scholarly journals Risk factors for the onset of gallbladder cancer: a review

2021 ◽  
Vol 8 (6) ◽  
pp. 1951
Author(s):  
Zhiyong Tan ◽  
Zhuofan Deng ◽  
Jianping Gong
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Gallbladder Cancer ◽  
Prophylactic Cholecystectomy ◽  
Gallbladder Polyps ◽  
Diagnosis And Prognosis ◽  
Insidious Onset ◽  
Degree Of Malignancy ◽  
High Degree

Gallbladder cancer (GBC) is the most common malignancy of the biliary system in clinic, which has the characteristics of insidious onset and high degree of malignancy. Most patients have progressed to an advanced stage when they are diagnosed. Early identification of risk factors of the onset of gallbladder cancer and active intervention are the key to improve the rate of early diagnosis and prognosis of gallbladder cancer. At present, the risk factors related to the onset of gallbladder cancer include gallstone, gallbladder polyps, primary sclerosing cholangitis, etc. In this review, we discuss the relevant latest research on the risk factors of the onset of gallbladder cancer in order to provide clinical evidence for the prevention and early diagnosis of gallbladder cancer. The intervention, follow-up, and monitoring of risk factors should be strengthened, and the possibility of malignancy of the gallbladder should be accurately assessed in combination with factors such as age and sex. In the case of possible malignancy, prophylactic cholecystectomy should be actively performed. 

Endocrine emergencies

2020 ◽  
Vol 13 (3) ◽  
pp. 165-172
Author(s):  
Apurva Mishra ◽  
Marc Quinn
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Adrenal Insufficiency ◽  
Small Group ◽  
Diabetic Ketoacidosis ◽  
Hospital Setting ◽  
Thyroid Storm ◽  
Relative Lack ◽  
Common Presentation ◽  
High Degree

Endocrine emergencies represent a small group of conditions, where the presentation is related to either a relative lack or excess of hormones. They may present with non-specific features, which can make them difficult to diagnose. Endocrine emergencies are commonly treated in a hospital setting. Having a high degree of suspicion and awareness of the presentation can lead to early diagnosis and prompt management. This article focuses on the epidemiology, common presentation, risk factors, investigation and management of diabetic ketoacidosis, hyperosmolar hyperglycaemic state, hypoglycaemia, thyroid storm, myxoedema crisis, adrenal insufficiency, hypercalcaemia, phaeochromocytoma and acute pituitary failure.

scholarly journals New Horizons in Early Dementia Diagnosis: Can Cerebellar Stimulation Untangle the Knot?

2019 ◽  
Vol 8 (9) ◽  
pp. 1470
Author(s):  
Antonino Naro ◽  
Angela Marra ◽  
Luana Billeri ◽  
Simona Portaro ◽  
Rosaria De Luca ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
New Horizons ◽  
Diagnosis And Prognosis ◽  
Challenging Tasks ◽  
Early Dementia ◽  
Diagnosis Of Dementia ◽  
Theta Burst ◽  
Cerebellar Stimulation

Differentiating Mild Cognitive Impairment (MCI) from dementia and estimating the risk of MCI-to-dementia conversion (MDC) are challenging tasks. Thus, objective tools are mandatory to get early diagnosis and prognosis. About that, there is a growing interest on the role of cerebellum-cerebrum connectivity (CCC). The aim of this study was to differentiate patients with an early diagnosis of dementia and MCI depending on the effects of a transcranial magnetic stimulation protocol (intermittent theta-burst stimulation -iTBS) delivered on the cerebellum able to modify cortico-cortical connectivity. Indeed, the risk of MDC is related to the response to iTBS, being higher in non-responder individuals. All patients with MCI, but eight (labelled as MCI-), showed preserved iTBS aftereffect. Contrariwise, none of the patients with dementia showed iTBS aftereffects. None of the patients showed EEG aftereffects following a sham TBS protocol. Five among the MCI- patients converted to dementia at 6-month follow-up. Our data suggest that cerebellar stimulation by means of iTBS may support the differential diagnosis between MCI and dementia and potentially identify the individuals with MCI who may be at risk of MDC. These findings may help clinicians to adopt a better prevention/follow-up strategy in such patients.

scholarly journals Pterostilbene inhibits gallbladder cancer progression by suppressing the PI3K/Akt pathway

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chenhao Tong ◽  
Yali Wang ◽  
Jiandong Li ◽  
Wenda Cen ◽  
Weiguang Zhang ◽  
...  
Keyword(s):  
Gallbladder Cancer ◽  
Cancer Progression ◽  
New Drugs ◽  
Tumor Xenograft ◽  
Migration And Invasion ◽  
Akt Activation ◽  
Degree Of Malignancy ◽  
High Degree

