Patient-reported Outcome Measure (PROM) Rand-36-item Health Survey for Gallstone Disease Patients Five Years Following Surgery: A Prospective Randomized Study.

Background/aim: There are no studies assessing the long-term quality of life (QoL) following three-dimensional laparoscopy cholecystectomy (3D-LC) in patients with cholelithiasis (Chole).

Patients And Methods: A cohort of 200 patients with Chole were randomized into 3D-LC or minilaparotomy cholecystectomy (MC) groups. RAND-36 survey was performed before randomization, four weeks and five years postoperatively.

First RAND-36-Item Health Survey in Three-dimensional Laparoscopy Cholecystectomy: A Prospective Randomized Study.

Background/aim: National healthcare organizers require feedback from patients to improve medical treatment methods. Three-dimensional laparoscopy cholecystectomy (3D-LC) is a modern technique in surgery. However, there are no studies with patient feedback from validated questionnaires assessing the postoperative treatment results in 3D-LC.

Three-dimensional Laparoscopy (3D-LC) Minilaparotomy (MC) in Cholecystectomy: A Prospective Randomized Study.

Background/aim: Three-dimensional laparoscopy (3D-Lap) is a recent innovation in surgery. The 3D-Lap is rarely used in cholecystectomy (3D-LC) and there are no prospective studies assessing advantages and disadvantages of 3D-LC versus minilaparotomy (MC) in cholecystectomy.

Patients And Methods: This was a prospective clinical study conducted in the Kuopio University Hospital, including 200 patients with symptomatic cholelithiasis who were randomized into 3D-LC (n=112) or MC (n=88) groups.

Expression Levels of microRNAs miR-93 and miR-200a in Pancreatic Adenocarcinoma with Special Reference to Differentiation and Relapse-Free Survival.

Objectives: Protein levels of the transcription factor nuclear factor erythroid-derived 2-like 2 (Nrf2) and its inhibitor Kelch-like ECH-associated protein 1 (Keap1) have been proposed as prognostic factors in pancreatic ductal adenocarcinomas (PDACs). These cellular redox-state-regulating enzymes are targeted by several microRNAs, including miR-93 and miR-200a.

Methods: We assessed mRNA levels of Nrf2 and Keap1 and tissue expression of miR-93 and miR-200a in 51 patients with surgically treated PDAC.

Gallstone Patients with Enhanced Oxidative Stress Biomarker Superoxide Dismutase (SOD1) Plasma Levels Have Significantly Lower Number of Postoperative Analgesic Oxycodone Doses: A Prospective Study with Special Reference to Cancer Patients.

Background/aim: Oxidative stress biomarker superoxide dismutase (SOD1) plasma levels in operated gallstone patients versus cancer patients are unknown. In addition, the number of analgesic doses during the first 24 h postoperatively (NAD) in gallstone patients operated with laparoscopic cholecystectomy (LC) or minicholecystectomy (MC) is unreported. The aim of the study was to determine a correlation between the plasma SOD1 levels in the LC and MC patients versus cancer patients.

Patients with Increased Levels of the Oxidative Stress Biomarker SOD1 Appear to Have Diminished Postoperative Pain After Midline Laparotomy: A Randomised Trial with Special Reference to Postoperative Pain Score (NRS).

Background/aim: The levels of the oxidative stress biomarker superoxide dismutase (SOD1) in plasma in relation to pain at rest 24 hours after (NRS) midline laparotomy in patients with rectus sheath block (RSB) analgesia is unknown.

Patients And Methods: Initially, 56 patients (39 with cancer), each with an intravenous oxycodone pump as patient-controlled analgesia, were randomized to four groups: control group, no RSB (n=12), single-dose (n=16), repeated-dose (n=12) and continuous infusion (n=16) of RSB analgesia. The plasma levels of SOD1 were measured directly before, immediately after and 24 hours after surgery.

Plasma Glutathione Peroxidase (GPX1) Levels and Oxidative Stress in Gallstone Patients Operated with Two Different Cholecystectomy Techniques: A Randomized Study with Special Reference to Cancer Patients.

Background/aim: The plasma glutathione peroxidase (GPX1) levels in gallstone patients operated with laparoscopic cholecystectomy (LC) or minicholecystectomy (MC) versus cancer patients is unknown.

Patients And Methods: Initially, 114 patients with symptomatic gallstone disease were randomized into LC (n=53) or MC (n=61) groups. Plasma levels of C-reactive protein (hs-CRP) and the oxidative stress marker GPX1 were measured at three time points; before (PRE), immediately after (POP1) and 6 hours after operation (POP2).

Does Rectus Sheath Block Analgesia Alter Levels of the Oxidative Stress Biomarker Glutathione Peroxidase: A Randomised Trial of Patients with Cancer and Benign Disease.

