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1.
Takahiro Imaizumi Masahiko Ando Masahiro Nakatochi Shoichi Maruyama Yoshinari Yasuda Hiroyuki Honda Yachiyo Kuwatsuka Sawako Kato Takaaki Kondo Masamitsu Iwata Toru Nakashima Hiroshi Yasui Hideki Takamatsu Hiroshi Okajima Yasuko Yoshida Seiichi Matsuo 《Clinical and experimental nephrology》2017,21(3):457-464
Background
Blood pressure is influenced by hereditary factors and dietary habits. The objective of this study was to examine the effect of dietary salt consumption and single-nucleotide polymorphisms (SNPs) on blood pressure (BP).Methods
This was a cross-sectional analysis of 2728 male participants who participated in a health examination in 2009. Average dietary salt consumption was estimated using electronically collected meal purchase data from cafeteria. A multivariate analysis, adjusting for clinically relevant factors, was conducted to examine whether the effect on BP of salt consumption, SNPs, and interaction between salt consumption and each SNP. This study examined the SNPs AGT rs699 (Met235Thr), ADD1 rs4961 (Gly460Trp), NPPA rs5063 (Val32Met), GPX1 rs1050450 (Pro198Leu), and AGTR1 rs5186 (A1166C) in relation to hypertension and salt sensitivity.Results
BP was not significantly associated with SNPs or salt consumption. The interaction between salt consumption and SNPs with systolic BP showed a significant association in NPPA rs5063 (Val32Met) (P = 0.023) and a marginal trend toward significance in rs4961 and rs1050450 (P = 0.060 and 0.067, respectively).Conclusion
The effect of salt consumption on BP differed by genotype. Dietary salt consumption and genetic variation can predict a high risk of hypertension.2.
G. Cai X. Zhang L. Xin L. Wang M. Wang X. Yang X. Li Q. Xia S. Xu C. Ding F. Pan 《Osteoporosis international》2016,27(7):2327-2333
Summary
We assessed whether the vitamin D receptor gene polymorphisms (FokI, BsmI, ApaI, and TaqI) were associated with ankylosing spondylitis (AS) in a Chinese Han population. The TaqI polymorphism G allele was a risk factor in AS susceptibility.Introduction
Previous studies have found that serum vitamin D levels are declined in patients with AS. The present study aims to evaluate the role of vitamin D receptor (VDR) gene polymorphisms in AS susceptibility in a Chinese Han population.Methods
Four single nucleotide polymorphisms (SNPs) in the VDR gene (FokI (rs2228570), BsmI (rs1544410), ApaI (rs7975232), and TaqI (rs731236)) were genotyped by the improved multiplex ligase detection reaction (iMLDR) method in 620 AS patients and 620 geographically and ethnically matched healthy controls. Haplotypes were constructed after linkage disequilibrium (LD) analysis.Results
Statistically significant difference was only found in the TaqI polymorphism between AS patients and controls. The TaqI polymorphism G allele was higher in AS group than that in controls (OR [95 % CI]?=?1.624 [1.122–2.352], χ 2?=?6.705, P?=?0.006). Linkage disequilibrium has been detected in TaqI and BsmI polymorphisms (D′?=?0.87, r 2?=?0.70). Two novel haplotypes (H1: AC and H2: GT) were significantly associated with the risk of AS, and they play protective and risk roles in AS morbidity, respectively.Conclusions
The VDR gene TaqI polymorphism G allele may be a risk factor in AS susceptibility.3.
