Hjortballard0054

4 %; median FU 48 months, IQR 24) were included. During FU, 116 patients (37.7 %) showed progression of IM and six patients (1.9 %) developed high-grade dysplasia or GC. The minor allele (C) on TLR4 (rs11536889) was inversely associated with progression of GIM (OR 0.6; 95 %CI 0.4-1.0). Family history (HR 1.5; 95 %CI 0.9-2.4) and smoking (HR 1.6; 95 %CI 0.9-2.7) showed trends towards progression of GIM. Alcohol use, body mass index, history of H. pylori infection, and serological markers were not associated with progression. Conclusions  Family history and smoking appear to be related to an increased risk of GIM progression in low GC incidence countries. TLR4 (rs11536889) showed a significant inverse association, suggesting that genetic information may play a role in GIM progression.Background and study aims  Previous reports have suggested that endoscopic retrograde cholangiopancreatography (ERCP) in pediatric patients are safe. However, the total number of cases presented in the literature remains small. We present results regarding safety and outcomes in pediatric patients undergoing ERCP at Oslo University Hospital. Patients and methods  Patients  1 year) post-ERCP pancreatitis were seen in 10.4 %. Conclusions  Our retrospective series of ERCP procedures includes 56 procedures in infants, which is one of the largest series presented. Complications in infants are rare and post-ERCP pancreatitis was not seen. In older children 10.4 % experienced post-ERCP pancreatitis. In expert hands, ERCP was shown to be acceptably feasible and safe in infants and children.Bowel obstruction is one of the most common surgical emergencies and a major cause of morbidity and mortality. Standard supportive measures must be instituted as soon as the diagnosis is confirmed. Anastomotic strictures are a benign etiology of intestinal obstruction, occurring in up to 22 % of patients following colorectal resection. Traditionally, endoscopic balloon dilation (EBD) has been the intervention of choice in such cases; however, it may not be feasible in all settings. We report a novel application of the AXIOS stent and electrocautery-enhanced delivery system (Boston Scientific, Marlborough, Massachusetts, United States) to create a colo-colostomy to bypass a sigmoid colon stricture in a 51-year-old woman who presented with acute intestinal obstruction. Despite stent dislodgment during the procedure, the preexisting tract allowed us to improvise our technique with a second LAMS placement. The patient was discharged well 48 hours after the procedure. However, 4 months later, she required a session of EBD following a presentation for fecal impaction. She is currently asymptomatic and being followed up regularly as an outpatient.Background and study aims  The COVID-19 pandemic has caused a major disruption in the healthcare system. This study determined the impact of the first wave of COVID-19 on the number and outcome of patients hospitalized for upper gastrointestinal bleeding (UGIB) in Hong Kong. Patients and methods  Records of all patients hospitalized for UGIB in Hong Kong public hospitals between October 2018 and June 2020 were retrieved. https://www.selleckchem.com/products/beta-aminopropionitrile.html The number and characteristics of patients hospitalized for UGIB after COVID-19 was compared by autoregressive integrated moving average (ARIMA) model prediction and historical cohort. Results  Since the first local case of COVID-19, there was an initial drop in UGIB hospitalizations (observed 29.8 vs predicted 35.5 per week; P  = 0.05) followed by a rebound (39.8 vs 26.7 per week; P   less then  0.01) with a turning point at week 14 (Petitt's test, P   less then  0.001). There was a negative association between the number of COVID-19 cases and the number of patients hospitalized for UGIB (Pearson correlation -0.53, P   less then  0.001). Patients admitted after the outbreak of COVID-19 had lower hemoglobin (7.5 vs baseline 8.3 g/dL; P   less then  0.01) and a greater need for blood transfusion (64.5 % vs baseline 50.4 %; P   less then  0.01), but similar rates of all-cause mortality (6.9 % vs 7.1 %; P  = 0.82) and rebleeding (6.7 % vs 5.1 %; P  = 0.11). There was also a higher proportion of patients with variceal bleeding (10.5 % vs baseline 5.3 %; P   less then  0 .01). Conclusions  There was a dynamic change in the number of patients hospitalized for UGIB in Hong Kong during the first wave of the COVID-19 outbreak, with more obvious impact during the initial phase only.The Capsule Endoscopy Group of the Chinese Society of Digestive Endoscopy has issued recommendations for capsule endoscopy (CE) practice during the COVID-19 pandemic to standardize workflow, preventive strategies, and management of a CE unit and in so doing, ensure the safety of both medical staff and patients.Prediction of COVID-19 incidence and transmissibility rates are essential to inform disease control policy and allocation of limited resources (especially to hotspots), and also to prepare towards healthcare facilities demand. This study demonstrates the capabilities of nonlinear smooth transition autoregressive (STAR) model for improved forecasting of COVID-19 incidence in the Africa sub-region were investigated. Data used in the study were daily confirmed new cases of COVID-19 from February 25 to August 31, 2020. The results from the study showed the nonlinear STAR-type model with logistic transition function aptly captured the nonlinear dynamics in the data and provided a better fit for the data than the linear model. The nonlinear STAR-type model further outperformed the linear autoregressive model for predicting both in-sample and out-of-sample incidence.

Utilization of neoadjuvant chemotherapy (NAC) for the management of muscle-invasive bladder cancer remains low. We sought to understand our practice of NAC use in order to design a quality improvement initiative geared towards optimizing medical oncology referral.

We identified 339 patients with ≥cT2 bladder cancer treated with radical cystectomy between 2012-2017 at our institution. We assessed the rate of referral to medical oncology, rate of NAC administration, as well as medical, patient and provider variables associated with NAC use. Bayesian logistic regression modeling identified variables associated with NAC use and chart review provided granular patient-level data.

85% (n=289) of patients were referred to medical oncology and 62.5% (n=212) received NAC. Renal insufficiency, hearing loss, and treating urologist were conclusively associated with lower odds of NAC use. 46 patients were not referred to medical oncology and 50% of these had medical contraindications to cisplatin cited as the reason for no referral.