Five-year Experience Research Articles

Five-Year Experience of Eviscerations in a District Hospital in Ghana: A Five-Year Experience

Purpose: Destructive eye surgeries have been described as necessary evils. Even though they are important and sometimes life-saving, their psychological impacts on the patients are many. This study sought to determine the prevalence and main indications of evisceration in Our Lady of Grace Hospital in the Asikuma–Odoben-Brakwa District of the Central Region of Ghana.
 Methodology: The mixed method study design was used. A five-year review of all cases of eviscerations from 2012-1016, was conducted. Also, in-depth interviews of 9 patients purposively selected, who had undergone eviscerations during the period under review were conducted. Data analysis was largely descriptive.
 Result: Out of a total of 2996 ocular surgeries conducted within the 5-year period, 101 were eviscerations. This gives a 5-year prevalence of 3.4 per 100 surgeries. Out of the 101 cases of eviscerations, 81 were included in the analysis due to the availability of complete data. The mean age of patients was 50 years (SD 1.53). The majority of patients who underwent eviscerations were 60 years and more. Right (51%) and left (49%) eyes were eviscerated in nearly equal proportion. The occupations of the majority of patients were farmers/fisherfolks (55.6%) and trading (19.8%). Most (76.5%) eviscerations were due to non-trauma-related causes mainly infections (55.6%). The trauma-related indications for evisceration (23.4%) were stick/vegetative materials, stone/particles, and assault.
 Unique Contribution to Theory, Policy and Practice: Eye infections and injuries which are largely preventable were the main causes of eviscerations in this study. Public education to encourage early reporting is needed. The aged should be discouraged from engaging in unprotected manual farm-related activities.

Five-year experience in providing infectious safety of donor blood and its components gained by the blood center of the RT Federal medical-biological agency

Screening technologies aimed at identifying such transfusion transmissible infections (TTI) as hepatitis B and C, HIV-1,2 and syphilis have been developing and this has resulted in increased safety of applied hemotherapy. Our research goal was to analyze detection of infectious markers in donors of the FMBA Blood Center over five years. We examined 167,389 samples of donor blood taken from 53,093 donors of blood and its components by the FMBA Blood Center over the period from 2015 to 2019. Over the whole analyzed period, we detected 1453 infectious-positive samples taken from 1235 donors. Average long-term quantity of detected hepatitis C markers equaled 78.6 ± 9.4; hepatitis B, 49.8 ± 8.2; syphilis, 66.2 ± 16.8; HIV, 52.8 ± 13.2. We also analyzed detected of TTI markers in long-term dynamics and established an ascending trend in a number of syphilis markers (the growth rate was 3.2), hepatitis B (the growth rate was 2.5), and a descending trend in hepatitis C markers (the decrease rate was 3.3) as well as HIV markers (the decrease rate was 1.7). This decrease rate in detection of HIV markers (fall by 1.7) occurred both among first-time and regular donors. At the same time, we revealed growing detection of syphilis markers both among first-time donors where it grew by 3.6 and among regular ones, by 1.4. Frequency of infection markers was higher among first-time donors than among regular ones as per syphilis markers, 2.351 (95 % CI: 1.862–2.938), p < 0.00001; hepatitis B markers, 2.111 (95 % CI: 1.622–2.763), p < 0.00001; hepatitis C markers, 2.107 (95 % CI: 1.708–2.609), p < 0.00001; and HIV, 2.471 (95 % CI: 1.9–3.238), p < 0.00001. Over the last 5 years, there was a descending trend in detection of transfusion transmissible infections among donors regarding HIV and viral hepatitis C excluding tests aimed at detecting syphilis and viral hepatitis B markers.

The optimal approach of EBUS-FNA rapid on-site evaluation (ROSE): a five-year experience from a large academic medical center.

