Risk factors for the occurrence of peptic esophagitis following laparoscopic Heller-Dor surgery for esophageal achalasia

2021 ◽  
Author(s):  
Kazuto Tsuboi ◽  
Fumiaki Yano ◽  
Nobuo Omura ◽  
Masato Hoshino ◽  
Se-Ryung Yamamoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Outcomes ◽  
Esophageal Achalasia ◽  
High Occurrence ◽  
Peptic Esophagitis ◽  
Esophageal Clearance ◽  
Primary Surgery ◽  
Mucosal Perforation ◽  
Independent Risk Factors ◽  
Male Patients

Summary Peptic esophagitis can occur as a complication of laparoscopic Heller-Dor surgery (LHD) among patients with esophageal achalasia. The goal of this study was to identify the characteristics of patients who have developed peptic esophagitis following LHD surgery along with the risk factors associated with the occurrence of peptic esophagitis. Among the 447 cases consisting of esophageal achalasia patients who underwent LHD as the primary surgery, we compared the patient background, pathophysiology, symptoms, and surgical outcomes according to whether or not peptic esophagitis occurred following surgery. We also attempted to use univariate and multivariate analyses to identify the risk factors for peptic esophagitis occurring following surgery. Esophagitis following surgery was confirmed in 67 cases (15.0%). With respect to the patient backgrounds for cases in which peptic esophagitis had occurred, a significantly higher number were male patients, with a significantly high occurrence of mucosal perforation during surgery in terms of surgical outcomes, along with a high occurrence of esophageal hiatal hernias in terms of postoperative course (P = 0.045, 0.041, and 0.022, respectively). However, there were no significant differences in terms of age, BMI, disease duration, preoperative symptoms, esophageal manometric findings, esophageal barium findings, and esophageal clearance. A multivariate analysis indicated independent risk factors for the occurrence of peptic esophagitis following LHD as being male, the occurrence of mucosal perforation during surgery, and the occurrence of esophageal hiatal hernias. Peptic esophagitis occurred following LHD in 15% of cases. Independent risk factors for the occurrence of peptic esophagitis following LHD included being male, the occurrence of mucosal perforation during surgery, and the occurrence of esophageal hiatal hernias following surgery.

scholarly journals Age, Initial Dose and Dose Increase are Independent Risk Factors for Symptomatic Vertebral Fractures in Glucocorticoid-Treated Male Patients

2011 ◽  
Vol 50 (8) ◽  
pp. 817-824 ◽  
Author(s):  
Takao Sugiyama ◽  
Sawako Suzuki ◽  
Tomohiko Yoshida ◽  
Takafumi Mayama ◽  
Naoko Hashimoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vertebral Fractures ◽  
Initial Dose ◽  
Dose Increase ◽  
Treated Male ◽  
Independent Risk Factors ◽  
Male Patients

scholarly journals Surgical Outcomes of Transverse Acetabular Fractures and Risk Factors for Poor Outcomes

2020 ◽  
Author(s):  
Jae Hoon Jang ◽  
Nam Hoon Moon ◽  
Seung Joon Rhee ◽  
Seok Jin Jung ◽  
Tae Young Ahn
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Surgical Outcomes ◽  
Acetabular Fractures ◽  
Patient Factors ◽  
Male Patients ◽  
Poor Outcomes ◽  
Transverse Fractures ◽  
Type Of Fracture ◽  
Postoperative Residual

Abstract Background: Transverse acetabular fractures, although classified as elementary, have been considered to have worse outcomes than other types of acetabular fractures. Prognostic factors for this type of fracture are not clearly established. The purpose of this study was to assess the surgical outcomes of transverse acetabular fractures and subtypes thereof and to investigate the prognostic factors.Methods: Between 2014 and 2019, 39 patients (39 hips) had transverse fractures or subtypes thereof. We reviewed the surgical outcomes and investigated patient factors, injury factors, and surgical factors in relation to osteoarthritis (OA) and conversion to total hip arthroplasty (THA). Additionally, we analyzed the cutoff values for postoperative residual gaps and steps.Results: Twenty-three male patients and 16 female patients with a mean age of 41.7 years (range, 18–78 years) were included. There were 29 satisfactory reductions (74.4%). Eleven hips (28.2%) developed OA. Five (12.8%) of them underwent THA. Dome impaction (odds ratio [OR], 41.173; 95% confidence interval [CI], 1.804–939.814; P=0.020) and residual gaps (OR, 4.251; 95% CI, 1.248–14.479; P=0.021) were correlated with poor outcomes. Residual gaps (≥3 mm) and residual steps (≥1 mm) were significantly associated with OA.Conclusion: Relatively poor reduction were found for transverse acetabular fractures and subtypes thereof. However, the rates of OA and conversion to THA were not high. Dome impaction and wide residual gaps were identified as risk factors for poor outcomes. The development of OA significantly increased if the residual gap and step were more than 3 mm and 1 mm, respectively.

