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[PMID]: 29521828
[Au] Autor:Kanda M; Oba K; Aoyama T; Kashiwabara K; Mayanagi S; Maeda H; Honda M; Hamada C; Sadahiro S; Sakamoto J; Saji S; Yoshikawa T; Japanese Foundation for Multidisciplinary Treatment of Cancer
[Ad] Address:Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan.
[Ti] Title:Clinical Signatures of Mucinous and Poorly Differentiated Subtypes of Colorectal Adenocarcinomas by a Propensity Score Analysis of an Independent Patient Database from Three Phase III Trials.
[So] Source:Dis Colon Rectum;61(4):461-471, 2018 Apr.
[Is] ISSN:1530-0358
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Although colorectal cancer comprises several histological subtypes, the influences of histological subtypes on disease progression and treatment responses remain controversial. OBJECTIVE: We sought to evaluate the prognostic relevance of mucinous and poorly differentiated histological subtypes of colorectal cancer by the propensity score weighting analysis of prospectively collected data from multi-institute phase III trials. DESIGN: Independent patient data analysis of a pooled database from 3 phase III trials was performed. SETTINGS: An integrated database of 3 multicenter prospective clinical trials (the Japanese Foundation for Multidisciplinary Treatment of Cancer 7, 15, and 33) was the source of study data. INTERVENTIONS: Surgery alone or postoperative adjuvant chemotherapy was offered in patients with resectable colorectal cancer. MAIN OUTCOME MEASURES: To balance essential variables more strictly for the comparison analyses, propensity score weighting was conducted with the use of a multinomial logistic regression model. We evaluated the clinical signatures of mucinous and poorly differentiated subtypes with regard to postoperative survival, recurrence, and chemosensitivity. RESULTS: Of 5489 patients, 136 (2.5%) and 155 (2.8%) were pathologically diagnosed with poorly differentiated and mucinous subtypes. The poorly differentiated subtypes were associated with a poorer prognosis than the "others" group (HR, 1.69; 95% CI, 1.00-2.87; p = 0.051), particularly in the patient subgroup of adjuvant chemotherapy (HR, 2.16). Although the mucinous subtype had a marginal prognostic impact among patients with stage I to III colorectal cancer (HR, 1.33; 95% CI, 0.90-1.96), it was found to be an independent prognostic factor in the subpopulation of patients with stage II disease, being associated with a higher prevalence of peritoneal recurrence. LIMITATIONS: The treatment regimens of postoperative chemotherapy are now somewhat outdated. CONCLUSIONS: Both mucinous and poorly differentiated subtypes have distinct clinical characteristics. Patients with the mucinous subtype require special attention during follow-up, even for stage II disease, because of the risk of peritoneal or local recurrence. See Video Abstract at http://links.lww.com/DCR/A531.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1097/DCR.0000000000001022

  2 / 26570 MEDLINE  
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[PMID]: 29521830
[Au] Autor:Kuckelman JP; Kononchik J; Smith J; Kniery KR; Kay JT; Hoffer ZS; Steele SR; Sohn V
[Ad] Address:Department of General Surgery, Madigan Army Medical Center, Tacoma, Washington.
[Ti] Title:Human-Derived Amniotic Membrane Is Associated With Decreased Postoperative Intraperitoneal Adhesions in a Rat Model.
[So] Source:Dis Colon Rectum;61(4):484-490, 2018 Apr.