Rapid on-site evaluation (ROSE) performed during endobronchial ultrasound-guided fine needle aspiration (EBUS-FNA) has shown significant value. However, ROSE may not be available for some pulmonary centers. Performing ROSE can be challenging and stressful due to time constrains for preparing, staining and reviewing the cytology slides between passes. A retrospective cytology report review of EBUS-FNA procedures performed between October 2014 and May 2019 revealed 516 cases that were included in the study. The number of passes for each procedure was documented. The adequacy rates were assessed at 4 different study points; ≤3 passes, ≤5 passes, at odd passes only, and the even passes only. The study groups results were compared to the overall ROSE and the final cytology adequacy. The overall ROSE interpretation was adequate in 370 (71.7%) and inadequate in 146 (28.3%). After reviewing the Papanicolaou stained slides and cell blocks, the final cytology results were adequate in 473 (91.7%) and inadequate in 43 (8.3%) of the cases. The number of passes per procedure ranged from 1 to 17. Our results showed that ROSE evaluation of the first 5 passes during the EBUS-FNA procedure could achieve the similar adequacy rate compared to the overall ROSE evaluation of all the passes. To achieve the most benefits of ROSE and to reduce the procedure time for EBUS-FNA, we recommend performing ROSE for ≤5 passes depending on the adequacy, and save all additional passes for cell blocks preparation if more than 5 passes are attempted.

Results of a Five-Year Experience in First Trimester Preeclampsia Screening

Background and Objectives: The study aimed to evaluate the ability defining the risk of developing preeclampsia by a screening test carried out in the first trimester (between 11 + 0 and 13 + 6 weeks of gestational age), in order to identify high-risk women requiring more intensive health surveillance. The secondary objective was to evaluate the ability of this test to predict the risk of adverse obstetric outcomes such as fetal growth restriction, intrauterine fetal death, gestational hypertension, HELLP syndrome, placental abruption, and preterm birth. Materials and Methods: This was a single-center study, conducted at the Operative Unit of Obstetrics of the State Hospital of the Republic of San Marino. Medical history was collected at the time of enrolment in writing. Subsequently, obstetric outcomes were collected for each enrolled woman, through the analysis of medical records. Results: From October 2014 to May 2019, 589 pregnant women were recruited, of whom, 474 (80.5%) were included in the “low-risk” group, and 115 (19.5%) in the “high-risk” group. At the time of analysis of this population, the obstetric outcomes were available for 498 women (84.5%), while 91 cases (15.5%) were current pregnancies. The PI of the uterine arteries was not significantly different between the two study groups. Otherwise, a significant difference was highlighted for MAP, which is higher in the case of pregnancies at high risk based on the risk factors only, and for PAPP-A, higher in the case of low-risk pregnancies. Regarding the percentage of fetal DNA, according to the most recent literature data, in our series, we report a statistically significant difference of the average between the low and high-risk groups. Conclusions: In our study, we demonstrate that the multiparametric screening test for early PE performed well in identifying women at high risk of early PE, which certainly has the most severe maternal–fetal outcomes. The data reported that ASA intake at low doses is significantly higher in the population with high-risk tests for both early PE and late PE suggest once again that anamnestic evaluation plays an essential role in women’s screening.

The use of strain-gauge plethysmography in the functional assessment of chronic venous disease: five-year experience at a single centre.

Plethysmography can be used in the diagnosis and evaluation of chronic venous disease in the lower extremities. This study aimed to evaluate the applicability and reliability of strain-gauge plethysmography (SDP) in the functional assessment of chronic venous disease. This descriptive study was conducted between 2016 and 2021 at a single centre. Four hundred and thirty-two patients with symptomatic chronic venous disease were included in the study. All participants were diagnosed initially with Doppler ultrasonography. SGP was then performed to evaluate venous outflow capacity, venous reflux and muscle pump function. The average age was 45.16 ± 12.54 years (median age 46 years; range 20-78 years), and 239 (55.3%) women and 193 (44.7%) men were included in the study. The age groups, diagnosis, pathological distribution and risk factors were quantitatively determined according to gender. Localisation and lateralisation statistics of the pathologies are given. SGP measurements, including venous volume (V), venous emptying (VE), expelled volume ratio in four seconds (EV4/V), half refilling time (t½) and refilling volume (RV) of each lower extremity, were done individually to compare the involved extremity with the normal contralateral side. SGP measurements of each affected lower limb were also compared separately by gender, age group and disease onset. The correlation between t½ values and skin discolouration or oedema of the affected limb was examined. Finally, receiver operating characteristic curve analyses of the V, VE, EV4/V, t½ and RV values were done, and the cut-off values of each parameter were defined accordingly. High reliability and consistent results indicate that SGP is a practical and sensitive test for quantitative functional assessment of patients with chronic venous disease. It can be used as an effective method in diagnosing and following up chronic venous disorders. As there are no currently accepted cut-off values, we suggest that ours can be used as new reference values for SGP measurements.

