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Gastrointestinal quality-of-life after cholecystectomy: indication predicts gastrointestinal symptoms and abdominal pain.

https://arctichealth.org/en/permalink/ahliterature263825
Source
World J Surg. 2014 Dec;38(12):3075-81
Publication Type
Article
Date
Dec-2014
Author
Viktor Wanjura
Patrik Lundström
Johanna Osterberg
Ib Rasmussen
Britt-Marie Karlson
Gabriel Sandblom
Source
World J Surg. 2014 Dec;38(12):3075-81
Date
Dec-2014
Language
English
Publication Type
Article
Keywords
Abdominal Pain - etiology
Adult
Age Factors
Aged
Cholecystectomy - adverse effects - methods
Cholecystitis - complications - surgery
Choledocholithiasis - complications - surgery
Cicatrix - etiology - psychology
Colic - complications - surgery
Elective Surgical Procedures
Female
Humans
Male
Middle Aged
Pancreatitis - complications - surgery
Patient satisfaction
Quality of Life
Questionnaires
Sex Factors
Smoking - adverse effects
Sweden
Abstract
Despite the fact that cholecystectomy is a common surgical procedure, the impact on long-term gastrointestinal quality of life is not fully known.
All surgical procedures for gallstone disease performed at Mora County Hospital, Sweden, between 2 January 2002 and 2 January 2005, were registered on a standard database form. In 2007, all patients under the age of 80 years at follow-up were requested to fill in a form containing the Gastrointestinal Quality-of-Life Index (GIQLI) questionnaire and a number of additional questions. The outcome was analysed with respect to age, gender, smoking, surgical technique, and original indication for cholecystectomy.
A total of 627 patients (447 women, 180 men) underwent cholecystectomy, including laparoscopic cholecystectomy (N = 524), laparoscopic cholecystectomy converted to open cholecystectomy (N = 43), and open cholecystectomy (N = 60). The mean time between cholecystectomy and follow-up with the questionnaire was 49 months. The participation rate was 79 %. Using multivariate analysis in the form of generalised linear modelling, the original indication for cholecystectomy in combination with gender (p = 0.0042) was found to predict the GIQLI score. Female gender in combination with biliary colic as indication for cholecystectomy correlated with low GIQLI scores. Female gender also correlated with a higher risk for pain in the right upper abdominal quadrant after cholecystectomy (p = 0.028).
We found the original indication for cholecystectomy, together with gender, to predict gastrointestinal symptoms and abdominal pain after cholecystectomy. Careful evaluation of symptoms is important before planning elective cholecystectomy.
PubMed ID
25189441 View in PubMed
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Psychiatric caseness is a marker of major depressive episode in general practice.

https://arctichealth.org/en/permalink/ahliterature96376
Source
Scand J Prim Health Care. 2010 Jul 13;
Publication Type
Article
Date
Jul-13-2010
Author
Søren Dinesen Ostergaard
Leslie Foldager
Christer Allgulander
Alv A Dahl
Marja-Terttu Huuhtanen
Ib Rasmussen
Povl Munk-Jørgensen
Author Affiliation
Unit for Psychiatric Research, Aalborg Psychiatric Hospital, Aarhus University Hospital, Aalborg, Denmark.
Source
Scand J Prim Health Care. 2010 Jul 13;
Date
Jul-13-2010
Language
English
Publication Type
Article
Abstract
Abstract Objective. Screening for a major depressive episode (MDE) in high-risk groups of patients within the primary care setting has been suggested by several Central Health Organizations. The objective of this study was to investigate whether patients rated as "psychiatric cases" by their general practitioner (GP) were likely to suffer from MDE and therefore qualified for systematic diagnostic screening. Design. Cross-sectional survey of primary care patients assessed through depression screening questionnaires and GP consultations. Setting. A total of 676 general practices in Denmark, Finland, Norway, and Sweden. Subjects. A total of 8879 unselected primary care patients. Main outcome measures. Sensitivity, specificity, and Youden Index of the GPs' diagnoses of depression and psychiatric caseness versus patients' MDE status. Results. The proportion of primary care patients receiving a false-positive diagnosis of depression by their GP ranged from 12.4% to 25.2% depending on country. The corresponding numbers for the false-negative diagnoses were 0.5-2.5%. Among patients with MDE, GPs recognize the disease in 56-75% of cases. However, GPs recognize as many as 79-92% of patients with MDE as "psychiatric cases". Conclusions. This report confirms that misclassifications of MDE are common in the primary care setting. In addition, it shows that psychiatric caseness is a valid marker for the presence of MDE in primary care patients. This relationship should be considered in future screening recommendations.
PubMed ID
20624110 View in PubMed
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