Y. Zheng C. Wang H. Zhang C. Shao L.-H. Gao S.-S. Li W.-J. Yu J.-W. He W.-Z. Fu Y.-Q. Hu M. Li Y.-J. Liu Z.-L. Zhang 《Osteoporosis international》2016,27(5):1805-1815
Summary
Our objective was to investigate the associations between polymorphisms in Wnt pathway genes and peak bone mineral density (BMD) and body composition in young Chinese men. Our study identified that WNT5B and CTNNBL1 for both BMD and body composition, and WNT4 and CTNNB1 gene polymorphisms contribute to the variation in BMD and body composition in young Chinese men, respectively.Introduction
Our objective was to investigate the associations between polymorphisms in WNT4, WNT5B, WNT10B, WNT16, CTNNB1, and CTNNBL1 genes and peak bone mineral density (BMD), lean mass (LM), and fat mass (FM) in young Chinese men.Methods
Using SNPscanTM kits, 51 single-nucleotide polymorphisms (SNPs) located in the 6 genes were genotyped in a total of 1214 subjects from 399 Chinese nuclear families. BMD, total lean mass (TLM), and total fat mass (TFM) were measured using dual energy X-ray absorptiometry (DXA). The associations between the 51 SNPs and peak BMD and body composition [including the TLM, percentage lean mass (PLM), TFM, percentage fat mass (PFM), and the body mass index (BMI)] were analyzed through quantitative transmission disequilibrium tests (QTDTs).Results
For peak BMD, we found significant within-family associations of rs2240506, rs7308793, and rs4765830 in the WNT5B gene and rs10917157 in the WNT4 gene with the lumbar spine BMD (all P?<?0.05). We detected an association of rs11830202, rs3809269, rs1029628, and rs6489301 in the WNT5B gene and rs2293303 in the CTNNB1 gene with body composition (all P?<?0.05). For the CTNNBL1 gene, six SNPs (rs6126098, rs6091103, rs238303, rs6067647, rs8126174, and rs4811144) were associated with peak BMD of the lumbar spine, femoral neck, or total hip (all P?<?0.05). Furthermore, two of the six SNPs (rs8126174 and rs4811144) were associated with body composition.Conclusions
This study identified WNT5B and CTNNBL1 for peak BMD and body composition in males from the Han Chinese ethnic group, and the results suggest a site-specific gene regulation. The WNT4 and CTNNB1 gene polymorphisms contribute to the variation in peak BMD and body composition, respectively.4.
Hong-xiang Lu Jian-hui Sun Da-lin Wen Juan Du Ling Zeng An-qiang Zhang Jian-xin Jiang 《World journal of emergency surgery : WJES》2018,13(1):52
Background
Previous study revealed that rs2232618 polymorphism (Phe436Leu) within LBP gene is a functional variant and associated with susceptibility of sepsis in traumatic patients. Our aim was to confirm the reported association by enlarging the population sample size and perform a meta-analysis to find additional evidence.Methods
Traumatic patients from Southwest (n?=?1296) and Southeast (n?=?445) of China were enrolled in our study. After genotyping, the relationship between rs2232618 and the risk of sepsis was analyzed. Furthermore, we proceeded with a comprehensive literature search and meta-analysis to determine whether the rs2232618 polymorphism conferred susceptibility to sepsis.Results
Significance correlation was observed between rs2232618 and risk of sepsis in Southwest patients (P?=?0.002 for the dominant model, P?=?0.006 for the recessive model). The association was confirmed in Southeast cohort (P?=?0.005 for the dominant model) and overall combined cohorts (P =?4.5?×?10?4, P?=?0.041 for the dominant and recessive model). Multiple logistical regression analyses suggested that rs2232618 polymorphism was related to higher risk of sepsis (OR?=?1.77, 95% CI?=?1.26–2.48, P?=?0.001 in Southwest patients; OR?=?2.11, 95% CI?=?1.24–3.58, P?=?0.006 in Southeast cohort; OR?=?1.54, 95% CI?=?1.34–2.08, P?=?0.006 in overall cohort). Furthermore, meta-analysis of four studies (including the present study) confirmed that rs2232618 within LBP increased the risk of sepsis (OR?=?1.75, P?<?0.001 for the dominant model; OR?=?6.08, P?=?0.003 for the recessive model; OR?=?2.72, P?<?0.001 for the allelic model).Conclusions
The results from our replication study and meta-analysis provided firm evidence that rs2232618T allele significantly increased the risk of sepsis.5.
