6 research outputs found
The association of gallstone disease with risk of colorectal cancer (CRC).
No full textSystematic Review
The association of gallstone disease with risk of colorectal cancer (CRC).
Searches
Three electronic databases: PubMed, Web of Science and Scopus will be searched from inception, without any restriction to language.
References from retrieved articles will be screened in order to find further relevant studies. For the same reason, we will evaluate in topic systematic reviews and meta-analyses identified during study search.
Types of study to be included
Observational studies
Condition or domain being studied
Gallstone disease(GD) is one of the most common ailments of the gastrointestinal tract. Numerous studies have been conducted to ascertain if cholecystectomy is associated with a higher risk of CRC with inconclusive results. To date there hasn’t been a systematic review on the association of symptomatic gallstones or screen-detected gallstones with CRC.
Participants/population
We will include studies conducted in adults (aged ≥18 years). Studies conducted exclusively on a group with a baseline chronic disease (e.g. CVD, type 2 diabetes, chronic kidney disease) or pregnant women will be excluded.
Exposure(s)
Screen-detected gallstones, symptomatic gallstones or cholecystectomy.
Comparator(s)/control
People who do not present with gallstones. Should there be prospective cohort studies without a comparator group we will perform further subgroup analyses.
Main outcome(s)
Colorectal cancer diagnosis.
* Measures of effect
Relative risks, Odds ratio/ Hazard ratio
Additional outcome(s)
None
Data extraction (selection and coding)
Observational studies will be included in this meta-analysis if they: 1) were observational in design; 2) reported the exposure of interest as screen-detected gallstones, symptomatic gallstones, gallstone disease or cholecystectomy ; 3) reported the outcome of interest as diagnosis of colorectal cancer; 4) provided odds ratios (OR) and/or relative risks (RR) and the corresponding confidence intervals (CI) or sufficient data to calculate them.
Two authors (G.P. and H.S.) independently will extract data on study characteristics. We will extract the following information from each study: study name, number of exposed, country name or geographical region, the last name of first author, publication year, study period or follow-up time, baseline age, ORs, RRs and 95% CIs for the association between each exposure category and CRC, and covariates.
Risk of bias (quality) assessment
Begg’s and Egger’s test will be used for publication bias.
The Newcastle-Ottawa quality assessment scale will be used for assessing the quality of the studies.
Strategy for data synthesis
All study estimates (OR/RR) will be interpreted as relative risk and used as effect size in analyses. They will be calculated using the DerSimonian and Laird random effects models. A two-tailed P value of <0.05 will be considered statistically significant.
Analysis of subgroups or subsets
A subgroup analysis by type of exposure, sex, adjustment for covariates, geographical region (US/ Europe/ Asia) and if necessary of studies without comparator groups will be conducted.
Contact details for further information
Georgios Polychronidis
Harvard T.H. Chan School of Public Health
Department of Epidemiology
[email protected]
Organisational affiliation of the review
Harvard T.H. Chan School of Public Health
Review team members and their organisational affiliations
Dr Georgios Polychronidis. Heidelberg University Clinic, Study Center of the German Surgical Society & Harvard T.H. Chan School of Public Health
Haziq Siddiqi. Harvard Medical School
Dr. Stefania Papatheodorou.Harvard T.H. Chan School of Public Health
Professor Albert Hofman. Harvard T.H. Chan School of Public Health
Assistant Professor Dr. Mingyang Song. Harvard T.H. Chan School of Public Health & Massachusetts General Hospital
Type and method of review
Epidemiologic, Meta-analysis, Systematic review
Anticipated or actual start date
01 July 2020
Anticipated completion date
30 January 2021
Funding sources/sponsors
Deutsche Forschungsgemeinschaft (DFG) Projektnummer 426308975
Conflicts of interest
None
Language
English
Country
USA
Stage of review
Review Ongoing
Subject index terms
Gallstones; Cholecystectomy; Colorectal cance
Evaluation of Different Modelling Techniques with Fusion of Satellite, Soil and Agro-Meteorological Data for the Assessment of Durum Wheat Yield under a Large Scale Application
