Venous thromboembolismafter surgical treatment of non-spinal skeletal metastases : An underdiagnosed complication

Introduction and aim: Venous thromboembolism (VTE) is a severe complication associated both with major orthopaedic surgery and cancer. However, survival and postoperative complications of skeletal metastases despite their thrombogenic potential, have received little attention in both the clinical management and research setting. This single-centre observational cohort study aimed to evaluate the incidence and impact of VTE in association with cancer surgery targeted to the management of fractures secondary to skeletal metastases. Methods: Data were collected retrospectively from the medical database. We included consecutive 306 patients operated for 343 non-spinal skeletal metastases during a 15-year period (1999-2014). The incidence of VTE and its risk factors were assessed using binary logistic regression analysis. Kaplan-Meier and Cox regression analyses were used to evaluate variables affecting survival. Results: The rate of symptomatic VTE was 10% (30/306) during the 3-month postoperative period, while 79% received thromboprophylaxis. Fatal pulmonary embolism (PE) rate was high, 3.3% (10/306) after surgery. Intraoperative oxygen saturation drop, pulmonary metastases and intramedullary nailing were independent risk factors for VTE. Indicators of decreased survival were lung cancer, intramedullary nailing, multiple skeletal and pulmonary metastases, anaemia, leukocytosis, and PE. Conclusion: Relationship between fractures secondary to skeletal metastases and VTE needs further clinical attention. Whether the survival of patients with fractures secondary to skeletal metastases can be improved by targeted thromboprophylactic means should be studied further. (C) 2016 Elsevier Ltd. All rights reserved.Peer reviewe

Tilan kokemisen kulttuurihistoriaa

Tilan kokemisen kulttuurihistoriaa lähtee kiinnostuksesta, millainen on ihmisen suhde häntä ympäröivään maailmaan. Tutkimalla tilan kokemista pääsemme jokapäiväisen elämän tasolle tavalla, joka läpäisee kulttuurin kollektiivisen tason ja tuo esiin sen, miten kulttuuri omaksutaan yksilötasolla. Artikkeleissa on yhteisenä taustakysymyksenä se, miten tila kussakin ajassa koetaan. Se, että korostetaan kokemisen näkökulmaa, painottaa jokapäiväisen elämän ruumiillista ja aisteihin pohjautuvaa kulttuurista perusluonnetta. Tilan kokemisen kulttuurihistoriaa soveltuu niin kulttuurihistorian opiskelijoille ja tutkijoille kuin myös yleisemmin historian tutkimuksesta tai tilan teorioista kiinnostuneille lukijoille.Siirretty Doriast

Radiographic and Ultrasonographic Findings in Three Surgically Confirmed Cases of Small Intestinal Ischemia Related to Mesenteric Volvulus or Intestinal Torsion in Dogs

This case report describes the radiographic and ultrasonographic findings of three surgically confirmed cases of mesenteric volvulus or intestinal torsion in dogs. In all three cases, ultrasonographic findings included segmental ileus and absent or markedly reduced peristalsis of the affected small intestine, and partial loss of wall layering with increased overall echogenicity of the intestinal wall, but with normal to mildly increased wall thickening. No blood flow was detected in the affected small intestinal wall when assessed with colour Doppler. A moderate amount of peritoneal effusion was also detected with hyperechoic omental and mesenteric fat tissue throughout the peritoneal cavity. Few reports describe ultrasonographic findings of small intestinal ischemia in small animals. In all three cases presented here, ultrasound was helpful in demonstrating typical intestinal wall changes and helped to obtain the correct diagnosis of ischemic disease of the small intestine.Peer reviewe

Preoperative coagulation biomarkers associate with survival and pulmonary embolism after surgical treatment of non-spinal skeletal metastases

Peer reviewe

Tuleeko toisiolaista tutkimuksen tulppa vai kasvumoottori?

Rekisteritietojen yhdistäminen ei ole vain tekninen ongelma, vaan edellyttää myös sisällön yhteismitallisuutta. Paras kliinisen ¬informatiikan osaaminen on yliopistosairaaloissa. Sitä ei pidä heittää hukkaan