• 제목/요약/키워드: Comorbidities

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Determining the incidence and risk factors for short-term complications following distal biceps tendon repair

  • Goedderz, Cody;Plantz, Mark A.;Gerlach, Erik B.;Arpey, Nicholas C.;Swiatek, Peter R.;Cantrell, Colin K.;Terry, Michael A.;Tjong, Vehniah K.
    • Clinics in Shoulder and Elbow
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    • 제25권1호
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    • pp.36-41
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    • 2022
  • Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Early complications following biceps tendon repair are not well described in the literature. This study utilizes a national surgical database to determine the incidence of and predictors for short-term complications following distal biceps tendon repair. Methods: The American College of Surgeons' National Surgical Quality Improvement Program database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017. Patient demographic variables of sex, age, body mass index, American Society of Anesthesiologists class, functional status, and several comorbidities were collected for each patient, along with 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables. Results: Early postoperative surgical complications (0.5%)-which were mostly infections (0.4%)-and medical complications (0.3%) were rare. A readmission risk factor was diabetes (risk ratio [RR], 4.238; 95% confidence interval [CI], 1.180-15.218). Non-home discharge risk factors were smoking (RR, 3.006; 95% CI, 1.123-8.044) and ≥60 years of age (RR, 4.150; 95% CI, 1.611-10.686). Maleness was protective for medical complications (RR, 0.024; 95% CI, 0.005-0.126). Surgical complication risk factors were obese class II (RR, 4.120; 95% CI, 1.123-15.120), chronic obstructive pulmonary disease (COPD; RR, 21.981; 95% CI, 3.719-129.924), and inpatient surgery (RR, 8.606; 95% CI, 2.266-32.689). Conclusions: Complication rates after distal biceps repair are low. Various patient demographics, medical comorbidities, and surgical factors were all predictive of short-term complications.

CYP3A4 기질과 억제제 약물의 병용 고령환자에서 부정맥 부작용 연관성 (Association of Arrhythmia in the Elderly Patients on Combination Therapy of CYP3A4 Substrates and Inhibitors with the Korean Claims Data)

  • 김태우;장준혁;추은정;박래웅;이숙향
    • 한국임상약학회지
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    • 제33권4호
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    • pp.242-253
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    • 2023
  • Background: Arrhythmia due to QT prolongation is one of the most serious adverse events with drug interactions in the elderly. This study aimed to examine the incidence of arrhythmia in Korean elderly patients who administered both cytochrome P450 3A4 (CYP3A4) substrates and inhibitors. Methods: Patients using CYP3A4 substrate and inhibitor were selected from the 2017 elderly patient dataset (the Korean Health Insurance Review and Assessment Service - Aged Population Sample). Selection criteria were patients with a medication possession ratio over 80%, medication duration of at least 7 days, and a follow-up period of 3 months or more. The patient's basic information is age, gender, health insurance type, and comorbidities. The top 50 drug pairs and comorbidity with high-incidence arrhythmia were presented. Results: In patients with drug combinations for over 7 days, there were 981 incidences of arrhythmia, and 351 incidences in those with combinations for over 30 days. The comorbidities of congestive heart failure and myocardial infarction had a significant association with incidence of arrhythmia. Among patients with 7 days or longer, the drug pairs [substrates-inhibitors] with significant adjusted odds ratio (aOR) were [propranolol-cimetidine] (aOR, 2.25; 95% confidence interval [CI], 1.66-3.04). Among patients with 30 days or longer, the drug pairs with significant aOR were [tramadol-amiodarone] (aOR, 2.87; 95% CI, 1.97-4.19). Conclusions: In elderly patients, the incidence of arrhythmia was high with drug interactions of CYP3A4 substrates and inhibitors. The comorbidity of congestive heart failure was the risk factor.

