Unexpected Gallbladder Cancer during or after Laparoscopic Cholecystectomy: Risk Factors and Experience of Diagnosis and Treatment of 22 Cases

This study aims to provide some experience in diagnosis and treatment of unexpected gallbladder cancer (UGBC) and find the major risk factors. Retrospective data were collected and analyzed on 22 patients who were diagnosed with UGBC during or after laparoscopic cholecystectomy from January 2013 to January 2018 at our hospital. Average age of the patients was (60.2 ± 12.8) years (range, 42–83 years). Among them, there were 6 men and 16 women. Gallbladder stones, atrophic gallbladder, uneven thickened wall of the gallbladder, and choledocholithiasis were found to be the major risk factors. Eight patients (36.4%) were diagnosed intraoperatively. Seven cases (31.8%) were at the T1 stage; of these, three were treated with laparoscopic cholecystectomy; two were converted to cholecystectomy; and two underwent cholecystectomy, lymph node dissection, and liver resection. Eight (36.4%) T2 patients, five (22.7%) T3 patients, and one T4 patient had radical cholecystectomy. Partial cholecystectomy and cholecystotomy were carried out in another T4 patient. T1 patients did not receive chemotherapy or radiotherapy. Eleven had chemotherapy and four received chemoradiotherapy. The follow-up period ranged from six months to five years. The one-year survival rate for T1 to T4 patients was 100 per cent, 75 per cent, 40 per cent, and 0 per cent, respectively. A high index of clinical suspicion of UGBC is needed if one patient suffered from both gallbladder stones and choledocholithiasis with atrophic gallbladder or uneven thickened wall of the gallbladder preoperatively. To avoid more UGBC and reoperation, imaging examinations combined with tumor marker tests and intraoperative histopathologic examination are highly recommended.

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Incidence of and Risk Factors for Missing Events Due to Wandering in Community-dwelling Older People with Dementia and Mild Cognitive Impairment

10.21203/rs.3.rs-673163/v1 ◽

2021 ◽

Author(s):

seungwon Jeong ◽

Takao Suzuki ◽

Kiyoko Miura ◽

Takashi Sakurai

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Recurrence Rate ◽

Community Dwelling ◽

Disease Assessment ◽

People With Dementia ◽

One Year ◽

The One

Abstract BackgroundThe burden of missing incidents is not only on the person with dementia, but also on their family, neighbors, and community. The extent to which dementia-related wandering and missing incidents occur in the community has not been evaluated thoroughly in the published literature. Therefore, we evaluated the incidence of and risk factors for missing events due to wandering.MethodsWe conducted a non-randomized prospective one-year follow-up cohort study based on symptom registration with missing events due to wandering as the endpoint. In the first consultation, 374 patients with dementia or mild cognitive impairment (MCI) and their caregivers who visited the National Center for Geriatrics and Gerontology in Japan were included. The incidence and recurrence rate of missing events were calculated. Participants were divided into (those with) dementia and (those with) MCI. Patients' basic and medical information was documented at baseline and after one year of follow-up. Furthermore, analysis of variance and logistic regression analysis were performed to clarify the risk factors associated with the missing event.ResultsAmong the 236 patients with dementia enrolled, 65 (27·5%) had a previous missing event at baseline, and 28 had a missing event during the one-year follow-up period (recurrence rate of 43·1%). Of the 171 who did not have a previous missing event at baseline, 23 had a missing event during the one-year follow-up period (incidence rate of 13·5%). The scores of Mini-Mental State Examination (MMSE), Dementia Behavior Disturbance Scale (DBD), and Alzheimer's Disease Assessment Scale (ADAS) were statistically significant as the risk factors for the incidence of wandering leading to a missing event (p<0·05).ConclusionsPrevention of missing event due to wandering requires focused attention on changes in the MMSE, DBD, ADAS scores, and the development of a social environment to support family caregivers.

