A novel discriminant formula for the prompt diagnosis of strangulated bowel obstruction

xlomafota.13 shared this article with you from Inoreader A novel discriminant formula for the prompt diagnosis of strangulated bowel obstruction Via Latest Results for Surgery Today Abstract Purposes The diagnosis of strangulated bowel obstruction (SBO) is sometimes difficult. We attempted to create and verify a discriminant formula for use as a diagnostic aid for the early diagnosis of SBO. Methods This retrospective study included 97 patients who underwent an operation for SBO from January 2007 to September 2018. First, a discriminant analysis was performed for 73 patients who underwent an operation from January 2007 to December 2015 in order to obtain a formula. Next, we analyzed 34 patients who underwent an operation from January 2016 to September 2018 to verify the formula. Results The risk factors for SBO included ascites, signs of preperitoneal irritation, and lactate > 1.16 mmol/L. The discriminant formula is as follows: 1.954 × collection of ascites (1 or 0) + 1.239 × peritoneal irritation sign (1 or 0) + 0.378 × lactate − 2.331 (1: positive, 0: negative). The predictive value was as follows: sensitivity, 87.5%; specificity, 64.7%; and predictive accuracy, 73.5%. In patients who presented within 24 h of the onset, the sensitivity was 92.3%, the specificity was 75.0%, and the predictive accuracy was 85.7%. Conclusion Our discriminant formula seems useful for the rapid diagnosis of SBO. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Small mutations in Duchenne/Becker muscular dystrophy

xlomafota.13 shared this article with you from Inoreader Small mutations in Duchenne/Becker muscular dystrophy in 164 unrelated Polish patients Via Latest Results for Journal of Applied Genetics Abstract In the 164 patients with Duchenne/Becker muscular dystrophy, we found 142 different small mutations including 51 novel mutations not listed in the LOVD, the UMD-DMD, the ClinVar, and the HGMD databases. Among all mutations, nonsense mutations occurred in 45.7%, frameshift mutations in 32.9%, and splicing mutations in 19.5%. Small mutations were distributed throughout the whole dystrophin gene. Splicing mutations were twice more common in BMD patients than in DMD patients. Eighty-two percent of mothers of the males affected with DMD/BMD were found to be carriers of small mutations. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Primary dedifferentiated Liposarcoma of vagina

xlomafota.13 shared this article with you from Inoreader Primary dedifferentiated Liposarcoma of vagina: a first case report Via Latest Results for Diagnostic Pathology Abstract Background Dedifferentiated liposarcoma, one of the most deadly types of soft tissue sarcoma, is an aggressive and high-grade form of liposarcoma. Liposarcoma occurs most commonly in the retroperitoneum, extremities and trunk, but less frequently in the female genital tract. The vagina is a very rare site of origin. Herein we report the first case of dedifferentiated Liposarcoma deriving from vagina and discuss its clinical course. Case presentation A 38-year-old female patient presented to our institution with a painless vaginal mass. Abdominal computed tomography showed a 17.6 cm× 10.4 cm solid mass originating from the right lateral wall of her vagina. Then she underwent complete surgical resection of the tumor mass, and postoperative pathological result confirmed the diagnosis of dedifferentiated liposarcoma deriving from vagina. Six courses of combination chemotherapy with pirarubicin plus ifosfamide were performed after surgery. The patient remains with no evidence of disease recurrence with 13 months of follow-up. Conclusions Liposarcoma is very rare in female genital tract, and more rare for dedifferentiated liposarcoma in gynecologic field. Little is known about the clinical characteristics, pathological diagnosis, prognosis and optimal management strategy of vaginal dedifferentiated liposarcoma. Complete surgical resection followed by systemic chemotherapy is suggested to be standard treatment for dedifferentiated liposarcoma. Combination chemotherapy with pirarubicin and ifosfamide may be effective for treating vaginal dedifferentiated liposarcoma. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Expression of IL4Rα and IL13Rα1 are associated with poor prognosis of soft-tissue sarcoma of the extremities, superficial trunk, and retroperitoneum