Simultaneous resection of synchronous colorectal liver metastasis: Feasibility and development of a prediction model

  • Mufaddal Kazi;Shraddha Patkar;Prerak Patel;Aditya Kunte;Ashwin Desouza;Avanish Saklani;Mahesh Goel
    • 한국간담췌외과학회지
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    • 제27권1호
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    • pp.40-48
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    • 2023
  • Backgrounds/Aims: Timing of resection for synchronous colorectal liver metastasis (CRLM) has been debated for decades. The aim of the present study was to assess the feasibility of simultaneous resection of CRLM in terms of major complications and develop a prediction model for safe resections. Methods: A retrospective single-center study of synchronous, resectable CRLM, operated between 2013 and 2021 was conducted. Upper limit of 95% confidence interval (CI) of major complications (≥ grade IIIA) was set at 40% as the safety threshold. Logistic regression was used to determine predictors of morbidity. Prediction model was internally validated by bootstrap estimates, Harrell's C-index, and correlation of predicted and observed estimates. Results: Ninety-two patients were operated. Of them, 41.3% had rectal cancers. Major hepatectomy (≥ 4 segments) was performed for 25 patients (27.2%). Major complications occurred in 20 patients (21.7%, 95% CI: 13.8%-31.5%). Predictors of complications were the presence of comorbidities and major hepatectomy (area under the ROC curve: 0.692). Unacceptable level of morbidity (≥ 40%) was encountered in patients with comorbidities who underwent major hepatectomy. Conclusions: Simultaneous bowel and CRLM resection appear to be safe. However, caution should be exercised when combining major liver resections with bowel resection in patients with comorbid conditions.

측두하악장애와 귀 증상과의 관계 (The Relationship between Temporomandibular Disorders(TMD) and Ear symptoms)

  • 박형욱;송지희;김성택
    • 대한치과의사협회지
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    • 제48권7호
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    • pp.522-530
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    • 2010
  • Temporomandibular disorders(TMD) have been defined as a collective term embracing a number of clinical problems that involve the temporomandibular joint, the masticatory muscles, and associated structures. Since Dr. James Costen has mentioned about the relationship between TMD and posterior bite collapse, there have been many controversies about the etiology and comorbidities of TMD. The purpose of this study was to investigate the relationship between TMD and hearing acuity in 158 volunteers with or without TMD symptoms. The subjects were examined clinically about TMJ sound, missing teeth, tinnitus, TMJ pain and masticatory muscle pain and the hearing acuity were measured by Audiometer(ITO AE-1000, Japan). The result of this study indicated that there was no significant differences between TMD symptoms and hearing acuity relatively.

B형 간염 환자에서 Lamivudine과 Adefovir 병용처방으로 유발된 이명의 증례보고 (Lamivudine- and Adefovir-Induced Tinnitus in a Patient with Hepatitis B: A Case Report)

  • 정은희;방준석;이유정
    • 한국임상약학회지
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    • 제23권2호
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    • pp.175-177
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    • 2013
  • Lamivudine and adefovir are medications used to treat hepatitis B. We observed the occurrence of tinnitus after administering lamivudine and adefovir to a 49-year-old hepatitis B patient for two months. The patient had no comorbidities and no history of ear diseases, including tinnitus, and was not taking any other medications. In general, neither lamivudine nor adefovir are known to induce tinnitus as an adverse reaction. A literature search revealed that this is the first case in which tinnitus occurred after lamivudine and adefovir were administered to a hepatitis B patient. Therefore, we believe that this case is clinically valuable and decided to report it.

Prognostic Factors in Stage III Non-Small-Cell Lung Cancer Patients

  • Urvay, Semiha Elmaci;Yucel, Birsen;Erdis, Eda;Turan, Nedim
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권10호
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    • pp.4693-4697
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    • 2016
  • Aim: The objective of this study is to investigate prognostic factors affecting survival of patients undergoing concurrent or sequential chemoradiotherapy (CRT) for stage III non-small-cell lung cancer (NSCL). Methods and materials: We retrospectively reviewed the clinical records of 148 patients with advanced, inoperable stage III NSCLC, who were treated between 2007 and 2015. Results: The median survival was found to be 19 months and 3-year overall survival was 27%. Age (<65 vs ${\geq}65years$, p=0.026), stage (IIIA vs IIIB, p=0.033), dose of radiotherapy (RT) (<60 vs ${\geq}60Gy$, p=0.024) and treatment method (sequential chemotherapy+RT vs concurrent CRT, p=0.023) were found to be factors affecting survival in univariate analyses. Gender, histological subtype, weight loss during CRT, performance status, induction/consolidation chemotherapy and presence of comorbidities did not affect survival (p>0.050). Conclusion: Young age, stage IIIA, radiotherapy dose and concurrent chemoradiotherapy may positively affect survival in stage III NSCL cases.

