Karnofsky's score modified for cats.
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Abstract Aim The study assessed the efficacy of laparoscopic ventral mesh rectopexy ( LVMR ) for full thickness external rectal prolapse ( ERP ), including recurrent prolapse. Method A prospective database identified all patients undergoing LVMR for ERP over the 16‐year period to December 2013. Clinical outcome, Cleveland Clinic Incontinence Score ( CCIS ), quality of life ( QOL ) and patient‐reported outcome were evaluated. Results In total, 190 LVMR s (87% women) were performed during the study period, with a median active follow‐up of 29 (1–196) months; 120 had a follow‐up > 5 years and 16 > 10 years. The median time from surgery was 73 (1–196) months. The 60‐day mortality, recurrence and mesh‐related complication rates were 1%, 3% and 3.7%. The mean improvement in CCIS was 8 ( P < 0.0001). Sixty‐two patients returned a complete sequence of QOL scores (Birmingham Bowel and Urinary Symptoms Questionnaire 22), which had improved by 46% at year 1 and were sustained at a median of 4 years ( P < 0.001). Mean patient‐reported outcome measures for satisfaction at final review in 119 responders was 9.1/10. Thirty‐nine patients underwent LVMR for recurrent ERP following perineal repair. Of these, full thickness recurrence occurred in one and there were no mesh complications. The same sustained improvement in QOL was observed. Conclusion LVMR for ERP is associated with low morbidity and recurrence and a long‐term improvement in function and QOL . LVMR achieves the same benefits after a failed perineal procedure.
Rectal prolapse
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Two experiments were conducted to explore whether facial identification performance could be predicted from observers' attitudes toward eyewitness evidence, perceived personal objectivity, expressed confidence, or completeness and accuracy of verbal descriptions of the suspect. None of these predictors was found to be significantly related to identification performance with either target-present or target-absent photoarrays. However, observers who perceived themselves to be more objective were likely to give higher confidence ratings regardless of the accuracy of their identification performance, and they were likely to include more incorrect elements in their verbal descriptions. Copyright © 2000 John Wiley & Sons, Ltd.
Objectivity (philosophy)
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Objective To investigate the efficacy and quality of life of patients with NTMG treated with VATS.Methods Thirty-two cases with NTMG in our hospital were treated using VATS,the efficacy and quality of life after 3 years of treatment observed.Results All patients were successfully operated.After 3 years of DeFilippi grade level of 1-3,4-5 were 32,0 cases,the total were efficiency was 100%;Compared MGFA score preoperative,postoperative was significantly lower(P0.05);Compared EORTC-QLQ score preoperative,postoperative were higher,in addition to social function,the other were significant differences(P0.05).Conclusion NTMG patients treated with VATS can significantly improve the clinical symptoms and quality of life,it has fewer postoperative complications.
Clinical efficacy
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Throat
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Objectives To report the complications and factors affecting outcome for cats following placement of a subcutaneous ureteral bypass (SUB™). Materials and Methods In this retrospective study, complications, the presence of a urinary tract infection and survival time were recorded following subctutaneous ureteral bypass placement. Factors affecting survival time were assessed using a Kaplan Meier curve and log rank test. Results Ninety‐five cats had 130 subcutaneous ureteral bypasses placed. Ten cats did not survive to discharge. Forty cats died or were euthanised after discharge (42%); the median survival time of these cats was 530 days (range 7 to 1915). Minor complications occurred in 18 cats (19%) and major complications occurred in 46 cats (48%), the majority of which were after hospital discharge. Twenty‐seven cats were diagnosed with a urinary tract infection (UTI) post‐operatively. A significant association between long‐term survival and creatinine at presentation was identified. The median survival time for cats presenting with creatinine concentration ≥440 μmol/L (International Renal Interest Society stage acute kidney injury (AKI) 4 and 5) was 530 days (95% CI 273–787 days), compared to a median survival time of 949 days (95% CI 655–1243 days; Log Rank P=0.024) for those cats presenting with creatinine <440 μmol/L (International Renal Interest Society stage AKI 1–3). Clinical Significance In this population of cats, subcutaneous ureteral bypass placement was associated with an approximately 10% in‐hospital mortality and a high complication rate. Most complications were manageable, resulting in an overall median survival time of over 2 years.
