Long-Term Effects of Pedicle Clamping during Major Hepatectomy for Colorectal Liver Metastases

The use of the Pringle maneuver (PM) varies widely among surgical departments. Its use depends on the operator and type of liver resection. The aim of this study was to determine the impact of the PM on patient outcomes when undergoing major liver resections. This retrospective study comprised 179 colorectal liver metastasis patients from two liver centers from Leeds and Warsaw. Only right or right extended hepatectomies with negative oncological margins were included. The primary outcome measure was the 5-year overall survival (OS). The PM was applied during 60 (33.5%) major hepatectomies included in the study and was associated with a higher peak 3-day postoperative bilirubin concentration (p = 0.002), yet not with the peak 3-day alanine aminotransferase activity (p = 0.415). The 5-year OS after liver resections with the PM and without the PM were 55.0% and 33.4%, respectively (p = 0.019). Following stratification by the Tumor Burden Score, after resections with the use of the PM, superior survival was particularly found in the subgroup of patients at intermediate risk of recurrence (p = 0.004). However, the use of the PM had no significant effect on the 5-year overall survival following adjustment for the confounding effect of the carcinoembryonic antigen concentration (p = 0.265). The use of the PM had no negative effects on the long-term outcomes in patients undergoing major, oncologically radical liver resections for colorectal metastases.

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Long-term oncological outcomes after laparoscopic parenchyma-sparing redo liver resections for patients with metastatic colorectal cancer: a European multi-center study

Surgical Endoscopy ◽

10.1007/s00464-021-08655-z ◽

2021 ◽

Author(s):

Leonid Barkhatov ◽

Davit L. Aghayan ◽

Vincenzo Scuderi ◽

Federica Cipriani ◽

Åsmund A. Fretland ◽

...

Keyword(s):

Overall Survival ◽

Liver Resection ◽

Long Term Results ◽

Colorectal Metastases ◽

Liver Recurrence ◽

Liver Resections ◽

Group 4 ◽

Significant Difference ◽

Group 1

Abstract Background Laparoscopic redo resections for colorectal metastases are poorly investigated. This study aims to explore long-term results after second, third, and fourth resections. Material and methods Prospectively updated databases of primary and redo laparoscopic liver resections in six European HPB centers were analyzed. Procedure-related overall survival after first, second, third, and fourth resections were evaluated. Furthermore, patients without liver recurrence after first liver resection were compared to those with one redo, two or three redo, and patients with palliative treatment for liver recurrence after first laparoscopic liver surgery. Survival was calculated both from the date of the first liver resection and from the date of the actual liver resection. In total, 837 laparoscopic primary and redo liver resections performed in 762 patients were included (630 primary, 172 first redo, 29 second redo, and 6 third redo). Patients were bunched into four groups: Group 1—without hepatic recurrence after primary liver resection (n = 441); Group 2—with liver recurrence who underwent only one laparoscopic redo resection (n = 154); Group 3—with liver recurrence who underwent two laparoscopic redo resections (n = 29); Group 4—with liver recurrence who have not been found suitable for redo resections (n = 138). Results No significant difference has been found between the groups in terms of baseline characteristics and surgical outcomes. Rate of positive resection margin was higher in the group with palliative recurrence (group 4). Five-year survival calculated from the first liver resection was 67%, 62%, 84%, and 7% for group 1, 2, 3, and 4, respectively. Procedure-specific 5-year overall survival was 50% after primary laparoscopic liver resection, 52% after the 1st reoperation, 52% after the 2nd, and 40% after the 3rd reoperation made laparoscopic. Conclusions Multiple redo recurrences can be performed laparoscopically with good long-term results. Liver recurrence does not aggravate prognosis as long as the patient is suitable for reoperation.

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Recombinant Erythropoietin and Survival in Myelodysplastic Syndromes.