Natália Luiza Kops Manoela A. Vivan Jaqueline D. C. Horvath Mariana L. D. de Castro Rogério Friedman 《Obesity surgery》2018,28(9):2705-2711
Purpose
Differences in weight loss outcomes after bariatric surgery may be related to individual preoperative characteristics. The aim of this study was to evaluate the potential effect of fatty acid binding protein-2 (rs1799883), leptin receptor (LEP223, rs1137101 and LEP656, rs1805094), and fat mass and obesity-related (rs9939609) genotypes on weight loss 2 years after bariatric surgery in Brazilian patients.Materials and Methods
Prospective observational study involving 105 patients (lost to follow-up, 25.7%). In the preoperative period, patients were clinically evaluated and a fasting blood sample for genetic analysis (by real-time DNA amplification technique) was collected. From the patient’s medical records, follow-up weight loss (3, 6, 12, 24 months) was obtained. Percentage of excess weight loss (%EWL) was examined by pairwise comparison across the polymorphisms.Results
At baseline, the mean weight was 127.5 (23.3) kg and age 43.1 (10.9) years old. The %EWL was significant over time (p?<?0.01). Only the LEP223 genotype showed association (p?<?0.01). Up to 6 months after surgery, no differences were observed. At 12 months, a significant difference (p?=?0.03) between AA (n?=?19) and GG (n?=?34) groups was observed, with 76.5% EWL versus 52.0%, respectively. This difference remained at 24 months. Other genotypes did not present any significant association.Conclusions
There is a different evolution of weight loss in carriers of the LEP223 after bariatric surgery. The AA genotype seems to be associated with a higher weight loss. However, this pattern was evident only at 12 months after surgery.6.
Sarka Davidkova Timothy D. Prestidge Peter W. Reed Tonya Kara William Wong Chanel Prestidge 《Pediatric nephrology (Berlin, Germany)》2016,31(5):819-826
Background
Anemia is a major complication for patients on chronic dialysis. Erythropoietin is effective if iron is available, however unnecessary iron supplementation results in iron overload. Reticulocyte hemoglobin equivalent (Ret-He) may be useful for assessing iron status.Methods
A national retrospective cohort study including all children on chronic dialysis in New Zealand between 2007 and 2013, pairing Ret-He with demographic information, anemia indices, and markers of iron status.Results
In 606 observations, we found a modest relationship between Ret-He and transferrin saturation (TSAT) (r?=?0.34, p?<?0.001) and a poor correlation between Ret-He and ferritin (r?=?0.09, p?=?0.04). There was a negative correlation between ferritin and hemoglobin (r?=??0.14, p?=?0.002), a weak positive correlation between TSAT and hemoglobin (r?=?0.12, p?=?0.007), and a modest positive correlation between Ret-He and hemoglobin (r?=?0.22, p?<?0.001). The diagnostic performance of Ret-He to detect absolute iron deficiency (cut-off value 28.9 pg, sensitivity 90 %, specificity 75 %, AUC 0.87) was good.Conclusions
Ret-He is a more relevant marker of iron status than ferritin and TSAT. This supports prospectively testing Ret-He to distinguish between iron deficiency and suboptimal erythropoietin dosing as competing causes for anemia. Ferritin is an unhelpful biomarker of iron deficiency in this setting.7.
John Dotis Antigoni Pavlaki Nikoleta Printza Stella Stabouli Stamatia Antoniou Chrysa Gkogka Nikolaos Kontodimopoulos Fotios Papachristou 《Pediatric nephrology (Berlin, Germany)》2016,31(12):2309-2316
Background
Progressive chronic kidney disease (CKD), irrespective of the underlying etiology, affects the quality of life (QoL) of children due to the need for regular follow-up visits, a strict medication program and diet intake.Methods
The Greek version of the KIDSCREEN-52 multidimensional questionnaire was used in children with CKD, renal transplantation (RT) and in a control group (CG) of healthy children.Results
Fifty-five patients between 8 and 18 years, with CKD (n?=?25), RT (n?=?16) and with end-stage renal disease (ESRD) on peritoneal dialysis (PD) (n?=?14) were included. Each group of studied children was compared with the CG (n?=?55), the validation sample (VS) (n?=?1200) and the parent proxy scores. Physical well-being of all studied children was significantly lower compared to CG (p?=?0.004). In contrast, all studied children between 8 and 11 years showed better social acceptance compared to VS (p?=?0.0001). When QoL of children with CKD was compared with parent proxy QoL, conflicting opinions were observed in several dimensions, such as self-perception (p?=?0.023), autonomy (p?=?0.012), school environment (p?=?0.012) and financial resources (p?=?0.03).Conclusions
QoL and mainly the dimension of physical well-being, may be affected dramatically in children with CKD unrelated to disease stage. In early school years children with CKD seem to feel higher social acceptance than the healthy controls, exhibiting better score in this dimension. Optimal care requires attention not only to medical management, but also to an assessment of QoL factors, that may help promote pediatric patient’s health.8.
