BMI1 encourages spermatogonia expansion through epigenetic repression regarding Ptprm

We conducted a prospective study to evaluate a new hemorrhoidal bleeding score (HBS).
All consecutive patients who had consulted between May 1, 2016, and June 30, 2017 for bleeding hemorrhoidal disease were prospectively assessed at a proctological department. The study was conducted in two stages. A first stage assessed the validity of the score on a prospective patient cohort. A second stage assessed the interobserver reproducibility of the score on another prospective cohort.
One hundred consecutive patients were studied (57 men, mean age 49.70 years). A positive association between HBS and surgery indication was found (p<0.001). A cut-off value of the score of 5 (≤ 5 vs. > 5) separated patients from surgical to medical-instrumental treatment with a sensitivity and specificity of 75.00% and 81.25% respectively. In the multivariate analysis, only HBS was significantly associated with the operative decision (OR 12.22). Prolapse was no longer significantly associated with the surgical indication. After a mean follow-up after treatment of 7 months, HBS improved statistically significantly (p<0.0001). For the reproducibility of the score, an additional 30 consecutive patients (13 men, mean age 53.14 years) were enrolled with an excellent agreement between two proctologists (kappa= 0.983).
HBS is sensitive, specific and reproducible. It can assess the severity of hemorrhoidal bleeding. It can discriminate between the most severe surgery-indicated patients, and does so in a more efficient way than the Goligher's prolapse score. It also allows to quantify the extent of change in hemorrhoidal bleeding after treatment.
HBS is sensitive, specific and reproducible. It can assess the severity of hemorrhoidal bleeding. It can discriminate between the most severe surgery-indicated patients, and does so in a more efficient way than the Goligher's prolapse score. It also allows to quantify the extent of change in hemorrhoidal bleeding after treatment.
This study aimed to evaluate the relationship between high-output stomas (HOSs), postoperative ileus (POI), and readmission after rectal cancer surgery with diverting ileostomy.
We included 302 patients with rectal cancer who underwent restorative resection with diverting ileostomy between January 2011 and December 2015. HOSs were defined as stomas with ≥ 2,000 mL/day output. We analyzed predictive factors for readmission of these patients.
Forty-eight patients (15.9%) had HOSs during the hospital stay, and 41 patients (13.6%) experienced POI. HOSs were strongly associated with POI (45.8% vs. 7.5%, P < 0.001). The all-cause readmission rate was 16.9%, with 19 (6.3%) and 20 (6.6%) experiencing ileus and acute kidney injury, respectively. HOSs (27.1% vs. 15.0%, P = 0.040) and POI (34.1% vs. 14.2%, P = 0.002) were associated with all-cause readmission, and POI was associated with readmission with ileus (17.1% vs. 4.6%, P = 0.007). POI was an independent risk factor for all-cause readmission (adjusted odds ratio [OR], 2.640; 95% confidence interval [CI], 1.162 to 6.001; P = 0.020) and readmission with ileus (adjusted OR = 3.869; 95% CI 1.387 to 10.792; P = 0.010).
POI was associated with readmission, particularly for subsequent ileus, in patients with diverting ileostomy. We should make efforts to reduce POI, such as strong control of HOSs, to prevent readmission.
POI was associated with readmission, particularly for subsequent ileus, in patients with diverting ileostomy. We should make efforts to reduce POI, such as strong control of HOSs, to prevent readmission.
Primary tumor location of colon cancer has been reported to affect the prognosis after curative resection. However, some reports suggested the impact was varied by tumor stage. This study analyzed the prognostic impact of the sidedness of colon cancer in Stages II, III, and liver metastasis after curative resection using propensity matched analysis.
Right-sided colon cancer was defined as a tumor located from cecum to splenic flexure, while any more distal colon cancer was defined as a left-sided colon cancer. Patients who underwent curative resection at Nara Medical University hospital between 2000 and 2016 were analyzed.
There were 110 patients with Stage II, 100 patients with Stage III, and 106 patients with liver metastasis. After propensity matching, 28 pairs with Stage II and 32 pairs with Stage III were identified. In the patients with Stage II, overall survival and recurrence-free survival were not significantly different for right- and left-sided colon cancers. In the patients with Stage III, overall survival and recurrence-free survival were significantly worse in right-sided colon cancer. In those with liver metastasis, overall survival of right-sided colon cancer was significantly worse than left-sided disease, while recurrence-free survival was similar. Regarding metachronous liver metastasis, the difference was observed only in the patients whose primary colon cancer was stage III. In each stage, significantly higher rate of peritoneal recurrence was found in those with right-sided colon cancer.
Sidedness of colon cancer had a significant and varied prognostic impact in patients with Stage II, III, and liver metastasis after curative resection.
Sidedness of colon cancer had a significant and varied prognostic impact in patients with Stage II, III, and liver metastasis after curative resection.
Anastomotic leak (AL) after a low pelvic anastomosis is a devastating complication, with short- and long-term morbidity and increased mortality. selleck Surgeons may employ various adjuncts in an attempt to reduce AL rates or mitigate their impact. These include the use of temporary diverting ileostomy (TDI), transanal or rectal tubes and pelvic drains. This questionnaire evaluates the preferences and routine use of these adjuncts in Australasian colorectal surgeons.
A cross-sectional survey was administered to Australian and New Zealand colorectal surgeons 20 Sept 2018. The study survey consisted of 15 questions exploring basic demographics and the number of rectal resections and ileal pouches performed in a 12-month period, along with the surgeon's preference for the use of diverting stomas, rectal tubes and pelvic drains.
There were 90 respondents to the survey (32%). Surgeons in Western Australia (71%) were more likely to use a mandatory TDI in colorectal extraperitoneal anastomoses than surgeons in Queensland (14%).