Clinical outcomes of Enhanced Recovery after Surgery Protocol for Hepato- pancreato- biliary Surgery; A Five-Year Experience from a Hellenic Oncological Hospital ERAS protocol and HPB surgery

Background: The development of enhanced recovery after surgery protocols (ERAS) for surgical intervention has contributed to reducing hospital length of stay and improved patient outcomes. Aim of the study was the assessment of the recovery time and cost-effectiveness of an ERAS protocol in oncological patients undergoing hepato- pancreato- biliary surgery (HPB) compared to conventional (CON) care.Methods: This prospective, open label, randomized trial, enrolled 283 patients who required hepatectomy or pancreatoduodenectomy. Eligible patients were stratified into hepatectomy or pancreatectomy groups then, randomly assigned to ERAS protocol (intervention) or CON care (control). The primary outcome of interest was post-operative recovery time (composite of; time to mobilization and oral intake) and secondary outcomes were cost effectiveness, dependance on post-operative opioids and post-operative complications (using the Clavien- Dindo classification). Results: The rate of complications for the patients underwent hepatectomy and treated in ERAS group was 18.18% compared to CON group, which was 40.9%. Whilst, of complications for the patients underwent pancreatectomy and treated in ERAS group was 15.94% compared to CON group, which was 38.2%.Conclusions: The ERAS protocol in this study significantly improved post-operative recovery time, reduced opioid dependance and reduced post-operative complications in patients undergoing HPB surgery.

Affectual intensities: toward a politics of listening in court ethnography

Listening occurs in many ways in fieldwork situations, but it is not always consensual or without complexities. It is especially challenging in situations deeply embedded in institutional power, rendered and shaped by the law and its objectives. Yet, how listening differ within and between sites saturated with institutional knowledge remain still understudied. In this paper, I use my five-year fieldwork experience in German antiterrorism trials to illustrate how applying different politics of listening gradually deepened my understanding of what the trial and the wider legal process as a whole were making visible, erasing, privileging, or ignoring. I suggest that such an approach has much to contribute to a feminist analysis of (state) power, including its expression through the law, by back-bound different modes of listening to three different occasions within the court and its antechambers. Rethinking the process of knowledge production within court ethnography in this way can provide a demonstration of the insights offered by a politics of listening that is alive to the affectual intensities that emerge out of and through our bodies’ engagements, coping with, negotiating over, and healing from the objectives that appear within these highly institutionalized and much powerful settings.

Five-Year Experience With the Zenith Fenestrated Endovascular Graft for Treatment of Juxtarenal Abdominal Aortic Aneurysms at a Medium Volume Center

