• Title/Summary/Keyword: Risk of bleeding

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Revisiting Use of Growth Factors in Myelodysplastic Syndromes

  • Newman, Kam;Maness-Harris, Lori;El-Hemaidi, Ihab;Akhtari, Mojtaba
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1081-1091
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    • 2012
  • Myelodysplastic syndromes (MDS) represent a heterogeneous group of clonal hematologic neoplasms characterized by morphologic dysplasia, aberrant hematopoiesis and peripheral blood refractory cytopenias. MDS is recognized to be associated with an increased risk of symptomatic anemia, infectious complications and bleeding diathesis, as well as a risk of progression to acute myeloid leukemia, particularly in patients with a high IPSS score. The advent of use of hematopoietic growth factors such as granulocyte colony-stimulating factor (G-CSF) and recombinant erythropoietin (EPO) has improved symptoms in MDS patients in addition to some data that suggest there might be an improvement in survival. G-CSF is an effective therapeutic option in MDS patients, and it should be considered for the management of refractory symptomatic cytopenias. G-CSF and EPO in combination can improve outcomes in appropriate MDS patients such as those with lower-risk MDS and refractory anemia with ring sideroblasts (RARS). This article reviews use of growth factors for lower-risk MDS patients, and examines the data for G-CSF, EPO and thrombopietic growth factors (TPO) that are available or being developed as therapeutic modalities for this challenging disease.

An Automatic Control System of the Blood Pressure of Patients Under Surgical Operation

  • Furutani, Eiko;Araki, Mituhiko;Kan, Shugen;Aung, Tun;Onodera, Hisashi;Imamura, Masayuki;Shirakami, Gotaro;Maetani, Shunzo
    • International Journal of Control, Automation, and Systems
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    • v.2 no.1
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    • pp.39-54
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    • 2004
  • We developed an automatic blood pressure control system to maintain the blood pressure of patients at a substantially low level during a surgical operation. The developed system discharges two functions, continuous feedback control of the mean arterial pressure (MAP) by a state-predictive servo controller and risk control based on the inference by fuzzy-like logics and rules using measured data. Twenty-eight clinical applications were made beginning in November 1995, and the effects of the automatic blood pressure control on the operation time and on bleeding were assessed affirmatively by means of Wilcoxon testing. This paper essentially reports the engineering details of the control system.

SURGICAL RESECTION OF CAROTID BODY TUMOR WITH CAROTID ARTERY REPLACEMENT (경동맥 절제후 혈관치환술을 시행한 경동맥체 종양)

  • Choi, Geon;Lee, Eun-Soo;Jung, Kwang-Yoon;Choi, Jong-Ouck
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.280-284
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    • 1996
  • Carotid body tumors are uncommon tumors of the head and neck Surgery is the primary treatment for the tumor. Large carotid body tumors frequently encircle the common, internal, and exernal carotid arteries, and extensive bleeding often complicates the resection, increasing the risk of carotid artery rupture and damange to major cranial nerves. Grafting should be used in high-risk patients. We have experienced a case of carotid body tumor which encircle the common, internal and external carotid arteries, treated with ligation of external carotid artery and grafting using Gortex between common carotid artery and internal carotid artery.

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Risk indicators for mucositis and peri-implantitis: results from a practice-based cross-sectional study

  • Rinke, Sven;Nordlohne, Marc;Leha, Andreas;Renvert, Stefan;Schmalz, Gerhard;Ziebolz, Dirk
    • Journal of Periodontal and Implant Science
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    • v.50 no.3
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    • pp.183-196
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    • 2020
  • Purpose: This practice-based cross-sectional study aimed to investigate whether common risk indicators for peri-implant diseases were associated with peri-implant mucositis and peri-implantitis in patients undergoing supportive implant therapy (SIT) at least 5 years after implant restoration. Methods: Patients exclusively restored with a single implant type were included. Probing pocket depth (PPD), bleeding on probing (BOP), suppuration, and radiographic bone loss (RBL) were assessed around implants. The case definitions were as follows: peri-implant mucositis: PPD ≥4 mm, BOP, no RBL; and peri-implantitis: PPD ≥5 mm, BOP, RBL ≥3.5 mm. Possible risk indicators were compared between patients with and without mucositis and peri-implantitis using the Fisher exact test and the Wilcoxon rank-sum test, as well as a multiple logistic regression model for variables showing significance (P<0.05). Results: Eighty-four patients with 169 implants (observational period: 5.8±0.86 years) were included. A patient-based prevalence of 52% for peri-implant mucositis and 18% for peri-implantitis was detected. The presence of 3 or more implants (odds ratio [OR], 4.43; 95 confidence interval [CI], 1.36-15.05; P=0.0136) was significantly associated with an increased risk for mucositis. Smoking was significantly associated with an increased risk for peri-implantitis (OR, 5.89; 95% CI, 1.27-24.58; P=0.0231), while the presence of keratinized mucosa around implants was associated with a lower risk for peri-implantitis (OR, 0.05; 95% CI, 0.01-0.25; P<0.001). Conclusions: The number of implants should be considered in strategies to prevent mucositis. Furthermore, smoking and the absence of keratinized mucosa were the strongest risk indicators for peri-implantitis in patients undergoing SIT in the present study.