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MO078HEMODIAFILTRATION MAINTAINS A SUSTAINED IMPROVEMENT IN BP COMPARED TO CONVENTIONAL HEMODIALYSIS IN CHILDREN - THE HDF, HEART AND HEIGHT (3H) STUDY

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa140.mo078 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Francesca De Zan ◽

Aysun Karabay Bayazit ◽

Karolis Azukaitis ◽

Nur Canpolat ◽

Sevcan Bakkaloglu ◽

...

Keyword(s):

Risk Factors ◽

Weight Gain ◽

Left Ventricular ◽

Post Hoc Analysis ◽

One Year ◽

The One ◽

Post Hoc ◽

Dialysate Sodium ◽

Conventional Hemodialysis

Abstract Background and Aims Hypertension is prevalent in children on dialysis and associated with left ventricular hypertrophy, cardiovascular disease and mortality. We studied the effect of different dialysis modalities (conventional hemodialysis [HD] vs hemodiafiltration [HDF]) on BP and risk factors affecting the evolution of BP over a one-year follow-up. Method This is a post-hoc analysis of the “3H - HDF-Hearts-Height” dataset, a multicenter, non-randomized, parallel-arm intervention study. The time–averaged 24-h mean arterial pressure (MAP) was used for the analyses and hypertension defined as 24-h MAP standard deviation score exceeding the 95th percentile. Results All 133 children who completed 12 months follow-up in the 3H study were included in this post - hoc analysis. 78 (74%) were on HD and 55 (77%) on HDF. At baseline MAP-SDS was > 95th percentile in 64 (82%) of children on HD and 23 (41.8%) patients on HDF, but these data are skewed by a high percentage of prevalent dialysis patients in the study. 43 (55%) of HD patients and 23 (42%) of HDF patients were on antihypertensive medications, and uncontrolled hypertension (BP>95th centile on medications) was present in 38 (88%) of HD patients and 6 (25%) of HDF patients. In the stepwise logistic regression at baseline, independent risk factors for hypertension were gender (OR 2.29; 95%CI 1.06–4.96; p=0.04) and inter-dialytic weight gain at baseline (OR 1.3; 95%CI 1.1–1.55; p=0.004). Over the one-year study period, MAP-SDS increased by 39% in HD patients and 12% in HDF patients (p< 0.001) (Figure). Significant risk factors for hypertension over time were dialysis modality (OR for HD compared to HDF 7.65; 95% CI 3.23 – 18.12; p< 0.001), inter-dialytic weight gain (OR 1.21; 95% CI 1.05 – 1.39; p=0.007), and dialysate sodium (for 1 mmol/L increase in dialysate sodium MAP-SDS increased by 1.1mmHg ; 95% CI 1.01 – 1.21; p=0.04). Conclusion Children on HD compared to HDF had a 7.6-fold higher 24-hr MAP-SDS and a sustained increase in BP over the one-year study period. Higher inter-dialytic weight gain and higher dialysate sodium levels were associated with a higher MAP-SDS in both groups.

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Catheter-directed foam sclerotherapy treatment of saphenous vein incompetence

VASA ◽

10.1024/0301-1526/a000174 ◽

2012 ◽

Vol 41 (2) ◽

pp. 120-124 ◽

Cited By ~ 11

Author(s):

Asciutto ◽

Lindblad

Keyword(s):

Saphenous Vein ◽

Short Term ◽

Foam Sclerotherapy ◽

Results Of Treatment ◽

Ulcer Healing Rate ◽

Complete Obliteration ◽

Ceap Classification ◽

One Year ◽

The One

Background: The aim of this study is to report the short-term results of catheter-directed foam sclerotherapy (CDFS) in the treatment of axial saphenous vein incompetence. Patients and methods: Data of all patients undergoing CDFS for symptomatic primary incompetence of the great or small saphenous vein were prospectively collected. Treatment results in terms of occlusion rate and patients grade of satisfaction were analysed. All successfully treated patients underwent clinical and duplex follow-up examinations one year postoperatively. Results: Between September 2006 and September 2010, 357 limbs (337 patients) were treated with CDFS at our institution. Based on the CEAP classification, 64 were allocated to clinical class C3 , 128 to class C4, 102 to class C5 and 63 to class C6. Of the 188 patients who completed the one year follow up examination, 67 % had a complete and 14 % a near complete obliteration of the treated vessel. An ulcer-healing rate of 54 % was detected. 92 % of the patients were satisfied with the results of treatment. We registered six cases of thrombophlebitis and two cases of venous thromboembolism, all requiring treatment. Conclusions: The short-term results of CDFS in patients with axial vein incompetence are acceptable in terms of occlusion and complications rates.

