Obstetric complications and age at onset in schizophrenia: an international collaborative meta-analysis of individual patient data

OBJECTIVE: An excess of obstetric complications in the histories of schizophrenic patients is a well-replicated finding, but less consistent results have been found concerning the relationships between obstetric complications and family history of schizophrenia, age at onset of schizophrenia, and gender. Small sample size limited the power of previous studies that attempted to assess such relationships. The aim of this study was to use data on individual patients from all available studies to examine the links between a history of obstetric complications and family history of schizophrenia, age at onset, and gender. METHOD: Raw data from 854 schizophrenic patients concerning history of obstetric complications rated according to the Lewis and Murray scale were obtained from 11 different research groups. Weighted average estimates were calculated with the use of regression techniques. RESULTS: A significant association was found between age at onset of schizophrenia and obstetric complications: the earlier the age at onset, the more likely the history of obstetric complications. Subjects with onset of schizophrenia before age 22 were 2.7 times more likely than those with onset at a later age to have had a history of abnormal presentation at birth and 10 times more likely to have had a history of complicated Cesarean birth. No association was found between obstetric complications and family history of schizophrenia or gender. CONCLUSIONS: The association between obstetric complications and early age at onset of schizophrenia indicates that the pathophysiology of early-onset schizophrenia involves neurodevelopmental impairment.     

Prevention and treatment of complications of inflatable penile prosthesis surgery: a review article

Over the last 16 years more than 3,000 procedures involving multi-component inflatable penile prosthesis have been performed. A variety of types of complications have been encountered, including mechanical problems with the prosthesis, intraoperative complications, postoperative complications, problems with infection and patient dissatisfaction. During the course of this experience we have made some observations and developed techniques to minimize and treat the complications seen with both routine and difficult inflatable penile prosthesis implantation surgery.     

The influence of low frequency acupuncture on a demand pacemaker

Various complications with demand pacemakers have been known to originate from their own sensing mechanisms. In these complications, electromagnetic interference is one of the well known causes of oversensing with demand pacemakers. The influence of low frequency acupuncture as a specific type of electromagnetic interference on a demand pacemaker was examined during a cervical operation. It was found that low frequency acupuncture is a cause of electromagnetic interference with demand pacemakers. Therefore, caution should be exercised when using the low frequency acupuncture on a pacemaker patient.     

Hemispherectomy complications in the light of craniocerebral disproportion: review of the literature and rationale for a filling-reduction cranioplasty

Hemispherectomy has had excellent results in treating drug-resistant seizures of infantile hemiplegia, except for the vulnerability of the remaining hemisphere. The hemispherectomy cavity has been considered responsible for early and late complications. Modified techniques have been widely performed and are not without complications. CNS hemosiderosis is probably not the only explanation; the craniocerebral disproportion following the surgery, the shunt effect and low pressure of the cavity should also be taken into account. Splinting the remaining hemisphere to avoid its dislodgment could be important. One of our patients who suffered a series of complications hitherto unreported in the literature was eventually treated with a filling-reduction cranioplasty. The rationale for the technique can be inferred from the literature reviewed in the article. Our technique is validated by a follow-up of 28 years since the hemispherectomy and 13 years since treatment for complications.     

Biliary reflux can be a contributory cause of esophagitis

In recent years duodenogastric reflux has been recognised as a possible cause of oesophagitis. Alone or in combination, bile salts, trypsin, pepsin, and hydrochloric acid have all been shown to cause oesophagitis. Duodenal content in the oesophagus can be measured by means of a new fibre-optic sensor, Bilitech 2000, a device measuring the occurrence of bilirubin and yielding 24-hour readings from the distal oesophagus. Studies in which the device has been used have shown oesophageal bilirubin to be increased in patients with oesophagitis, especially in the subgroup with such complications as oesophageal stricture or ulceration, or Barrett's oesophagus. The evidence suggests that unsatisfactory response to proton pump inhibitors in reflux patients might be due to an increase in duodenal reflux, and should be treated surgically with fundoplication or biliary diversion. This may also be true of oesophagitis patients with complications, though this remains to be shown in clinical studies.     

Total versus partial musculofascial coverage for steroid-containing double-lumen breast implants in augmentation mammaplasty

The use of intraluminal steroids in double-lumen breast implants is effective in preventing fibrous capsular contraction around the implant. This technique has not been accepted widely, however, and remains controversial primarily because steroid-related complications, including extrusion, late inferior migration, and atrophy of the skin, have been associated with their use. This nonrandomized retrospective study of 76 patients (146 breasts) who underwent submuscular augmentation of the breast through inframammary and periareolar incisions compares results after total musculofascial coverage of the implant with partial muscle coverage of the implant. In patients with partial muscle coverage of the implant, 7.8% steroid-related complications were observed. In the group with total musculofascial coverage of the implant, no steroid-related complications and no symptomatic contractions of the capsule were observed. Our study suggests that total musculofascial coverage provides a statistically significant margin of protection from steroid-related complications compared with techniques using only partial muscle coverage of the implant in patients who underwent cosmetic augmentation mammaplasty.     