Blood ◽

10.1182/blood.v106.11.2539.2539 ◽

2005 ◽

Vol 106 (11) ◽

pp. 2539-2539 ◽

Cited By ~ 2

Author(s):

Pellegrino Musto

Keyword(s):

Overall Survival ◽

Clinical Outcome ◽

Myelodysplastic Syndromes ◽

Causes Of Death ◽

Lower Percentage ◽

Recombinant Erythropoietin ◽

Long Term Effects ◽

Published Evidence ◽

The Impact

Abstract Several reports have recently raised the question of whether the use of recombinant erythropoietin (r-EPO) may influence clinical outcome and survival of neoplastic patients who receive this drug along with the therapy for their disease. r-EPO is frequently employed for the treatment of anemia in myelodysplastic syndromes (MDS). The efficacy of r-EPO in these patients have been extensively investigated in terms of improvement of Hb levels and quality of life parameters and its use is now recommended in selected settings of MDS. However, there is very small published evidence about the long term effects of r-EPO in patients with MDS and, above all, about its possible relationship with survival. In particular, low-risk MDS, which generally do not receive cytostatic treatments, represent an interesting model to evaluate the impact of r-EPO on the natural history of these diseases. We performed a retrospective analysis on our patients with MDS which was focused on determining overall survival and causes of death in relationship to the use or not of r-EPO. Between 1986 and 2001, 346 patients affected by MDS were identified in our database. Among them, we selected 169 anemic (Hb < 10 g/dl) patients with well defined diagnosis of MDS according to FAB criteria (excluding CMMoL and RAEB-T), low-intermediate IPSS score (retrospectively assessed) and regular follow-up. Ninety-nine patients belonged to the pre-r-EPO era or had never received r-EPO for other reasons. Seventy patients had instead received r-EPO for at least 8 weeks during the course of their disease. The two groups (r-EPO no/r-EPO yes) resulted comparable for age, type of diagnosis, additional treatments, Hb levels and transfusion requirement. Among patients who received r-EPO, 22 (31.4%) achieved an hematological erythroid improvement (HI-E), according to IWG criteria. In these patients the drug was given for 5–51 months (median 19). There was no difference between the two groups in terms of leukemic evolution (19% vs 21% at 4 years) and causes of death (infections, hemorrhages, second tumors, cardiovascular events). No death could be directly attributable to r-EPO. Median overall survival was also not statistically different between patients who had received (45 months) or not (41 months) r-EPO. However, when survival was analysed according to response to r-EPO, it was found significantly longer (p < 0.02) in responders (median 54 months) than in non-responders (median 37 months), as well as than in subjects who had never received the drug. Such a difference was not modified by the time (early, during the first year from diagnosis, or later) of r-EPO administration. Response to r-EPO was associated with baseline lower levels of endogenous EPO, lower percentage of marrow blasts and higher Hb values. At multivariate analysis, however, response to r-EPO maintained an independent favourable prognostic value on survival. This is the first large study focused on the long-term clinical outcome of MDS analysed according to the role of r-EPO. Our data indicate that the prolonged administration of this drug is safe and that response to r-EPO is significantly associated with better survival in MDS patients.

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SUMBER-SUMBER RESILIENSI PADA REMAJA AKHIR YANG MENGALAMI KEKERASAN DARI ORANGTUA PADA MASA KANAK-KANAK

Psibernetika ◽

10.30813/psibernetika.v11i1.1161 ◽

2018 ◽

Vol 11 (1) ◽

Author(s):

Devina Calista ◽

Garvin Garvin

Keyword(s):

