Incidence Of Related Complications Research Articles

Factors Associated With Short-Term Complications After Percutaneous Endoscopic Gastrostomy Tube Insertion: A Retrospective Cohort Study.

Percutaneous endoscopic gastrostomy (PEG) tube placement is generally safe but is associated with a range of complications. Minor complications include infections, granuloma formation, leakage, and blockages, while major complications encompass aspiration pneumonia, hemorrhage, and more serious conditions such as necrotizing fasciitis and colonic fistula. This study aimed to assess the rate of short-term complications within one month of endoscopic PEG insertion, focusing on their correlation with patient characteristics. This retrospective cohort study analyzed data from patients who underwent PEG insertion between January 2020 and December 2022. It evaluated the incidence of complications in relation to variables such as the indication for the procedure, the patient's immune status, albumin and CRP levels, and the setting of the procedure (inpatient vs. outpatient). The study included 121 patients, with a mean age of 69.73 years, comprising 71 males (58.7%) and 50 females (41.3%). Neurological indications accounted for 64.5% of the cases. Notably, 67.8% of the patients were immunocompromised. Within 30 days of PEG insertion, 16.5% experienced complications, including GI bleeding (4.1%), infection at the PEG site (11.6%), and peritonitis (0.8%). Complications were significantly higher in immunocompromised patients and those with non-neurological indications. Higher serum albumin and lower CRP levels were associated with fewer complications, though the association was not statistically significant. The study highlights that gastrostomy site infection is the most common short-term complication following PEG insertion. Immune status and the reason for PEG insertion emerged as key factors influencing the likelihood of complications.

Comparing the effects of biguanides and dipeptidyl peptidase-4 inhibitors on cardio-cerebrovascular outcomes, nephropathy, retinopathy, neuropathy, and treatment costs in diabetic patients.

Western guidelines often recommend biguanides as the first-line treatment for diabetes. However, dipeptidyl peptidase-4 (DPP-4) inhibitors, alongside biguanides, are increasingly used as the first-line therapy for type 2 diabetes (T2DM) in Japan. However, there have been few studies comparing the effectiveness of biguanides and DPP-4 inhibitors with respect to diabetes-related complications and cardio-cerebrovascular events over the long term, as well as the costs associated. We aimed to compare the outcomes of patients with T2DM who initiate treatment with a biguanide versus a DPP-4 inhibitor and the long-term costs associated. We performed a cohort study between 2012 and 2021 using a new-user design and the Shizuoka Kokuho database. Patients were included if they were diagnosed with T2DM. The primary outcome was the incidence of cardio-cerebrovascular events or mortality from the initial month of treatment; and the secondary outcomes were the incidences of related complications (nephropathy, renal failure, retinopathy, and peripheral neuropathy) and the daily cost of the drugs used. Individuals who had experienced prior events during the preceding year were excluded, and events within 6 months of the start of the study period were censored. Propensity score matching was performed to compare between two groups. The matched 1:5 cohort comprised 529 and 2,116 patients who were initially treated with a biguanide or a DPP-4 inhibitor, respectively. Although there were no significant differences in the incidence of cardio-cerebrovascular events or mortality and T2DM-related complications between the two groups (p = 0.139 and p = 0.595), daily biguanide administration was significantly cheaper (mean daily cost for biguanides, 61.1 JPY; for DPP-4 inhibitors, 122.7 JPY; p<0.001). In patients with T2DM who initiate pharmacotherapy, there were no differences in the long-term incidences of cardio-cerebrovascular events or complications associated with biguanide or DPP-4 use, but the former was less costly.