xlomafota.13 shared this article with you from Inoreader Expression of IL4Rα and IL13Rα1 are associated with poor prognosis of soft-tissue sarcoma of the extremities, superficial trunk, and retroperitoneum Via Latest Results for Diagnostic Pathology Abstract Background IL4Rα and IL13Rα1 are constituents of the type II IL4 receptor. Recently, IL4Rα and IL13Rα1 were reported to have roles in cancer progression and suggested as potential prognostic markers. However, studies on IL4Rα and IL13Rα1 in soft-tissue sarcomas have been limited. Methods This study investigated the immunohistochemical expression of IL4Rα and IL13Rα1 in 89 soft-tissue sarcomas of the extremities, superficial trunk, and retroperitoneum. Immunohistochemical staining for IL4Rα and IL13Rα1 were scored according to a combination of staining intensity and staining area in tissue microarray samples. Positivity for the immunohistochemical expression of IL4Rα and IL13Rα1 were determined using receiver operating curve analysis. Statistical analysis was performed using regression analysis and a chi-square test. Results In human soft-tissue sarcomas, immunohistochemical expression of IL4Rα was significantly associated with IL13Rα1 expression. Nuclear and cytoplasmic expression of IL4Rα and IL13Rα1 were significantly associated with shorter survival of soft-tissue sarcoma patients in univariate analysis. Multivariate analysis indicated that nuclear expression of IL4Rα and IL13Rα1 were independent indicators of shorter overall survival (IL4Rα; p = 0.002, IL13Rα1; p = 0.016) and relapse-free survival (IL4Rα; p = 0.022, IL13Rα1; p < 0.001) of soft-tissue sarcoma patients. Moreover, the co-expression pattern of nuclear IL4Rα and IL13Rα1 was an independent indicator of shorter survival of soft-tissue sarcoma patients (overall survival; overall p < 0.001, relapse-free survival; overall p < 0.001). Conclusions This study suggests IL4Rα and IL13Rα1 are associated with the progression of soft-tissue sarcoma, and the expression of IL4Rα and IL13Rα1 might be novel prognostic indicators of soft-tissue sarcoma patients. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Onion Extract Encapsulated on Nano Chitosan: a Promising Anticancer Agent

xlomafota.13 shared this article with you from Inoreader Onion Extract Encapsulated on Nano Chitosan: a Promising Anticancer Agent Via Latest Results for Journal of Gastrointestinal Cancer Abstract Background Onion (Allium cepa) is very rich in nutritional and pharmaceutical components, such as saponins, tannins, alkaloids, steroids, and phenols. Many recent researches approved its anticancer activity against various cancer cell lines. In this paper, we attempt to improve its anticancer activity with encapsulation on nano chitosan. On the best of our knowledge, this is considered the first study that tries to increase the anticancer activity of the onion extract on nano chitosan. Methods An aqueous extract of the onion was prepared and the extract efficiency as anticancer agent was enhanced by encapsulating the extract on nano chitosan. The antioxidant capacity and the functional ingredients such as alkaloid, tannin, saponin, steroid, phenolic, and flavonoid in either the free or encapsulated one were estimated. Also, the anticancer activity of the two extracts was tested against different cell lines. Results Encapsulation of the extract on chitosan nano particles decreased IC50 in different cell lines and induced apoptosis through decreasing BCL-2 level and increasing caspase-3 and caspase-9 activity. Conclusion Onion extract encapsulated on nano chitosan can be used as protective agents from cancer, antitumor, or act synergistically with the cancer chemotherapy. This greatly participates in improving the use of natural products in cancer therapy instead of chemotherapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Frequent Downregulation and Promoter Hypermethylation of DLC1: Relationship with Clinical Outcome in Gallbladder Cancer

xlomafota.13 shared this article with you from Inoreader Frequent Downregulation and Promoter Hypermethylation of DLC1: Relationship with Clinical Outcome in Gallbladder Cancer Via Latest Results for Journal of Gastrointestinal Cancer Abstract Introduction Down regulation of DLC1 is associated with poor prognosis in many cancers, however, its role in gallbladder cancer (GBC) is still unclear. In present study, we investigated the expression profile and promoter methylation status of DLC1. Methods Expression profiles of DLC1 in 55 GBC and their paired adjacent control samples were analyzed through real time RT-PCR and immunohistochemistry. The mRNA data was correlated with clinico-pathological parameters. Promoter hypermethylation was analyzed through MSP. Results DLC1 shows downregulation in 76.4%, upregulation in 10.9% whereas no change in 12.7% of GBC samples. Its underexpression shows significant correlation with tumor grade and nodal spread. IHC shows cytoplasmic expression of DLC1 in normal as well as tumor samples. IHC result was concordant to mRNA result. Samples having downregulated DLC1 expression show heterozygous methylation in 83.3% of samples and homozygous methylation in 9.5% of samples whereas 7% of samples have no methylation. Kaplan–Meier analysis shows patient with decreased mRNA of DLC1 have significant low mean survival compared to patients with higher mRNA expression of DLC1. Conclusion Our findings suggested that dysregulated expression of DLC1 and its hypermethylation may be one of the events playing roles in tumorigenesis of GBC and may serve as a potential target for development of future GBC gene therapy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extended Total Mesorectal Excision (e-TME) for Locally Advanced Rectal Cancer

