scholarly journals The association between serum CD4 T lymphocyte counts and surgical outcomes in HIV/AIDS patients in Guangxi, China: a retrospective cohort study

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12023
Author(s):  
Aimei Liu ◽  
Cunxu Liu ◽  
Xiaojun Deng ◽  
Yongbao Huang ◽  
Linchu Liao ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Surgical Therapy ◽  
T Lymphocyte ◽  
Surgical Outcomes ◽  
Surgical Complications ◽  
Secondary Outcome ◽  
Cd4 Cell Count ◽  
Outcome Indicator ◽  
Significant Difference ◽  
Hiv Aids

Background HIV/AIDS is a chronic disease leading to complications in infected individuals that often require surgical intervention. These patients’ serum CD4 T lymphocyte (CD4) counts represent one of the most important indicators of their ability to tolerate surgical treatment. Previous studies have demonstrated that CD4 cell count (CD4-CC) < 200 cells/μl may increase the risk of surgical complications in these patients, limiting their ability to undergo surgery, which may negatively affect their quality of life. Further investigation into the surgical outcomes of patients with CD4-CC < 200 cells/μl should provide guidance in making appropriate clinical decisions for the optimal healthcare of this patient demographic. Methods All enrolled patients were selected from 14 prefecture-level general hospitals in Guangxi, China, and were referred to AIDS outpost hospitals for inpatient surgical therapy. A total cohort of 168 adult patients was retrospectively analyzed. Multifactorial and stratified analyses were performed to evaluate the in surgical outcome differences for patients with CD4-CC < 200 cells/μl (N = 43), using those with CD4-CC ≥ 200 cells/μl (N = 125) as controls. Results Poor incisional healing was used as the primary outcome indicator, and postoperative complications were used as the secondary outcome indicator. In the patient group with CD4-CC < 200 cells/μl, the risk of surgical complications was significantly increased (OR 2.379; 95% CI [1.049–5.394]) after adjustment. Adjusted stratified analysis of the CD4-CC < 200 cells/μl group revealed that individuals over 60 years (OR 27.504; 95% CI [2.297–329.317]) with erythrocyte counts below 4.00/ml for males or 3.50/ml for females (OR 3.353; 95% CI [1.079–10.419]) had a significantly higher risk of postoperative complications; this finding was statistically different from the control (CD4 ≥ 200 cells/μl) group. However, there was no significant difference between the two groups regarding the risk of poorly healed incision outcomes. Conclusions Preliminary findings suggest that a serum CD4-CC < 200 cells/μl is not a definitive contraindication for surgical therapy and that baseline and surgical characteristics may help predict surgical outcomes in these patients. Further studies are needed to confirm these findings.

scholarly journals Surgical Outcomes of LigaSure Hemorrhoidectomy in the Elderly Population: A retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chuang-Wei Chen ◽  
Tzung-Ju Lu ◽  
Koung-Hung Hsiao
Keyword(s):  
Cohort Study ◽  
Postoperative Complications ◽  
Surgical Outcomes ◽  
Multivariate Logistic Regression Analysis ◽  
Operation Time ◽  
Admission Rate ◽  
Complication Rates ◽  
Time Duration ◽  
Significant Difference ◽  
Prone Jackknife Position

Abstract Background This study aims to assess the association between age and outcomes in patients undergoing hemorrhoidectomy. Methods This is a population-based cohort study. A retrospectively collected database with consecutive patients whose symptomatic prolapsed hemorrhoids managed by the LigaSure hemorrhoidectomy between Jan. 2015 and May 2017 was reviewed. Among 1238 patients, 1075 were under 65 years old (group 1), and 163 were 65 years old or older (group 2). Both groups were compared regarding baseline characteristics and surgical outcomes. Results All patients tolerated the whole course of the operation in the prone jackknife position without anesthetic-associated complications. There was no significant difference between these two groups regarding sex, hemorrhoids grade, operation time, duration of hospital stays, postoperative pain score, analgesic consumption, total postoperative complications, re-admission rate, reoperation rate and follow-up times. The multivariate logistic regression analysis that may contribute to postoperative complications revealed no significant difference for all complications between both groups. Conclusion The LigaSure hemorrhoidectomy for elderly patients is safe and effective without significant difference in short-term operative outcomes and all complication rates, compared with younger patients.

scholarly journals Korelasi Jumlah CD4 Pasien Yang Diberi Isoniazid Dengan Ko-infeksi TB Pada Pasien HIV/AIDS

