Unexpected outcome from Trousseau syndrome

Thrumurthy, Sri G.; Anuruddha, Abeyratne H M P; Zoysa, Merrenna Ishan Malith De; Samarasekera, Dharmabandhu Nandadeva

doi:10.1186/1471-2482-11-1

Cited by 10 publications

(8 citation statements)

References 13 publications

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“…A controlled, prospective, randomized clinical trial was carried out based on our previously published study protocol [ 14 ], following approval from the Human Research Ethics Committee of the Universidade Nove de Julho(Brazil) under protocol number 220506/2009. This study is registered with the World Health Organization (Universal Trial Number: U1111-1121-8873) and the Brazilian Registry of Clinical Trials (RBR-9k9hhv).…”

Section: Methodsmentioning

confidence: 99%

Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial

Aguiar

Freitas

Santos

et al. 2014

Multidiscip Respir Med

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BackgroundThe increasing prevalence of obesity in both developed and developing countries is one of the most serious public health problems and has led to a global epidemic. Obesity is one of the greatest risk factors of obstructive sleep apnea (OSA), which is found in 60 to 70% of obese patients mainly due to the buildup of fat tissue in the upper portion of the thorax and neck. The aim of the present randomized clinical trial is to assess daytime sleepiness, sleep architecture and pulmonary function in patients with severe obesity before and after bariatric surgery.MethodsThis randomized, controlled trial, was designed, conducted, and reported in accordance with the standards of The CONSORT (Consolidated Standards of Reporting Trials) Statement. Patients were divided into a bariatric surgery group and control group. The clinical evaluation was performed at the Sleep Laboratory of the Nove de JulhoUniversity (Sao Paulo, Brazil) and consisted of the collection of clinical data, weight, height, body mass index (BMI), measurements of neck and abdomen circumferences, spirometry, maximum ventilatory pressure measurements, standard overnight polysomnography (PSG) and the administration of the Berlin Questionnaire and Epworth Sleepiness Scale.ResultsFifty-two patients participated in the present study and performed PSG. Out of these, 16 underwent bariatric surgery. After surgery, mean BMI decreased from 48.15 ± 8.58 to 36.91 ± 6.67 Kg/m2. Significant differences were found between the preoperative and postoperative periods regarding neck (p < 0.001) and waist circumference (p < 0.001), maximum inspiratory pressure (p = 0.002 and p = 0.004) and maximum expiratory pressure (p = 0.001 and p = 0.002) for women and men, respectively, as well as sleep stage N3 (p < 0.001), REM sleep (p = 0.049) and the apnea-hypopnea index (p = 0.008).ConclusionsBariatric surgery effectively reduces neck and waist circumference, increases maximum ventilatory pressures, enhances sleep architecture and reduces respiratory sleep disorders, specifically obstructive sleep apnea, in patients with severe obesity.Trial registrationThe protocol for this study was registered with the World Health Organization (Universal Trial Number: U1111-1121-8873) and Brazilian Registry of Clinical Trials – ReBEC (RBR-9k9hhv).

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Section: Methodsmentioning

confidence: 99%

Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial

Aguiar

Freitas

Santos

et al. 2014

Multidiscip Respir Med

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“…10 In addition to their clinical evidence, adhesions are a major cost factor in health care. 17 If adhesions necessitate surgery, they reoccur in 55 to 100% of patients postsurgically, with an average of approximately 85%. 5 The predominant locations of reoccurrence are the former sites of adhesiolysis.…”

Section: Discussionmentioning

confidence: 99%

“…The treatment of adhesion-related complications contributes substantially to health care costs. In the U.S. adhesiolysis-related costs were estimated to be as much as U.S. $2.3 billion in 2005, 17 corresponding to approximately U.S. $600 million translated to Germany. In a smaller Swedish study comprising 102 patients operated for SBO, there were 273 episodes of SBO with 237 readmissions and 47% of episodes resulting in further surgery within a mean follow-up of 14 years.…”

mentioning

confidence: 99%

Significant Adhesion Reduction with 4DryField PH after Release of Adhesive Small Bowel Obstruction

Ahmad¹,

Crescenti²

2019

Surg J

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Background Peritoneal adhesions reoccur in up to 100% of cases, possibly causing complications like pain, secondary female infertility, and small bowel obstruction. The latter has a mortality rate of up to 15% during hospitalization. This study investigates if recurrence of peritoneal adhesions can be prevented by prophylactic use of the starch-based medical device 4DryField. Methods The course of 40 patients with surgery for intestinal obstruction and, partially, second intervention was analyzed. In both operations, adhesion severity and extent were scored 0 (no adhesions) to III (massive/dense and vascular adhesions) and 0 (no adhesions) to III (extensive, covering more than approximately 25 × 25 cm), respectively. To prevent recurrence of adhesions all patients were treated with 4DryField gel (60 mL saline solution per 5 g powder), evenly distributed on the whole impaired intestine (including anastomoses) before abdominal closure. Follow-up was up to 1.5 years in a 3 to 6 months' interval. Results Eight patients had relaparotomies on postoperative days 1 to 155. In the first operation, median adhesion severity score was III, median adhesion extent II. In redo-surgeries, significantly lower scores were detected (median adhesion severity: 0, p = 0.0003; median adhesion extent: 0, p = 0.0009). No adverse events related to the product were observed. One patient had later redo-surgery in another hospital due to recurrence of adhesions, one patient suffered from flatulence. All other patients were free of adhesion-related symptoms during follow-up. Conclusion Based on the high severity of diseases and the significant reduction of adhesion severity and extent in redo-surgeries, 4DryField gel is a promising adjunct for adhesion prevention in bowel surgery. The favorable results should be confirmed in prospective randomized trials.

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“…3 Lack of transport and employment obstacles as reasons for LTFU are supported by a number of other studies conducted in South Africa and Mozambique. 3 ,14, 15 …”

Section: Discussionmentioning

confidence: 99%

Factors associated with retention in HIV care at Sediba Hope Medical Centre

Ramdas

Meyer

Cameron

2015

South. Afr. j. HIV med.

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BackgroundLost to follow-up (LTFU) is a major challenge that hinders the success of antiretroviral treatment (ART).ObjectiveTo identify factors conducted to a low LTFU rate.MethodsWe conducted a two-part descriptive and quantitative study. Part 1 comprised interviews with clinic staff to determine their perspectives on LTFU and to establish the clinic’s follow-up procedures for patients on ART. Part 2 of the study was a retrospective review of clinic and patient records. LTFU patients were identified and those with contact details were contacted for telephonic interview to determine if they were still on ART and/or their reasons for becoming LTFU.ResultsA low LTFU rate (7.9%; N = 683) was identified. Work-related stress, and lack of transport and funds were reported reasons for LTFU. Monthly visits, non-adherent defaulters and LTFU patients were tracked by an electronic system (SOZO). Factors contributing to high rates of retention in care were: location of the clinic in the inner city, thus in close proximity to patients’ homes or work; clinic operating on Saturdays, which was convenient for patients who could not attend during the week; an appointment/booking system that was in place and strictly adhered to; a reminder SMS being sent out the day before an appointment; individual counselling sessions at each visit and referrals where necessary; and a stable staff complement and support group at the clinic.ConclusionAchieving a low LTFU rate is possible by having a patient-centred approach and monitoring systems in place.

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Unexpected outcome from Trousseau syndrome

Cited by 10 publications

References 13 publications

Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial

Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial

Significant Adhesion Reduction with 4DryField PH after Release of Adhesive Small Bowel Obstruction

Factors associated with retention in HIV care at Sediba Hope Medical Centre

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