Gregory T Brennan, Muhammad Wasif Saif
Pancreatic enzyme replacement therapy is safe and effective at treating pancreatic exocrine insufficiency. There are multiple causes of pancreatic exocrine insufficiency including chronic pancreatitis, cystic fibrosis and pancreatic cancer. Testing fecal elastase-1 level is useful for the diagnosis of pancreatic exocrine insufficiency. Starting doses of pancreatic enzyme replacement therapy should be at least 30-40,000 IU with each meal and 15-20,000 IU with snacks. pancreatic enzyme replacement therapy should be taken in divided doses throughout meals...
2019: JOP: Journal of the Pancreas
Stanley Kalata, Jyothi R Thumma, Edward C Norton, Justin B Dimick, Kyle H Sheetz
IMPORTANCE: Robotic-assisted cholecystectomy is rapidly being adopted into practice, partly based on the belief that it offers specific technical and safety advantages over traditional laparoscopic surgery. Whether robotic-assisted cholecystectomy is safer than laparoscopic cholecystectomy remains unclear. OBJECTIVE: To determine the uptake of robotic-assisted cholecystectomy and to analyze its comparative safety vs laparoscopic cholecystectomy. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study used Medicare administrative claims data for nonfederal acute care hospitals from January 1, 2010, to December 31, 2019...
September 20, 2023: JAMA Surgery
Sebastiaan van Steensel, Eva B Deerenberg, Marijn M Poelman
No abstract text is available yet for this article.
September 15, 2023: British Journal of Surgery
Takeshi Wada, Satoshi Gando
Two phenotypes of disseminated intravascular coagulation (DIC) are systematically reviewed. DIC is classified into thrombotic and fibrinolytic phenotypes characterized by thrombosis and hemorrhage, respectively. Major pathology of DIC with thrombotic phenotype is the activation of coagulation, insufficient anticoagulation with endothelial injury, and plasminogen activator inhibitor-1 (PAI-1)-mediated inhibition of fibrinolysis, leading to microvascular fibrin thrombosis and organ dysfunction. DIC with fibrinolytic phenotype is defined as massive thrombin generation commonly observed in any type of DIC, combined with systemic pathologic hyperfibrinogenolysis caused by underlying disorder that results in severe bleeding due to excessive plasmin formation...
September 1, 2023: Thrombosis and Haemostasis
Francesco Panzuto, John Ramage, D Mark Pritchard, Marie-Louise F van Velthuysen, Joerg Schrader, Nehara Begum, Anders Sundin, Massimo Falconi, Dermot O'Toole
The aim of the present guidance paper was to update the previous ENETS guidelines on well-differentiated gastric and duodenal neuroendocrine tumours (NETs), providing practical guidance for specialists in the diagnosis and management of gastroduodenal NETs. Type II gastric NETs, neuroendocrine carcinomas (NECs), and functioning duodenal NETs are not covered, since they will be discussed in other ENETS guidance papers.
August 2023: Journal of Neuroendocrinology
Christopher J D Wallis, Angela Jerath, Khatereh Aminoltejari, Kirusanthy Kaneshwaran, Arghavan Salles, Natalie Coburn, Frances C Wright, Lesley Gotlib Conn, Zachary Klaassen, Amy N Luckenbaugh, Sanjana Ranganathan, Carlos Riveros, Colin McCartney, Kathleen Armstrong, Barbara Bass, Allan S Detsky, Raj Satkunasivam
IMPORTANCE: Sex- and gender-based differences in a surgeon's medical practice and communication may be factors in patients' perioperative outcomes. Patients treated by female surgeons have improved 30-day outcomes. However, whether these outcomes persist over longer follow-up has not been assessed. OBJECTIVE: To examine whether surgeon sex is associated with 90-day and 1-year outcomes among patients undergoing common surgeries. DESIGN, SETTING, AND PARTICIPANTS: A population-based retrospective cohort study was conducted in adults in Ontario, Canada, undergoing 1 of 25 common elective or emergent surgeries between January 1, 2007, and December 31, 2019...
August 30, 2023: JAMA Surgery
M Sahm, M Pross, M Hukauf, D Adolf, F Köckerling, R Mantke
PURPOSE: Elective open incisional hernia operations are a frequently performed and complex procedure. Prophylactic drainage is widely practised to prevent local complications, but nevertheless the benefit of surgical drain placement remains a controversially discussed subject. Objective of this analysis was to evaluate the current status of patient care in clinical routine and outcome in this regard. METHODS: The study based on prospectively collected data of the Herniamed Register...