2020 ◽  
Vol 1 (4) ◽  
pp. 284-290
Author(s):  
Niken Ayu Farida Salim ◽  
Zulfian ◽  
Neno Fitriyani Hasbie ◽  
Arif Effendi
Keyword(s):  
Total Sample ◽  
Cross Sectional ◽  
Cd4 Cell Count ◽  
Tb Treatment ◽  
Cell Counts ◽  
Cd4 Cell Counts ◽  
Significant Difference ◽  
Latent Tb Infection ◽  
Cd4 Cell ◽  
Hiv Aids

The interaction between TB and HIV infection is complex. In HIV-infected individuals, this situation will decrease the immune system and increase vulnerability to TB incidence. HIV causes reactivation, reinfection, and progression of latent TB infection to active tuberculosis. It also led to differences in the clinical presentation of TB in HIV patients, complications, and response to anti-TB treatment than in HIV negative patients. The purpose of this study To Know Correlation CD4 counts in patients with HIV / AIDS in hospitals Dr.H. Abdul Moeloek Lampung Province 2018. Research methods: cross-sectional approach, in which several variables tested in this research object data got from the medical record. Analysis of the data used is the Mann-Whitney statistical test. Research The total sample of 160 medical records of patients seen that the Asymp. Sig. (2-tailed) is 0,000. Half of this significance value ½ (0.000) is <0.05. It can be concluded that reject H0 and Ha accepted, which implies a significant difference in CD4 cell counts in patients given isoniazid as TB prevention with patients TB co-infection. With all forces, correlation means that their relationship CD4 cell counts in patients given isoniazid to prevent TB and TB co-infection. There is a significant relationship between CD4 cell count in patients who given isoniazid for the prevention of TB and TB co-infection in HIV / AIDS patients in hospitals Dr.H. Abdul Moeloek Lampung Province 2018.

PERAN WARGA PEDULI AIDS CAHAYA CARE TUREN DALAM MENINGKATKAN KUALITAS HIDUP ODHA

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Tri Nurhudi Sasono
Keyword(s):  
Quality Of Life ◽  
Antiretroviral Drugs ◽  
P Value ◽  
People Living With Hiv ◽  
Purposive Sampling ◽  
Significant Difference ◽  
Development Goals ◽  
Living With Hiv ◽  
Hiv Aids

Abstract : Indicator of the health welfare through Sustanable Development Goals (SDGs) is to reduce the incidence of HIV-AIDS, decrease the rate of the epidemic and maintain the quality of life of people living with HIV-AIDS (PLWHA). Trend cases of HIV-AIDS is the most recent spread among people, especially housewives. In Malang until 2015 found 278 Housewife of 409 cases of AIDS. The prevalence of HIV-AIDS in Malang Regency is ranked second after Surabaya city in East Java. For the importance of public participation and citizen care AIDS Cahaya Care Turen take responsibility for the condition. Determination Rule Goverment number 2 2015 year on the Participation of the community response to HIV-AIDS in Malang as a legal rule. Concerned Citizens activities AIDS (WPA). WPA Cahaya Care Turen is increases HIV risk and quality of life PLWHA. The purpose of this study was to determine the role of Citizens AIDS Cahaya Care Quality of Care Turen against people living with HIV in Puskesmas Turen Malang. The study design using a quasi-experimental, with purposive sampling using a sampling technique. Total number of research subjects 23. Based on test results obtained with the Wilcoxon p value <0.005, which means that there is a significant difference before and after PLWHA joining participated in the WPA Cahaya Care Turen. The conclusion of this study is WPA activities involving people living with HIV and at risk groups can optimize compliance with antiretroviral drugs that have an impact on improving the quality of life of PLHIV. Suggestions in this research is done WPA Program activities are structured and ongoing cross-sector in order to improve the quality of life and empower PLWHA.Keywords : WPA Cahaya Care Turen, Quality of life, PLWHA Abstrak : Salah satu indikator kesejahteraan kesehatan melalui Sustanable Development Goals (SDGs) adalah menekan angka kejadian HIV-AIDS, menurunkan laju epidemik dan mempertahankan kualitas hidup Orang dengan HIV-AIDS (ODHA). Trend kasus HIV-AIDS terkini terbanyak adalah menjangkit dikalangan masyarakat khususnya pada ibu rumah tangga. Kabupaten Malang sampai dengan tahun 2015 ditemukan 278 Ibu Rumah Tangga dari 409 kasus AIDS. Prevalensi HIV-AIDS di Kabupaten Malang ini merupakan peringkat kedua di Jawa Timur setelah Kota Surabaya. Untuk itu pentingnya peran serta masyarakat dan warga peduli AIDS Cahaya Care Turen ikut bertanggung jawab terhadap kondisi tersebut. Penetapan Peraturan Bupati Malang no.2 th.2015 tentang Peran serta masyarakat penanggulangan HIV-AIDS di Kabupaten Malang diharapkan dapat mengurangi risiko penularan HIV dan meningkatkan kualitas hidup ODHA. Tujuan dari penelitian ini adalah untuk mengetahui Peran Warga Peduli AIDS Cahaya Care Turen terhadap Kualitas ODHA Di Wilayah Kerja Puskesmas Turen Kabupaten Malang. Desain penelitian menggunakan quasi eksperimen, dengan teknik sampling menggunakan purposive sampling. Jumlah subyek penelitian sejumlah 23. Berdasarkan hasil uji dengan Wilcoxon didapatkan nilai p value < 0.005 yang berarti bahwa terdapat perbedaan bermakna sebelum dan sesudah ODHA bergabung mengikuti kegiatan WPA Cahaya Care Turen. Kesimpulan dalam penelitian ini adalah kegiatan WPA dengan melibatkan ODHA dan kelompok beresiko dapat mengoptimalkan kepatuhan obat ART sehingga berdampak terhadap peningkatan kualitas hidup ODHA. Saran dalam penelitian ini adalah dilakukannya Program kegiatan WPA yang terstruktur dan berkesinambungan lintas sektor guna meningkatkan kualitas hidup dan memberdayakan ODHA.     Kata kunci : WPA Cahaya Care Turen, kualitas hidup, ODHA

