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Dental Clinics of North America Oct 2023A patient with type I diabetes withheld her diabetes medications without consulting her physician and was not able to resume her normal diet after extensive dental... (Review)
Review
A patient with type I diabetes withheld her diabetes medications without consulting her physician and was not able to resume her normal diet after extensive dental surgery resulting in hyperglycemia postoperatively. Clear communication between clinicians and patient about the expected postoperative course and changes to factors that may influence glycemic control could prevent hyperglycemia in the postoperative period.
Topics: Female; Humans; Hyperglycemia; Communication; Postoperative Period; Referral and Consultation; Diabetes Mellitus
PubMed: 37714608
DOI: 10.1016/j.cden.2023.05.013 -
Current Eye Research Jul 2023This study investigated the effect and long-term efficacy of binocular visual function training after concomitant exotropia surgery. (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
This study investigated the effect and long-term efficacy of binocular visual function training after concomitant exotropia surgery.
METHODS
A total of 92 patients who underwent concomitant exotropia surgery were randomly divided into group A (the training group) ( = 54), who received binocular four-dimensional (4D) visual function training after surgery, and group B (control group) ( = 38). The patients in group A received personalized 4D visual function training 2 weeks after surgery and were followed up for 12 months. The eye position, distant and near stereo acuity, respectively, and postoperative efficacy were compared with those of the patients in group B.
RESULTS
The normal eye position rate in group A was higher than in group B at the end of the overall follow-up period ( < .05), and the near stereo acuity rate was higher than the distant stereo acuity rate in both groups A and B at 2 weeks after surgery and at the end of follow up. The distant and near stereo acuity rates of the patients in group A were higher than those in group B ( < .05) at the end of the follow-up period, and the distant stereo acuity of group A was significantly improved ( < .05). The functional complete and incomplete response rates of group A were significantly higher than those of group B at the end of the follow-up period ( < .05).
CONCLUSIONS
Four-dimensional visual function training for patients after concomitant exotropia surgery could facilitate the recovery of postoperative binocular visual function, as well as prevent the recurrence of exotropia after surgery.
Topics: Humans; Exotropia; Visual Acuity; Vision, Binocular; Postoperative Period; Oculomotor Muscles; Retrospective Studies; Ophthalmologic Surgical Procedures; Follow-Up Studies
PubMed: 36999910
DOI: 10.1080/02713683.2023.2188574 -
Radiologie (Heidelberg, Germany) Nov 2023Pelvic floor dysfunction is common in women. (Review)
Review
BACKGROUND
Pelvic floor dysfunction is common in women.
OBJECTIVES
To describe the role of ultrasound in the urogynecological examination and imaging of the pelvic floor.
MATERIALS AND METHODS
Analysis and summary of current recommendations and literature on the role of pelvic floor ultrasound.
RESULTS
Pelvic floor ultrasound is a dynamic and real-time imaging modality. It is readily available, allows for a realistic assessment of anatomy and morphology, and poses minimal patient burden.
CONCLUSIONS
Pelvic floor ultrasound is of great value in preoperative diagnostics as well as in the postoperative management of complications.
Topics: Female; Humans; Pelvic Floor; Pelvic Organ Prolapse; Ultrasonography; Pelvic Floor Disorders; Postoperative Period
PubMed: 37789193
DOI: 10.1007/s00117-023-01215-7 -
Anesthesiology Sep 2023
Topics: Humans; Postoperative Care; Preoperative Care; Postoperative Period
PubMed: 37402270
DOI: 10.1097/ALN.0000000000004637 -
Open Veterinary Journal Aug 2023A cataract is one of the underlying causes of blindness in animals. Phacoemulsification is the standard procedure in cataract surgery for humans and animals. This...
BACKGROUND
A cataract is one of the underlying causes of blindness in animals. Phacoemulsification is the standard procedure in cataract surgery for humans and animals. This procedure has been used to restore vision in cataracts in a variety of animals. However, this technique is difficult in very small animals, such as rodents, due to their small eyes.