Aim: To evaluate whether the overall satisfaction, as measured by numeric rating scale (NRS), regarding rectus sheath block (RSB) analgesia is associated with the plasma glutathione peroxidase (GPX1) level. The second end-point of the study was to evaluate the differences in GPX1 levels in patients with and without RSB analgesia, with special emphasis on benign or malign disease status.

Patients And Methods: Initially, 56 patients were randomized to the placebo group (n=12) and to one of three active RSB analgesia groups: single-dose (n=16), repeated-dose (n=12) and continuous infusion (n=16) groups.

A randomised clinical trial of routine versus selective CT imaging in acute abdomen: Impact of patient age on treatment costs and hospital resource use.

Objectives: To evaluate the impact of patient age on hospital resource use and treatment costs of acute abdominal pain (AAP).

Materials And Methods: A total of 300 adult patients with AAP were randomised to either computed tomography (CT, n=150) or selective imaging practice (SIP, n=150) groups. Final analysis included 254 patients, 143 (42 patients ≥65years) in the CT and 111 (32 patients ≥65years) in the SIP group.

Improvement in the quality of life following cholecystectomy: a randomized multicenter study of health status (RAND-36) in patients with laparoscopic cholecystectomy versus minilaparotomy cholecystectomy.

Purpose: The assessment of the quality of life (QoL) in minilaparotomy cholecystectomy (MC) versus laparoscopic cholecystectomy (LC) with the ultrasonic dissection in both groups has not been addressed earlier.

Methods: Initially, 109 patients with non-complicated symptomatic gallstone disease were randomized to undergo either MC (n = 59) or LC (n = 50). RAND-36 survey was conducted preoperatively and at 4 weeks and 6 months postoperatively.

The plasma 8-OHdG levels and oxidative stress following cholecystectomy: a randomised multicentre study of patients with minilaparotomy cholecystectomy versus laparoscopic cholecystectomy.

Objective: The aim of the study was to evaluate the role of 8-OHdG (8-hydroxy-2'-deoxyguanosine) detecting oxidative stress response following cholecystectomy in a randomised multicentre study of patients with minilaparotomy cholecystectomy (MC) versus laparoscopic cholecystectomy (LC).

Methods: Initially, 106 patients with non-complicated symptomatic gallstone disease were randomised into MC (n = 56) or LC (n = 50) groups. Plasma levels of the oxidative stress marker 8-OHdG measured at three time points; before (PRE), immediately after (POP1) and 6 h after operation (POP2).

Does the Rectus Sheath Block Analgesia Reduce the Inflammatory Response Biomarkers' IL-1ra, IL-6, IL-8, IL-10 and IL-1β Concentrations Following Surgery? A Randomized Clinical Trial of Patients with Cancer and Benign Disease.

Aim: To evaluate whether the post-surgery placement of the rectus sheath block analgesia (RSB) reduces the inflammatory response following surgery. The main hypothesis of our study was to find any correlation between patients' pain experience, numeric rating scale (NRS) postoperatively and concentrations of inflammatory response biomarkers, such as interleukin-1 receptor antagonist (IL-1ra), IL-6, IL-8, IL-10, IL-1β, in patients with benign disease and cancer.

Patients And Methods: Initially, 46 patients with midline laparotomy were randomized to the placebo group (n=11) and to one of the three active groups; single-dose (n=12), repeated-dose (n=12) and continuous infusion (n=11) RSB analgesia groups.

Does Post-Surgery Placement of Rectus Sheath Block Analgesia Alter the Oxidative Stress Biomarker 8-OHdG Concentrations: A Randomised Trial of Patients with Cancer and Benign Disease.

Background: The aim of the study was to evaluate whether the post-surgery placement of the rectus sheath block (RSB) analgesia could alter the oxidative stress response. The main hypothesis of our study was to find some correlation between patients' pain experience, numeric rating scale (NRS) and the concentration of oxidative stress marker, 8-OHdG (8-hydroxy-2'-deoxyguanosine) in patients with benign disease and cancer.

Materials And Methods: Initially, 46 patients were randomized to the placebo group (n=11) and to one of the three active groups; single-dose (n=12), repeated-dose (n=12) and continuous infusion (n=11) RSB analgesia group.

Inflammatory response to surgical trauma in patients with minilaparotomy cholecystectomy versus laparoscopic cholecystectomy: a randomised multicentre study.

Objective: The aim of the study was to evaluate the inflammatory response to surgical trauma in minilaparotomy cholecystectomy (MC) compared to laparoscopic cholecystectomy (LC). Assessment of inflammatory response to surgical trauma in MC has not been addressed properly. Therefore, we investigated five interleukins (IL) and C-reactive protein (CRP) in MC versus LC group in a prospective randomised trial.

