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Results for “Complicity”

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At least 19 recordsLinked to original sources

PubMed1992

Psychosocial factors and complications of IDDM. The Pittsburgh Epidemiology of Diabetes Complications Study. VIII.

OBJECTIVE: To investigate whether psychosocial factors are associated with diabetic complications. RESEARCH DESIGN AND METHODS: Questionnaires on quality of life, depressive symptomatology, and personality type were completed and a clinical assessment was performed. The study population was an incident cohort of childhood-onset insulin-dependent diabetic (IDDM) subjects whose duration of IDDM was greater than or equal to 25 yr (n = 175). RESULTS: Patients with macrovascular disease (P less than 0.01) or nephropathy (P less than 0.05) reported significantly poorer quality of life compared with those who were free from all complications. Patients with macrovascular disease also reported greater depressive symptomatology (P less than 0.05). Quality of life significantly deteriorated according to the presence of multiple (greater than or equal to 4) complications (P less than 0.001). Higher depression symptom scores were also related to the presence of greater than or equal to 4 complications (P less than 0.001). Those with multiple complications reported less type A behavior than those without any complications (P less than 0.05). CONCLUSIONS: This study shows that psychosocial differences exist according to both the number and the type of diabetic complications present. Because poorer quality of life and symptoms of depression may both result form complications, prospective follow-up is needed to clarify their temporal interrelationships, and to determine whether type A personality affords any protection against complications or is diminished as a result of developing complications.

Adult↗

PubMed1986

Complications in arthroscopy: the knee and other joints. Committee on Complications of the Arthroscopy Association of North America.

A questionnaire was sent to members of the Arthroscopy Association of North America surveying complications in arthroscopic surgery of the knee and other joints. There were 395,566 arthroscopies reported including 375,069 knee arthroscopies, 14,329 shoulder arthroscopies, 4,478 ankle arthroscopies, 1,569 elbow arthroscopies, and 121 wrist arthroscopies. There were 2,215 complications reported. The overall complication rate was 0.56%. Specific procedures were surveyed for the first time. The complication rate reported for meniscal repair was 2.4%. The complication rate in anterior cruciate ligament (ACL) procedures (repairs and reconstructions) was 1.8%. The procedure with the highest complication rate was the anterior staple capsulorrhaphy of the shoulder (5.3%). Surgery in the subacromial space resulted in a complication rate of 0.76%. None of these complication rates included failures. As newer procedures are instituted into clinical practice that involve various joints, and are more technically demanding, the complication rate is increasing.

Anesthesia↗

PubMed1992

Medical complications of cocaine: changes in pattern of use and spectrum of complications.

We sought to determine whether changes in patterns of cocaine use, characterized by widespread abuse of cocaine alkaloid, have altered the nature and severity of medical complications over the past decade. Infectious complications, almost invariably associated with intravenous use, accounted for nearly all hospital admissions in the early 1980s. Cardiovascular, neurologic and psychiatric complications rose dramatically after 1987 both in absolute number and as a proportion of total complications. This rise parallelled increases in the absolute number and proportion of hospitalized patients smoking cocaine alkaloid or using intranasal cocaine, both disproportionately associated with non-infectious complications. While infectious complications were often local in nature, serious neurologic and cardiovascular sequelae were observed. These data indicate that changes in patterns of cocaine use have altered the nature and increased the severity of medical complications with a shift from infectious to cardiovascular, neurologic and psychiatric complications which may be life-threatening and associated with substantial morbidity.

Administration, Intranasal↗

PubMed1988

Financial risk, hospital cost, and complications and comorbidities in medical non-complications and comorbidity-stratified diagnosis-related groups.

A number of methods are being studied to modify and improve the accuracy of the Medicare Diagnosis-Related Group (DRG) hospital classification system. This study analyzed resource consumption for 2,431 medical Medicare patients in the 53 non-complicating condition-stratified (i.e., non-complication and comorbidity) medical DRGs. Resource consumption per patient increased as the number of complications and comorbidities per patient per DRG increased, as measured by total hospital cost, hospital length of stay, the number of diagnoses and procedures per patient, the percent outliers, and mortality. Patients with more than four complications and comorbidities generated significant financial risk ($5,667 loss per patient) under DRG reimbursement. This study raises the question of the equity of DRG reimbursement for the medical non-complication and comorbidity-stratified DRGs. A method for DRG adjustment based on complications and comorbidities should be implemented by Congress to assure equitable payment for patients in these medical DRGs.

