Anne F Peery
Left sided colonic diverticulitis is a common and costly gastrointestinal disease in Western countries, characterized by acute onset of often severe abdominal pain. Imaging is necessary to make an initial diagnosis and determine disease severity. Colonoscopy should be done six to eight weeks after diagnosis to rule out a missed colon malignancy. Antibiotic treatment is used selectively in immunocompetent patients with mild acute uncomplicated diverticulitis. The clinical course of diverticulitis commonly includes unpredictable recurrences and chronic gastrointestinal symptoms, which are a detriment to quality of life...
March 24, 2021: BMJ: British Medical Journal
Rita M Meganck, Ralph S Baric
The twenty-first century has already recorded more than ten major epidemic or pandemic virus emergence events, including the ongoing and devastating coronavirus disease 2019 (COVID-19) pandemic. As viral disease emergence is expected to accelerate, these data dictate a need for proactive approaches to develop broadly active family-specific and cross-family therapeutics for use in future disease outbreaks. Emphasis should focus not only on the development of broad-spectrum small-molecule and antibody direct-acting antivirals, but also on host-factor therapeutics, including repurposing previously approved or in-pipeline drugs...
March 2021: Nature Medicine
Andrea Ciarrocchi, Guido Rindi, Renato Pietroletti
INTRODUCTION: The aim of the current paper was to critically collect, select and summarize the evidence regarding diagnosis, treatment and follow up of primary tumors of the appendix. METHODS: A literature review was performed by search and review of the scientific studies pertaining to the subject of our inquiry. RESULTS: Recommendations regarding pimary tumors of the appendix were formulated on the basis of the collected evidence. CONCLUSION : Primary tumors of the appendix are rare and a high index of suspicion is required not to miss a potentially life threatening medical condition...
March 19, 2021: Journal of Gastrointestinal Cancer
Soran Gadan, Judith S Brand, Martin Rutegård, Peter Matthiessen
PURPOSE: A defunctioning stoma reduces the risk of symptomatic anastomotic leakage after low anterior resection for rectal cancer and mitigates the consequences when a leakage occurs, but the impact on mortality and oncological outcomes is unclear. The aim was to investigate the associations of a defunctioning stoma with short- and long-term outcomes in patients undergoing low anterior resection for rectal cancer. METHODS: Data from all patients who underwent curative low anterior resection for rectal cancer between 1995 and 2010 were obtained from the Swedish Colorectal Cancer Register...
March 17, 2021: International Journal of Colorectal Disease
Jennifer A Yonkus, Roberto Alva-Ruiz, Travis E Grotz
Treatment with the tyrosine kinase inhibitor (TKI), imatinib is the standard first-line treatment for metastatic gastrointestinal stromal tumors (GISTs). Unfortunately, acquired c-kit mutations cause secondary resistance to imatinib in a median of 18-24 months. Sunitinib and regorafenib are multi-kinase inhibitors that can be used as second-line or third-line therapy in imatinib-resistant or -intolerant GISTs, respectively. Ripretinib (a switch-control tyrosine kinase inhibitor) has recently been approved for fourth-line treatment in metastatic GIST...
March 20, 2021: Current Treatment Options in Oncology
Viraj Pandit, Tze-Woei Tan, Kelly Kempe, Joshua Chitwood, Hyein Kim, Vernon Horst, Wei Zhou, Peter Nelson
BACKGROUND: Frailty syndrome is an established predictor of adverse outcomes after surgical procedures. Our study aimed to compare the simplified National Surgical Quality Improvement Program 5-factor-modified frailty index (mFI-5) to its prior 11-factor-modified frailty index (mFI-11) with respect to the predictive ability for mortality, postoperative complications, and unplanned 30-d readmission in patients undergoing lower limb amputation. METHODS: The National Surgical Quality Improvement Program (2005-2012) databank was queried for all geriatric patients (>65 y) who underwent above-knee and below-knee amputations...
March 8, 2021: Journal of Surgical Research
Amy H Attaway, Rachel G Scheraga, Adarsh Bhimraj, Michelle Biehl, Umur Hatipoğlu
Severe covid-19 pneumonia has posed critical challenges for the research and medical communities. Older age, male sex, and comorbidities increase the risk for severe disease. For people hospitalized with covid-19, 15-30% will go on to develop covid-19 associated acute respiratory distress syndrome (CARDS). Autopsy studies of patients who died of severe SARS CoV-2 infection reveal presence of diffuse alveolar damage consistent with ARDS but with a higher thrombus burden in pulmonary capillaries. When used appropriately, high flow nasal cannula (HFNC) may allow CARDS patients to avoid intubation, and does not increase risk for disease transmission...