Randomized Multicenter Trial Comparing Glue Fixation, Self-gripping Mesh, and Suture Fixation of Mesh in Lichtenstein Hernia Repair (FinnMesh Study).

Objective: Three different mesh fixation techniques were compared to find out how to perform a safe and cost-effective open inguinal hernioplasty in day-case setting with the best outcomes with regard to chronic pain.

Summary Background Data: Mesh fixation method may influence on the incidence of chronic pain after Lichtenstein hernioplasty.

Methods: Lichtenstein hernioplasty was performed under local anesthesia in 625 patients as day-case surgery in 8 Finnish hospitals.

A randomized multicenter study of minilaparotomy cholecystectomy versus laparoscopic cholecystectomy with ultrasonic dissection in both groups.

Objective: Ultrasonic dissection (UsD) has been used in laparoscopic cholecystectomy (LC), though it is not the golden standard technique. Applying UsD to cholecystectomy by minilaparotomy (MC) is less common and there are no prospective randomized trials comparing these two techniques. Therefore, we conducted the present study to investigate the use of the UsD in the MC versus the LC procedure.

History-taking and the Usefulness Index in the diagnosis of functional dyspepsia.

Background: The primary diagnosis of functional dyspepsia (FD) is made on the basis of typical symptoms and by excluding organic gastrointestinal diseases that cause dyspeptic symptoms. However, there is difficulty reaching a diagnosisin FD.

Objectives: To assess the efficiency of the Usefulness Index (UI) test and history-taking in diagnosing FD.

A prospective, randomized multicenter study comparing conventional laparoscopic cholecystectomy versus minilaparotomy cholecystectomy with ultrasonic dissection as day surgery procedure--1-year outcome.

Objective: The long-term outcome between laparoscopic cholecystectomy (LC) and minilaparotomy cholecystectomy (MC) with ultrasonic dissection (UsD) technique has not been compared in randomized trials. Therefore, we investigated the outcome after conventional LC and MC with UsD in 78 patients (ClinicalTrials.gov Identifier: NCT0172340).

The impact of age and sex adjusted body mass index (ISO-BMI) in obese versus non-obese children and adolescents with cholecystectomy.

Background: The impact of the age and sex adjusted body mass index (ISO-BMI) in the obese vs. non-obese children and adolescents with cholecystectomy for cholelithias is rarely reported.

Patients And Methods: The national database was searched for cholecystectomies performed in paediatric patients between 1997 and 2011, and the 59 paediatric and adolescent patients having cholecystectomy in the Kuopio University Hospital district were divided in two groups by age and sex adjusted BMI (ISO-BMI) using the cut-off point of overweight (ISO-BMI 25 kg/m(2)) based on the Finnish growth standards.

Seasonal variations of acute appendicitis and nonspecific abdominal pain in Finland.

Aim: To investigate whether seasonal changes had an effect on the incidence of acute appendicitis (AA) or nonspecific abdominal pain (NSAP).

Methods: We carried out a national register study of all patients with a hospital discharge diagnosis of AA and acute NSAP in Finland. Data were analyzed for the whole country and correlated to seasonal and weather parameters (temperature, humidity).

The need for surgery in acute abdominal pain: a randomized study of abdominal computed tomography.

Aim: To assess the need for surgical treatment in patients with acute abdominal pain in a prospective randomized study.

Patients And Methods: Initially 203 patients with acute abdominal pain were randomized to the routine abdominal computed tomography CT (rCT, n=118), or selective abdominal CT group (sCT, n=85) over a period of 16 months. Ninety-three of the randomized patients (45.

Long-term outcome of patients with acute non-specific abdominal pain compared to acute appendicitis: prospective symptom audit after two decades.

Background: Non-specific abdominal pain (NSAP) and acute appendicitis (AA) are the two most frequent diagnoses of acute abdomen in the emergency wards. The long-term morbidity, mortality and quality of life of the patients with NSAP compared to AA are unknown.

Methods: The study group consisted of 186 patients with acute NSAP compared to 147 patients with AA initially treated during 1985-1986.

Statin use in patients with acute pancreatitis and symptomatic gallstone disease.

Objective: The long-term use of statins may be associated with a decreased risk for gallstones and biliary-induced acute pancreatitis (AP). Our aim was to study the relationship of statin use and outcome of AP.

Methods: We investigated the records of 461 consecutive patients with AP and 1140 patients with symptomatic gallstones during 2008 to 2010.

Strong claudin 5 expression is a poor prognostic sign in pancreatic adenocarcinoma.

We investigated the expression of claudin 5 in 88 ductal adenocarcinomas of the pancreas. The results were correlated with patient prognosis, with claudin 5 expression in blood vessels, with the expression level of bcl2 and bax and with apoptosis. Claudin 5 expression was detected in 24 (38%) cases.