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Mental health and resilience among Eritrean refugees at arrival and one-year post-registration in Switzerland: a cohort study

BMC Research Notes ◽

10.1186/s13104-021-05695-5 ◽

2021 ◽

Vol 14 (1) ◽

Author(s):

Afona Chernet ◽

Nicole Probst-Hensch ◽

Véronique Sydow ◽

Daniel H. Paris ◽

Niklaus D. Labhardt

Keyword(s):

Mental Health ◽

Asylum Seekers ◽

Assessment Tools ◽

Migration Route ◽

Post Traumatic Stress ◽

Hazardous Alcohol Use ◽

Hazardous Alcohol ◽

One Year ◽

The One

Abstract Objective Eritrea is the most frequent country of origin among asylum seekers in Switzerland. On their journey through the desert and across the Mediterranean Sea, Eritrea refugees are often exposed to traumatizing experiences. The aim of this study is to assess the mental health status and resilience of Eritrean migrants in Switzerland upon arrival and one-year post-arrival, using standardized mental health screening and resilience assessment tools. Results At baseline, 107 refugees (11.2% female, median age 25) were interviewed: 52 (48.6%) screened positive for Post-Traumatic Stress Disorder (score ≥ 30), 10.3% for anxiety (≥ 10) and 15.0% for depression (≥ 10); 17.8% scored as risk/hazardous drinkers (≥ 8). The majority (94.4%) had a high resilience score (≥ 65). For one-year follow-up, 48 asylum seekers could be reached. In interviews 18 (38%) of these reported imprisonment in a transit country and 28 (58%) that they had witnessed the death of a close person along the migration route. At the one year assessment, rates of risky/hazardous alcohol use remained unchanged, rates of positive PTSD screening tended to be lower (50.0% (24/48) at baseline vs 25.0% (12/48) at follow-up), as were rates of positive screening for anxiety (8.3% vs 4.2%) and depression (14.6 vs 6.3%).

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THU0254 Risk factors for back pain in a cross sectional and in a one-year follow up study in nurses

10.1136/annrheumdis-2001.798 ◽

2001 ◽

Author(s):

M Brzosko ◽

I Fiedorowicz-Fabrycy ◽

J Fliciñski ◽

H Przepiera-Bêdzak ◽

K Prajs

Keyword(s):

Risk Factors ◽

Back Pain ◽

Cross Sectional ◽

Follow Up Study ◽

One Year

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One-year results of half-dose versus one-third-dose photodynamic therapy in chronic or recurrent central serous chorioretinopathy

BMC Ophthalmology ◽

10.1186/s12886-020-01796-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jirarattanasopa Pichai ◽

Banchasakjaroen Vanchalerm ◽

Ratanasukon Mansing

Keyword(s):

