scholarly journals Maternal Hypotension during Fetoscopic Surgery: Incidence and Its Impact on Fetal Survival Outcomes

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Pornswan Ngamprasertwong ◽  
Mounira Habli ◽  
Anne Boat ◽  
Foong Yen Lim ◽  
Hope Esslinger ◽  
...  
Keyword(s):  
Survival Rate ◽  
Epidural Anesthesia ◽  
Retrospective Cohort ◽  
Fetal Survival ◽  
Intraoperative Hypotension ◽  
Significant Difference ◽  
Fetal Cardiomyopathy ◽  
The Impact ◽  
Higher Doses ◽  
Surgery Incidence

In this retrospective cohort study, we aimed to determine the incidence of intraoperative maternal hypotension during fetoscopic surgery for twin-twin transfusion syndrome (TTTS) and to evaluate the impact of intraoperative hypotension on fetal survival. A total of 328 TTTS patients with recipient twin cardiomyopathy who underwent fetoscopic surgery under epidural anesthesia were included. The exposure of interest was maternal medical therapy with nifedipine for the treatment of fetal cardiomyopathy. We found that intraoperative hypotension occurred in 53.4% (175/328 patients). There was no statistically significant difference in incidence of hypotension between nifedipine exposure and nonexposure groups (54.8% versus 50.8%,P=0.479). However, the nifedipine exposure group received a statistically significant higher dose of phenylephrine (7.04 ± 6.38 mcg/kg versus 4.70 ± 4.14 mcg/kg,P=0.018) and higher doses of other vasopressor, as counted by number of treatments (6.06 ± 4.58 versus 4.96 ± 3.42,P=0.022). There were no statistically significant differences in acute fetal survival rate (within 5 days) and fetal survival rate at birth between hypotensive and nonhypotensive patients. We concluded that preoperative exposure to nifedipine resulted in increased intraoperative maternal vasopressor requirement during fetoscopic surgery under epidural anesthesia. In patients who had intraoperative maternal hypotension, there was no correlation between the presence of maternal hypotension and postoperative fetal survival.

Impact of obesity upon the survival of cholangiocarcinoma patients.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 288-288
Author(s):  
Phani Keerthi Surapaneni ◽  
Zhuo Li ◽  
Lalitha Padmanabha Vemireddy ◽  
Pashtoon Murtaza Kasi ◽  
Jason Scott Starr ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rate ◽  
Survival Rates ◽  
Tumor Location ◽  
Normal Weight ◽  
Categorical Variables ◽  
Overall Survival Rate ◽  
Exact Test ◽  
Significant Difference ◽  
The Impact

288 Background: Obesity is a risk factor for developing cholangiocarcinoma (CCA). However, the effect of obesity on survival of CCA is unclear. The primary aim of this study was to analyze the impact of obesity upon overall survival of CCA patients. Secondary aims were to analyze impact of obesity upon other disease characteristics such as tumor site, stage, age, sex, BMI and Ca 19-9. Methods: A total of 411 unique pts diagnosed with CCA at Mayo Clinic Florida between 2000 and 2018 were retrieved from our collective SDMS database. Variables evaluated included:demographics, Body Mass Index (BMI), AJCC stage, tumor location and Ca 19-9.A total of 185 pts had all data available pertaining to these variables. We further restricted the analysis to pts with intrahepatic CCA classified BMI as per CDC criteria normal (18.5-25kg/m2), overweight (25-29.9kg/m2) and obese (≥30 kg/m2), thus leaving a total of 152 pts. Continuous and categorical variables were compared across BMI groups using Chi-squared or Fisher’s exact test. Overall survival rates after diagnosis at 1, 2 and 3 years were estimated using Kaplan-Meier method. Results: Among 152 pts included in the study, 28% were normal weight, 40% were overweight and 32% were obese. The overall survival rate at 1, 2 and 3 years for normal weight pts with all stages combined was 54.1%, 35%, and 30.7%, respectively. The overall survival rate at 1, 2 and 3 years for overweight pts with all stages combined was 59.7 %, 32.6%, and 25.4%, respectively. The overall survival rate at 1, 2 and 3 years for obese pts with all stages combined was 63.9%, 37.6%, and 26.7%, respectively(p = 0.8766). Multivariate analysis demonstrated is no significant difference in overall survival for obese pts compared to normal or overweight pts.(Table to be shown) However it showed, gender and Ca19-9 were statistically significant predictors of overall survival, with males and pts with Ca19-9≥100 doing worse (HR1.65 (CI = 1.05, 2.61, p = 0.031) and HR 2.31 (CI = 1.49, 3.59, p = < 0.01), respectively). Conclusions: BMI did not make a significant impact on the overall survival, though there may be a trend toward worse OS for ptswith higher BMI. A larger, stage focused evaluation is warranted for further exploration of this trend.

