis, and other localized infectious complications). Over the past few decades, major efforts have been made to increase survival in patients with cirrhosis, but unfortunately, few therapeutic methods have been proven effective. Bacterial infections are frequent and serious complications of liver cirrhosis, resulting in high morbidity and mortality, especially in hospitalized patients, despite significant progress in health care for those with advanced liver disease. PMID:25341269

Preda, Sînziana; Trifan, Anca; Gîrleanu, Irina; Stanciu, C; Cojocariu, Camelia

2014-01-01

301

Complications of Intravesical Bacillus Calmette-Guérin  

PubMed Central

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

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

2014-01-01

302

Switching antiretroviral therapy to minimize metabolic complications  

PubMed Central

Advances in HIV therapy have made living with HIV for decades a reality for many patients. However, antiretroviral therapy has been associated with multiple long-term complications, including dyslipidemia, fat redistribution, insulin resistance and increased cardiovascular risk. As newer agents with improved metabolic profiles have become available, there is growing interest in the safety and efficacy of switching ART as a strategy to reduce long-term complications. This article reviews recently published data on switching ART to minimize the contributions of specific agents to these complications. PMID:22171239

Lake, Jordan E; Currier, Judith S

2011-01-01

303

Salmonella hepatitis: an uncommon complication of a common disease.  

PubMed

Typhoid fever is a very common infectious disease of tropics, associated with high morbidity and mortality. Typhoid fever is often associated with hepatomegaly and mildly deranged liver functions; a clinical picture of acute hepatitis is a rare complication. We report a young patient who presented with fever and jaundice and was found to have acute hepatitis secondary to typhoid fever. Recognition of Salmonella hepatitis is of clinical importance as it can mimic acute viral hepatitis. Early institution of specific therapy can improve the prognosis in these patients. Typhoid fever is a very common infectious disease of tropics, associated with high morbidity and mortality. Typhoid fever is often associated with hepatomegaly and mildly deranged liver functions; a clinical picture of acute hepatitis is a rare complication. We report a young patient who presented with fever and jaundice and was found to have acute hepatitis secondary to typhoid fever. Recognition of Salmonella hepatitis is of clinical importance as it can mimic acute viral hepatitis. Early institution of specific therapy can improve the prognosis in these patients. PMID:24479030

Karoli, Ritu; Fatima, Jalees; Chandra, Ashok; Singh, Gagandeep

2012-07-01

304

Complications of microsurgical reconstruction of obstetrical brachial plexus palsy.  

PubMed

The charts of the 173 consecutive patients who underwent microsurgical reconstruction for obstetrical brachial plexus palsy from 1988 to 1999 (inclusive) in the Division of Plastic Surgery at the Hospital for Sick Children were analyzed. The overall complication rate was 33.5 percent, and there was no mortality in this series. The most significant intraoperative complication was accidental extubation, which occurred five times in the first 84 patients (6 percent of this early group; 2.9 percent of the whole series). This complication was addressed by suturing the endotracheal tube to the membranous septum and by using a transparent drape to allow direct visualization of the tube in all 89 subsequent patients. There have been no further accidental extubations. Postoperative fluid overload occurred in 14 patients (8.1 percent), three (1.7 percent) of whom developed pulmonary edema. Intensive care unit admission was required in two of those patients. Diuretic treatment was required in seven patients. No patient receiving less than or equal to 4 ml/kg/hour developed fluid overload, whereas 50 percent of the patients receiving greater than or equal to 10 ml/kg/hour did. Currently, the authors' policy is to strictly limit intravenous maintenance fluids to 4 ml/kg/hour or less. Despite the long and complex procedure required to reconstruct obstetrical brachial plexus palsy, the incidence of significant complications can be minimized with simple precautions, such as suturing the endotracheal tube to the septum or reducing the amount of fluids administered during the operation. PMID:12618596

La Scala, Giorgio C; Rice, Sean B; Clarke, Howard M

2003-04-01

305

Eleven years of experience with the neurologic complications in Korean patients with acute aortic dissection: a retrospective study  

PubMed Central

Background This study attempts to explore the clinical features, possible mechanisms and prognosis of the neurologic complications in patients with acute aortic dissection (AD). Methods Medical records of 278 consecutive patients with AD (165 with type A and 113 with type B dissection) over 11.5 years were retrospectively analyzed for clinical history, CT findings, neurologic complications and outcome. Neurologic complications were classified into early-onset or delayed-onset complications. Independent t-test or Chi-square test (or Fisher exact test) was used for comparing the different groups. Multivariable logistic regression analysis was performed to determine the independent association between variables. Results The mean age of the included patients (145 male and 133 female) was 59.4 years (range 19–91 years). 41 patients (14.7%) had a neurologic complication, which included 21 with early-onset complication and 23 with delayed-onset complication, including 3 with both. Advanced age and classic type of dissection were independently associated with the neurologic complication in patients with type A dissection. The most frequent manifestation was ischemic stroke (26 patients, 9.4%), followed by hypoxic encephalopathy (9, 3.2%), ischemic neuropathy (5, 1.8%), spinal cord ischemia (5, 1.8%), seizure (2, 0.7%), hoarseness (1, 0.4%) and septic encephalopathy (1, 0.4%). Overall in-hospital mortality was 10.1%, whereas the complicated group had a mortality rate of 43.9%. Renal impairment, pulse deficit, neurologic complication and nonsurgical treatment were independent variables for determining in-hospital mortality in patients with type A dissection. Conclusions The dominance of neurologic symptom in the early stage of AD may make its early diagnosis difficult. Besides chest pain and widened mediastinum in chest x-ray, variable neurologic symptoms including left hemiparesis with asymmetric pulse and hypotension may suggest underlying AD. PMID:23692963

2013-01-01

306

Pulmonary hypertension complicating connective tissue disease.  

PubMed

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

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

2013-10-01

307

[Complications of transrectal biopsy of the prostate].  

PubMed

The aim of the study was to assess frequency of various complications of transrectal multifocal biopsy of the prostate (TMBP), to specify prophylactic measures against such complications. Primary TMBP under US guidance was made in 612 patients (mean age 65.8 years, mean level of PSA 12.6 ng/ml). TMBP complications include: hematuria (220 patients, 35.9%), hemospermia (166 patients, 27.1%), pain in the perineum and the rectum (189, 30.9%), acute prostatitis (21 patients, 3.4%), acute orchiepididymitis (7 patients, 1.1%), acute urine retention (9 patients, 1.5%), long-term rectal hemorrhage (13 patients, 2.1%), loss of consciousness during the biopsy (7 patients, 1.1%). The analysis of TMBP complications leads to the conclusion that adequate preparation of the patients and accurate conduction of the prostatic biopsy technique under US guidance make this invasive manipulation diagnostically effective and safe. PMID:15989026

Pushkar', D Iu; Govorov, A V

2005-01-01

308

Fertility Treatments Have Low Complication Rates  

MedlinePLUS

... procedures. As the use of assisted reproductive technology (ART) in the United States increases, efforts have been ... better understanding of how these changes have improved ART complication rates, the researchers examined statistics and trends ...

309

Complications to Avoid with Pre-Diabetes  

MedlinePLUS

... and spreads upwards. Damage to nerves that control digestion can cause vomiting, diarrhea, or constipation. In men, ... Pre-diabetes • What's the Problem? Intro Pre-diabetes & Digestion Complications to Avoid • Understand Your Risks for Pre- ...

310

Acute polyradiculoneuropathy complicating systemic lupus erythematosus.  

PubMed Central

Two elderly patients with systemic lupus erythematosus (SLE) are presented. Both developed an acute polyradiculoneuropathy which is an unusual complication of this disease. Features of their presentation are discussed. PMID:3714625

Morgan, S. H.; Kennett, R. P.; Dudley, C.; Mackworth-Young, C.; Hull, R.; Hughes, G. R.

1986-01-01

311

Renal mucormycosis complicating extracorporeal membrane oxygenation.  

PubMed

Zygomycosis can manifest as severe infections, particularly in immunocompromised patients, which can be nosocomial in nature resulting from complications of invasive procedures. We report the case of a 65-year-old woman with a medical history of unclassified inflammatory rheumatism who underwent arteriovenous extracorporeal membrane oxygenation because of a myocardial failure following the drainage of a tuberculous tamponade. This procedure was complicated by a superinfection of the scarpa which revealed a disseminated zygomycosis with renal involvement. A favorable outcome was achieved after 15 months of antifungal therapy involving the use of liposomal amphotericin B followed with posaconazole which involved the close monitoring of the concentrations of this antifungal. Extracorporeal membrane oxygenation is a frequent procedure which could be complicated with severe fungal nosocomial infections such as zygomycosis. The outcome of such complication can be favorable with the utilization of new antifungal therapies. PMID:22587731

Charles, Pierre; Kahn, Jean-Emmanuel; Ackermann, Felix; Honderlick, Patrick; Lortholary, Olivier

2013-02-01

312

Clinical spectrum of levodopa-induced complications.  

PubMed

The first years of Parkinson disease (PD) treatment are marked by good and sustained responses to dopaminergic therapy. With disease progression and longer exposure to levodopa (l-dopa), patients develop a range of l-dopa-induced complications that include motor and non-motor symptoms. Motor complications include motor fluctuations, characterized by periods of reduced benefit from the medication, and l-dopa-induced dyskinesia, characterized by emergence of hyperkinetic involuntary movements. Dyskinesia can occur at peak effect of l-dopa, at the beginning and end of dose, or between doses. These motor complications are often associated with fluctuations in non-motor symptoms, particularly fluctuations in neuropsychiatric, autonomic, and sensory symptoms. Recognizing such complications and understanding their relationship with the timing of l-dopa doses is essential for adequate diagnosis and management. Society. PMID:25488260

Aquino, Camila Catherine; Fox, Susan H

2015-01-01

313

Avoidance and Management of Stomal Complications  

PubMed Central

The construction of an intestinal stoma is fraught with complications and should not be considered a trivial undertaking. Serious complications requiring immediate reoperations can occur, as can minor problems that will subject the patient to daily and nightly distress. Intestinal stomas undoubtedly will dramatically change lifestyles; patients will experience physiologic and psychologic detriment with stoma-related problems, however minor they may seem. Common complications include poor stoma siting, high output, skin irritation, ischemia, retraction, parastomal hernia (PH), and prolapse. Surgeons should be cognizant of these complications before, during, and after stoma creation, and adequate measures should be taken to avoid them. In this review, the authors highlight these often seen problems and discuss management and prevention strategies. PMID:24436659

Kwiatt, Michael; Kawata, Michitaka

2013-01-01

314

Home Enteral Nutrition (HEN) Complication Chart  

MedlinePLUS

... the tube may be caused by: A. Gastric ulcer/irritation B. Erosion of stomach lining from excessive tube movement C. External granulation tissue. Prevention: 1. Reduce diarrhea (see Complication #2 “Diarrhea”) ...

315

Cirrhosis and its complications: Evidence based treatment  

PubMed Central

Cirrhosis results from progressive fibrosis and is the final outcome of all chronic liver disease. It is among the ten leading causes of death in United States. Cirrhosis can result in portal hypertension and/or hepatic dysfunction. Both of these either alone or in combination can lead to many complications, including ascites, varices, hepatic encephalopathy, hepatocellular carcinoma, hepatopulmonary syndrome, and coagulation disorders. Cirrhosis and its complications not only impair quality of life but also decrease survival. Managing patients with cirrhosis can be a challenge and requires an organized and systematic approach. Increasing physicians’ knowledge about prevention and treatment of these potential complications is important to improve patient outcomes. A literature search of the published data was performed to provide a comprehensive review regarding the management of cirrhosis and its complications. PMID:24833875

Nusrat, Salman; Khan, Muhammad S; Fazili, Javid; Madhoun, Mohammad F

2014-01-01

316

Treatment of biliary complications after liver transplant: results of a single center.  

PubMed

Biliary complications are major sources of morbidity after liver transplant due to vulnerable vascularization of the bile ducts. Biliary complications are the "Achilles' heel" of liver transplant with their high incidence, need for repeated and prolonged treatment, and potential effects on graft and patient survival. Although standardization of reconstruction techniques and improvements in immunosuppression and organ preservation have reduced the incidence of biliary complications, in early reports the morbidity rates are 50%, with related mortality rate 25% to 30%. Prophylaxis is a major issue. Although many risk factors (old donor age, marginal graft, prolonged ischemia time, living-donor liver transplant, partial liver transplant, donation after cardiac death, hepatic arterial thrombosis, organ preservation, chronic rejection, and other donor and recipient characteristics) do not directly affect biliary complications, accumulation of the factors mentioned above, should be avoided. However, no accepted standard has been established. Treatment strategy is a subject of debate. Recently, nonoperative treatment of biliary complications have been preferred for diagnosis and therapy, because percutaneous or endoscopic treatment may prevent the need for surgical intervention. In this study, we reviewed our treatment of early and late biliary complications after liver transplant. PMID:25894131

Yildirim, Sedat; Ayvazoglu Soy, Ebru Hatice; Akdur, Aydincan; Kirnap, Mahir; Boyvat, Fatih; Karakayali, Feza; Torgay, Adnan; Moray, Gokhan; Haberal, Mehmet

2015-04-01

317

Thromboembolic complications in nephrotic syndrome: imaging spectrum.  

