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101.
Cristina García-Amador Vladimir Arteaga Peralta Roberto de la Plaza Llamas Miguel Torralba Anibal Medina Velasco José Manuel Ramia 《Cirugía espa?ola》2021,99(4):282-288
BackgroundTo analyze whether clinical and analytical parameters differ according to histopathology in cases of acute appendicitis (AA).MethodsThis is a retrospective, observational study including patients (>14 years of age) admitted for suspicion of AA from 1 April 2014 to 31 July 2016. Histopathology was divided into complicated (including perforated and gangrenous AA) and uncomplicated appendicitis (phlegmonous). Sex, age, temperature of patients on admission to the Emergency Department, symptom duration, preoperative white blood cell (WBC) count, neutrophil percentage, mean platelet volume (MPV), platelet distribution width (PDW), C-reactive protein (CRP) and hospital stay were compared in the two groups.ResultsThree hundred and thirty-five patients were analyzed, and 284 were included. Appendicitis was uncomplicated in 194 (68.3%) and complicated in 90 (31.7%). Age, symptom duration, neutrophil percentage, CRP and hospital stay were higher in the complicated AA group (P < .05). The mean differences between uncomplicated and complicated AA were: age 13.2 years (95% CI: 8.2-18.2), symptom duration 14.1 hours (95% CI: 6.3-21.9), neutrophil percentage 5.0% (95% CI: 3.2-6.8), CRP 73.6 mg/l (95% CI: 50.0-97.2) and hospital stay 2.2 days (95% CI: 1.4-3.0), with p<0.05 for all these variables. A model based on the preoperative parameters (age, symptom duration, neutrophil percentage and CRP) was calculated to predict the likelihood of complicated AA. The receiver operating characteristic (ROC) of the model had an area under the curve of 0.80 (95% CI 0.75-0.85).ConclusionThis model is able to diagnose complicated AA without the need for imaging techniques, although it must be validated with prospective analysis. 相似文献
102.
Pablo Moreno Llorente Erick A. Gonzales Laguado Marta Alberich Prats José Manuel Francos Martínez Arantxa García Barrasa 《Cirugía espa?ola》2021,99(4):267-275
Thyroidectomy is the most frequent procedure in endocrine surgery. The conventional approach through a collar incision, as described by Kocher in XIXth century, has become the “gold standard”. It is continuously evolving in spite of, many years ago, it showed to be safe and efficient with quality standards difficult to beat.Endoscopic and robotic surgery have developed “new approaches” to thyroid in order to improve the cosmetic results, looking even for invisible scars.We have done a thoughtful review of most of them trying to understand their benefits and drawbacks.Currently none of these “new approaches” have been shown to be better than conventional open thyroidectomy beyond offering a better cosmetic result. Besides, only a small percentage of patients can benefit of them. However, most of these approaches will remain if they treat the diseased thyroid and also improve the quality of life of our patients. 相似文献
103.
Rafael Lucas Costa de Carvalho Miguel Lia Tedde Jose Ribas Milanese de Campos Niura Noro Hamilton Gustavo Falavigna Guilherme Vanessa Moreira Sousa Vitor Floriano Salomao Junior Flavio Henrique Savazzi Paulo Manuel Pego-Fernandes 《Journal of pediatric surgery》2021,56(3):545-549
Background/PurposeThe aim of the study was to evaluate the postoperative quality of life (QoL) of patients who underwent minimally invasive repair of pectus excavatum (MIRPE) with a newly designed bar and bar stabilizers.MethodsWe conducted a prospective randomized study in which patients were operated either with standard perpendicular stabilizers (control group) or with the newly designed oblique stabilizers (intervention group). All patients were evaluated 6 months after the operation with the Pectus Excavatum Evaluation Questionnaire (PEEQ).ResultsThere were 16 patients in the control group and 14 in the intervention group. Mean age was 17 (SD: 3.3, range 14–27) years. There were no demographic differences between groups. Two patients in the control group and one in the intervention group were repaired with two bars instead of one. There was one reoperation in each group. There was a significant difference between the pre- and postoperative scores, in both groups, in the patient body image domain (control group: 9.5 to 3; p < 0.01; intervention group 10 to 3; p < 0.01), as well as in the psychosocial domain (control group: 13.5 to 24, p < 0.01; intervention group: 15 to 24, p < 0.01). With regards to the patients' perception of physical difficulties before and after MIRPE, the difference between pre- and postoperative scores was greater in the intervention group (8 to 12, p < 0.01) than in the control group (10 to 11, p = 0.04). The mean length of stay was 4.5 and 5 days in the intervention group and the control group, respectively.ConclusionOur study showed that patients who underwent MIRPE with the newly designed bars and stabilizers had non-inferior outcomes than patients reported in the literature who underwent MIRPE with standard bars and stabilizers. We found slightly better outcomes in patients in the intervention group compared to the control group, but larger studies will be needed to confirm if those differences are statistically significant.Level of evidenceII 相似文献
104.