scholarly journals Long-term experience with a collagen-elastin scaffold in combination with split-thickness skin grafts for the treatment of full-thickness soft tissue defects: improvements in outcome—a retrospective cohort study and case report

2021 ◽  
Author(s):  
Maximilian Lempert ◽  
Sascha Halvachizadeh ◽  
Clara Charlotte Salfelder ◽  
Valentin Neuhaus ◽  
Hans-Christoph Pape ◽  
...  
Keyword(s):  
Cohort Study ◽  
Soft Tissue ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Skin Grafting ◽  
Full Thickness ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Significant Difference ◽  
The Impact

Abstract Purpose The management of severe soft tissue injuries to the extremities with full-thickness wounds poses a challenge to the patient and surgeon. Dermal substitutes are used increasingly in these defects. The aim of this study was to investigate the impact of the type of injury on the success rate of Matriderm® (MD)-augmented split-thickness skin grafting, as well as the role of negative pressure wound therapy (NPWT) in preconditioning of the wounds, with a special focus on the reduction of the bioburden. Methods In this study, 45 wounds (44 affecting lower extremities (97.7%)), resulting from different types of injuries: soft tissue (ST), soft tissue complications from closed fracture (F), and open fracture (OF) in 43 patients (age 55.0 ± 18.2 years, 46.7% female), were treated with the simultaneous application of MD and split-thickness skin grafting. The study was designed as a retrospective cohort study from March 2013 to March 2020. Patients were stratified into three groups: ST, F, and OF. Outcome variables were defined as the recurrence of treated wound defects, which required revision surgery, and the reduction of bioburden in terms of reduction of number of different bacterial strains. For statistical analysis, Student’s t-test, analysis of variance (ANOVA), Mann–Whitney U test, and Pearson’s chi-squared test were used. Results There was no significant difference in the rate of recurrence in the different groups (F: 0%; OF: 11.1%; ST: 9.5%). The duration of VAC therapy significantly differed between the groups (F: 10.8 days; OF: 22.7 days; ST: 12.6 days (p < 0.05)). A clinically significant reduction of bioburden was achieved with NPWT (bacterial shift (mean (SD), F: − 2.25 (1.89); OF: − 1.9 (1.37); ST: − 2.6 (2.2)). Conclusion MD-augmented split-thickness skin grafting is an appropriate treatment option for full-thickness wounds with take rates of about 90%. The complexity of an injury significantly impacts the duration of the soft tissue treatment but does not have an influence on the take rate. NPWT leads to a relevant reduction of bioburden and is therefore an important part in the preconditioning of full-thickness wounds.

scholarly journals The Impact of Steatosis on the Outcome of Liver Transplantation: A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Qiong-Yue Zhang ◽  
Qiong-Fang Zhang ◽  
Da-Zhi Zhang
Keyword(s):  
Liver Transplantation ◽  
Survival Rate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Graft Dysfunction ◽  
Outcome Indicators ◽  
Significant Difference ◽  
Early Graft ◽  
The Impact ◽  
Early Graft Dysfunction

Background and Aims. Liver transplantation is one of the most effective treatments for end-stage liver disease as well as for cases of acute liver failure. Facing organ donor shortage, liver transplant teams had to use marginal organs. Thus, increasing availability is a key concern of donor liver grafts including steatotic livers. However, the use of steatotic liver is still controversial. The aim of this systematic review and meta-analysis was to analyze the impact of steatosis on the outcome of liver transplantation. Methods. We searched PubMed, Cochrane Library, Embase, Web of knowledge, and so on for studies published through May 31, 2018, in which patients experienced liver transplantation using fatty liver. All studies extracted outcome indicators, and we draw conclusions by contrasting outcome indicators in different groups of steatosis. Odds ratios and 95% confidence intervals were calculated. P<0.05 was considered as statistically significant difference. Results. 19 publications were included. There was no significant difference between the group of no steatosis and mild group in primary nonfunction rate (P=0.605) or early graft dysfunction rate (P=0.44). The PNF rate was significantly higher in moderate group (P=0.003) and severe group (P <0.001) compared with that in no steatosis group. The same results were seen in early graft dysfunction rate. However, graft survival rate and patient survival rate did not differ between groups. Conclusions. Livers with mild steatosis, even with moderate or severe steatosis, could be suitable donor under strict control of transplant conditions.