PubMed

Thromboembolism is a well-known complication of nephrotic syndrome. Pulmonary embolism, renal vein thrombosis, and deep vein thrombosis are the most common venous thromboembolic diseases in patients with nephrotic syndrome, while arterial thromboembolic complications are observed less frequently. Imaging plays an important role in the detection and follow-up of thromboembolism in these patients. The purpose of this essay is to describe the epidemiology, pathophysiological mechanisms, the imaging diagnosis, and treatment of thromboembolism in patients with nephrotic syndrome. PMID:23081957

Yang, Gui Fen; Schoepf, U Joseph; Zhu, Hong; Lu, Guang Ming; Gray, J Cranston; Zhang, Long Jiang

2012-12-01

318

Esophageal rupture complicated by acute pericarditis.  

PubMed

Esophageal perforation is a serious condition with a high mortality rate. Delayed detection of esophageal perforation may result in devastating complications such as mediastinitis and pericarditis. Esophageal perforation is rarely due to aspiration of foreign bodies. Here we report the case of a 59-year-old male patient with complicated esophageal perforation due to ingestion of a chicken bone, whose first signs are considered to be acute non-specific pericarditis. PMID:25490302

Duman, Hakan; Bak?rc?, Eftal Murat; Karada?, Zakir; U?urlu, Yavuz

2014-10-01

319

Complications in pediatric cochlear implant surgery  

Microsoft Academic Search

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

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

1999-01-01

320

Trends in neurological complications of endocarditis  

Microsoft Academic Search

\\u000a Abstract\\u000a   Neurological complications (NCs) are a major cause of morbidity and mortality in patients with infectious endocarditis (IE).\\u000a The frequency of these complications has been found to remain constant since the preantibiotic era despite profound epidemiological\\u000a changes and therapeutic advances. We have reviewed retrospectively all the cases of IE attended at a single institution between\\u000a 1985 and 2003, aiming to

Ińigo Corral; Pilar Martín-Dávila; Jesús Fortún; Enrique Navas; Tomasa Centella; José Luis Moya; Javier Cobo; Carmen Quereda; Vicente Pintado; Santiago Moreno

2007-01-01

321

Fatal bilateral pneumothoraces complicating subclavian vein catheterization.  

PubMed

Bilateral pneumothoraces complicating attempted bilateral subclavian vein catheterization culminated in the iatrogenic death of the patient. Complications of subclavian vein catheterization are reviewed briefly. This procedure should be limited to patients in whom its use is clearly indicated and should be performed only by individuals who are experienced in the anatomy of the region, who are trained in the technique of subclavian puncture, and who have the means and ability to perform immediate tube thoracostomy should pneumothorax occur. PMID:404118

Maggs, P R; Schwaber, J R

1977-04-01

322

Complicated Grief in Survivors of Suicide  

Microsoft Academic Search

Complicated grief is a newly defined and distinctive psychiatric disorder that occurs in response to a significant loss through death. New findings suggest that survivors who were close to the deceased are at heightened risk for complicated grief. Little is known about whether close kinship (spouses, parents, children, siblings, vs. in-laws, aunts\\/uncles, nieces\\/nephews, friends, or coworkers) to a suicide victim

Ann M. Mitchell; Yookyung Kim; Holly G. Prigerson; MaryKay Mortimer-Stephens

2004-01-01

323

Complications Associated With Intermittent Pneumatic Compression  

Microsoft Academic Search

Lachmann EA, Rook JL, Tunkel R, Nagler \\\\V. Complications associated with intermittent pneumatic compression. Arch Phys Med Rehabil I992;73:482-5. • The intermittent pneumatic compression device (1PCD) is prophylaxis for prevention of deep-venous thrombosis (DVT). This pneumatic leg sleeve has been used extensively in high-risk surgical patients, without complication. We describe two cases, one with peroneal neuropathy and the other with

Elisabeth A. Lachmann; Jack L. Rook; Richard Tunkel; Willibald Nagler

324

Complications of second and third trimester pregnancies.  

PubMed

The second and third trimester of pregnancy is a period of extensive physical growth and maturation of the fetus. Unfortunately, it is also a period that is marked by complications that can be life threatening for both the mother and fetus. The top three complications that affect pregnancy are hemorrhage, infection, and the hypertensive diseases of pregnancy. This article focuses on preterm labor, premature rupture of membranes, chorioamnionitis, bleeding in later pregnancy, and the hypertensive diseases of pregnancy. PMID:12962354

Abbrescia, Kelly; Sheridan, Barry

2003-08-01

325

Complications of abortion performed under local anesthesia  

Microsoft Academic Search

Objective. To assess the incidence of complications of abortion performed under local anesthesia.Design. Prospective study.Setting. A family planning center in the Paris area.Population. Eight hundred and fifty-eight women admitted for abortion under local anesthesia.Main outcome measures. Incidence of immediate (the day of vacuum aspiration) and delayed complications (at the follow-up visit 2 weeks after the procedure).Results. Among the 858 women

Patrick Thonneau; Beatrice Fougeyrollas; Beatrice Ducot; Dominique Boubilley; Jouda Dif; Martine Lalande; Catherine Soulat

1998-01-01

326

Complications of anterior compartment vaginal surgery  

Microsoft Academic Search

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

Eric S. Rovner

2007-01-01

327

Complications Detection in Treatment for Bacterial Endocarditis  

Microsoft Academic Search

\\u000a This study proposes the use of decision trees to detect possible complications in a critical disease called endocarditis.\\u000a The endocarditis illness could produce heart failure, stroke, kidney failure, emboli, immunological disorders and death. The\\u000a aim is to obtained a tree decision classifier based on the symptoms (attributes) of patients (the data instances) observed\\u000a by doctors to predict the possible complications

Leticia Curiel; Bruno Baruque; Carlos Dueńas; Emilio Corchado; Cristina Pérez

328

Complications of laparoscopic paraesophageal hernia repair  

Microsoft Academic Search

The complications of laparoscopic paraesophageal hernia repair at two institutions were reviewed to determine the rate and\\u000a type of complications. A total of 76 patients underwent laparoscopic paraesophageal hernia repair between December 1992 and\\u000a April 1996. Seventy-one of them had fundoplication (6 required a Collis-Nissen procedure). Five patients underwent hernia\\u000a reduction and gastropexy only. There was one conversion to laparotomy.

Thadeus L. Trus; Tim Bax; William S. Richardson; Gene D. Branum; Susan J. Mauren; Lee L. Swanstrom; John G. Hunter

1997-01-01

329

Self-expanding prostheses complicating augmentation mammoplasties.  

PubMed

A new and serious complication was experienced by patients of three independent surgeons following routine augmentation procedures. In each case reported, double-lumen prostheses had been used. All cases were reoperated with a diagnosis of capsular contracture. However, at surgery it was found that the outer lumen of the prostheses had overfilled with 60-160 cc of interstitial fluid, probably because of an osmotic gradient. The possible causes of this unfortunate complication are considered. PMID:8017225

Signorini, M; Grisotti, A; Ponzielli, G; Pajardi, G; Gilardino, P

1994-01-01

330

Traumatic neuroma: a late complication of otoplasty.  

PubMed

We report on the development of traumatic ear lobe neuromas as a late complication of bilateral otoplasty performed 16 years previously. To our knowledge, this is the first and only described case of traumatic neuromas arising as a late complication of otoplasty in the English literature. Traumatic neuroma should be considered in the differential diagnosis of any nodular lesions that develop within the external ear in patients who have had otoplasty or any other form of external ear surgery or trauma. PMID:17362823

Lwin, Christine T-T; Birch, Jeremy; Giele, Henk

2007-01-01

331

MicroRNAs and Diabetic Complications  

PubMed Central

Both Type 1 and Type 2 diabetes can lead to debilitating microvascular complications such as retinopathy, nephropathy and neuropathy, as well as macrovascular complications such as cardiovascular diseases including atherosclerosis and hypertension. Diabetic complications have been attributed to several contributing factors such as hyperglycemia, hyperlipidemia, advanced glycation end products, growth factors and inflammatory cytokines/chemokines. However, current therapies are not fully efficacious and hence there is an imperative need for a better understanding of the molecular mechanisms underlying diabetic complications in order to identify newer therapeutic targets. microRNAs (miRNAs) are short non-coding RNAs that repress target gene expression via post-transcriptional mechanisms. Emerging evidence shows that they have diverse cellular and biological functions and play key roles in several diseases. In this review, we explore the role of miRNAs in the pathology of diabetic complications and also discuss the potential use of miRNAs as novel diagnostic and therapeutic targets for diabetic complications. PMID:22552970

Natarajan, Rama; Putta, Sumanth; Kato, Mitsuo

2012-01-01

332

Excess costs attributable to postoperative complications.  

PubMed

This article estimates excess costs associated with postoperative complications among inpatients treated in Veterans Health Administration (VA) hospitals. The authors conducted an observational study on 43,822 hospitalizations involving inpatient surgery in one of 104 VA hospitals during fiscal year 2007. Hospitalization-level cost regression analyses were performed to estimate the excess cost of each of 18 unique postoperative complications. The authors used generalized linear modeling techniques to account for the heavily skewed cost distribution. Costs were measured using an activity-based cost accounting system and complications were assessed based on medical chart review conducted by the VA 'National Surgical Quality Improvement Program. The authors found excess costs associated with postoperative complications ranging from $8,338 for "superficial surgical site infection" to $29,595 for "failure to wean within 24 hours in the presence of respiratory complications." The results obtained suggest that quality improvement efforts aimed at reducing postoperative complications can contribute significantly to lowering of hospital costs. PMID:21536599

Carey, Kathleen; Stefos, Theodore; Shibei Zhao; Borzecki, Ann M; Rosen, Amy K

2011-08-01

333

Standardizing the reporting of percutaneous nephrolithotomy complications  

PubMed Central

Accurate reporting of complications is an essential component to critical appraisal and innovation in surgery and specifically with percutaneous nephrolithotomy (PCNL). We review the evolution of complication reporting for PCNL and suggest future directions for innovation. A selective review was carried out using Pubmed. Key search terms and their combinations included percutaneous, anatrophic, nephrolithotomy, PCNL, complications, Clavien, Martin score, bleeding, bowel injury, perforation, fever, sepsis. The references from relevant papers and reviews as well as AUA and EAU guidelines were also scanned for inclusion. PCNL has become the procedure of choice for large renal stones owing to decreased morbidity over alternative procedures. Both common and rare complications have been described in large case series, small randomized controlled trials, and case reports in an unstandardized form. Although these reports have provided an informative starting point, a standardized complication reporting methodology is necessary to enable appropriate comparisons between institutions, time periods, or innovations in technique. The Clavien-Dindo grading system has become widely accepted in urology and has facilitated the study of PCNL complications. Future research should focus on adaptions of this system to render it more comprehensive and applicable to PCNL. PMID:24497689

Violette, Philippe D.; Denstedt, John D.

2014-01-01

334

Elevated Aldosterone in Amniotic Fluid and Maternal Blood Has Diagnostic Potential in Pregnancies Complicated with a Fetus of Bartter Syndrome  

Microsoft Academic Search

Pregnancies with fetuses affected with the Bartter syndrome, an autosomal recessive disorder of hyperreninism and hyperaldosteronism, are complicated by early onset of polyhydramnios which results in preterm deliveries. We have assessed biochemical changes in amniotic fluid and the mother’s blood with a view to early diagnosis. Aldosterone levels of both amniotic fluid and the mother’s blood were found to be

Tamao Nakanishi; Nobuhiro Suzumori; Haruo Mizuno; Kazutaka Suzuki; Takeshi Sato; Mitsuyo Tanemura; Yoshikatsu Suzuki; Kaoru Suzumori

2005-01-01

335

Growth hormone and early treatment.  

PubMed

Growth hormone (GH) treatment is approved by the US Food and Drug Administration (FDA) not only for GH deficiency (GHD) but also for other childhood growth disorders with growth failure and/or short stature. GHD is the most frequent endocrine disorder presenting with short stature in childhood. During neonatal period, metabolic effects due to congenital GHD require a prompt replacement therapy to avoid possible life-threatening complications. In childhood and adolescence, growth impairment is the most evident effect of GHD and early treatment has the aim of restore normal growth and to reach normal adult height. We reassume in this review the conditions causing GHD and the diagnostic challenge to reach an early diagnosis, and an early treatment, necessary to obtain the best results. Finally, we summarize results obtained in clinical studies about pediatric patients with GHD treated at an early age, in which a marked early catch-up growth and a normalization of adult height were obtained. PMID:25734895

Antoniazzi, F; Cavarzere, P; Gaudino, R

2015-06-01

336

Laparoscopic Radical Prostatectomy: Perioperative Complications in an Initial and Consecutive Series of 80 Cases  

Microsoft Academic Search

Objectives: We retrospectively evaluated the intraoperative and early postoperative complications of the initial experience with the first 80 laparoscopic radical prostatectomies performed at our institution.Methods: Between January 17, 2001 and July 24, 2002, 80 patients between 53 and 78 years old (mean age 63.8) with clinically localized prostate cancer underwent laparoscopic radical prostatectomy with the Montsouris technique. A total of

Andrea Gregori; Alchiede Simonato; Andrea Lissiani; Andrea Bozzola; Stefano Galli; Franco Gaboardi

2003-01-01

337

MD Anderson study finds side effects, complications, and mastectomy are more likely after partial breast irradiation:  

Cancer.gov

Accelerated partial breast irradiation (APBI) brachytherapy, the localized form of radiation therapy growing increasingly popular as a treatment choice for women with early-stage breast cancer, is associated with higher rate of later mastectomy, increased radiation-related toxicities and post-operative complications, compared to traditional whole breast irradiation (WBI), according to researchers from The University of Texas MD Anderson Cancer Center.

338

[Classification of complications of combined injuries of abdominal organs and long tubular bones in traffic accidents].  