The basis of complications in the context of SARS-CoV-2 infection: Pathological activation of ADAM17

The virulence of SARS-CoV-2 decreases with increasing infectivity, the primary approaches for antiviral treatments will be preventing or minimizing the complications resulting from virus infection. ADAM metallopeptidase domain 17 (ADAM17) activation by SARS-CoV-2 infection has a dual effect on the development of the disease: increased release of inflammatory cytokines and dysregulation of Angiotensin converting enzyme II (ACE2) on cell surfaces, inflammatory cytokine infiltration and loss of ACE2 protective function lead to a significant increase in the incidence of related complications. Importantly, pathologically activated ADAM17 showed superior features than S protein in regulating ACE2 expression and participating in the intra cellular replication of SARS-CoV-2. In short, SARS-CoV-2 elicits only a limited immune response when it promotes its own replication and pathogenicity through ADAM17. Therefore, the pathological activation of ADAM17 may also represent a diminished innate antiviral defense and an altered strategy of SARS-CoV-2 infection. In this review, we summarized recent advances in our understanding of the pathophysiology of ADAM17, with a focus on the new findings that SARS-CoV-2 affects ADAM17 expression through Furin protein converting enzyme and Mitogen-activated protein kinase (MAPK) pathway, and raises the hypothesis that SARS-CoV-2 may mediates the pathological activation of ADAM17 by hijacking the actin regulatory pathway, and discussed the underlying biological principles.

Clinical observation and finite element analysis of femoral stable interlocking intramedullary nail in intertrochanteric fractures.

This study was designed to compare clinical outcomes of the femoral stable interlocking intramedullary nail (FSIIN) with proximal femoral nail anti-rotation (PFNA) for the treatment of intertrochanteric fractures (OTA 31A1 + A2). This study retrospectively analyzed a registered sample of 74 intertrochanteric fractures (OTA 31A1 + A2) surgically treated using FSIIN (n = 36) or PFNA (n = 38) from January 2015 to December 2021. The intra-operative variables (operation time, fluoroscopy time, intra-operative blood loss, length of incision) and fracture healing time were compared between the two groups in this study. Harris hip score (HHS) and visual analog scale (VAS) were used to evaluate the functional states. At the last follow-up, the incidence of related complications in patients was calculated. Eventually, the 3D finite element model was established to analyze the stress of FSIIN and PFNA. The distribution of all basic characteristics was similar between the two groups (p > 0.05). The operation time, fluoroscopy time, intra-operative blood loss, and length of incision were significantly decreased in the FSIIN group (p < 0.001). The FSIIN group had a shorter fracture healing time than the PFNA group (p < 0.001). There is no significant difference between the two groups in the Harris and VAS (p > 0.05). The incidences of post-operative anaemia, electrolyte imbalance, varus malalignment, and thigh pain were significantly lower in FSIIN than in PFNA groups (all p < 0.05). The finite element results show that the stress shielding effect of FSIIN is smaller. Our study revealed that FSIIN seemed to be superior to PFNA in the treatment of intertrochanteric fractures (OTA 31A1 + A2) due to less surgical damage and shorter fracture healing time.

Efficacy and safety of subanesthetic doses of esketamine combined with propofol in painless gastrointestinal endoscopy: a prospective, double-blind, randomized controlled trial