Costs and Cost Analysis↗

PubMedDate not supplied

Spontaneous whole blood platelet aggregation, hematological variables and complications in insulin-dependent diabetes mellitus: the Pittsburgh Epidemiology of Diabetes Complications Study.

The role of platelet aggregation in the pathogenesis of diabetes complications remains unclear despite a number of reports suggesting associations in univariate analyses. The Pittsburgh Epidemiology of Diabetes Complications Study is a prospective study initiated in 1985 to determine risk factors for the development of complications in insulin-dependent diabetes mellitus (IDDM). This report focuses on the cross-sectional correlation between platelet count and aggregation and IDDM complications, in 563 participants aged 18 years and older seen at baseline. Spontaneous whole blood platelet aggregation (SWBPA) and other hematological variables [hematocrit, total platelet count (TPC), red blood cell count (RBC), fibrinogen and white blood cell count (WBC)] were evaluated as risk factors for IDDM complications (nephropathy, neuropathy, and retinopathy) in the baseline cross-sectional data of the Pittsburgh Epidemiology of Diabetes Complications Study. SWBPA was determined by a method based on the percentage fall in platelet count after shaking a fresh citrated blood sample kept at 37 degrees C. Subjects with chronic aspirin use or on dialysis were excluded from analysis. An increased TPC was observed in subjects with overt nephropathy (291.4 +/- 65.1 versus 261.2 +/- 64.9, p less than 0.001) compared with subjects without nephropathy. Similar results were found for proliferative retinopathy. The association with nephropathy (but not with retinopathy) persisted in multivariate analyses.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

Factors associated with avoidance of severe complications after 25 yr of IDDM. Pittsburgh Epidemiology of Diabetes Complications Study I.

To identify characteristics associated with long-term avoidance of insulin-dependent diabetes mellitus (IDDM) complications, subjects taking part in an epidemiologic natural history study of childhood-onset IDDM, with a duration of disease greater than or equal to 25 yr, were studied. Nineteen percent of 175 subjects had avoided overt nephropathy, definite cardiovascular and peripheral vascular disease, clinical neuropathy, and proliferative retinopathy. Approximately half of the nonrenal complications occurred in the absence of renal disease. Subjects free of these advanced complications were characterized by a longer duration of disease (P less than 0.05), better lipid profile and blood pressure (P less than 0.01), and considerably lower glycosylated hemoglobin levels (P less than 0.001). Health-related behaviors, including recent medical contact, regular glucose monitoring, physical activity in youth, and avoidance of cigarette smoking, did not relate to complication status, although regular (at least weekly) alcohol consumption was more prevalent (P less than 0.05) in those without complications. We conclude that a lower mean glycosylated hemoglobin level is strongly related to the avoidance of all IDDM complications.

Adult↗

PubMed1991

The association of physical activity and diabetic complications in individuals with insulin-dependent diabetes mellitus: the Epidemiology of Diabetes Complications Study--VII.

The relationship between leisure-time physical activity and diabetes complications was examined in 628 individuals with insulin-dependent diabetes mellitus. Neuropathy was based upon clinical exam; retinopathy by fundus photographs; nephropathy by urine samples and macrovascular disease by clinician diagnosis. Past week physical activity was found to be inversely related to complication status but since current inactivity could be the result of the complications, historical activity (estimated leisure activity during ages 14-17) was also examined in relation to complication status. Males reporting higher levels of historical physical activity had a significantly lower prevalence of nephropathy and neuropathy but not retinopathy as demonstrated by multivariate analysis (controlling for duration of disease, age, and current activity levels). The lack of similar findings in women may be due to their low levels of reported physical activity. The consistent relationship between historical leisure physical activity and development of complications in males suggests that activity may be protective or at least not detrimental to the individual with insulin-dependent diabetes.

Adolescent↗

PubMed1989

Antenatal complications and perinatal outcome in patients with nausea and vomiting-complicated pregnancy.

The incidence of nausea and vomiting-complicated pregnancy was determined in a district hospital in Hong Kong. Nausea was present in 11.4% and vomiting in 63.5% of pregnant women. Patients with vomiting complicating early pregnancy have a statistically significant higher incidence of antepartum haemorrhage of indeterminate origin. The incidences of medical diseases complicating pregnancy, other major antenatal complications, and the neonatal outcome were not different between vomiting and non-vomiting patients.