The use of fenestrated endovascular aortic repair (FEVAR) to treat abdominal aortic aneurysms involving the visceral arteries has increased worldwide with excellent results. The aim of this study was to evaluate the safety and effectiveness of the Zenith fenestrated endovascular graft (Cook Medical, Bloomington, IN) for the treatment of juxtarenal abdominal aortic aneurysms (AAAs) at a medium volume center. We performed a 5-year (2015-2020) retrospective analysis of all patients who had presented to our institution with juxtarenal AAAs and undergone FEVAR. Custom-made fenestrated stent grafts were designed with one to three fenestrations after analysis of computed tomography data sets. Renal alignment was performed with balloon-expandable stents. Follow-up included clinical examination, laboratory studies, mesenteric-renal duplex ultrasound, abdominal radiography, and computed tomography at hospital discharge, at 1, 6, and 12 months, and annually thereafter for ≤5 years. A total of 25 patients with juxtarenal AAAs had undergone FEVAR during the study period and were included in our analysis. Of the 25 patients, 18 were men and 7 were women, with a mean age of 71 ± 10 years. The mean aneurysm diameter was 60 ± 5 mm. A total of 53 visceral arteries required incorporation with fenestrations. Of these, 51 (96%) fenestrations were aligned by stents. Technical success was 100%. One intraoperative complication occurred. The patient developed bilateral common femoral artery plaque dissection and required common femoral artery endarterectomy. The mean length of hospital stay was 2.8 ± 1.5 days. No aneurysm ruptures or conversions were noted during a mean follow-up of 41 ± 15 months (range, 6-67 months). Of a total of 50 renal arteries targeted by fenestration, one renal artery occlusion (2%) and five cases of stenosis (10%) developed. Five patients (20%) required secondary interventions for renal artery stenosis or occlusion. One type I endoleak developed in 2 patients and one type II endoleak developed in 11 patients. One patient with a type II endoleak had experienced an increase in sac size at 1 year and underwent inferior mesenteric artery ligation. None of the patients died during the follow-up period. Our study has demonstrated that endovascular repair of juxtarenal AAAs with the Zenith fenestrated AAA stent graft at a medium volume center is safe and effective. Mortality and morbidity are low for properly selected patients treated at centers with experience in these procedures.

A clinicopathological spectrum of vulvar and vaginal lesions in a tertiary health care centre in North India: A five-year experience

Spectrum of lesions occur on the vulvar/vaginal regions ranging from non-neoplastic to precursor lesions to malignancy, however, these lesions presents with non-specific symptoms due to which they get unnoticed and progress. An early histopathologic examination is of paramount importance for a rapid diagnosis and initiation of treatment. Thus this study was done to study the clinicopathological spectrum of vulval and vaginal lesions with an emphasis on precursor and malignant lesions. Present study was a five-year retrospective study including all the vulval and vaginal specimens that were sent for histopathological examination. A total of 66 cases were studied ranging from non-neoplastic to malignant lesions. Maximum cases were found in the fourth decade. The most common presenting complaints were found to be ulcers, pain and nodular growth. Amongst the non-neoplastic lesions, Bartholin cyst (12.1%) was the most common lesion. Vulval/vaginal intraepithelial Neoplasia II was found to have a slightly more occurrence than VIN I and III. Neoplastic lesions formed the bulk of cases with moderately differentiated squamous cell carcinoma (18.2%) being the most common diagnosis. Early identification and histopathological diagnosis are essential for recognization and its further categorization to initiate an early and proper treatment.

Experience in geriatric patients at the Gastrointestinal Surgery Department of the Hospital Español, Mexico, 2013–2019. Five-year experience in GI surgery in geriatric patients

IntroductionThe aging of the population is one of the most widely studied and impactful social phenomena of this century. Up to 25% of all emergency hospital admissions can be due to diseases that require general surgery. AimsTo describe the experience at the Department of Gastrointestinal Surgery of the Hospital Español, Mexico, in patients above 65 years of age. Materials and methodsA retrospective, observational, analytic, and cross-sectional study was conducted that included 595 medical records of geriatric patients that underwent surgical procedures, within the time frame of November 2013 and February 2019. ResultsA total of 52% (309) of the patients were men and 48% (286) were women. Mean patient age was 75.38 years, with a mode of 73 years, and a maximum age of 100 years. Mean hospital stay was 4.5 days. Postoperative complications presented in 12.77% of the patients, 3.02% of which were severe. Reoperation was required in 13 patients (0.02%). The perioperative mortality rate was 2.02%. ConclusionsThe morbidity and mortality rates of the procedures that corresponded to general surgery in our case series were similar to those reported in the literature. A statistically significant number of patients underwent laparoscopic surgery, within the study period.

