• 제목/요약/키워드: the mortality index

검색결과 448건 처리시간 0.035초

Thromboprophylaxis in Abdominoplasty: Efficacy and Safety of a Complete Perioperative Protocol

  • Marangi, Giovanni Francesco;Segreto, Francesco;Poccia, Igor;Campa, Stefano;Tosi, Daniele;Lamberti, Daniela;Persichetti, Paolo
    • Archives of Plastic Surgery
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    • 제43권4호
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    • pp.360-364
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    • 2016
  • Background Venous thromboembolism, a spectrum of diseases ranging from deep venous thrombosis to pulmonary embolism, is a major source of morbidity and mortality. The majority of cases described in plastic surgery involve abdominoplasty. Risk assessment and prophylaxis are paramount in such patients. General recommendations were recently developed, but the evidence in the literature was insufficient to prepare exhaustive guidelines regarding the medication, dosage, timing, or length of the prophylaxis. Methods A thromboprophylaxis protocol was developed for patients undergoing abdominoplasty. The protocol consisted of preoperative, intraoperative, and postoperative measures. Enoxaparin was administered as chemoprophylaxis in selected patients. The study involved 253 patients. The patients were analyzed for age, body mass index, enoxaparin dosage, risk factors, and complications. Results Deep venous thrombosis was documented in two cases (0.8%). No pulmonary embolism occurred. Three patients (1.2%) presented mild subcutaneous abdominal hematoma within the first postoperative week that spontaneously resorbed with neither aesthetic nor functional complications. Two patients (0.8%) presented severe hematoma requiring surgical re-intervention for drainage and hemostasis revision. Statistical analysis showed no significant correlation between enoxaparin dosage and hematoma (P=0.18) or deep venous thrombosis (P=0.61). Conclusions The described thromboprophylaxis protocol proved to be effective in the prevention of thrombotic events, with an acceptable risk of hemorrhagic complications. Furthermore, it provides new evidence regarding the currently debated variables of chemoprophylaxis, namely type, dosage, timing, and length.

Clinical Midterm Results of Surgical Aortic Valve Replacement with Sutureless Valves

  • Soonchang Hong;Jung-Woo Son;Yungjin Yoon
    • Journal of Chest Surgery
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    • 제57권3호
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    • pp.255-262
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    • 2024
  • Background: Sutureless aortic valves may enable shorter procedure times, which benefits patients with elevated surgical risk. We describe the outcomes of patients with aortic stenosis who underwent aortic valve replacement (AVR) using the sutureless Perceval aortic bioprosthesis. Methods: Data from a retrospective cohort were obtained from a clinical database. The study enrolled patients with symptomatic severe aortic stenosis who underwent surgical AVR with a sutureless bioprosthesis between August 2015 and December 2020. In total, 113 patients were included (mean age, 75.3±8.4 years; 57.5% women; median Society of Thoracic Surgeons score, 9.7%; mean follow-up period, 51.19±20.6 months). Of these patients, 41 were octogenarians (36.2%) and 3 were nonagenarians (2.6%). Transthoracic echocardiography was employed to assess changes in ejection fraction (EF), left ventricular mass index (LVMI), and mean pressure gradient (MPG). Results: The in-hospital mortality rate was 2.6%, and 13 patients developed new-onset atrial fibrillation. A permanent pacemaker was implanted in 3 patients (2.6%). The median intensive care unit stay was 1 day (interquartile range [IQR], 1-2 days), and the median hospital stay was 12 days (IQR, 9.5-15 days). The overall survival rate at 5 years was 95.9%. LVMI and MPG were reduced postoperatively, while EF increased over the follow-up period. No structural valve deterioration was observed, and no meaningful paravalvular leakage developed during follow-up. Conclusion: The use of a sutureless valve in the aortic position is safe and feasible, even for high-risk elderly patients requiring surgical AVR. LVMI and MPG decreased postoperatively, while EF increased over the follow-up period.