scholarly journals Clonorchiasis in Patients with Biliary and Pancreatic Diseases: Diagnosis and Risk Factors

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Guolin Liao ◽  
Huaqiang Ruan ◽  
Peng Peng ◽  
Shiquan Liu ◽  
Jianfu Qin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Protective Factor ◽  
Univariate Analysis ◽  
Clonorchis Sinensis ◽  
Epidemiological Studies ◽  
Pancreatic Diseases ◽  
Fecal Samples ◽  
Independent Risk Factors ◽  
Male Patients ◽  
Bile Samples

Background. Many epidemiological studies have investigated the risk factors for clonorchiasis, but endoscopic findings of this disease in endoscopic retrograde cholangiopancreatography (ERCP) have not been well characterized. In this study, we evaluated clonorchiasis in ERCP in patients with biliary and pancreatic diseases. Methods. This was a retrospective two-center study in hospitalized patients who received ERCP between January 2012 and October 2018. All patients were divided into clonorchiasis and nonclonorchiasis groups. Data were analyzed using univariate analysis and multivariate analyses. Results. A total of 1119 patients were included, and clonorchiasis was diagnosed in 19.2% patients. Detection of Clonorchis sinensis eggs in bile samples was higher than that in fecal samples (85.9% vs. 58.7%; P=0.001). In multivariate analysis, male patients (95% confidence interval (CI): 1.945–4.249, P=0.0001), age≤60 years old (95% CI: 1.212–2.474, P=0.003), patients with papilla fistula (95% CI: 0.081–0.900, P=0.033), and patients with a common bile duct (CBD) diameter<12 mm (95% CI: 1.093–2.130, P=0.013) were associated with clonorchiasis incidence. Nonclonorchiasis endoscopic diagnosis did not significantly correlate with clonorchiasis incidence (P>0.05). Conclusions. The detection of C. sinensis eggs was significantly higher in bile than in fecal samples; thus, bile samples represent a preferable sample for the diagnosis of clonorchiasis in patients with biliary obstruction. We found that male, age≤60 years old, and CBD diameter<12 mm were independent risk factors for clonorchiasis, while papilla fistula was a protective factor.

scholarly journals Factors Affecting the Outcome of Multiple Intracranial Aneurysm Surgery

2018 ◽  
Vol 07 (02) ◽  
pp. 116-121 ◽  
Author(s):  
Anas Abdallah ◽  
Murad Asiltürk ◽  
Erhan Emel ◽  
Betül Güler Abdallah
Keyword(s):  
Risk Factors ◽  
Surgical Outcomes ◽  
Medical Records ◽  
Core Sample ◽  
Morbidity Rate ◽  
Factors Affecting ◽  
Unruptured Aneurysms ◽  
History Of ◽  
Independent Risk Factors

Abstract Objectives Multiple intracranial aneurysms (MIAs) are fairly common entities. Unless MIAs are incidentally diagnosed, they remain asymptomatic until they rupture. In this study, the authors investigated factors affecting the surgical outcomes in patients with MIA by evaluating the surgical outcomes of 90 consecutive cases. Material and Methods Medical records were retrospectively reviewed for 409 consecutive cerebral aneurysm cases that underwent surgery in the hospital from 2011 to 2013. The patients’ data were prospectively collected. All MIA patients (n = 90) constituted the core sample for this study. Results The authors detected 221 aneurysms in 90 patients (49 females and 41 males; mean age: 50.8 ± 11.9 years; range: 25–82 years). Of the patients, 67 presented with subarachnoid hemorrhage, whereas 23 were incidentally diagnosed with unruptured aneurysms. The mortality rate was 13.3% (n = 12). The morbidity rate was 18.8% (n = 17). Of the patients, 67.8% (n = 61) had returned to their jobs and normal daily activities by their last follow-up (average: 52.3 months). History of coronary artery diseases (CADs) and low neurologic grade at presentation (Hunt-Hess grade 4/5) are independent risk factors for increasing morbidity and mortality in patients with MIA (odds ratio [OR]: 18.46; p = 0.007); (OR: 30.0; p = 0.002) and (OR: 0.06; p = 0.0001); (OR: 0.07; p = 0.002), respectively. Conclusion History of CADs and high Hunt-Hess grade are independent risk factors for poor surgical outcomes of patients with MIA.