August 18, 2023: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Adam North, Nilanjana Tewari
Peroral endoscopic myotomy (POEM) is an intervention for the treatment of achalasia which has gained popularity over the last decade. It's efficacy and invasiveness are comparable to laparoscopic Heller myotomy (LHM). The purpose of this systematic review is to compare POEM to existing therapies. The systematic review was performed following the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. MEDLINE, EMBASE, Web of Science and Cochrane Libraries were searched using keywords: esophageal achalasia, POEM, LHM, pneumatic dilation (PD), and related terms...
August 3, 2023: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
Heather Desaire, Aleesa E Chua, Madeline Isom, Romana Jarosova, David Hua
ChatGPT has enabled access to artificial intelligence (AI)-generated writing for the masses, initiating a culture shift in the way people work, learn, and write. The need to discriminate human writing from AI is now both critical and urgent. Addressing this need, we report a method for discriminating text generated by ChatGPT from (human) academic scientists, relying on prevalent and accessible supervised classification methods. The approach uses new features for discriminating (these) humans from AI; as examples, scientists write long paragraphs and have a penchant for equivocal language, frequently using words like "but," "however," and "although...
June 21, 2023: Cell reports. Physical science
Robert Farquhar, Scott Matthews, Nesta Baxter, George Rayers, Chathura B B Ratnayake, Francis P Robertson, Sandip Nandhra, Wei Boon Lim, Miles Witham, Sanjay Pandanaboyana
BACKGROUND: The prevalence and impact of sarcopenia and sarcopenic obesity noted on body composition analysis in severe acute pancreatitis (SAP) is unknown. This study investigates the prevalence of sarcopenia at different timepoints and its effect on post-pancreatitis complications and mortality. METHODS: A prospective database of SAP admissions with organ failure at a single institution from 2015 to 2019 were analysed. Sarcopenia was determined by IMAGE J software on CT...
August 4, 2023: World Journal of Surgery
Tara van Veen, Purushotham Ramanathan, Lolita Ramsey, Jonathan Dort, Dina Tabello
BACKGROUND: Small bowel obstruction (SBO) is responsible for 350,000 U.S. hospitalizations and costs ~ $2.3 billion annually. The current standard of care for SBO is to trial 3 to 5 days of non-operative management. This study evaluated the factors associated with operative management. METHODS: This retrospective cohort study included adult patients admitted with adhesive SBO. Exclusions were for operative intervention within 24 h or death...
July 26, 2023: Surgical Endoscopy
Nam Yong Cho, Nikhil L Chervu, Sara Sakowitz, Arjun Verma, Elsa Kronen, Manuel Orellana, Christian de Virgilio, Peyman Benharash
BACKGROUND: Retrospective and single-center studies have demonstrated that early cholecystectomy is associated with shorter length of stay in patients with mild gallstone pancreatitis. However, these studies are not powered to detect differences in adverse events. Using a nationally representative cohort, we evaluated the association of timing for cholecystectomy with clinical outcomes and resource use in patients with gallstone pancreatitis. METHODS: All adult hospitalizations for gallstone pancreatitis were tabulated from the 2016-2019 Nationwide Readmissions Database...
June 22, 2023: Surgery
Aagje J M Pronk, Anne Roelofs, David R Flum, H Jaap Bonjer, Mohammed Abu Hilal, Marcel G W Dijkgraaf, Marc G Besselink, Usama Ahmed Ali
BACKGROUND: RCTs are essential in guiding clinical decision-making but are difficult to perform, especially in surgery. This review assessed the trend in volume and methodological quality of published surgical RCTs over two decades. METHODS: PubMed was searched systematically for surgical RCTs published in 1999, 2009, and 2019. The primary outcomes were volume of trials and RCTs with a low risk of bias. Secondary outcomes were clinical, geographical, and funding characteristics...
September 6, 2023: British Journal of Surgery
Derek C Angus, Christopher W Seymour, Kirsten Bibbins-Domingo
No abstract text is available yet for this article.
July 25, 2023: JAMA
Rachel Lawrence, Melissa Watters, Caitlin R Davies, Klaus Pantel, Yong-Jie Lu
Given that cancer mortality is usually a result of late diagnosis, efforts in the field of early detection are paramount to reducing cancer-related deaths and improving patient outcomes. Increasing evidence indicates that metastasis is an early event in patients with aggressive cancers, often occurring even before primary lesions are clinically detectable. Metastases are usually formed from cancer cells that spread to distant non-malignant tissues via the blood circulation, termed circulating tumour cells (CTCs)...
