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eral a 5 años fue del 70% en el grupo abierto frente al 80% en el grupo mínimamente invasivo (p = 0,344), mientras que la tasa de supervivencia libre de enfermedad a 5 años en el grupo abierto fue del 63,2% frente al 77,6% en el grupo mínimamente invasivo (p = 0,09).LIMITACIONESExperiencia en una institución de referencia única.CONCLUSIONESSi bien ambos tienen resultados perioperatorios similares, el enfoque mínimamente invasivo, beneficia a los pacientes con estadía más corta y menor riesgo de infecciones de la herida quirúrgica. Ambos enfoques, producen una calidad técnica oncológica similar en términos de ganglios linfáticos extraídos y estado de los márgenes, y tienen resultados oncológicos comparables a largo plazo. Consulte Video Resumen en http//links.lww.com/DCR/B754. (Traducción - Dr. Fidel Ruiz Healy).

The vertical rectus abdominis flap is considered the gold standard in perineal reconstruction after oncological abdominoperineal resection; however, it has a nonnegligible donor site morbidity. The anterolateral thigh flap offers reliable soft tissue coverage.

The aim was to analyze long-term outcomes of composite anterolateral thigh-vastus lateralis flaps in oncological abdominoperineal resections.

We conducted a retrospective cohort analysis of a prospectively maintained database.

This study was conducted in the Lausanne University Hospital. Annually, approximately 10 oncological abdomioperineal resections are performed. Literature reports 7% to 20% of patients undergoing abdominoperineal resection require flap reconstruction; in our institution, approximately 2 patients with large defects after abdominoperineal resections required reconstruction.

Twenty-nine pedicled anterolateral thigh-vastus lateralis flaps in 27 consecutive patients (mean age 63 years +/-11.2, 23 with radiochemotherapy) after veló tres fístulas crónicas, dos recidivas tumorales, una disestesia de colgajo y un acné perineal inverso.LIMITACIONESLas limitaciones incluyen análisis retrospectivo, sesgo de selección y falta de grupo de control. El tamaño de la muestra limita el poder estadístico.CONCLUSIONESEl colgajo pediculado anterolateral de muslo - vasto lateral - ofrece tejido confiable y estable con baja morbilidad y buenos resultados a largo plazo. Los resultados de las complicaciones se mostraron favorables con respecto a la literatura actual que describe reconstrucciones perineales con colgajos de recto abdominal. El colgajo compuesto anterolateral de muslo es una alternativa válida sin el revés de la morbilidad del sitio donante abdominal. Consulte Video Resumen en http//links.lww.com/DCR/B757. (Traducción-Dr. Osvaldo Gauto).

A 72-year-old male patient presented to our outpatient clinic complaining with a perineal bulge one year after abdominoperineal excision for rectal cancer. He described a progressively enlarging bulge in the perineum causing a dull pain that was worse when sitting. On examination, the skin was intact, and a soft 7-cm hernia was identified that could be reduced into the pelvis but recurred immediately. Treatment options were discussed.

A 72-year-old male patient presented to our outpatient clinic complaining with a perineal bulge one year after abdominoperineal excision for rectal cancer. He described a progressively enlarging bulge in the perineum causing a dull pain that was worse when sitting. On examination, the skin was intact, and a soft 7-cm hernia was identified that could be reduced into the pelvis but recurred immediately. Treatment options were discussed.

There have been conflicting reports regarding a protective effect of statin therapy after colon cancer surgery.

This study aimed to evaluate the association between statin therapy and the postoperative mortality following elective colon cancer surgery.

This population-based cohort study is a retrospective analysis of prospectively collected data from the Swedish Colorectal Cancer Register.

Patient inclusion was achieved by inclusion through a nationwide register.

All adult patients undergoing elective surgery for colon cancer between the period of January 2007 and September 2016 were included in the study. Patients who had received and collected a prescription for statins pre- and postoperatively were allocated to the statin positive cohort.

The primary and secondary outcomes of interest were 90-day all-cause mortality and 90-day cause-specific mortality.

A total of 22,337 patients underwent elective surgery for colon cancer during the study period, of whom 6,494 (29%) were classified as statin e colon cancer surgery in the current study, however, further research is needed to ascertain if this relationship is causal. See Video Abstract at http//links.lww.com/DCR/B738 .

Chronic joint pain is a major symptom in rheumatoid arthritis (RA) and its adequate treatment represents an unmet medical need. Noncoding microRNAs (miRNAs) have been implicated in the pathogenesis of RA as negative regulators of specific target mRNAs. Yet, their significance in RA pain is still not well defined. We and other groups recently identified neuronally expressed FcγRI as a key driver of arthritis pain in mouse RA models. Thus, we tested the hypothesis that miRNAs that target and regulate neuronal FcγRI attenuate RA pain. Here, we show that miR-544-3p was robustly downregulated, whereas FcγRI was significantly upregulated in the dorsal root ganglion (DRG) in mouse RA models. Intrathecal injection of miR-544-3p mimic attenuated established mechanical and heat hyperalgesia partly through the downregulation of FcγRI in the DRG in a mouse model of collagen II-induced arthritis. Moreover, this effect was likely mediated, at least in part, by FcγRI because miR-544-3p mimic downregulated Fcgr1 mRNA expreuggest that miR-544-3p causally participates in the maintenance of arthritis pain by targeting neuronal FcγRI, and thus define miR-544-3p as a new potential therapeutic target for treating RA pain.