scholarly journals Risk Factors of Difficult Pharyngeal Accidental Fishbones Ingestion

2021 ◽  
pp. 014556132110367
Author(s):  
Yi-Bo Huang ◽  
Fan Zhang ◽  
Hui-Ju Chen ◽  
Dong-Dong Ren ◽  
Hua-Peng Yu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Foreign Body ◽  
Neck Pain ◽  
Foreign Body Sensation ◽  
Missing Teeth ◽  
Body Sensation ◽  
Independent Risk Factors ◽  
Male Patients ◽  
A Prospective Study ◽  
Nose And Throat

Objective: Accidental pharyngeal fishbone ingestion is a common complaint in ear, nose, and throat clinics. Approximately two-thirds of the accidentally ingested fishbones can be removed using tongue depressors and indirect laryngoscopy. However, the remaining third is challenging to identify and remove using these methods. These difficult fishbones require identification and removal via more advanced approaches. Video-guided laryngoscope is used to deal with difficult fishbones in our center. This study aimed to explore the risk factors for difficult fishbones. Methods: A prospective study was performed at a teaching hospital on 2080 patients. Univariate and multivariate analyses were performed to identify the risk factors. Results: The common fishbone locations were the tonsils (39.8%; defined as STEP-I), tongue base (37.1%), vallecula (13.3%; STEP-II), and hypopharynx (9.8%; STEP-III). With increasing STEP level, the ratio of difficult fishbones correspondingly increased (Z = 13.919, P < .001), and the proportions were 21.1%, 41.9%, and 70% in STEP-I, II, and III, respectively. In particular, fishbones in STEP-III (vs STEP-I) had a higher risk of difficult fishbones (odds ratio [OR]: 11.573, 95% CI: 7.987-16.769). Complaints of neck pain (yes vs no), foreign body sensation (yes vs no), and shorter length of fishbones always had a lower risk of difficult fishbones (OR: 0.455, 95% CI: 0.367-0.564; OR: 0.284, 95% CI: 0.191-0.422; OR: 0.727, 95% CI: 0.622-0.85). Missing teeth (yes vs no), swallowing behavior after fishbone ingestion (yes vs no), and male patients (vs female) had a higher risk of difficult fishbones (OR: 1.9, 95% CI: 1.47-2.456; OR: 1.631, 95% CI: 1.293-2.059; OR: 1.278, 95% CI: 1.047-1.56). Conclusions: Neck pain, foreign body sensation, fishbone length, patient age and sex, tooth status, and swallowing behavior after fishbone ingestion are independent risk factors for difficult fishbones.

scholarly journals Surgical outcomes of transverse acetabular fractures and risk factors for poor outcomes

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jae Hoon Jang ◽  
Nam Hoon Moon ◽  
Seung Joon Rhee ◽  
Seok Jin Jung ◽  
Tae Young Ahn
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Surgical Outcomes ◽  
Odds Ratio ◽  
Acetabular Fractures ◽  
Patient Factors ◽  
Male Patients ◽  
Poor Outcomes ◽  
Transverse Fractures ◽  
Postoperative Residual