Apremilast Survival and Reasons for Discontinuation in Psoriasis: Five-Year Experience From a Greek Tertiary Care Centre.

IntroductionDrug survival is an indirect measure of efficacy and safety and its post-marketing assessment using real-life data is invaluable.ObjectivesTo investigate the survival of apremilast in a cohort of psoriasis patients treated with apremilast in a Greek hospital.MethodsA retrospective cross-sectional study examined adult psoriasis patients receiving apremilast (March 2016 to January 2021). Primary endpoint was the cumulative survival probability at 52 weeks. Kaplan-Meier analysis was used to calculate survival probability. Cox regression analysis was performed to investigate potential risk factors for apremilast discontinuation.ResultsOne hundred and two patients (29.4% females) with a mean age of 55.9 years (standard deviation 15.21) were included. Sixty-five patients (63.7%) had discontinued treatment by lock date: 19 (18.6%) due to lack of efficacy, 24 (23.5%) due to loss of efficacy, 15 (14.7%) due to adverse reactions, and 7 (6.9%) due to other reasons. Cumulative survival probability at 52 weeks was 52.1%. Median survival time for all reasons for discontinuation was 58 weeks (95% Confidence Interval 40.02, 75.98).ConclusionsApproximately half of patients remained on apremilast after 1 year of treatment. Secondary drug failure was the most common reason for discontinuation.

Magnetic resonance-guided high-intensity ultrasound (MR-HIFU) in the treatment of symptomatic uterine fibroids - five-year experience.

Uterine fibroids (UF) are the most common benign tumors of the female reproductive organ. It is crucial to recognize that the appropriate treatment of UFs requires an individualized approach. The present paper aimed at the presentation of the five-year experience of our center in the treatment of UFs with the use of magnetic resonance-guided high-intensity ultrasound (MR-HIFU) therapy. The study enrolled a total of 1284 patients with symptomatic UFs. The Sonalleve MR-HIFU system (Philips Ingenia 3.0T System) was used for magnetic resonance imaging (MRI) qualification and treatment. The group of patients qualified for thermal ablation included 356 (28%) women. No significant differences were observed between the group undergoing thermal ablation and patients who were disqualified. A complete procedure was performed in 22.6% of patients who presented at the center. Non-perfused volume (NPV) is one of the most important parameters assessed during MR-HIFU procedures. The mean NPV value in the present study was 71%. The average UF volumes decreased by 27% at three-month follow-up ultrasound, by 34% after six months and by 39% as shown by MRI measurements performed 6 months post-treatment. According to our data, MR-HIFU therapy is associated with good clinical outcomes in patients with symptomatic UFs. The method facilitates a marked symptom reduction and, in many cases, diminishing tumor volume. The presented five-year outcomes as regards our experience in the MR-HIFU therapy of patients with symptomatic UFs indicate that the method offers an attractive alternative to the traditional methods of UF treatment in selected cases.

Factors Related to Mortality in Occupational Injuries: Five-Year Experience

Factors Related to Mortality in Occupational Injuries: Five-Year Experience

Maternal and perinatal outcomes in placenta accreta spectrum disorders with prophylactic internal iliac artery balloon catheterization and embolization.

To summarize our five-year experience with managing patients diagnosed with wide range of PAS disorder and treated with prophylactic internal iliac balloon implantation prior to cesarean section and to assess maternal and fetal outcomes. Retrospective cohort study. A total of 30 patients were included in the study. Hysterectomy was performed in 10 cases - partial hysterectomy in six and total hysterectomy in four. Median estimated blood loss was 1.18 L. In two cases technical complications were noted. In one case bilateral internal iliac artery thrombosis requiring urgent surgical intervention occurred. A total of 30 live infants were delivered. Mean birth weight was 2435 g and mean Apgar score at 1', 5' and 10' minutes was 6.8, 8 and 8.7 respectively. After average 30 days of hospitalization all infants and their mothers were discharged in good clinical condition. Placenta accreta spectrum remains a challenge for obstetricians and gynecologists and despite interdisciplinary approach is associated with numerous complications with life-threatening postpartum hemorrhage being the most serious one. Prophylactic placement of iliac balloons is a minimally invasive and safe endovascular technique which allows rapid and effective control of postpartum bleeding in patients with PAS, with low complication rate for both mother and the child.