Diagnosis and treatment of obstructive atelectasis after general anesthesia in a patient with abscess in the maxillofacial area: A case report

  • Um, Byung-Koo;Ku, Jeong-Kui;Kim, Yong-Soo
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.4
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    • pp.271-275
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    • 2018
  • The purpose of this study was to report and discuss the diagnosis and treatment of obstructive atelectasis secondary to pus obstruction in a patient who had developed a maxillofacial abscess, and to review the literature on similar cases. Persistently discharging pus within the oral cavity can act as an aspirate, and may lead to obstructive atelectasis. Additionally, maxillofacial surgery patients should be carefully assessed for the presence of risk factors of obstructive atelectasis, such as, epistaxis after nasotracheal intubation, oral bleeding, and mucus secretion. Furthermore, patients with these risk factors should be continuously followed up by monitoring $SPO_2$, breath sounds, and chest x-ray.

Understanding the Concept of Iron Deficiency Anemia in Athletes: A Narrative Review

  • RANA, Anvi
    • Journal of Sport and Applied Science
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    • v.6 no.4
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    • pp.11-23
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    • 2022
  • New insights into the aetiology of anaemia in athletes have been discovered in recent years. From hemodilution and redistribution, which are thought to commit to so-called "sports anaemia," to iron deficiency triggered by higher requirements, dietary requirements, decreased uptake, enhanced losses, hemolysis, and sequester, to genetic factors of different types of anaemia (some related to sport), anaemia in athletes necessitates a careful and multisystem methodology. Dietary factors that hinder iron absorption and enhance iron bioavailability (e.g., phytate, polyphenols) should be considered. Celiac disease, which is more common in female athletes, may be the consequence of an iron deficiency anaemia that is unidentified. Sweating, hematuria, gastrointestinal bleeding, inflammation, and intravascular and extravascular hemolysis are all ways iron is lost during strength training. In training, evaluating the iron status, particularly in athletes at risk of iron deficiency, may work on improving iron balance and possibly effectiveness. Iron status is influenced by a healthy gut microbiome. To eliminate hemolysis, athletes at risk of iron deficiency should engage in non-weight-bearing, low-intensity sporting activities.

Single Life Time Cytological Screening in High Risk Women as an Economical and Feasible Approach to Control Cervical Cancer in Developing Countries Like India

  • Misra, Jata Shankar;Srivastava, Anand Narain;Das, Vinita
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.859-862
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    • 2015
  • In view of funding crunches and inadequate manpower in cytology in developing countries like India, single lifetime screening for cervical cancer has been suggested. In this study, an attempt was made to cscreening to make it more effective for early detection. Cytological data were derived from the ongoing routine cervical cytology screening program for women attending Gynaecology Out Patient Department of Queen Mary's Hospital of K.G.Medical University, Lucknow, India during a span of 35 years (April 1971 - December 2005). Cervical smears in a total of 38,256 women were cytologically evaluated. The frequencies of squamous intraepithelial lesions of cervix (SIL) and carcinoma cervix were found to be 7.0% and 0.6%, respectively, in the series. Predisposing factors related to cervical carcinogenesis were analyzed in detail to establish the most vulnerable groups of women for single life time screening. The incidence of SIL and carcinoma cervix was found to be maximal in women above the age of 40 years irrespective of parity and in multiparous women (with three or more children) irrespective of age. The incidence of cervical cytopathologies was significantly higher in symptomatic women, the frequency of SIL being alarmingly higher in women complaining of contact bleeding and that of carcinoma cervix in older women with postmenopausal bleeding. It is consequently felt that single life time screening must include the three groups of women delineated above. Such selective screening appears to be the most economical, cost effective and feasible approach to affordably control the menace of cervical cancer in developing countries like India.

Predictors of Readmission after Inpatient Plastic Surgery

  • Jain, Umang;Salgado, Christopher;Mioton, Lauren;Rambachan, Aksharananda;Kim, John Y.S.
    • Archives of Plastic Surgery
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    • v.41 no.2
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    • pp.116-121
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    • 2014
  • Background Understanding risk factors that increase readmission rates may help enhance patient education and set system-wide expectations. We aimed to provide benchmark data on causes and predictors of readmission following inpatient plastic surgery. Methods The 2011 National Surgical Quality Improvement Program dataset was reviewed for patients with both "Plastics" as their recorded surgical specialty and inpatient status. Readmission was tracked through the "Unplanned Readmission" variable. Patient characteristics and outcomes were compared using chi-squared analysis and Student's t-tests for categorical and continuous variables, respectively. Multivariate regression analysis was used for identifying predictors of readmission. Results A total of 3,671 inpatient plastic surgery patients were included. The unplanned readmission rate was 7.11%. Multivariate regression analysis revealed a history of chronic obstructive pulmonary disease (COPD) (odds ratio [OR], 2.01; confidence interval [CI], 1.12- 3.60; P=0.020), previous percutaneous coronary intervention (PCI) (OR, 2.69; CI, 1.21-5.97; P=0.015), hypertension requiring medication (OR, 1.65; CI, 1.22-2.24; P<0.001), bleeding disorders (OR, 1.70; CI, 1.01-2.87; P=0.046), American Society of Anesthesiologists (ASA) class 3 or 4 (OR, 1.57; CI, 1.15-2.15; P=0.004), and obesity (body mass index ${\geq}30$) (OR, 1.43; CI, 1.09-1.88, P=0.011) to be significant predictors of readmission. Conclusions Inpatient plastic surgery has an associated 7.11% unplanned readmission rate. History of COPD, previous PCI, hypertension, ASA class 3 or 4, bleeding disorders, and obesity all proved to be significant risk factors for readmission. These findings will help to benchmark inpatient readmission rates and manage patient and hospital system expectations.