Kamal K. Mahawar Abdelrahman Nimeri Marco Adamo Cynthia-Michelle Borg Rishi Singhal Omar Khan Peter K. Small 《Obesity surgery》2018,28(9):2650-2660
Background
There is currently little evidence available on various aspects of Revisional Bariatric Surgery (RBS) and no published consensus amongst experts. The purpose of this study was to understand variation in practices concerning RBS.Methods
Bariatric surgeons from around the world who perform RBS were invited to participate in a questionnaire-based survey on SurveyMonkey®.Results
A total of 460 respondents from 62 countries took the survey. For revision after gastric banding, Roux-en-Y gastric bypass (RYGB) (75.5%, n?=?345) emerged as the commonest choice followed by sleeve gastrectomy (SG) (56.9%, n?=?260) and one anastomosis gastric bypass (OAGB) (37.2%, n?=?170). For revision after SG, RYGB (77.7%, n?=?355) was the commonest option followed by OAGB (42.45%, n?=?194) and re-sleeve (22.32%, n?=?102). For revision after RYGB, surgical pouch reduction (49.1%, n?=?223), prolongation of bilio-pancreatic limb (30.0%, n?=?136), and surgical stoma size reduction (26.43%, n?=?120) were the most preferred options. Approximately 90.0% of respondents (n?=?406/454) routinely perform an upper gastrointestinal endoscopy before an RBS, and 85.6% (n?=?388/453) routinely perform a contrast study. Ninety percent (n?=?403/445) reported that the demand for RBS was usually patient-driven, and there was wide variation in criteria used to define successful response, non-responders, and significant weight regain.Conclusions
This survey is the first attempt to understand various aspects of RBS. The findings will help in identifying areas for research and allow consensus building amongst experts.9.
Summary
This study compared the effects sarcopenic osteoarthritis on metabolic syndrome, insulin resistance, osteoporosis, and bone fracture. By using national survey data, we suggest that the relationship between sarcopenia and metabolic syndrome or insulin resistance is potentiated by the severity of osteoarthritis and is independent of body weight.Introduction
Sarcopenia and osteoarthritis are known risk factors for metabolic syndrome. However, their combined effects on metabolic syndrome, insulin resistance and osteoporosis remain uncertain.Methods
We used data from the fifth Korean National Health and Nutrition Examination Survey using a total of 3158 adults (age >50 years). Sarcopenia was defined as a skeletal muscle index score (appendicular skeletal muscle mass/body weight) within the fifth percentile of sex-matched younger reference participants. Radiographic knee osteoarthritis was defined as a Kellgren-Lawrence (K-L) grade of 2 or greater. Metabolic syndrome was diagnosed using the National Cholesterol Education Program criteria. Insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance index (HOMA-IR). Osteoporosis was defined using the World Health Organization T-score criteria.Results
In multivariable logistic regression analysis, the sarcopenic osteoarthritis group had a higher odds ratio (OR) for metabolic syndrome (OR?=?11.00, 95 % confidential interval (CI)?=?2.12–56.99, p?=?0.013) than the non-sarcopenic osteoarthritis (OR?=?1.02, 95 % CI?=?0.65–1.62, p?=?0.972) and sarcopenic non-osteoarthritis groups (OR?=?7.15, 95 % CI?=?1.57–32.53, p?=?0.027). Similarly, sarcopenic osteoarthritis had a greater OR of highest HOMA-IR quartiles (OR?=?8.19, 95 % CI?=?2.03–33.05, p?=?0.003) than the other groups. Overall, the association between the K-L grade and body mass index was significant; however, this significance was lower in individuals with sarcopenia and was lost in those with sarcopenic osteoarthritis. Additionally, osteoporosis and bone fracture were not associated to sarcopenic osteoarthritis (p?>?0.05).Conclusions
These results suggest that the relationship between sarcopenia and metabolic syndrome or insulin resistance is potentiated by the severity of osteoarthritis and is independent of body weight.10.
