Age-sex specific prevalence of radiographic abnormalities of the joints of the hands, wrists and cervical spine of adult residents of the Tecumseh, Michigan, Community Health Study area, 1962-1965

Radiographs of the hands and wrists and cervical spine of 4415 residents of Tecumseh, Michigan, aged 16 yr and over, have been reviewed. Evidence of rheumatoid arthritis was observed in the hands and wrists of 0.19 per cent of males and 0.34 per cent of females. The prevalence of cervical spine changes, which could be attributed to rheumatoid arthritis or ankylosing spondylitis, was insignificant.Degenerative changes in both examined regions occurred much more frequently and showed a marked positive correlation with advancing age. Radiographic evidence of osteoarthrosis of the hands and wrists was observed in 19.5 per cent of males and 23 per cent of females. In the cervical spine, degenerative disc disease (16-19 per cent) was noted somewhat more frequently than osteoarthrosis (11 per cent).Among the other radiographic lesions which were observed, those of post traumatic changes, including amputation of digits, in the hands and wrists and fusion of cervical vertebral bodies, thought to represent a failure of segmentation in embryonic life, were most frequent.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/32700/1/0000067.pd

Predictors for anastomotic leak, postoperative complications, and mortality after right colectomy for cancer: Results from an international snapshot audit

Background: A right hemicolectomy is among the most commonly performed operations for colon cancer, but modern high-quality, multination data addressing the morbidity and mortality rates are lacking. Objective: This study reports the morbidity and mortality rates for right-sided colon cancer and identifies predictors for unfavorable short-term outcome after right hemicolectomy. Design: This was a snapshot observational prospective study. Setting: The study was conducted as a multicenter international study. Patients: The 2015 European Society of Coloproctology snapshot study was a prospective multicenter international series that included all patients undergoing elective or emergency right hemicolectomy or ileocecal resection over a 2-month period in early 2015. This is a subanalysis of the colon cancer cohort of patients. Main Outcome Measures: Predictors for anastomotic leak and 30-day postoperative morbidity and mortality were assessed using multivariable mixed-effect logistic regression models after variables selection with the Lasso method. Results: Of the 2515 included patients, an anastomosis was performed in 97.2% (n = 2444), handsewn in 38.5% (n = 940) and stapled in 61.5% (n = 1504) cases. The overall anastomotic leak rate was 7.4% (180/2444), 30-day morbidity was 38.0% (n = 956), and mortality was 2.6% (n = 66). Patients with anastomotic leak had a significantly increased mortality rate (10.6% vs 1.6% no-leak patients; p 65 0.001). At multivariable analysis the following variables were associated with anastomotic leak: longer duration of surgery (OR = 1.007 per min; p = 0.0037), open approach (OR = 1.9; p = 0.0037), and stapled anastomosis (OR = 1.5; p = 0.041). Limitations: This is an observational study, and therefore selection bias could be present. For this reason, a multivariable logistic regression model was performed, trying to correct possible confounding factors. Conclusions: Anastomotic leak after oncologic right hemicolectomy is a frequent complication, and it is associated with increased mortality. The key contributing surgical factors for anastomotic leak were anastomotic technique, surgical approach, and duration of surgery