BackgroundPainless gastrointestinal endoscopy is widely used for the diagnosis and treatment of digestive diseases. At present, propofol is commonly used to perform painless gastrointestinal endoscopy, but the high dose of propofol often leads to a higher incidence of cardiovascular and respiratory complications. Studies have shown that the application of propofol combined with ketamine in painless gastrointestinal endoscopy is beneficial to reduce the dosage of propofol and the incidence of related complications. Esketamine is dextrorotatory structure of ketamine with a twice as great anesthetic effect as normal ketamine but fewer side effects. We hypothesized that esketamine may reduce the consumption of propofol and to investigate the safety of coadministration during gastrointestinal endoscopy.MethodsA total of 260 patients undergoing painless gastrointestinal endoscopy (gastroscope and colonoscopy) were randomly divided into P group (propofol + saline), PK1 group (propofol + esketamine 0.05 mg/kg), PK2 group (propofol + esketamine 0.1 mg/kg), and PK3 group (propofol + esketamine 0.2 mg/kg). Anesthesia was achieved by 1.5 mg/kg propofol with different doses of esketamine. Propofol consumption per minute was recorded. Hemodynamic index, pulse oxygen saturation, operative time, induction time, awakening status, orientation recovery time, adverse events, and Mini-Mental State Examination (MMSE) were also recorded during gastrointestinal endoscopy.ResultsPropofol consumption per minute was 11.78, 10.56, 10.14, and 9.57 (mg/min) in groups P, PK1, PK2, and PK3, respectively; compared with group P, groups PK2 and PK3 showed a decrease of 13.92% (P = 0.021) and 18.76% (P = 0.000), respectively. In all four groups, systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), but not pulse oxygen saturation (SpO2) significantly decreased (P = 0.000) immediately after administration of induction, but there were no significant differences between the groups. The induction time of groups P, PK1, PK2, and PK3 was 68.52 ± 18.394, 64.83 ± 13.543, 62.23 ± 15.197, and 61.35 ± 14.470 s, respectively (P = 0.041). Adverse events and psychotomimetic effects were observed but without significant differences between the groups.ConclusionsThe combination of 0.2 mg/kg esketamine and propofol was effective and safe in painless gastrointestinal endoscopy as evidenced by less propofol consumption per minute, shorter induction time, and lower incidence of cough and body movement relative to propofol alone. The lack of significant differences in hemodynamic results, anesthesia-related indices, adverse events, and MMSE results showed the safety to apply this combination for painless gastrointestinal endoscopy.Trial registration This study was registered with China Clinical Trial Registration on 07/11/2020 (registration website: chictr.org.cn; registration numbers: ChiCTR https://clinicaltrials.gov/ct2/show/2000039750).

Fracture in the middle of the femoral stem and relevant treatment after the revision total hip arthroplasty: A case report

Introduction: Total hip arthroplasty (THA) remains one of the most effective treatments for grievous hip joint diseases. However, with an increase in the number of operations, the incidence of related complications has also increased dramatically. Prosthetic failure is a relatively rare but extremely serious complication. Reports related to this type of complication and the corresponding treatment are rare. Case Report: Here we report the case of a 63-year-old man, who complained of sudden pain in the right lower limb thigh and was subjected to stem failure without obvious inducement after revision total hip arthroplasty. The patient was discharged from the hospital after undergoing relevant revision surgery, and was satisfied with the recovery at the 1-year follow-up. Conclusion: Combining this report with previous literatures, it was not difficult to find that there were many reasons for prosthesis fracture. Therefore, prevention of this kind of complication should be considered in many aspects, to avoid the occurrence of this kind of situation to the greatest extent and improve the effect of surgery.

Effect of AI deep learning techniques on possible complications and clinical nursing quality of patients with coronary heart disease

To analyze the effect of AI deep learning techniques on understanding possible complications and improving clinical nursing quality of patients with coronary heart disease. The clinical data of 182 patients with coronary heart disease who received treatment were collected, among which 80 patients received routine nursing management only during hospitalization, set as the control group; AI deep learning techniques were applied to the other 102 patients During treatment and nursing, the incidence of related complications in the control group was higher than that in the observation group, and the average hospitalization time of the patients was longer than that in the observation group. In the observation group, AI deep learning techniques were applied to predict the incidence of complications of coronary heart disease in 14 patients, with an accuracy rate of 87.50% (14/16) and an error rate of 12.50% (2/16). Both the clinical nursing quality and patients’ satisfaction score of the observation group were higher than those of the control group, and the overall nursing satisfaction rate of the patients was higher. Applied in prediction of possible complications of hospitalized patients with coronary heart disease, AI deep learning techniques were of high accuracy rate.