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Objective: Patients suffering from an incisional hernia after abdominal surgery have an impaired quality of life (QoL). Surgery aims to improve QoL with a minimum risk of further complications. The aim was to analyze QoL, predictors for outcome, including recurrence and reoperation rates during the first postoperative year. Methods: In a randomized controlled trial comparing laparoscopic and open mesh repair, 133 patients were assessed preoperatively and after 1 year with regard to QoL using the Short Form-36 (SF-36), visual analog scale (pain, movement limitation, and fatigue), and questions addressing abdominal wall complaints. Factors concerning recurrence, reoperations, satisfaction, and improved QoL were analyzed. Results: A total of 124 patients remained for analysis. All SF-36 scores except mental composite score increased, reaching and maintaining levels of the Swedish norm already after 8 weeks with no difference between groups. Event-free recovery was seen in 85% in the laparoscopic group and in 65% of the open cases (P < 0.010). Five recurrences occurred after laparoscopic surgery and 1 in the open group (P < 0.112). Overall, abdominal wall complaints decreased from 82% to 13% of the patients; and 92% were satisfied with the result after 1 year. In univariable logistic regression analyses laparoscopic surgery and male sex predicted an event-free recovery. Obesity (BMI > 30) predicted better outcome with regard to QoL. No predictors for recurrence or satisfaction were identified. Conclusions: Patients with incisional hernia benefit substantially from surgery concerning QoL, independent of surgical technique. An event-free recovery occurred frequently after laparoscopic surgery. SF-36 seems well suited for assessing surgical outcome in patients after incisional hernia repair.
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Improved oncological outcomes after cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) in highly selected patients have been well documented. The extensive nature of the procedure adversely affects quality of life (QoL). The aim of this study is to longitudinally evaluate QoL following CRS/HIPEC. This is a retrospective review of a prospectively maintained database of patients with peritoneal malignancies undergoing CRS/HIPEC. Clinicopathological data, oncologic outcomes, and QoL were analyzed preoperatively and post-operatively at 2 weeks, and 1, 3, 6, and 12 months. The Functional Assessment of Cancer Therapy-Colorectal instrument was used to determine changes in QoL after CRS/HIPEC and the impact of early recurrence (<12 months) on QoL. Thirty-six patients underwent CRS/HIPEC over 36 months. The median peritoneal cancer index score was 18 and the completeness of cytoreduction-0/1 rate was 97.2 per cent. Postoperative major morbidity was 16.7 per cent with one perioperative death. Disease-free survival was 12.6 months in patients with high-grade tumors versus 31.0 months in those with low-grade tumors (P = 0.03). QoL decreased postoperatively and improved to baseline in six months. Patients with early recurrence had a decrease in global QoL compared with preoperative QoL at 6 (P < 0.03) and 12 months (P < 0.05). This correlation was not found in patients who had not recurred. Patients who undergo CRS/HIPEC have a decrease in QoL that plateaus in 3 to 6 months. Early recurrence adversely impacts QoL at 6 and 12 months. This study emphasizes the importance of patient selection for CRS/HIPEC. The expected QoL trajectory in patients at risk for early recurrence must be carefully weighed against the potential oncological benefit of CRS/HIPEC.
Hyperthermic Intraperitoneal Chemotherapy
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Objective:To explore of the application effect of early escharectomy and skin grafting in elderly patients with burns prevention of complications and the quality of life improvement.Method:82 elderly patients with burns were selected in our hospital from August 2011 to October 2013,they were randomly divided into the control group and the observation group,41 cases in each group.The control group was given the late granulation scraping zonation grafting treatment,the observation group was given early escharectomy and skin grafting for treatment,the complications and quality of life of the two groups were observed and compared.Result:The complication rate of the observation group was 39.0%, it was significantly lower than 12.2% of the control group,and the survival quality scores of the observation group were significantly higher than those in the control group,the differences were statistically significant(P0.05).Conclusion:In the treatment of elderly patients with burn,take early escharectomy and skin grafting operation treatment can achieve a significant effect,can effectively reduce the incidence of complications,improve the quality of life of patients,it is worthy to be popularized in clinic.
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Venous leg ulcer
Varicose Ulcer
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