Adult↗

PubMed1989

Complications of endodrainage retinotomies created during vitreous surgery for complicated retinal detachment.

The authors report nine cases of endodrainage retinotomy site complications that occurred after vitreous surgery for complicated retinal detachments (RDs). Postoperative subretinal neovascularization developed in four eyes at the retinotomy drainage site. In two eyes, postoperative proliferation at a posteriorly placed endodrainage site created traction macular detachments. Redetachment due to retinotomy opening caused by postoperative drainage site proliferation developed in three eyes. The retinas of all nine eyes were eventually reattached, and vision improved from the preoperative level. These complications are related to retinal pigment epithelium and/or Bruch's membrane damage during internal subretinal fluid drainage and retinotomy endolaser photocoagulation. Careful evaluation of extrusion instruments, drainage techniques, retinotomy placement, and subsequent endolaser treatment is necessary to minimize these complications.

Adolescent↗

PubMed1988

Fertility after complicated and non-complicated use of IUDs. A controlled prospective study.

From 1980 to 1985, 600 women participated in a prospective study of three copper IUDs. Women who had removed their IUD by April 1985 because of IUD-related complications or planned pregnancy after non-complicated use were examined for return of fertility. Within 39 months after removal, all 97 women who planned pregnancy had conceived. By April 1987, one of the 147 women with a previous IUD complication needed a fertility work-up. Among the remaining 146 women, 72 women had conceived, while 74 women neither had pregnancy plans nor had conceived after IUD removal. Three (1.8%) out of the 169 pregnancies after IUD removal were extrauterine; 17 (10.1%) were spontaneous abortions. One percent of the women planning pregnancy requested induced abortion, compared to 29% among women who removed the IUD due to complications (p less than 0.01). From these data we conclude that use of copper-containing IUDs did not affect subsequent fertility.

Adult↗

PubMed1990

Normal tissue reactions and complications following high-energy neutron beam therapy. II: Complication rates adjusted for censoring.

A dose response analysis was performed on patients at risk for significant radiation injuries following neutron radiotherapy. Complication rates were calculated at various dose intervals using a maximum likelihood method that is formally equivalent to the product limit estimator of survival. The variance of each complication rate was used to weight a logistic regression on log dose. The treatment sites that were analyzed were head and neck, pelvis, thorax, and pancreas. Except for osteomyelitis of the mandible, complications of all types were considered collectively at each site and dose increment since there were too few complications to determine dose response functions for individual types of injuries. The head and neck was observed to be the site with the highest tolerance to radiation whereas the thorax was the most sensitive site.

Dose-Response Relationship, Radiation↗

PubMed1978

Complications of catheter cerebral arteriography: analysis of 5,000 procedures. II. Relation of complication rates to clinical and arteriographic diagnoses.

Clinical (prearteriographic) and arteriographic diagnoses were grouped into six categories each for analysis of central nervous system and systemic complications of 5,000 catheter cerebral arteriograms. Within each category, there was no significant difference in complication rate between clinical and arteriographic diagnoses. The highest complication rates (1.2%-1.9%) were in patients with cerebrovascular occlusive disease, posttraumatic or postoperative conditions, and subarachnoid hemorrhage. Significantly lower complication rates (0.2%-0.5%) were found in patients with tumor, seizure or headache, and patients with normal arteriographic findings.

Adult↗

PubMed1990

Oral complications of cancer therapies. Description and incidence of oral complications.

No part of the body reflects the complications of cancer chemotherapy as visibly and as vividly as the mouth. The infectious, hemorrhagic, cytotoxic, nutritional, and neurologic signs of drug toxicity are reflected in the mouth by changes in the color, character, comfort, and continuity of the mucosa. The stomatologic complications of radiotherapy for oral cancer are physical and physiological in nature, transient or lasting in duration, and reversible or irreversible in type. Some linger as permanent mementos long after the cancer has been destroyed. They stem from radiation injury to the salivary glands, oral mucosa, oral musculature, alveolar bone, and developing teeth. They are expressed clinically by xerostomia, trismus, radiation dermatitis, nutritional stomatitis, and dentofacial malformation. In both cancer chemotherapy and cancer radiotherapy, the oral complications vary in pattern, duration, intensity, and number, with not every patient developing every complication.

Antineoplastic Agents↗

PubMed1979

[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examinations. II. Complications (author's transl)].