Photodynamic Therapy ◽

Recurrence Rate ◽

Central Serous Chorioretinopathy ◽

Subretinal Fluid ◽

Corrected Visual Acuity ◽

Half Dose ◽

One Year ◽

The One ◽

Different Doses

Abstract Background Central serous chorioretinopathy (CSC) is characterized by an accumulation of subretinal fluid (SRF) in the macula. It is usually treated by laser photocoagulation or photodynamic therapy (PDT) with consisting of different doses and power. This study aimed to compare the efficacy of half-dose PDT and one-third-dose PDT in chronic or recurrent CSC. Methods A retrospective review of patients with chronic or recurrent CSC who were treated with either a half-dose or one-third-dose PDT, and had follow up 12 months afterwards. Best-corrected visual acuity (BCVA), central retinal thickness (CRT) and resolution of subretinal fluid (SRF) at baseline as well as 1, 3, 6 and 12 months post-PDT were assessed. Results Forty-six eyes and 20 eyes received half-dose and one-third-dose PDT, respectively. The study showed efficacy of the one-third-dose PDT compared with half-dose PDT in BCVA improvement (0.10±0.04 logMAR for one-third-dose versus 0.17±0.04, for half-dose, P=0.148) and CRT improvement (125.6±24.6 μm for one-third-dose versus 139.1±16.54, for half-dose, P=0.933) at 12 months. The SRF recurrence rate was significantly higher in the one-third-dose PDT group compared with the half-dose PDT group (40.0% versus 15.2%, P=0.027) at 12-months. Conclusion At 12 months, the one-third-dose PDT was effective in terms of BCVA and CRT improvement, when compared with half-dose PDT. However, this study showed that one-third-dose PDT had a higher recurrence rate of SRF.

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Impact of atrial fibrillation pattern on outcomes after left atrial appendage closure: lessons from the prospective LAARGE registry

Clinical Research in Cardiology ◽

10.1007/s00392-021-01874-3 ◽

2021 ◽

Author(s):

Shinwan Kany ◽

Johannes Brachmann ◽

Thorsten Lewalter ◽

Ibrahim Akin ◽

Horst Sievert ◽

...

Keyword(s):

Atrial Fibrillation ◽

Left Atrial Appendage ◽

Systemic Embolism ◽

Long Term Outcomes ◽

Increased Risk ◽

History Of ◽

One Year ◽

The One

Abstract Background Non-paroxysmal (NPAF) forms of atrial fibrillation (AF) have been reported to be associated with an increased risk for systemic embolism or death. Methods Comparison of procedural details and long-term outcomes in patients (pts) with paroxysmal AF (PAF) against controls with NPAF in the prospective, multicentre observational registry of patients undergoing LAAC (LAARGE). Results A total of 638 pts (PAF 274 pts, NPAF 364 pts) were enrolled. In both groups, a history of PVI was rare (4.0% vs 1.6%, p = 0.066). The total CHA2DS2-VASc score was lower in the PAF group (4.4 ± 1.5 vs 4.6 ± 1.5, p = 0.033), while HAS-BLED score (3.8 ± 1.1 vs 3.9 ± 1.1, p = 0.40) was comparable. The rate of successful implantation was equally high (97.4% vs 97.8%, p = 0.77). In the three-month echo follow-up, LA thrombi (2.1% vs 7.3%, p = 0.12) and peridevice leak > 5 mm (0.0% vs 7.1%, p = 0.53) were numerically higher in the NPAF group. Overall, in-hospital complications occurred in 15.0% of the PAF cohort and 10.7% of the NPAF cohort (p = 0.12). In the one-year follow-up, unadjusted mortality (8.4% vs 14.0%, p = 0.039) and combined outcome of death, stroke and systemic embolism (8.8% vs 15.1%, p = 0.022) were significantly higher in the NPAF cohort. After adjusting for CHA2DS2-VASc and previous bleeding, NPAF was associated with increased death/stroke/systemic embolism (HR 1.67, 95% CI 1.02–2.72, p = 0.041). Conclusion Atrial fibrillation type did not impair periprocedural safety or in-hospital MACE patients undergoing LAAC. However, after one year, NPAF was associated with higher mortality. Graphic abstract

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Incidence and risk factors for trocar site hernia following laparoscopic cholecystectomy: A long-term follow-up study

Hernia ◽

10.1007/s10029-012-0929-y ◽

2012 ◽

Vol 16 (4) ◽

pp. 431-437 ◽

Cited By ~ 31

Author(s):

E. Erdas ◽

C. Dazzi ◽

F. Secchi ◽

S. Aresu ◽

A. Pitzalis ◽

...

