In order to determine the incidence of postoperative pulmonary complications (POPC) and the value of preoperative spirometry to predict pulmonary complications after upper abdominal surgery, 24 women and 36 men (total 60 patients) were studied prospectively (mean age 48 center dot 3 years). On the day before the operation and for 15 days after the operation, each patient's respiratory status was assessed by clinical examination, chest radiography, spirometry and blood gas analysis, and patients were monitored for pulmonary complications by a chest physician and a surgeon independently. In this study, postoperative pulmonary complications developed in 21 (35%) patients (pneumonia in 10 patients, bronchitis in nine patients, atelectasis in one patient, pulmonary embolism in one patient). Of 31 patients with abnormal preoperative spirometry, 14 (45 center dot 2%) patients showed complications, whereas among 29 patients with normal preoperative spirometry, 7 (24 center dot 1%) patients showed complications (P <0 center dot 05). The incidence of POPC was higher in patients with advanced age, smoking, preoperative abnormal findings obtained from physical examination of the chest, higher ASA class and longer duration of operation. The sensitivity (0 center dot 76) and specificity (0 center dot 79) of abnormal preoperative findings obtained from physical examination to predict POPC were higher than abnormal preoperative spirometry (0 center dot 67 and 0 center dot 56 retrospectively). There was no significant difference between patients with and without pulmonary complications in regard to weight, serum albumin, type of incision, incidence of abnormal preoperative blood gases and duration of postoperative hospital stay. We conclude that POPC is still a serious cause of postoperative morbidity. Multiple risk factors include preoperative abnormal spirometry responsible for development of POPC. If used alone, spirometry has limited clinical value as a screening test to predict POPC after upper abdominal surgery.

No abstract

No abstract

No abstract

Background Psychogenic non-epileptic seizures (PNES) resemble epileptic seizures and are often misdiagnosed as epilepsy. Objective To investigate the frequency of PNES and to calculate the economic burden of the patients who admitted to video-electroencephalographicmonitoring (VEM) to obtain a diagnosis of epilepsy in order to apply for disability retirement. Methods The present retrospective study included 134 patients who required disability reports between 2013 and 2019 and had their definite diagnoses after VEM. Following VEM, the patients were divided into three groups: epilepsy, PNES, and epilepsy + PNES. Results In total, 22.4% (n = 30) of the patients were diagnosed with PNES, 21.6% (n = 29) with PNES and epilepsy, and 56% (n = 75), with epilepsy. The frequency of PNES among all patients was of 44% (n = 59). In patients with PNES alone, the annual cost of using anti-seizure medication was of 160.67 ± 94.04 dollars; for psychostimulant drugs, it was of 148.3 ± 72.48 dollars a year; and the mean direct cost for diagnostic procedures was of 582.9 ± 330.0 (range: 103.52–1601.3) dollars. Conclusions Although it is challenging to determine the qualitative and quantitative total cost in these patient groups, early diagnosis and sociopsychological support will reduce the additional financial burden on the health system and increase the quality of life of the patients.