Background: The aim of this post hoc analysis of a large cohort study was to evaluate the association between night-time surgery and the occurrence of intraoperative adverse events (AEs) and postoperative pulmonary complications (PPCs). Methods: LAS VEGAS (Local Assessment of Ventilatory Management During General Anesthesia for Surgery) was a prospective international 1-week study that enrolled adult patients undergoing surgical procedures with general anaesthesia and mechanical ventilation in 146 hospitals across 29 countries. Surgeries were defined as occurring during 'daytime' when induction of anaesthesia was between 8:00 AM and 7:59 PM, and as 'night-time' when induction was between 8:00 PM and 7:59 AM. Results: Of 9861 included patients, 555 (5.6%) underwent surgery during night-time. The proportion of patients who developed intraoperative AEs was higher during night-time surgery in unmatched (43.6% vs 34.1%; P<0.001) and propensity-matched analyses (43.7% vs 36.8%; P¼0.029). PPCs also occurred more often in patients who underwent night-time surgery (14% vs 10%; P¼0.004) in an unmatched cohort analysis, although not in a propensity-matched analysis (13.8% vs 11.8%; P¼0.39). In a multivariable regression model, including patient characteristics and types of surgery and anaesthesia, night-time surgery was independently associated with a higher incidence of intraoperative AEs (odds ratio: 1.44; 95% confidence interval: 1.09e1.90; P¼0.01), but not with a higher incidence of PPCs (odds ratio: 1.32; 95% confidence interval: 0.89e1.90; P¼0.15). Conclusions: Intraoperative adverse events and postoperative pulmonary complications occurred more often in patients undergoing night-time surgery. Imbalances in patients' clinical characteristics, types of surgery, and intraoperative management at night-time partially explained the higher incidence of postoperative pulmonary complications, but not the higher incidence of adverse events. Clinical trial registration: NCT01601223.
Aim: The aim of this article is to determine the possible correlation between the smoking habit and the incidence of basocellular skin cancer (BCC). Patients and methods: The prospective study, which lasted from June 2012 to June 2018, included subjects diagnosed with basocellular skin cancer (BCC). Respondents were divided into 3 groups. The first, group A (21 respondents), are respondents who smoke 20-35 cigarettes a day. The second, group B (19 respondents), consists of respondents who smoke 35-50 cigarettes a day. The third, group C (91 respondents), consist of non-smokers. Observed parameters are sex, age, current and previous smoking habits, including duration (total smoking year) and intensity (average number of cigarettes smoked per day), age at the start of smoking, and prolonged exposure to the sun. Results: No statistically significant relationship was found between smoking and BCC frequency. It was shown that with BCC of the skin was more affected those who did not smoke. There is no clear relationship between the duration of smoking and/or the amount of smoking and the development of BCC, and it follows that this relationship is not likely to be causative. A suggestive, but not significant, evidence of relationship between smoking and skin cancer is found at this time. Conclusion: Since it is a conglomerate of possible etiological factors, further research is needed to definitively clarify the effect of tobacco consumption on the development of BCC by monitoring a larger number of respondents over a longer period of time in large prospective studies. In any case, a possible association with skin cancer is a reason to avoid smoking.
A prospective study, which lasted from September 2014 to October 2016, covered the subjects who were examined for various benign tumor changes on the skin. The examinees were divided into 2 groups. The first group A (92 examinees) was composed of the examinees who inhabited a rural area. The second group B (98 examinees) was consisted of examinees who lived in an urban environment. The analyzed examinees gravitate towards rural and urban areas of Banja Luka, Gradiska, Stanari, Prijedor and Teslic in Bosnia and Herzegovina. The aim of this study is to analyze the attitude of examinees from rural and urban areas towards skin tumors. Parameters that were used for comparison of results are: personal attitude to skin tumors and previous skin examinations. There was no statistically significant difference in terms of prejudices among the respondents: that there is no risk of skin cancer, if a person is not exposed to the sun, and/or if changes in the skin are innate, as well as in the number of examinees who said they were not afraid of a skin tumor. In group A the number of examinees that have no opinion about skin tumors is three times higher, while in group B the number of examinees who said that they had a phobia of skin cancer is three times higher. It turned out that regular self-examination of the skin in group A is performed only by 7 (7.6%) examinees, while in group B it is done by 21 (21.5%) examinees, which proved to be statistically significantly different. Occasionally skin examination by a specialist family doctor (and/or a dermatologist) has been performed by 3 (3.3%) examinees of group A and 10 (10.3%) from group B. 4 (4.1%) examinees from group B and no one from group A perform dermoscopic examination occasionally. It was found that regular dermoscopy inspections or skin examinations by a specialist family doctor and/or dermatologist have not been done by any examinees from both analyzed groups. Attitude toward skin tumors of group A is more leisurely (less responsible), so for that group there is a possibility of higher risk degree for late diagnosis of malignant skin tumors.
The prospective study, which ran from January 2010 to January 2015, included the respondents treated for breast carcinoma. The respondents were divided into 3 groups. The first, the A group (63 respopndents), consists of women with (not) completed elementary school. The second, group B (60 resppondents), consists of women who have secondary education, while the third, group C (33 respondents) make women with college or university degrees. The aim is to analyze the impact of the level of education on early diagnosis of breast carcinoma in women. The observed parameters are the age of respondents and the primary risk factors. Parameters for the comparison of the results were: the attitude of the respondents to breast tumors, history of the breast self-examination, breast ultrasound examinations, data on mammography, as well as information on the diameter of the tumor at the moment of the discovery. There was no statistical difference in attitude of respondents about breast tumors when it comes to fear and / or phobia of breast carcinoma. It is almost identical to the number of respondents who have no opinion on breast tumors. Concerning the attitude of respondents that there is no risk of breast carcinoma, if nobody in the family previously had breast carcinoma, then in terms of the attitude that they do not want "their breasts to be explored", as well as the attitude that "any breast examination does not help much", a statistical difference between the studied groups was found. It was found that breast self-examination is performed by most of the respondents, but that patients in group C do it more often. It has been shown that ultrasound and mammography are more often performed by patients in group C and this characteristic makes a significant statistical difference. In Group C, the tumor was detected in diameter to 2 cm which proved statistically different. One of the reasons for early detection of tumors (diameter to 2 cm) in group C may be better enlightenment or a higher level of education of this group.
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