March 10, 2021: BMJ: British Medical Journal
Alexander M Fagenson, Henry A Pitt, Kwan N Lau
BACKGROUND: Perioperative blood transfusions and operative time are surgical quality indicators. The aim of this analysis is to determine which of these variables drives post-hepatectomy outcomes. METHODS: Patients undergoing major or partial hepatectomy were identified in the 2014-2018 American College of Surgeons National Surgical Quality Improvement Program hepatectomy targeted database. Prolonged operative time was defined as ≥ 240 minutes. Multivariable logistic regressions were performed for multiple postoperative outcomes...
January 1, 2021: American Surgeon
Gwyneth A Sullivan, Nicholas J Skertich, Brian C Gulack, Adan Z Becerra, Ami N Shah
INTRODUCTION: The disruption score is a new bibliometric tool that has recently been utilized to identify studies that are innovative and shift paradigms. We sought to identify and characterize the top 100 most disruptive publications in pediatric surgery. METHODS: The 100 most disruptive and cited publications in 17 pediatric surgery journals were identified from a validated dataset and linked with the iCite NIH tool. The top 100 most disruptive publications were reviewed to determine study design, clinical focus, and perceived contribution...
February 11, 2021: Journal of Pediatric Surgery
P Gavriilidis, N de'Angelis, J Wheeler, A Askari, S Di Saverio, J R Davies
INTRODUCTION: The debate on the best surgical management strategy for acute malignant left-sided colonic obstruction is ongoing. Decompressing colostomy (DC) and stenting as a bridge to surgery (SBTS) are the currently proposed alternative approaches to emergency colectomy (EC). However, the results of a traditional meta-analysis were inconclusive. Therefore, a network meta-analysis (NMA) was conducted to compare the three approaches for acute left-sided colonic obstruction. METHODS: A systematic literature search of Embase, PubMed, Google Scholar and the Cochrane library was performed...
March 8, 2021: Annals of the Royal College of Surgeons of England
Christopher D Griffiths, Tyler McKechnie, Yung Lee, Jeremy E Springer, Aristithes G Doumouras, Dennis Hong, Cagla Eskicioglu
Background: The incidence of colorectal cancer in North America is rising among patients younger than 50 years. Available data are conflicting regarding presentation and outcomes in this population. This review aimed to synthesize literature regarding young patients with colorectal cancer with respect to patient demographics, disease extent and survival, compared with patients older than 50 years. Methods: We searched Medline, Embase, the Cochrane Central Register of Controlled Trials and PubMed for articles published between 1990 and the time of search...
February 18, 2021: Canadian Journal of Surgery. Journal Canadien de Chirurgie
Oliver J Muensterer, Hendrik Kreutz, Alicia Poplawski, Jan Goedeke
BACKGROUND: For over a decade, the preoperative timeout procedure has been implemented in most paediatric surgery units. However, the impact of this intervention has not been systematically studied. This study evaluates whether purposefully introduced errors during the timeout routine are detected and reported by the operating team members. METHODS: After ethics board approval and informed consent, deliberate errors were randomly and clandestinely introduced into the timeout routine for elective surgical procedures by a paediatric surgery attending...
February 25, 2021: BMJ Quality & Safety
Mark A Healy, Oliver Peacock, Chung-Yuan Hu, Brian K Bednarski, Matthew M Tillman, Craig Messick, Harmeet Kaur, George J Chang
OBJECTIVE: To identify rates of positive circumferential resection margin (CRM) for colon cancer surgery in the U.S. SUMMARY BACKGROUND DATA: CRM is one of the most important determinants of local control in colorectal cancers. The extent to which CRM involvement exists after colon cancer surgery is unknown. METHODS: Colon cancer cases with resection 2010-2015 were identified from the National Cancer Data Base. Adjusting for patient and tumor characteristics, comparisons were made between cases with CRM >1 mm (negative margin) and those with margin involved with tumor or ≤1 mm (positive margin, CRM+)...