PubMed

The outcomes of treatment of 386 victims with abdominal trauma and fractures of the long tubular bones were studied. The authors systematized the typical complications developing after the trauma, both on the part of the injured organs of the abdominal cavity and true pelvis and the fractures of the long tubular bones. This allowed the developed complications to be divided according to time into early, late, and sequelae of trauma. The early complications of injuries to the organs of the abdomen and true pelvis are as follows: suppuration of postoperative wounds, postoperative wound dehiscence with or without eventration, recurrent intracavitary hemorrhage, progressing local peritonitis, incompetence of anastomoses, intestinal obstruction, abdominal abscesses and infiltrates, abscesses and infiltrates in the true pelvis, intestinal paresis, large hematomas, phlegmons of the anterior abdominal wall. The late complications are: sluggish wounds of the anterior abdominal wall, formation of ligature fistulas, postoperative ventral hernias, suppuration of intraorganic and interstitial hematomas, subclinical forms of sepsis and sepsis, thrombophlebitic complications, chronic venous insufficiency, persistent wounds, and other complications. The sequelae of injury to the organs of the abdominal cavity and true pelvis are: intestinal fistulas, functional intestinal disorders, gastric disease, the dumping syndrome, cicatricial changes of the anterior abdominal wall, posttraumatic disease, venous insufficiency, pneumosclerosis, chronic pneumonia, pulmonary emphysema, chronic vascular insufficiency, etc. The early complications in fractures of long tubular bones in the group of studied patients: suppuration of osteomuscular wounds, recurrent displacement of bone fragments, bone necrosis in open type IIIC, IIID fractures, gangrene of the limb consequent upon crushing of skin and subcutaneous tissue, subluxations, secondary subluxations of limbs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1469878

Popov, I F; Berezka, N I; Gnedushkin, Iu N; Iavdak, A K

1992-01-01

339

Hardware complications related to the surgical fixation of slipped capital femoral epiphyses.  

PubMed

Slipped upper femoral epiphysis is a disabling condition with an annual incidence of 2-13 per 100,000. In situ surgical fixation is the preferred initial treatment for both stable and unstable slipped capital femoral epiphysis (SCFE) cases. The main aim is to avoid further slippage and complications such as osteonecrosis and chondrolysis. The choice of medical implants in managing this condition has changed along the years from large nail-like devices to cannulated screws. The biomechanical properties of different fixation techniques have been studied. All implants have been associated with complications that can occur intraoperatively as well as in the early and late postoperative periods. This report examines a number of different implants used and identifies complications and ways on how to avoid such complications. It also looks at the complications directly related to medical implants in the management of SCFE. We looked at published literature in peer-reviewed journals describing the use of the different medical implants and the documented complications. We also examined literature that suggests ways on how to avoid and manage these complications. A review of the current literature is presented in this text. PMID:25272215

Massa, Edward; Silk, Zacharia; Heidari, Nima; Ramachandran, Manoj

2014-01-01

340

[Early Intervention.  

ERIC Educational Resources Information Center

This newsletter focuses on the theme of early intervention which infants and young children with special needs in nine brief articles: "Early Intervention: A Matter of Context" (Samuel J. Meisels); "Early Intervention Research: Asking and Answering Meaningful Questions" (Jack P. Shonkoff); "From Case Management to Service Coordination: Families,…

Pawl, Jeree, Ed.

1992-01-01

341

A prospective study of complications from comprehensive abortion care services in Nepal  

PubMed Central

Background In March 2002, Nepal's Parliament approved legislation to permit abortion on request up to 12 weeks of pregnancy. Between 2004 and 2007, 176 comprehensive abortion care (CAC) service sites were established in Nepal, leading to a rise in safe, legal abortions. Though monitoring systems have been developed, reporting of complications has not always been complete or accurate. The purpose of this study was to report the frequency and type of abortion complications arising from CAC procedures in different types of facilities in Nepal. Methods A total of 7,386 CAC clients from a sample of facilities across Nepal were enrolled over a three-month period in 2008. Data collection included an initial health questionnaire at the time of abortion care and a follow-up questionnaire assessing complications, administered two weeks after the abortion procedure. A total of 7,007 women (95%) were successfully followed up. Complication rates were assessed overall and by facility type. Multivariable logistic regression was used to assess the association between experiencing a complication and client demographic and facility characteristics. Results Among the 7,007 clients who were successfully followed, only 1.87% (n = 131) experienced signs and symptoms of complications at the two-week follow up, the most common being retained products of conception (1.37%), suspected sepsis (0.39%), offensive discharge (0.51%) and moderate bleeding (0.26%). Women receiving care at non-governmental organization (NGO) facilities were less likely to experience complications than women at government facilities, adjusting for individual and facility characteristics (AOR = 0.18; 95% CI: 0.08-0.40). Compared to women receiving CAC at 4-5 weeks gestation, women at 10-12 weeks gestation were more likely to experience complications, adjusting for individual and facility characteristics (AOR = 4.21; 95% CI: 1.38-12.82). Conclusions The abortion complication rate in Nepali CAC facilities is low and similar to other settings; however, significant differences in complication rates were observed by facility type and gestational age. Interventions such as supportive supervision to improve providers' uterine evacuation skills and investment in equipment for infection control may lower complication rates in government facilities. In addition, there should be increased focus on early pregnancy detection and access to CAC services early in pregnancy in order to prevent complications. PMID:22221895

2012-01-01

342

Perioperative complications of total ankle arthroplasty.  

PubMed

A retrospective radiographic and chart review was performed for the initial 50 patients who underwent Agility (DePuy, Warsaw IN) total ankle arthroplasty by the senior author (M.S.M.). The review focused on the perioperative complications of nerve or tendon lacerations, intraoperative fractures, acute deep infections, wound complications and component positioning. Major wound complications were defined as those requiring a soft-tissue coverage procedure. Minor wound complications did not require soft tissue coverage and included wound breakdowns, wound edge necrosis, and superficial infections. The immediate mortise and lateral postoperative radiographs were reviewed to measure component positioning. The patients were divided into two groups to compare the initial 25 patients (Group A) with the subsequent 25 patients (Group B). There were no major wound complications in either group. Minor wound complications decreased from six in Group A to two in Group B. There were four lacerations (flexor hallucis longus, posterior tibial tendon, deep peroneal nerve, and superficial peroneal nerve), all occurring in Group A. Five patients sustained intraoperative fractures in Group A, as compared with two fractures in Group B. The number of components varying greater than 4 degrees from neutral as measured by the lateral talar, lateral tibial and mortise tibial component angles decreased by 9% from Group A to Group B. The only tibial component to be placed in more than 4 degrees of valgus occurred in Group A. It seems that a notable learning curve exists in the performance of total ankle arthroplasty as demonstrated by a comparison of the initial 25 patients with the subsequent 25 patients performed by one orthopaedic surgeon. This improvement most likely resulted from the use of enhanced techniques and further training with the prosthesis. This information can be used as a teaching tool to decrease the incidence of complications for surgeons performing their initial arthroplasties with this potentially technically demanding procedure. PMID:12540076

Myerson, Mark S; Mroczek, Kenneth

2003-01-01

343

Pregnancy complications among women born preterm  

PubMed Central

Background: Adults who were born with low birth weights are at increased risk of cardiovascular and metabolic conditions, including pregnancy complications. Low birth weight can result from intrauterine growth restriction, preterm birth or both. We examined the relation between preterm birth and pregnancy complications later in life. Methods: We conducted a population-based cohort study in the province of Quebec involving 7405 women born preterm (554 < 32 weeks, 6851 at 32–36 weeks) and a matched cohort of 16 714 born at term between 1976 and 1995 who had a live birth or stillbirth between 1987 and 2008. The primary outcome measures were pregnancy complications (gestational diabetes, gestational hypertension, and preeclampsia or eclampsia). Results: Overall, 19.9% of women born at less than 32 weeks, 13.2% born at 32–36 weeks and 11.7% born at term had at least 1 pregnancy complication at least once during the study period (p < 0.001). Women born small for gestational age (both term and preterm) had increased odds of having at least 1 pregnancy complication compared with women born at term and at appropriate weight for gestational age. After adjustment for various factors, including birth weight for gestational age, the odds of pregnancy complications associated with preterm birth was elevated by 1.95-fold (95% confidence interval [CI] 1.54–2.47) among women born before 32 weeks’ gestation and 1.14-fold (95% CI 1.03–1.25) among those born at 32–36 weeks’ gestation relative to women born at term. Interpretation: Being born preterm, in addition to, and independent of, being small for gestational age, was associated with a significantly increased risk of later having pregnancy complications. PMID:23008489

Boivin, Ariane; Luo, Zhong-Cheng; Audibert, François; Mâsse, Benoit; Lefebvre, Francine; Tessier, Réjean; Nuyt, Anne Monique

2012-01-01

344

Catecholamine predictors of complicated grief treatment outcomes.  

PubMed

Could sympathetic hyperarousal limit treatment success in complicated grief? The present study investigated persons with complicated grief, a chronic condition with distinct symptoms including persistent intense yearning and longing for the person who died, avoidance of reminders that the person is gone, deep relentless sadness, self-blame, bitterness, or anger in connection with the death, and an inability to gain satisfaction or joy through engaging in meaningful activities or relationships with significant others. Length of bereavement did not correlate with complicated grief scores. Catecholamines (i.e., epinephrine, norepinephrine, dopamine) in plasma were assessed pre- and post-psychotherapeutic treatment. Participants with the highest levels of epinephrine at pre-treatment had the highest levels of complicated grief symptoms at post-treatment, accounting for baseline levels of symptoms. This predictive relationship was not seen for depressive symptoms. The present study supports the hypothesis that catecholamine levels are affected by bereavement, and in turn, can affect the ability of those with complicated grief to benefit from psychotherapy. PMID:23044089

O'Connor, Mary-Frances; Shear, M Katherine; Fox, Rachel; Skritskaya, Natalia; Campbell, Bevin; Ghesquiere, Angela; Glickman, Kim

2013-06-01

345

Acute complications of spinal cord injuries.  

PubMed

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

Hagen, Ellen Merete

2015-01-18

346

Neurologic complications of valvular heart disease.  

PubMed

Valvular heart disease (VHD) is frequently associated with neurologic complications; cerebral embolism is the most common of these since thrombus formation results from the abnormalities in the valvular surfaces or from the anatomic and physiologic changes associated with valve dysfunction, such as atrial or ventricular enlargement, intracardiac thrombi, and cardiac dysrhythmias. Prosthetic heart valves, particularly mechanical valves, are very thrombogenic, which explains the high risk of thromboembolism and the need for anticoagulation for the prevention of embolism. Infective endocarditis is a disease process with protean manifestations that include not only cerebral embolism but also intracranial hemorrhage, mycotic aneurysms, and systemic manifestations such as fever and encephalopathy. Other neurologic complications include nonbacterial thrombotic endocarditis, a process associated with systemic diseases such as cancer and systemic lupus erythematosus. For many of these conditions, anticoagulation is the mainstay of treatment to prevent cerebral embolism, therefore it is the potential complications of anticoagulation that can explain other neurologic complications in patients with VHD. The prevention and management of these complications requires an understanding of their natural history in order to balance the risks posed by valvular disease itself against the risks and benefits associated with treatment. PMID:24365289

Cruz-Flores, Salvador

2014-01-01

347

Acute complications of spinal cord injuries  

PubMed Central

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

Hagen, Ellen Merete

2015-01-01

348

Complications of Microsurgery of Vestibular Schwannoma  

PubMed Central

Background. The aim of this study was to analyze complications of vestibular schwannoma (VS) microsurgery. Material and Methods. A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup. Results. In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225) removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III–VI) was observed in 124 cases (45%) immediately after surgery and in 104 cases (33%) on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX–XI) deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%), headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis. Conclusions. Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery. PMID:24987677

Zv??ina, Eduard; Balogová, Zuzana; Sk?ivan, Ji?í; Kraus, Josef; Syka, Josef; Chovanec, Martin

2014-01-01

349

Gut microbiota-related complications in cirrhosis  

PubMed Central

Gut microbiota plays an important role in cirrhosis. The liver is constantly challenged with commensal bacteria and their products arriving through the portal vein in the so-called gut-liver axis. Bacterial translocation from the intestinal lumen through the intestinal wall and to mesenteric lymph nodes is facilitated by intestinal bacterial overgrowth, impairment in the permeability of the intestinal mucosal barrier, and deficiencies in local host immune defences. Deranged clearance of endogenous bacteria from portal and systemic circulation turns the gut into the major source of bacterial-related complications. Liver function may therefore be affected by alterations in the composition of the intestinal microbiota and a role for commensal flora has been evidenced in the pathogenesis of several complications arising in end-stage liver disease such as hepatic encephalopathy, splanchnic arterial vasodilatation and spontaneous bacterial peritonitis. The use of antibiotics is the main therapeutic pipeline in the management of these bacteria-related complications. However, other strategies aimed at preserving intestinal homeostasis through the use of pre-, pro- or symbiotic formulations are being studied in the last years. In this review, the role of intestinal microbiota in the development of the most frequent complications arising in cirrhosis and the different clinical and experimental studies conducted to prevent or improve these complications by modifying the gut microbiota composition are summarized. PMID:25400446

Gómez-Hurtado, Isabel; Such, José; Sanz, Yolanda; Francés, Rubén

2014-01-01

350

Management of neurological complications of infective endocarditis in ICU patients  

PubMed Central

Patients with infective endocarditis (IE) are generally referred to the intensive care unit (ICU) for one or more organ dysfunctions caused by complications of IE. Neurologic events are frequent causes of ICU admission in patients with IE. They can arise through various mechanisms consisting of stroke or transient ischemic attack, cerebral hemorrhage, mycotic aneurysm, meningitis, cerebral abscess, or encephalopathy. Most complications occur early during the course of IE and are a hallmark of left-sided abnormalities of native or prosthetic valves. Occlusion of cerebral arteries, with stroke or transient ischemic attack, accounts for 40% to 50% of the central nervous system complications of IE. CT scan is the most easily feasible neuroimaging in critically unstable patients. However, magnetic resonance imaging is more sensitive and when performed should follow a standardized protocol. In patients with ischemic stroke who are already receiving oral anticoagulant therapy, this treatment should be replaced by unfractionated heparin for at least 2 weeks with a close monitoring of coagulation tests. Mounting evidence shows that, for both complicated left-sided native valve endocarditis and Staphylococcus aureus prosthetic valve endocarditis, valve replacement combined with medical therapy is associated with a better outcome than medical treatment alone. In a recent series, approximately 50% of patients underwent valve replacement during the acute phase of IE before completion of antibiotic treatment. After a neurological event, most patients have at least one indication for cardiac surgery. Recent data from literature suggest that after a stroke, surgery indicated for heart failure, uncontrolled infection, abscess, or persisting high emboli risk should not be delayed, provided that the patient is not comatose or has no severe deficit. Neurologic complications of IE contribute to a severe prognosis in ICU patients. However, patients with only silent or transient stroke had a better prognosis than patients with symptomatic events. In addition, more than neurologic event per se, a better predictor of mortality is neurologic dysfunction, which is associated with location and extension of brain damage. Patients with severe neurological impairment and those with brain hemorrhage have the worse outcome. PMID:21906336

2011-01-01

351

Vaginal Evisceration: An Unexpected Complication of Conization  

PubMed Central

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

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

2014-01-01

352

Ophthalmic complications associated with orthognathic surgery.  

