scholarly journals The prognosis of type III biliary atresia with a hilar cyst on ultrasonography might not be better than that without

2019 ◽  
Author(s):  
Quan-yuan Shan ◽  
Bao-xian Liu ◽  
Zhi-hai Zhong ◽  
Hua-dong Chen ◽  
Yu Guo ◽  
...  

Abstract Background Biliary atresia (BA) with a hilar cyst is an uncommon variant of BA that may be misunderstood to have a relatively favorable prognosis. Methods A single-center retrospective review of patients that matched BA with a hilar cyst (n=27) with BA without a cyst (n=27) over a 5-years period was done. All patients were diagnosed as type III BA by histologic examination and cholangiograms. Results There were no significant intergroup differences between baseline characteristics and outcomes after Kasai portoenterostomy surgery in two groups. The Kaplan–Meier survival curves showed no significant difference in cumulative native liver survival rate of the two groups (p = 0.584). Of the 27 BA patients with a hilar cyst, 8 were showed the cyst communicated with the gallbladder on cholangiograms, and Kaplan-Meier survival curves indicated that the cumulative native liver survival rate was significantly shorter (P=0.045) in them than those who the cyst was not communicated with the gallbladder. Conclusions Type III BA with a hilar cyst had no better prognosis compared with Type III BA without a cyst. A cyst communicated with the gallbladder may be associated with a poor eventual outcome for Type III BA with a hilar cyst.

2019 ◽  
Vol 29 (1) ◽  
pp. 121-125 ◽  
Author(s):  
Kin Wai Edwin Chan ◽  
Kim Hung Lee ◽  
Hei Yi Vicky Wong ◽  
Siu Yan Bess Tsui ◽  
Jennifer Wai Cheung Mou ◽  
...  

2020 ◽  
Vol 105 (8) ◽  
pp. 720-723 ◽  
Author(s):  
Jiachen Zheng ◽  
Yongqin Ye ◽  
Bin Wang ◽  
Lihui Zhang

ObjectiveTo elaborate on the implementation and achievements of a biliary atresia (BA) screening programme in Shenzhen.MethodsIn 2015, we partnered with the government in Shenzhen and attached the stool colour card (SCC) to the health handbook for mothers and children. These handbooks have been distributed through official channels to every pregnant woman in Shenzhen since 1 January 2015. A total of 118 patients diagnosed with BA at Shenzhen Children’s Hospital were enrolled and divided into two cohorts based on their date of diagnosis: cohort A before and cohort B after introduction of screening. The cohorts were compared to evaluate differences in age at diagnosis, jaundice-free rate, 2-year native liver survival rate and so on.ResultsAfter the implementation of the screening programme, the age at diagnosis decreased from 81±12 to 56±15 days old (p<0.05), the incidence of postoperative complications decreased from 58.8% to 52.6% (p<0.05), the jaundice-free rate increased from 47.1% to 54.4% (p<0.05), and the 2-year native liver survival rate increased from 44.4% to 52.6% (p<0.05). The percentage of patients who underwent surgery increased from 68.0% to 83.8% (p<0.05).ConclusionIn Shenzhen, our screening programme led to earlier diagnoses and better prognoses. The latter resulted in an increased willingness to undergo the Kasai procedure. Through a hospital and government collaboration, this programme exerted a considerable influence, and guardians observed benefits with only a small cost of implementation. Our results may eventually help promote the widespread use of the SCC across the whole country.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Kazuoki Dai ◽  
Masaharu Ishihara ◽  
Ichiro Inoue ◽  
Takuji Kawagoe ◽  
Yuji Shimatani ◽  
...  