Laura N. Walti Catrina Mugglin Daniel Sidler Matteo Mombelli Oriol Manuel Hans H. Hirsch Nina Khanna Nicolas Mueller Christoph Berger Katia Boggian Christian Garzoni Dionysios Neofytos Christian van Delden Cédric Hirzel Swiss Transplant Cohort Study 《American journal of transplantation》2021,21(7):2532-2542
Posttransplant lymphoproliferative disorder (PTLD) is a serious complication of solid organ transplantation (SOT). Most PTLD cases are associated with Epstein–Barr virus (EBV) infection. The role of antiviral prophylaxis or rituximab therapy for prevention of PTLD in SOT recipients is controversial. In a nationwide cohort, we assessed the incidence, presentation, and outcome of histologically proven PTLD. We included 4765 patients with a follow-up duration of 23 807 person-years (py). Fifty-seven PTLD cases were identified; 39 (68%) were EBV positive (EBV+ PTLD). Incidence rates for EBV+ PTLD at 1, 2, and 3 years posttransplant were 3.51, 2.24, and 1.75/1000 py and 0.44, 0.25, and 0.29/1000 py for EBV− PTLD. We did not find an effect of antiviral prophylaxis on early and late EBV+ PTLD occurrence (early EBV+ PTLD: SHR 0.535 [95% CI 0.199–1.436], p = .264; late EBV+ PTLD: SHR 2.213, [95% CI 0.751–6.521], p = .150). However, none of the patients (0/191) who received a rituximab-containing induction treatment experienced PTLD, but 57 of 4574 patients without rituximab induction developed PTLD. In an adjusted restricted mean survival time model, PTLD-free survival was significantly longer (0.104 years [95% CI 0.077–0.131]) in patients receiving rituximab as induction treatment. This study provides novel data on the association of rituximab induction and reduced risk for PTLD. 相似文献
105.
Aránzazu Caballero-Marcos Magdalena Salcedo Roberto Alonso-Fernández Manuel Rodríguez-Perálvarez María Olmedo Javier Graus Morales Valentín Cuervas-Mons Alba Cachero Carmelo Loinaz-Segurola Mercedes Iñarrairaegui Lluís Castells Sonia Pascual Carmen Vinaixa-Aunés Rocío González-Grande Alejandra Otero Santiago Tomé Javier Tejedor-Tejada José María Álamo-Martínez Luisa González-Diéguez Flor Nogueras-Lopez Gerardo Blanco-Fernández Gema Muñoz-Bartolo Francisco Javier Bustamante Emilio Fábrega Mario Romero-Cristóbal Rosa Martin-Mateos Julia Del Rio-Izquierdo Ana Arias-Milla Laura Calatayud Alberto A. Marcacuzco-Quinto Víctor Fernández-Alonso Concepción Gómez-Gavara Jordi Colmenero Patricia Muñoz José A. Pons the Spanish Society of Liver Transplantation 《American journal of transplantation》2021,21(8):2876-2884
The protective capacity and duration of humoral immunity after SARS-CoV-2 infection are not yet understood in solid organ transplant recipients. A prospective multicenter study was performed to evaluate the persistence of anti-nucleocapsid IgG antibodies in liver transplant recipients 6 months after coronavirus disease 2019 (COVID-19) resolution. A total of 71 liver transplant recipients were matched with 71 immunocompetent controls by a propensity score including variables with a well-known prognostic impact in COVID-19. Paired case–control serological data were also available in 62 liver transplant patients and 62 controls at month 3 after COVID-19. Liver transplant recipients showed a lower incidence of anti-nucleocapsid IgG antibodies at 3 months (77.4% vs. 100%, p < .001) and at 6 months (63.4% vs. 90.1%, p < .001). Lower levels of antibodies were also observed in liver transplant patients at 3 (p = .001) and 6 months (p < .001) after COVID-19. In transplant patients, female gender (OR = 13.49, 95% CI: 2.17–83.8), a longer interval since transplantation (OR = 1.19, 95% CI: 1.03–1.36), and therapy with renin–angiotensin–aldosterone system inhibitors (OR = 7.11, 95% CI: 1.47–34.50) were independently associated with persistence of antibodies beyond 6 months after COVID-19. Therefore, as compared with immunocompetent patients, liver transplant recipients show a lower prevalence of anti-SARS-CoV-2 antibodies and more pronounced antibody levels decline. 相似文献
106.
107.
Schuerwegen Alana Huys Wim Coppens Violette De Neef Nele Henckens Josée Goethals Kris Morrens Manuel 《Archives of sexual behavior》2021,50(3):1197-1206
Archives of Sexual Behavior - Despite the gaining popularity in mainstream media of the phenomenon that is BDSM, empirical research on the motives and underlying psychological mechanisms driving... 相似文献
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