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1.
Birth Defects Res ; 111(16): 1192-1204, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31313527

RESUMO

BACKGROUND: With their unique history of exposure to extensive nuclear testing between 1946 and 1958, descendants of Marshall Island residents may have underappreciated genetic abnormalities, increasing their risk of birth defects. METHODS: We conducted a retrospective cohort study of resident women with at least one singleton live birth between 1997 and 2013 in northwest Arkansas using state birth certificate data linked to data from the Arkansas Reproductive Health Monitoring System, a statewide birth defects registry. We calculated unadjusted and adjusted prevalence ratios (PR) and 95% confidence intervals (CI) from modified Poisson regression analyses for non-Hispanic (NH) whites, NH-blacks, Hispanics and Marshallese, using NH-whites as the reference group. RESULTS: Of the 91,662 singleton births during the study period, 2,488 were to Marshallese women. Due to the relatively small number of Marshallese births, we could not calculate prevalence estimates for some defects. Marshallese infants had higher rates of congenital cataracts (PR = 9.3; 95% CI: 3.1, 27.9). Although the number of defects was low, Marshallese infants also had higher rates of truncus arteriosus (PR = 44.0; 95% CI: 2.2, 896.1). CONCLUSIONS: Marshallese infants may have increased risk of specific birth defects, but estimates are unstable because of small sample size so results are inconclusive. Larger population-based studies would allow for further investigation of this potential risk among Marshallese infants.


Assuntos
Anormalidades Induzidas por Radiação/embriologia , Anormalidades Congênitas/epidemiologia , Adulto , Catarata/etiologia , Estudos de Coortes , Anormalidades Congênitas/etiologia , Feminino , Humanos , Recém-Nascido , Nascido Vivo , Micronésia/epidemiologia , Parto , Gravidez , Gravidez Múltipla , Prevalência , Liberação Nociva de Radioativos , Sistema de Registros , Estudos Retrospectivos , Tronco Arterial
2.
Am Surg ; 69(7): 578-80, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12889620

RESUMO

The purpose of this study was to examine the results of a single institution experience with hand-assisted laparoscopic colon resection for benign disease. We conducted a retrospective study of consecutive cases performed by experienced laparoscopic surgeons at a single institution. From August 1999 to June 2001, 37 patients underwent hand-assisted laparoscopic colon resection. Seventeen patients were male, and 20 were female. Median patient age was 58 years (range 20-80). Indications for surgery were: polyp (13), uncomplicated diverticular disease (eight), complicated diverticular disease (i.e., colovesicular fistula, phlegmon, etc.) (seven), chronic constipation (four), rectal prolapse (two), ulcerative colitis (one), endometriosis (one), and fecal incontinence (one). Procedures performed were: sigmoidectomy (14), right colectomy (nine), low anterior resection (seven), subtotal colectomy (five), cecectomy (one), and transverse colectomy (one). Variables examined were: conversion to open procedure, operative time, blood loss, time to return of flatus, length of postoperative hospital stay, and complications. There were no deaths. One case was converted to celiotomy (unable to rule out malignancy). The median operative time was 122 minutes (range 32-240) with a median operative blood loss of 132 mL (range 0-300). Return of flatus was noted (median) at postoperative day 3 (range 1-5), and the median length of stay after operation was 4 days (range 2-8). One patient developed a superficial wound infection, and there was one pelvic abscess (drained percutaneously). One patient developed urinary retention. There were no reoperations. In this single-institution experience hand-assisted laparoscopic elective colectomy for benign disease was successful in both straightforward and complicated cases. A low conversion rate to celiotomy and favorable operative times compared with published "pure" laparoscopic results suggest a flatter learning curve for handoscopy while retaining the benefits of "minimally invasive" surgery such as early return of flatus and short postoperative hospital stay. For these reasons hand-assisted laparoscopy should be considered an acceptable technique in elective colon resection for benign disease.


Assuntos
Colectomia , Laparoscopia , Adulto , Idoso , Idoso de 80 Anos ou mais , Colectomia/efeitos adversos , Colectomia/métodos , Feminino , Humanos , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos
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