Modified Frailty Index as a Predictor of Postoperative Complications and Patient-Reported Outcomes after Posterior Cervical Decompression and Fusion

Methods@#Patients undergoing elective PCDF at our urban academic medical center from 2014 to 2020 were included. Patients were categorized by mFI scores (0–0.08, 0.09–0.17, 0.18–0.26, and ≥0.27). Univariate statistics compared demographics, comorbidities, and clinical/surgical outcomes. Multiple linear regression analysis evaluated the magnitude of improvement in PROMs at 1 year. @*Results@#A total of 165 patients were included and grouped by mFI scores: 0 (n=36), 0.09 (n=62), 0.18 (n=42), and ≥0.27 (n=30). The severe frailty group (mFI ≥0.27) was significantly more likely to be diabetic (p <0.001) and have a greater Elixhauser comorbidity index (p =0.001). They also had worse baseline Physical Component Score-12 (PCS-12) (p =0.011) and modified Japanese Orthopaedic Association (mJOA) (p =0.012) scores and worse 1-year postoperative PCS-12 (p =0.008) and mJOA (p =0.001) scores. On regression analysis, an mFI score of 0.18 was an independent predictor of greater improvement in ΔVisual Analog Scale neck (β =−2.26, p =0.022) and ΔVAS arm (β =−1.76, p =0.042). Regardless of frailty status, patients had similar 90-day readmission rates (p =0.752), complication rates (p =0.223), and revision rates (p =0.814), but patients with severe frailty were more likely to have longer hospital length of stay (p =0.006) and require non-home discharge (p <0.001). @*Conclusions@#Similar improvements across most PROMs can be expected irrespective of the frailty status of patients undergoing PCDF. Complication rates, 90-day readmission rates, and revision rates are not significantly different when stratified by frailty status. However, patients with severe frailty are more likely to have longer hospital stays and require non-home discharge.

Effect of autologous platelet-rich plasma treatment on patients with thin endometrium / Efecto del tratamiento con plasma autólogo rico en plaquetas en pacientes con endometrio delgado

ABSTRACT Introduction: The success of frozen embryo transfer cycles depends on a delicate interaction between embryo quality and endometrium. Low pregnancy rates are associated with a thin endometrium. Objective: To evaluate the effect of autologous platelet-rich plasma treatment on patients with thin endometrium. Methods: In 34 patients with thin endometrium (< 7 mm), canceled in the previous frozen embryo transfer cycles, autologous platelet-rich plasma was prepared, from autologous peripheral vein blood; intrauterine infusion was given during hormone replacement therapy in frozen embryo transfer cycles. Frozen embryo transfer was performed when the endometrium thickness reached ≥ 7mm. Results: Six patients canceled the embryo transfer cycle due to endometrium thickness did not reach 7 mm; 28 patients got endometrial thickness ≥ 7 mm and performed frozen embryo transfer. The endometrial thickness was 7.5 ± 0.8 mm, which was significantly thicker than in the previous cycles (5.6 ± 0.79 mm) with p< 0.002, the implantation rate was 23.07 %, and the clinical pregnancy rate was 12/28 (42.8 %). Conclusion: Autologous platelet-rich plasma improves the endometrial thickness and the pregnancy rate outcomes in women with thin endometrium.

RESUMEN Introducción: El éxito de los ciclos de transferencia de embriones congelados depende de una delicada interacción entre la calidad del embrión y el endometrio. Las bajas tasas de embarazo están asociadas con un endometrio delgado. Objetivo: Evaluar el efecto del tratamiento con plasma rico en plaquetas autólogo en pacientes con endometrial delgado. Métodos: En 34 pacientes con endometrio delgado (< 7 mm) canceladas en los ciclos previos de transferencia de embriones congelados, se preparó plasma autólogo rico en plaquetas, a partir de sangre autóloga de venas periféricas; la infusión intrauterina se administró durante la terapia de reemplazo hormonal en los ciclos de transferencia de embriones congelados. La transferencia de embriones congelados se realizó cuando el grosor del endometrio alcanzó ≥ 7 mm. Resultados: En 6s pacientes se canceló el ciclo de transferencia embrionaria debido a que el grosor del endometrio no alcanzó los 7 mm; 28 pacientes obtuvieron un grosor endometrial ≥ 7 mm y realizaron transferencia de embriones congelados. El grosor del endometrio fue de 7,5 ± 0,8 mm, significativamente mayor que en los ciclos anteriores (5,6 ± 0,79 mm) con p< 0,002; la tasa de implantación fue de 23,07 % y la tasa de embarazo clínico fue de 12/28 (42,8 %). Conclusión: El plasma autólogo rico en plaquetas mejora el grosor endometrial y los resultados de la tasa de embarazo en mujeres con endometrio delgado.

