SciCombinator

Discover the most talked about and latest scientific content & concepts.

Concept: Complication

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Background and purpose - Increasing numbers of shoulder arthroplasty are performed internationally. The predictors of intraoperative complications when implanting primary shoulder replacements are unknown. We determined the incidence of intraoperative complications during primary shoulder arthroplasty using the National Joint Registry of England, Wales, Northern Ireland and the Isle of Man (NJR), and analyzed the associated risk factors for complications. Patients and methods - NJR data on primary shoulder arthroplasty were scrutinized for intraoperative complications. 2 analyses were performed: the first examined the incidence and predictors of any recorded complication; the second examined the incidence and predictors for intraoperative fractures specifically. Analysis of risk factors was performed using multivariable binary logistic regression modeling. Results - 12,559 primary shoulder arthroplasties were recorded, with an intraoperative complication rate of 2.5%, the majority being fractures (1.6% overall). The incidence of all complications was lower in men (RR vs. women =0.63 (95% CI 0.47-0.84)). Patients undergoing surgery for avascular necrosis (RR =2.3 (1.3-4.2)) or trauma sequelae (RR =1.6 (1.2-2.7)) had a higher risk of complications compared with OA. Patients undergoing a stemmed hemiarthroplasty (RR =1.8 (1.2-2.5)) and reverse shoulder arthroplasty (RR 1.6 (1.1-2.5)) had a higher risk of complications compared with total shoulder arthroplasty. The incidence of all complications was less in patients undergoing resurfacing arthroplasty (vs. total shoulder arthroplasty (RR 0.42 (0.24-0.73)) and when performing the superior approach (vs. deltopectoral (RR 0.56 (0.39-0.80)). Interpretation - This is the first study to use a national data set to examine risk factors for intraoperative complications during all types of primary shoulder arthroplasty, and identifies several previously unrecognized risk factors, such as surgical approach.

Concepts: Regression analysis, Logistic regression, Avascular necrosis, Sequela, Late effect, Order theory, Complication, Isle of Man

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Despite all advances regarding the surgical treatment of gastric cancer (GC), duodenal stump fistula (DF) continues to negatively affect postoperative outcomes. This study aimed to assess DF regarding its incidence, risk factors, management and impact on overall survival.

Concepts: Epidemiology, Evaluation methods, Stomach, Peptic ulcer, Duodenum, Complication, Gastrectomy

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Ureteral injury represents an uncommon but potentially morbid complication surgical complication. This study sought to characterize the complications of iatrogenic ureteral injury and assess the effect of recognized vs delayed recognition on patient outcomes.

Concepts: Iatrogenesis, Complication

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External ventricular drain (EVD) placement is a common neurosurgical procedure used to control acute hydrocephalus and other neurosurgical complications. The infection and complication rates reported in the literature are highly variable and iatrogenic factors determine the outcome of drain placement. We examined the impact of the setting of the EVD placement (ED vs. ICU vs. OR) and the experience of the operating surgeon on the infection rate, complication rate, EVD replacement, eventual placement of VP shunt and need for further surgical intervention.

Concepts: Surgery, Rates, Neurosurgery, Hydrocephalus, Outcome, Reaction rate, Iatrogenesis, Complication

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Iatrogenic urethral lesion with subsequent cuff erosion during cystoscopy is a rare complication. The alternative surgical strategy with in situ urethroplasty while maintaining the open cuff left in situ will be presented.

Concepts: Medicine, Medical terms, In situ, The Alternative, Complication

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Gossypiboma and textiloma are terms used to describe tumor-like masses caused by retained gauze or surgical sponges after any operation. It is a rare surgical complication, usually difficult to diagnose due to its variable clinical presentation and nonstandard radiological appearance. We describe here a rare case of orbital gossypiboma in a child after surgical correction of an orbital blowout fracture.

Concepts: Medical terms, Mass, Tourism, Complication

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Sinus membrane thickness has been associated with the incidence of membrane perforation during the sinus elevation procedure. Understanding the sinus membrane thickness is essential for prevention of this specific surgical complication. Therefore, the aim of this retrospective study was to investigate the impact of sex, age, and season on the membrane thickness.

Concepts: Complication

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Iatrogenic injury to the trochlea is a potential complication of the Draf III or endoscopic modified Lothrop procedure; however, the location of the trochlea from within the sinus cavity has yet to be clearly characterized. We performed the first cadaveric study assessing the position of the trochlea in relation to the first olfactory neuron, a commonly identified landmark during the Draf III procedure.

Concepts: Medicine, Iatrogenesis, Complication

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Fever and neutropenia (FN) clinical decision rules (CDRs) are recommended to help distinguish children with cancer at high and low risk of severe infection. The aim of this study was to validate existing pediatric FN CDRs, designed to stratify children with cancer at high or low risk of serious infection or medical complication.

Concepts: Medicine, Disease, Infectious disease, Validation, Avicenna, ARIA Charts, Iatrogenesis, Complication

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Iatrogenic lip injury is a rather common complication after facial bone surgery, but is usually treated lightly by the surgeon compared with other more severe functional complications. However, these injuries can have permanent sequelae and can therefore be a reason for patient dissatisfaction, especially after cosmetic surgery. Intraoperative lip injuries during facial bone surgery are usually caused by heat-generating surgical instruments or forced traction on the operative fields. The authors have applied a special technical strategy using a hydrocolloid dressing material to avoid these intraoperative lip injuries. This method does not disturb the operative procedure itself, but efficiently prevents lip injuries and decreases surgical morbidities and postoperative swelling.

Concepts: Hospital, Surgery, Physician, Injury, Amputation, Sequela, Iatrogenesis, Complication