June 2, 2023: Nature Reviews. Clinical Oncology
Saketh R Guntupalli, Daniel Spinosa, Stephanie Wethington, Ramez Eskander, Alok A Khorana
Venous thromboembolism (VTE) is a major cause of both morbidity and mortality in patients with cancer. Venous thromboembolism, which includes both deep vein thrombosis and pulmonary embolism, affects a sizable portion of patients with malignancy and can have potentially life threatening complications. Accurate assessment of risk as well as diagnosis and treatment of this process is paramount to preventing death in this high risk population. Various risk models predictive of venous thromboembolism in patients with cancer have been developed, and knowledge of these rubrics is essential for the treating oncologist...
June 1, 2023: BMJ: British Medical Journal
Maxwell S Renna, Mariusz T Grzeda, James Bailey, Alison Hainsworth, Sebastien Ourselin, Michael Ebner, Tom Vercauteren, Alexis Schizas, Jonathan Shapey
BACKGROUND: Anastomotic leak is one of the most feared complications of colorectal surgery, and probably linked to poor blood supply to the anastomotic site. Several technologies have been described for intraoperative assessment of bowel perfusion. This systematic review and meta-analysis aimed to evaluate the most frequently used bowel perfusion assessment modalities in elective colorectal procedures, and to assess their associated risk of anastomotic leak. Technologies included indocyanine green fluorescence angiography, diffuse reflectance spectroscopy, laser speckle contrast imaging, and hyperspectral imaging...
May 30, 2023: British Journal of Surgery
Jessica Roelands, Peter J K Kuppen, Eiman I Ahmed, Raghvendra Mall, Tariq Masoodi, Parul Singh, Gianni Monaco, Christophe Raynaud, Noel F C C de Miranda, Luigi Ferraro, Tatiana C Carneiro-Lobo, Najeeb Syed, Arun Rawat, Amany Awad, Julie Decock, William Mifsud, Lance D Miller, Shimaa Sherif, Mahmoud G Mohamed, Darawan Rinchai, Marc Van den Eynde, Rosalyn W Sayaman, Elad Ziv, Francois Bertucci, Mahir Abdulla Petkar, Stephan Lorenz, Lisa Sara Mathew, Kun Wang, Selvasankar Murugesan, Damien Chaussabel, Alexander L Vahrmeijer, Ena Wang, Anna Ceccarelli, Khalid A Fakhro, Gabriele Zoppoli, Alberto Ballestrero, Rob A E M Tollenaar, Francesco M Marincola, Jérôme Galon, Souhaila Al Khodor, Michele Ceccarelli, Wouter Hendrickx, Davide Bedognetti
The lack of multi-omics cancer datasets with extensive follow-up information hinders the identification of accurate biomarkers of clinical outcome. In this cohort study, we performed comprehensive genomic analyses on fresh-frozen samples from 348 patients affected by primary colon cancer, encompassing RNA, whole-exome, deep T cell receptor and 16S bacterial rRNA gene sequencing on tumor and matched healthy colon tissue, complemented with tumor whole-genome sequencing for further microbiome characterization...
May 2023: Nature Medicine
Laura L Meijer, Ninos Ayez, Charlotte S van Kessel
No abstract text is available yet for this article.
May 13, 2023: British Journal of Surgery
Charlotte Jl Molenaar, Stefan J van Rooijen, Hugo Jp Fokkenrood, Rudi Mh Roumen, Loes Janssen, Gerrit D Slooter
BACKGROUND: Surgery is the cornerstone in curative treatment of colorectal cancer. Unfortunately, surgery itself can adversely affect patient health. 'Enhanced Recovery After Surgery' programmes, which include multimodal interventions, have improved patient outcomes substantially. However, these are mainly applied peri- and postoperatively. Multimodal prehabilitation includes multiple preoperative interventions to prepare patients for surgery with the aim of increasing resilience, thereby improving postoperative outcomes...
May 10, 2023: Cochrane Database of Systematic Reviews
2023-05-11 15:01:33
Fetch more papers »
Fetching more papers... Fetching...
Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"

We want to hear from doctors like you!

Take a second to answer a survey question.