Claudius Conrad Onur C. Kutlu Arvind Dasari Jennifer A Chan Jean-Nicolas Vauthey David B. Adams Michael Kim Jason B. Fleming Matthew H. G. Katz Jeffrey E. Lee 《Journal of gastrointestinal surgery》2016,20(12):1966-1974
Background
The impact of lymph node (LN) status and lymphadenectomy (LA) on survival in pancreatic neuroendocrine tumors (pNETs) remains controversial. We evaluated the impact of tumor extension and grade on nodal metastasis and survival.Methods
Surgical pNET patients were queried in the Surveillance Epidemiology and End Results (SEER) database (1998–2012, N?=?981). Factors associated with LN status were analyzed by logistic regression and by Cox analyses.Results
For T1–T2 tumors, N status was associated only with tumor size. N status (p?=?0.001), grade (p?<?0.001), age (p?=?0.001), and sex (p?=?0.007) predicted overall survival (OS). For T3–T4, grade (p?<?0.001), sex (p?=?0.004), size (p?=?0.013), and age (p?=?0.007) but not N status (p?=?0.789) predicted OS. For T1–T2, disease-specific survival (DSS; p?=?0.003) and OS (p?=?0.008) were longer for N0 vs N1, while N0 vs NX had similar OS (p?=?0.59) and DSS (p?=?0.80). While a difference was seen in DSS for NX vs N1 (p?=?0.04), no significant difference in OS was seen (p?=?0.08). For T3–T4, N status did not affect DSS (p?=?0.365) or OS (p?=?0.454). For all T groups and any N status, extended LA (≥10 nodes resected) was not associated with OS.Conclusion
While in T1–T2 pNET N1 status is a predictor of negative OS, similar outcome between NX and N0 supports limited LN resection in selected patients. Extended LA is unlikely to be helpful in T3–T4.11.
H. Bomberg N. Paquet A. Huth S. Wagenpfeil P. Kessler H. Wulf T. Wiesmann T. Standl A. Gottschalk J. Döffert W. Hering J. Birnbaum B. Kutter J. Winckelmann S. Liebl-Biereige W. Meissner O. Vicent T. Koch H. Bürkle D. I. Sessler A. Raddatz T. Volk 《Der Anaesthesist》2018,67(12):922-930
Background
Dural puncture, paraesthesia and vascular puncture are the most common complications of epidural catheter insertion. Their association with variation in midline needle insertion depth is unknown.Objective
This study evaluated the risk of dural and vascular punctures and the unwanted events paraesthesia and multiple skin punctures related to midline needle insertion depth.Material and methods
A total of 14,503 epidural catheter insertions including lumbar (L1–L5; n?=?5367), low thoracic (T7–T12, n?=?8234) and upper thoracic (T1–T6, n?=?902) insertions, were extracted from the German Network for Regional Anaesthesia registry between 2007 and 2015. The primary outcomes were compared with logistic regression and adjusted (adj) for confounders to determine the risk of complications/events. Results are presented as odds ratios (OR, [95% confidence interval]).Main results
Midline insertion depth depended on body mass index, sex, and spinal level. After adjusting for confounders increased puncture depth (cm) remained an independent risk factor for vascular puncture (adjOR 1.27 [1.09–1.47], p?=?0.002) and multiple skin punctures (adjOR 1.25 [1.21–1.29], p?<?0.001). In contrast, dural punctures occurred at significantly shallower depths (adjOR 0.73 [0.60–0.89], p?=?0.002). Paraesthesia was unrelated to insertion depth. Body mass index and sex had no influence on paraesthesia, dural and vascular punctures. Thoracic epidural insertion was associated with a lower risk of vascular puncture than at lumbar sites (adjOR 0.39 [0.18–0.84], p?=?0.02).Conclusion
Variation in midline insertion depth is an independent risk factor for epidural complications; however, variability precludes use of depth as a reliable guide to insertion in individual patients.12.