AbstractGallbladder cancer is the most common malignant tumor of the biliary system and is characterized by difficulty to diagnose in early stages, a high degree of malignancy, and poor prognosis. Finding new drugs may improve the prognosis for this dismal cancer. Herein, we investigated the potential application of pterostilbene (PTS) against gallbladder cancer in vivo and in vitro. PTS potently inhibited cell proliferation, migration and invasion of gallbladder cancer cells. Moreover, PTS also had a function of inducing apoptosis in vitro. Meanwhile, PTS reversed EMT with a correlated inhibition of PI3K/Akt activation. Tumor xenograft models showed that PTS inhibited tumor growth and had low toxicity in vivo, which were consistent with the in vitro data. These findings indicate that PTS arrests cell growth through inhibition of PI3K/AKT signaling and is a potential drug for the therapy of gallbladder cancer.

scholarly journals Prognostic Factors for Conversion to Arthroplasty after Hip Arthroscopy. Review of the Literature

2021 ◽  
Vol 07 (04) ◽  
pp. e374-e380
Author(s):  
Roberto Seijas ◽  
David Barastegui ◽  
Ferran Montaña ◽  
Marta Rius ◽  
Xavier Cuscó ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hip Arthroscopy ◽  
Hip Osteoarthritis ◽  
Joint Space ◽  
Improve Patient Selection ◽  
Number Of Patients ◽  
Pubmed Database ◽  
High Degree ◽  
Improve Patient

AbstractArthroscopic techniques in the treatment of femoroacetabular impingement have experienced an exponential increase over recent years for both diagnosis and treatment. The main risks with treatment are poor clinical outcomes and the conversion to prosthesis. Better knowledge and understanding of the various risk factors leading to prosthesis will improve patient selection for arthroscopic treatments rendering better results. The published papers that have been selected are related to series of hip arthroscopies with risk factors that lead to total hip arthroplasty (THA), in the PubMed database, without a time limit, number of patients, or follow-up time. We selected over 302 papers, 19 papers that show risk factors for conversion to THA. The main risk factors found were femoral chondropathy grade III/IV (relative risk 58.1–12 times increased), acetabular (20–2.96 times), an articular space <2 mm (39–4.26 times), age (14.6–1.06 times), Tönnis 2 in radiographic studies (7.73–3.1 times), obesity (5.6–2.3 times), and osteoarthritis (4.6–2.4 times). There are several risk factors which in an isolated way, highly increase the risk of THA. Some of them have a clear relationship (chondropathy, reduced joint space, Tönnis 2, and osteoarthritis). Based on the review we observed that the elements that are most associated with a conversion to THA after a hip arthroscopy are a high degree of femoral and acetabular chondropathy, a reduced joint space below 2 mm, older age, Tönnis 2, obesity, and hip osteoarthritis.

scholarly journals Management of Porcelain Gallbladder, Its Risk Factors, and Complications: A Review

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1073
Author(s):  
Masaya Morimoto ◽  
Takahiro Matsuo ◽  
Nobuyoshi Mori
Keyword(s):  
Risk Factors ◽  
Gallbladder Cancer ◽  
Current Literature ◽  
Gallbladder Disease ◽  
Patient Age ◽  
Prophylactic Cholecystectomy ◽  
Gallbladder Diseases ◽  
Malignancy Risk ◽  
Porcelain Gallbladder ◽  
Asymptomatic Patients

The porcelain gallbladder condition describes gallbladder calcification. While gallbladder calcification is believed to increase the risk of developing gallbladder cancer, recent reports have shown that the malignancy risk is much lower than previously reported. Symptomatic patients with porcelain gallbladder should be recommended for cholecystectomy, but the management of asymptomatic patients is debatable. Based on recent evidence, prophylactic cholecystectomy is not routinely recommended in all patients with porcelain gallbladder. From the assessment of the current literature, there are three essential factors in the management of patients with porcelain gallbladder: 1) symptoms or complications of gallbladder disease, 2) calcification pattern and 3) patient age and comorbidities. Patients who do not undergo cholecystectomy should be educated about the symptoms of gallbladder diseases, and a thorough discussion is essential between patients and clinicians.

scholarly journals Paediatric retropharyngeal abscess with potts spine — A rare case