지역사회 획득 폐렴환자의 중증도 평가에서 혈청 코티졸의 유용성 (Usefulness of Serum Cortisol in Assessment for the Severity of Community-Acquired Pneumonia)

  • 윤경화;김연재;김미영;김은영;배명남;배상묵;김민수;박훈표
    • Tuberculosis and Respiratory Diseases
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    • 제69권6호
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    • pp.450-455
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    • 2010
  • Background: High cortisol levels are frequently observed in patients with severe infections are of prognostic value in sepsis. The aim of this study was to evaluate the clinical usefulness of serum cortisol in assessment for the severity of community-acquired pneumonia (CAP). Methods: This study analyzed the results of 52 CAP subjects admitted in Changwon Fatima Hospital between July 2008 to May 2010. Total serum cortisol, infection markers such as C-reactive protein (CRP), procalcitonin (PCT) and CURB (Confusion, Uremia, Respiratory rate, Blood pressure)-65 were examined retrospectively. Results: In clinically unstable subjects on admission day 4, baseline serum cortisol, CURB-65, and CRP were elevated significantly compared to those of stable subjects. Area under curve (AUC) of cortisol, CRP, and CURB-65 from ROC curves were 0.847, 0.783, and 0.724 respectively. In the subjects with serum cortisol ${\geq}22.82{\mu}g/dL$, CRP, PCT, CURB-65 score, and mortality were significantly elevated. Conclusion: These findings suggest that measurement of serum cortisol in early stage may provide helpful information in the assessment of CAP severity.

국민건강보험공단 청구자료를 활용한 파킨슨병과 관련된 코호트 연구 디자인 분석 및 향후 한의중재 관련 파킨슨 후향적 코호트 연구를 위한 제언 (Current Research Status of National Health Insurance Database Studies in Korea Related to Parkinson's Disease and Future Research Proposals for Integrative Therapies)

  • 황예채;임정태
    • 대한예방한의학회지
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    • 제28권1호
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    • pp.69-87
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    • 2024
  • Objectives : This study is to investigate the current National Health Insurance Database cohort studies related to complications of Parkinson's Disease (PD) and suggest the design of Korean medical epidemiological studies of PD. Methods : Nationwide longitudinal studies of PD patients in South Korea were collected through Pubmed and the Korea Citation Index (KCI). We selected cohort studies that used the National Health Insurance Database in Korea and targeted Parkinson's disease patients. Studies published before February 2024 were categorized according to study designs. We examined variables and covariates, enroll dates and matching methods. Results : Of a total of 536 studies, 18 studies met the inclusion criteria. All studies used the National Health Insurance (NHI) Research Database and among them, 5 used sample data and one senior database. Studies can be classified into two types. 11 cohort studies were comparing PD patients and non-PD patients. Another type was 4 PD patients cohort studies. Most studies used two diagnostic codes (G20 and V124) for inclusion criteria. Enroll periods were from 2002 to 2017, and follow-up periods were from 7 to 14 years. 16 studies considered age and sex as covariates. 15 studies used the propensity score matching method to increase the level of causality. There was only one study related to the Korean medical treatment. Conclusion : In future cohort studies on Korean medical treatment, more attempts should be made to reveal the effect of the treatments on PD patients by defining inclusion criteria for patient groups, covariates, exposure variables, and assessment indicators more operatively.

관상어로부터 분리한 Megalocytiviruses에서 나타나는 ORF25 유전자 부위의 반복서열 특성 분석 (Characterization of the Repetitive Sequences Present in the ORF25 Genomic Region of Megalocytiviruses from Ornamental Fishes)

  • 진지웅;남정희;김광일;홍수희;변주영;정현도
    • 한국수산과학회지
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    • 제44권4호
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    • pp.352-358
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    • 2011
  • The presence of ISKNV-like viruses in various freshwater ornamental fish species imported from Asia was confirmed by polymerase chain reaction(PCR) amplification of the ATPase(adenosine triphosphatase) gene. Interestingly, molecular analyses of the Open Reading Frame 25(ORF25) region of these isolates based on the ISKNV(Infectious spleen and kidney necrosis virus) genome revealed the presence of various repetitive sequences. ORF25 repeat sequence length had no effect on cumulative mortality of rock bream Oplegnathus fasciatus challenged with tissue homogenates of infected pearl gourami, Trichogaster leeri; silver gourami, Trichogaster microlepis; blue gourami, or Trichogaster trichopterus. All isolates induce cumulative mortalities after 12 days of infection, confirming that ORF25 polymorphism did not affect the pathogenicity of ornamental fish megalocytiviruses that cross infect rock bream, a seawater fish. Also, no statistically significant differences in spleen index or viral copy number in infected tissues was detected between isolates with varying ORF25 repeat sequence lengths. However, further studies are necessary to fully characterize the functional characteristics of these polymorphisms in megalocytivirus disease in ornamental fishes.