Purpose
To investigate the clinical characteristics of acute type A aortic dissection (ATAAD) occurring during a sporting activity.Methods
The subjects of this study were 615 patients who underwent surgery for ATAAD between 1990 and 2015. The patients were divided into two groups according to whether the ATAAD was associated with a sporting activity (sports group: n?=?25, mean age 62.3 years; non-sports group: n?=?590, mean age 63.7 years). Specific activity was assessed in the sports group, and the characteristics and outcomes were compared between the groups.Results
The sports group accounted for 5% of the patients with daytime onset ATAAD (25/479). The most common sport was golf (n?=?8), followed by swimming (n?=?4), cycling (n?=?4), and weight lifting (n?=?3). The average diameter of the ascending aorta on preoperative computed tomography was 4.8 cm. The dissection characteristics of the sports group included DeBakey type I (n?=?23, 92%) and malperfusion (n?=?9, 36%), which were similar to those of the non-sports group. The 30-day mortality rates were 16% (4/25) for the sports group and 8% (49/590) for the non-sports group (P?=?0.33).Conclusions
The most common sport associated with ATAAD was golf, followed by swimming cycling, and weight lifting. The findings of this study reinforce that sports-related aortic dissection is not a unique clinical condition of young syndromic patients, but can occur in all age groups.13.
Background and purpose
Delayed gastric emptying (DGE) is the most common complication following pancreaticoduodenectomy (PD). The clinical efficacy of stapled side-to-side anastomosis using a laparoscopic stapling device during alimentary reconstruction in PD is not well understood and its superiority over conventional hand-sewn end-to-side anastomosis remains controversial. The objective of this study was to evaluate the effectiveness of the stapled side-to-side anastomosis in preventing the development of DGE after PD.Methods
The subjects of this retrospective study were 137 patients who underwent pancreaticoduodenectomy, as subtotal stomach-preserving pancreaticoduodenectomy (SSPPD; n?=?130), or conventional whipple procedure (n?=?7) with Child reconstruction, between January 2010 and May 2014. The patients were divided into two groups according to whether they had had a stapled side-to-side anastomosis (SA group; n?=?57) or a conventional hand-sewn end-to-side anastomosis (HA group; n?=?80).Results
SA reduced the operative time (SA vs. HA: 508 vs. 557 min, p?=?0.028) and the incidence of delayed gastric emptying (SA vs. HA: 21.1 vs. 46.3%, p?=?0.003) and was associated with shorter hospitalization (SA vs. HA: 33 vs. 39.5 days, p?=?0.007). In this cohort, SA was the only significant factor contributing to a reduction in the incidence of DGE (p?=?0.002).Conclusions
Stapled side-to-side gastrojejunostomy reduced the operative time and the incidence of DGE following PD with Child reconstruction, thereby also reducing the length of hospitalization.14.
Audrey H. Choi Amanda Arrington Ann Falor Rebecca A. Nelson Michael Lew Joseph Chao Byrne Lee Joseph Kim 《Journal of gastrointestinal surgery》2016,20(4):688-692
Introduction
Reports on outcomes after double-staple technique (DST) for total and proximal gastrectomy are limited, originating mostly from Asian centers. Our objective was to examine anastomotic leak and stricture with DST for esophagoenteric anastomosis in gastric cancer patients.Methods
A single institution review was performed for patients who underwent total/proximal gastrectomy with DST between 2006 and 2015. DST was performed using transoral anvil delivery (OrVil?) with end-to-end anastomosis. Clinical characteristics and outcomes, including anastomotic leak and stricture, were recorded.Results
Overall, DST was performed in 60 patients [total gastrectomy (81.7 %, n?=?49/60), proximal gastrectomy (10.0 %, n?=?6/60), and completion gastrectomy (8.3 %, n?=?5/60)]. Neoadjuvant chemotherapy was administered to 21 patients (35.0 %), and 6 patients (10.0 %) received external beam radiation therapy prior to completion gastrectomy. Operative approach was open (51.7 %, n?=?31/60), laparoscopic (43.3 %, n?=?26/60), or robotic (5.0 %, n?=?3/60). Anastomotic leak occurred in 6.7 % (n?=?4/60), while stricture independent of leak was identified in 19.0 % (n?=?11/58) of patients. Complications occurred in 38.3 % (n?=?23/60) of patients, of which 52 % were classified as Clavien-Dindo grades III–V complications.Conclusion
In the largest Western series of DST for esophagoenteric anastomoses in gastric cancer surgery, our experience demonstrates that DST is safe and effective with low rates of leak and stricture.15.