PubMed

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

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

1993-05-01

353

Neurological complications associated with epidural steroid injections.  

PubMed

Multiple case reports of neurological complications resulting from intraarterial injection of corticosteroids have led the Food and Drug Administration (FDA) to issue a warning, requiring label changes, warning of serious neurological events, some resulting in death. The FDA has identified 131 cases of neurological adverse events, including 41 cases of arachnoiditis. A review of the literature reveals an overwhelming proportion of the complications are related to transforaminal epidural injections, of which cervical transforaminal epidural injections constituted the majority of neurological complications. Utilization data of epidural injections in the Medicare population revealed that cervical transforaminal epidural injections constitute only 2.4 % of total epidural injections and <5 % of all transforaminal epidural injections. Multiple theories have been proposed as the cause of neurological injury including particulate steroid, arterial intimal flaps, arterial dissection, dislodgement of plaque causing embolism, arterial muscle spasm, and embolism of a fresh thrombus following disruption of the intima. PMID:25795154

Manchikanti, Laxmaiah; Hirsch, Joshua A

2015-05-01

354

Pathogenesis of diabetic cerebral vascular disease complication  

PubMed Central

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

Xu, Ren-Shi

2015-01-01

355

Neurological Complications of Solid Organ Transplantation  

PubMed Central

Solid organ transplantation (SOT) is the preferred treatment for an expanding range of conditions whose successful therapy has produced a growing population of chronically immunosuppressed patients with potential neurological problems. While the spectrum of neurological complications varies with the type of organ transplanted, the indication for the procedure, and the intensity of long-term required immunosuppression, major neurological complications occur with all SOT types. The second part of this 2-part article on transplantation neurology reviews central and peripheral nervous system problems associated with SOT with clinical and neuroimaging examples from the authors’ institutional experience. Particular emphasis is given to conditions acquired from the donated organ or tissue, problems specific to types of organs transplanted and drug therapy-related complications likely to be encountered by hospitalists. Neurologically important syndromes such as immune reconstitution inflammatory syndrome (IRIS), posterior reversible encephalopathy syndrome (PRES), and posttransplantation lymphoproliferative disorder (PTLD) are readdressed in the context of SOT. PMID:24167649

Pruitt, Amy A.; Graus, Francesc; Rosenfeld, Myrna R.

2013-01-01

356

Curcumin: a pleiotropic phytonutrient in diabetic complications.  

PubMed

Curcumin is the major polyphenolic constituent of an indigenous herb, Curcuma longa, found to have a wide range of applications right from its kitchen use as a spicy ingredient to therapeutic and medicinal applications in various diseases. Curcumin has been identified to have a plethora of biologic and pharmacologic properties owing to its antioxidant and anti-inflammatory activities. This pleiotropic regulation of redox balance of cell and inflammation might be the basis of curcumin's beneficial activities in various pathologic conditions including diabetic complications. This review summarizes various in vitro, in vivo studies done on curcumin and its therapeutic utility in diabetic micro-vascular complications. This review also emphasizes the importance of curcumin in addition to the existing therapeutic modalities in diabetic complications. PMID:25441584

Jeenger, Manish Kumar; Shrivastava, Shweta; Yerra, Veera Ganesh; Naidu, V G M; Ramakrishna, Sistla; Kumar, Ashutosh

2015-02-01

357

Psychiatric complications of burned adults: a classification.  

PubMed

The psychiatric complications occurring in a group of adult burn patients were correlated with pertinent data in the literature and a classification constructed, based on the three stages of the acute grief response to injury: psychiatric complications occur when the process of mourning is arrested in a regressive episode. Thirty-five adult patients with burns of greater than 7% body surface area were studied. It was found that Body Surface Area burned, the presence of a Premorbid Psychiatric Diagnosis, and Age are all significantly correlated with the occurrence of psychiatric complications following burn injuries and account for 61% of the variance in the sample. The implications of these findings and possibilities for further research are discussed. PMID:846020

Steiner, H; Clark, W R

1977-02-01

358

Radiation-induced neurological complications of nasopharyngeal carcinoma Radiation-induced neurological complications of nasopharyngeal carcinoma Radiation-induced neurological complications of nasopharyngeal carcinoma Radiation-induced neurological complications of nasopharyngeal carcinoma Radiation-induced neurological complications of nasopharyngeal carcinoma  

Microsoft Academic Search

Objectives: To review radiation-induced neurological complications of nasopharyngeal carcinoma (NPC). Materials & Methods: Retrospective review of patients with radiation-induced neurological complications of NPC who presented to the Neurology and Neurosurgery Departments, Tan Tock Seng Hospital in the five-year period from 1994 to 99. Results: Nine patients with 10 neurological complications were seen. Four patients had cranial nerve palsies, of whom

LCS Tan; YY Sitoh; HTL Tjia

1999-01-01

359

Complications analysis of 266 immediate breast reconstructions.  

PubMed

The purpose of this study was to describe the complications of immediate breast reconstruction, to compare their rates with respect to the surgical procedure and to patient's characteristics, in order to improve surgical indications and patient information. We carried out a retrospective study of 266 immediate breast reconstructions (249 women) over a 12-year period (latissimus dorsi myocutaneous flap with implant 61%, autologous latissimus dorsi myocutaneous flap 15%, subpectoral implant 24%). Mean age was 48 and the median follow-up was seven years (2-14). The overall complication rate was 49% (128), and there were 10 reconstruction failures. The most frequent complications were dorsal seroma 26% (70), capsular contracture 10% (27), skin necrosis 8.3% (22), and haematoma 5.6% (15). The complication rate for immediate breast reconstruction with implant alone (39%) was lower than that associated with latissimus dorsi with or without implant (51%), but the difference was not significant (Chi-square: p=0.07). The risk factors for complications were smoking (skin necrosis, Fisher: p=0.02), obesity (infection, Fisher: p=0.004), and radiotherapy (capsular contracture, Chi-square: p=2.6 x 10(-5)). Smoking was found as the only risk factor of reconstruction failure (Fisher: p=0.015). Capsular contractures were more frequent when implants were used alone (25%) as well as when used along with a flap (6.8%) (Chi-square: p=2 x 10(-5)). Infections were also higher in the non-flap group than in the flap group (Fisher: p=0.02). In our opinion, latissimus dorsi myocutaneous flap with or without an implant is a good compromise between complication risk and necessity of good cosmetic result requirement. These results have led us to delay or contraindicate reconstruction in the case of obesity or heavy smoking. In the case of probable post-operative radiotherapy, we prefer to delay the breast reconstruction. PMID:16996422

Pinsolle, Vincent; Grinfeder, Christophe; Mathoulin-Pelissier, Simone; Faucher, Alain

2006-01-01

360

Long-term complications of JJ stent and its management: A 5 years review  

PubMed Central

Objectives: To assess the long term complications of JJ stent, the management of complications and the role of endoscopic approach to manage these complications. Materials and Methods: Nineteen patients with indwelling JJ stent for a duration of more than 6 months were included in this study. Patients were assessed with X-ray KUB, USG KUB, blood urea, creatinine and DTPA renogram. Data were analyzed by Microsoft excel 2007. Results: Out of 19 patients 12 (63.16%) were male and 7 (36.84%) were female. The mean age was 39.78 ± 13.69 years., Mean duration for which the stent was in situ was 29.56 months. The most common complication was broken stent, in 11 cases (57.89%). Other complications were migration in 5 (26.32%), encrustation in 2 (10.52%) and 1 case of (5.26%) stone formation. Eighteen cases were managed by endoscopic approaches. A total of 22 procedures were performed to treat the complications. Eleven cases were managed by a single procedure and 8 patients required multiple procedures. All were managed successfully with no death reported. Post-operative complications were seen in eight cases (42.11%). Conclusions: JJ stent related long-term complications are not uncommon and are usually seen after 6 months of indwelling time. Endourological procedure should be the initial approach with a high success rate. Coordinated use multimodality and technology helps in management of difficult cases. Open surgery is rarely required. Prevention of the complication by judicious use and early removal is the cornerstone. PMID:25657542

Ray, Rajendra Prasad; Mahapatra, Rajkumar Singha; Mondal, Partha Pratim; Pal, Dilip Kumar

2015-01-01

361

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

PubMed Central

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

2014-01-01

362

Late complications of Hodgkin's disease management  

SciTech Connect

In the past several decades, Hodgkin's disease has been transformed from a uniformly fatal illness to one that can be treated with the expectation of long-term remission or cure in the majority of patients. Because patients now survive for long periods after curative intervention, various complications have been identified. The spectrum of complications following curative therapy is quite diverse and includes immunologic, cardiovascular, pulmonary, thyroid, and gonadal dysfunction. In addition, second malignant neoplasms in the form of acute leukemia as well as secondary solid tumors have now been documented to occur with increased frequency in patients cured of Hodgkin's disease. 80 references.

Young, R.C.; Bookman, M.A.; Longo, D.L. (Fox Chase Cancer Center, Philadelphia, PA (USA))

1990-01-01

363

Cardiovascular complications of cocaine: imaging findings.  

PubMed

Cocaine is the second most commonly abused illicit drug in the US and the most common one involved in emergency department visits, the majority of which are related to the cardiovascular system. Cardiovascular complications related with cocaine abuse include myocardial ischemia and infarction, myocarditis, hypertrophic cardiomyopathy, dilated cardiomyopathy, aortic dissection, thrombosis, stroke and cerebral hemorrhage, and different forms of visceral ischemia, among others. In an era where cocaine use has reached epidemic proportions, it is necessary for the radiologist to understand the pathophysiology, clinical presentation, and imaging characteristics of its cardiovascular complications. PMID:18773229

Restrepo, Carlos S; Rojas, Carlos A; Martinez, Santiago; Riascos, Roy; Marmol-Velez, Alejandro; Carrillo, Jorge; Vargas, Daniel

2009-01-01

364

Giant aortic arch aneurysm complicating Kawasaki's disease.  

PubMed

Kawasaki disease (KD) is a common acute vasculitis in pediatric population that usually involves small- and middle-sized arteries, commonly coronary arteries. Although the incidence and natural course of coronary aneurysms after KD are well documented in studies, related reports on peripheral arterial and aortic aneurysms are scarce. We report the occurrence of a giant aortic aneurysm involving the horizontal part of aortic arch in a 28-month-old boy diagnosed with KD. This complication was managed by steroids therapy in the beginning. Because of mechanical complication and potential risk of rupture, surgery was undertaken. PMID:25298695

Hakim, Kaouthar; Boussada, Rafik; Chaker, Lilia; Ouarda, Fatma

2014-09-01

365

Rare complication of a dialysis catheter insertion  

PubMed Central

Insertion of a dialysis catheter is a very common procedure in renal medicine, which is associated with one or more complications in ?15% of patients. Central venous catheter vascular erosion is a rare but serious complication, the incidence appears to be between 0.4 and 1% which can be difficult to diagnose, leading to increased morbidity and mortality. We report a case of a persistent left-sided superior vena cava (PLSVC) and a possible central venous catheter vascular erosion following insertion of a left-sided internal jugular dialysis catheter. We discuss the mechanisms, diagnosis and measures to limit vascular erosion and also briefly discuss PLSVC.