Can the Serum Level of Myostatin be Considered as an Informative Factor for Cachexia Prevention in Patients with Medullary Thyroid Cancer?

  • Hedayati, Mehdi;Nozhat, Zahra;Hannani, Masoomeh
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권sup3호
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    • pp.119-123
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    • 2016
  • Thyroid cancer, the most common endocrine neoplasia, consists of four main types of carcinomas: papillary, follicular, and anaplastic, all with thyroid follicular origin, and medullary thyroid cancer (MTC) related to para-follicular cells. Cronic diseases such as diverse cancers may be associated with cachexia, especially at advanced stage. Cancer-induced cachexia is associated with diminished quality of life, functional performance, reduced response to antitumor therapy, and increased morbidity and mortality. Myostatin (Mst) is one of the outstanding molecules in the skeletal muscle loss process in cancer and it may be released by both skeletal muscle and cachexia-inducing tumors. Recently changes in serum levels of Mst have been identified as an important factor of cancer-induced cachexia. The goal of this study was to assessserum Mst levels in MTC patients. In this descriptive and case-control study, 90 participants were selected, comprising 45 MTC patients (20 males, $29{\pm}13.9years$, 25 females, $29{\pm}14.5years$) and 45 control individuals (25 males, $23.1{\pm}11.6years$, 20 females, $31.5{\pm}14.4years$). Serum Mst was determined using an ELISA kit and body mass index (BMI) was calculated by weight and height measurements. The Kolmogorov Simonov test showed a normal distribution for log transformed Mst serum levels in both case and control groups. Geometric means were 5.9 and 8.2 ng/ml respectively, and a significant difference was found according to the independent t-test results (P<0.01). There was also a significant difference mean of Mst between females in control and MTC groups, but not for the males. Pearson correlation test showed no correlation between age and BMI with Mst serum levels. The findings of this study support the hypothesis that Mst serum levels may have a potential ability for early diagnosis of cachexia in MTC patients, especially in females.

A Case of Renal Cortical Necrosis in a 15-year-old Boy with Acute Kidney Injury

  • Lee, Mi-ji;Yim, Hyung Eun;Yoo, Kee Hwan
    • Childhood Kidney Diseases
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    • 제23권1호
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    • pp.53-57
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    • 2019
  • Renal cortical necrosis (RCN) is patchy or diffuse ischemic destruction of the renal cortex caused by significantly reduced renal arterial perfusion. It is a rare cause of acute kidney injury (AKI) and is associated with high mortality. Here, we review the case of RCN in a 15-year-old boy who developed AKI. A 15-year-old boy was referred to our hospital from a local hospital due to a sharp decrease in his renal function. He presented with acute flank pain, nausea with vomiting, and oliguria for the past two days. He had taken a single dose of antihistamine for nasal congestion. At our hospital, his peak blood pressure was 148/83 mmHg and he had a high body mass index of $32.9kg/m^2$. The laboratory data showed a blood urea nitrogen (BUN) of 28.4 mg/dL, a creatinine of 4.26 mg/dL, and a glomerular filtration rate estimated from the serum cystatin C of $20.2mL/min/1.73m^2$. Proteinuria (spot urine protein to creatinine ratio 1.66) with pyuria was observed. Kidney sonography showed parenchymal swelling and increased renal echogenicity. Due to rapidly progressing nephritis, steroid pulse therapy (750 mg/IV) was done on the second day of his admission and the patient showed complete recovery with normal renal function. However, the kidney biopsy findings revealed renal cortical hemorrhagic necrosis. Multifocal, relatively well-circumscribed, hemorrhagic necrotic areas (about 25%) were detected in the tubulointerstitium. Although RCN is an unusual cause of AKI, especially in children, pediatricians should consider the possibility of RCN when evaluating patients with rapidly decreasing renal function.