Hanife Doğan Nuriye Özengin Yeşim Bakar Bülent Duran 《International urogynecology journal》2016,27(10):1577-1581
Introduction and hypothesis
The aim of this study was to translate the Global Pelvic Floor Bother Questionnaire (GPFBQ) into Turkish and to assess its validity and reliability.Methods
The Turkish adaptation of the GPFBQ was created by following the stages of the intercultural adaptation process. A test–retest interval of 1 week was used to assess the reliability, which was examined by the intraclass correlation coefficient. The validity of the GPFBQ was assessed and compared with the Pelvic Floor Distress Inventory-20 (PFDI-20) and the Pelvic Floor Impact Questionnaire-7 (PFIQ-7) using Spearman’s rank correlation coefficients. For construct validity, confirmatory factor analysis was performed.Results
A total of 131 women, whose mean age was 46.83 years, were included in the study. The test–retest reliability of the GPFBQ was excellent (0.998, p?<?0.0001). The GPFBQ correlated significantly with the PFDI-20 (r?=?0.860, p?=?0.00) and PFIQ-7 (r?=?0.802, p?=?0.00). Confirmatory factor analysis was performed to determine construct validity, and it was found that it had four dimensions.Conclusions
The Turkish version of the GPFBQ is a valid and reliable tool for assessing the symptoms of bother and severity in Turkish-speaking women with pelvic floor dysfunction.16.
Ersin Gundogan Cuneyt Kayaalp Aydin Aktas Kutay Saglam Mufit Sansal Cihan Gokler Egemen Cicek Ufuk Uylas Fatih Sumer 《Obesity surgery》2018,28(11):3499-3504
Background
There is currently no evidence to support the routine use of an abdominal drain following laparoscopic Roux-en-Y gastric bypass (RYGB). Our aim was to investigate drain use in laparoscopic RYGB and its effects on postoperative pain.Methods
Sixty-six patients were randomly divided into two groups as no-drain (n?=?36) and with-drain (n?=?30). Intraoperative (time, blood loss, complications) and postoperative outcomes (morbidities, pain scores, hospital stay) were compared.Results
Demographics of both groups were comparable. Three patients in the no-drain group required a drain (8.3%). Median visual analog scale scores for days 1–3 for with-drain and no-drain groups were 4.5 (2–9) vs. 3 (0–8) (p?=?0.02), 3 (0–7) vs. 2 (0–7) (p?=?0.10), and 2 (0–7) vs. 0 (0–4) (p?=?0.0004), respectively. There was no difference between the groups in terms of complications and length of hospital stay.Conclusion
Drain use increased the postoperative pain following laparoscopic RYGB. Drain placement following laparoscopic RYGB should be selective instead of a routine application.17.
Interpretation of Abdominal CT Findings in Patients Who Develop Acute on Chronic Mesenteric Ischemia
Jussi M. Kärkkäinen Petri Saari Hannu-Pekka Kettunen Tiina T. Lehtimäki Ritva Vanninen Hannu Paajanen Hannu Manninen 《Journal of gastrointestinal surgery》2016,20(4):791-802
Background
We studied whether ischemia-specific computed tomography (CT) findings are consistently detectable in patients who develop acute on chronic mesenteric ischemia (AOCMI), whereas absent in chronic mesenteric ischemia (CMI).Methods
Consecutive patients with symptomatic angiography-verified atherosclerotic obstruction of the superior mesenteric artery (SMA) were categorized as AOCMI (n?=?27) or CMI (n?=?20). Three experienced radiologists blindly evaluated the contrast-enhanced CTs for vascular and intestinal findings. Kappa statistics was used to test interobserver agreement.Results
Two observers had substantial agreement (k?=?0.66) that two thirds of AOCMI patients showed ischemia-specific CT findings (decreased bowel wall enhancement, pneumatosis, or thrombotic SMA clot); the third observer agreed only fairly regarding pneumatosis and thrombosis (k?=?0.3–0.4). All observers had substantial agreement (k?=?0.65–0.71) that most patients with AOCMI had unspecific intestinal findings such as mesenteric fat stranding in up to 96 %, bowel lumen dilatation in 93 %, and bowel wall thickening in 70 %, while only few patients with CMI had such findings (due to chronic ischemic colitis) (P?<?0.001).Conclusion
One third of AOCMI patients presented without any ischemia-specific CT signs. However, any intestinal abnormality in CT together with SMA obstruction should raise suspicion of intestinal ischemia. Furthermore, clinicians need to be aware of the interobserver variability in the CT interpretation.18.