Ophthalmic complications after spinal surgery

STUDY DESIGN: A retrospective review of 3450 spinal surgeries was performed. OBJECTIVES: To review ophthalmic complications and their etiologies, as well as treatments and outcomes, in patients who have undergone spinal surgery. SUMMARY OF BACKGROUND DATA: Ophthalmic complications after major spinal reconstructive surgery are rare and have not been adequately addressed in the orthopedic literature. METHODS: In a series of 3450 spinal surgeries at three institutions, the authors identified seven patients (incidence = 0.20%) whose postoperative course was complicated by loss of visual acuity. These perioperative ophthalmic complications included posterior optic nerve ischemia, occipital lobe infarcts, and central retinal vein thrombosis. Operative time, estimated blood loss, and medical history of peripheral vascular, cardiovascular, or ophthalmic disease were obtained from the charts, as were follow-up data. RESULTS: Three patients recovered completely, and one had partial return of visual function. In the remaining three patients, significant visual loss persisted. CONCLUSIONS: The risk of ophthalmic complications with spinal surgery has not been fully appreciated. Because ophthalmic complications in spinal surgery may be reversed with prompt recognition and intervention, it is important for clinicians to be aware of their possible occurrence.     

Clinical experience with the copper-7 intrauterine contraceptive device. A preliminary report

There have been 203 copper-7 IUD insertions performed in 199 women. The data from 2,230 woman-months of use have been analyzed and compared with other published reports. The copper-7 IUD was an acceptable contraceptive method in regard to effectiveness, continuation, and lack of serious complications.     

Non-parametric methods for analysing recurrent complications of varying severity

Non-parametric methods have recently been proposed to take into account the recurrent nature of complications in clinical trials, by estimating the prevalence Q(t), defined as the probability of relapse-free patients being in a complication state at time t. Recoveries are also considered. These methods have been adapted in this paper to take into consideration not only the recurrent nature of complications but also their severity through the interpretation of average weight functions. Results of a randomized trial comparing late complications following two alternative doses of pre-operative internal brachytherapy in patients with localized stage cervix carcinoma are used to illustrate the methods.     

Nephrolithiasis due to primary hyperparathyroidism and enteric hyperoxaluria: a case report

Enteric hyperoxaluria and primary hyperparathyroidism have been associated with the development of nephrolithiasis. We report a case involving a patient who had hyperparathyroidism due to a parathyroid adenoma and enteric hyperoxaluria resulting from a small bowel bypass and who had severe stone-related complications. This combination of stone-generating factors has heretofore not been reported. The pathophysiology of these entities is discussed.     

Admission modalities of brain dead patients at Ile de France hospitals which do not harvest organs. Cooperative Group for Transplantation of Ile de France (GCIF)]

It has been suggested that the potential for thrombo-embolic complications is greater with the use of non-ionic contrast agents than with ionic contrast agents. The increasing use of interventional therapy in patients with acute coronary disease makes the discussion of a possible relationship between thrombo-embolic complications and use of non-ionic contrast media pertinent. It has been shown that ionic contrast media have a marked effect on the coagulation system and platelet function. The non-ionic contrast media have a less pronounced effect on the coagulation system and platelet function although there is no evidence of a thrombogenic effect. The anticoagulant effect observed with ionic contrast media in connection with coronary angiography or angioplasty (PTCA) is short and disappears as soon as the medium is excreted. Therefore an effective antithrombotic treatment in relation to the procedure is necessary. Larger randomized clinical studies need to be performed with effective antithrombotic regimens in order to clarify any difference in thrombo-embolic complications from the different contrast media. Until then, the non-ionic contrast media should be preferred to the ionic contrast media in high-risk PTCA, owing to their overall lower toxicity and fewer adverse reactions.     

The noninfectious respiratory complications of infection with HIV

Infection with HIV was first recognized through a clustering of unusual respiratory infections. The lung has been a major target manifesting many of the infectious complications of the immunodeficiency. Noninfectious pulmonary complications in HIV-infected individuals are also common and have been recognized since the advent of the AIDS epidemic. Malignancies involving the respiratory system, specifically Kaposi's sarcoma and non-Hodgkin's lymphoma, are epidemiologically linked to infection with HIV. Although other cancers have been identified in patients with HIV, these malignancies have a relationship to HIV infection that is unknown. Nonetheless, all cancers in the HIV-infected individual appear to follow a very deadly course. Interstitial pneumonitis and an alveolitis are also seen in individuals infected with HIV. Their relationship to the virus is unknown but may involve the lung's immune response to HIV. Pneumothorax and bullous lung disease are the sequela of pulmonary infections in the HIV-infected host. Pulmonary hypertension has been reported in HIV-infected patients, and like the other noninfectious respiratory complications, the link between the disease process and HIV is unknown. Bronchiectasis is now commonly recognized in AIDS patients who have survived prolonged immunosuppression and infection. Bronchoscopists have accumulated a collection of endobronchial lesions uncommonly seen in non-HIV-related pulmonary consultation. In the following review, we discuss the epidemiology, pathology, pathogenesis, clinical features, diagnostic findings, prognosis, and therapeutic options available for each noninfectious pulmonary complication. As the life expectancy for HIV-infected patients increases, the incidence of noninfectious pulmonary complications will rise.     