Nursing Effect of Zinc Oxide Nanoantibacterial Materials after Adrenalectomy

Laparoscopic adrenalectomy (RLA) is widely used for adrenal tumors, cancer, cortical hyperplasia, etc. Therefore, how to care for patients after surgery is a necessary means to speed up the rapid healing of surgical wounds and reduce the incidence of related complications. To solve the problem in traditional wound treatment, antibacterial dressings are used, and most of the auxiliary materials need to be replaced frequently, or there is serious adhesion to the wound, which causes secondary wound infection. The methods used to study in this work report a new long‐acting antibacterial and breathable wound dressing based on nanoscale zinc oxide nanoparticles (ZnO NPs) in the care of adrenalectomy; the clinical effects of ZnO NP‐based antibacterial dressings were systematically evaluated in terms of patients’ wound healing rate (%), infection rate (%), healing time (d), and the number of dressing changes. The results revealed that the wound healing rate of patients with ZnO NP‐based antibacterial dressing was as high as 16.67% and the incidence of adverse reactions was only 26.19%, which was 40.48% lower than traditional dressings. Such promising antibacterial dressings are expected to be greatly used in the medical field in the future.

A systematic review and meta-analysis of different mask ventilation schemes on management of general anesthesia in patients with respiratory failure.

Difficulty in mask ventilation is one of the more dangerous factors in general anesthesia. The traditional mask has some problems, such as air leakage and facial skin compression injury. The head cover is a new interactive non-invasive ventilation (NIV) model. NIV studies comparing hoods and masks have all been single-center and small-sample randomized trials, and extensive clinical studies are lacking. We conducted a computerized search in the databases of PubMed, Embase, Medline, Chinese Biomedical Literature (CBM), and others for randomized controlled trials (RCTs) on the effect of hoods and masks on patients with respiratory failure published since their establishment to March 2021. The quality of the included literature was assessed using the Cochrane Systematic Review Manual, and the data was analyzed using Review Manager 5.3 to assess the risk of bias. A total of 9 articles were included, involving 462 patients, with 233 patients in the hood group and 229 patients in the face mask group. The results of meta-analysis showed the comparative endotracheal intubation rate of the hood group and the mask group [odds ratio (OR) =0.26; 95% confidence interval (CI): 0.14 to 0.47; Z=4.48; P<0.00001], the complications rate (OR =0.54; 95% CI: 0.31 to 0.97; Z=2.08; P=0.04) was statistically considerable, although there was no considerable difference in in-hospital mortality (OR =0.56; 95% CI: 0.28 to 1.14; Z=1.59; P=0.11). NIV with a hood can reduce the rate of endotracheal intubation and the incidence of related complications in patients with acute respiratory failure (ARF), which has considerable advantages in contrast to the traditional mask.

Application of multi-slice spiral CT refarmation reconstruction technique and DR photography of pneumoconiosis patients at stage three

Objective: To investigate the value of CT multiplanar reconstruction (MPR) in the diagnosis of stage Ⅲ pneumoconiosis and complications. Methods: In September 2020, 94 patients with stage Ⅲ pneumoconiosis in Guangzhou 12th people's hospital were selected for digital radiography (DR) and MPR. The detection rate of the number of large shadows and the incidence of related complications were compared and analyzed. The counting data were expressed by frequency and percentage (%) , and the comparison was performed by chi square test. Results: 178 and 132 large shadows were detected in MPR and DR chest films respectively. Compared with Dr examination, MPR had higher detection rates of pneumoconiosis related complications such as pulmonary tuberculosis, emphysema, pleural thickening, adhesion, pneumonia, pleural effusion, enlargement of hilar and mediastinal lymph nodes and calcification (P<0.05) , There was no significant difference in the detection rate of pulmonary bullae (P>0.05) . Compared with Dr, MPR had a higher detection rate in the diagnosis of cavity, calcification, bronchiectasis and parascar emphysema (P<0.05) . Conclusion: MPR is better in detecting large shadow and complications of stage Ⅲpneumoconiosis, and has important value.