Minimally Invasive Excision of Breast Masses under Ultrasound Guidance: A Single Center's Five-Year Experience on the Breast Lesion Excision System.

Background The purpose of this study was to investigate the feasibility of the percutaneous radiofrequency (RF) excision system (BLES) as a primary method of diagnosis and removal of small breast masses. Methods Ninety-six lesions in 95 patients with 50.5 ± 8.4 years of age were treated in a five-year period by a single operator. Inclusion criteria were as follows: size (<20 mm), depth (>10 mm), and indeterminate or suspicious radiological features (74 BI-RADS 3 and 22 BI-RADS 4). The procedure was performed under ultrasound (US) guidance using 6 G retriever probes with 12-, 15-, and 20-mm baskets. Results Lesions were between 5 and 20 (12.3 ± 3.8) mm in length. They were removed at the first attempt in all but one case. The technical success rate was 98.95%, and the diagnostic success rate was 100%. Ninety-one lesions were histologically benign and five were neoplastic. Two lesions that were previously classified as BI-RADS 3 were diagnosed as neoplasia (atypical lobular hyperplasia), and nineteen lesions that were previously classified as BI-RADS 4a were diagnosed as benign. The complete excision rate (presence of tumor-free negative surgical margin) was 40% in neoplastic lesions. There were no major complications. The minor complication rate was 1.58%. No recurrence was observed during 18 months of follow-up. Conclusion BLES delivers surgical quality specimens for confident histopathological examination and is a safe alternative to surgical resection in lesions with suitable size.

Open paediatric laryngotracheal reconstruction: a five-year experience at a tertiary referral centre.

Laryngotracheal reconstruction with costal cartilage graft is a cornerstone procedure in treatment of multiple paediatric airway pathologies. The current study aimed to report on the experience of laryngotracheal reconstruction and document post-operative outcomes and complications. Records of laryngotracheal reconstruction procedures performed between 2016 and 2020 were retrospectively reviewed. Primary indication, clinical data, decannulation rate, voice assessment, need for revision surgery and possible complications were analysed. A total of 41 patients were treated with laryngotracheal reconstruction. Subglottic stenosis formed the largest percentage of cases followed by congenital glottic web (20 and 14 patients, respectively). Three patients (7.3 per cent) underwent single stage surgery, and the remaining cases had a double stage procedure. Revision laryngotracheal reconstruction was needed in a single case, and 38 out of 39 tracheostomised patients were successfully decannulated. Favourable outcomes were reported with costal cartilage laryngotracheal reconstruction as a definitive treatment for a large range of paediatric airway problems.

Outcomes of anastomotic venous flow couplers in head and neck free flap reconstruction – five-year experience in a single centre

Flow couplers for venous anastomosis, which enable the invasive monitoring of free flaps during the postoperative period with a continuous venous signal audible immediately after completion of the anastomosis, have been reported to be reliable, sensitive, and specific as anastomotic flap monitoring adjuncts. The purpose of this study was to evaluate the reliability, sensitivity, specificity, and outcomes of surgical exploration, and the impact on free-flap survival of the venous anastomotic flow coupler for microvascular head and neck reconstruction in a consecutive series of patients. This is a retrospective review of consecutive patients treated in the department of oral and maxillofacial surgery who underwent reconstruction of a head and neck defect using venous anastomosis with a flow coupler-vascularised free flap between October 2015 and December 2020. A total of 189 patients had free-flap reconstruction of head and neck defects. We compared the venous flow coupler group (n = 72) with patients who had free flaps with hand-sewn anastomoses over the same period (n = 117). There were no false positive/negatives associated with the flow coupler as an implantable flap monitor. The flow coupler cohort had a significantly higher flap salvage rate compared with free flaps that were monitored clinically (p = 0.04). The venous flow coupler has been shown to be a reliable microvascular anastomotic and invasive flap monitor that enables accurate and timely detection of flap compromise and prompt, successful free-flap salvage.

