ABSTRACT
BACKGROUND: Subcuticular suture has proven to reduce superficial incisional SSI (si-SSI) in clean surgery. However, question remains regarding clean-contaminated procedures. The aim of this study is to assess if subcuticular suture is superior to staples in reducing si-SSI incidence in elective HBP surgery. METHODS: Single-centre, open-label, parallel, pragmatic randomized clinical trial conducted at a referral tertiary Hospital between January 2020 and April 2022. Patients eligible for elective HBP surgery were randomly assigned (1:1) to subcuticular suture or surgical staples wound closure using a minimisation method based on previously confirmed risk factors. The primary endpoint was the incidence of si-SSI. Considered secondary endpoints were major postoperative morbidity in both groups, additional wound complications, median hospital length of stay and need for re-hospitalisation. RESULTS: Of the 379 patients, 346 patients were randomly assigned to receive skin closure with staples (n = 173) or subcuticular suture (n = 173). After further exclusion of 11 participants, 167 and 168 patients, respectively in the control and the experimental group received their allocated intervention. For the primary endpoint, no significant differences in si-SSI rate were found: 17 (9.82%) staples group vs. 8 (4.62%) in subcuticular suture group (p = 0.062). Subset analysis confirmed absence of significant differences. As for secondary endpoints, overall wound complications did not differ significantly between two procedures: 19 (10.98%) vs. 10 (6.35%) (p = 0.127). There were no treatment related adverse events. However, occurrence of si-SSI contributed to major postoperative morbidity in both groups (p < 0.001 and p = 0.018) and to a substantially prolonged postoperative hospitalization (p = 0.015). CONCLUSIONS: Subcuticular suture might offer a relative benefit for skin closure reducing incidence of si-SSI after elective HBP surgery, although this was found not to be clinically relevant. Yet, this should not be interpreted as equivalence among both treatments. Therefore, wound closure strategy should not be based only on these grounds. TRIAL REGISTRATION NUMBER: ISRCTN Registry number ISRCTN37315612 (registration date: 14/01/2020).
Subject(s)
Digestive System Surgical Procedures , Suture Techniques , Humans , Suture Techniques/adverse effects , Digestive System Surgical Procedures/adverse effects , Surgical Stapling , Surgical Wound Infection/epidemiology , Surgical Wound Infection/prevention & control , Surgical Wound Infection/etiology , Sutures/adverse effectsABSTRACT
(1) Objective: To determine the incidence, visual outcomes and risk factors associated with the recurrence of primary retinal detachment (RD) in a tertiary hospital. (2) Methods: A retrospective observational study was conducted, and data were collected on all eyes diagnosed with primary RD between January 2017 and December 2020. A detailed database was generated with data on anatomic and visual outcomes, and surgical technique information, for all the cases. (3) Results: 570 eyes with primary RD were included. Mean annual incidence of primary RD was 21.8 cases per 100,000 inhabitants. Mean follow-up time was 465 (±410.5) days. Mean time to redetachment was 114.4 (±215.8) days, with the median being 35 days. Statistically significant variables related to a higher risk of recurrence were: male sex (p = 0.04), type of tamponade (p = 0.01), surgeon (p = 0.035), inferonasal (p = 0.002) and inferotemporal (p = 0.032) involvement, complex RD (p < 0.001) and ocular comorbidity (p < 0.001). More satisfactory final visual acuity (VA) in patients not suffering redetachment was associated with shorter duration of central vision loss. (4) Conclusions: Sex, type of tamponade, inferior detachment, RD complexity, surgeon and ocular comorbidity were identified as prognostic factors for recurrence. Worse final postoperative VA was found in patients referring central vision loss for more than 4 days before surgery.
ABSTRACT
People with schizophrenia have deficits in the ability to identify emotions. An area of important dysfunction is the understanding of affective prosody, which can limit communication and social functionality. The objective of this study is to compare emotional recognition through prosody between a group of people with schizophrenia versus a control group without pathology, through the Reading the Mind in the Voice - Spanish Version scale (RMV-SV).
Subject(s)
Emotions , Schizophrenia , Case-Control Studies , Humans , Recognition, PsychologyABSTRACT
Introducción: Las personas con esquizofrenia presentan déficits en lahabilidad para identificar emociones. Un área de importante disfunción es la comprensión de la prosodia afectiva, que puede limitar la comunicación y la funcionalidad social. Elobjetivo de este estudio es comparar el reconocimiento emocional a través de la prosodia entre un grupo de personas con esquizofrenia frente a un grupo control sin patología, através de la escala Reading the Mind in the Voice SpanishVersion (RMV-SV).Metodología:Se reclutó un grupo de personas con esquizofrenia otrastorno esquizo-afectivo, clínicamente estables (n = 62).Se compararon con un grupo control (n = 63) en las características sociodemográficas, clínicas, el coeficiente intelectualy el rendimiento en la escala RMV-SV.Resultados:El grupo de casos presentó puntuaciones más bajas enla RMV-SV, con diferencias estadísticamente significativas (p< ,001) frente a los controles. En 17/22 ítems de respuestaserróneas, los enunciados contenían emociones negativas. Lacorrelación fue positiva entre RMV-SV y CI. Se correlacionó de forma inversa el RMV-SV y PANSS, principalmente lasubescala negativa, y la edad.Conclusiones:La escala RMV-SV, validada en autismo, permite detectarlas alteraciones del reconocimiento prosódico en español enla esquizofrenia, postulándose como una herramienta evaluadora de este dominio de la cognición social. (AU)
Introduction: People with schizophrenia have deficits in the ability toidentify emotions. An area of important dysfunction is theunderstanding of affective prosody, which can limit communication and social functionality. The objective of this studyis to compare emotional recognition through prosody between a group of people with schizophrenia versus a controlgroup without pathology, through the Reading the Mind inthe Voice - Spanish Version scale (RMV-SV).MethodA group of people with clinically stable schizophrenia orschizoaffective disorder was recruited (n = 62). They werecompared with a control group (n = 63) in sociodemographic, clinical characteristics, intelligence quotient, and performance on RMV-SV scale. ResultsThe case group presented lower scores on the RMV-SV,with statistically significant differences (p < .001) comparedto controls. In 17/22 items of wrong answers, the statementscontained negative emotions. The correlation was positivebetween RMV-SV and IQ. RMV-SV and PANSS, mainly thenegative subscale, and age were inversely correlated.ConclusionsThe RMV-SV scale, validated in autism, allows detectingthe alterations of prosodic recognition in Spanish in schizophrenia, postulating itself as an evaluating tool of this domain of social cognition. (AU)
