1,721,149 research outputs found
Integrative medicine and surgery: what are the diet and supplement recommendations for someone with pancreatic cancer?
Full text linkLiver transplantation in patients with liver metastases from neuroendocrine tumors
No full textThe prevalence of metastatic disease in neuroendocrine tumors (NETs) is very high (60-80%) and cancer-related death among these patients is generally due to metastatic disease. Numerous treatment options for cure and disease control have been investigated for patients with neuroendocrine liver metastases (NELM). Despite the success of liver directed therapy on slowing tumor progression and palliating symptoms, the chance of being cured by liver resection is 40-50% and only roughly 20% of patients have potentially resectable disease. As such, there has been interest in liver transplantation (LT) as a potentially curative option for patients with unresectable disease. Several criteria have been proposed in order to balance long-term outcomes of patients with NELM and the problem of organ shortage including the Milan-NET criteria, the UNOS criteria and the ENETS guidelines. In the most representative studies, recurrence rate after LT has ranged from 30% to 60% with a 5-year OS ranging from 50% to 97%. This large variability is due to the retrospective nature of the studies available, which used different inclusion criteria. As such, outcomes and the prognostic factors associated with LT for NELM warrant further investigation
Gender Disparity in Surgical Research: An Analysis of Authorship in Randomized Controlled Trials
Full text linkIntroduction: Despite increasing female representation in medical fields, women remain underrepresented in high-impact authorship positions. This study examines gender disparities in authorship of randomized controlled trials in general surgery journals over the past 20 y. Methods: Utilizing PubMed and the Journal Citation Reports (Clarivate, 2023), we identified 8810 randomized controlled trials from 117 surgery journals, filtering down to 5694 studies for final analysis. Gender identification was performed using Genderize.io. Results: Results indicate that women accounted for 26.4% of first authorships and 18.7% of last authorships. Logistic regression revealed that a male last author significantly increases the likelihood of a male first author (odds ratio 2.68; 95% confidence interval 2.18-3.32). Over time, there is a positive trend in female authorship, with high correlation coefficients for both first (Spearman's correlation coefficient 0.916, P < 0.005) and last (Spearman's correlation coefficient 0.878, P < 0.005) authors. Interestingly, journal quartiles did not significantly influence the gender of first authors. Conclusions: These findings suggest persistent gender inequity in surgical research authorship, influenced by mentorship dynamics. The study underscores the need for strategies to enhance female representation in academic leadership to foster a more equitable scholarly environment. Limitations include reliance on Genderize.io for gender determination and the focus on general surgery journals, which may omit relevant studies from other domains. Overall, this research highlights incremental progress toward gender equality in surgical academia, advocating for continued efforts to close the gender gap
Management and outcomes among patients with mixed hepatocholangiocellular carcinoma: A population-based analysis
No full textBackground: We sought to define the management of mixed hepatocellular carcinoma-intrahepatic cholangiocarcinoma (HCC-ICC) as well as characterize short- and long-term outcomes of patients with mixed HCC-ICC. Methods: Patients diagnosed with HCC-ICC, HCC, or ICC between 2004 and 2015 were identified from the National Cancer Data Base using the International Classification of Diseases for Oncology codes. Short- and long-term outcomes were assessed using univariate and multivariate analyses. Results: Among 174 454 patients, 86.8% had HCC, 12.1% ICC, and 1.1% HCC-ICC. The incidence of lymphadenectomy was 55.6% among ICC patients vs 15.1% and 34.2% for HCC and HCC-ICC patients, respectively (P < 0.001). A 90-day mortality was comparable among patients with HCC (9.1%), ICC (8.8%), and HCC-ICC (10.5%) (all P > 0.2). While 42.0% of ICC patients received adjuvant chemotherapy, adjuvant chemotherapy among HCC and HCC-ICC patients was 13.1% and 27.4%, respectively (P < 0.001). A 5-year survival was 43.5% (95% CI, 42.5-44.5), 33.3% (95% CI, 31.4-35.3), 34.4% (95% CI, 29.1-39.8) for HCC, ICC, and HCC-ICC patients, respectively. Conclusion: Patients who underwent resection of mixed HCC-ICC had a prognosis that was comparable to ICC, yet worse than HCC. Utilization of lymphadenectomy and adjuvant therapy were low. HCC-ICC remains a rare disease with a guarded prognosis that should be treated in a multidisciplinary setting
Breaking barriers: Analysing the professional landscape for female gynaecological surgeons in Italy
No full textObjective: To examine the status of female gynaecological surgeons in Italy in terms of discriminatory practices and the availability of opportunities for improvement within the operating theatre. Methods: This study is a subanalysis of a comprehensive 83-item questionnaire, administered to 3242 female surgeons across various specialties from 1 November to 31 December 2020. This study focuses specifically on 219 female gynaecological surgeons in order to explore their unique experiences and challenges in surgical practice. Main outcome measures: Data concerning subjective satisfaction of respondents were collected. Satisfaction was evaluated using a five-point Likert scale. Data are presented using mean, median or frequency. Results: This subanalysis included 207 respondents. Among the respondents, 47 % reported that they had children, while 31 % had decided not to have children for professional reasons. Nearly half of the respondents (42 %) were trainees. Despite a considerable workload (mean working week of 45 h), 96 % of the respondents reported spending less than half of their working time in the operating theatre. They performed a median of two operations per week, compared with five operations for their male counterparts. Despite challenges, 65 % expressed a commitment to their career path. Conclusions: Efforts to address gender bias, promote work–life balance, and enhance female leadership representation are essential. These findings emphasize the need for systemic changes to create a supportive environment for female gynaecologists. Further research with broader sampling is warranted to fully understand and address these challenges
Outcomes of polytetrafluoroethylene-covered stent versus bare-metal stent in the primary treatment of severe iliac artery obstructive lesions Presented at the Forty-third Annual Symposium of the Society for Clinical Vascular Surgery, Miami, Fla, March 29-April 2, 2015
No full textLiver Resection for Advanced Intrahepatic Cholangiocarcinoma: A Cost-Utility Analysis
No full textData on cost-effectiveness and efficacy of hepatic resection (HR) for advanced intrahepatic cholangiocarcinoma (ICC) are lacking. We sought to estimate the cost-effectiveness of upfront HR resulting in an R1 resection (strategy A) relative to initial systemic chemotherapy (sCT) followed by possible curative HR (strategy B) for patients with advanced ICC
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