xlomafota.13 shared this article with you from Inoreader Extended Total Mesorectal Excision (e-TME) for Locally Advanced Rectal Cancer Via Latest Results for Journal of Gastrointestinal Cancer Abstract Background Locally advanced rectal cancer (LARC) can involve surrounding pelvic organs requiring multivisceral resection. Extended total mesorectal excision (e-TME) or multivisceral resection is a complex procedure associated with high morbidity, mortality, and R1 resection rates. However, e-TME in LARC with surrounding organ involvement is the only potential option for cure. The study aims to assess the clinical outcome of patients requiring e-TME for LARC. Methods The study is a retrospective review of all patients with LARC requiring multivisceral resection (2013 to 2019). The database includes clinic-demographic profile, pelvic organ involved, operative details, resection margin status, morbidity, mortality, and survival. Results Seven consecutive patients (9.2%) out of 76 LARC (median age 46 years; 5 females) required multivisceral resection. The organs involved were bladder (4); posterior wall of vagina (2); and uterus (1). The en bloc resection included total cystoprostatectomy - 1; partial cystectomy - 3; posterior vaginectomy - 2; and hysterectomy - 1. Additionally, four required abdominoperineal resection. All were adenocarcinoma: stage III, with R0 resection - 76%. The overall complications were seen in 60% of patients, majority being wound related. There was no operative mortality. The median survival was 32.2 months in the entire series, while one died with the disease at a 28-month follow-up. Conclusion e-TME with curative intent, though a complex procedure, is associated with high wound-related morbidity, R1 resection, but improved median survival benefit. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gender Differences in Psychological Distress in Patients with Colorectal Cancer and Its Correlates in the Northeast of Iran

xlomafota.13 shared this article with you from Inoreader Gender Differences in Psychological Distress in Patients with Colorectal Cancer and Its Correlates in the Northeast of Iran Via Latest Results for Journal of Gastrointestinal Cancer Abstract Purpose Colorectal cancer has a significant impact on patients' physical, psychological, and social aspects. This study aimed to examine the gender difference in anxiety and depression and its relationship with some of the characteristics of the disease and demographic in the northeast of Iran. Methods In this cross-sectional study, patients with colorectal cancer aged over 18 years who were admitted to hospitals, without considering the disease stage and type of treatment, were enrolled during 2014–2016. The Hospital Anxiety and Depression Scale (HADS) Questionnaire was completed via interview. Results A total of 303 survivors of colorectal cancer were included in the current analysis, of whom 55.1% (167) were male. The overall frequency of depression was 44.9%, and it was 38.3% and 32.9% for men and women, respectively. The overall frequency of anxiety was 53.4% (50.3% and 57.4% for men and women, respectively). The results showed that compared to men, women (52%) were more likely to report depression (OR = 0.48, 95% CI = 0.22–1.04, P = 0.065); in contrast, men (12%) were less likely than women to report anxiety (OR = 0.88, 95% CI = 0.38–2.03, P = 0.779), which was less than 12% in men. Among other variables, education and employment were identified as independent and strong predictive variables for depression and anxiety. Conclusions The frequency of anxiety and depression is high among colorectal cancer survivors, especially in women. Therefore, screening for psychological distress is recommended in clinical settings and there is a need to pay attention to women. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Claudicatio des jungen Menschen

xlomafota.13 shared this article with you from Inoreader Claudicatio des jungen Menschen Via Latest Results for Gefässchirurgie Zusammenfassung Die Claudicatio beim jungen Menschen ist eine seltene Entität. In Abwesenheit bekannter Risikofaktoren der Atherosklerose ist die klassische periphere arterielle Verschlusskrankheit (pAVK) als Ursache eher unwahrscheinlich. An Differenzialdiagnosen kommen vaskulitische Erkrankungen wie M. Winiwarter-Bürger und M. Behçet in Frage. Als vaskuläre Ursache ist die venöse Claudicatio als Teil des postthrombotischen Syndroms zu beachten. An arteriellen Ursachen sind die zystische Adventitiadegeneration und die fibromuskuläre Dysplasie zu nennen. Bei anamnestisch intensiver sportlicher Belastung ist an vaskuläre Kompressionssyndrome der unteren Extremität zu denken (popliteales Entrapment-Syndrom, Adduktorenkanalsyndrom, iliakale Endofibrose). Die Untersuchungen sind an die pAVK-Diagnostik angelehnt. Allerdings sollten diese auch nach Belastung bzw. in entsprechender Funktionsstellung durchgeführt werden. Der therapeutische Ansatz ist primär konservat iv. Bei operativer Notwendigkeit sind die offen-operativen Verfahren führend. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Chronic subdural haematoma

