Postoperative stay following colorectal surgery: a study of factors associated with prolonged hospital stay.
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AIM: To study the factors that contribute to postoperative stay following colorectal surgery. DESIGN: A prospective observational study. SETTING: Three colorectal surgical units - a teaching hospital, a large district general hospital and a district general hospital. PARTICIPANTS: 350 patients undergoing colorectal surgery. MAIN OUTCOME MEASURES: 28 pre-, peri- and postoperative patient- and treatment-related factors. RESULTS: Stepwise regression analysis suggests that the factors that significantly lengthen postoperative stay include a low albumin on admission, stoma formation, operative blood loss, urinary and respiratory complications, wound infections, postoperative ventilation and social delay at the time of discharge. The postoperative stay was not affected by patient age or by the seniority of the surgical team. CONCLUSIONS: Factors have been identified that determine the postoperative length of stay. These data may allow better planning and treatment of patients undergoing colorectal surgery. (+info)
What to do if it gets 'bigger'.
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The problems associated with intra-operative erections are discussed. Present theory is reviewed to allow a better understanding of the available treatment options. (+info)
Acaroid mite, intestinal and urinary acariasis.
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AIM: To investigate epidemiology and pathogenic mite species of intestinal and urinary acariasis in individuals with different occupations. METHODS: A total of 1994 individuals were tested in this study. History collection, skin prick test and pathogen identification were conducted. The mites were isolated from stool and urine samples by saturated saline flotation methods and sieving following centrifugation, respectively. RESULTS: Among the 1994 individuals examined, responses to the skin prick test of "+++", "++", "+","+/-" and "-" were observed at frequencies of 3.96 % (79), 3.21 % (64), 2.31 % (46), 1.25 % (25) and 89.27 % (1780), respectively. A total number of 161 (8.07 %) individuals were shown to carry mites, with 92 (4.61 %) positive only for stool samples, 37 (1.86 %) positive only for urine samples and 32 (1.60 %) for both. The positive rate of mites in stool samples was 6.22 % (124/1994), being 6.84 % (78/1140) for males and 5.39 % (46/854) for females. No gender difference was observed in this study (chi(2)=1.77, P>0.05). The mites from stool samples included Acarus siro, TyroPhagus putrescentiae, Dermatophagoides farinae, D. pteronyssinus, Glycyphagus domesticus, G. ornatus, Carpoglyphus lactis and Tarsonemus granaries. The positive rate of mites in urine samples was 3.46 % (69/1994). The positive rates for male and female subjects were found to be 3.95 % (45/1140) and 2.81 % (24/854) respectively, with no gender difference observed (chi(2)=1.89, P>0.05). Mites species in urine samples included Acarus siro, Tyrophagus putrescentiae, T. longior, Aleuroglyphus ovatus, Caloglyphus berlesei, C. mycophagus, Suidasia nesbitti, Lardoglyphus konoi, Glycyphagus domesticus, Carpoglyphus lactis, Lepidoglyphus destructor, Dermatophagoides farinae, D. pteronyssinus, Euroglyphus magnei, Caloglyphus hughesi, Tarsonemus granarus and T. hominis. The species of mites in stool and urine samples were consistent with those separated from working environment. A significant difference was found among the frequencies of mite infection in individuals with different occupations (chi(2)=82.55, P<0.001), with its frequencies in those working in medicinal herb storehouses, those in rice storehouse or mills, miners, railway workers, pupils and teachers being 15.89 % (68/428), 12.96 % (53/409), 3.28 % (18/549), 2.54 % (6/236), 5.10 % (13/255) and 2.56 % (3/117), respectively. CONCLUSION: The prevalence of human intestinal and urinary acariasis was not associated with gender, and these diseases are more frequently found in individuals working in medicinal herb, rice storehouses or mills and other sites with high density of mites. More attention should be paid to the mite prevention and labor protection for these high-risk groups. (+info)
The performance properties of the International Index of Erectile Function (IIEF-15) in assessing erectile dysfunction in patients with lower urinary tract symptoms.
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To validate the International Index of Erectile Function (IIEF-15) in Malaysian population. Reliability and internal consistency were evaluated using the test-retest method and Cronbach's alpha. Sensitivity to change was expressed as the effect size index. Internal consistency was excellent (Cronbach's alpha value = 0.75 to 0.90) Test-retest correlation coefficient and intraclass correlation coefficient were highly significant (ICC = 0.75 and above) and a high degree of sensitivity and specificity was observed. The IIEF-15 is suitable, reliable, valid and sensitive to clinical change in the Malaysian population. (+info)
Population pharmacokinetics of netilmicin in short-term prophylactic treatment.
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AIMS: To characterize the population pharmacokinetics of netilmicin, an aminoglycoside antibiotic, in adult urology patients and to develop a covariate model for improved dose titration. METHODS: Data from 62 adult patients (55 male, seven female), undergoing urological surgery and treated with netilmicin for short-term prophylaxis, were evaluated retrospectively. The group had (median, range) ages 68, 31-92 years, weights 72, 43-106 kg and heights 167, 148-182 cm. No patient showed renal impairment before netilmicin treatment (serum creatinine +info)
Nonosseous abnormalities on bone scans.
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Although bone scanning is a test primarily concerned with skeletal abnormalities, important nonosseous findings are occasionally present on the images. To gauge the significance of such nonosseous uptake and, in particular, to determine whether these findings contain useful diagnostic information, the technical and medical staff in nuclear medicine must recognize the various patterns of nonbony uptake and understand their causes. The objectives of this article are to demonstrate the appearances of nonosseous uptake on bone scans, to categorize the forms of soft-tissue uptake, to emphasize technical artifacts leading to soft-tissue uptake, and to highlight the clinical significance of pathologic soft-tissue uptake. (+info)
Urethral stenosis in young girls; a cause of recurrent infection of the urinary tract.
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Recurrent urinary tract infection in young girls may result from unsuspected urethral stenosis. The diagnosis should be considered in the presence of symptoms suggesting obstruction of the lower urinary tract-symptoms such as infrequent voiding and straining on urination, particularly in intervals between bouts of acute febrile illness accompanied by pyuria or bacilluria. If radiopaque medium is retained in the bladder in unusual quantity following voiding at the close of excretory urography, it is suggestive but not pathognomonic of urethral stenosis. The diagnosis is established by instrumental calibration of the urethra under general anesthesia. Treatment consists in removing the cause by urethral dilatation and administering antibiotics and chemotherapeutic agents to overcome the infection. (+info)
Urinary tract infections; problems in medical management.
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The lesion principally responsible for chronic, or recurrent, urinary tract infection is a focus in the interstitial tissue of the kidney. Most cursory antimicrobial therapy suppresses the manifestations of lower urinary tract involvement but does not eradicate the renal focus. In order to cure rather than merely suppress the infection, it is imperative that, as early as possible, steps be taken to isolate and identify the etiologic microorganism and to determine its sensitivity to antimicrobial agents. Based on this information sufficient amounts of drug should be given for an adequate period (probably at least two weeks) to eradicate the infection within the renal tissue. Such a program would tend to reduce the number of cases in which irreversible renal failure develops from chronic pyelonephritis. (+info)