[Is] ISSN:1530-0358
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Complications from adhesions after intra-abdominal surgery accounts for ~6% of hospital admissions. Currently, hyaluronate/carboxymethylcellulose represents the main option to prevent postoperative adhesion formation. Human amniotic membrane contains inherent anti-inflammatory properties that mitigate adhesion formation. OBJECTIVE: This study aimed to evaluate adhesion generation after surgical trauma with amniotic membranes compared with standard intraperitoneal adhesion barriers. DESIGN: This study is a double-blinded, prospective evaluation. SETTING: This study was conducted at an animal research facility. ANIMALS: Forty male rats were studied. INTERVENTION: Laparotomy was performed with peritoneal disruption to the cecum. Animals were randomly assigned to 1 of 5 groups: sham, control, saline, hyaluronic acid membrane, or amniotic membrane. Animals were euthanized at 14 days. MAIN OUTCOME MEASURES: Independent gross and histological assessments of adhesions were analyzed between groups by using adhesion scoring and microscopy. Scoring was based on the percentage of the cecum involved (0-4), vascularity of adhesions (0-3), strength (0-3), inflammation (0-3), and fibrosis (0-3). Adhered tissue was harvested for polymerase chain reaction analysis for gene regulation activity. RESULTS: All rats survived 14 days. Adhesions were observed in all animals. There were significantly fewer adhesions in the amniotic membrane group (2) versus hyaluronic acid (3) group (p = 0.01). The percentage of adhesion to the cecum was lower in the amniotic membrane group (29%) than in the hyaluronic acid group (47%, p = 0.04). Histological examination showed no significant difference between or within the 3 groups for inflammation or fibrosis. Genetic analysis of adhered tissues supported high rates of epithelialization and inhibition of fibrosis in the amniotic membrane group. LIMITATIONS: We are limited by the small sample size and the preclinical nature of the study. CONCLUSION: Human-derived amniotic membrane is effective at reducing intraperitoneal adhesion after surgical trauma and is superior to the current antiadhesion barriers. Amniotic membranes are well absorbed and demonstrate short-term safety. See Video Abstract at http://links.lww.com/DCR/A554.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180309
[Lr] Last revision date:180309
[St] Status:In-Data-Review
[do] DOI:10.1097/DCR.0000000000001037

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[PMID]: 29481557
[Au] Autor:Dong B; Tong Z; Li R; Chen SC; Liu W; Liu W; Chen Y; Zhang X; Duan Y; Li D; Chen L
[Ad] Address:Center for Infectious Skin Diseases, Department of Dermatology, No. 1 Hospital of Wuhan, Wuhan, China.
[Ti] Title:Transformation of Fonsecaea pedrosoi into sclerotic cells links to the refractoriness of experimental chromoblastomycosis in BALB/c mice via a mechanism involving a chitin-induced impairment of IFN-γ production.
[So] Source:PLoS Negl Trop Dis;12(2):e0006237, 2018 Feb.
[Is] ISSN:1935-2735
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Fonsecaea pedrosoi (F. pedrosoi) is the most common agent of chromoblastomycosis. Transformation of this fungus from its saprophytic phase into pathogenic sclerotic cells in tissue is an essential link to the refractoriness of this infection. Experimental studies in murine models have shown that the absence of CD4+ T cells impairs host defense against F. pedrosoi infection. Clinical research has also suggested that a relatively low level of the Th1 cytokine INF-γ and inefficient T cell proliferation are simultaneously present in patients with severe chromoblastomycosis upon in vitro stimulation with ChromoAg, an antigen prepared from F. pedrosoi. In the present study, we show that in mice intraperitoneally infected with F. pedrosoi-spores, -hyphae or in vitro-induced sclerotic cells respectively, the transformation of this causative agent into sclerotic cells contributes to a compromised Th1 cytokine production in the earlier stage of infection with impaired generation of neutrophil reactive oxygen species (ROS) and pan-inhibition of Th1/Th2/Th17 cytokine production with disseminated infection in the later stage by using a CBA murine Th1/Th2/Th17 cytokine kit. In addition, we have further demonstrated that intraperitoneal administration of recombinant mouse IFN-γ (rmIFN-γ) effectively reduces the fungal load in the infected mouse spleen, and dampens the peritoneal dissemination of F. pedrosoi-sclerotic cells. Meanwhile, exogeneous rmIFN-γ contributes to the formation and maintenance of micro-abscess and restores the decrease in neutrophil ROS generation in the mouse spleen infected with F. pedrosoi-sclerotic cells. Of note, we have once again demonstrated that it is a chitin-like component, but not -glucans or mannose moiety, that exclusively accumulates on the outer cell wall of F. pedrosoi-sclerotic cells which were induced in vitro or isolated from the spleens of intraperitoneally infected BALB/c mice. In addition, our results indicate that decreased accumulation of chitin on the surface of live F. pedrosoi-sclerotic cells after chitinase treatment can be self-compensated in a time-dependent manner. Importantly, we have for the first time demonstrated that exclusive accumulation of chitin on the transformed sclerotic cells of F. pedrosoi is involved in an impaired murine Th1 cytokine profile, therefore promoting the refractoriness of experimental murine chromoblastomycosis.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1802
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Data-Review
[do] DOI:10.1371/journal.pntd.0006237

  4 / 26570 MEDLINE  
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[PMID]: 29516956
[Au] Autor:Yang J; Liu J; Gao S; Yang Y; Kong W; Ren W; Zhu L; Yang M; Wei J; Zou Z; Qian X; Liu B; Yan J
[Ad] Address:The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University and Clinical Cancer Institute of Nanjing University, Nanjing, China.