Observation on the Clinical Effect of Modified Circumcision in the Treatment of Phimosis and Excessive Foreskin

Objective: To study the clinical effect of modified circumcision in the treatment of phimosis and excessive foreskin. Methods: 110 patients with overly long foreskin or phimosis were divided into experimental group and control group by random number table method, with 55 cases in each group. The experimental group was treated with modified circumcision, and the control group was treated with traditional manual cutting and suture. Then the clinical effects of the two treatments were compared. Results: Two different surgical procedures were performed. During the operation, the blood loss of the experimental group was less than that of the control group; the operation time and wound healing time were shorter than those of the control group; after the operation, the incidence of related complications in the experimental group was 14.55%, which was significantly lower than For 25.45% of the control group, the clinical treatment effect was obvious, and the difference was statistically significant (P&lt;0.05). Conclusion: The clinical effect of modified circumcision in the treatment of patients with phimosis and excessive foreskin is good. Compared with the traditional manual cutting and suture treatment, it not only has the advantages of simple operation and clinical application, but also benefits the rehabilitation of patients. Rehabilitation time reduces the incidence of postoperative complications. It is an ideal treatment plan for this type of disease in the current clinic, and it is worthy of popularization and application in general surgery and reproductive surgery.

Application of Polydioxanone Sutures in the Nuss Procedure.

Background/Purpose The Nuss procedure is the most common surgical repair for pectus excavatum (PE). Surgical steel wires are used in some modifications of the Nuss procedure to attach one or both ends of a support bar to the ribs. During follow-up, wire breakage was found in some cases. Patients with wire breakage may undergo prolonged bar removal surgery and may be exposed to excessive radiation. In this study, we had a series of patients who received polydioxanone suture (PDS) fixations instead of steel wires. This retrospective study was conducted to explore the differences between these two fixation materials in the incidence of related complications and efficacies. Furthermore, we attempted to observe whether the two materials lead to similar surgical efficacy in the Nuss procedure, whether they have divergent effects on the bar removal surgery, and whether PDS can reduce the risks due to steel wire breakage as expected.Methods We retrospectively studied PDS and surgical steel wires as fixation materials for the Nuss procedure in children with congenital PE and reviewed the outcomes and complications. A total of 75 children who had undergone Nuss procedure repairs and bar removals from January 2013 to December 2019 were recruited to participate in this study. They were divided into three groups: the PDS group, the unbroken wire (UBW) group, and the broken wire (BW) group, according to the fixation materials and whether the wires had broken or not. Moreover, we selected the duration of operation (DO), intraoperative blood loss (BL), bar displacement (BD), postoperative pain score (PPS), and incision infection as the risk indicators and the postrepair Haller index (HI) as the effectiveness indicator. These indicators were statistically compared to determine whether there were differences among the three groups. Results One BD occurred in the PDS and BW groups while none took place in the UBW group. No incision infection was found in any of the groups. The PDS group had the shortest DO, while the DO in the UBW group was shorter than that in the BW group ( p < 0.05). BL in the PDS group was less than that in the other two groups ( p < 0.05). Additionally, no difference was observed in BL between the BW and UBW groups ( p > 0.05). The PPS of the PDS group was less than that of the BW group ( p < 0.05), whereas no differences were found between the other two groups. No statistical difference emerged in HI among the groups ( p > 0.05). Conclusion PDS fixation results in a similar repair outcome and shows certain advantages in the DO, BL, and PPS; also, PDSs are safe and effective in the Nuss procedure. Level of evidence Level III.

Effect of topical tranexamic acid on post-traumatic elbow stiffness in patients treated with open arthrolysis: a prospective comparative study

