26 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
The association of gallstone disease with risk of colorectal cancer (CRC).
No full textSystematic Revie
The association of gallstone disease with risk of colorectal cancer (CRC).
No full textSystematic Revie
Is resection of pancreatic adenocarcinoma with synchronous hepatic metastasis justified? A review of current literature
No full textIncidence trends and survival prediction of hepatoblastoma in children: a population‐based study
No full textImpact of hiatal hernia on histological pattern of non-erosive reflux disease
No full textAbstract Background Hiatus hernia (HH) has major pathophysiological effects favoring gastroesophageal reflux and hence contributing to esophageal mucosa injury, especially in patients with severe gastroesophageal disease. However, prospective studies investigating the impact of HH on the esophageal mucosa in non-erosive reflux disease (NERD) are lacking. This study evaluated the association between the presence of (HH) and the histological findings in symptomatic patients with NERD. Methods Fifty consecutive patients with gastroesophageal reflux disease (GERD) were enrolled. After conventional endoscopy, Lugol solution was applied and biopsy specimens were obtained. Histological parameters including basal zone hyperplasia, papillary length and cellular infiltration were evaluated. The chi-square test with Yates' correlation was used for comparing discrete parameters between groups. However, Fisher's exact probability test was used where the expected frequencies were lower than 5. Wilcoxon's test for unpaired samples was preferred in cases of semi-quantitative parameters. Results The presence of HH along with more severe findings (0.01 P P Conclusion The presence of HH is correlated with more severe endoscopy findings, and predisposes for severe histological abnormality in cases of NERD.</p
Use of a hydrophilic coating wire reduces significantly the rate of central vein punctures and the incidence of pneumothorax in totally implantable access port (TIAP) surgery
No full textBackground: Insertion of a Totally Implantable Access Port (TIAP) can be performed either via Central Vein Puncture (CVP) or Brachiocephalic Vein Cut-down (venous section-VS). The primary success rate of TIAP implantation using VS rarely ever achieves 100%. The objective of this study was to describe a modified VS approach using a hydrophilic coated wire (TVS).
Methods: From 01.01.2015 to 31.12.2015, all patients receiving TIAP implantations were screened. During this time, all patients in whom the primary VS procedure was found to be unsuccessful were analysed.
Results: In 2015, 1152 patients had TIAP implantations performed by 24 different surgeons. Of these, 277 patients needed a second line rescue strategy either by CVP (n= 69) or TVS (n= 208). There were no statistically significant differences regarding demographics or indication for TIAP implantation between CVP and TVS. The operation time and the qualification of the operating surgeon between CVP and TVS did not differ significantly. After the introduction of the guidewire with a hydrophilic coated wire, the need for CVP decreased significantly from 12.7% to 8.8% (p< 0.0001). In patients receiving CVP as a second line rescue strategy, the incidence of pneumothorax (n= 3 patients (4.3%)) was significantly higher compared to patients with TVS as a second line rescue strategy (n= 1 patient (0.48%),p=0.02).
Conclusion: The use of a hydrophilic coated wire significantly decreased the number of CVP and the incidence of pneumothorax. TVS is a safe and successful second-line rescue strategy
The Histological and Immunohistochemical Aspects of Bile Reflux in Patients with Gastroesophageal Reflux Disease
No full textIntroduction. The pathogenesis of GERD is strongly
related with mixed acid and bile reflux. Benign and malignant
esophageal and gastric lesions have been associated with synergetic
activity between those parameters. Bile reflux causes reactive
gastropathy evaluated with Bile Reflux Index (BRI). The aim was to
investigate if the sequence: bile reflux-intestinal
metaplasia-GERD-esophagitis, is associated with
apoptotic/oncogenetic disturbances.
Materials/Methods. Fifteen asymptomatic subjects and
53 GERD patients underwent gastroscopy with biopsies. The
specimens examined histologically and immunohistochemically for
p53, Ki-67, Bax, and Bcl-2. Results.
Elevated BRI score detected in 47% (25/53) of patients with GERD
and in 13% (2/15) of controls (=0.02). Severe esophageal lesions were significantly more common
in BRI (+) patients (14/25) compared to BRI (−) ones (=0.0049). Immunohistochemical analysis did not show associations
between BRI score and biomarker expression.
Conclusions. Bile reflux gastropathy is
associated with GERD severity, but not with oncogene expression or
apoptotic discrepancies of the upper GI mucosa
Interleukin-1 associations in inflammatory bowel disease and the enteropathic seronegative spondylarthritis
No full textChallenges and adaptations in pancreatic cancer surgery during the COVID-19 pandemic in a high-volume center
No full textAbstract Background The COVID-19 pandemic affected healthcare systems worldwide, disrupting elective surgeries including those for cancer treatment. This study examines the effects of the pandemic on outcomes of pancreatic cancer surgeries at a specialized high-volume surgery center. Materials and methods This study compared surgical volume and outcomes of pancreas resections between the pre-pandemic (January 2019 to February 2020), early pandemic (March 2020 to January 2021), and late pandemic (February 2021 to December 2021) periods. Perioperative and postoperative data were retrospectively analyzed from a prospectively maintained database together with surgical complications, mortality rates, and hospital stays. Results There was no significant reduction in the number of pancreas resections performed during the pandemic. The rate of primary resectable tumors was significantly lower during the late pandemic phase (66% vs. 65.9% vs. 56.5%; P = 0.024), and subsequently application of neoadjuvant therapies increased in the late pandemic phase (26% vs. 25.4% vs. 33.8%; P = 0.079). The number of chemotherapy cycles were also higher during the late pandemic phase (P = 0.009). Surgical complication rates were higher during the late pandemic phase (47.8% vs. 45.6% vs. 56%; P = 0.043), but mortality rates remained low (30-day mortality: 1.6% vs. 1% vs. 3.7%, P = 0.116; 90-day mortality: 2.5% vs. 1.6% vs. 3.7%, P = 0.296). Conclusion Our results indicate effective management of pancreatic cancer despite the challenges presented by the pandemic. These findings suggest that centralized, specialized surgical centers can maintain high-quality care of patients with pancreatic cancer during crises like the COVID-19 pandemic. These findings underscore the importance of timely surgical interventions for cancer patients, even when the healthcare system is disrupted