Several studies have shown that both chronic kidney disease (CKD) and diabetes mellitus are risk factors for mortality in patients with acute myocardial infarction (AMI). This study was undertaken to investigate influence of CKD on the prognostic significance of diabetes in patients with AMI. Between January 1996 and December 2005, 888 patients with AMI underwent coronary angiography within 24 hours after the onset of chest pain. CKD was difined estimated glomerular filtration rate (eGFR) of less than 60.0 ml/minute/1.73 m 2 of body-surface area (stage3–5). Kaplan-Meier method was used to compare 5-year survival of diabetic and non-diabetic patients, in the presence (n=337) or absence (n=551). Kaplan-Meier curves for 5-year survival rate are shown in Figure . In the absence of CKD, there was no significant difference in 5-year survival rate between patients with diabetes and those without (93 % v.s. 94 %, p=0.82). In patients with CKD, however, diabetes was associated with lower 5-year survival rate (65 % v.s. 87 %, p<0.001). Multivariate analysis showed that diabetes was an independent predictor for 5-year survival in patients with CKD (OR 3.2, 95%CI 1.8–5.8, p=0.0002), but not in patients without CKD (OR 1.1, 95%CI 0.4–2.5, p=0.82). Diabetes mellitus was an independent predictor for death after AMI in patients with CKD. Aggressive treatment after AMI should be advocated in diabetic patients with CKD.


2020 ◽  
Vol 70 (1) ◽  
pp. 87-92
Author(s):  
Catalina Jaramillo ◽  
Stephen L. Guthery ◽  
Amy Lowichik ◽  
Gregory Stoddard ◽  
Taegun Kim ◽  
...  

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 2845-2845 ◽  
Author(s):  
Naveen Pemmaraju ◽  
Hagop M Kantarjian ◽  
Jorge E. Cortes ◽  
Alfonso Quintas-Cardama ◽  
Sherry A. Pierce ◽  
...  

Abstract Abstract 2845 Background: The MPNs are a family of chronic hematologic malignancies that typically affect pts ages 60–70s. However, there is growing awareness of hematologic malignancies developing in young pts, particularly a unique subset of pts known as AYAs. Little is known about incidence and outcomes of AYA pts with MPNs. Objectives: To determine the incidence and outcomes of MPN AYA pts. Results: We retrospectively reviewed charts of 1,616 MPN pts evaluated at our institution from 1986–2011. A total of 171 MPN pts (11%) were identified whose ages were 16–39, defined as AYA pts (per NCCN guideline recommendations on AYA cancers). Breakdown by MPN subtype: Essential Thrombocytosis, ET (n=78, 46% of AYA MPNs), Polycythemia Vera, PV (n=25, 15%), Myelofibrosis, MF(n=24, 14%), [3 post-ET, 1 post-PV, 20 primary MF], Hypereosinophilic syndrome, HES (n=22, 13%), and Systemic Mastocytosis, SM (n=22, 13%). Baseline characteristics of AYA MPN pts detailed in Table 1. Only significant difference among AYA and non-AYA pts in terms of baseline CBC parameters was WBC: 6.4 (0.4–108.4) in AYA MF vs 10.1 (0.6–361) in non-AYA MF, p=0.0049. Analysis of median overall survival (OS), by Kaplan-Meier method, compared by age group (AYA vs non-AYA pts) and broken down by MPN subtype, shown in Table 2. Conclusion: MPN AYA pts constitute 11% of MPN pts at our institution. Overall, their 5- and 10- yr OS were significantly better than their older counterparts in the 3 major MPN subtypes (ET, PV, MF) and trended towards better survival but not statistically significant in HES and SM. Among AYA MPN pts, female predominance was noted among ET and SM pts and only 1 transformation event was noted among all MPN AYA pts in this analysis. Disclosures: No relevant conflicts of interest to declare.


2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15092-e15092
Author(s):  
Nasser Ghaly Yousif