Balasubramanian, Santhanakrishnan; Gupta, Sanjay; Nicholls, Marcus; Laboi, Paul

2014-01-01

366

Complications of Aortic Stenting in Patients below 20 Years Old: Immediate and Intermediate Follow-Up  

PubMed Central

Background: Optimal timing and mode of treatment for patients with coarctation of the aorta (COA) remain controversial, particularly in children. Surgery, balloon dilatation, and stent implantation have all proven effective in the treatment of moderate or severe obstruction. The aim of this study was to investigate the complications of COA stenting angioplasty in pediatric patients. Methods: This retrospective, descriptive study was conducted on patients less than 20 years of age who underwent aortic stenting angioplasty because of congenital COA in the pediatric catheterization laboratory of Rajaie cardiovascular, medical and research Center, Tehran between 2005 and 2010. Results: A total of 26 patients (18 [65.4%] males and 9 [34.6%] females) with congenital COA who had undergone aortic stenting angioplasty were recruited. Nineteen (73.1%) of these patients had native COA and 7 (26.9%) had recurrent COA. Most of the early complications were minor and temporary; only one patient developed early major complications. During the follow-up, whereas none of the native group patients developed late complications, in the re-COA group 28.57% of the patients had re-stenosis and 14.28% had chronic systemic hypertension, requiring drug therapy. Conclusion: Our investigation into post-stenting complications in patients with native COA and re-COA showed that endovascular stenting could be an effective and safe method, even in young patients with native COA. PMID:23074369

Molaei, Akbar; Merajie, Mahmood; Mortezaeian, Hodjjat; Malakan Rad, Elaheh; Haji Heidar Shemirani, Rahele

2011-01-01

367

Fournier's Gangrene as a Postoperative Complication of Inguinal Hernia Repair  

PubMed Central

Fournier's gangrene is the necrotizing fasciitis of perianal, genitourinary, and perineal regions. Herein, we present a case of scrotal Fournier's gangrene as a postoperative complication of inguinal hernia repair. A 51-year-old male with giant indirect hernia is presented. Patient underwent inguinal hernia repair, and after an unproblematic recovery period, he was discharged. He applied to our outpatient clinic on the fifth day with swollen and painful scrotum and it turned out to be Fournier's gangrene. Polypropylene mesh was not infected. Patient recovered and was discharged after repeated debridements. Basic principles in treatment of Fournier's gangrene are comprised of initial resuscitation, broad-spectrum antibiotics therapy, and early aggressive debridement. In the management of presented case, aggressive debridement was made right after diagnosis and broad-spectrum antibiotics were given to the hemodynamically stable patient. In these circumstances, the important question is whether we could prevent occurrence of Fournier's gangrene. PMID:25506030

Dinc, Tolga; Kayilioglu, Selami Ilgaz; Sozen, Isa; Yildiz, Baris Dogu; Coskun, Faruk

2014-01-01

368

Surgical management for complications of pediatric lung injury.  

PubMed

The etiologies of pediatric lung injury requiring surgical intervention can be infectious, traumatic, congenital, or iatrogenic. Childhood pneumonia is a significant global health problem affecting 150 million children worldwide. Sequelae of pulmonary infections potentially requiring surgery include bronchiectasis, lung abscess, pneumatocele, and empyema. Trauma, congenital conditions such as cystic fibrosis and iatrogenic injuries can result in pneumothoraces, chylothoraces, or bronchopleural fistulae. Recurrence rates for spontaneous pneumothorax treated non-operatively in pediatric patients approach 50-60%. Chylothoraces in newborns may occur spontaneously or due to birth trauma, whereas in older children the etiology is almost always iatrogenic. This article examines the surgical management for the complications of lung injury in pediatric patients. In addition, we review the available pediatric evidence for early tracheostomy as well as treatment strategies for the negative ramifications of tracheostomy. PMID:25639811

Pandian, T K; Hamner, Chad

2015-02-01

369

A Prospective Study of Villous Capillary Lesions in Complicated Pregnancies  

PubMed Central

The vascularity of placental tissue is dependent on various factors of which fetomaternal hypoxia plays a major role. Hypoxia can be of different types and each type influences the vascularity of the villi, especially terminal villi, in its own way. In this study, we attempted to identify villous vascular changes in a group of term placentae from mothers with diseases complicating pregnancy. Chorangiosis was the most frequently identified lesion while chorangioma was found in only 2 cases. There were no cases of chorangiomatosis. A few cases had normal villous vasculature. Maternal diseases have a major role in disrupting the placental vasculogenesis and angiogenesis by creating a hypoxic environment that may affect the fetus adversely. Hence, such conditions need to be identified early in pregnancy and managed appropriately as it is possible to maintain a normal vasculature and prevent neonatal mortality and morbidity if prompt intervention is done. PMID:25506430

Omprakash, B. O. Parijatham; Lavanya, Kandhimalla; Subbulakshmi Murugesan, Priyadharshini; Kandaswamy, Saraswathi

2014-01-01

370

Continuous dopaminergic delivery to minimize motor complications in Parkinson's disease.  

PubMed

Motor fluctuations and dyskinesias are common sequelae of Parkinson's disease (PD) that may limit function and quality of life. With disease progression, striatal dopamine concentration becomes closely linked to plasma levodopa levels, which vary considerably with standard oral regimens. Exposure of striatal dopamine receptors to wildly fluctuating transmitter levels is thought to contribute to the development of dyskinesias and motor fluctuations. Continuous dopaminergic delivery has been shown to reduce motor complications in advanced PD patients, and has been hypothesized to prevent their incidence when given as early therapy in mild PD. In this article, the authors outline the rationale for continuous dopaminergic delivery and review clinical strategies implementing the concept, including transdermal rotigotine, subcutaneous apomorphine infusion, intraduodenal infusion of levodopa gel and the investigational oral levodopa formulation IPX066. PMID:23739008

Wright, Brenton A; Waters, Cheryl H

2013-06-01

371

Diabetic Complications in Obese Type 2 Diabetic Rat Models  

PubMed Central

We overviewed the pathophysiological features of diabetes and its complications in obese type 2 diabetic rat models: Otsuka Long-Evans Tokushima fatty (OLETF) rat, Wistar fatty rat, Zucker diabetic fatty (ZDF) rat and Spontaneously diabetic Torii (SDT) fatty rat. Pancreatic changes with progression of diabetes were classified into early changes, such as islet hypertrophy and degranulation of ? cells, and degenerative changes, such as islet atrophy and fibrosis of islet with infiltration of inflammatory cells. Renal lesions in tubuli and glomeruli were observed, and nodular lesions in glomeruli were notable changes in OLETF and SDT fatty rats. Among retinal changes, folding and thickening were interesting findings in SDT fatty rats. A decrease of motor nerve conduction velocity with progression of diabetes was presented in obese diabetic rats. Other diabetic complications, osteoporosis and sexual dysfunction, were also observed. Observation of bone metabolic abnormalities, including decrease of osteogenesis and bone mineral density, and sexual dysfunction, including hypotestosteronemia and erectile dysfunction, in obese type 2 diabetic rats have been reported. PMID:24770637

Katsuda, Yoshiaki; Ohta, Takeshi; Miyajima, Katsuhiro; Kemmochi, Yusuke; Sasase, Tomohiko; Tong, Bin; Shinohara, Masami; Yamada, Takahisa

2014-01-01

372

Staphylococcus aureus cavernous sinus thrombosis mimicking complicated fungal sinusitis.  

PubMed

Septic cavernous sinus thrombosis is a rare and potentially life-threatening complication of infections involving the paranasal sinuses or the middle one-third of the face. We report a challenging case of cavernous sinus thrombosis to familiarize otolaryngologists with its clinical features, diagnosis, and management. The patient was a 45-year-old diabetic woman whose signs and symptoms mimicked those of complicated fungal sinusitis. She presented with fever, nausea without vomiting, frontal headache, bilateral ptosis and swelling, double vision, a partial loss of visual acuity in the left eye, and restricted lateral ocular movements. Her Snellen visual acuity had been reduced to 8/10 on the right and 6/10 on the left. Radiologic investigation revealed cavernous sinus extension of sphenoid sinusitis and a fungus-ball appearance in the sphenoid sinus. On the second day of her admission, the patient's vision was further reduced to 6/10 on the right and 2/10 on the left. She then underwent urgent bilateral anterior and posterior ethmoidectomy and sphenoidectomy. At postoperative follow-up, her vision had stabilized at 10/10 bilaterally. At 2 months after discharge, she exhibited no evidence of abducens nerve palsy, and her ocular function had returned to normal. The diagnosis of cavernous sinus thrombosis requires a high index of suspicion and confirmation by imaging. The favorable outcome in our case was attributable to early diagnosis, prompt initiation of appropriate intravenous antibiotic therapy, and surgical drainage by the skillful surgical team. PMID:22829043

Songu, Murat; Can, Nazan; Onal, Kazim; Arslanoglu, Secil; Erdogan, Nezahat; Kopar, Aylin; Ciger, Ejder

2012-07-01

373

Protein O-GlcNAcylation in diabetes and diabetic complications  

PubMed Central

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

Ma, Junfeng; Hart, Gerald W

2014-01-01

374

Orthopedic surgery and its complication in systemic lupus erythematosus  

PubMed Central

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

Mak, Anselm

2014-01-01

375

How I treat renal complications in sickle cell disease.  

PubMed

Renal disease is one of the most frequent and severe complications experienced by patients with sickle cell disease; its prevalence is likely to increase as the patient population ages. We recommend regular monitoring for early signs of renal involvement and a low threshold for the use of hydroxyurea as preventative measures for end-stage renal disease. Once renal complications are detected, a careful assessment of the patient is required to rule out other causes of renal disease. Proteinuria and hypertension should be managed aggressively and the patient referred to a specialist nephrology center when progressive decline in renal function is noted. For the few patients who develop advanced chronic kidney disease, timely planning for dialysis and transplantation can significantly improve outcome, and we recommend an exchange blood transfusion policy for all patients on the transplant waiting list and for those with a functioning graft. Alongside the invasive treatment regimes, it is important to remember that renal failure in conjunction with sickle cell disease does carry a significant burden of morbidity and that focusing on symptom control has to be central to good patient care. PMID:24764565

Sharpe, Claire C; Thein, Swee Lay

2014-06-12

376

Diabetic complications in obese type 2 diabetic rat models.  

PubMed

We overviewed the pathophysiological features of diabetes and its complications in obese type 2 diabetic rat models: Otsuka Long-Evans Tokushima fatty (OLETF) rat, Wistar fatty rat, Zucker diabetic fatty (ZDF) rat and Spontaneously diabetic Torii (SDT) fatty rat. Pancreatic changes with progression of diabetes were classified into early changes, such as islet hypertrophy and degranulation of ? cells, and degenerative changes, such as islet atrophy and fibrosis of islet with infiltration of inflammatory cells. Renal lesions in tubuli and glomeruli were observed, and nodular lesions in glomeruli were notable changes in OLETF and SDT fatty rats. Among retinal changes, folding and thickening were interesting findings in SDT fatty rats. A decrease of motor nerve conduction velocity with progression of diabetes was presented in obese diabetic rats. Other diabetic complications, osteoporosis and sexual dysfunction, were also observed. Observation of bone metabolic abnormalities, including decrease of osteogenesis and bone mineral density, and sexual dysfunction, including hypotestosteronemia and erectile dysfunction, in obese type 2 diabetic rats have been reported. PMID:24770637

Katsuda, Yoshiaki; Ohta, Takeshi; Miyajima, Katsuhiro; Kemmochi, Yusuke; Sasase, Tomohiko; Tong, Bin; Shinohara, Masami; Yamada, Takahisa

2014-01-01

377

Selecting a Principal: Keep It Complicated!  

ERIC Educational Resources Information Center

When searching for a new principal, many search committees tend to use the lists of competencies published in the literature and provided by state departments of education as if they were checklists. Instead, they should focus on more complicated competencies, such as acumen, judgment, and ability to manage the dilemmas of practice.

Naso, Paul A.

2011-01-01

378

Endoscopic complications—avoidance and management  

Microsoft Academic Search

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

Jacques Devičre; Daniel Blero

2012-01-01

379

Complications of Hemorrhagic Stroke in Children  

Microsoft Academic Search

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

Robin P. Humphreys

1992-01-01

380

Lymphatic Leak Complicating Central Venous Catheter Insertion  

SciTech Connect

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.

Barnacle, Alex M., E-mail: alexbarnacle@yahoo.co.uk; Kleidon, Tricia M. [Great Ormond Street Hospital for Children, Department of Radiology (United Kingdom)

2005-12-15

381

Renal Complications of Hematopoietic Stem Cell Transplantation  

Microsoft Academic Search

Hematopoietic stem cell transplantation (HSCT) offers curative potential in the treatment of both malignant and nonmalignant disorders of lymphohematopoiesis. Over the last two decades, advances in graft matching, expanded donor registries, better post-graft immunosuppression, and improved management of infectious com- plications have fueled dramatic growth in these transplants. Despite this progress, renal complications of HSCT remain a very important cause

Reza Abdi; Jessamyn Bagley; Joseph V. Bonventre; Barry M. Brenner; Charles B. Carpenter; Anil K. Chandraker; David M. Charytan; Kenneth B. Christopher; Gary C. Curhan; Bradley M. Denker; John P. Forman; Markus H. Frank; M. D. Won; Kook Han; Dirk M. Hentschel; Li-Li Hsiao; Stephen Hsu; Benjamin D. Humphreys; John J. Iacomini; Takaharu Ichimura; Julie Lin; M. P. H. Colm; C. Magee; M. P. H. Edgar; L. Milford; David B. Mount; Nader Najafian; Shona Pendse; Martin R. Pollack; Stephen T. Reeders; Mohamed H. Sayegh; Julian L. Seifter; Jagesh V. Shah; Alice M. Sheridan; Ajay K. Singh; Theodore I. Steinman; Eric N. Taylor; Kathryn Tinckam; John K. Tucker; Wolfgang C. Winkelmayer; D. Xueli Yuan; D. Kambiz Zandi-Nejad; Jing Zhou

382

Hypertensive encephalopathy complicating transplant renal artery stenosis  

Microsoft Academic Search

A 26-year-old female diabetic patient developed hypertensive encephalopathy with gross neurological abnormalities complicating renal artery stenosis of her transplant kidney. The elevated blood pressure was unresponsive to medical treatment. Surgical correction of the stenoses in the renal artery cured the hypertension and renal failure and led to the patient's complete recovery.