Ryo Miyoshi Toyofumi F. Chen-Yoshikawa Masatsugu Hamaji Atsushi Kawaguchi Hidenao Kayawake Kyoko Hijiya Hideki Motoyama Akihiro Aoyama Hiroshi Date 《General thoracic and cardiovascular surgery》2018,66(9):529-536
Objectives
The purpose of this study was to evaluate the effect of early tracheostomy in patients following lung transplantation and to determine its optimal timing and influence on clinical outcomes.Methods
We retrospectively reviewed records of 96 adult patients who underwent lung transplantation at our institution between August 2008 and January 2016. Time-to-tracheostomy was defined based on timing of the procedure: “early” if less than 3 days or “late” if 3 or more days after lung transplantation.Results
Forty-nine patients (51%) underwent tracheostomy 3.2?±?1.8 days after lung transplantation. Among these patients, 21 patients (42.9%) underwent early tracheostomy and 28 patients (57.1%) underwent late tracheostomy. Multivariable logistic regression analysis indicated that preoperative performance status was a significant predictor for tracheostomy (p?=?0.006, odds ratio 2.72). Patients in the early tracheostomy group began walking (p?=?0.003) and oral feeding (p?=?0.0006) earlier and had a shorter duration of mechanical ventilation (p?=?0.04) and shorter length of intensive care unit (p?=?0.01) and hospital stay (p?=?0.04) than patients in the late tracheostomy group. No significant differences in postoperative walking (p?=?0.06), oral feeding (p?=?0.17), or length of hospital stay (p?=?0.37) were observed between patients who underwent early tracheostomy and those who did not undergo tracheostomy.Conclusions
Early tracheostomy following lung transplantation decreased both intensive care and hospital stay, due to improved postoperative recovery, even in patients with poor preoperative conditions. Furthermore, length of hospital stay in patients with early tracheostomy was similar to that of patients without tracheostomy after lung transplantation.19.
Anant Dixit Frank S. Cautela Colin S. Cooper George A. Beyer James C. Messina Jeffrey E. Mait Neil V. Shah Bassel G. Diebo Carl B. Paulino William P. Urban 《Journal of orthopaedics and traumatology》2018,19(1):12
Background
Limited data exists in analyzing open reduction and internal fixation (ORIF) and arthroplasty in the management of open proximal humerus fractures. We analyzed differences in hospital course between these procedures, patient demographics, complication rate, length of stay, hospital charges, and mortality rate.Materials and methods
This is a retrospective review of the Nationwide Inpatient Sample database. ICD-9 codes identified patients hospitalized for open proximal humerus fractures from 1998 to 2013 who underwent ORIF or shoulder arthroplasty (hemi-, total, or reverse). Demographics and in-hospital complications were compared. Logistic regression controlling for age, gender, and Deyo index tested the impact of ORIF vs ARTH on any complications.Results
Seven hundred thirty patients were included (ORIF, n?=?662 vs ARTH, n?=?68). ORIF patients were younger (p?<?0.001), more likely to be males (p?<?0.001), and had a lower Deyo score (p?=?0.012). Both groups had comparable complication rates (21.4% vs 18.0%, p?=?0.535), lengths of stay (7.86 days vs 7.44 days, p?=?0.833), hospital charges ($76,998 vs $64,133, p?=?0.360), and mortality rates (0.2% vs 0%, p?=?0.761). Type of surgery was not a predictor of any complications (OR?=?0.67 [95% CI 0.33–1.35], p?=?0.266), extended length of stay (OR?=?1.01 [95% CI 0.58–1.78], p?=?0.967), or high hospital charges (OR?=?1.39 [95% CI 0.68–2.86], p?=?0.366).Conclusion
We revealed no differences in hospital course between ORIF and arthroplasty for management of open proximal humerus fractures. Although differences in demographics existed, no differences in complication rates, length of stay, hospital charges and mortality rates were noted. Future studies can evaluate the long-term outcomes of these procedures.Level of evidence
Level III.20.
Beom Jin Lim Jae Il Shin Sung-eun Choi Hyechang Rhim Jae Seung Lee Pyung Kil Kim Hyeon Joo Jeong Ji Hong Kim 《Pediatric nephrology (Berlin, Germany)》2016,31(11):2087-2093