Outpatient urodynamic monitoring in the diagnosis of subclinical forms of a urination disorder in women

Improvements in ureteroscope design and technique have led to increase the success of diagnostic and therapeutic ureteroscopy while decreasing morbidity. Most important complications have been categorized in the following manner: access complications, preoperative complications and early and late postoperative complications.     

Progress in HIV and AIDS care

These recent meetings emphasized the considerable progress that has been made in HIV/AIDS. The prospect for non-progression of the disease, improved management of complications arising from the condition, and the potential for additional progress were the hallmarks of these meetings. The considerable developments that have occurred make it necessary for the dental profession to continue to play a role in the recognition, diagnosis, and management of oral conditions, and to keep abreast of the considerable developments in this field-and the implications that these developments have for patients presenting with complications related to other conditions, which may include bacterial, fungal or viral infections and malignant disease.     

Causes for transfer of obstetric patients to an intensive care unit (1990-19960

BACKGROUND: In order to have an updated review of the causes for transferring patients from our Institute to Intensive Care Unit (ICU), a study has been conducted on patients admitted from 1990 to 1996. METHODS: Of the 28 women transferred, one underwent dilatation & curettage of uterine cavity after abortion, 3 had a normal delivery and 24 underwent a cesarean section. RESULTS AND CONCLUSIONS: The complications were as follows: respiratory failure (5 cases); suspected or confirmed lung embolism (1); cerebral ischemia (1); septic complications (1); cardiocirculatory complications (19 cases; 7 of them were due to DIC; 6 due to cardiocirculatory failure; 6 due to haemorrhagic shock). These patients were divided into 3 groups, those with pre-existing pathologies which worsened (2 cases); those due to deterioration of pathology arose during pregnancy (17) and, finally, complications during delivery (9). In total the cases of mortality were 7, all of them following cardiocirculatory complications.     

The surgical procedure in neck wounds

The results of 44 patients treatment with neck wounds are analysed. Isolated wounds of the neck were shown to be in 77.3%, combined trauma was determined in 22.7% of examination. Cervical organ's injury had been revealed in 51 patients (84.1%). Postsurgical complications have developed in 6. The main reasons for complications occurred to be primary surgical wound treatment from little operative approach and noncomplete revision of the wound canal.     

Evaluation of the risk of postoperative pulmonary complications

Ten of 40 patients who underwent major thoracic or abdominal operations developed postoperative pulmonary complications, consisting of six massive atelectasis, three pneumonias and one edema. They were mostly thoracotomy cases and cigarette smokers. Many of these complications would have been prevented, if reliable pulmonary function tests are available to predict preoperatively such occurrence. Flow-volume curve tracing and closing volume measurement were evaluated in this respect. Both flow at the point of functional residual capacity on flow-volume curve, and the closing capacity subtracted from functional residual capacity were found to be well correlated with the occurrence of postoperative complications and can be used to evaluate the risk of pulmonary complications developing in postoperative period.     

Complications of chronic otitis media

In summary, recent literature indicates that the complications of chronic otitis media have been decreasing. However, even with the advent of modern and more powerful antimicrobials and aggressive surgical eradication of disease, the morbidity and mortality are still high. Some complications may initially be quite obvious and some complications may be quite subtle. Therefore, the most important tools in making early diagnosis are careful history and physical examination, and a high index of suspicion for impending complications.     

Prevention of type 2 diabetes

Type 2 diabetes is a major cause of morbidity and mortality resulting from its microangiopathic and macroangiopathic complications. Current approaches to its management and to the prevention of diabetic complications are difficult to implement effectively, and there is little evidence to date that these approaches are reducing the impact of this disease. The recognition that type 2 diabetes usually has a prolonged prediabetic phase raises the possibility that the emergence of hyperglycemia and the atherosclerotic complications associated with diabetes may be preventable by the institution of early treatment modalities. Sufficient data suggest that life-style modification or pharmacotherapy directed at improving insulin sensitivity or insulin secretion in subjects with impaired glucose tolerance may reduce progression to diabetes. Two long-term prospective, controlled trials have been initiated to test this hypothesis.     

Relative risk of perinatal complications in common childhood disorders.

Perinatal complications have been associated with a myriad of later-developing behavioral, neurological, and psychological disorders. These have included school-related disorders such as attention-deficit/hyperactivity disorder, autism, mood and anxiety disorders, and learning disabilities. This article reviews the research that considers the relative risk relationship between prepregnancy, pregnancy, neonatal complications, and later childhood disorders. Specifically, research with the Maternal Perinatal Scale (MPS), which highlights the relative risk ratios of perinatal complications, and later childhood disorders will be reviewed. The MPS is a self-report measure that uses a standardized, structured format to identify perinatal complications. Research using the MPS has revealed that a combination of perinatal complications can increase the relative risk of educational difficulty by up to 6.35 times. Implications for psychological services in the school are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)