R. J. McGonigle; M. Bewick; J. A. Trafford; V. Parsons

1984-01-01

383

Long-term complications of chemotherapy  

Microsoft Academic Search

Patients with cancer are living longer and, therefore, are not only at risk for recurrence of the disease but also for long-term side effects of treatment. For patients treated with chemotherapy, secondary malignancies are a special concern, with acute nonlymphocytic leukemia being the most common. Although typically associated with alkylating agents, this complication is now being seen with use of

Mark A. Morgan; Stephen C. Rubin

1998-01-01

384

Postoperative complications among octogenarians after cardiovascular surgery  

Microsoft Academic Search

BackgroundThe octogenarian patient is often perceived as too fragile to undergo cardiothoracic surgery. Our study aimed to compare postoperative complications in patients aged less than 80 versus elderly patients (80 years or more) after surgical cardiac intervention (coronary artery bypass or valve replacement).

Scott D Barnett; Linda S Halpin; Alan M Speir; Robert A Albus; Bechara F Akl; Paul S Massimiano; Nelson A Burton; Lucas R Collazo; Edward A Lefrak

2003-01-01

385

Neurological complications of surgery and anaesthesia.  

PubMed

Injury to the central and peripheral nervous systems is often permanent. As such, adverse neurological outcomes of surgery and anaesthesia can be devastating for patients and their families. In this article, we review the incidence, risk factors, outcomes, prevention, and treatment of a number of important neurological complications in the perioperative period. PMID:25204699

Mashour, G A; Woodrum, D T; Avidan, M S

2015-02-01

386

Rare complications of pediatric diabetic ketoacidosis  

PubMed Central

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

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

2015-01-01

387

Sigmoid Volvulus Complicating Pregnancy: A Case Report  

PubMed Central

Sigmoid volvulus during pregnancy is a rare complication, and as of 2012, fewer than 100 cases had been reported. In this report, we present a 30 year-old pregnant woman with sigmoid volvulus, and we discuss this rare entity. PMID:25745351

Atamanalp, Sabri Selcuk; Kisaoglu, Abdullah; Ozogul, Bunyami; Kantarci, Mecit; Disci, Esra; Bulut, O. Hakan; Aksungur, Nurhak; Atamanalp, Refik Selim

2015-01-01

388

Self-expanding prostheses complicating augmentation mammoplasties  

Microsoft Academic Search

A new and serious complication was experienced by patients of three independent surgeons following routine augmentation procedures. In each case reported, double-lumen prostheses had been used. All cases were reoperated with a diagnosis of capsular contracture. However, at surgery it was found that the outer lumen of the prostheses had overfilled with 60–160 cc of interstitial fluid, probably because of

M. Signorini; A. Grisotti; G. Ponzielli; G. Pajardi; P. Gilardino

1994-01-01

389

Lymphatic Leak Complicating Central Venous Catheter Insertion  

Microsoft Academic Search

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.

Alex M. Barnacle; Tricia M. Kleidon

2005-01-01

390

[Chronic complications of sickle cell disease].  

PubMed

Chronic complications of sickle cell disease take an increasing role in the management of patients due to their morbidity and mortality impact. The prevalence of chronic organ damages increases as the age of patients followed in France. Few organs seem unaffected by the disease. The natural history of chronic complication is highly variable from one patient to another, and the distribution of those manifestations throughout life, is different depending on their nature and pathophysiology. Thus we can, for example, distinguish SS patients presenting a "hyperhemolytic" phenotype associated with dense red blood cells that have a high risk of vascular complications including kidney disease, pulmonary hypertension, leg ulcers and priapism, from SC patients with high hemoglobin levels, who have a higher risk of retinopathy, osteonecrosis and sensory syndrome, probably related to hyperviscosity. Dependent on the age, we could also oppose cerebral vasculopathy responsible of ischemic stroke since childhood, and kidney damage which effects are visible more gradually with aging. Sickle cell disease is one of the most systemic pathologies contrasting with its monogenic characteristic and its inter- and intra-individual variability. A better understanding of pathophysiological mechanisms responsible for those complications is necessary to develop new preventive and therapeutic approaches. PMID:25510140

Bartolucci, Pablo; Lionnet, François

2014-10-01

391

Measuring Leakage From Large, Complicated Machinery  

NASA Technical Reports Server (NTRS)

Test chamber improvised from large bag. Cumulative sizes of leaks in large, complicated machinery measure with relatively simple variation of helium leak-checking technique. When used to check Space Shuttle main engine, new technique gave repeatable and correct results within 0.5 stdin.3/min (1.4 x 10 negative to the seventh power stdm3/s).

Bottemiller, S.

1987-01-01

392

Risk factors for postoperative pulmonary complications: an update of the literature.  

PubMed

Perioperative medicine is a growing area of research that brings together internists, anesthesiologists, surgeons, and hospitalists. A medical team approach to ensure the best possible patient outcomes has fostered collaborative strategies across disciplines. Perioperative pulmonary complications are common and can be associated with significant morbidity and mortality. Effective strategies to identify and reduce risks of pulmonary complications can improve patient outcomes. We review the new literature (2013 to early 2014) in the field of perioperative pulmonary medicine that reports new strategies to improve outcomes in the area of perioperative pulmonary care. PMID:25485924

Smetana, Gerald W; Pfeifer, Kurt J; Slawski, Barbara A; Jaffer, Amir K; Dutta, Suparna; Cohn, Steven L

2014-12-01

393

Life-Threatening Complication of Percutaneous Transthoracic Fine-Needle Aspiration Biopsy: Systemic Arterial Air Embolism  

PubMed Central

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.

Olgun, Deniz Cebi; Samanci, Cesur; Ergin, Ayse Seda; Akman, Canan

2015-01-01

394

A rare case report of chronic cholecystitis complicated with incomplete gallbladder volvulus.  

PubMed

Gallbladder volvulus, or gallbladder torsion, is a rare condition. There have been very few case reports of chronic cholecystitis complicated by incomplete gallbladder volvulus. A 63-year-old woman had suffered recurrent right upper quadrant pain for 3 years, which had grown worse during the past day. She was admitted through the emergency department on February 24, 2012. Laparoscopic exploration revealed approximately 180° torsion of the gallbladder. Postoperative pathologic examination suggested a diagnosis of chronic cholecystitis, without operative complications. Incomplete gallbladder volvulus is associated with anatomic changes to the gallbladder mesentery, constipation, and increased bowel movements. Early diagnosis and laparoscopic exploration are the keys to management. PMID:25419406

Luo, P; Wang, Cm; Zhang, Gx

2014-01-01

395

A rare case report of chronic cholecystitis complicated with incomplete gallbladder volvulus  

PubMed Central

Gallbladder volvulus, or gallbladder torsion, is a rare condition. There have been very few case reports of chronic cholecystitis complicated by incomplete gallbladder volvulus. A 63-year-old woman had suffered recurrent right upper quadrant pain for 3 years, which had grown worse during the past day. She was admitted through the emergency department on February 24, 2012. Laparoscopic exploration revealed approximately 180° torsion of the gallbladder. Postoperative pathologic examination suggested a diagnosis of chronic cholecystitis, without operative complications. Incomplete gallbladder volvulus is associated with anatomic changes to the gallbladder mesentery, constipation, and increased bowel movements. Early diagnosis and laparoscopic exploration are the keys to management. PMID:25419406

Luo, P; Wang, CM; Zhang, GX

2014-01-01

396

Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management  

PubMed Central

Diabetes mellitus has a number of long-term effects on the genitourinary system. These effects predispose to bacterial urinary tract infections (UTIs) in the patient with diabetes mellitus. Complicated UTIs are also common and potentially life-threatening conditions. They include emphysematous pyelonephritis, emphysematous pyelitis/cystitis, xanthogranulomatous pyelonephritis, renal/perirenal abscess, and renal papillary necrosis. Improved outcomes of these entities may be achieved by early diagnosis, knowledge of common predisposing factors, appropriate clinical and radiological assessment, and prompt management. Herein we review complicated UTIs associated with diabetes mellitus in terms of pathogenesis, clinical manifestations, radiological features, and current management options. PMID:23869299

Mnif, Mouna Feki; Kamoun, Mahdi; Kacem, Faten Hadj; Bouaziz, Zainab; Charfi, Nadia; Mnif, Fatma; Naceur, Basma Ben; Rekik, Nabila; Abid, Mohamed

2013-01-01

397

Complicated urinary tract infections associated with diabetes mellitus: Pathogenesis, diagnosis and management.  

PubMed

Diabetes mellitus has a number of long-term effects on the genitourinary system. These effects predispose to bacterial urinary tract infections (UTIs) in the patient with diabetes mellitus. Complicated UTIs are also common and potentially life-threatening conditions. They include emphysematous pyelonephritis, emphysematous pyelitis/cystitis, xanthogranulomatous pyelonephritis, renal/perirenal abscess, and renal papillary necrosis. Improved outcomes of these entities may be achieved by early diagnosis, knowledge of common predisposing factors, appropriate clinical and radiological assessment, and prompt management. Herein we review complicated UTIs associated with diabetes mellitus in terms of pathogenesis, clinical manifestations, radiological features, and current management options. PMID:23869299

Mnif, Mouna Feki; Kamoun, Mahdi; Kacem, Faten Hadj; Bouaziz, Zainab; Charfi, Nadia; Mnif, Fatma; Naceur, Basma Ben; Rekik, Nabila; Abid, Mohamed

2013-05-01

398

Gastrointestinal complications of laparoscopic/robot-assisted urologic surgery and a review of the literature.  

PubMed

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

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

2015-04-01

399

Catastrophic early drug eluting stents thrombosis and aspirin hypersensitivity  

Microsoft Academic Search

Stent thrombosis is a feared complication of percutaneous coronary intervention. Promises and problems, late complications and early stent thrombosis have been reported after drug eluting stents implantation too. Moreover some patients with imperative cardiologic indications for combination therapy with aspirin and clopidogrel (stent placement and\\/or acute coronary syndrome) have a history of allergy to aspirin. We present a case of

Salvatore Patanč; Filippo Marte; Gianluca Di Bella

2008-01-01

400

Assessing the risk of transplant-related complications and individually tailoring the HSCT procedure in children and adolescents—is it possible?  

Microsoft Academic Search

Children surviving after haematopoietic SCT (HSCT) are a growing population that need to keep their health status under control. They may experience early and late complications that are related to transplant procedures and to treatments administered before HSCT. Monitoring transplant-related complications is mandatory, especially during the child's growth. The purpose of this report is to define preassessment in patients who

M Faraci; G Dini

2008-01-01

401

Positioning and early mobilisation in stroke.  

PubMed

Stroke unit care, providing early rehabilitation, improves long-term outcomes for patients following a stroke. Early mobilisation and good positioning are recognised as key aspects of care in stroke units. Nurses working on stroke units have an important role because they are able to implement positioning and early mobilisation strategies 24 hours a day, reducing the risk of complications and improving functional recovery. Patients benefit if nurses work effectively with the therapy team in positioning and early mobilisation. Nurses also need appropriate training and expertise to make best use of specialist equipment. PMID:23495578

Keating, Moira; Penney, Maree; Russell, Petra; Bailey, Emma

402

Analysis of Senate Bill 1104: Diabetes-related Complications  

E-print Network

and treatment of diabetes-related complications. Diabetes-related complications may lead to kidneytreatment is likely to delay or reduce complications such as neuropathic pain, kidneyand treatment of diabetes-related conditions. Medical Effectiveness Diabetes-related complications may lead to kidney

California Health Benefits Review Program (CHBRP)

2010-01-01

403

Thrombotic and bleeding complications associated with chemotherapy.  

PubMed

It is well recognized that cancer patients have an increased risk of thrombosis and bleeding. Contributory factors to thrombotic complications include prothrombotic risks carried by many chemotherapeutic agents, type of cancer, stage of cancer, age, and comorbidities. Surgical procedures and the presence of an indwelling vascular device, often used as a mode of delivery for chemotherapy, further increase the risk. Correlative studies have demonstrated upregulation of coagulation in response to chemotherapeutics, and clinical studies have shown that various cancer treatments are independent risk factors for thrombotic complications. It has also been shown that patients who develop thrombosis during treatment have a worse overall prognosis. Mechanisms for chemotherapy and cancer-associated thrombosis are not well understood. Better insight into the mechanism for thrombosis may help better identify those cancer patients at highest risk, who may then benefit from up-front anticoagulant prophylaxis. PMID:23055392

McMahon, Brandon J; Kwaan, Hau C

2012-11-01

404

Liver biopsy complications monitored by ultrasound.  

PubMed

Ultrasound (US) was performed in 96 patients (on 108 occasions) 2-4 h after diagnostic liver puncture with a modified Menghini needle. Serious complications (major haemorrhages: one intraparenchymal and one into the abdominal cavity) were seen in two patients, while seven presented with minor bleedings though without any registered clinical abnormality (slight pain in one). On 11 occasions (10 patients) slight to moderate pain was observed though in combination with a normal US. Findings on US and clinical observations showed poor correlation and the number of bleeding complications discovered by US examination seems to depend upon when the study is performed. US does not replace the clinical follow-up but may be helpful in the presence of adverse clinical reactions in order to establish the type of lesion: profuse parenchymal haemorrhage versus bleeding into the abdominal cavity. This information may be helpful in the choice between conservative and surgical therapy. PMID:2646368

Hederström, E; Forsberg, L; Florén, C H; Prytz, H

1989-01-01

405

Neurological Complications of Biologic Therapy in Psoriasis  

PubMed Central

Biologic agents have been a significant advancement in the management of psoriasis. Along with significant clinical improvement, there have been concerns for emerging side effects with the use of biologics. Reports have emerged showing the association between efalizumab and the development of progressive multifocal leukoencephalopathy and other demyelinating disorders. Tumor necrosis factor-alpha inhibitors have been associated with various demyelinating disorders. As such, it is imperative for dermatologists to be well informed regarding how to notify patients about the risks of biologic treatment. Dermatologists must be able to identify the signs and symptoms of neurological complications and recognize when to refer patients to neurologists for diagnostic workup, disease confirmation, and any necessary treatment. This review is a compilation of evidence showing the association between biologic therapy and neurological complications, as well as an overview of the clinical presentation and diagnosis of such diseases. PMID:20725577

Sanders, Catherine; Bechtel, Ann

2009-01-01

406

[Pelvic lymph node dissection. Complication management].  

