Adolescent ; Adult ; Aged ; Anxiety ; psychology ; Blood Transfusion ; Cross-Sectional Studies ; Depression ; psychology ; Female ; Health Status ; Humans ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Quality of Life ; Severity of Illness Index ; Surveys and Questionnaires ; Young Adult ; beta-Thalassemia ; psychology ; therapy

BACKGROUND: The perceived risks of blood transfusions are important to be considered in creating a blood service policy. We surveyed the perception of blood transfusion risks among Korean laypeople. METHODS: A one-month nationwide telephone survey was conducted in September, 2007. The questionnaire was designed to assess the demographics of respondents, their responses to the term 'blood transfusion', and the perceived risks of a transfusion. A total of 500 interviews were completed. RESULTS: The words evoked by the term 'blood transfusion' included blood, donation, AIDS, help, and patients. About one third (33.6-35.8%) of the respondents gave a moderate to high rating for the perceived risks of blood transfusions. More than half (55.6%) of the respondents agreed that the blood supply in Korea is safe, and 81.6% of the respondents agreed to be transfused when transfusion is needed. The perceived risk of a blood transfusion was greater in women than in men and in people who never had a transfusion than those who had. More men than women agreed that the blood supply in Korea is safe, and the proportion of respondents who agreed to be transfused when needed was higher in men and in less educated people. The relative perceived transfusion risk (scale of 10) was 4.5+/-2.3. CONCLUSIONS: The Koreans in the survey had a tendency of positive thinking about blood transfusions, and previous transfusion experiences appear to decrease the fear about transfusions. These results will be useful in understanding how Koreans think about the risks associated with transfusions.
Adult ; Asian Continental Ancestry Group ; Blood Transfusion/*psychology ; Demography ; Female ; Humans ; Interviews as Topic ; Male ; Middle Aged ; *Perception ; Questionnaires ; Republic of Korea ; Risk Factors ; Sex Factors

A review of recent reports showed that many surgeons define large-volume liposuction as the removal of over 5000ml of total aspirate. However, no clinical reports of single procedures in Korean involving aspirate volume of 5000 ml or greater have been presented. From May 2002 to December 2004, 59 patients with age averaging 31.2 years old underwent large-volume liposuction. Liposuction was performed using the superwet technique and a Lipomatic(R) vibropneumatic system. Clinical data, which included; body weight changes and BMIs at a postoperative 2 months, hemoglobin and hematocrit at a postoperative 2 days, operative time, and volume of infiltrate and aspirate, were evaluated. The average volumes of infiltrate and aspirate were 6916.7+/-1665.8ml and 6549.6+/-1787.2ml, respectively. Mean patient weight had decreased from 62.96+/-14.21 to 58.61+/-13.43kg with an average weight loss of 4.35kg, and mean body mass index from 23.84+/-3.91 to 22.17+/-3.70kg/m2 with an average drop of 1.67kg/m2; equivalent to a fall in weight per liter of aspirated volume of 0.66+/-0.09kg/L. Falls in hemoglobin and hematocrit per liter of aspirate volume were 0.46+/-0.07g/dl/L and 1.70+/-0.35%/L, respectively. Mean operative time per liter of aspirate was 39.6+/-2.1min/L. Complications were palpable skin irregularity in 5 patients; hyperpigmentation scars occurred in 5 patients; 2 of the heaviest women required blood transfusions; and 1 patient experienced prolonged edema. One major complication of subclinical fat embolism occurred. Cosmetic results were generally good. In conclusion, if patients are properly selected and fluid resuscitations are performed adequately, single stage liposuction involving aspirations of greater than 5000ml can be undertaken safely in Korean.
Aspirations (Psychology) ; Blood Transfusion ; Body Mass Index ; Body Weight Changes ; Cicatrix ; Edema ; Embolism, Fat ; Female ; Hematocrit ; Humans ; Hyperpigmentation ; Lipectomy* ; Operative Time ; Resuscitation ; Skin ; Weight Loss

