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91.
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Molly Orcutt Wendy C. King Melissa A. Kalarchian Michael J. Devlin Marsha D. Marcus Luis Garcia Kristine J. Steffen James E. Mitchell 《Surgery for obesity and related diseases》2019,15(2):295-303
Background
A history of childhood maltreatment and psychopathology are common in adults with obesity.Objectives
To report childhood maltreatment and to evaluate associations between severity and type of childhood maltreatment and lifetime history of psychopathology among adults with severe obesity awaiting bariatric surgery.Setting
Four clinical centers of the Longitudinal Assessment of Bariatric Surgery Research Consortium.Methods
The Childhood Trauma Questionnaire, which assesses presence/severity (i.e., none, mild, moderate, severe) of physical abuse, mental abuse, physical neglect, mental neglect, and sexual abuse, was completed by 302 female and 66 male bariatric surgery patients. Presurgery lifetime history of psychopathology and suicidal ideation/behavior were assessed with the Structured Clinical Interview for DSM-IV and the Suicidal Behavioral Questionnaire-Revised, respectively. Presurgery lifetime history of antidepressant use was self-reported.Results
Two thirds (66.6%) of females and 47.0% of males reported at least 1 form of childhood trauma; 42.4% and 24.2%, respectively, at greater than or equal to moderate severity. Among women, presence/greater severity of childhood mental or physical abuse or neglect was associated with a higher risk of history of psychopathology (i.e., major depressive disorder, posttraumatic stress disorder, other anxiety disorder, alcohol use disorder, binge eating disorder), suicidal ideation/behavior and antidepressant use (P for all ≤ .02). These associations were independent of age, race, education, body mass index, and childhood sexual abuse. Childhood sexual abuse was independently associated with a history of suicidal ideation/behavior and antidepressant use only (P for both ≤ .05). Statistical power was limited to evaluate these associations among men.Conclusion
Among women with obesity, presence/severity of childhood trauma was positively associated with relatively common psychiatric disorders. 相似文献93.
随着科学技术的进步和对疾病本身认识的深入,直肠癌的外科治疗从局部切除到全直肠系膜切除(TME),从开放手术到腹腔镜手术,再从腹腔镜手术到机器人手术,目前已经进入微创时代。在此时代背景下,经肛门全直肠系膜切除(TaTME) 应运而生。正如TME的提出者Heald所言:“TaTME是近30年直肠癌外科治疗技术的集大成者”,其发展的每一个阶段都有很强的代表性,已成为直肠癌微创外科治疗技术进步发展的一个缩影。 相似文献
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Changes in Right Ventricular Shape and Deformation Following Coronary Artery Bypass Surgery—Insights from Echocardiography with Strain Rate and Magnetic Resonance Imaging 下载免费PDF全文
96.
《European journal of surgical oncology》2020,46(5):888-892
ObjectiveBorderline ovarian tumours (BOTs) are characterized by the presence of cellular proliferation and nuclear atypia without stromal invasion. Compared to malignant ovarian tumours, BOTs have better prognoses. The most important treatment of BOT is surgery. Considering the good prognosis of BOT, fertility-sparing surgery (FSS) can be considered for young women who desire to preserve fertility. Our study evaluated the pregnancy rate in patients with childbearing desire, the efficacy and risk of recurrence of women affected by BOTs who have undergone FSS.Materials and methodsPatients characteristics have been restrospectively retrieved for diagnosis made from June 2000 to December 2017 from San Raffaele Hospital and Policlinico Cagliari. Patients underwent FSS for BOT were interviewed about child wishing and pregnancy outcomes.Results85 patients were recruited for the study. Median age at diagnosis was 33 years. Unilateral salpingo-oophorectomy was performed in 33 patients (38%), unilateral cystectomy in 40 (47%) and 12 underwent both procedures (14%). 40 women (50%) tried to conceive after surgery. The pregnancy rate was 73% and live birth rate was 67%. Childbearing desire and age at diagnosis were significantly associated with the pregnancy rate.ConclusionsConservative surgical treatment seems to be a reasonable therapeutic option for women with BOTs who wish to preserve fertility. Our results suggest that the obstetric outcomes after FSS are promising. Maternal desire and the age of diagnosis are the most important factors affecting PR after surgery. Fertility counselling should be an integral part of the clinical management of women with BOT. 相似文献
97.
Christos Loizou Göran Laurell Andreas Arvidsson David Lindquist Karin Nylander Katarina Olofsson 《Acta oto-laryngologica》2015,135(10):1058-1064
Conclusion: Recurrent respiratory papillomatosis (RRP) patients with high surgical treatment frequency (≥ 1/year, HF) were significantly younger and had a more widespread laryngeal disease compared to a low frequency treated group (< 1 treatment/year, LF). This study confirms the existence of a clinical RRP group, not primarily related to HPV sub-type, but more care-intensive and in need of more vigilant follow-up. Objectives: RRP is associated with high morbidity due to its influence on breathing and voice. The purpose of this study was to characterize RRP patients in northern Sweden and investigate possible predictor factors affecting therapeutic needs. Method: Patients from the regional referral area (northern Sweden) were categorized for age, disease duration, juvenile or adult onset, profile of disease development, number of surgical sessions in relation to disease duration, laryngeal deposition of papilloma, gender, and HPV sub-types, in order to identify patients with increased need for frequent surgical treatment. Results: The median age of the RRP patients (n = 48) was 44.5 years; 34 (71%) were males and 14 (29%) females, most were infected with HPV 6. Patients with high surgical treatment frequency/year were significantly younger and showed more widespread papillomatous vegetation in the larynx, compared to the low frequency treated group. 相似文献
98.
美国胃肠病协会(AGA)于2019年8月在Gastroenterology(《胃肠病学》)杂志上发表了针对胰腺坏死处理的临床实践专家共识的更新,归纳并总结了当前的临床证据与专家意见,旨在为胰腺坏死这一复杂临床情况的最佳干预提供指导建议。近年来,随着临床实践的不断深入,急性胰腺炎胰腺坏死的处理经历了较大的变革。从一开始的以手术为主的清创策略过渡到现阶段较为成熟的升阶梯治疗模式。针对胰腺坏死的治疗主要包含两个方面:非手术治疗和有创干预。其中,非手术治疗主要包括抗菌治疗和营养支持等。一旦坏死组织发生感染或无菌性坏死使病人产生显著临床症状,提示有强烈干预指征时,此时更多地依赖于有创干预。升阶梯治疗模式的主要内容为:以经皮引流或透壁内镜引流为首要手段,对于引流无法处理的大量固体坏死,可进行经皮微创或经内镜下坏死清除,若微创手段干预无效可进行开放手术清创。关于选择经皮微创阶梯治疗还是经内镜阶梯治疗,目前尚无研究显示两者之间对病死率等主要临床结局产生影响,不同治疗中心可根据各中心的专业特长和医疗资源,合理选择治疗方案。 相似文献
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