[Ti] Title:Use of simultaneous radiation boost achieves high treatment response rate in patients with metastatic gastric cancer.
[So] Source:J Cancer Res Ther;14(1):36-39, 2018 Jan.
[Is] ISSN:1998-4138
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Objective: Intensity-modulated radiation therapy (IMRT) with a simultaneous integrated boost (SIB) could improve local control rates at different anatomic sites. However, little is known for its use in metastatic gastric cancer. Our study aimed to compare the treatment response rates of IMRI-SIB and conformal radiotherapy (CRT) in patients with metastatic gastric cancer. Materials and Methods: We retrospectively identified twenty patients with metastatic gastric cancer from 2013 to 2015, 12 given IMRT-SIB, and eight given CRT. Treatment response and toxicities were evaluated for all patients. The radiation target included peritoneal lymph nodes. RECIST criteria were used to assess the treatment response. Three patients of eight in the CRT group died before the end of treatment due to the progression of diseases in the field. Results: For the IMRT-SIB group, the median dose of high dose field was 60.8 Gy (50-64.4 Gy), and the median dose of low-dose field was 45 Gy (36-50.4 Gy). For the CRT group, the median dose of the total dose was 50 Gy (41.4-60 Gy). IMRT-SIB could elevate local dose significantly, compared to the CRT group. One patient of 12 in the IMRT-SIB group achieved complete response, and nine patients achieved partial response (PR), whereas no patient achieved CR in the CRT group. Two of five patients achieved PR (40%) in the CRT group. IMRT-SIB improved the treatment response rate significantly (odds ratio 8.33, 95% confidence interval: 1.03-67.14, P = 0.046). Two patients of 12 in the IMRT-SIB group developed enteritis, whereas two patients of five developed enteritis in the CRT group. Conclusions: IMRT-SIB could escalate the local dose and improve the treatment response rates in patients with metastatic gastric cancer and with acceptable toxicities. Further study with a larger population to validate our data is underway.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.4103/jcrt.JCRT_387_17

  5 / 26570 MEDLINE  
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[PMID]: 29185267
[Au] Autor:Sasada S; Yunokawa M; Takehara Y; Ishikawa M; Ikeda S; Kato T; Tamura K
[Ad] Address:Department of Breast and Medical Oncology, National Cancer Center Hospital, Tokyo, Japan.
[Ti] Title:Baseline risk of recurrence in stage I-II endometrial carcinoma.
[So] Source:J Gynecol Oncol;29(1):e9, 2018 Jan.
[Is] ISSN:2005-0399
[Cp] Country of publication:Korea (South)
[La] Language:eng
[Ab] Abstract:OBJECTIVE: Though there are no evidences that postoperative therapy improves overall survival (OS) in stage I-II endometrial carcinoma, many women receive postoperative radiation or chemotherapy. This study aimed to investigate the baseline risk of recurrence after complete resection without any adjuvant therapies and to suppose the validity of postoperative therapy for stage I-II endometrial carcinoma. METHODS: Charts for patients with stage I-II endometrial carcinoma who underwent operation without postoperative therapy between January 2005 and December 2011 were retrospectively reviewed and the baseline risk of recurrence and prognosis were assessed. Risk classifications were performed according to European Society for Medical Oncology (ESMO) clinical practice guidelines and Japanese guideline written by Japan Society of Gynecologic Oncology Group. RESULTS: Among 374 patients who underwent complete resection, 311 were evaluable. Five-year recurrence rates by ESMO and Japanese were 2.6% and 3.1% in low-risk, 9.2% and 6.6% in intermediate-risk and 13.5% and 13.8% in high-risk group (p=0.003 and 0.015, respectively). High-risk group had worse OS compared with low- and intermediate-risk groups (5-year OS, low: 97.9% and 97.6%, intermediate: 97.9% and 98.8%, and high: 89.5% and 87.5%; p=0.003 and 0.008, respectively). Independent predictive factors of recurrence were age over 60 years, type 2 (estrogen-independent) and peritoneal cytology. CONCLUSION: ESMO and Japanese risk classification similarly stratify the baseline risk of recurrence. Patients with stage I-II endometrial carcinoma, especially low- and intermediate-risk diseases, have low recurrence rate and favorable OS, and the benefit of postoperative therapy might be small.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 180308
[Lr] Last revision date:180308
[St] Status:In-Process
[do] DOI:10.3802/jgo.2018.29.e9

  6 / 26570 MEDLINE  
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[PMID]: 29510919
[Au] Autor:Bowman B; Zheng S; Yang A; Schiller B; Morfn JA; Seek M; Lockridge RS
[Ad] Address:Division of Nephrology, Department of Medicine, University of Virginia Health System, Charlottesville, VA.