Late Adolescents ◽

Long Term Effects ◽

Short Term ◽

Parental Affection ◽

Resilience Factors ◽

Childhood Violence ◽

Past Experiences ◽

The Impact ◽

Depth Interviews

Child abuse by parents is common in households. The impact of violence on children will bring short-term effects and long-term effects that can be attributed to their various emotional, behavioral and social problems in the future; especially in late adolescence that will enter adulthood. Resilience factors increase the likelihood that adolescents who are victims of childhood violence recover from their past experiences, become more powerful individuals and have a better life. The purpose of this study was to determine the source of resilience in late adolescents who experienced violence from parents in their childhood. This research uses qualitative research methods with in-depth interviews as a method of data collection. The result shows that the three research participants have the aspects of "I Have", "I Am", and "I Can"; a participant has "I Can" aspects as a source of resilience, and one other subject has no source of resilience. The study concluded that parental affection and acceptance of the past experience have role to the three sources of resilience (I Have, I Am, and I Can) Keyword : Resilience, adolescence, violence, parents

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The Quantification of Structural Reforms in OECD Countries

10.1093/oso/9780198821878.003.0007 ◽

2018 ◽

Cited By ~ 1

Author(s):

Balázs Égert ◽

Peter Gal

Keyword(s):

Product Market ◽

Physical Capital ◽

Oecd Countries ◽

Market Regulation ◽

Structural Reforms ◽

Long Term Effects ◽

Per Capita ◽

Product Market Regulation ◽

The Impact

This chapter describes and discusses a new supply-side framework that quantifies the impact of structural reforms on per capita income in OECD countries. It presents the overall macroeconomic impacts of reforms by aggregating over the effects on physical capital, employment, and productivity through a production function. On the basis of reforms defined as observed changes in policies, the chapter finds that product market regulation has the largest overall single policy impact five years after the reforms. But the combined impact of all labour market policies is considerably larger than that of product market regulation. The paper also shows that policy impacts can differ at different horizons. The overall long-term effects on GDP per capita of policies transiting through capital deepening can be considerably larger than the five- to ten-year impacts. By contrast, the long-term impact of policies coming only via the employment rate channel materializes at a shorter horizon.

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Antibiotics at birth and later antibiotic courses: effects on gut microbiota

Pediatric Research ◽

10.1038/s41390-021-01494-7 ◽

2021 ◽

Author(s):

Sofia Ainonen ◽

Mysore V Tejesvi ◽

Md. Rayhan Mahmud ◽

Niko Paalanne ◽

Tytti Pokka ◽

...

Keyword(s):

Gut Microbiota ◽

Control Group ◽

List Type ◽

Antibiotic Exposure ◽

Microbiota Composition ◽

Long Term Effects ◽

The Impact ◽

Antibiotic Courses ◽

Gut Microbiota Composition

Abstract Background Intrapartum antibiotic prophylaxis (IAP) is widely used, but the evidence of the long-term effects on the gut microbiota and subsequent health of children is limited. Here, we compared the impacts of perinatal antibiotic exposure and later courses of antibiotic courses on gut microbiota. Methods This was a prospective, controlled cohort study among 100 vaginally delivered infants with different perinatal antibiotic exposures: control (27), IAP (27), postnatal antibiotics (24), and IAP and postnatal antibiotics (22). At 1 year of age, we performed next-generation sequencing of the bacterial 16S ribosomal RNA gene of fecal samples. Results Exposure to the perinatal antibiotics had a clear impact on the gut microbiota. The abundance of the Bacteroidetes phylum was significantly higher in the control group, whereas the relative abundance of Escherichia coli was significantly lower in the control group. The impact of the perinatal antibiotics on the gut microbiota composition was greater than exposure to later courses of antibiotics (28% of participants). Conclusions Perinatal antibiotic exposure had a marked impact on the gut microbiota at the age of 1 year. The timing of the antibiotic exposure appears to be the critical factor for the changes observed in the gut microbiota. Impact Infants are commonly exposed to IAP and postnatal antibiotics, and later to courses of antibiotics during the first year of life. Perinatal antibiotics have been associated with an altered gut microbiota during the first months of life, whereas the evidence regarding the long-term impact is more limited. Perinatal antibiotic exposure had a marked impact on the infant’s gut microbiota at 1 year of age. Impact of the perinatal antibiotics on the gut microbiota composition was greater than that of the later courses of antibiotics at the age of 1 year.

