Background: Sarcopenia is common in oncology patients and has been found to be associated with poorer outcomes after surgery. Pelvic exenteration is a major surgery associated with high rates of morbidity. The aim of this study was to determine if preoperative sarcopenia is associated with postoperative complications and outcomes after pelvic exenteration surgery. Methods: A retrospective study was conducted including 64 oncology patients who had undergone pelvic exenteration surgery between August 2015 and January 2018 and had available preoperative lumbar CT images. Skeletal muscle index (SMI) was calculated by analysing CT images using body composition software. Sarcopenia was determined by using previously published SMI sex-specific cut-offs. Preoperative nutritional status, nutritional indicators and other clinical factors were also collected. Results: There was no association between preoperative sarcopenia and outcomes after pelvic exenteration surgery, however, increased weight (p=0.027) and BMI (p=0.025) were associated with a greater number of total complications. Increasing age was also significant (p=0.001) in explaining the greater number of complications. Greater complexity of surgery itself was associated with greater postoperative complications (p=0.014) and increased length of hospital stay (p=0.001). Conclusion: Preoperative sarcopenia, using dichotomous cut-off points, is not sensitive enough to predict postoperative complications and outcomes in oncology patients undergoing pelvic exenteration surgery; however, other preoperative factors such as weight, BMI and age, and the complexity of surgery, do affect outcomes. Assessment tools that incorporate several clinical and physical factors, such as frailty assessments, should be used in future studies to identify risk factors in such major surgeries.
International audienceOutsourcing data to cloud environments can offer ease of access, provisioning, and cost benefits, but makes the data more vulnerable to disclosure. Loss of complete control over the data can be offset through encryption, but this approach requires an omniscient third party key authority to handle key management, increasing overhead complexity. We present the ZeroVis framework that provides confidentiality for data stored in a cloud environment without requiring a third party key manager. It combines fine-grained access control with the ability to search over encrypted data to allow existing applications to migrate to cloud environments with very minimal software changes, while maintaining data provider control over who can consume that data
This study evaluates methods of sterilizing contaminated bone-tendon autografts using 10% povidone-iodine solution. Sterile grafts were prepared from human cadavers. Grafts were immersed in a suspension of either Staphylococcus aureus or Pseudomonas aeruginosa, and three sets of sterilization experiments were performed in 10% povidone-iodine for 30 minutes: one each with S aureus and P aeruginosa by static soaking and a third with S aureus by serial washing with agitation. Of grafts inoculated with S aureus, six of six grew the test organism after soaking at room temperature, as did five of six after soaking at 36°C and also eight of nine after washing with agitation. Of grafts inoculated with P aeruginosa, five of six grew the test strain after soaking at room temperature, as did six of six after soaking at 36°C. Thirty minutes of exposure to aqueous 10% povidone-iodine does not adequately sterilize an inoculated graft.
The surgical approach is planned using magnetic resonance imaging. The abdominal approach is performed prior to the perineal approach. Stomas, conduits, and the myocutaneous flap are performed prior to or during the perineal approach. The location of the primary or recurrent tumor determines the operative approach for a perineal or prone dissection. Tumors involving the posterior compartment and the sacrum above the junction of the S3-S4 disc space require a prone abdominosacral excision in most cases (always for lateral combined with posterior compartments). If the tumor is centrally placed on the sacrum, dissection of the upper sacral nerves first (to free them laterally) can allow an anterior central sacral vertebral body excision between the sacral foramina without lateral or prone excision. The anterior compartment excision and planes are best performed radically in modified Lloyd-Davies and can be performed prior to prone positioning for the posterior and lateral completions. This also allows access into the pelvis from the prone position to guide excision of the sacrum radically with identification and preservation of the sciatic nerves. This maneuver of disconnecting the anterior compartment, anterolateral muscles, and ligaments during the abdominal and perineal resections means when prone disconnection of the sacrum is performed, access can be more readily achieved into the pelvis by rotating the transected sacrum caudal to expose the anterior pelvis free of muscular and ligamentous anterior attachments and direct visualization of the preserved lumbosacral trunks. 6.12
Introduction Infection with M tuberculosis is a necessary but not sufficient condition for development of clinical Tuberculosis (TB). The reasons why some tuberculosis infections progress to clinical TB while most remain latent is not clear. A vegetarian diet has been implicated as a risk factor for tuberculosis among South-Asians in the UK. Methods To explore whether this is the case in India we analysed data from the nationally representative National Family Health Survey-3 (2006) which collected information on TB and diet, and tested for HIV-1. Tuberculosis was reported by heads of households.Results Vegetarianism was not a risk factor for tuberculosis among HIV-1 negative married men and women between 15 and 49 (women) or 54 (men) years [OR 0.66 (95% CI 0.49 to 0.89)] while poverty and a history of blood transfusions were. Individuals reporting TB were slightly older than those who did not (31.8 vs 29.4 in women, 39.3 vs 37.2 in men). Vegetarians were also slightly older than non-vegetarians (29.5 vs 29.4 in women, and 37.9 vs 37.0 in men). Except for 11 men and 11 women all individuals with TB were reported to have received treatment for their condition. Urban residence, poverty, higher age, and blood transfusion were positively associated with TB. Conclusion Vegetarianism appeared to be protective against TB, perhaps due to confounding by unmeasured life-style factors. As it seems unlikely that confounding has masked a strong positive association between vegetarianism and TB, we conclude that vegetarianism is not a risk factor for TB in India.
No abstract
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.