Keyword(s):

Risk Factors ◽

Laparoscopic Cholecystectomy ◽

Trocar Site ◽

Follow Up Study ◽

Trocar Site Hernia ◽

Long Term Follow Up

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Long-term effects of an intensive prevention program (IPP) after acute myocardial infarction – the IPP Follow-up and Prevention Boost Trial

European Heart Journal ◽

10.1093/ehjci/ehaa946.2961 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

H Wienbergen ◽

A Fach ◽

S Meyer ◽

J Schmucker ◽

R Osteresch ◽

...

Keyword(s):

Risk Factors ◽

Myocardial Infarction ◽

Risk Factor ◽

Prevention Program ◽

Study Endpoint ◽

Funding Source ◽

Risk Factor Control ◽

One Year

Abstract Background The effects of an intensive prevention program (IPP) for 12 months following 3-week rehabilitation after myocardial infarction (MI) have been proven by the randomized IPP trial. The present study investigates if the effects of IPP persist one year after termination of the program and if a reintervention after >24 months (“prevention boost”) is effective. Methods In the IPP trial patients were recruited during hospitalization for acute MI and randomly assigned to IPP versus usual care (UC) one month after discharge (after 3-week rehabilitation). IPP was coordinated by non-physician prevention assistants and included intensive group education sessions, telephone calls, telemetric and clinical control of risk factors. Primary study endpoint was the IPP Prevention Score, a sum score evaluating six major risk factors. The score ranges from 0 to 15 points, with a score of 15 points indicating best risk factor control. In the present study the effects of IPP were investigated after 24 months – one year after termination of the program. Thereafter, patients of the IPP study arm with at least one insufficiently controlled risk factor were randomly assigned to a 2-months reintervention (“prevention boost”) vs. no reintervention. Results At long-term follow-up after 24 months, 129 patients of the IPP study arm were compared to 136 patients of the UC study arm. IPP was associated with a significantly better risk factor control compared to UC at 24 months (IPP Prevention Score 10.9±2.3 points in the IPP group vs. 9.4±2.3 points in the UC group, p<0.01). However, in the IPP group a decrease of risk factor control was observed at the 24-months visit compared to the 12-months visit at the end of the prevention program (IPP Prevention Score 10.9±2.3 points at 24 months vs. 11.6±2.2 points at 12 months, p<0.05, Figure 1). A 2-months reintervention (“prevention boost”) was effective to improve risk factor control during long-term course: IPP Prevention Score increased from 10.5±2.1 points to 10.7±1.9 points in the reintervention group, while it decreased from 10.5±2.1 points to 9.7±2.1 points in the group without reintervention (p<0.05 between the groups, Figure 1). Conclusions IPP was associated with a better risk factor control compared to UC during 24 months; however, a deterioration of risk factors after termination of IPP suggests that even a 12-months prevention program is not long enough. The effects of a short reintervention after >24 months (“prevention boost”) indicate the need for prevention concepts that are based on repetitive personal contacts during long-term course after coronary events. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Stiftung Bremer Herzen (Bremen Heart Foundation)

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Concurrence of Meningomyelocele and Salt-Wasting Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency

Case Reports in Pediatrics ◽

10.1155/2015/196374 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Heves Kırmızıbekmez ◽

Rahime Gül Yesiltepe Mutlu ◽

Serdar Moralıoğlu ◽

Ahmet Tellioğlu ◽

Ayşenur Cerrah Celayir

Keyword(s):

Congenital Adrenal Hyperplasia ◽

Growth Retardation ◽

Adrenal Hyperplasia ◽

Hydroxylase Deficiency ◽

Salt Wasting ◽

Significant Regression ◽

One Year ◽

The One ◽

21 Hydroxylase Deficiency

Congenital adrenal hyperplasia (CAH) is a group of inherited defects of cortisol biosynthesis. A case of classical CAH due to 21-hydroxylase deficiency (21-OHD) with early onset of salt waste and concurrence of meningomyelocele (MMC) was presented here. The management of salt-wasting crisis which is complicated by a postrenal dysfunction due to neurogenic bladder was described. Possible reasons of growth retardation in the one-year follow-up period were discussed. A significant regression of the phallus with proper medical treatment was also mentioned.

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