Surgical management in a severe OSA patient diagnosed with Stickler syndrome

Stickler syndrome is a genetic disorder of connective tissue. One of the major symptoms associated with this disorder is an oro-facial malformation, which may cause a submucous cleft or a complete cleft of the hard palate. A 32-year-old man diagnosed with Stickler syndrome and a submucosal cleft palate (SMCP) visited our hospital with a chief complaint of excessive daytime sleepiness. The patient was diagnosed with severe obstructive sleep apnea (OSA), and administration of a polysomnography test revealed an apnea-hypopnea index (AHI) of 30.9 events/hour (h). Auto-titrating continuous positive airway pressure was initiated to control the OSA symptoms and subsequently the patient showed some improvement. However, due to continuous velopharyngeal insufficiency symptoms, intravelar veloplasty was performed. Three months after surgery, the AHI had decreased to 12.4 events/h. Recent studies have described a greater risk for OSA in individuals with cleft palate, than in the general population. The present case demonstrates surgical success in a patient with OSA and SMCP, suggesting that palatal surgery may be considered an optional surgical treatment for OSA patients with SMCP.     

Overweight and obesity as risk factors for biochemical recurrence of prostate cancer after radical prostatectomy

International Journal of Clinical Oncology - Previous studies have shown a relationship between the occurrence and recurrence of prostate cancer; however, this relationship remains controversial....     

Effect of iron deficiency without anaemia on days alive and out of hospital in patients undergoing valvular heart surgery

Comprehensive evidence regarding the treatment of non-anaemic iron deficiency in patients undergoing valvular heart surgery is lacking. This study aimed to investigate the association between non-anaemic iron deficiency and postoperative outcomes in these patients. We retrospectively analysed 321 patients of which 180 (56%) had iron deficiency (defined as serum ferritin < 100 ng.ml^-1 or < 300 ng.ml^-1 with transferrin saturation < 20%). While the iron-deficient group had lower pre-operative haemoglobin levels than the non-iron deficient group (median (IQR [range]) 134 (127–141 [120–172]) g.l^-1, 143 (133–150 [120–179]) g.l^-1, p = 0.001), there was no between-group difference in allogeneic red blood cell transfusion. Median (IQR [range]) days alive and out of hospital at postoperative day 90 was 1 day shorter in the iron-deficient group (80 (77–82 [9–85]) days vs. 81 (79–83 [0–85]) days, p = 0.026). In multivariable analysis, only cardiopulmonary bypass duration (p = 0.032) and intra-operative allogeneic red blood cell transfusion (p = 0.011) were significantly associated with reduced days alive and out of hospital at postoperative day 90. Iron deficiency did not exert any adverse influence on secondary outcomes except length of hospital stay. Our findings indicate that non-anaemic iron deficiency alone is not associated with adverse effects in patients undergoing valvular heart surgery when it does not translate into an increased risk of allogeneic transfusion.     

Evaluation of Prostate Cancer Stage Groups Updated in the 8th Edition of the American Joint Committee on Cancer Tumor–Node–Metastasis Staging Manual

Introduction

The American Joint Committee on Cancer (AJCC) tumor, node, metastasis classification system (TNM) staging manual has been updated and provides more specified stage grouping for prostate cancer (PCa). We aimed to validate the updated AJCC stage groups for PCa using a radical prostatectomy (RP) cohort.

Comparison of Cancer Detection Rates Between TRUS-Guided Biopsy and MRI-Targeted Biopsy According to PSA Level in Biopsy-Naive Patients: A Propensity Score Matching Analysis

Background

The purpose of the study was to compare cancer detection rates between 12-core transrectal ultrasound-guided prostate biopsy (TRUS-Bx) and multiparametric magnetic resonance imaging (mpMRI)-guided target prostate biopsy (MRI-TBx) according to prostate-specific antigen (PSA) level in biopsy-naive patients.

Quality of life and subjective health status according to handgrip strength in the elderly: a cross-sectional study

Objectives: The purpose of this cross-sectional study was to examine potential associations between handgrip strength and health-related quality of life, or subjective health status, in the elderly.

Method: We performed secondary data analysis on 2377 elderly individuals aged >65 years. Raw data from the Korea National Health and Nutrition Examination Survey VI (2014–2015), were drawn from a representative national sample.

Results: Of those aged ≥65 years or older, 25.4% had low handgrip strength. After adjusting for confounding variables, the odds ratios of elderly individuals with low handgrip strength were 1.30 (95% confidence interval [CI]: 1.00–1.69) for mobility, 2.18 (95% CI: 1.47–3.22) for self-care, 1.70 (95% CI: 1.30–2.23) for usual activities, 1.30 (95% CI: 1.01–1.67) for pain/discomfort, 1.03 (95% CI: 0.74–1.44) for anxiety/depression, 1.44 (95% CI: 1.10–1.87) for the EQ-5D index, and 1.37 (95% CI: 1.08–1.73) for subjective health status.

Conclusion: Health-related quality of life and subjective health status differ according to handgrip strength. Therefore, handgrip strength should be addressed to improve quality of life in elderly individuals. Elderly individuals require exercise education and adequate nutritional intake to increase handgrip strength.