Elbow joint open arthrolysis is an effective method to release contracted tissue and débride heterotopic ossification in cases of post-traumatic elbow stiffness. Recurrence remains one of the most common concerns for surgeons. Soft tissue contracture may result from intra- and/or extra-articular bleeding, edema, effusion, and granulation. The increasing incidence of intraoperative and postoperative bleeding has caused uncertainty about surgical outcomes. Tranexamic acid (TXA) is effective for reducing surgery-related bleeding and effusions in total hip or knee arthroplasty. To investigate whether topical TXA can decrease blood loss and effusions in patients treated with elbow joint open arthrolysis and whether it affects final function. A prospective comparative study was conducted. Sixty-one patients with joint stiffness were enrolled and randomly divided into 2 groups: one consisting of 31 patients treated with topical TXA intraoperatively after open arthrolysis (experimental group)and the other consisting of 30 patients who received saline administration (control group). The operation time, tourniquet time, and intraoperative blood loss were recorded. Drainage volume, elbow rotation, elbow motion arc, Mayo Elbow Performance Score, and operation-related complications were followed up and recorded, whereas hematoma volume remaining in the joint space after drainage tube removal was assessed on ultrasonography. Tourniquet time, intraoperative blood loss, and postoperative drainage were significantly lower in the TXA group than in the control group. However, no significant intergroup differences were found in the incidence of related complications and final function evaluated at the final follow-up. Topical TXA improves surgical quality by controlling intraoperative bleeding, decreases the amount of blood loss soon after surgery, and could become a routine procedure in elbow joint open arthrolysis.

Clinical Application and Research Progress of Accelerated Rehabilitation Surgery in Perioperative Period of Advanced Gastric Cancer in the Elderly

Enhanced recovery after surgery (ERAS) has been used in various surgical professions in recent years and is widely accepted by doctors. This concept not only helps patients speed up postoperative recovery, reduce the incidence of related complications and shorten hospital stays, but also has been proved to be effective and safe in the perioperative application of gastric cancer. This article reviews the clinical application and research progress of enhanced recovery after surgery in the perioperative period of advanced gastric cancer in the elderly.

Microengineered biosynthesized cellulose as anti-fibrotic in vivo protection for cardiac implantable electronic devices

Upon cardiac implantable electronic device (CIED) exchange, upgrade, or revision surgery patients are exposed to a considerable risk of adverse events. The presence of firm fibrotic tissue endangers these procedures. Leads can be damaged in the attempt of freeing them from fibrotic tissue. Hematoma can form as result of capsulectomy, pocket debridement and leads dissection. Due to the increasing number of CIED exchange, upgrade and revision surgeries, the incidence of related complications is expected to rise in the near future.The aim of the study was to evaluate the feasibility, safety, and performance of a rationally micro-engineered non-resorbable biosynthesized cellulose (BC) membrane as conformal wrapping protection around CIED implants. Protective membranes were generated by means of a recently established method to transfer on-demand microscale geometries onto the surface of BC. A chronic minipig animal model was selected to investigate the performance of the BC anti-fibrotic protection, directly measured as reduction of fibrotic tissue formation. Sixteen (n = 16) animals received each one BC coated pacemaker (PMC) and one native pacemaker (BI) at equivalent anatomical sites. BC protective layers were juxtaposed around pacemakers through a fast and well-repeatable procedure. Explants were performed at 3 and 12 months after implantation. Endpoint analysis showed that the BC protective layers were 100% integer, with no sign of chemical or mechanical degradation and appeared as a thin layer of white-tan material, adherent to the surrounding thin fibrous capsule, from which it could be peeled off by gently pulling with forceps. The protective effect of micro-engineered BC yielded an average thickness reduction of 66% of the fibrotic tissue thickness generated around PMC, as compared to that measured around the naked counterpart (i.e. the BI). When protected by in BC, both the generator and the proximal parts of the leads were completely free from fibrotic tissue. The insertion of an anti-adhesive, non-resorbable and well-tolerated BC interface between the implant and the surrounding tissue in the surgical pocket significantly reduced the formation of fibrotic tissue, ensuring an easy access to the device pocket, and thus creating the conditions for simplified CIED revision surgeries.