[Ti] Title:Improving Incident ESRD Care Via a Transitional CareUnit.
[So] Source:Am J Kidney Dis;, 2018 Mar 03.
[Is] ISSN:1523-6838
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Dialysis care in the United States continues to move toward an emphasis on continuous quality improvement and performance benchmarking. Government- and industry-sponsored programs have evolved to assess and incentivize outcomes for many components of end-stage renal disease care. One aspect that remains largely unaddressed at a systemic level is the high-risk transition period from chronic kidney disease and acute kidney injury to permanent dialysis dependence. Incident dialysis patients experience disproportionately high mortality and hospitalization rates coupled with high costs. This article reviews the clinical case for a special emphasis on this transition period, reviews published literature regarding prior transitional care programs, and proposes a novel iteration of the first 30 days of dialysis care: the transitional care unit (TCU). The goal of a TCU is to improve awareness of all aspects of renal replacement therapy, including modalities, access, transplantation options, and nutritional and psychosocial aspects of the disease. This enables patients to make truly informed decisions regarding their care. The TCU model is open to all patients, including incident patients with end-stage renal disease, those for whom peritoneal dialysis is failing, or those with failing transplants. This model may be especially beneficial to those who are deemed inadequately prepared or "crash start" patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180307
[Lr] Last revision date:180307
[St] Status:Publisher

  7 / 26570 MEDLINE  
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[PMID]: 29489659
[Au] Autor:Yao Z; Tian W; Xu X; Huang Q; Zhao Y
[Ad] Address:Department of General Surgery, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu, China.
[Ti] Title:An innovative method for placing a double-lumen irrigation-suction tube in the management of abdominal infection: A case report.
[So] Source:Medicine (Baltimore);97(9):e0048, 2018 Mar.
[Is] ISSN:1536-5964
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:RATIONALE: Currently, the use of double-lumen irrigation-suction tube for drainage has become increasingly more common. However, the insertion process is complex, and the position of the double cannula placed in this manner is not accurate. We developed a method for placing the drainage tube and use it in the treatment of an abdominal infection. PATIENT CONCERNS: A 51-year-old man with an abdominal infection due to colonic anastomotic fistula was admitted. Routine laboratory tests revealed an elevated white blood cell count (17  10/L) and C-reactive protein level (78 mg/L). Computed tomography (CT) revealed that the peritoneal cavity was filled with fluid. DIAGNOSES: The patient was diagnosed with colonic anastomosis fistula by gastrointestinal radiography. Abdominal infection was diagnosed based on CT scan, inflammatory markers, and patient signs and symptoms. INTERVENTIONS: Two punctures were performed. After skin expansion, the source of infection was drained with a suction catheter (diameter = 1.0 cm) under continuous negative pressure of 150 to 200 millibars, along with continuous saline irrigation at 300 mL/h. OUTCOMES: Pus in the abdomen drained completely. The abdominal infection was controlled. There were no adverse events. LESSONS: Abdominal infection in fistulas is a fatal disease. The main therapeutic target is full drainage at an early stage. Precise positioning of the tube, continuous negative pressure irrigation and drainage are key points in the treatment.
[Mh] MeSH terms primary: Abdominal Abscess/therapy
Suction/methods
[Mh] MeSH terms secundary: Abdominal Abscess/etiology
Colonic Diseases/complications
Humans
Intestinal Fistula/complications
Male
Middle Aged
Suction/instrumentation
Therapeutic Irrigation/instrumentation
Treatment Outcome
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180301
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000010048

  8 / 26570 MEDLINE  
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[PMID]: 29502869
[Au] Autor:Sunil MA; Sunitha VS; Radhakrishnan EK; Jyothis M
[Ad] Address:School of Biosciences, Mahatma Gandhi University, Kottayam 686560, Kerala, India. Electronic address: sunilmicro7@gmail.com.