scholarly journals Depredación del borrego Ovis canadensis (Artiodactila: Bovidae) y el venado bura Odocoileus hemionus (Artiodactila: Cervidae) por Puma concolor (Carnivora: Felidae) en Coahuila, México

2018 ◽  
Vol 66 (4) ◽  
pp. 1496
Author(s):  
Hugo Sotelo-Gallardo ◽  
Juan Antonio García-Salas ◽  
Armando Jesús Contreras-Balderas
Keyword(s):  
Survival Rate ◽  
Puma Concolor ◽  
Mule Deer ◽  
Bighorn Sheep ◽  
Conservation Strategies ◽  
Isolated Populations ◽  
Mountain Lion ◽  
Significant Difference ◽  
The Impact ◽  
Predation Rates

Small and isolated populations of bighorn sheep (subject to special protection according to NOM-059-SEMARNAT-2010) are vulnerable to predation by mountain lion in habitat sympatric with mule deer. Understanding the specific causes of death and survival is important for the development of conservation strategies for bighorn sheep and other ungulates that share the same habitat, such as mule deer.We evaluated and compared the rate of predation by puma in 12 bighorn sheep (10 females, two males) and 10 adult females of mule deer with radio collars through measure risk program (micromorts). The impact of predation in both populations of herbivores is evaluated through the estimation of densities of sheep and mule deer. 88 % (8/9) deaths by puma in bighorn sheep with an average monthly survival rate of 0.79 and predation rates due to puma range from 0.17 to 0.30. In mule deer predation due to puma was 83 % (5/6) with an average monthly survival rate of 0.86 and predation rates due to puma range from 0.10 to 0.25, however when comparing the mountain lion depredation rate we found a significant difference between species (Z = 1.826, df = 6, P = 0.05). The density in mule deer was 9x more that bighorn. The bighorn sheep being the prey most selected and the one most affected as the population with the lowest density.

scholarly journals A Comparison of Transplant Outcomes in Peritoneal and Hemodialysis Patients: A Meta-Analysis

2016 ◽  
Vol 42 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Maozhi Tang ◽  
Tianyi Li ◽  
Hong Liu
Keyword(s):  
Survival Rate ◽  
Journal Club ◽  
Meta Analysis ◽  
Graft Function ◽  
Cochrane Central Register ◽  
Transplant Outcomes ◽  
Central Register ◽  
Significant Difference ◽  
Short And Long Term ◽  
The Impact

Background: Peritoneal dialysis (PD) and hemodialysis (HD) have been considered the 2 standard pre-transplant dialysis modalities in patients awaiting kidney transplantation. However, the impact of pretransplant dialysis on the short- and long-term post-transplant outcomes remains controversial. Methods: We searched PubMed, EMBASE and the Cochrane central register of controlled trials for this review. Twelve studies were identified by strict screening for the meta-analysis. Results: We found that pretransplant PD patients had a significantly lower incidence of delayed graft function than HD patients, with an OR 0.67 (95% CI 0.62-0.72, p < 0.05). In contrast, there was no significant difference in the incidence of acute rejection, OR 0.96 (95% CI 0.75-1.16). Pretransplant PD had a better 5-year patient survival rate than HD, with a hazard ratio 0.86 (95% CI 0.79-0.95, p < 0.05); however, there were no significant differences in the graft survival rate (p = 0.08). Conclusions: We found that PD was a better choice of pretransplant dialysis modality than HD. Video Journal Club ‘Cappuccino with Claudio Ronco' at http://www.karger.com/?doi=446272.

Does left atrial appendage morphology have any impact on the results of percutaneous closure?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
V Constantin ◽  
A Cinaud ◽  
F Brigadeau ◽  
A Lepillier ◽  
B Pierre ◽  
...  
Keyword(s):  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Left Atrial ◽  
Retrospective Cohort ◽  
Left Atrial Appendage ◽  
Cardiac Computed Tomography ◽  
Atrial Appendage ◽  
Significant Difference ◽  
The Impact