xlomafota.13 shared this article with you from Inoreader Chronic subdural haematoma during the COVID-19 lockdown period: late presentation with a longer interval from the initial head injury to the final presentation and diagnosis Via Latest Results for Chinese Neurosurgical Journal Abstract Background The COVID-19 novel coronavirus is contagious, and the mortality is higher in the elderly population. Lockdown in different parts of the world has been imposed since January 2020. Chronic subdural haematoma (cSDH) has a unique natural history in which symptoms can be non-specific, and the onset is insidious. This study aims to evaluate the impact of the COVID-19 pandemic on the presentation of cSDH. Methods Consecutive adult cSDH patients admitted from 1 March 2020 to 30 April 2020 were reviewed. Exclusion criteria including those who had no definite history of head injury or the diagnosis of cSDH were made from a scheduled follow-up scan. Corresponding data during the same period in 2019 were reviewed for comparison. The primary outcome was the interval between the initial head injury and the final radiological diagnosis of cSDH. Secondary outcomes include Markwalder chronic subdural haematoma grade upon admission, length of stay in the acute hospital, and the modified Rankin scale (mRS) upon discharge. Results For the primary outcome, the average interval between head injury and the diagnosis of cSDH was significantly longer at 56.6 days (49 to 74 days, SD 9.83 days) during the period from March to April 2020, versus 29.4 days (17 to 42 days, SD 8.59 days) in 2019 for the corresponding period (p = 0.00703). There was no significant difference in the functional outcome upon discharge. Conclusions cSDH patients can present late during the COVID-19 lockdown period. The functional outcome was comparable when operations for drainage were timely performed. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Papillary meningioma of the central nervous system: a SEER database analysis

xlomafota.13 shared this article with you from Inoreader Papillary meningioma of the central nervous system: a SEER database analysis Via Latest Results for Neurosurgical Review Abstract Papillary meningioma (PM) is a rare central nervous system tumor. We aimed to analyze the characteristics and outcomes of patients with PM (WHO grade III) and identify risk factors that influence survival using the Surveillance, Epidemiology, and End Results (SEER) database. Clinical characteristics, tumor features, and outcomes of 108 PM patients included in the SEER database between 1990 and 2016 were retrieved. Risk factors related to prognosis of PM were assessed by Kaplan–Meier curves and the Cox proportional hazards model. All 108 patients, including 65 males and 43 females (1.5:1), with a median age of 52 years (range, 9 to > 85 years) had undergone surgical resection. Gross total resection (GTR) was achieved in 50%, and 50% underwent subtotal resection (STR). While 55.6% underwent postoperative radiation therapy, 48% did not. The median disease-specific survival (DSS) was 128 months, and the 5-year DSS rate was 77%. In multivariate a nalysis, age ≤ 52 years and GTR were both independently associated with higher probability of DSS (p = 0.033 and p = 0.029, respectively). Stratification analysis showed that postoperative radiotherapy had no significant impact on the DSS, irrespective of resection extent (p = 0.172). Our SEER analysis showed that age and extent of resection were prognostic factors for PM, but race, tumor size, gender, chemotherapy, and postoperative radiotherapy did not significantly impact DSS of PM patients. There was no significant improvement in survival of patients who underwent radiotherapy and GTR, or radiotherapy and STR, compared with GTR or STR alone. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Postoperative stroke and neurological outcomes in the early phase after revascularization surgeries for moyamoya disease: an age-stratified comparative analysis

xlomafota.13 shared this article with you from Inoreader Postoperative stroke and neurological outcomes in the early phase after revascularization surgeries for moyamoya disease: an age-stratified comparative analysis Via Latest Results for Neurosurgical Review Abstract Stroke and neurological outcomes in the early phase following revascularization for moyamoya disease (MMD) may depend on the patient's age. In this study, an age-stratified comparative analysis was performed to clarify this issue. We reviewed 105 MMD patients who underwent 179 revascularization surgeries. The demographic characteristics were collected in four age groups (≤ 5 and 6–17 years for pediatric patients and 18–49 and ≥ 50 years for adults). Additionally, we assessed the incidence of subsequent stroke and deterioration of modified Rankin Scale (mRS) score. Then, we evaluated predictors of postoperative stroke and mRS deterioration using logistic regression. The mean patient age was 26.2 ± 18.5 years. No significant difference in the incidence of postoperative stroke was observed between age groups; however, the incidence tended to be increased among patients aged ≤ 5 years (17.9%) and patients aged ≥ 50&nbs p;years (16.7%). Deterioration of mRS scores was significantly associated with ages ≤ 5 years (17.9%) and ≥ 50 years (11.1%). Logistic regression showed that posterior cerebral artery involvement (odds ratio [OR], 4.6) and postoperative transient neurological events (TNEs) (OR, 5.93) were risk factors for postoperative stroke. Age ≤ 5 years (OR, 9.73), postoperative TNEs (OR, 7.38), and postoperative stroke (OR, 49) were identified as predictors of unfavorable neurological outcomes. The novel feature of this comparative analysis by age group is that membership in the early-childhood MMD patient group (under 5 years old) was an independent risk factor for unfavorable short-term neurological outcomes and was mainly associated with the incidence of postoperative severe cerebral infarction. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.