Background: The hepatosplenic schistosomiasis (HSS) with portal hypertension can cause vascular complications such as hepatopulmonary syndrome (HPS). HPS increases the risk of mortality in patients with cirrhosis; however, there is no data on the mortality of patients with HSS and HPS.
Aim: To perform a survival analysis of patients with HPS related to cirrhotic and non-cirrhotic (schistosomiasis) portal hypertension.
Methods: From August 2023 to January 2024, medical records and the official mortality information service of 121 patients who participated in a cross-sectional study on HPS between 2010 and 2012 were analyzed. Survival curves were created using the Kaplan-Meier method, and comparisons were performed using the log-rank test. Cox regression models estimated the hazard ratios (HR).
Results: Overall, data of 113 patients were analyzed; most (55.8%) had HSS and concomitant cirrhosis (HSS/cirrhosis). Meanwhile, HPS was present in 39 (34.5%) patients. Death occurred in 65 patients [57.5%; 95% confidence interval (CI): 48%-67%. The average time to death was lower in those with HPS when compared to those without HPS (3.37 years 5.65 years; = 0.017). According to the cause of liver disease, patients with HSS/cirrhosis died earlier, and their risk of death was twice as high compared with patients with HSS without cirrhosis (HR: 2.17; 95%CI: 1.3-3.60; = 0.003). Meanwhile, there were no differences when comparing the two groups with and without HPS (HR: 1.01; 95%CI: 0.59-1.73; = 0.967).
Conclusion: Patients with HSS and concomitant cirrhosis had a lower survival rate, but there was no difference in survival regardless of the presence of HPS.
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http://dx.doi.org/10.4254/wjh.v17.i2.99134 | DOI Listing |
J Arthroplasty
March 2025
Department of Adult Reconstruction and Joint Replacement, Hospital for Special Surgery, 535 East 70(th) Street, New York, NY, 10021, United States of America. Electronic address:
Introduction: Periarticular injections (PAI) are an important component in modern multimodal pain management protocols for total joint arthroplasty. There is a wide variety of formulas reported in the literature, from simple bupivacaine to surgeon-specific "cocktails" that include up to seven different components. Due to the broad lack of standardization in PAI formulations, this study aimed to evaluate the cost savings associated with our institution's transition to a standardized approach while ensuring no adverse impact on inpatient pain outcomes.
View Article and Find Full Text PDFJ Orthop Surg Res
March 2025
Department of Joint Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China.
Objective: Anterior cruciate ligament deficiency (ACLD) has traditionally been regarded as a contraindication for unicompartmental knee arthroplasty (UKA). However, advancements in surgical techniques and improvements in prosthetic manufacturing have challenged this notion. Controversy persists regarding whether the anterior cruciate ligament (ACL) influences the postoperative outcomes of fixed-bearing (FB) UKA.
View Article and Find Full Text PDFJ Clin Monit Comput
March 2025
Department of Surgical and Interventional Sciences, McGill University Health Center, Montreal, Quebec, Canada.
The administration of propofol for sedation or general anesthesia presents challenges due to the complex relationship between patient factors and real-time physiological responses. This study explores the application of deep reinforcement learning (DRL) to automate propofol dosing, aiming to maintain multiple physiological parameters including bispectral index (BIS), heart rate (HR), respiratory rate (RR), and mean arterial pressure (MAP) within safe and desired ranges. A multi-variable pharmacokinetic-pharmacodynamic (PK/PD) simulation environment was developed to model the effects of propofol on the physiological parameters.
View Article and Find Full Text PDFSpine Deform
March 2025
Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Introduction: With the rapid increase in the use of robotic-assisted spine surgery (RASS), reports describing complications have inevitably emerged. This study builds on previous work done to identify, characterize, and classify potential sources of error in spine surgery performed with enabling technology in the operating room. The goal of this study is to leverage expert opinion to develop a set of best practice guidelines that can be employed to minimize complications and optimize patient safety, specifically as it relates to RASS.
View Article and Find Full Text PDFWorld J Hepatol
February 2025
Postgraduate Program in Tropical Medicine, Center of Medical Sciences, Universidade Federal de Pernambuco, Recife 50670901, Pernambuco, Brazil.
Background: The hepatosplenic schistosomiasis (HSS) with portal hypertension can cause vascular complications such as hepatopulmonary syndrome (HPS). HPS increases the risk of mortality in patients with cirrhosis; however, there is no data on the mortality of patients with HSS and HPS.
Aim: To perform a survival analysis of patients with HPS related to cirrhotic and non-cirrhotic (schistosomiasis) portal hypertension.
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