CASE DESCRIPTION
A 4-year-old male domestic chinchilla was presented with cloudiness in the lenses for 1 month. The ophthalmic examination revealed cataracts (oculus uterque: both eyes). Positive dazzle reflex oculus sinister; left eye (OS) and negative reflex oculus dexter; right eye (OD) were noted. The electroretinography was low amplitude OS whereas a flat waveform presented OD. In this case, cataract surgery was performed using phacoemulsification without intraocular lens implantation OS. Postoperative, the chinchilla was alert and could jump on and jump off the ledge in a house. When the veterinarian approached closely to OS, the chinchilla displayed an erect body posture and open eyes, whereas the chinchilla was ignored when the veterinarian doing the same OD. The chinchilla was alert and had improved vision observe by this chinchilla can jump on and jump off the ledge in his house throughout the follow-up period 18 months later.
CONCLUSION
In this chinchilla, phacoemulsification was successfully performed and resulted in better overall vision. The chinchilla was alert and could jump on and jump off the ledge in a house after cataract surgery throughout the follow-up period of 18 months.
Topics: Animals; Humans; Male; Phacoemulsification; Chinchilla; Cataract; Postoperative Period
PubMed: 37701661
DOI: 10.5455/OVJ.2023.v13.i8.10 -
Scientific Reports Sep 2023To clarify the association between pre- and postoperative rotational mismatches of the femorotibial components and bones for total knee arthroplasty (TKA) with...
Association between pre- and postoperative rotational mismatches of the femorotibial components and bones in bi-cruciate retaining and posterior stabilized total knee arthroplasty.
To clarify the association between pre- and postoperative rotational mismatches of the femorotibial components and bones for total knee arthroplasty (TKA) with bi-cruciate retaining (BCR) design and with fixed bearing posterior stabilized (PS) design. This retrospective cohort study included 40 BCR TKAs and 50 PS TKAs. Pre- and postoperative rotational mismatches of the femorotibial components and bones were measured by three-dimensional assessment based on computed tomography imaging. The mean value and percentage within ± 5° of pre- and postoperative rotational mismatches were compared between BCR TKA and PS TKA. Correlations between pre- and postoperative rotational mismatches of the femorotibial components and bones were investigated in BCR TKA and PS TKA. There was no significant difference in mean preoperative rotational mismatch of femorotibial components and bones between BCR TKA and PS TKA. Mean postoperative rotational mismatch of femorotibial components and bones was significantly greater in BCR TKA than in PS TKA. Postoperative rotational mismatch of the femorotibial components was within ± 5° in 21 knees (52.5%) for BCR TKA and in 43 knees (86.0%) for PS TKA. The rate of postoperative rotational mismatch of the femorotibial components and bones within ± 5° was significantly lower for BCR TKA than for PS TKA. In BCR TKA, there was a positive correlation between pre- and postoperative rotational mismatches of the femorotibial components and of bones. We consider these results can be attributed to the retention of both cruciate ligaments, which may affect the reduction of rotational permittance of the components and bones.
Topics: Humans; Arthroplasty, Replacement, Knee; Retrospective Studies; Ligaments, Articular; Postoperative Period
PubMed: 37689778
DOI: 10.1038/s41598-023-42243-6 -
Pediatric Nephrology (Berlin, Germany) Sep 2023Evaluate the association of postoperative day (POD) 2 weight-based fluid balance (FB-W) > 10% with outcomes after neonatal cardiac surgery.
OBJECTIVES
Evaluate the association of postoperative day (POD) 2 weight-based fluid balance (FB-W) > 10% with outcomes after neonatal cardiac surgery.
METHODS
Retrospective cohort study of 22 hospitals in the NEonatal and Pediatric Heart and Renal Outcomes Network (NEPHRON) registry from September 2015 to January 2018. Of 2240 eligible patients, 997 neonates (cardiopulmonary bypass (CPB) n = 658, non-CPB n = 339) were weighed on POD2 and included.