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Parental alienation: the impact on men’s mental health

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2015-0083 ◽

2015 ◽

Vol 29 (3) ◽

Cited By ~ 3

Author(s):

Leo Sher

Keyword(s):

Mental Health ◽

Separation Anxiety ◽

Self Esteem ◽

Long Term Effects ◽

Parental Alienation ◽

Adult Men ◽

Self Confidence ◽

High Conflict ◽

The Impact

Abstract Parental alienation is defined as a mental state in which a child, usually one whose parents are engaged in a high-conflict separation or divorce, allies himself strongly with one parent (the preferred parent) and rejects a relationship with the other parent (the alienated parent) without legitimate justification. Parental alienation may affect men’s mental health: a) parental alienation negatively influences mental health of male children and adolescents who are victims of parental alienation. Alienated children/adolescents display guilt, sadness, and depressed mood; low self-esteem and lack of self-confidence; distress and frustration; lack of impulse control, substance abuse and delinquent behavior; separation anxiety, fears and phobias; hypochondria and increased tendency to develop psychosomatic illness; suicidal ideation and suicide attempt; sleep and eating disorders; educational problems; enuresis and encopresis; b) parental alienation negatively affects the mental health of adult men who were victims of parental alienation when they were children and/or adolescents. Long-term effects of parental alienation include low self-esteem, depression, drug/alcohol abuse, lack of trust, alienation from own children, divorce, problems with identity and not having a sense of belonging or roots, choosing not to have children to avoid being rejected by them, low achievement, anger and bitterness over the time lost with the alienated parent; c) parental alienation negatively influences mental health of men who are alienated from their children. Fathers who have lost some or all contact with their children for months or years following separation or divorce may be depressed and suicidal.

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Do researchers impact their study populations? Assessing the effect of field procedures in a long term population monitoring of sea kraits

Amphibia-Reptilia ◽

10.1163/15685381-00002839 ◽

2012 ◽

Vol 33 (3-4) ◽

pp. 365-372 ◽

Cited By ~ 11

Author(s):

Thomas Fauvel ◽

François Brischoux ◽

Marine Jeanne Briand ◽

Xavier Bonnet

Keyword(s):

Body Condition ◽

New Caledonia ◽

Stress Hormones ◽

Population Level ◽

Population Monitoring ◽

Long Term Effects ◽

Negative Effects ◽

Short Term ◽

Head Morphology

Long term population monitoring is essential to ecological studies; however, field procedures may disturb individuals. Assessing this topic is important in worldwide declining taxa such as reptiles. Previous studies focussed on animal welfare issues and examined short-term effects (e.g. increase of stress hormones due to handling). Long-term effects with possible consequences at the population level remain poorly investigated. In the present study, we evaluated the effects of widely used field procedures (e.g. handling, marking, forced regurgitation) both on short-term (hormonal stress response) and on long-term (changes in body condition, survival) scales in two intensively monitored populations of sea kraits (Laticauda spp.) in New Caledonia. Focusing on the most intensively monitored sites, from 2002 to 2012, we gathered approximately 11 200 captures/recaptures on 4500 individuals. Each snake was individually marked (scale clipping + branding) and subjected to various measurements (e.g. body size, head morphology, palpation). In addition, a subsample of more than 500 snakes was forced to regurgitate their prey for dietary analyses. Handling caused a significant stress hormonal response, however we found no detrimental long-term effect on body condition. Forced regurgitation did not cause any significant effect on both body condition one year later and survival. These results suggest that the strong short-term stress provoked by field procedures did not translate into negative effects on the population. Although similar analyses are required to test the validity of our conclusions in other species, our results suggest distinguishing welfare and population issues to evaluate the potential impact of population surveys.