Factors related to vaccines for both patients exposed with rabies and dogs

ABSTRACT Introduction: Rabies is a viral disease that can be transmitted from animals to humans. All warm-blooded animals, including humans, can host rabies's virus. Vaccination of dogs is an effective method of preventing rabies in humans. Objectives: To evaluate knowledge, attitudes and practices towards rabies prevention and factors related to vaccines for both patients exposed with rabies and dogs. Methods: A cross-sectional descriptive study, using the questionnaire on rabies prevention by interviewing 1 484 households. Multivariable logistic regression analysis was used to identify factors related to vaccines for both patients exposed to rabies and dogs. Results: Of all 67.32 % of the people surveyed with high knowledge, only 43.8 % and 31.47 % were assessed as having a good attitude and practice. Interviewees with poor knowledge and practice are independently related to low-rate vaccines provision for pets. Factors associated with low vaccination rates after pet bites were poor attitudes and practices. Conclusion: People with a high level of education, knowledge and practice, the rabies vaccination rate on pets is high. People with good attitudes and practices had a high rate of rabies vaccination after being bitten by an animal.

RESUMEN Introducción: La rabia es una enfermedad viral que puede transmitirse de animales a humanos. Todos los animales de sangre caliente, incluidos los humanos, pueden albergar el virus de la rabia. La vacunación de perros es un método eficaz para prevenir la rabia en humanos. Objetivos: Evaluar conocimientos, actitudes y prácticas de la comunidad hacia la prevención de la rabia y los factores relacionados con las vacunas, tanto para pacientes expuestos como para perros. Métodos: Estudio descriptivo transversal, se utilizó un cuestionario sobre prevención de la rabia, mediante entrevistas en 1 484 hogares. Se realizó un análisis de regresión logística multivariable para identificar los factores relacionados con las vacunas, tanto para pacientes expuestos como para los perros. Resultados: Del 67,32 % de encuestados, con alto conocimiento, solo el 43,8 % y el 31,47 % fueron evaluados como de buena actitud y práctica. Los entrevistados con insuficiente conocimiento y prácticas se relacionan de forma independiente con la baja provisión de vacunas para las mascotas. Las razones de bajas tasas de vacunación después de las mordeduras causadas por mascotas fueron las malas actitudes y prácticas. Conclusión: Las personas con nivel alto de práctica, educación y conocimientos, tienen elevados niveles de vacunación antirrábica de sus mascotas. Después de la mordedura de un animal, las personas con buenas prácticas y actitudes, tienen más altos niveles de vacunación antirrábica.

Study of insulin resistance in hypertensive patients with impaired fasting glucose \r\n', u'\r\n', u'

Background: Hypertensive with impaired fasting glucose is the basic expression of metabolic syndrome. Objectives: To study the IR and the correlation between Fasting Plasma Insulin (FPI) and Fasting Plasma Glucose (FPG) concentration in hypertensive patients with Impaired Fasting Glucose (IFG). Subjects and method: The descriptive, cross-sectional study was carried out on 38 hypertensive patients with IFG (IFG group) and 30 hypertensive patients without IFG (control group). The data were collected and analyzed by SPSS 11.5 software. Results:The FPI and IR index in the IFG group were 14.6+/-5.2 micro mol/ml and 3. 94+/- l.40, respectively, higher than in the control group (9.6+/-4.2 micro mol/ml and 2.17+/-0.99/ respectively) with p<0.00l. There was a positive correlation between FPI and FPG systolic blood and diastolic blood pressure/ with correlation coefficients were 0.4/ 0.48 and 0.46/ respectively (p<0.00l). Conclusion: There was an increase of FPI and IR index in the hypertensive patients with IFG compared to those without IFG. \r\n', u'\r\n', u'