Abstract Background Transverse acetabular fractures, although classified as elementary, have worse outcomes than other types of acetabular fractures. Prognostic factors for this fracture type are not clearly established. This study aimed to assess the surgical outcomes of transverse acetabular fractures and subtypes thereof and to investigate the prognostic factors. Methods Between 2014 and 2019, 39 patients (39 hips) had transverse fractures or subtypes thereof. We reviewed the surgical outcomes and evaluated patient factors, injury factors, and surgical factors in relation to osteoarthritis (OA) and conversion to total hip arthroplasty (THA). Additionally, we analyzed the cutoff values for postoperative residual gaps and steps. Results Twenty-three male patients and sixteen female with a mean age of 41.7 years (range, 18–78 years) were included. There were 29 satisfactory reductions (74.4%). Eleven hips (28.2%) developed OA, and five (12.8%) of them underwent THA. Dome impaction (odds ratio [OR], 41.173; 95% confidence interval [CI], 1.804–939.814; p = 0.020) and residual gaps (OR, 4.251; 95% CI, 1.248–14.479; p = 0.021) were correlated with poor outcomes. Residual gaps (≥3 mm) and residual steps (≥1 mm) were significantly associated with OA. Conclusions Relatively poor reduction was found for transverse acetabular fractures and subtypes thereof. However, the rates of OA and conversion to THA were not high. Dome impaction and wide residual gaps were identified as risk factors for poor outcomes. The development of OA significantly increased if residual gap and step were more than 3 mm and 1 mm, respectively.

scholarly journals Risk Factors for Hypogonadism in Male Patients with Type 2 Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Rendong Zheng ◽  
Lin Cao ◽  
Wen Cao ◽  
Xiaoqiu Chu ◽  
Yongxin Hu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Serum Insulin ◽  
Resistance Index ◽  
Serum Testosterone ◽  
Total Testosterone ◽  
Male Hypogonadism ◽  
Independent Risk Factors ◽  
Male Patients

Background. Male hypogonadism is an endocrine disease characterized by low levels of serum testosterone and is closely related to the development of diabetes. The purpose of the present study was to observe the risk factors for hypogonadism in male patients with type 2 diabetes.Methods. A total of 213 patients with type 2 diabetes were enrolled and divided into a low total testosterone (TT) group (=75) and a normal TT group (=138). The patients’ blood glucose, blood lipids, serum insulin, and sex hormones were measured. The correlations between the patients’ metabolic index and sex hormone levels were analyzed.Results. Compared with the normal TT group, body mass index (BMI), fasting insulin (FINS), and HOMA insulin resistance index (HOMA-IR) levels were significantly higher, but the luteinizing hormone (LH) levels were significantly lower in the low TT group (p<0.05). Correlation analyses found that TT was negatively correlated with BMI, waist circumference (WC), FINS, and HOMA-IR. TT was positively correlated with LH and follicle-stimulating hormone (FSH).Conclusions. Several risk factors of diabetes associated closely with hypogonadism. BMI, metabolic syndrome (MS), HOMA-IR, and LH are independent risk factors for hypogonadism in male patients with type 2 diabetes.

scholarly journals AB0627 PROGNOSIS AND MORTALITY OF DERMATOMYOSITIS AND POLYMYOSITIS PATIENTS WITH MALIGNANCY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1609.1-1609
Author(s):  
X. Yang ◽  
Y. Hao ◽  
Z. Zhang
Keyword(s):  
Risk Factors ◽  
Malignant Tumor ◽  
Age Of Onset ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Disease Onset ◽  
National Bureau ◽  
Peking University ◽  
Independent Risk Factors ◽  
Male Patients