This observational study evaluated people's attitudes towards educational statements and tested whether this predicted intention to self-manage low back pain (LBP). People with or without LBP who were older than 18 years and fluent in written English were recruited. Participants completed an online survey asking demographic questions and questions on the presence or absence of LBP, its duration, and intensity. We assessed attitude toward educational statements and conducted linear regression analyses to investigate the relationship between attitude toward each statement and intention to self-manage. We recruited 656 participants, n = 345 (53.6%), with LBP of varying duration. On average, participants had a positive attitude toward all statements except one; participants with chronic LBP had a negative attitude toward a statement relating to the cause of LBP. The effect of attitude on intention to self-manage was dependent on whether someone had LBP and for how long. For example, increased intention to self-d differences in attitude toward educational messages and individuals' intention to self-manage LBP depending on pain duration. Self-management could be encouraged with specific reassurance in people with acute or subacute LBP and education about severity in people with chronic LBP.

This study examined the joint association of red and processed meat intake and food insecurity with hypertension.

Adult participants of the National Health and Nutrition Examination Survey 2003-2016 were included. Total red meat intake was estimated using 24 h dietary recalls. Food insecurity was defined as having three or more affirmative responses using the Food Security Survey Module. Hypertension was defined as having mean SBP of at least 130 mmHg or DBP of at least 85 mmHg or use of antihypertensive drugs. β-Glycerophosphate chemical structure Multivariable surveylogistic regression models were used to examine the independent and joint associations of total red meat and food insecurity with hypertension.

A total of 31 314 participants [mean (SE) age of 46.8 (0.3) years] were included, of whom 18.3% were food insecure. Total red meat consumption and food insecurity were independently associated with higher odds of hypertension. Compared with the first quintile of total red meat intake, participants in the fourth and fifth quintiles of total red meat intake had 29 and 39% higher odds of hypertension, respectively (P = 0.003). These associations were stronger among food insecure participants (P value for interaction <0.001). Substituting one serving/day of poultry, fish, eggs, dairy products, or plant-based protein sources for total red meat was each associated with 8-15% lower odds of hypertension.

This study provides further evidence regarding the health hazards of total red meat consumption in relation with hypertension and calls for more awareness among food insecure groups.

This study provides further evidence regarding the health hazards of total red meat consumption in relation with hypertension and calls for more awareness among food insecure groups.

The aim of this study was to evaluate the association between plasma aldosterone concentration (PAC) and renal impairment in patients with both hypertension and abnormal glucose metabolism (AGM).

The longitudinal observational study included 2033 hypertensive individuals with AGM who did not have chronic kidney disease (CKD) at baseline. CKD was defined as estimated glomerular filtration rate (eGFR) less than 60 ml/min per 1.73 m2 and/or positive proteinuria. Directed acyclic graphs and LASSO regression analyses were applied to identify adjusted sets. Cox proportional hazard models and linear regression were used to evaluate the association of PAC with CKD and its components including decreased renal function (DRF) and proteinuria. Mediation analysis was used to examine the role of blood pressure (BP) in the association between the two.

During total follow-up of 5951 person-years with a median follow-up of 31 months, 291 participants developed CKD. The incidence of CKD was increased with the elevation in tertile PAC. link2 Multivariable Cox model showed that PAC was positively associated with increased CKD risk (hazard ratio = 1.76 for natural log-transformed PAC, P < 0.001), and with increased risk of DRF and proteinuria. SBP mediated 7.5-17.9% of the association between PAC and renal impairment. Overall results remained consistent and significant in sensitivity analysis by excluding those with suspicious primary aldosteronism, too short follow-up time and mineralocorticoid receptor antagonists use.

Higher PAC was associated with increased CKD risk in patients with hypertension and AGM, even in the absence of suspicious primary aldosteronism. The results indicate PAC may serve as a potential therapeutic target in this population.

Higher PAC was associated with increased CKD risk in patients with hypertension and AGM, even in the absence of suspicious primary aldosteronism. The results indicate PAC may serve as a potential therapeutic target in this population.

Previous studies on the association between metabolic biomarkers and hypertension have been limited by small sample sizes, low number of studied biomarkers, and cross-sectional study design. In the largest study to date, we assess the cross-sectional and longitudinal associations between high-abundance serum biomarkers and blood pressure (BP).

We studied cross-sectional (N = 36 985; age 50.5 ± 14.2; 53.1% women) and longitudinal (N = 4197; age 49.4 ± 11.8, 55.3% women) population samples of Finnish individuals. We included 53 serum biomarkers and other detailed lipoprotein subclass measures in our analyses. link3 We studied the associations between serum biomarkers and BP using both conventional statistical methods and a machine learning algorithm (gradient boosting) while adjusting for clinical risk factors.

Fifty-one of 53 serum biomarkers were cross-sectionally related to BP (adjusted P < 0.05 for all). Conventional linear regression modeling demonstrated that LDL cholesterol, remnant cholesterol, apolipoprotein B, and acetate were positively, and HDL particle size was negatively, associated with SBP change over time (adjusted P < 0.