scholarly journals Clinical Evaluation of Microendoscopy-Assisted Oblique Lateral Interbody Fusion

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 135
Author(s):  
Tomohide Segawa ◽  
Hisashi Koga ◽  
Masahito Oshina ◽  
Katsuhiko Ishibashi ◽  
Yuichi Takano ◽  
...  
Keyword(s):  
Interbody Fusion ◽  
Outcome Measure ◽  
Operation Time ◽  
Secondary Outcome ◽  
Invasive Technique ◽  
Lateral Interbody Fusion ◽  
Surgical Methods ◽  
Significant Difference ◽  
Oblique Lateral Interbody Fusion ◽  
Lateral Interbody

Background and objectives: Oblique Lateral Interbody Fusion (OLIF) is a widely performed, minimally invasive technique to achieve lumbar lateral interbody fusion. However, some complications can arise due to constraints posed by the limited surgical space and visual field. The purpose of this study was to assess the short-term postoperative clinical outcomes of microendoscopy-assisted OLIF (ME-OLIF) compared to conventional OLIF. Materials and Methods: We retrospectively investigated 75 consecutive patients who underwent OLIF or ME-OLIF. The age, sex, diagnosis, and number of fused levels were obtained from medical records. Operation time, estimated blood loss (EBL), and intraoperative complications were also collected. Operation time and EBL were only measured per level required for the lateral procedure, excluding the posterior fixation surgery. The primary outcome measure was assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The secondary outcome measure was assessed using the Oswestry Disability Index (ODI) and the European Quality of Life–5 Dimensions (EQ-5D), measured preoperatively and 1-year postoperatively. Results: This case series consisted of 14 patients in the OLIF group and 61 patients in the ME-OLIF group. There was no significant difference between the two groups in terms of the mean operative time and EBL (p = 0.90 and p = 0.50, respectively). The perioperative complication rate was 21.4% in the OLIF group and 21.3% in the ME-OLIF group (p = 0.99). In both groups, the postoperative JOABPEQ, EQ-5D, and ODI scores improved significantly (p < 0.001). Conclusions: Although there was no significant difference in clinical results between the two surgical methods, the results suggest that both are safe surgical methods and that microendoscopy-assisted OLIF could serve as a potential alternative to the conventional OLIF procedure.