No full textFood and feed production must be increased or maintained in order to meet the demands of the earth’s population. Under this scenario, the question that arises is how to address the demand for agricultural products given that the pressures on land use have already increased. In addition, it is obvious that climate change will have a serious negative impact and threaten the productivity and sustainability of food production systems. Therefore, understanding and predicting the outcome of crop production, while considering adaptation and sustainability, is essential. The need for information on decision making at all levels, from crop management to adaptation strategies, is constantly increasing and methods for providing such information are urgently needed in a relatively short period of time. Thus arises the need to use effective data, such as satellite and meteorological data, but also operational tools, to assess crop yields over local, regional, national, and global scales. In this work, three modeling approaches built on a fusion of satellite-derived vegetation indices, agro-meteorological indicators, and crop phenology are tested and evaluated in terms of data intensiveness for the prediction of wheat yields in large scale applications. The obtained results indicated that medium input data intensity methods are effective tools for yield assessments. The methods, namely, a semi-empirical regression model, a machine learning regression model, and a process-based model, provided high to moderate accuracies by fully relying on freely available datasets as sources of input data. The findings are comparable with those reported in the literature for detailed field experiments, thereby introducing a promising framework that can support operational platforms for dynamic yield forecasting, operating at the administrative or regional unit scale
A Unique Case of Unilateral Pseudogynecomastia
No full textBackground/Objectives: Gynecomastia is a common condition characterized by the benign enlargement of male breast tissue, often resulting from hormonal imbalances. A rare variant, unilateral pseudogynecomastia, involves enlargement due to adipose tissue accumulation without glandular proliferation and can be associated with occupational factors. Methods: We report the case of a 45-year-old male mechanic presenting with unilateral enlargement of the left breast. The patient reported daily microtrauma on his left axilla and chest wall. The clinical evaluation and imaging revealed lipomatosis with pronounced fibrous tissue and no glandular tissue involvement. The hormonal assays were within the normal limits. The patient underwent surgical excision of excess adipose tissue using the Kornstein technique, preserving the nipple–areola complex. Results: The histopathological examination confirmed the absence of malignancy. The postoperative recovery was uneventful, and the follow-up examination at 12 months demonstrated a symmetrical breast appearance with no recurrence. This case underscores the importance of differentiating pseudogynecomastia from true gynecomastia and recognizing potential occupational risks. Surgical management using techniques that preserve the nipple–areola complex can achieve excellent cosmetic outcomes
Spontaneous Transvaginal Small Bowel Evisceration After Laparoscopic Hysterectomy
No full textVaginal cuff dehiscence can be a rare complication of total hysterectomy, with an estimated prevalence of 0.032% to 1.25% and a high mortality rate of 6 to 10%. Dehiscence is also reported in cases following total laparoscopic hysterectomy, with a prevalence of 0.87%. This case report details the emergency management of a 59-year-old female who complained of abdominal and pelvic pain and the feeling of a foreign body in her vagina. The patient reported a history of laparoscopic total hysterectomy 6 months prior to presenting at the Emergency Department. A clinical examination revealed small bowel loops protruding through the vagina. The patient underwent exploratory laparotomy through a Pfannenstiel incision, and the terminal ileum was found prolapsing through the vaginal cuff. The bowel loops were identified as viable and the vagina was sutured. The patient had an unremarked post operative course. This case report showcases that in patients with transvaginal evisceration, immediate surgical management is crucial in order to avoid serious life threatening complications, and both surgeons and gynecologists should remain vigilant regarding this pathology
Metastasis of colorectal carcinoma to the testes: Clinical presentation and possible pathways