Abstract Introduction Transcatheter left atrial appendage (LAA) occlusion is an alternative treatment in patients with atrial fibrillation (AF), high CHADSVASC Score and a contra-indication to anticoagulants. This retrospective cohort study aims to evaluate the impact of LLA morphology on procedure outcomes. Methods Patients from eight French centers who underwent left atrial appendage occlusion from February 2012 to January 2017 were included in this retrospective cohort study. LLA morphology was described by preoperative cardiac computed tomography (CT). Clinical data and Transoesophageal echocardiography (TEE) or CT results were collected during follow-up. Results Among 469 included patients, LAA morphologies were described in 215 cases 45.8%), 150 patients (70%) were implanted with Watchman devices, 57 (26%) with Amplatzer devices and 8 procedures (4%) failed. LAA Morphology was Chicken Wing (34%), Windsock (45%), cauliflower (18%) and 3% had another morphology including Cactus. There was no difference in patient characteristics between the different morphology groups. Mean follow-up was 9.6±11 months, during which 190 patients underwent LAA imaging (TEE in 171 and CT in 19 patients). There was no significant difference in the failure rate (p=0.72), duration of the procedure (p=0.065), peri-device leak (p=0.83) device-related thrombus (p=0.96) and the occurrence of stroke (p=1) during follow-up. Conclusion LLA morphology did not influence complication occurrence after occlusion in this cohort. Funding Acknowledgement Type of funding source: None

scholarly journals Continuous Blood purification on Influenza-Associated Neurological Disease in children: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jingwen Ni ◽  
Kenan Fang ◽  
Zhe Zhao ◽  
Zhiyuan Wang ◽  
Qian Huang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Intensive Care ◽  
Survival Rate ◽  
Retrospective Cohort Study ◽  
Neurological Disease ◽  
Retrospective Cohort ◽  
Blood Purification ◽  
Parental Consent ◽  
Significant Difference ◽  
Continuous Blood Purification

Abstract Background Due to lack of proven therapies, we evaluated the effect of CBP on Influenza-Associated Neurological Disease in children. Methods A single-center, retrospective, cohort study was conducted in Luoyang, Henan province, China from January 2018 to January 2020. Children (<18 years) with influenza-associated neurological disease were enrolled in the study. Children with indications for CBP and parental consent received CBP (Continuous Blood purification), while others received maximal intensive care treatment because of the absence of parental consent. The outcomes of the CBP and non-CBP groups were compared. Categorical variables were presented as percentage and compared by Chi-square test. Continuous variables were expressed as median (interquartile ranges) and compared with non-parametric independent sample test. Statistical analyses were carried out by SPSS (version 26.0) and p < 0.05 (2 tailed) was considered to be statistically significant. Results 30 children with influenza-associated neurological disease were recruited to the study. 18 received CBP and the other 12 received maximal intensive care. There were no differences between CBP and non-CBP children in age, sex, body weight, type of influenza virus, neurological complications, Glasgow score, PIM-2 score and PCIS at admission (p > 0.05). The inflammatory factors (CRP, PCT and IL-6) of 30 cases were tested at admission and after 3 days of admission. In the CBP group, there was a significant decrease in IL-6 levels at 3 days of admission (p = 0.003) and a decrease in CRP and PCT levels, but no significant difference (p > 0.05). In the non-CBP group, there were no significant difference on levels of CRP, PCT and IL-6 at admission and 3-day of admission (p > 0.05). The 28-day mortality was significantly lower in the CBP group compared with the non-CBP group (11.11% vs. 50%, p = 0.034). Conclusions CBP definitely reduces IL-6 levels significantly. We did find that the survival rate of patients in the CBP group was improved. But we don’t know if there is a relationship between the reduction of IL-6 levels and the survival rate. Trial registration: http://www.chictr.org.cn/index.aspx(ChiCTR2000031754).

scholarly journals Effect of an Oral Adsorbent, AST-120, on Dialysis Initiation and Survival in Patients with Chronic Kidney Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Shingo Hatakeyama ◽  
Hayato Yamamoto ◽  
Akiko Okamoto ◽  
Kengo Imanishi ◽  
Noriko Tokui ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Survival Rate ◽  
Kidney Disease ◽  
Dialysis Initiation ◽  
Kaplan Meier ◽  
Significant Difference ◽  
Oral Adsorbent ◽  
Matched Study ◽  
The Impact ◽  
Free Rate