Effect of the interactive exercise of the self-care scenario module on the self-care ability and complications of patients with PICC in the department of oncology

Objective To observe the impact of the interactive exercise of the self-care scenario module on the self-care ability and complications of patients with Peripherally Inserted Central Catheter (PICC) in the oncology department. Methods From January to March 2017, a total of 84 patients who received chemotherapy in the oncology department of the hospital and received PICC catheterization as the chemotherapy channel were selected as the research objects.They were randomly divided into control group and experimental group, 42 cases of each group.The control group received conventional PICC catheterization education, while the experimental group added the interactive exercise mode of self-nursing situation module to the intervention.The observation indexes of the two groups after intervention were compared. Results After intervention, the self-care ability score of PICC patients in the oncology department of the experimental group was significantly higher than that of similar tumor patients in the control group, and the complication rate in 1 month after intervention was significantly lower than that of the control group(P<0.05). Conclusion Nursing intervention for patients with PICC catheterization in the oncology department by using the interactive exercise mode of self-care situation module is very effective for improving self-care ability of such patients and reducing the incidence of related complications. Key words: Self-care; Exercise; Tumor; PICC; Nursing care

Bioabsorbable implants in foot trauma surgery

BackgroundResorbable osteosynthesis has been used in orthopaedic surgery for many years. However, indications for the use of these implants in the surgery of traumatic lesions of the foot have not yet been clearly defined. The aim of this study is to analyse reported experiences with the bioabsorbable devices and to suggest guidelines for their use in foot trauma surgery MethodsWe conducted a literature review to identify known indications for the use of absorbable devices in traumatic lesions of the foot. We also conducted a retrospective analysis of our registry, reviewing patients with traumatic lesions of the foot who were treated surgically with absorbable devices from November 2005 to January 2017. To this end, we analysed for each case the indication for the use of resorbable devices and the incidence of related complications. ResultsOnly 14 relevant studies were found. In the selected period, 76 patients were treated using bioabsorbable devices for a traumatic lesion of the foot. Nine patients were lost to follow-up or did not satisfy the inclusion criteria. Therefore, the final size of the registry was 67 patients. The average follow-up was 20.5 months (range 6–66). All the bioabsorbable devices used were screws and bars of poly-L-lactic acid (PLLA). The indications identified in the literature review and in our registry were osteosynthesis of small periarticular fragments in talus and calcaneus fractures, preliminary stabilisation of articular fragments in Sanders III calcaneal fractures and fracture-dislocations of the Lisfranc or Chopart joints. No foreign-body reactions occurred. However, in one case we registered a late mobilisation of a PLLA bar in a healed calcaneal fracture, probably as a consequence of surgical malpositioning of the device. All the operated lesions demonstrated a normal healing time, and the complication rate was comparable with those of other types of osteosynthesis. ConclusionIn foot trauma surgery the use of absorbable devices can give advantages.The most clearly defined indications are osteosynthesis of peri-articular or articular fragments in talus and calcaneus fractures, Sanders III calcaneal fractures and fracture-dislocations of Lisfranc's or Chopart's joints.Foreign-body reactions are rare and seem not to present a problem.

Effects of comfort nursing interventions on clinical effects and negative emotions in patients receiving transurethral plasmakinetic resection of the prostate

Objective To explore the effects of comfort nursing interventions on clinical effects and negative emotions in patients receiving transurethral plasmakinetic resection of the prostate (PKRP) . Methods A total of 94 patients with benign prostatic hyperplasia (BPH) were selected and randomized into a control group (n=47) and an observation group (n=47) from May 2013 to June 2015. All the patients received PKRP. Patients in the control group received conventional nursing care, while patients in the observation group received perioperative comfort nursing interventions in addition to conventional nursing. The changes in the patients' blood pressure and heart rate were detected; SAS and SDS were used to evaluate their anxiety and depression levels post operation; relevant clinical indicators were measured and compared between the two groups to evaluate their short- and long-term clinical effects; and the incidence of complications and satisfaction were compared between the two groups. Results Compared with control group, the systolic pressure, diastolic pressure, average arterial pressure and heart rate of the oberservation group were lower, and SAS and SDS scores in the patients of the oberservation group were lower postoperatively (P<0.05) . The time of bladder irrigation, catheter indwelling, operation and hospital stay was shortened in the patients in the observation group as compared to the control group (P<0.01) . International prostate symptom score (IPSS) and residual urine volume decreased 3 months post operation, while the maximum urine flow rate and quality of life score (QLS) increased compared with preoperative conditions (P<0.05) . The satisfaction and the incidence of complications following nursing interventions were 95.74% and 12.77% for the patients in the observation group and 78.72% and 40.43% for the patients in the control group, respectively (P<0.05) . Conclusions Comfort nursing interventions can improve the psychological state of PKRP patients, enhance their short-and long-term effects and satisfaction, and reduce the incidence of related complications. Key words: Urological surgery; Anxiety; Depression; Comfort nursing; Clinical effects; Complication; Transurethral plasmakinetic resection of the prostate