2021 ◽  
Vol 4 (3) ◽  
pp. 119-121
Author(s):  
Subhadeep Chowdhury ◽  
Tithi Debnath
Keyword(s):  
Early Diagnosis ◽  
Rare Case ◽  
Retropharyngeal Abscess ◽  
Neck Swelling ◽  
Delay In Diagnosis ◽  
Conventional Medical Treatment ◽  
Specific Sign ◽  
High Degree ◽  
Improve Clinical Outcome

Tubercular retropharyngeal abscess along with potts spine is very rare in children. As there is no specific sign and symptoms of tuberculosis are present and even if present can be masked by features of nretropharyngeal abscess these cases may have delay in diagnosis. Early diagnosis is important to start proper treatment and can prevent the disability and mortality. In this article we report a case where a child presented to our opd with complaint of right sided neck swelling, dysphagia and neck pain with restricted movement. Any symptoms or signs of tuberculosis were not present. Clinical examination and MRI of neck suggested this as a case of retropharyngeal abscess with cervical spine involvement. Intraoral surgical drainage of pus sent for CBNAAT examination and it revealed the diagnosis of tuberculosis. Antitubercular regimen was given for 12 months. During follow up his symptoms gradually improved and after 1 and 2 year follow up child was free from tuberculosis. So in conclusion we can say retropharyngeal abscess in child should be dealt promptly and in case of abcesses refractory to conventional medical treatment, high degree of suspicion of tuberculosis should have present especially in endemic countries in order to reduce morbidities and improve clinical outcome. Early diagnosis and treatment can improve the scenario significantly.

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

2019 ◽  
Vol 85 (6) ◽  
pp. 671-675 ◽  
Author(s):  
Hua Zhong ◽  
Tuan Tuan Hao ◽  
Yong Chen ◽  
Fang Luo
Keyword(s):  
Risk Factors ◽  
Laparoscopic Cholecystectomy ◽  
Gallbladder Cancer ◽  
Diagnosis And Treatment ◽  
Gallbladder Stones ◽  
T1 Stage ◽  
One Year ◽  
The One ◽  
Thickened Wall

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.

scholarly journals Leprosy incidence and risk estimates in a 33-year contact cohort of leprosy patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mariana Andrea Hacker ◽  
Anna Maria Sales ◽  
Nádia Cristina Duppre ◽  
Euzenir Nunes Sarno ◽  
Milton Ozório Moraes
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Lower Risk ◽  
Household Contact ◽  
Molecular Tools ◽  
Leprosy Patients ◽  
Control And Prevention ◽  
Novel Approaches ◽  
Index Cases

AbstractReduction in incidence has been associated with the introduction of novel approaches, like chemo/immune-prophylaxis. Incidence determined through follow-up cohort studies can evaluate the implementation of these innovative policies towards control and prevention. We have assessed the incidence in our contacts cohort over past 33 years, considering the effect of demographic and clinical variables. Survival analysis was used to estimate the risk of leprosy. A total of 9024 contacts were evaluated, of which 192 developed leprosy, resulting in an overall incidence of 1.4/1000 person-years. The multivariate analysis showed that the major risk factors were (i) contact from MB index cases and (ii) consanguinity (iii) intra household contact. Lower risk was detected for contacts with BCG scar who were revaccinated. There was a significant decrease in accumulated risk between the 2011–2019 period compared with 1987, probably linked to the improvement in laboratory tools to monitor contacts, thereby providing early diagnosis of contacts at intake and reduction of transmission. Our findings suggest that a combination of contact surveillance and tracing, adequate neurodermatological examination, and availability of molecular tools is highly effective in supporting early diagnosis, while a second dose of the BCG vaccination can exert extra protection.

scholarly journals Association of plasma proteins with rate of cognitive decline and dementia: 20-year follow-up of the Whitehall II and ARIC cohort studies

2020 ◽  
Author(s):  
Joni V. Lindbohm ◽  
Nina Mars ◽  
Keenan A. Walker ◽  
Archana Singh-Manoux ◽  
Gill Livingston ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Diagnosis ◽  
Cognitive Decline ◽  
Plasma Proteins ◽  
Replication Cohort ◽  
Dementia Risk ◽  
Decline Rate ◽  
Related Proteins

AbstractThe role of circulating proteins in Alzheimer’s disease and related dementias is unknown. Using a follow-up of two decades, 4953 plasma proteins, and discovery (Whitehall II) and replication cohort (ARIC), we examined plasma proteins associated with cognitive decline rate and dementia. After replication and adjustment for known dementia risk factors, fifteen proteins were associated with cognitive decline rate and dementia. None of these were amyloid, tau, or neurofilament-related proteins. Currently approved medications can target five of the proteins. The results support systemic pathogenesis of dementias, may aid in early diagnosis, and suggest potential targets for drug development.

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