[Ti] Title:Immunomodulatory activities of Acacia catechu, a traditional thirst quencher of South India.
[So] Source:J Ayurveda Integr Med;, 2018 Mar 01.
[Is] ISSN:0975-9476
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Acacia catechu has been widely used in Ayurveda for treating many diseases. Its heartwood extract is used in asthma, cough, bronchitis, colic, diarrhea, dysentery, boils, skin afflictions, sores and for stomatitis. The decoction of heartwood is used for drinking purpose in southern part of India especially in Kerala. OBJECTIVE: The current study was carried out to scientifically evaluate immunomodulatory effects of heartwood extracts of A. catechu in Swiss albino mice. MATERIAL AND METHODS: In vivo immunomodulatory activity was analyzed by hemagglutinating antibody (HA) titer, plaque forming cell assay and delayed type hypersensitivity (DTH). In vitro immunomodulatory potential of the extracts was studied using peritoneal macrophages and splenocytes from mice. Effect of extracts on phagocytic activity of macrophages was analyzed by nitroblue tetrazolium (NBT) reduction assay and cellular lysosomal enzyme assay. Anti-inflammatory activity was studied by nitric oxide (NO) assay and production of TNF-α and IL-10. RESULTS: A dose dependent increase in antibody titer was observed with extracts treatment. Treatment with extracts produced an enhancement in the number of antibody producing cells in the spleen. DTH reaction was significantly decreased with extracts treatment. An increased phagocytic response was shown by peritoneal macrophages on treatment with the extracts as evidenced by its effect on NBT reduction and cellular lysosomal enzyme activity. The extracts inhibited the release of pro-inflammatory cytokine TNF-α and the production of NO. IL-10 production was significantly increased after extract treatment. CONCLUSION: The results of the present study indicate the immunomodulatory effects of A. catechu extracts on humoral, cell mediated and non-specific immune functions.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180305
[Lr] Last revision date:180305
[St] Status:Publisher

  9 / 26570 MEDLINE  
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[PMID]: 29450530
[Au] Autor:Henderson JT; Webber EM; Sawaya GF
[Ad] Address:Kaiser Permanente Research Affiliates Evidence-based Practice Center, Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon.
[Ti] Title:Screening for Ovarian Cancer: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.
[So] Source:JAMA;319(6):595-606, 2018 02 13.
[Is] ISSN:1538-3598
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Importance: Ovarian cancer is relatively rare but the fifth-leading cause of cancer mortality among United States women. Objective: To systematically review evidence on benefits and harms of ovarian cancer screening among average-risk women to inform the United States Preventive Services Task Force. Data Sources: MEDLINE, PubMed, Cochrane Collaboration Registry of Controlled Trials; studies published in English from January 1, 2003, through January 31, 2017; ongoing surveillance in targeted publications through November 22, 2017. Study Selection: Randomized clinical trials of ovarian cancer screening in average-risk women that reported mortality or quality-of-life outcomes. Interventions included transvaginal ultrasound, cancer antigen 125 (CA-125) testing, or their combination. Comparators were usual care or no screening. Data Extraction and Synthesis: Independent critical appraisal and data abstraction by 2 reviewers. Meta-analytic pooling of results was not conducted because of the small number of studies and heterogeneity of interventions. Main Outcomes and Measures: Ovarian cancer mortality, false-positive screening results and surgery, surgical complications, and psychological effects of screening. Results: Four trials (N = 293 587) were included; of these, 3 (n = 293 038) assessed ovarian cancer mortality, and 1 (n = 549) reported only on psychological outcomes. Evaluated screening interventions included transvaginal ultrasound alone, transvaginal ultrasound plus CA-125 testing, and CA-125 testing alone. Test positivity for CA-125 was defined by a fixed serum level cutpoint or by a proprietary risk algorithm based on CA-125 level, change in CA-125 level over time, and age (risk of ovarian cancer algorithm [ROCA]). No trial found a significant difference in ovarian cancer mortality with screening. In the 2 