Effect of adductor canal block combined with local infiltration anesthesia on rehabilitation of primary total knee arthroplasty

To investigate the effect of adductor canal block combined with local infiltration anesthesia on the rehabilitation of primary total knee arthroplasty (TKA). A total of 104 patients who met the selection criteria for the first unilateral TKA between March 2017 and August 2017 were included in the study. They were randomly divided into trial group (53 cases) and control group (51 cases). In the trial group, the adductor canal block with intraoperative local infiltration anesthesia were performed. In the control group, only intraoperative local infil-tration anesthesia was performed. There was no significant difference in gender, age, body mass index, diagnosis, effected side, and the preoperative American Society of Anesthesiologists (ASA) grading between 2 groups ( P>0.05). The operation time, length of stay, and complications were compared between 2 groups, as well as visual analogue scale (VAS) score of incision at rest and during activity, the range of motion (ROM) of knee flexion and extension activity, limb swelling (thigh circumference), walking distance, and pain VAS score while walking. The operation time of the trial group was significantly shorter than that of the control group ( t=-2.861, P=0.005). However, there was no significant difference in length of stay between 2 groups ( t=-0.975, P=0.332). The wound effusion occurred in 1 patient of trial group and 2 of control group; hematoma occurred in 2 patients of trial group and 3 of control group; no symptom of intermuscular venous thrombosis occurred in 1 patient in each of 2 groups; ecchymosis occurred in 14 patients of trial group and 15 of control group; there was no significant difference in the incidence of related complications between 2 groups ( P>0.05). There was no significant difference in the preoperative VAS score at rest and during activity, ROM of knee flexion and extension activity, and thigh circumference between 2 groups ( P>0.05). However, there were significant differences in the VAS score at rest and during activity after 2, 4, 8, and 12 hours, ROM of knee flexion and extension activity after 1 and 2 days, and the walking distance on the day of discharge, pain VAS scores while walking after 1 and 2 days and on the day of discharge, and thigh circumference after 1 day between 2 groups ( P<0.05). For the primary TKA, the adductor canal block combined with local infiltration anesthesia can early relieve the initial pain of the incision, shorten the operation time, and promote the mobility and functional recovery of the knee joint.

Implementation of Intravenous Drip Infusion Therapy with Peripheral Venous Catheters and the Incidence of Related Complications in Home-Based Medical Care Settings in Japan

Background/Aims: Home-based medical care is rapidly expanding in Japanese health care settings. We aimed to clarify the implementation status of drip injection with peripheral venous catheters (PVCs) and the incidence of related complications. Methods: We investigated the number of patients who required intravenous drip infusion therapy at home. We also examined the incidence rate of PVC-related complications and their statistical correlation with patients’ characteristics. Results: Of 139 patients, 30 (21.6%) received intravenous drip infusion therapy through PVCs at home. Patients’ activities of daily living (bed-ridden) and the presence of underlying disease (terminal cancer) were significantly correlated with the requirement for drip infusion therapy (p < 0.0001 and p < 0.0001, respectively). A high incidence of PVC-related complications (75%: 15 out of 20 patients) was observed. More than 50% of patients experienced multiple needling due to difficulty in securing venous access. Conclusions: This is the first report to reveal the relatively high incidence of PVC-related complications in home-based medical care settings. Safer vascular devises should be incorporated for more stable intervention.