RESULTS
Forty-five percent (n = 444) of patients had FB-W > 10%. Patients with POD2 FB-W > 10% had higher acuity of illness and worse outcomes. Hospital mortality was 2.8% (n = 28) and not independently associated with POD2 FB-W > 10% (OR 1.04; 95% CI 0.29-3.68). POD2 FB-W > 10% was associated with all utilization outcomes, including duration of mechanical ventilation (multiplicative rate of 1.19; 95% CI 1.04-1.36), respiratory support (1.28; 95% CI 1.07-1.54), inotropic support (1.38; 95% CI 1.10-1.73), and postoperative hospital length of stay (LOS 1.15; 95% CI 1.03-1.27). In secondary analyses, POD2 FB-W as a continuous variable demonstrated association with prolonged durations of mechanical ventilation (OR 1.04; 95% CI 1.02-1.06], respiratory support (1.03; 95% CI 1.01-1.05), inotropic support (1.03; 95% CI 1.00-1.05), and postoperative hospital LOS (1.02; 95% CI 1.00-1.04). POD2 intake-output based fluid balance (FB-IO) was not associated with any outcome.
CONCLUSIONS
POD2 weight-based fluid balance > 10% occurs frequently after neonatal cardiac surgery and is associated with longer cardiorespiratory support and postoperative hospital LOS. However, POD2 FB-IO was not associated with clinical outcomes. Mitigating early postoperative fluid accumulation may improve outcomes but requires safely weighing neonates in the early postoperative period. A higher resolution version of the Graphical abstract is available as Supplementary information.
Topics: Infant, Newborn; Child; Humans; Retrospective Studies; Cardiac Surgical Procedures; Water-Electrolyte Imbalance; Water-Electrolyte Balance; Cardiopulmonary Bypass; Postoperative Period; Postoperative Complications
PubMed: 36973562
DOI: 10.1007/s00467-023-05929-7 -
Scientific Reports Jul 2023We aimed to evaluate the effect of the patient's clinical and paraclinical condition before and after surgery on short-term mortality and complication and long-term...
We aimed to evaluate the effect of the patient's clinical and paraclinical condition before and after surgery on short-term mortality and complication and long-term mortality. A retrospective cohort study was conducted and multivariate logistic regression was applied to determine the effect of demographic characteristics (sex, age, AO/OTA classification, height, weight, body mass index), medical history (hypertension, ischemic heart disease, diabetes mellitus, thyroid malfunction, cancer, osteoporosis, smoking) lab data (Complete blood cell, blood sugar, Blood Urea Nitrogen, Creatinine, Na, and K), surgery-related factors (Anesthesia time and type, implant, intraoperative blood transfusion, postoperative blood transfusion, and operation time), duration of admission to surgery and anticoagulant consumption on short-term mortality and complication and long-term mortality. Three hundred ten patients from November 2016 to September 2020 were diagnosed with an intertrochanteric fracture. 3.23% of patients died in hospital, 14.1% of patients confronted in-hospital complications, and 38.3% died after discharge till the study endpoint. ΔNumber of Neutrophiles is the primary determinant for in-hospital mortality in multivariate analysis. Age and blood transfusion are the main determinants of long-term mortality, and Na before surgery is the primary variable associated with postoperative complications. Among different analytical factors Na before surgery as a biomarker presenting dehydration was the main prognostic factor for in hospital complications. In hospital mortality was mainly because of infection and long-term mortality was associated with blood transfusion.
Topics: Humans; Retrospective Studies; Hip Fractures; Postoperative Complications; Postoperative Period; Morbidity; Treatment Outcome; Risk Factors
PubMed: 37495718
DOI: 10.1038/s41598-023-38667-9 -
Liver International : Official Journal... Nov 2023Surgical resection (SR) is a potentially curative treatment of hepatocellular carcinoma (HCC) hampered by high rates of recurrence. New drugs are tested in the adjuvant...