The oral adsorbent AST-120 has the potential to delay dialysis initiation and improve survival of patients on dialysis. We evaluated the effect of AST-120 on dialysis initiation and its potential to improve survival in patients with chronic kidney disease. The present retrospective pair-matched study included 560 patients, grouped according to whether or not they received AST-120 before dialysis (AST-120 and non-AST-120 groups). The cumulative dialysis initiation free rate and survival rate were compared by the Kaplan-Meier method. Multivariate analysis was used to determine the impact of AST-120 on dialysis initiation. Our results showed significant differences in the 12- and 24-month dialysis initiation free rate (P<0.001), although no significant difference was observed in the survival rate between the two groups. In conclusion, AST-120 delays dialysis initiation in chronic kidney disease (CKD) patients but has no effect on survival. AST-120 is an effective therapy for delaying the progression of CKD.

scholarly journals Long term (five-year) survival following radical surgical treatment plus adjuvant chemotherapy (FAM) in advanced gastric cancer: a controlled study

2000 ◽  
Vol 55 (4) ◽  
pp. 129-136 ◽  
Author(s):  
Cláudio Bresciani ◽  
Joaquim Gama-Rodrigues ◽  
Victor Strassmann ◽  
Dan L. Waitzberg ◽  
Mitsunori Matsuda ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Surgical Treatment ◽  
Survival Rate ◽  
Tnm Classification ◽  
Controlled Study ◽  
Hematological Toxicity ◽  
Control Group ◽  
Significant Difference ◽  
The Impact

Several drugs and their associations are being used for adjuvant or complementary chemotherapy with the aim of improving results of gastric cancer treatment. The objective of this study was to verify the impact of these drugs on nutrition and on survival rate after radical treatment of 53 patients with gastric cancer in stage III of the TNM classification. A control group including 28 patients who had only undergone radical resection was compared to a group of 25 patients who underwent the same operative technique followed by adjuvant polychemotherapy with FAM (5-fluorouracil, Adriamycin, and mitomycin C). In this latter group, chemotherapy toxicity in relation to hepatic, renal, cardiologic, neurological, hematologic, gastrointestinal, and dermatological functions was also studied. There was no significant difference on admission between both groups in relation to gender, race, macroscopic tumoral type of tumor according to the Borrmann classification, location of the tumor in the stomach, length of the gastric resection, or response to cutaneous tests on delayed sensitivity. Chemotherapy was started on average, 2.3 months following surgical treatment. Clinical and laboratory follow-up of all patients continued for 5 years. The following conclusions were reached: 1) The nutritional status and incidence of gastrointestinal manifestation were similar in both groups; 2) There was no occurrence of cardiac, renal, neurological, or hepatic toxicity or death due to the chemotherapeutic method per se; 3) Dermatological alterations and hematological toxicity occurred exclusively in patients who underwent polychemotherapy; 4) There was no significant difference between the rate and site of tumoral recurrence, the disease-free interval, or the survival rate of both study groups; 5) Therefore, we concluded, after a 5-year follow-up, chemotherapy with the FAM regimen did not increase the survival rate.

scholarly journals Kelangsungan Hidup Larva Planula Acropora sp dalam Pemeliharaan Terkontrol Kepadatan yang Berbeda

2021 ◽  
Vol 1 (2) ◽  
pp. 1-8
Author(s):  
Syafyudin Yusuf ◽  
Juniur Rangan ◽  
Esther Sandamanapa
Keyword(s):  
Survival Rate ◽  
Coral Reefs ◽  
Larval Mortality ◽  
Water Medium ◽  
Coral Larvae ◽  
Reef Restoration ◽  
Significant Difference ◽  
Small Container ◽  
The Impact ◽  
Critical Survival

The survival of coral larvae as early phase of coral life is very important for their viability in environmen. This research aims to determine the survival of Acropora sp planula at different densities intensive nursery, and also to khow the critical survival time of them.. This research method was used experiment in density of larvae were held in control laboratory. The planula were rearing ini small container 200 ml of water while the lavae density were used namely 0.5; 1.0, 1.5, 2.0 larvae / ml. The results indicated that survival rate for larvae of different densities (0.5 larvae/ml; 1.0 larvae/ml; 1.5 larvae/ml; 2.0 larvae/m) did not show any significant difference (P>0.05). the highest survival rate of planula larvae was in the treatment with a density of 1.5 larvae/ml and the lowest from a density of 2.0 larvae/ml, and the most larval mortality was in the first 12 hours of rearing, due to the degree of adaptation of larvae to the rearing water medium in all treatment units, then death coral larvae decreased exponentially. This research will be very useful for efforts to restore coral reefs sexually, so as to reduce the impact of exploitation of coral seedlings which are often taken for asexual coral reef restoration as is often done throughout the world's coral reefs.

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