Lorenzenjohns8628
23; 95% CI 0.92 to 1.63). We also found a U-shape relationship between ΔPLT and HCC survival at the turning point of ΔPLT as 0 (20×10
/L). The HR for the death was 1.12 (95% CI 1.06, 1.18) with ΔPLT≥0 (20×10
/L) while 0.95 (95% CI 0.92, 0.98) with ΔPLT<0 (20×10
/L). After potential confounding factors were adjusted, the non-linear relationship between ΔPLT and OS was still significant (
=0.013). Besides, ΔPLT≥20 (×10
/L) was associated with new lesions (OR, 2.74; 95% CI 1.38 to 5.45).
Elevated PLT was associated with poor overall survival of HCC patients after TACE treatment.
Elevated PLT was associated with poor overall survival of HCC patients after TACE treatment.
To evaluate the potential of drug-eluting bead (DEB)-transcatheter arterial chemoembolization (TACE) as a treatment option for patients with refractory to conventional lipiodol-based TACE (c-TACE) especially with decreased liver function.
We retrospectively evaluated the treatment results of DEB-TACE for 89 HCC nodules in 27 patients with c-TACE refractory according to liver function.
Although overall survival was significantly better in Child-Pugh A patients than in Child-Pugh B patients (median survival time, MST 561 vs 347 days,
=0.031), progression-free survival was almost similar in both patients between Child-Pugh A and B (MST 79 vs 87 days,
=0.534). Regarding antitumor response, the objective response rate (ORR) and disease-control rate (DCR) were 5.3/12.5% and 52.7/87.5% in Child-Pugh A/B, respectively. In each 89 HCC nodules, ORR and DCR were almost similar between Child-Pugh A and B (ORR, 20.3 vs 13.3%; DCR, 77.0 vs 73.3%, respectively). Adverse events of DEB-TACE were well-tolerated, and liver function was reserved during DEB-TACE procedures.
DEB-TACE could be a therapeutic option for advanced HCC patients with c-TACE refractory and decreased liver function.
DEB-TACE could be a therapeutic option for advanced HCC patients with c-TACE refractory and decreased liver function.
To improve the understanding of hepatic carcinosarcoma (HCS) by analyzing radiological imaging data and clinicopathological features.
A retrospective analysis was performed on four patients with HCS confirmed immunohistochemically. The analysis included three males and one female, aged 29 to 64 years. Four patients underwent computed tomography (CT) scans, and one underwent magnetic resonance imaging (MRI) scans simultaneously.
Three patients had a history of hepatitis B, cirrhosis or fibrosis, and two patients had schistosomiasis. Two cases tested positive for elevated serum carbohydrate antigen (CA) 19-9. The maximum diameters of the lesions ranged from 7.8 to 9.0cm. Pathologically, the carcinomatous and sarcomatous elements in two patients could not be classified, one of the patients had cholangiocellular carcinoma (CCC) and undifferentiated sarcoma, the other had hepatocellular carcinoma (HCC) and undifferentiated pleomorphic sarcoma (UPS). All tumors showed heterogeneous density/intensity, accompanperative chemoradiotherapy can improve the survival rate of patients.
To investigate the value of amide proton transfer (APT) imaging in predicting the histological grade of hepatocellular carcinoma (HCC), compared with diffusion kurtosis imaging (DKI).
A total of 88 patients with HCC were enrolled and divided into four groups (G1, G2, G3, and G4) based on histologic grades. Preoperative APT signal intensity (SI), mean diffusivity (MD), mean kurtosis (MK) of HCC were measured and compared. Those quantitative magnetic resonance imaging (qMRI) parameters were compared using an analysis of variance. The correlations between the qMRI parameters and the histological grades were determined using Spearman's rank analysis. In addition, the predictive performance for differentiating low- (G1 and G2) from high-grade (G3 and G4) HCC was evaluated using receiver operating characteristic (ROC) curve analysis.
Significant differences were found in APT SIs, MD, and MK among the four groups (
<0.05). Moderate to good relationships were found between the histologic grade of HCC and APT SI and MK (
=0.679,
<0.001 and
=0.539,
<0.001, respectively). The area under the ROC curves (AUCs) of APT SI, MK, and MD for differentiating low- from high-grade HCC were 0.890 (95%CI 0.805-0.947), 0.765 (95%CI 0.662-0.849) and 0.717 (95%CI 0.611-0.808), respectively. Comparison of ROC curves showed a significantly higher AUC of APT SI compared with those of the DKI-derived parameters (
<0.05).
The APT imaging may be more accurate than DKI for predicting the histological grade of HCC.
The APT imaging may be more accurate than DKI for predicting the histological grade of HCC.
Urinary incontinence (UI) is a common health-related problem in the female population and has a negative impact on many aspects of patients' quality of life including mental problems. This study evaluated the mental effects of mid-urethral sling (MUS) surgery in female patients with stress UI or stress UI-dominant mixed UI.
Women with stress UI or stress UI-dominant mixed UI who underwent MUS surgery and were enrolled in this study and followed up for 12 months. The International Consultation of Incontinence Questionnaire-Short Form (ICIQ-SF) and the Hospital Anxiety and Depression Scale (HADS) at baseline and 12 months after the MUS to evaluate the efficacy of the surgery.