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Cancer Care and Survivorship Planning: Promises and Challenges

Journal of Oncology Practice ◽

10.1200/jop.0934407 ◽

2009 ◽

Vol 5 (3) ◽

pp. 116-118 ◽

Cited By ~ 7

Author(s):

Len Lichtenfeld

Keyword(s):

Cancer Care ◽

Long Term Effects ◽

Cancer Treatments ◽

The Impact

Although we have made some progress in understanding long-term effects of some cancer treatments, there is still much more to learn about the impact of our treatments on our patients.

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Welfare Use in Japan: Trends and Determinants

Journal of Income Distribution ◽

10.25071/1874-6322.7232 ◽

2007 ◽

pp. 88

Author(s):

Wataru Suzuki ◽

Yanfei Zhou

Keyword(s):

Time Series ◽

Longitudinal Data ◽

Time Series Data ◽

Positive Impact ◽

Series Data ◽

Negative Effects ◽

Long Time ◽

Welfare Use ◽

The Impact

This article represents the first step in filling a large gap in knowledge concerning why Public Assistance (PA) use recently rose so fast in Japan. Specifically, we try to address this problem not only by performing a Blanchard and Quah decomposition on long-term monthly time series data (1960:04-2006:10), but also by estimating prefecturelevel longitudinal data. Two interesting findings emerge from the time series analysis. The first is that permanent shock imposes a continuously positive impact on the PA rate and is the main driving factor behind the recent increase in welfare use. The second finding is that the impact of temporary shock will last for a long time. The rate of the use of welfare is quite rigid because even if the PA rate rises due to temporary shocks, it takes about 8 or 9 years for it to regain its normal level. On the other hand, estimations of prefecture-level longitudinal data indicate that the Financial Capability Index (FCI) of the local government2 and minimum wage both impose negative effects on the PA rate. We also find that the rapid aging of Japan's population presents a permanent shock in practice, which makes it the most prominent contribution to surging welfare use.

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The immediate effect of Sinapis nigra and Zingiber officinale as thermogenic substances during footbaths: A Randomized Controlled Cross-over Trial

Complementary Medicine Research ◽

10.1159/000521590 ◽

2021 ◽

Author(s):

Jan Vagedes ◽

Silja Kuderer ◽

Eduard Helmert ◽

Katrin Vagedes ◽

Matthias Kohl ◽

...

Keyword(s):

Sleep Quality ◽

Zingiber Officinale ◽

Well Being ◽

Primary Outcome Measure ◽

Warm Water ◽

Long Term Effects ◽

Stimulus Perception ◽

Late Evening ◽

Short And Long Term

Objective: Warm footbaths infused with Sinapis nigra (mustard, or MU) or Zingiber officinale (ginger, or GI) are used for various thermoregulatory conditions, but little is known about how they are perceived by individuals, both short- and long-term. We analyzed the immediate and long-term effects of MU and GI on warmth and stimulus perception in healthy adults. Methods: Seventeen individuals (mean age 22.1±2.4 years; 11 female) received three footbaths (mean temperature was 40 ± 0.2 ℃, administered between 1:30-6:30pm) in a randomized order with a cross-over design: 1. with warm water only (WA), 2. with warm water and MU and 3. with warm water and GI. Warmth and stimulus perception at the feet were assessed at the 1st, 5th, 10th, 15th, and 20th minute of the footbaths, in the late evening (EVE), and the following morning (MG). We further assessed well-being (at EVE and MG) and sleep quality (at MG). The primary outcome measure was the warmth perception at the feet at the 10th minute of the footbath. Results: At the 10th minute of the footbath, warmth perception at the feet was significantly higher with MU and GI compared to WA. The immediate thermogenic effects pointed to a quick increase in warmth and stimulus perception with MU, a slower increase with GI, and a gradual decrease with WA. Regarding the long-term effects, warmth and stimulus perception were still higher after GI compared to WA at EVE and MG. No differences were seen for general well-being and sleep quality. Conclusion: Thermogenic substances can significantly alter the dynamics of warmth and stimulus perception when added to footbaths. The different profiles in the application of GI and MU could be relevant for a more differentiated and specific use of both substances in different therapeutic indications.

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