1
|
Bretschneider CE, Myers E, Geller EG, Kenton K, Henley B, Wu JM, Matthews CA. Long-Term Pain After Minimally Invasive Total Hysterectomy and Sacrocolpopexy. Urogynecology (Phila) 2023; 29:144-150. [PMID: 36735427 DOI: 10.1097/spv.0000000000001266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
IMPORTANCE There are limited long-term data on patient-reported pain after surgical treatment of uterovaginal prolapse. OBJECTIVE This study aimed to evaluate pain in women undergoing minimally invasive total hysterectomy and sacrocolpopexy with a lightweight polypropylene Y-mesh (Upsylon) >2 years after surgery. STUDY DESIGN This is a planned secondary analysis of a 5-site randomized trial comparing permanent versus absorbable suture for vaginal attachment of a lightweight polypropylene Y-mesh during total laparoscopic hysterectomy and sacrocolpopexy in women with stage ≥2 uterovaginal prolapse. Our primary outcome was patient-reported pain or dyspareunia at >2 years. RESULTS Of the 185 participants eligible for enrollment in the e-PACT study, 106 enrolled; 98 participants (96%) completed either in-person examinations or study questionnaires regarding pain and are included in this analysis. At >2 years, 28% reported any pain: 14% reported dyspareunia on questionnaires, 5% reported pelvic pain on questionnaires, and 14% of those who had an in-person examination reported pain. Of participants who reported pain or dyspareunia at baseline before surgery, 59% reported resolution of their symptoms >2 years. On multiple logistic regression controlling for age and baseline pain or dyspareunia, baseline pain or dyspareunia was associated with a nearly 3-fold increased risk of reporting any pain >2 years (adjusted odds ratio, 2.7; 95% confidence interval, 1.1-6.9). No women had repeat surgical intervention for pain. CONCLUSIONS Although 60% of women report pain resolution >2 years after surgery, de novo pain was present in 1 of 5 women. Baseline history of pain or dyspareunia is the only factor associated with an increased likelihood of experiencing pain >2 years after surgery.
Collapse
Affiliation(s)
| | | | | | - Kimberly Kenton
- From the Northwestern Feinstein School of Medicine, Chicago, IL
| | | | | | | |
Collapse
|
2
|
Vijayaraghavan S, Lipfert L, Chevalier K, Bushey B, Henley B, Lenhart R, Sendecki J, Beqiri M, Millar H, Packman K, Lorenzi M, Laquerre S, Moores S. B03 JNJ-61186372, an Fc Effector Enhanced EGFR/cMet Bispecific Antibody, Induces EGFR/cMet Downmodulation and Efficacy Through Monocyte and Macrophage Trogocytosis. J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
3
|
Abstract
Introduction: Despite major advances in biomaterial research and blood conservation, bleeding is still a common complication after cardiopulmonary bypass and cardiac surgery remains a major consumer of blood products. Although the underlying mechanisms for these effects are not fully established, two proposed major etiologies are the hemodilution associated with the use of the heart-lung machine and the impact of reinfusion of shed cardiotomy blood. Therapeutic strategies that primarily encompass the use of devices or technologies to overcome these effects may result in improved clinical outcomes. Objective: To determine the extent to which 1) lipid/leukocyte filtration and centrifugal processing of cardiotomy blood, and 2) modified ultrafiltration (MUF) are currently applied in adult cardiac surgery in Canada. Methods: A questionnaire was mailed to the chief perfusionist at all adult cardiac surgical centers in Canada, addressing details regarding the frequency of use of cardiotomy blood processing and MUF. Results: All questionnaires (36, 100%) were completed and returned. With regards to cardiotomy blood management, in 21 centers (58%), no specific processing steps were utilized exclusive of the integrated cardiotomy reservoir filter. Of the remaining centers, two (6%) reported using lipid/leukocyte filtration and 15 (42%) reported washing their cardiotomy blood. Three centers (8%) reported using MUF at the end of CPB. Conclusions: Despite growing concern about the potential detrimental effects of cardiotomy blood, few centers in Canada routinely manage this blood with additional filtration and/or centrifugal processing prior to reinfusion. Similarly, MUF, demonstrated to be effective in the pediatric population, has not seen popular application in adult cardiac surgical practice.
Collapse
Affiliation(s)
- D Belway
- Division of Perfusion Services, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | | | | | | |
Collapse
|
4
|
Belway D, Rubens FD, Henley B, Babaev A, Mesana T. Delayed thrombin generation is not associated with fibrinopeptide formation during prolonged cardiopulmonary bypass with hirudin anticoagulation. Perfusion 2007; 21:259-62. [PMID: 17201079 DOI: 10.1177/0267659106074768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Patients with heparin-induced thrombocytopenia urgently requiring surgery with cardiopulmonary bypass (CPB) present a unique management challenge that must be addressed by the use of alternative anticoagulants. Although clinical success with the direct thrombin inhibitor hirudin has been reported, there is sparse information in the literature supporting the efficacy of this drug as an anti-thrombotic to prevent fibrin formation during CPB. In this report, we describe the efficacy of this drug to prevent thrombin-mediated fibrin formation during CPB.
Collapse
Affiliation(s)
- D Belway
- Department of Cardiovascular Perfusion, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | | | | | | | | |
Collapse
|
5
|
Bryant D, Cates RN, Singer GE, Walker CD, France R, Evans KM, Price J, Henley B, Porter AMW, Smith EL, Key IA, Whitehouse MS, Mason DP, Summerhayes J, Attenborough J, Cule J, May WJ, Faber VC, Bergel RE, Drake-Lee JWD, Hadfield GW, Whittingham W, Smith PS. Hospital Practitioner Grade. West J Med 1969. [DOI: 10.1136/bmj.1.5645.717-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
6
|
Attenborough J, Aubrey DR, Auger H, Austin AJ, Bartlett CIS, Bellamy RCT, Bergel RC, Bryant D, Carpenter ME, Cates R, Christmas AR, Clyne GE, Collings-Wells JA, Crawshaw PFA, Cule JH, Dobbin LWB, Donovan B, Edwards J, Evans KM, Faber VC, France R, Gent NSC, Hadfield GW, Haskins TD, Henley B, Henry DO, Holden JJ, James JP, Kayll JN, Kent SG, Key IA, Kieft BT, Wright MFL, Lister CO, MacAdam AD, McNutt J, Mason JYJM, Mason DP, Mathewson J, May W, Morrison RWM, Narula YP, Price JCN, Norman JM, Page HJC, Perry JR, Poole PB, Porter AMW, Powell JK, Poyntz-Wright RC, Price DJ, Price J, Pritchard JNA, Robinson IH, Rust NE, Scriven JM, Singer GE, Smart PC, Smith PS, Summerhayes JLV, Tilly CR, Tipler HB, Trust DGL, Turner AG, Urquhart DRH, Walker CD, Wallace IW, Watson M, Whitehouse MS, Whittingham MA, Whittingham W, Williams EM, Winchurch B. Threat to Hospital Privileges. West J Med 1968. [DOI: 10.1136/bmj.1.5586.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
7
|
Henley B, Davis MS. Satisfaction and dissatisfaction: a study of the chronically-ill aged patient. J Health Soc Behav 1967; 8:65-75. [PMID: 6039389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
|
8
|
Cross H, Schwartz D, Henley B, Zeitz L. The Elderly Ambulatory Patient: Nursing and Psychological Needs. Am J Nurs 1965. [DOI: 10.2307/3453136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|