At baseline, proportions of the patients with anxiety (HADS-Anxiety score of
8) and depression (HADS-Depression score of
8) were 21.6% (22/102) and 24.5% (25/102), respectively. At 12 months postoperatively, the median ICIQ-SF score, HADS-Anxiety score, and HADS-Depression score were significantly improved compared with their baseline values (p<0.001 for ICIQ-SF and HADS-Depression, p=0.011 for HADS-Anxiety). At 12 months postoperatively, changes in the ICIQ-SF and HADS-A scores showed a moderate correlation (r = 0.578, p < 0.001), and changes in the ICIQ-SF and HADS-D scores had a strong correlation (r = 0.838, p <0.001).
This study demonstrated that MUS surgery significantly improved UI, anxiety, and depression with significant correlations in their symptoms. This suggests that improvement of the patients' UI helped to relieve their symptoms of anxiety and depression.
This study demonstrated that MUS surgery significantly improved UI, anxiety, and depression with significant correlations in their symptoms. This suggests that improvement of the patients' UI helped to relieve their symptoms of anxiety and depression.
Chordee correction, urethroplasty, and tissue reconstruction are performed to correct and retain standard functionality of the penis in hypospadias. Conventional reconstruction techniques, such as onlay island flap and the dorsal inlay graft, can be performed based on the classification of hypospadias. However, the outcomes and complication rates have not been widely studied. Thus, we aimed to provide preliminary evidence regarding the efficacy and safety of both approaches in hypospadias reconstruction.
A prospective study with two time evaluations of 14 and 180 days post-operatively was performed at the Urology outpatient clinic from October 2014 to September 2019. A proportion comparison of success rate, time to the complication, operation time, catheterization duration, uroflowmetry parameter post-surgery, and mean scores comparison of PPPS were measured as the intended outcomes.
In a total of 59 pediatric hypospadias, patients who had undergone reconstruction are included in this study. IPA-3 concentration Higher subjable incidence of complications.
Outcome evaluation regarding functional, complication and patient satisfaction comparing onlay flap and dorsal inlay graft for hypospadias patients is scarce. This study found that both procedures can be considered safe with comparable incidence of complications.
To identify components representing optimal delivery of follow-up care after radical cystectomy because of bladder cancer and report the current level of evidence.
We conducted a systematic literature search of the following databases Cochrane, MEDLINE, Embase, CINAHL, Web of Science, Physiotherapy Evidence Database and ClinicalTrials.gov. The search results were managed in Covidence Reference Manager and abstracts were screened by title. Articles relevant to the subject of interest were included and the results are reported narratively.
Several studies have evaluated the positive impact of enhanced recovery after surgery (ERAS) on length of stay, albeit not on the further impact on 90-day postoperative complication rate, functional recovery, or mortality. Minimally invasive surgery may result in a slighter shorter length of stay compared to open surgery. Physical training combined with nutritional intervention can improve functional recovery up to one year after surgery. Nutritional supplements can prets of this review provide guidance for future directions in research and further attempts to develop and test an evidence-based program for follow-up care after radical cystectomy.
Data are scarce but indicate that peri- and postoperative multi-professional interventions can reduce prevalence of sarcopenia, and improve functional recovery, physical capacity, nutritional status, and self-efficacy in stoma care (level 1 evidence). Continued smoking increases the risk of complications, but the effects of a smoking and alcohol intervention remain unclear (level 3 evidence). The results of this review provide guidance for future directions in research and further attempts to develop and test an evidence-based program for follow-up care after radical cystectomy.
Hypospadias is one of the commonest congenital penile abnormalities in newborn males. The external urethral opening can be located anywhere from the glans penis along the ventral aspect of the shaft of the penis up to the scrotum or the perineum in extreme cases. The condition has a huge impact on the patient's psychological, emotional and sexual well-being.
To determine the proportion of patients who develop long-term complications after hypospadias repair and its associated risk factors.
This was a hospital-based analytical cross-sectional study, conducted at KCMC Urology Institute from January 2009 to December 2018 and all children were followed up for 1-year post-operatively. A structural data sheet was used to collect information from patients' files. Study parameters include age, location of hypospadias, surgical technique, surgeon experience, chordee, suture size, materials to assess the association with long-term complications.
A total of 254 patients were included in the study, the majority were aged more than 2 years (71.83%) with mean age at operation (SD) of 4.74 ± 2.99 years. Distal types were the most common type of hypospadias (125 patients; 50%), and 51 patients (20%) had severe chordee. Tubularized incised plate (TIP) repair was the most common technique (130 patients; 51.59%). The number of patients with long-term complications following hypospadias repair was 156 (61.60%) and urethrocutaneous fistula (UCF) accounted for 40.5%. The surgeon's experience, location of hypospadias, surgical technique and associated chordee were significant predictors of long-term complications of hypospadias repair.
Tubularized incised plate urethroplasty is a safe and reliable method of hypospadias repair. Proximal hypospadias with severe chordee still remain a challenge.
Tubularized incised plate urethroplasty is a safe and reliable method of hypospadias repair. Proximal hypospadias with severe chordee still remain a challenge.