Millswaters2474

sign. CONCLUSION Redo pouch can be offered to selected patients with colonic Crohn's disease diagnosed at the time of their primary pouch. See Video Abstract at http//links.lww.com/DCR/B206.BACKGROUND Previous studies have reported that 30-40% of patients with squamous cell carcinoma of the anus will require salvage abdominoperineal resection following chemoradiotherapy. OBJECTIVE To identify the utilization, risk factors and impact on survival of salvage abdominal perineal resection for squamous cell carcinoma of the anus. DESIGN Retrospective, population-based cohort study. PATIENTS All incident cases of squamous cell anal cancer who underwent curative intent radiotherapy from 2007-2015. SETTING Patients treated in Ontario, Canada, a single payer universal health care system. MAIN OUTCOME MEASURES Risk of salvage abdominoperineal resection, factors associated with salvage abdominoperineal resection and survival. RESULTS A total of 1125 patients were treated with curative intent radiotherapy for squamous cell cancer of the anus. Within this cohort, salvage surgery was performed in 8% (93/1125), while 14% (156/1125) required a permanent colostomy. In log-binomial regression, younger age was assoatients requiring salvage surgery had poor 5-year overall survival. See Video Abstract at http//links.lww.com/DCR/B205.BACKGROUND Frailty and sarcopenia are important concepts in surgical practice due to their association with adverse postoperative outcomes. Radiologically assessed psoas muscle mass has been proposed as a surrogate for sarcopenia and may be predictive of poor postoperative outcomes. OBJECTIVE To determine the association between sarcopenia, as assessed by psoas cross-sectional area, and postoperative outcomes in patients undergoing colorectal cancer surgery. DESIGN This was a retrospective review of patient records from 2014 to 2016. SETTINGS This study was conducted at a single tertiary center. PATIENTS Patients undergoing elective resection of colorectal cancer were included. MAIN OUTCOME MEASURES Sarcopenia was assessed using the total psoas index (TPI), calculated by measuring the cross-sectional area of the psoas muscle at the third lumbar vertebrae and normalized for patient height. Preoperative and intraoperative variables, including the presence of preoperative sarcopenia were evaluated as potential rging, provide an opportunity to assess for sarcopenia preoperatively. See Video Abstract at http//links.lww.com/DCR/B201.BACKGROUND Impact of restorative proctocolectomy failure on fertility has not been studied and is greatly relevant. OBJECTIVE Evaluate the impact of restorative proctocolectomy failure on birth rate in females and males, along with in vitro fertilization incidence and success. DESIGN Retrospective registry-based cohort study over 17 years. SETTINGS Records for parenting a child were crosslinked with patient records. In females, in vitro fertilization records were crosslinked. AK 7 price All data were prospectively registered. PATIENTS Patients of fertile age with ulcerative colitis between 1994-2010 were identified in Danish national databases. Patients with restorative proctocolectomy and restorative proctocolectomy failure were identified as subgroups. MAIN OUTCOME MEASURES Birth rate ratios, and in vitro fertilization incidence and success. RESULTS We included 11939 females and 13569 males with ulcerative colitis. 711 females and 730 males had restorative proctocolectomy; 114 females and 90 males had failure. Birth r.OBJECTIVES The use of opioids to relieve pain is a challenge because of the high variability in dose requirements and tolerance profiles. Amongst potential modulators are individual's genetic background as well as being female. Our aim was to evaluate gender bias and genotype-related influence on opioid titration safety, in chronic low back pain (CLBP), as the most frequent chronic non-cancer pain. METHODS A 3 years, prospective study, was developed in opioids naïve CLBP patients. Data was self-reported by patients (pain [Visual Analogy Scale, VAS], adverse events [AEs], and healthcare resources utilization) and physicians (analgesic prescription, morphine equivalent daily dose [MEDD] and suspected adverse drug reactions [ADRs]). Outcomes were analyzed as patients with AEs (case) or without (control) together with patients' gender and genotype. Gene variants in OPRM1 (rs1799971), COMT (rs4680), ABCB1 (rs1045642), UGT2B7 (rs12233719 and rs7438135), KCNJ6 (rs2070995 and rs6517442) and CYP3A5*3 (rs776746) were ato resolve inequalities in health care access.OBJECTIVES Previous exposure to hepatitis B virus (HBV) may increase the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis C. We aim to study the impact of previous HBV infection on the severity and outcomes of patients with nonalcoholic fatty liver disease (NAFLD). METHODS This was a multicenter study of 489 patients with biopsy-proven NAFLD and 69 patients with NAFLD-related or cryptogenic HCC. Antihepatitis B core antibody (anti-HBc) was used to detect the previous HBV infection. RESULTS In the biopsy cohort, positive anti-HBc was associated with lower steatosis grade but higher fibrosis stage. 18.8% and 7.5% of patients with positive and negative anti-HBc had cirrhosis, respectively (P less then 0.001). The association between anti-HBc and cirrhosis remained significant after adjusting for age and metabolic factors (adjusted odds ratio 2.232; 95% confidence interval, 1.202-4.147). At a mean follow-up of 6.2 years, patients with positive anti-HBc had a higher incidence of HCC or cirrhotic complications (6.5% vs 2.2%; P = 0.039). Among patients with NAFLD-related or cryptogenic HCC, 73.9% had positive anti-HBc. None of the patients had positive serum HBV DNA. By contrast, antihepatitis B surface antibody did not correlate with histological severity. DISCUSSION Positive anti-HBc is associated with cirrhosis and possibly HCC and cirrhotic complications in patients with NAFLD. Because a significant proportion of NAFLD-related HCC may develop in noncirrhotic patients, future studies should define the role of anti-HBc in selecting noncirrhotic patients with NAFLD for HCC surveillance.