transfusion protocols have shifted toward early intervention. This study aimed to develop a prediction model for transfusion of ≥5 units of packed red blood cells (PRBCs) during cesarean section in women with placenta previa.MATERIALS AND METHODS: We conducted a cohort study including 287 women with placenta previa who delivered between September 2011 and April 2018. Univariate and multivariate logistic regression analyses were used to test the association between clinical factors, ultrasound factors, and massive transfusion. For the external validation set, we obtained data (n=50) from another hospital.RESULTS: We formulated a scoring model for predicting transfusion of ≥5 units of PRBCs, including maternal age, degree of previa, grade of lacunae, presence of a hypoechoic layer, and anterior placentation. For example, total score of 223/260 had a probability of 0.7 for massive transfusion. Hosmer-Lemeshow goodness-of-fit test indicated that the model was suitable (p>0.05). The area under the receiver operating characteristics curve (AUC) was 0.922 [95% confidence interval (CI) 0.89–0.95]. In external validation, the discrimination was good, with an AUC value of 0.833 (95% CI 0.70–0.92) for this model. Nomogram calibration plots indicated good agreement between the predicted and observed outcomes, exhibiting close approximation between the predicted and observed probability.CONCLUSION: We constructed a scoring model for predicting massive transfusion during cesarean section in women with placenta previa. This model may help in determining the need to prepare an appropriate amount of blood products and the optimal timing of blood transfusion.]]>
Area Under Curve ; Blood Transfusion ; Calibration ; Cesarean Section ; Cohort Studies ; Discrimination (Psychology) ; Early Intervention (Education) ; Erythrocytes ; Female ; Humans ; Logistic Models ; Maternal Age ; Nomograms ; Placenta Previa ; Placenta ; Placentation ; Postpartum Hemorrhage ; Pregnancy ; ROC Curve ; Ultrasonography

BACKGROUND: Biportal endoscopic spine surgery (BESS) is a recent addition to minimally invasive spine surgery treatments. It boasts excellent magnification and fine discrimination of neural structures. Selective decompression with preservation of facet joints for structural stability is also feasible owing to access to the spinal canal and foramen deeper inside. This study has a purpose to investigate clinical benefits of BESS for spinal stenosis in comparison to the other common surgical treatments such as microscopic decompression-only (DO) and fusion and instrumentation (FI). METHODS: From December 2013 to March 2015, 30 cases of DO, 48 cases of FI, and 66 consecutive cases of BESS for lumbar spinal stenosis (LSS) were enrolled to evaluate the relative clinical efficacy of BESS. Visual analog scale (VAS) for back pain and leg pain, postoperative hemoglobin, C-reactive protein (CRP) changes, transfusion, and postoperative complications were examined. RESULTS: All the patients were followed up until 6 months, and 98 patients (86.7%) for 2 years. At the 6-month follow-up, VAS for back pain improved from 6.8 to 2.8, 6.8 to 3.2, and 6.8 to 2.8 (p = 0.078) for BESS, DO, and FI, respectively; VAS for leg pain improved from 6.3 to 2.2, 7.0 to 2.5, and 7.2 to 2.5 (p = 0.291), respectively. Two cases in the BESS group underwent additional foraminal decompression, but no fusion surgery was performed. Postoperative hemoglobin changes for BESS, DO, and FI were −2.5, −2.4, and −1.3 mL, respectively. The BESS group had no transfusion cases, whereas 10 cases (33.3%) in DO and 41 cases (85.4%) in FI had transfusion (p = 0.000). CRP changes for BESS, DO, and FI were 0.32, 6.53, and 6.00, respectively, at day 2 postoperatively (p = 0.000); the complication rate for each group was 8.6% (two dural tears and one root injury), 6.7% (two dural tears), and 8.3% (two dural tears and two wound infections), respectively. CONCLUSIONS: BESS for LSS showed clinical results not inferior to those of the other open surgery methods in the short-term. Stable hemodynamic changes with no need for blood transfusion and minimal changes in CRP were thought to cause less injury to the back muscles with minimal bleeding. Foraminal stenosis decompression should be simultaneously conducted with central decompression to avoid an additional surgery.
Back Muscles ; Back Pain ; Blood Transfusion ; C-Reactive Protein ; Constriction, Pathologic ; Decompression ; Discrimination (Psychology) ; Endoscopy ; Follow-Up Studies ; Hemodynamics ; Hemorrhage ; Humans ; Leg ; Lumbar Vertebrae ; Minimally Invasive Surgical Procedures ; Pain, Postoperative ; Postoperative Complications ; Spinal Canal ; Spinal Stenosis ; Spine ; Tears ; Treatment Outcome ; Visual Analog Scale ; Wounds and Injuries ; Zygapophyseal Joint