만성 족관절 불안정성의 진단 및 동반 질환 (Diagnosis and Comorbidity of Chronic Ankle Instability)

  • 하동준;김덕희;곽희철
    • 대한족부족관절학회지
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    • 제22권2호
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    • pp.49-54
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    • 2018
  • Ankle sprains are among the most common injuries sustained during athletic activities and daily life. Acute ankle sprain is usually managed conservatively with functional rehabilitation but the failure of conservative treatment leads to the development of chronic ankle instability. The development of repetitive ankle sprains and persistent symptoms after injury has been termed chronic ankle instability. Acute ankle sprains and chronic ankle instability require a careful evaluation to detect other comorbidities, such as subtalar instability, osteochondral defect, peroneal tendinopathy, tarsal coalition, os trigonum, flexor hallucis longus tendinitis, calcaneus anterior process fracture, and neural injuries. For the successful treatment of acute ankle sprains and chronic ankle instability, the treatment of comorbidity lesions should be performed first.

Stereotactic radiotherapy for early stage non-small cell lung cancer

  • Ricardi, Umberto;Badellino, Serena;Filippi, Andrea Riccardo
    • Radiation Oncology Journal
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    • 제33권2호
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    • pp.57-65
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    • 2015
  • Stereotactic body radiotherapy (SBRT) represents a consolidated treatment option for patients with medically inoperable early stage non-small cell lung cancer (NSCLC). The clinical evidence accumulated in the past decade supports its use as an alternative to surgery with comparable survival outcomes. Due to its limited toxicity, SBRT is also applicable to elderly patients with very poor baseline pulmonary function or other severe comorbidities. Recent comparative studies in operable patients raised the issue of the possible use of SBRT also for this subgroup, with quite promising results that still should be fully confirmed by prospective trials with long-term follow-up. Aim of this review is to summarize and discuss the major studies conducted over the years on SBRT and to provide data on the efficacy and toxicity of this radiotherapy technique for stage I NSCLC. Technical aspects and quality of life related issues are also discussed, with the goal to provide information on the current role and limitations of SBRT in clinical practice.

측두하악장애와 청력과의 관계 (The Relationship between Temporomandibular Disorders(TMD) and Hearing Acuity)

  • 강진규;김성택
    • 구강회복응용과학지
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    • 제23권3호
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    • pp.187-195
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    • 2007
  • Temporomandibular disorders have been defined as a collective term embracing a number of clinical problems that involve the temporomandibular joint, the masticatory muscles, and associated structures. Since Dr. James Costen has mentioned about the relationship between TMD and posterior bite collapse, there have been many controversies about the etiology and comorbidities of TMD. The purpose of this study was to investigate the relationship between TMD and hearing acuity in 158 volunteers with or without TMD symptoms. The subjects were examined clinically about TMJ sound, missing teeth, tinnitus, TMJ pain and masticatory muscle pain and the hearing acuity were measured by Audiometer(ITO AE-1000, Japan). The result of this study indicated that there was no significant differences between TMD symptoms and hearing acuity relatively.

주의력결핍 과잉행동장애에서 비정신자극제 약물치료 (Non-Stimulant Medications in the Treatment of Attention-Deficit Hyperactivity Disorder)

  • 황준원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제19권2호
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    • pp.72-82
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    • 2008
  • The aim of this paper is to evaluate the use of non-stimulants, including atomoxetine, bupropion and modafinil, as alternative approaches to the treatment of children with attention-deficit hyperactivity disorder. A comprehensive review of the empirically based literature regarding the efficacy and the safety of the non-stimulants was performed. There is a large and increasing body of data supporting the efficacy and the safety of non-stimulants. Although the treatment effect sizes for non-stimulants may be smaller than those for stimulants, non-stimulants alone have been shown to be effective in the treatment of attention-deficit hyperactivity disorder as well as several comorbidities. These results suggest that non-stimulants are effective in the treatment of attention-deficit hyperactivity disorder. Further studies are needed to improve our understanding of alternative pharmacological medications in the treatment of attention-deficit hyperactivity disorder.

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