The author reviewed the complications of 700 heart catheterizations in infants and children performed between 1970 and 1978 with a frequency of 55 to 113 investigations per year. Arrhythmias occurred on 70 occasions (10%), death within 24 hours: 14 (2%), extravasation of contrast media: 11 (1,6%), perforation by catheter: 6 (0,9%), cyanotic spells 5 (0,7%), myocardial ischemia: 4 (0,6%), respiratory arrest: 4 (0,6%), convulsions: 2 (0,3%), wound infection: 2 (0,3%), icterus 2 (0.3%), lung atelactasis: 1 (0,15%), bacterial endocarditis: 1 (0,15%), pyrexia: 1 (0,15%), exanthema: 1 (0,15%), pulmonary edema: 1 (0,15%), meningitis purulenta and hepatitis as possible complications: 1 (0,15%) each. The mortality figue of 2% lies well within the range of rates reported by Ho and ass. (1972): 1,5%, Stanger and ass. (1974): 3,0%, Rowe (1978): 0,95%, and Graham (1978): 2,9%. Mortality mainly occurs in sick neonates and infants with complex cardiac malformations. It could be lowered by a more aggressive approach to diagnostic work-up of suspected cardiac disease, as well as by using more sophisticated catheterization techniques and material and by introducing intensive care principles on the infant ward. Catheter related mortality (e. g. by perforation, severe arrhythmia) could be reduced to zero during the last three years. Myocardial staining by contrast media and electrocardiographic alterations suggesting myocardial ischemia occurred comparatively often but were never followed by serious or long lasting sequelae. Their occurrence was not related to the diagnosis or to the age of the patient. Respiratory arrest and convulsions could only be observed in sick infants. The seizures were not directly related to angiocardiography. All other complications were incidental events. Arrhythmias and vascular complications are discussed in separate papers.

Atrial Fibrillation↗

PubMed1977

[Urological and nephrological complications after general surgery. Urological complications. Kidney and ureter].

Urologic complications can result from abdominal, gynecologic, and retroperitoneal operations. As a result, surgical treatment of colonic tumors, genital tumors, the vertebral column, the lymphatic system, and the aortoiliacal vessels assumes a greater importance. Immediate therapy is possible as a result of intraoperative diagnosis. The postoperative diagnosis may become manifest as early or late symptoms. Certain criteria for avoiding such complications are mentioned. Following diagnosis of a urologic complication, immediate therapy seems to produce the best results and the shortest period of hospitalization.

Abdomen↗

PubMed1988

[Infectious complications, delayed wound healing and inflammatory syndromes as late complications of cardiovascular surgery].

Four-hundred and three patients were admitted to an internal medicine unit for late complications of cardiac or vascular surgery; 321 of these patients (80 per cent) had a total of 379 complications or intercurrent disease, 147 (40 per cent) of which were infections (71 cases), delayed healing of the operative wound (39 cases) or inflammatory syndromes (37 cases). Such complications are notable for their immediate or secondary severity, the diagnostic problems sometimes raised by their latency, their repercussions on the length of hospitalization and cost of surgery, and the thoughts they inspire concerning the minimal stay in hospital required after this type of surgery.

Cardiovascular Diseases↗

PubMed1991

Complications of foot surgery. Complications of anesthesia.

Anesthesia is a necessity when performing surgery. As with any component of the surgical task, there are complications associated with any of the various anesthetic agents and techniques. The most effective way to diminish a complication is through prevention. A detailed medical history and examination of the patient will alert the physician to possible hazards along the surgical path. Dialogue with the anesthesiologist to promote teamwork is always in the patient's best interest and can lower the complication rate.

Aged↗

PubMed1990

Oral complications of cancer therapies. Oral complications in the pediatric population.

A number of acute oral complications may be associated with cancer therapy in children, but the extent and duration of these complications, and the most effective management techniques. have not been well described. The few studies differ in design, making comparisons difficult. Well-controlled, prospective clinical studies are needed to define the most effective strategies for the management of acute oral complications in children. However, it is clear that dental intervention prior to cancer therapy is an important factor in the optimal preparation of the patient. During cancer therapy, intensive supervised oral preventive protocols appear to be of benefit to the child's oral health, overall comfort, and well-being. Furthermore, the prevention of oral infection may significantly reduce the morbidity associated with cancer therapy. Long-term preventive oral care may help prevent dental disease and infection in medically compromised children and contribute to improving the quality of life.

Antineoplastic Agents↗