Hicksandreassen3164

Data on prognostic factors associated with outcome following resection of perihilar cholangiocarcinoma vary. We sought to define and characterize current available evidence on prognostic factors associated with perihilar cholangiocarcinoma after resection. The PubMed, Embase, and Cochrane library were systematically searched for relevant studies published before December 2019. Prognostic factors were identified from multivariate regression analyses in studies. Only high-quality studies were included (Newcastle-Ottawa Scale > 6 stars). A total of 45 studies involving 7338 patients were analyzed. The meta-analysis demonstrated that serum bilirubin levels (hazard ratio 1.76, 95% confidence interval 1.27-2.44), serum CA19-9 levels (hazard ratio 1.32, 95% confidence interval 1.05-1.65), tumor size (hazard ratio 1.27, 95% confidence interval 1.04-1.55), major vascular involvement (hazard ratio 1.61, 95% confidence interval 1.09-2.38), distance metastasis (hazard ratio 17.60, 95% confidence interval 2.01-154.09), pe to characterize patients in clinical practice and enrich prognostic tools, which could be included in future trial designs and generate hypotheses to be tested in future research to promote personalized treatment.Obesity remains a growing public health epidemic that has increased healthcare costs and related comorbidities. Current treatment guidelines encourage a multidisciplinary approach starting from patient selection, interventions, and long-term follow-up to maintain weight loss. However, these conservative interventions are largely ineffective at reducing body weight due to low adherence to the treatment regimen. Recently, endoscopic bariatric therapies have become an attractive alternative to traditional invasive bariatric surgeries due to their improved efficacy, safety, and cost-effectiveness. Endoscopic bariatric therapies include intragastric balloon placement, endoscopic sleeve gastroplasty, gastric bypass revision, and aspiration therapy. These procedures fall into two separate categories depending on the primary mechanism involved restrictive or malabsorptive. Restrictive methods, such as the Orbera® and ReShape™ intragastric balloons, increase satiation and delay gastric emptying while decreasing the amount of food that can be ingested. In contrast, malabsorptive devices, such as the EndoBarrier®, interfere with the small intestine's ability to absorb food while restoring normal gastrointestinal hormone levels regulating satiation. Together, these techniques provide useful alternatives for patients in whom pharmacological or lifestyle modifications have proven ineffective. Despite these advantages, the long-term effects of these procedures on metabolic changes remain to be studied. Furthermore, the management of complications from these procedures continues to evolve. In this review, we aim to elaborate on the clinical indications and efficacy of the endobariatric procedures, together with various types of available endoscopic bariatric therapy procedures.Eosinophilic granulomatosis with polyangiitis (EGPA) is a multisystemic disease that mainly affects the lungs and skin. It is considered to be a small and medium-vessel vasculitis. Although neurologic manifestations of EGPA are reported, usually consisting of peripheral neuropathy, central nervous system manifestations are quite rare, those described being cerebral infarctions or hemorrhages. We present the case of a 79-year-old woman diagnosed in 2016 with EGPA, being treated with Prednisone and Azathioprine, who presented to the Neurological Emergency Department with right hemiplegia, dysmetria in the left arm and right hemi-hypoesthesia. CT (computed tomography) and MRI (Magnetic resonance imaging) findings on admission described lacunar strokes. The patient presented with low creatinine clearance on admission (positive for chronic renal disease), grade III hypertension, ischemic cardiomyopathy and right calf deep vein thrombosis. The patient was started on neuroprotective and neurotrophic treatment associated with parenteral hydration, anticoagulant and hypotensive drugs. The patient's symptoms partially improved, with possibility of independently maintaining a sitting position and upright stance with unilateral sustenance at discharge. Patients suffering from vasculitides must be carefully observed in order to prevent or treat complications that may emerge.Bell's palsy is described as a type of facial paralysis, which is unilateral in 70% of the cases. Bell's palsy accounts for about 23% of bilateral facial paralysis. Here, we present a rare case of bilateral Bell's palsy in a 15-year-old female who developed sudden facial weakness with no associated symptoms. The patient was subjected to thorough clinical, laboratory, and necessary radiological investigations. As there was no conclusive evidence from any of the investigations, this could be a case of idiopathic bilateral Bell's palsy. This is the first ever case of bilateral Bell's palsy in a young female which has been reported in the Indian population.Nevus sebaceus of Jadassohn (NSJ) is a congenital cutaneous hamartoma mainly developing from pilosebaceous unit cells. Plumbagin order NSJ has the potential to develop into a variety of benign and malignant tumors, which are not limited to sebaceous differentiation. The dynamical monitoring for the earliest malignant transformation is necessary. Herein, we report the combined noninvasive NSJ examination with videodermoscopy in polarized and non-polarized light and high-frequency ultrasound (HFUS) imaging at 33 and 50 MHz. Typical NSJ dermoscopic signs where described, the internal nevus structure and its location, depths, and margins with surrounded tissues were examined with high-frequency ultrasound. Some HFUS characteristics for NSJ were described. Videodermoscopy and high-frequency ultrasound combined examination could be useful for NSJ dynamical monitoring in order to detect malignant transformation and to define necessary and sufficient tissue excision volume in case of surgical treatment.

In recent years a link between periodontitis and cardiovascular diseases has been proposed. Oxidative stress has been found to be involved in their pathophysiology.

The aim of this study was to demonstrate that a wire ligature placed around the first mandibular molars of the rat causes inflammation in the periodontium and lipid deposits in the aorta, via oxidative stress.

Twenty male Wistar rats were divided randomly into two groups of 10 Control group and Periodontitis group. An orthodontic wire ligature was placed around the cervix of the first mandibular molar and was kept in place for 4 weeks. Clinical attachment loss was determined to assess the gingival recession. Aorta was harvested after 4 weeks and the malondialdehyde (MDA) levels in the aorta tissue homogenate were determined. Lipid deposits were evaluated using Oil Red staining and immunofluorescence under confocal microscopy. Total lipid deposits in the aorta were assessed using a computer morphometry system.

Significant gingival recession was observed in the Periodontitis group in comparison with the Control group.