e15092 Background: Gastric cancer is the fourth most common malignancy in the world, The presence of estrogen receptor alpha (ER a) and estrogen receptor beta (ER b) have been reported in cell and tissue level in gastric cancer, but its impact on patients' survival remains unclear. The male predominance of gastric cancer suggests that female sex hormones may have a protective effect against gastric cancer. To understand the clinical impact of the estrogen pathway, we analyzed the national SEER database to compare the outcomes for gastric cancer in premenopausal vs.postmenopausal women. Methods: Data from the national SEER registry between the years of 1985-2009 was analyzed. Women between the ages 31-50 were chosen as representative of the pre-menopausal group (n=1291) and 51-70 year-old women represented the post-menopausal group (n=3089) as defined by the American College of Obstetricians and Gynecologists. To control the effect of age alone as a determinant of outcome, we compared the survival between men were similarly divided into two categories: younger men (n = 2114) aged 31- 50 years and older men (n = 5102) aged 51 - 70 years. Survival rates were analyzed by Kaplan-Meier method and compared by Z-test through SEER*Stat software version 7.0.9. Results: The cardiac gastric cancer site type and diffuse histological subtype had statistical significance difference between premenopausal and postmenopausal groups (49% vs.72%), (44% vs. 692%) respectively. The Kaplan-Meier curve shows the survival rate in premenopausal superior to postmenopausal women in diffuse gastric cancer P=0.01, while no statistically significant difference regarding mixed sub-types P>0.05 and control groups. Conclusions: The results suggest varying estrogen effects between localization and histological subtype of gastric cancer, the presence of estrogen in gastric cancer could have a protective effect against gastric cancer and support clinical strategies need to stimulate the ER pathway or use estrogen for the treatment of gastric cancer, and additional studies are warranted as well as experimental studies that can shed light on the mechanism underlying this potentially protective action.


2021 ◽  
Vol 8 ◽  
Author(s):  
Yue Yin ◽  
Yiling Li ◽  
Lichun Shao ◽  
Shanshan Yuan ◽  
Bang Liu ◽  
...  

Objective: At present, the association of body mass index (BMI) with the prognosis of liver cirrhosis is controversial. Our retrospective study aimed to evaluate the impact of BMI on the outcome of liver cirrhosis.Methods: In the first part, long-term death was evaluated in 436 patients with cirrhosis and without malignancy from our prospectively established single-center database. In the second part, in-hospital death was evaluated in 379 patients with cirrhosis and with acute gastrointestinal bleeding (AGIB) from our retrospective multicenter study. BMI was calculated and categorized as underweight (BMI &lt;18.5 kg/m2), normal weight (18.5 ≤ BMI &lt; 23.0 kg/m2), and overweight/obese (BMI ≥ 23.0 kg/m2).Results: In the first part, Kaplan–Meier curve analyses demonstrated a significantly higher cumulative survival rate in the overweight/obese group than the normal weight group (p = 0.047). Cox regression analyses demonstrated that overweight/obesity was significantly associated with decreased long-term mortality compared with the normal weight group [hazard ratio (HR) = 0.635; 95% CI: 0.405–0.998; p = 0.049] but not an independent predictor after adjusting for age, gender, and Child–Pugh score (HR = 0.758; 95%CI: 0.479–1.199; p = 0.236). In the second part, Kaplan–Meier curve analyses demonstrated no significant difference in the cumulative survival rate between the overweight/obese and the normal weight groups (p = 0.094). Cox regression analyses also demonstrated that overweight/obesity was not significantly associated with in-hospital mortality compared with normal weight group (HR = 0.349; 95%CI: 0.096-1.269; p = 0.110). In both of the two parts, the Kaplan–Meier curve analyses demonstrated no significant difference in the cumulative survival rate between underweight and normal weight groups.Conclusion: Overweight/obesity is modestly associated with long-term survival in patients with cirrhosis but not an independent prognostic predictor. There is little effect of overweight/obesity on the short-term survival of patients with cirrhosis and with AGIB.


2021 ◽  
Vol 48 (1) ◽  
pp. 12-20
Author(s):  
Hyejun Seo ◽  
Soyoung Park ◽  
Eungyung Lee ◽  
Taesung Jeong ◽  
Jonghyun Shin

The purpose of this retrospective study was to evaluate the survival rate by comparing Class II restoration using flowable resin composite with stainless steel crown in primary molars.Electronic medical records and radiographs of 1,504 primary molars with proximal caries of 590 patients from June 2015 to August 2019 were analyzed. With the collected data, survival analysis was performed using the Kaplan-Meier method.The 1-year survival rate of flowable resin composite in the primary molar was 98.5%, 3-year survival rate was 87.7%, and mean survival time was 39 months. There was no statistically significant difference between flowable resin composite and stainless steel crown (<i>p</i> = 0.896).Within the limits of this study, Class II restoration using flowable resin composite can be considered a promising option for the treatment of proximal caries in primary molars.


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