Spectrum of histopathological findings in pediatric renal biopsies; a five-year single center experience in Egypt

Introduction: Medical renal diseases stand as one of the major health problems in pediatric age group considering its morbidity/mortality and the subsequent management plans. Objectives: In this manuscript, the spectrum of histopathological patterns of medical nephropathic lesions in Egyptian pediatric patients over duration of five years is reported with clinical indications. Patients and Methods: We conducted a retrospective study for analysis of our pathological reports of renal needle biopsies during the period from January 2014 until January 2019. One hundred and sixteen cases were included. Results: The most commonly encountered pediatric renal pathology was minimal change disease (27.59%), followed by congenital glomerular diseases (22.41%), focal segmental glomerulosclerosis (12.93%), and thrombotic microangiopathy (7.76%). The most common clinical indication for biopsy was nephrotic syndrome (37.07%) followed by impaired renal functions with elevated serum creatinine (21.55%). In addition, we report very rare histological findings in few cases including infantile nephropathic cystinosis, Barakat syndrome and C3 glomerulopathy. Conclusion: Minimal change disease and congenital glomerular diseases accounted for half of pediatric renal pathologies in the study population. The most common clinical indication for renal biopsy was nephrotic syndrome. Electron microscopic examination and genetic studies are mandatory for proper evaluation of pediatric nephropathies.

Red Blood Cell Alloimmunization in Pediatric group with Beta Thalassemia: A Five-Year Experience.

Beta-thalassemia is one of the most frequently occurring hematological disorders in [Removed for blinded peer-review]. Regular blood transfusion is required in almost all cases for management. However, this is associated with significant major complications like red blood cell (RBC) alloimmunization. This retrospective cross-sectional is conducted to evaluate the RBC alloimmunization frequency in children with beta-thalassemia aged between 6 months and 16 years in [Removed for blinded peer-review]. Antibody screening was performed using the Dia clon3 cell antigen panel. If the screening came back positive, a detailed panel was created for the identification of specific antibody. In our sample, the frequency of RBC alloimmunization was found in 22 (26.19%) patients. Of these 22 patients, the Rhesus system was found in most patients 17 (77.3%), followed by Kell 5 (22.7%). RBC alloimmunization was significantly associated with a family history of a blood disorder and splenectomy.

Management of primary spontaneous pneumothorax: Our single-center, five-year experience.

Background In this study, we aimed to analyze the effects of admission time to the hospital and different variables on the treatment efficiency and to evaluate the recurrence during the clinical management process in patients with the diagnosis of primary spontaneous pneumothorax. Methods A total of 149 patients with primary spontaneous pneumothorax (131 males, 18 females; mean age: 24.8±6.8 years; range, 17 to 35 years) treated in our clinic between January 2015 and December 2019 were retrospectively analyzed. Time from symptom onset to hospital admission (admission time) was classified as three periods: <24 h, between 24 and 72 h, and >72 h. Data including admission time, demographic and clinical characteristics, smoking history, body mass index, the use of pleurectomy or pleural abrasion during surgery were collected from the charts of the patients. Results Admission time had no statistically significant effect on the length of hospital stay, recurrence, and the need for surgery. Male sex, smoking history, and lower body mass index had no significant effect on the recurrence. Recurrence and length of hospital stay did not significantly differ between the patients in whom pleurectomy or pleural abrasion added to the procedure during the operation. Conclusion A longer interval between symptom onset and hospital admission and lower body mass index have no adverse effect on treatment outcomes and the recurrence in patients with primary spontaneous pneumothorax. Despite the fact that surgical treatment significantly decreases the recurrence rate, pleurectomy and pleural abrasion techniques have no significant difference on the clinical influence and recurrence of these patients.