large screening trials (PLCO and UKCTOCS, n = 271 103), there was not a statistically significant difference in complete intention-to-screen analyses of ovarian, fallopian, and peritoneal cancer cases associated with screening (PLCO: rate ratio, 1.18 [95% CI, 0.82-1.71]; UKCTOCS: hazard ratio [HR], 0.91 [95% CI, 0.76-1.09] for transvaginal ultrasound and HR, 0.89 [95% CI, 0.74-1.08] for CA-125 ROCA). Within these 2 trials, screening led to surgery for suspected ovarian cancer in 1% of women without cancer for CA-125 ROCA and in 3% for transvaginal ultrasound with or without CA-125 screening, with major complications occurring among 3% to 15% of surgery. Evidence on psychological harms was limited but nonsignificant except in the case of repeat follow-up scans and tests, which increased the risk of psychological morbidity in a subsample of UKCTOCS participants based on the General Health Questionnaire 12 (score ≥4) (odds ratio, 1.28 [95% CI, 1.18-1.39]). Conclusions and Relevance: In randomized trials conducted among average-risk, asymptomatic women, ovarian cancer mortality did not significantly differ between screened women and those with no screening or in usual care. Screening harms included surgery (with major surgical complications) in women found to not have cancer. Further research is needed to identify effective approaches for reducing ovarian cancer incidence and mortality.
[Mh] MeSH terms primary: Early Detection of Cancer
Mass Screening
Ovarian Neoplasms/diagnosis
[Mh] MeSH terms secundary: Asymptomatic Diseases
CA-125 Antigen/blood
Early Detection of Cancer/methods
False Positive Reactions
Female
Humans
Mass Screening/adverse effects
Ovarian Neoplasms/mortality
Randomized Controlled Trials as Topic
Risk Assessment
Ultrasonography
[Pt] Publication type:JOURNAL ARTICLE; RESEARCH SUPPORT, U.S. GOV'T, P.H.S.; REVIEW
[Nm] Name of substance:0 (CA-125 Antigen)
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:180217
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.21421

  10 / 26570 MEDLINE  
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[PMID]: 29428040
[Au] Autor:Jia B; Liu K; Tan L; Jin Z; Fu Y; Liu Y
[Ti] Title:Evaluation of the Safety and Efficacy of Percutaneous Transhepatic Gallbladder Drainage Combined with Laparoscopic Cholecystectomy for Treating Acute Complicated Cholecystitis.
[So] Source:Am Surg;84(1):133-136, 2018 Jan 01.
[Is] ISSN:1555-9823
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:The rate of acute cholecystitis in patients with severe underlying diseases is currently increasing. Several studies have reported percutaneous transhepatic gallbladder drainage (PTGBD) combined with laparoscopic cholecystectomy (LC) as a safe and reliable therapeutic option in such patients. This study aimed to elucidate the optimal time interval between PTGBD and LC. In total, 65 patients with acute complicated cholecystitis from our hospital were divided into two groups, short-term LC (sLC) and postponed LC (pLC) group according to whether the procedure was performed within 5 days of gallbladder drainage or after 5 days, respectively. The complications after PTGBD, rate of conversion to open surgery, and complications and mortality after LC were compared between the groups. The sLC group showed significantly lesser operating time, blood loss, postoperative peritoneal drainage time, postoperative oral intake time, and complications compared to the pLC group (P < 0.05). Other factors such as the length of hospital stay (LOS), conversion to open cholecystectomy, and mortality were not statistically significant between the groups. Combined treatment with PTGBC and sLC showed superior outcomes compared to PTGBC and pLC for acute cholecystitis in severely ill patients, thus constituting a feasible and secure treatment option in specialized centers.
[Mh] MeSH terms primary: Cholecystectomy, Laparoscopic
Cholecystitis, Acute/surgery
Drainage
[Mh] MeSH terms secundary: Aged
Cholecystectomy, Laparoscopic/methods
Cholecystitis, Acute/mortality
Cholecystostomy/methods
Conversion to Open Surgery
Feasibility Studies
Female
Humans
Male
Middle Aged
Operative Time
Risk Factors
Treatment Outcome
[Pt] Publication type:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Entry month:1803
[Cu] Class update date: 180301
[Lr] Last revision date:180301
[Js] Journal subset:IM
[Da] Date of entry for processing:180212
[St] Status:MEDLINE


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