No full textDistant metastasis from colorectal carcinoma most often occurs in the liver and lungs. Metastasis to bones, adrenals, lymph nodes, brain, and skin has also been reported. Metastatic colorectal carcinoma to the testes is very uncommon. Even more uncommon is testicular metastasis from rectal carcinoma. Researchers throughout the last few decades have not acquired a clear understanding of the lymphatic pathways involved in reported cases of testicular metastasis from primary colorectal carcinoma. These cases may present with testicular complaints after or even before the diagnosis of colorectal cancer; this is why it is crucial to differentiate between primary testicular tumor and a secondary one from a colorectal primary. We searched the English medical literature using the MEDLINE-PUBMED database from 1950 through January 2010. Our search yielded 33 cases of testicular metastasis from rectal or colonic carcinoma. These cases are reviewed and summarized. This paper reviews the literature for all cases of testicular metastasis from colonic and rectal ade-nocarcinomas shedding light on the possible pathways of metastasis. We recommend that physicians be aware of the risk of metastasis from the colorectal region to the testis in their evaluation of patients with testicular symptoms in the setting of colorectal carcinoma. © Japan Society of Clinical Oncology 2010.ALMAGRO UA, 1988, UROLOGY, V32, P357, DOI 10.1016-0090-4295(88)90245-2; BELSKY JB, 1954, J UROLOGY, V72, P712; BODON GR, 1967, J UROLOGY, V97, P885; Bryan NP, 1997, POSTGRAD MED J, V73, P47; Burger R, 1973, Urology, V2, P566, DOI 10.1016-0090-4295(73)90571-2; Charles W, 2005, J CLIN ONCOL, V23, P5256, DOI 10.1200-JCO.2005.06.109; Chen Y, 1999, LYMPHOLOGY, V32, P70; CRICCO RP, 1977, J UROLOGY, V118, P489; DeVita V. T., 2005, CANC PRINCIPLES PRAC; Dutt N, 2000, HISTOPATHOLOGY, V37, P323, DOI 10.1046-j.1365-2559.2000.00983.x; GRAY H, 1918, LYMPHATICS ABDOMEN P; HANASH KA, 1969, J UROLOGY, V102, P465; Hatoum HA, 2006, COLORECTAL DIS, V8, P529, DOI 10.1111-j.1463-1318.2006.01040.x; HAUPT HM, 1984, CANCER, V54, P709, DOI 10.1002-1097-0142(1984)54:4709::AID-CNCR28205404193.0.CO;2-6; HUNTER DT, 1959, J UROLOGY, V81, P305; Iczkowski KA, 2008, HUM PATHOL, V39, P275, DOI 10.1016-j.humpath.2007.07.002; JUBELIRER SJ, 1986, J SURG ONCOL, V32, P22, DOI 10.1002-jso.2930320107; KANNO K, 1994, JPN J CLIN ONCOL, V24, P340; Leroy X, 2002, J HISTOCHEM CYTOCHEM, V50, P283; LOONEY WW, 1939, AM J SURG, V46, P143, DOI 10.1016-S0002-9610(39)90246-1; McWeeney Doireann M, 2009, Cases J, V2, P111, DOI 10.1186-1757-1626-2-111; MEACHAM RB, 1988, J UROLOGY, V140, P621; MOORE JB, 1982, CANCER, V49, P411, DOI 10.1002-1097-0142(19820115)49:2411::AID-CNCR28204902343.0.CO;2-S; Moreno Anton F, 2005, CLIN TRANSL ONCOL, V7, P321, DOI 10.1007-BF02710272; Ouellette JR, 2007, AM SURGEON, V73, P79; Parra R O, 1992, Mo Med, V89, P298; PIENKOS EJ, 1972, CANCER, V30, P481, DOI 10.1002-1097-0142(197208)30:2481::AID-CNCR28203002283.0.CO;2-X; Polychronidis A, 2002, SURG TODAY, V32, P376; POWELL BL, 1985, J CLIN ONCOL, V3, P110; PRICE EB, 1957, CANCER, V10, P592, DOI 10.1002-1097-0142(195705-06)10:3592::AID-CNCR28201003263.0.CO;2-3; Rahman S U, 2003, J Pak Med Assoc, V53, P38; RASMUSSEN HH, 1988, ACTA CHIR SCAND, V154, P65; Riquet M, 2010, ANN THORAC SURG, V89, P375, DOI 10.1016-j.athoracsur.2009.10.005; Shimada H, 2009, LANGENBECK ARCH SURG, V394, P973, DOI 10.1007-s00423-009-0530-8; SMALLMAN LA, 1984, UROLOGY, V23, P598, DOI 10.1016-0090-4295(84)90081-5; Sonne SB, 2010, INT J DEV BIOL, V54, P755, DOI 10.1387-ijdb.082668ss; TILTMAN AJ, 1979, HISTOPATHOLOGY, V3, P31, DOI 10.1111-j.1365-2559.1979.tb02979.x; Tiong HY, 2005, DIS COLON RECTUM, V48, P582, DOI 10.1007-s10350-004-0808-4; Ulbright TM, 2008, AM J SURG PATHOL, V32, P1683, DOI 10.1097-PAS.0b013e318178851663
The Challenging Management of Short Bowel Syndrome
No full textA 62-year-old female presented to the Emergency Department of the General Hospital of Katerini, Greece, complaining of abdominal pain, fever, and general discomfort. Laboratory tests indicated an elevated white blood cell count and an elevated C-reactive protein level. A computed tomography (CT) scan revealed dilated small bowel loops and free intraperitoneal fluid. During laparotomy, extensive ischemia and necrosis of both the small and large bowel were discovered, and a resection of the small bowel and the right colon was performed, leaving the patient with only 90 cm of small intestine and a jejunocolic anastomosis. Postoperative management was particularly challenging, requiring a multidisciplinary approach, an intensive care unit stay, reoperations due to anastomotic leaks, continuous parenteral nutrition and electrolyte management, and aggressive antibiotic treatment for persistent bacterial infections. This case report highlights the importance of appropriate management of this life-threatening complication following extensive bowel resection