Single Versus Dual Headless Compression Screw Fixation of Scaphoid Nonunions: A Biomechanical Comparison

Hand ◽  
2021 ◽  
pp. 155894472097411
Author(s):  
Luke T. Nicholson ◽  
Kristen M. Sochol ◽  
Ali Azad ◽  
Ram Kiran Alluri ◽  
J. Ryan Hill ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Qualitative Assessment ◽  
Secondary Outcome ◽  
Scaphoid Nonunion ◽  
Compression Screw ◽  
Single Screw ◽  
Headless Compression Screw ◽  
Significant Difference ◽  
Load To Failure ◽  
Headless Compression Screws

Background: Management of scaphoid nonunions with bone loss varies substantially. Commonly, internal fixation consists of a single headless compression screw. Recently, some authors have reported on the theoretical benefits of dual-screw fixation. We hypothesized that using 2 headless compression screws would impart improved stiffness over a single-screw construct. Methods: Using a cadaveric model, we compared biomechanical characteristics of a single tapered 3.5- to 3.6-mm headless compression screw with 2 tapered 2.5- to 2.8-mm headless compression screws in a scaphoid waist nonunion model. The primary outcome measurement was construct stiffness. Secondary outcome measurements included load at 1 and 2 mm of displacement, load to failure for each specimen, and qualitative assessment of mode of failure. Results: Stiffness during load to failure was not significantly different between single- and double-screw configurations ( P = .8). Load to failure demonstrated no statistically significant difference between single- and double-screw configurations. Using a qualitative assessment, the double-screw construct maintained rotational stability more than the single-screw construct ( P = .029). Conclusions: Single- and double-screw fixation constructs in a cadaveric scaphoid nonunion model demonstrate similar construct stiffness, load to failure, and load to 1- and 2-mm displacement. Modes of failure may differ between constructs and represent an area for further study. The theoretical benefit of dual-screw fixation should be weighed against the morphologic limitations to placing 2 screws in a scaphoid nonunion.

scholarly journals Donepezil for mild cognitive impairment in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Group ◽  
Outcome Measures ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

Comparative Morbidity Profile of Elective vs Therapeutic Neck Dissection

2021 ◽  
pp. 019459982110089
Author(s):  
Quinn Dunlap ◽  
James Reed Gardner ◽  
Amanda Ederle ◽  
Deanne King ◽  
Maya Merriweather ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Surgical Complications ◽  
Chart Review ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Neck Surgery ◽  
Continuous Variables ◽  
Significant Difference ◽  
History Of

Objective Neck dissection (ND) is one of the most commonly performed procedures in head and neck surgery. We sought to compare the morbidity of elective ND (END) versus therapeutic ND (TND). Study Design Retrospective chart review. Setting Academic tertiary care center. Methods Retrospective chart review of 373 NDs performed from January 2015 to December 2018. Patients with radical ND or inadequate chart documentation were excluded. Demographics, clinicopathologic data, complications, and sacrificed structures during ND were retrieved. Statistical analysis was performed with χ2 and analysis of variance for comparison of categorical and continuous variables, respectively, with statistical alpha set a 0.05. Results Patients examined consisted of 224 males (60%) with a mean age of 60 years. TND accounted for 79% (n = 296) as compared with 21% (n = 77) for END. Other than a significantly higher history of radiation (37% vs 7%, P < .001) and endocrine pathology (34% vs 2.6%, P < .001) in the TND group, no significant differences in demographics were found between the therapeutic and elective groups. A significantly higher rate of structure sacrifice and extranodal extension within the TND group was noted to hold in overall and subgroup comparisons. No significant difference in rate of surgical complications was appreciated between groups in overall or subgroup analysis. Conclusion While the significantly higher rate of structure sacrifice among the TND population represents an increased morbidity profile in these patients, no significant difference was found in the rate of surgical complications between groups. The significant difference seen between groups regarding history of radiation and endocrine pathology likely represents selection bias.

scholarly journals Pattern of symptom improvement following endoscopic sinus surgery for chronic rhinosinusitis

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Salma S. Al Sharhan ◽  
Mohammed H. Al Bar ◽  
Shahad Y. Assiri ◽  
Assayl R. AlOtiabi ◽  
Deemah M. Bin-Nooh ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Endoscopic Sinus Surgery ◽  
T Test ◽  
Sinus Surgery ◽  
Symptom Improvement ◽  
P Value ◽  
Psychological Dysfunction ◽  
Significant Difference ◽  
The Mean ◽  
Snot 22

