RESUMEN
BACKGROUND: Deep venous thrombosis (DVT) is considered the most common cause of preventable death among hospitalized patients. A few studies have investigated the risk of venous thromboembolic events in patients undergoing elective spine surgery and reported varying incidences. We aim to assess the incidence of preoperative lower limb DVT in patients with lumbar degenerative disease undergoing elective surgery. METHODS: This is a retrospective review of prospectively collected data on adult patients with lumbar degenerative spine diseases (lumbar stenosis [LST], lumbar spondylolisthesis [SPL], or lumbar disc herniation) who were scheduled for operative management. Each patient underwent a preoperative lower limb venous Duplex (LLVD). Incidence of DVT, risk factors, and clinical course of patients were reported. RESULTS: Forty-nine patients (32 females; 65%) were included. All patients were diagnosed clinically and radiologically with lumbar degenerative diseases; LST (44.9%), SPL (36.7%), and lumbar disc herniation (18.4%), requiring surgical management. Three patients (6.1%) were found to have positive DVT studies, leading to the cancellation or rescheduling of their procedures (P < 0.01). These included 1 patient with LST (P = 0.045) and 2 patients with SPL (P = 0.006). Among patients with LST and SPL, higher disability (modified Rankin scale ≥3) was significantly associated with positive LLVD (P = 0.035). CONCLUSION: Patients with LST or SPL with higher preoperative disability scores were at higher risk to have preoperative DVT. Further research is needed to evaluate the feasibility and value of preoperative LLVD to detect DVT in patients planned for lumbar degenerative surgery.
Asunto(s)
Desplazamiento del Disco Intervertebral , Tromboembolia Venosa , Trombosis de la Vena , Adulto , Femenino , Humanos , Desplazamiento del Disco Intervertebral/complicaciones , Prevalencia , Columna Vertebral/diagnóstico por imagen , Columna Vertebral/cirugía , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/epidemiología , Trombosis de la Vena/etiología , Tromboembolia Venosa/epidemiología , Estudios Retrospectivos , Constricción Patológica/complicaciones , Vértebras Lumbares/diagnóstico por imagen , Vértebras Lumbares/cirugíaRESUMEN
Cervical leiomyoma is considered a rare pathology with limited treatment options especially if preserving fertility is a concern. Traditional fertility-preserving surgery such as myomectomy has been the mainstay of management if it is possible (Ferrari F, Forte S, Valenti G, Ardighieri L, Barra F, Esposito V, et al. Current treatment options for cervical leiomyomas: a systematic review of literature. Medicina (Kaunas) 2021;57:1-15). Trachelectomy was described as fertility-preserving surgery in patients with early-stage cervical cancer. However, recent studies manage patients with trachelectomy for benign pathology and suggest that; it as an alternative option that otherwise will be treated as hysterectomy (Ferrari F, Forte S, Valenti G, Ardighieri L, Barra F, Esposito V, et al. Current treatment options for cervical leiomyomas: a systematic review of literature. Medicina (Kaunas) 2021;57:1-15). A 33-year-old female, Para 3, referred to a gynecology clinic with a history of heavy menstrual flow, pelvic pain and pressure symptoms. She is known case of fibroid uterus however after having done pelvic MRI with contrast it confirmed the diagnosis of cervical myoma, measured 10 cm × 10 cm, which is intraoperatively managed by trachelectomy as a fertility preservation surgery. The surgery was complicated by ureterovaginal fistula, which was managed with a DJ stent conservatively. Cervical myoma is a rare pathology, and trachelectomy should be considered as an option for a woman who wants to preserve her fertility. Complication and obstetrical outcome should be discussed with the patient; hence, more studies are needed to address the management of cervical myoma, surgical complications and outcome of this procedure, especially in a benign condition.
RESUMEN
BACKGROUND: Group therapy assists individuals in learning many behavioral techniques for smoking cessation and providing each other with mutual support. Group behavior therapy is not routinely provided as a modality of tobacco cessation assistance in tobacco cessation clinics in Saudi Arabia despite it is effectiveness. Therefore, this study aimed to assess the knowledge, attitude, and beliefs toward group behavior therapy programs among male adults who attend smoking cessation clinics and to identify the associated factors. METHODS: A cross-sectional study was conducted with a targeted sample of 229 males aged 18 and above who were attending smoking cessation clinics. The participants were randomly selected. Data were collected using a paper-based questionnaire. One-way ANOVA and chi-square test were used for statistical analysis. RESULTS: Results showed a high percentage of the study participants were in the age group of 21-40 years. Most of them were consuming 10-20 cigarettes per day. Around 79% of the participants had previous attempted to quit smoking. This study demonstrated a deficit in knowledge about group behavior therapy. The mean score for attitude and beliefs was 5.3 out of 11. Multiple factors influenced their attitudes and beliefs, such as previous attempts to quit smoking (p-value < 0.05) and the number of cigarettes used per day (p-value = 0.03). The knowledge was found to be affected by the level of education (p-value = 0.04). CONCLUSION: The study demonstrates a deficit in knowledge about group behavior therapy and it shows that the level of education was associated with the knowledge. Additionally, previous attempts to quit smoking and the number of cigarettes used per day, influenced the participants' attitude and beliefs toward group behavioral therapy. Increase awareness about the role of group behavior therapy in smoking cessation is required before this method is implemented in the routine practice.