December 22, 2020: Annals of Surgery
Lara Dotto, Mateus de Azevedo Kinalski, Pablo Soares Machado, Gabriel Kalil Rocha Pereira, Rafael Sarkis-Onofre, Mateus Bertolini Fernandes Dos Santos
OBJECTIVE: This study aimed to assess the characteristics of different designs of systematic reviews (SRs) registered in the International Prospective Register of Systematic Reviews (PROSPERO) about COVID-19. METHODS: The search was performed in the PROSPERO database using the strategy proposed by the database and considered only human studies. The last date of the search was April 27, 2020. Full text of all records was accessed, and data were extracted by a single researcher, which was further double-checked by another researcher...
February 17, 2021: Journal of Evidence-based Medicine
Alicja Zientara, Anja-Rebeka Domenghino, Igor Schwegler, Hans Bruijnen, Annelies Schnider, Markus Weber, Stefan Gutknecht, Nicolas Attigah
BACKGROUND: Mesenteric ischemia is associated with poor outcome and high overall mortality. The aim was to analyze an interdisciplinary treatment approach of vascular and visceral specialists focusing on the in-hospital outcome and follow-up in patients with acute and acute-on-chronic mesenteric ischemia. METHODS: From 2010 until 2017, 26 consecutive patients with acute or acute on chronic mesenteric ischemia were treated by an interdisciplinary team. Data were prospectively collected and retrospectively evaluated...
February 18, 2021: BMC Surgery
Izaskun Balciscueta, Ferran Barberà, Javier Lorenzo, Susana Martínez, Maria Sebastián, Zutoia Balciscueta
BACKGROUND: Outpatient laparoscopic cholecystectomy has proven to be a safe and cost-effective technique; however, it is not yet a universally widespread procedure. The aim of the study was to determine the predictive factors of outpatient laparoscopic cholecystectomy failure. METHOD: A systematic review and meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analysis methodology. MEDLINE, Cochrane Library, Ovid, and ISRCTN Registry were searched...
February 5, 2021: Surgery
Steven Morrison, Dale Han
The vast majority of patients newly diagnosed with melanoma present with clinically localized disease, and sentinel lymph node biopsy (SLNB) is a standard of care in the management of these patients, particularly in intermediate thickness cases, in order to provide important prognostic data. However, SLNB also has an important role in the management of patients with other subtypes of melanoma such as thick melanomas, certain thin melanomas, and specific histologic variants of melanoma such as desmoplastic melanoma...
February 9, 2021: Current Treatment Options in Oncology
Christopher A Lewis-Lloyd, Eleanor M Pettitt, Alfred Adiamah, Colin J Crooks, David J Humes
BACKGROUND: Colorectal cancer has the second highest mortality of any malignancy, and venous thromboembolism is a major postoperative complication. OBJECTIVE: This study aimed to determine the variation in incidence of venous thromboembolism after colorectal cancer resection. DATA SOURCES: Following PRISMA and MOOSE guidelines (PROSPERO, ID: CRD42019148828), Medline and Embase databases were searched from database inception to August 2019 including 3 other registered medical databases...
April 1, 2021: Diseases of the Colon and Rectum
Stacy A Mandras, Hirsch S Mehta, Anjali Vaidya
Pulmonary hypertension (PH) is classified into 5 clinical subgroups: pulmonary arterial hypertension (PAH), PH due to left-sided heart disease, PH due to chronic lung disease, chronic thromboembolic PH (CTEPH), and PH with an unclear and/or multifactorial mechanisms. A range of underlying conditions can lead to these disorders. Overall, PH affects approximately 1% of the global population, and over half of patients with heart failure may be affected. Cardiologists are therefore likely to encounter PH in their practice...
September 2020: Mayo Clinic Proceedings
Rebecca L Siegel, Kimberly D Miller, Hannah E Fuchs, Ahmedin Jemal
Each year, the American Cancer Society estimates the numbers of new cancer cases and deaths in the United States and compiles the most recent data on population-based cancer occurrence. Incidence data (through 2017) were collected by the Surveillance, Epidemiology, and End Results Program; the National Program of Cancer Registries; and the North American Association of Central Cancer Registries. Mortality data (through 2018) were collected by the National Center for Health Statistics. In 2021, 1,898,160 new cancer cases and 608,570 cancer deaths are projected to occur in the United States...
January 2021: CA: a Cancer Journal for Clinicians
2021-01-29 17:32:45
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