Abstract Background Chronic rhinosinusitis (CRS) is a common inflammation of the nose and the paranasal sinuses. Intractable CRS cases are generally treated with endoscopic sinus surgery (ESS). Although the effect of ESS on CRS symptoms has been studied, the pattern of symptom improvement after ESS for CRS is yet to be investigated. The aim of this study was to determine the magnitude and sequence of symptom improvement after ESS for CRS, and to assess the possible preoperative factors that predict surgical outcomes in CRS patients. Methods This was a longitudinal prospective study of 68 patients who had CRS (with or without nasal polyps). The patients underwent ESS at King Fahd Hospital of the University, Al Khobar, Saudi Arabia. The Sino-nasal Outcome Test-22 (SNOT-22) questionnaire was used for assessment at four time points during the study: pre-ESS, 1-week post-ESS, 4 weeks post-ESS, and 6 months post-ESS. Results The difference between the mean scores recorded for the five SNOT-22 domains pre-ESS and 6 months post-ESS were as follows: rhinologic symptoms (t-test = 7.22, p-value =  < 0.001); extra-nasal rhinologic symptoms (t-test = 4.87, p-value =  < 0.001); ear/facial symptoms (t-test = 6.34, p-value =  < 0.001); psychological dysfunction (t-test = 1.99, p-value = 0.049); and sleep dysfunction (t-test = 5.58, p-value =  < 0.001). There was a significant difference between the mean scores recorded for the five domains pre-ESS and 6 months post-ESS. Rhinologic symptoms had the largest effect size (d = 1.12), whereas psychological dysfunction had the least effect size (d = 0.24). The only statistically significant difference in the SNOT-22 mean scores recorded 4 weeks post-ESS was observed between allergic and non-allergic patients (t = − 2.16, df = 66, p = 0.035). Conclusion Understanding the pattern of symptom improvement following ESS for CRS will facilitate patient counselling and aid the optimization of the current treatment protocols to maximize surgical outcomes and quality of life. Level of evidence Prospective observational.

scholarly journals 1692. Retrospective Review on the Safety and Efficacy of Nitrofurantoin for the Treatment of Cystitis in the Veteran Population With or Without Renal Insufficiency

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S829-S830
Author(s):  
Elwyn W Welch ◽  
Shaila Sheth ◽  
Chester Ashong ◽  
Caroline Pham
Keyword(s):  
Renal Function ◽  
Renal Dysfunction ◽  
Clinical Cure ◽  
Clinical Cure Rate ◽  
Retrospective Chart Review ◽  
Outpatient Setting ◽  
Secondary Outcome ◽  
Cure Rate ◽  
Acute Cystitis ◽  
Significant Difference

Abstract Background Nitrofurantoin has been used to treat cystitis in women; however, data supporting its use in men is lacking. In addition, recent retrospective studies have challenged the manufacturer’s recommendation to avoid nitrofurantoin with creatinine clearances (CrCl) less than 60 mL/min. The purpose of this study is to compare the efficacy and safety of nitrofurantoin for the treatment of acute cystitis in male and female veterans with variable degrees of renal dysfunction. Methods A retrospective chart review was conducted in adult patients who received nitrofurantoin for acute cystitis in the outpatient setting between May 1, 2018 and May 1, 2019. The primary outcomes were rates of clinical cure as compared between males and females, and across various renal function groups (CrCl greater than 60 mL/min, 30 to 60 mL/min, and less than 30 mL/min) following treatment with nitrofurantoin. The secondary outcome was adverse event rates. Results A total of 446 patients were included with 278 females and 168 males. Overall clinical cure rate was 86.5% (n=386). Clinical cure rate did not vary between genders (p=0.0851) or CrCl ranges (p=1.0) as shown in the tables. Benign prostatic hyperplasia (BPH) was associated with decreased odds of clinical cure (OR 0.50 [95% CI 0.26-0.97], p=0.0404) in addition to cirrhosis (OR 0.22 [95% CI 0.06-0.91], p=0.0357). Adverse events occurred in 2% of patients and did not vary based on gender or renal function. RATES OF CLINICAL CURE Conclusion There was no statistically significant difference in clinical cure with nitrofurantoin between genders and various renal impairments. However, history of BPH and cirrhosis were associated with decreased efficacy. Subgroup analysis also revealed lower efficacy in males with CrCl greater than 60 mL/min versus females with similar renal function. This study adds to the growing body of literature suggesting that renal dysfunction with CrCl of 30 to 60 mL/min may not carry the risk of treatment failure and adverse effects previously associated with nitrofurantoin, but large randomized trials are needed to confirm these results. Disclosures All Authors: No reported disclosures

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