한국인의 이상지질혈증 발생 위험 요인 및 약물복용이행 영향 요인 평가: 2013-2015 국민건강영양조사 자료 이용 (Risk Factors of Dyslipidemia and Related Factors of Medication Adherence in Korea Adults: KNHANES 2013-2015)

  • 전미양;최원희;서영미
    • Journal of Korean Biological Nursing Science
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    • 제19권3호
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    • pp.131-140
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    • 2017
  • Purpose: Dyslipidemia was a known risk factor for cardiovascular disease and was a leading cause of mortality in worldwide. This study aimed to determine the factors associated with prevalence and medication treatment of dyslipidemia in Korean adult population. Methods: In this study, based on the criteria set by the Korean Society of Lipidology and Atherosclerosis, the factors associated with prevalence and medication treatment of dyslipidemia was evaluated in a population of 12,506 people ($age{\geq}20$), who participated in the Korean National Health and Nutrition Examination Survey (2013-2015). The findings were tested by using multivariate logistic regression. Results: Dyslipidemia prevalence rate was 36.5%. Among populations with dyslipidemia, 17.5% were treated with lipid-lowering drugs. In the multivariate logistic regression model, male, increase in age, lower education level, non-drinker, current smoking, less physical activity, increase of body mass index, hypertension, and diabetes were associated with an increased odd of dyslipidemia. Female, increase in age, higher income, excess fat intake, hypertension, diabetes, myocardial infarction, and angina were associated with an increased odd of medication treat. Conclusion: The results of this study could be used to screen patients at the high risk for dyslipidemia or to predict medication adherence.

Sex-Biased Molecular Signature for Overall Survival of Liver Cancer Patients

  • Kim, Sun Young;Song, Hye Kyung;Lee, Suk Kyeong;Kim, Sang Geon;Woo, Hyun Goo;Yang, Jieun;Noh, Hyun-Jin;Kim, You-Sun;Moon, Aree
    • Biomolecules & Therapeutics
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    • 제28권6호
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    • pp.491-502
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    • 2020
  • Sex/gender disparity has been shown in the incidence and prognosis of many types of diseases, probably due to differences in genes, physiological conditions such as hormones, and lifestyle between the sexes. The mortality and survival rates of many cancers, especially liver cancer, differ between men and women. Due to the pronounced sex/gender disparity, considering sex/gender may be necessary for the diagnosis and treatment of liver cancer. By analyzing research articles through a PubMed literature search, the present review identified 12 genes which showed practical relevance to cancer and sex disparities. Among the 12 sex-specific genes, 7 genes (BAP1, CTNNB1, FOXA1, GSTO1, GSTP1, IL6, and SRPK1) showed sex-biased function in liver cancer. Here we summarized previous findings of cancer molecular signature including our own analysis, and showed that sex-biased molecular signature CTNNB1High, IL6High, RHOAHigh and GLIPR1Low may serve as a female-specific index for prediction and evaluation of OS in liver cancer patients. This review suggests a potential implication of sex-biased molecular signature in liver cancer, providing a useful information on diagnosis and prediction of disease progression based on gender.

사료내 다양한 첨가제가 넙치 (Paralichthys olivaceus) 치어의 성장 및 비특이적 면역반응에 미치는 영향 (Effects of Dietary Inclusion of Various Additives on Growth Performance and Immune Responses in Juvenile Olive Flounder(Paralichthys olivaceus))

  • 김강웅;김경덕;이봉주;이진혁;배승철;최윤희;한현섭
    • 수산해양교육연구
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    • 제25권6호
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    • pp.1285-1293
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    • 2013
  • This study was conducted to investigate the effects of dietary inclusion of various additives Solid sulfur, fucoidan, and glucan on growth performance and immune responses in Juvenile olive flounder paralichthys olivaceus. Six experimental diets supplemented with : no additives (CON); 0.5 and 1.0% solid sulfur (S); 0.2 and 0.4% fucoidan (F); 0.1% glucan (G) of these additives diet on a dry-matter basis. Fish averaging $8.2{\pm}0.17g$ were fed one of six experimental diets in triplicate groups for 6 weeks. By the end of the feeding trial, weight gain, feed efficiency, specific growth rate, protein efficiency ratio, hepatosomatic index and condition factor of fish fed diet CON were significantly lower then those of fish fed the all additives diets (P < 0.05). In challenge test, fish were infected by intraperitonel injection of 0.1 ml bacterial suspension with Edwardsiella tarda per fish after the feeding trial. As a result fish fed All additive diet showed a lower cumulative mortality then did fish fed CON diet throughout the challenge test. In conclusion, these results indicated that solid sulfur, fucoidan and glucan enhanced the growth, feed efficiency and non-specific immune activity of juvenile flounder and protect the fish against microbial infections.