PubMed

Extended pelvic lymph node dissection allows exact lymph node staging and has the potential to improve prognosis. In addition to these advantages, there are some perioperative and postoperative complications. In case of transection of the obturator nerve, a microsurgical end-to-end anastomosis should be performed. The most frequent postoperative complication is (symptomatic) lymphocele which is predominantly diagnosed after extraperitoneal surgery. Meticulous lymph node dissection with clipping of lymphatic vessels, sparing the lateral wall of the external iliac artery from dissection, sufficient postoperative drainage, and application of low molecular weight heparin in the upper arm may reduce their incidence. Instillation of sclerosing agents and sufficient drainage are normally successful. If not, laparoscopic fenestration of lymphocele should be performed. Regular ultrasound examinations are necessary to diagnose and treat postoperative lymphocele in a timely manner. PMID:24705476

Weckermann, D

2014-07-01

407

Prevention of complications in neck dissection  

PubMed Central

Background The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option into an elective setting, in part promoted by efforts to reduce its morbidity. Objectives This review will consider the potential complications of neck dissection and on the basis of the available evidence describe both their management and prevention. Conclusion Although the neck dissection continues to provide clinicians with a method of addressing cervical disease, its reliability and safety can only be assured if surgeons remain cognisant of the potential complications and aim to minimise such morbidity by appropriate management in the peri-operative period. PMID:19822010

Kerawala, Cyrus J; Heliotos, Manolis

2009-01-01

408

[Haemocholecyst: a rare complication of anticoagulant treatment].  

PubMed

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

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

2004-07-01

409

Transcatheter Embolization of Pseudoaneurysms Complicating Pancreatitis  

SciTech Connect

Purpose: To evaluate the therapeutic role of angiography in patients with pseudoaneurysms complicating pancreatitis. Methods: Thirteen symptomatic pseudoaneurysms were treated in nine patients with pancreatitis. Eight patients had chronic pancreatitis and pseudocyst and one had acute pancreatitis. Clinical presentation included gastrointestinal bleeding in seven patients and epigastric pain without bleeding in two. All patients underwent transcatheter embolization. Results: Transcatheter embolization resulted in symptomatic resolution in all patients. Rebleeding occurred in two patients, 18 and 28 days after embolization respectively, and was successfully treated by repeated emnbolization. One patient with severe pancreatitis died from sepsis 28 days after embolization. Follow-up was then available for eight patients with no relapse of bleeding after a mean follow-up of 32 months (range 9-48 months). Conclusion: Transcatheter embolization is safe and effective in the management of pseudoaneurysms complicating pancreatitis.

Golzarian, Jafar; Nicaise, Nicole [Department of Radiology, Brussels University, Hopital Erasme, 808 Route de Lennik, B-1070 Brussels (Belgium); Deviere, Jacques [Department of Gastroenterology, Brussels University, Hopital Erasme, 808 Route de Lennik, B-1070 Brussels (Belgium); Ghysels, Marc; Wery, Didier; Dussaussois, Luc; Gansbeke, Daniel van; Struyven, Julien [Department of Radiology, Brussels University, Hopital Erasme, 808 Route de Lennik, B-1070 Brussels (Belgium)

1997-11-15

410

Incidence of complications following laparoscopic hernioplasty  

Microsoft Academic Search

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

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

411

Abdominal Aortic Aneurysm Complicated by Intestinal Malrotation  

PubMed Central

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

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

2015-01-01

412

Complications of laparoscopic pyeloplasty in children  

Microsoft Academic Search

Introduction  Laparoscopic pyeloplasty in children has been proven to be safe and effective, with comparable results to open surgery. Due\\u000a to the extension of laparoscopic indications from ablative to reconstructive procedures requiring endoscopic suturing, most\\u000a centres have plateaued within their learning curve. Based on our own experience with a little more than 100 cases, we focus\\u000a on the complications and the

Rajendra B. Nerli; Mallikarjun Reddy; Vikram Prabha; Ashish Koura; Praveen Patne; M. K. Ganesh

2009-01-01

413

Secondary pleural hydatidosis: Complication of intrapulmonary echinococcosis  

PubMed Central

Hydatid disease has a wide geographic distribution around the world. In human, the liver is the most commonly affected organ, followed by the lungs. Intrathoracic extrapulmonary locations are generally the mediastinum, pleura, pericardium and chest wall. Pleural involvement usually follows the rupture of a pulmonary or hepatic cyst inside the pleural space causing secondary pleural hydatidosis. We report four cases of patients who were referred to our hospital for management of pleural hydatid disease as a complication of intrapulmonary echinococcosis. PMID:25125817

Feki, Walid; Ketata, Wajdi; Bahloul, Najla; Msaad, Sameh; Kammoun, Samy

2014-01-01

414

Oxidative stress and diabetic vascular complications  

Microsoft Academic Search

Vascular complications of diabetes represent the leading cause of morbidity and mortality in affected patients. Production\\u000a of reactive oxygen species is increased in diabetic patients, especially in those with poor glycemic control. Reactive oxygen\\u000a species affect vascular smooth muscle cell growth and migration, endothelial function, including abnormal endothelium-dependent\\u000a relaxation and expression of a proinflammatory phenotype, and modification of the extracellular

Seok Man Son; Matthew K. Whalin; David G. Harrison; W. Robert Taylor; Kathy K. Griendling

2004-01-01

415

Deep enteroscopy - indications, diagnostic yield and complications  

PubMed Central

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

Moeschler, Oliver; Mueller, Michael Karl

2015-01-01

416

Limy Bile Syndrome Complicated with Primary Hyperparathyroidism  

PubMed Central

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.

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

2015-01-01

417

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

PubMed

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

Knoll, T; Wendt-Nordahl, G

2014-05-01

418

Pulmonary gangrene as a complication of mucormycosis  

SciTech Connect

Pulmonary gangrene, a rare complication of pneumonia occurs when vascular thrombosis leads to necrosis of a large portion of lung. The devitalized lung is then sloughed into a cavity, resulting in a characteristic radiographic appearance. The previously reported cases of pulmonary gangrene have been associated with either bacterial or tuberculous pneumonia; the authors describe a case resulting from mucormycosis. In addition to the plain-film findings, the computed tomographic (CT) appearance is described.

Zagoria, R.J.; Choplin, R.H.; Karstaedt, N.

1985-06-01

419

[Hypercalcemia complicating BCG lymphadenitis: Case report].  

PubMed

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

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

2015-03-01

420

2. Co-morbidities and complications  

Microsoft Academic Search

This self-directed learning module highlights new advances in the understanding of co-morbid conditions and medical complications of stroke. It is part of the chapter on stroke rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article covers co-morbid conditions of stroke patients, including cardiovascular disease, diabetes, and sleep apnea. It reviews recent

Richard L. Harvey

1999-01-01

421

Vascular complications after pediatric liver transplantation  

Microsoft Academic Search

From February 1986 to July 1994, 81 hepatic transplantations were performed in 73 children, with an oveall patient survival rate of 83%. Forty-two patients received whole-liver grafts (WLG) and 39 had reduced-size grafts (RSG). The mean patient weight was 19.7 kg, with 29 patients weighing less than 10 kg. Seventeen vascular complications (21%) occurred in 13 children: 8 (10%) had

Michel Lallier; Dickens St-Vil; Josée Dubois; Khazal Paradis; Jean-Martin Laberge; Arié L. Bensoussan; Frank M. Guttman; Herve Blanchard

1995-01-01

422

Pancreaticopleural fistula: an unusual complication of pancreatitis.  

PubMed

Pancreaticopleural fistula is an uncommon complication of pancreatitis. The authors describe a case of a man in his mid-40s with a history of alcohol abuse, who presented with dyspnoea and whose chest X-ray revealed a massive left pleural effusion. Further diagnostic work up revealed a pancreaticopleural fistula. There was no improvement with a conservative approach and endoscopic treatment was not feasible, leading to the need for a surgical intervention. PMID:25678619

Francisco, Elsa; Mendes, Miguel; Vale, Sílvio; Ferreira, Joana

2015-01-01

423

Genetics of macrovascular complications in diabetes  

Microsoft Academic Search

Diabetic patients have a threefold higher risk of developing atherosclerosis and its clinical complications compared with\\u000a nondiabetic individuals. Part of the cardiovascular risk associated with diabetes is probably due to genetic determinants\\u000a influencing both glucose homeostasis and the development of atherosclerosis. However, type 2 diabetes frequently coexists\\u000a with other cardiovascular risk factors such as arterial hypertension, central obesity, and dyslipidemia.

Fréd éric Fumeron; André F. Reis; Gilberto Velho

2006-01-01

424

Limy bile syndrome complicated with primary hyperparathyroidism.  

PubMed

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

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

2015-01-01

425

Orbital Complications of Fungal Pan-Sinusitis in Uncontrolled Diabetes  

PubMed Central

ABSTRACT The purpose of our clinical case presentation is to emphasize the role of ear, nose and throat specialist in early recognition and urgent treatment of mucormycosis, which is a rare infection caused by fungus belonging to the order Mucorales. They are known opportunistic organisms, which potentially invade and infect a host with depressed immunity. In our paper we present a case of an uncontrolled diabetic male with orbital complications caused by a fungal pan-sinusitis. The typical presentation of rhino-orbital fungal infection is that of anterior orbital inflammation, severe visual loss, external ophthalmoplegia and fever. Our diagnostic was based on an otolaryngological, ophthalmological, imagistic but especially biopsy exam, which is the only one that can make the certain diagnostic in this case. We followed the standard treatment for these situations. Early recognition and treatment with urgent surgical debridement and systemic antifungal therapy is the key to the management of rhino-orbital mucormycosis and is necessary to limit the spread of infection, which can lead to high morbidity and mortality. Therefore, health practitioners should be familiar with the signs and symptoms of the disease. The authors certify that they do not have any financial or personal relationships that might bias the content of this work. PMID:24371499

NICOLAE, Miruna; POPESCU, Cristian Radu; POPESCU, Bogdan; GRIGORE, Raluca

2013-01-01

426

Advanced glycation end products and diabetic complications.  

PubMed

During long standing hyperglycaemic state in diabetes mellitus, glucose forms covalent adducts with the plasma proteins through a non-enzymatic process known as glycation. Protein glycation and formation of advanced glycation end products (AGEs) play an important role in the pathogenesis of diabetic complications like retinopathy, nephropathy, neuropathy, cardiomyopathy along with some other diseases such as rheumatoid arthritis, osteoporosis and aging. Glycation of proteins interferes with their normal functions by disrupting molecular conformation, altering enzymatic activity, and interfering with receptor functioning. AGEs form intra- and extracellular cross linking not only with proteins, but with some other endogenous key molecules including lipids and nucleic acids to contribute in the development of diabetic complications. Recent studies suggest that AGEs interact with plasma membrane localized receptors for AGEs (RAGE) to alter intracellular signaling, gene expression, release of pro-inflammatory molecules and free radicals. The present review discusses the glycation of plasma proteins such as albumin, fibrinogen, globulins and collagen to form different types of AGEs. Furthermore, the role of AGEs in the pathogenesis of diabetic complications including retinopathy, cataract, neuropathy, nephropathy and cardiomyopathy is also discussed. PMID:24634591

Singh, Varun Parkash; Bali, Anjana; Singh, Nirmal; Jaggi, Amteshwar Singh

2014-02-01

427

Epigenetics: mechanisms and implications for diabetic complications.  