BACKGROUND
Surgical resection (SR) is a potentially curative treatment of hepatocellular carcinoma (HCC) hampered by high rates of recurrence. New drugs are tested in the adjuvant setting, but standardised risk stratification tools of HCC recurrence are lacking.
OBJECTIVES
To develop and validate a simple scoring system to predict 2-year recurrence after SR for HCC.
METHODS
2359 treatment-naïve patients who underwent SR for HCC in 17 centres in Europe and Asia between 2004 and 2017 were divided into a development (DS; n = 1558) and validation set (VS; n = 801) by random sampling of participating centres. The Early Recurrence Score (ERS) was generated using variables associated with 2-year recurrence in the DS and validated in the VS.
RESULTS
Variables associated with 2-year recurrence in the DS were (with associated points) alpha-fetoprotein (<10 ng/mL:0; 10-100: 2; >100: 3), size of largest nodule (≥40 mm: 1), multifocality (yes: 2), satellite nodules (yes: 2), vascular invasion (yes: 1) and surgical margin (positive R1: 2). The sum of points provided a score ranging from 0 to 11, allowing stratification into four levels of 2-year recurrence risk (Wolbers' C-indices 66.8% DS and 68.4% VS), with excellent calibration according to risk categories. Wolber's and Harrell's C-indices apparent values were systematically higher for ERS when compared to Early Recurrence After Surgery for Liver tumour post-operative model to predict time to early recurrence or recurrence-free survival.
CONCLUSIONS
ERS is a user-friendly staging system identifying four levels of early recurrence risk after SR and a robust tool to design personalised surveillance strategies and adjuvant therapy trials.
Topics: Humans; Carcinoma, Hepatocellular; Liver Neoplasms; Prognosis; Retrospective Studies; Postoperative Period; Neoplasm Recurrence, Local; Hepatectomy
PubMed: 37577984
DOI: 10.1111/liv.15683 -
Nutrition (Burbank, Los Angeles County,... Jul 2024Orthognathic surgery is a complex orofacial surgery that can significantly impact occlusal function and effect nutritional and quality of life parameters. This study...
OBJECTIVE
Orthognathic surgery is a complex orofacial surgery that can significantly impact occlusal function and effect nutritional and quality of life parameters. This study aimed to evaluate alterations in dietary intake, chewing function, physical activity, and oral health-related quality of life of patients undergoing orthognathic surgery.
RESEARCH METHODS AND PROCEDURES
In this prospective longitudinal study, the assessments were conducted at: preoperatively (T0) and postoperative first week (T1), second week (T2), first month (T3), and third month (T4) between May 2021 and March 2023. Sociodemographic questionnaire, 24-h dietary recall record, chewing ability form, International Physical Activity Questionnaire, and Oral Health Impact Profile-14 (OHIP-14) was applied at face-to-face interviews.
RESULTS
Seventy eligible orthognathic surgery patients were evaluated, and 37 patients (52.8%) completed this study. Energy and fat intake significantly decreased from T0 to T1 (P < 0.001) and returned to basis by T4 (P = 0.015). Fiber intake was found to be lowest at T1 and T2 compared with other time points (P < 0.001). Chewing ability showed a deterioration and then improvement; however, patients still had difficulties chewing hard foods at T4. The OHIP-14 increased at T2 and T3 from T0 (P < 0.001 and P = 0.021, respectively) and showed a significant improvement at T4 (P < 0.05).
CONCLUSION
The findings indicate a temporary decline in nutritional intake and chewing ability with subsequent recovery by the third month postsurgery. These changes, along with the trends in oral health-related quality of life, underscore the need for tailored nutritional and functional rehabilitation programs following orthognathic surgery.
Topics: Humans; Quality of Life; Female; Male; Oral Health; Prospective Studies; Nutritional Status; Longitudinal Studies; Mastication; Orthognathic Surgical Procedures; Adult; Young Adult; Postoperative Period; Surveys and Questionnaires; Preoperative Period; Diet; Exercise; Adolescent
PubMed: 38569254
DOI: 10.1016/j.nut.2024.112418