Background:Previous studies indicate that cancers in DM/PM patients are associated with increased mortality. Hence, identifying predictors of malignancy in PM and DM is crucial. However, few large series studies have reported prognostic and predictive factors of malignancy in patients with PM and DM. Moreover, in recent years, several published studies also allow us to better understand the clinical characteristics of malignancy in PM and in DM.Objectives:To analyze the mortality and identify the major independent risk factors for death in patients with dermatomyositis/polymyositis (DM/PM) complicated with malignant tumor.Methods:The clinical data of all patients with DM/PM in Peking University First Hospital from January 2007 to Jan 2019 were retrospectively reviewed. All patients were followed up to confirm whether they had malignant tumors. According to the statistics of the National Bureau of Statistics of China, the standard mortality (SMR) and life lost years (YLL) of patients with DM/PM were combined with malignant tumors. The Kaplan-Meier method was used to analyze the 10-year survival of DM/PM patients with malignant tumors. Cox multivariate regression was used to predict independent risk factors for DM/PM patients with malignant tumors.Results:A total of 334 patients with dermatomyositis and 69 patients with polymyositis were enrolled in the study. The mean age of onset was 50.5 ± 14.8 years and 48.9 ± 16.1 years, with a median follow-up of 40.6 (11.6-77.6) months. Among them, 320 patients were successfully followed up, including 69 patients with death, 46 DM/PM with malignant tumors (38 with dermatomyositis and 8 with polymyositis). The average age of onset of DM/PM patients with malignant tumors was 55.4 ± 15.1 years and 59.5 ± 4.7 years, respectively, of which 17 died. The age-sex adjusted SMR of DM/PM patients without malignant tumors was 9.0 (95% CI 6.8-11.2). The age-sex adjusted SMR of DM/PM with malignant tumors was 12.3 (95% CI 9.0-14.7). The life loss of male patients with dermatomyositis complicated with malignant tumors was 30.1 years, and that of females was 38.6 years; the life loss of male patients with polymyositis was 27.6 years, and that of females was 22.1 years. A 10-year survival analysis showed that DM/PM patients with malignant tumor had significantly worse prognosis than patients without malignancy (p=0.001 Log-rank). The 1-, 5-, and 10-year survival rates of DM/PM patients who did not have malignant tumors were 87.9%, 81.9%, and 78.4%, respectively. DM/PM Patients with malignant tumors 1, 5, and 10 years The survival rates were 73.3%, 56.0%, and 45.7%, respectively. The independent risk factors for death in DM/PM patients with malignant tumors were advanced age (HR=1.11 95% CI 1.02-1.20, p=0.014) and infection (HR=17.07 95% CI 1.66-175.75, p= 0.017).Conclusion:Malignant tumor is a common in patients with DM/PM, and the mortality of DM/PM patients with malignant tumors is high. The independent predictors of mortality for PM/DM patients with malignant tumors were age at disease onset and infection.Acknowledgments:We thank our patients with PM/DM participating in this study.Disclosure of Interests:None declared

Therapeutic options in male osteoporosis

2013 ◽  
Vol 22 (04) ◽  
pp. 271-276 ◽  
Author(s):  
P. Farahmand ◽  
J. D. Ringe
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Public Health Problem ◽  
Male Osteoporosis ◽  
Individual Risk ◽  
Modes Of Action ◽  
Increased Risk ◽  
Study Results ◽  
Long Term Treatment ◽  
Male Patients

SummaryOsteoporosis in men is increasingly recognized as an important public health problem but affected patients are still under-diagnosed and -treated. As in women the diagnostic and therapeutic strategy has to be adapted to the individual case. In the practical management it is very important to detect possible causes of secondary osteoporosis, to explain the possibilities of basic therapy counteracting individual risk factors and communicate that osteoporosis is a chronic disease and adherence to a long-term treatment is crucial. In established severe osteoporosis a careful analgesic therapy is important to avoid further bone loss related to immobility. In elderly men with increased risk of falling insufficient Vitamin D supply or impaired activation of Vitamin D due to renal insufficiency must be taken into consideration. Specific medications available today for the treatment of male osteoporosis comprise among antiresorptive drugs the bis phosphonates alendronate, risedronate and zoledronic acid. Denosumab, the first biological therapy is approved for men with androgen deprivation therapy for prostate cancer. An important advantage of this potent antiresorptive drug is the increased adherence due to the comfortable application by sixmonthly subcutaneous injections. Study results from the 2-year multi-center randomized controlled ADAMO-Study will very soon allow the use of denosumab in all types of male osteoporosis. Teriparatide, the 34 N-terminal amino acid sequence of parathyroid hormone was approved for men with osteoporosis as an anabolic agent based on proven efficacy by different studies. Among drugs with other modes of action the D-hormone pro-drug alfacalcidol can be used in men alone or in combination with the advantage of pleiotropic effects on calcium absorption, parathyroids, bone and muscle. Recently also Strontium-ranelate was approved for male patients with the limitation to exclude men with clinical relevant cardiovascular risk factors. In general the possibilities to treat male osteoporosis have considerably improved during recent years. Today there is a choice of a spectrum of drugs from mild to strong potency with different modes of action on bone turnover to design strategies for individual male patients.

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