PubMed

Epigenetic modifications regulate critical functions that underlie chromosome metabolism. Understanding the molecular changes to chromatin structure and the functional relationship with altered signaling pathways is now considered to represent an important conceptual challenge to explain diabetes and the phenomenon of metabolic or hyperglycemic memory. Although it remains unknown as to the specific molecular mechanisms whereby hyperglycemic memory leads to the development of diabetic vascular complications, emerging evidence now indicates that critical gene-activating epigenetic changes may confer future cell memories. Chemical modification of the H3 histone tail of lysine 4 and 9 has recently been identified with gene expression conferred by hyperglycemia. The persistence of these key epigenetic determinants in models of glycemic variability and the development of diabetic complications has been associated with these primary findings. Transient hyperglycemia promotes gene-activating epigenetic changes and signaling events critical in the development and progression of vascular complications. As for the role of specific epigenomic changes, it is postulated that further understanding enzymes involved in writing and erasing chemical changes could transform our understanding of the pathways implicated in diabetic vascular injury providing new therapeutic strategies. PMID:21148447

Cooper, Mark E; El-Osta, Assam

2010-12-10

428

Bilateral orbital complications of paediatric rhinosinusitis  

PubMed Central

Background The spread of infection from the ethmoid sinuses to the orbit occurs directly through a congenital dehiscence of the lamina papyracea or via haematogenous spread through ophthalmic venous system. Hence orbital complications of paediatric rhinosinusitis are usually unilateral at presentation. Methods We describe three children with bilateral orbital cellulitis that occurred as a complication of rhinosinusitis without intracranial spread of the infection. The children ranged in the age group from 4 to 7 years. All these children had a prolonged hospital stay from 14 to 25 days and underwent multiple surgical procedures to drain the subperiosteal abscess. These children presented to the hospital with bilateral orbital cellulitis without significant past history. All of them on radiological evaluation showed subperiosteal abscess involving only one orbit. They were taken up for functional endoscopic sinus surgery and the subperiosteal abscess was drained endoscopically with partial removal of lamina papyracea. One case required second surgery despite good recovery for two days post first surgery. Result and conclusion Two cases had severe unilateral visual loss at presentation but both recovered dramatically after the surgery. All cases had uneventful recovery with no residual disability. The purpose of this article is to discuss the reasons for bilateral orbital complications of rhinosinusitis at initial presentation despite the previous hypothesis of unilateral involvement. PMID:24623951

Singh, S.K.; James, E.; Sabarigirish, K.; Swami, H.; Sood, Tarun

2013-01-01

429

Advanced Glycation End Products and Diabetic Complications  

PubMed Central

During long standing hyperglycaemic state in diabetes mellitus, glucose forms covalent adducts with the plasma proteins through a non-enzymatic process known as glycation. Protein glycation and formation of advanced glycation end products (AGEs) play an important role in the pathogenesis of diabetic complications like retinopathy, nephropathy, neuropathy, cardiomyopathy along with some other diseases such as rheumatoid arthritis, osteoporosis and aging. Glycation of proteins interferes with their normal functions by disrupting molecular conformation, altering enzymatic activity, and interfering with receptor functioning. AGEs form intra- and extracellular cross linking not only with proteins, but with some other endogenous key molecules including lipids and nucleic acids to contribute in the development of diabetic complications. Recent studies suggest that AGEs interact with plasma membrane localized receptors for AGEs (RAGE) to alter intracellular signaling, gene expression, release of pro-inflammatory molecules and free radicals. The present review discusses the glycation of plasma proteins such as albumin, fibrinogen, globulins and collagen to form different types of AGEs. Furthermore, the role of AGEs in the pathogenesis of diabetic complications including retinopathy, cataract, neuropathy, nephropathy and cardiomyopathy is also discussed. PMID:24634591

Singh, Varun Parkash; Bali, Anjana; Singh, Nirmal

2014-01-01

430

Update on complications in pediatric anesthesia  

PubMed Central

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

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

431

Complex dynamics in learning complicated games  

E-print Network

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

Tobias Galla; J. Doyne Farmer

2011-09-20

432

Necrotizing Pneumonia and Its Complications in Children.  

PubMed

Necrotizing pneumonia (NP) is an emerging complication of community acquired pneumonia (CAP) in children. This study aimed at the evaluation of etiology, clinical features, treatment, and prognosis of NP. The institutional database of children with CAP treated between April 2008 and July 2013 was searched to identify children with NP. Then, data on the NP characteristics were retrospectively reviewed and analyzed. We found that NP constituted 32/882 (3.7 %) of all CAPs. The median age of children with NP was 4 (range 1-10) years. The causative pathogens were identified in 12/32 children (37.5 %) with Streptococcus pneumoniae being the most common (6/32). All but one patient developed complications: parapneumonic effusion (PPE), pleural empyema or bronchopleural fistula (BPF), which required prompt local treatment. The median duration of hospital stay and antibiotic treatment was 26 (IQR 21-30) and 28 (IQR 22.5-32.5) days, respectively. Despite severe course of the disease no deaths occurred. A follow-up visit after 6 months revealed that none of the patients presented with any signs and symptoms which could be related to earlier pneumonia. Chest radiographs showed complete or almost complete resolution of pulmonary and pleural lesions in all patients. We conclude that necrotizing pneumonia is a relatively rare but severe form of CAP that is almost always complicated by PPE/empyema and/or BPF. It can be successfully treated with antibiotics and pleural drainage without major surgical intervention. PMID:25468010

Krenke, K; Sanocki, M; Urbankowska, E; Kraj, G; Krawiec, M; Urbankowski, T; Peradzy?ska, Joanna; Kulus, M

2014-12-01

433

Hypothalamic pituitary complications in Kabuki syndrome.  

PubMed

Kabuki syndrome is characterized by distinctive facial features, multiple anomalies and mental retardation. In this syndrome, structural CNS abnormalities are commonly observed, but congenital abnormalities in the pituitary gland or hypothalamus have rarely been reported. We searched the published medical literature on the complications in hypothalamic pituitary axis in this syndrome. As a result, only nine patients with Kabuki syndrome had been reported to have complications in hypothalamic pituitary axis in previous papers. Among the nine reported patients and one presented case in this report, GH deficiency was the most frequent complication and found in six patients. Precocious puberty and central diabetes insipidus (DI) was identified in two cases, respectively, and ACTH deficiency was found in one. One case had combination of GH deficiency and central DI. Three of the 10 patients demonstrated abnormal pituitary findings in MRI study. Two of the six patients with GH deficiency were accompanied with premature thelarche. This review highlights that patients with Kabuki syndrome could present various clinical manifestations due to abnormalities in hypothalamic pituitary axis. PMID:22434255

Ito, Naoko; Ihara, Kenji; Tsutsumi, Yasushi; Miyake, Noriko; Matsumoto, Naomichi; Hara, Toshiro

2013-06-01

434

Pancreatic transplantation: Radiologic evaluation of vascular complications  

SciTech Connect

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.

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

435

Complications Following BellaGen™ Injection  

PubMed Central

BellaGen™ is an injectable acellular dermal matrix granule derived from donated human skin tissue that was recently developed for soft tissue augmentation. Its use has been sporadically reported in penile girth enhancement procedures. Many cases of complications have been reported after injecting acellular dermal matrices like AlloDerm or SureDerm™ but few reports on complications associated with BellaGen™ injection. We report here on penile skin inflammation and necrosis following augmentation phalloplasty with BellaGen™, which developed 3 days after the injection and persisted for more than 2 weeks. The patient had a 15 year history of type 2 diabetes mellitus, and he was treated with oral antibiotics and wet dressings with KMNO4 solution to combine preservation of the remaining penile soft tissue with debridement of avascular tissue. The lesion improved with this treatment, but the patient experienced pain for about 2 weeks. All patients should be informed of the potential complications with the use of injectable acellular dermal matrices before treatment. Patient selection for augmentation is also important to have the most desirable results. PMID:22346264

Park, Mi Kyung; Kim, Hyun Kyu; Park, Kui Young; Li, Kapsok; Hong, Chang Kwun

2011-01-01

436

Advances, problems, and complications of polypectomy  

PubMed Central

The major role of colonoscopy with polypectomy in reducing the incidence of and mortality from colorectal cancer has been firmly established. Yet there is cause to be uneasy. One of the most striking recent findings is that there is an alarmingly high incomplete polyp removal rate. This phenomenon, together with missed polyps during screening colonoscopy, is thought to be responsible for the majority of interval cancers. Knowledge of serrated polyps needs to broaden as well, since they are quite often missed or incompletely removed. Removal of small and diminutive polyps is almost devoid of complications. Cold snare polypectomy seems to be the best approach for these lesions, with biopsy forcep removal reserved only for the tiniest of polyps. Hot snare or hot biopsy forcep removal of these lesions is no longer recommended. Endoscopic mucosal resection and endoscopic submucosal dissection have proven to be effective in the removal of large colorectal lesions, avoiding surgery in the majority of patients, with acceptably low complication rates. Variants of these approaches, as well as new hybrid techniques, are being currently tested. In this paper, we review the current status of the different approaches in removing polypoid and nonpolypoid lesions of the colon, their complications, and future directions in the prevention of colorectal cancer. PMID:25210470

Anderloni, Andrea; Jovani, Manol; Hassan, Cesare; Repici, Alessandro

2014-01-01

437

Magnetic resonance cholangiography in the assessment and management of biliary complications after OLT  

PubMed Central

Despite advances in patient and graft management, biliary complications (BC) still represent a challenge both in the early and delayed period after orthotopic liver transplantation (OLT). Because of unspecific clinical presentation, imaging is often mandatory in order to diagnose BC. Among imaging modalities, magnetic resonance cholangiography (MRC) has gained widespread acceptance as a tool to represent the reconstructed biliary tree noninvasively, using both the conventional technique (based on heavily T2-weighted sequences) and contrast-enhanced MRC (based on the acquisition of T1-weighted sequences after the administration of hepatobiliary contrast agents). On this basis, MRC is generally indicated to: (1) avoid unnecessary procedures of direct cholangiography in patients with a negative examination and/or identify alternative complications; and (2) provide a road map for interventional procedures or surgery. As illustrated in the review, MRC is accurate in the diagnosis of different types of biliary complications, including anastomotic strictures, non-anastomotic strictures, leakage and stones. PMID:25071883

Girometti, Rossano; Cereser, Lorenzo; Bazzocchi, Massimo; Zuiani, Chiara

2014-01-01

438

Technique, Complication, and Long-Term Outcome for Endovascular Treatment of Iliac Artery Occlusion  

SciTech Connect

The aim of this study was to report technical details, procedure-related complications, and results of endovascular treatment in chronic iliac artery occlusion. Between 2001 and 2008, endovascular treatments of 127 chronic iliac artery occlusions in 118 patients (8 women and 110 men; mean age, 59 years) were retrospectively reviewed. The study was based on Ad Hoc Committee on Reporting Standards (Society for Vascular Surgery/International Society for Cardiovascular Surgery Standards). All occlusions were treated with stent placement with or without preliminary balloon angioplasty. Kaplan-Meier estimators were used to determine patency rates. Univariate and multivariate analyses were performed to determine variables affecting successful recanalization, major complications, early stent thrombosis ({<=}30 days), and primary and secondary patency rates. Initial technical success was achieved in 117 (92%) procedures. Successful recanalization was obtained by antegrade approach in 69 of 77 (90%) procedures and by retrograde approach in 52 of 105 (50%) procedures (p < 0.001). Complications were encountered in 28 (24%) patients [minor in 7 patients (6%) and major in 22 patients (19%)]. One death occurred in the operative period secondary to iliac artery rupture. Early stent thrombosis was seen in eight (7%) patients. Presence of critical limb ischemia (p = 0.03), subintimal recanalization (p = 0.03), and major complication (p = 0.02) were the independent predictors of early stent thrombosis on multivariate analysis. Primary and secondary patency rates at 5 years were 63 and 93%, respectively. Presence of critical limb ischemia, TASC type C iliac lesions, combined occlusions of both common and external iliac arteries, and major complications were associated with decreased patency rates on univariate analysis, whereas these factors were not independent predictors of stent patency on multivariate analysis. In conclusion, endovascular treatment of iliac artery occlusion has a high technical success rate with favorable long-term patency rate. Success of recanalization increases with use of the antegrade approach and with the presence of a stump of artery before the occlusion.

Ozkan, Ugur, E-mail: radugur@yahoo.com; Oguzkurt, Levent; Tercan, Fahri [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)

2010-02-15

439

Aggressive Surgical Treatment and Early Return to Sports in Athletes With Grade III Syndesmosis Sprains  

Microsoft Academic Search

Background: Grade III syndesmosis sprains are usually treated with internal fixation. Limited information is available on early weightbearing and early return to activity after operative treatment for grade III syndesmosis sprains.Hypothesis: Treatment of grade III syndesmosis sprains in intercollegiate athletes with internal fixation, early range of motion, and early weightbearing can lead to rapid return to sport with minimal complications

Dean C. Taylor; Joachim J. Tenuta; John M. Uhorchak; Robert A. Arciero

2007-01-01

440

Impact of Sequencing of Postmastectomy Radiotherapy and Breast Reconstruction on Timing and Rate of Complications and Patient Satisfaction  

SciTech Connect

Purpose: There are few long-term studies of how the sequencing of postmastectomy radiotherapy (PMRT) and breast reconstruction (BR) affects the time to development of complications or patient satisfaction with BR. We therefore studied this issue. Methods and Materials: One hundred thirteen women who underwent BR at Beth Israel Deaconess Medical Center (Boston, MA) from 1999-2006 and also received PMRT were included. Complications requiring surgery were categorized as early (within 90 days of BR) or late. The median length of follow-up after BR was 46.5 months. Patients' general and esthetic satisfaction was assessed with a validated questionnaire. Results: Complications occurred among 32% of 57 women receiving PMRT before BR and 44% of 57 patients having BR before PMRT (p = 0.176). Early complications were more frequent in patients who had PMRT first (18%) than for those with BR first (11%) (p = 0.210); conversely, late complication rates in the two groups were 14% and 33%, respectively (p = 0.009). General satisfaction was comparable between the PMRT-first and BR-first groups (68% and 68%, respectively; p = 0.995); esthetic satisfaction rates were also similar (50% and 62%, respectively; p = 0.238). Conclusions: The sequencing of PMRT and BR did not have a substantial impact on the total risk of complications or patients' general and esthetic satisfaction. However, early complications tended to develop in patients having PMRT first, whereas patients having BR first had a higher risk of late complications. Additional study of the effects of sequencing of PMRT on particular types of reconstructions may help devise strategies for reducing these risks.

Adesiyun, Tolulope A.; Lee, Bernard T.; Yueh, Janet H.; Chen, Chen [Harvard Medical School, Boston, MA (United States); Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA (Israel); Colakoglu, Salih; Anderson, Katarina E.M.; Nguyen, Minh-Doan T. [Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA (Israel); Recht, Abram, E-mail: arecht@bidmc.harvard.ed [Harvard Medical School, Boston, MA (United States); Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA (Israel)

2011-06-01