Publications by authors named "Nejo Joseph"
Background: Abdominal pain is the cardinal symptom of acute pancreatitis (AP), often requiring opioid therapy. This study aimed to investigate the dose-dependent relationship between opioid therapy and moderately severe or severe AP.
Methods: This was a post-hoc analysis of the prospective PAINAP database, which recruited patients with first-time AP from 118 centres across 27 countries between April-June 30, 2022.
Background: The use of minimally invasive (laparoscopic and robotic) pancreatoduodenectomy (PD) is being increasingly adopted despite the lack of hard evidence to support its utilisation. With recent randomised controlled trials (RCTs) comparing open pancreatoduodenectomy (OPD) with robotic or laparoscopic pancreatoduodenectomy (RPD or LPD), we undertook a network meta-analysis (NMA) comparing all 3 approaches to evaluate comparative outcomes.
Methods: A systematic search of MEDLINE, EMBASE, and Cochrane CENTRAL was conducted up to May 2024 and relevant RCTs were identified.
Aim: Poorer postoperative outcomes have been observed for patients admitted and operated on later in the week and over the weekend. This is thought to be related to temporal fluctuations in the quality of perioperative care. The aim of this work was to identify if the day of surgery influenced outcomes in a national cohort of colorectal cancer (CRC) resections.
View Article and Find Full Text PDFMethods: The review was conducted adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist.
Results: 15 studies including 147 patients (adult n = 71/paediatric n = 76) reported on CGM use post-TP (n = 42) and TPIAT (n = 105). 4 were randomized controlled trials and 10 observational studies.
Analgesia in paediatric acute pancreatitis: A scoping systematic review.
J Pediatr Gastroenterol Nutr
November 2024
Article Synopsis
- Acute pancreatitis (AP) is common in children, yet there is limited information on effective pain management strategies, which this scoping review aims to address.
- The review involved a systematic search of various medical databases, analyzing three studies focused on analgesic practices in pediatric AP with a total of 658 patients in North America.
- Findings indicate that opioids are predominantly used for pain relief, but there are knowledge gaps regarding factors affecting analgesic choices, their influence on recovery outcomes, and long-term pain management after discharge.
Aim: Lynch syndrome (LS) is estimated to affect 1-3.9% of patients with colorectal cancer (CRC). Testing for LS is important in determining management and establishing surveillance for "Lynch families".
View Article and Find Full Text PDFArticle Synopsis
- Intraductal oncocytic papillary neoplasms (IOPNs) are now identified as distinct from intraductal papillary mucinous neoplasms (IPMNs), with limited information on their recurrence and survival outcomes.
- A study analyzed outcomes of 415 patients with invasive IOPNs and adenocarcinoma from IPMN over a median of 6 years, finding similar recurrence rates between invasive IOPNs and ductal A-IPMN, but poorer survival compared to colloid A-IPMN.
- The research concluded that invasive IOPNs behave like aggressive cancers, with adjuvant chemotherapy showing no significant impact on recurrence rates in any of the studied cancer types.
Article Synopsis
- The study examines the outcomes of different precursor epithelial subtypes of adenocarcinoma from intraductal papillary mucinous neoplasms (A-IPMN), focusing on clinical features and recurrence patterns among patients who underwent pancreatic surgery.
- A total of 297 patients were analyzed, revealing that gastric, pancreatobiliary, and mixed subtypes have similar outcomes that are worse than the intestinal subtype in terms of recurrence and overall survival.
- The research found that adjuvant chemotherapy specifically improved survival rates in the pancreatobiliary subtype, but not in gastric, intestinal, or mixed subtypes, indicating a potential area for further exploration in treatment strategies.
Article Synopsis
- - The study investigates factors affecting long-term survival and recurrence in patients with adenocarcinoma from intraductal papillary mucinous neoplasms, focusing on those who had pancreatic resection between 2010 and 2017 in Europe and Asia.
- - It analyzed data from 288 patients, revealing that 48% experienced recurrence within about 98 months, with 35% remaining disease-free at the 5-year mark.
- - Key negative predictors for long-term disease-free survival included multivisceral resection, tumor location in the pancreatic tail, poor differentiation, lymphovascular invasion, and perineural invasion, leading to the development of a predictive model with a good success rate.
Background: Non-operative management of splenic injuries has significantly increased in the last decade with an increased emphasis on splenic preservation. This shift was assisted by increased availability of angioembolization, however, potential geographical variability in access exists in Aotearoa New Zealand (AoNZ). The aim of this study was to assess the management of splenic injury across AoNZ.
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- The study aimed to compare long-term cancer outcomes between patients with adenocarcinoma from intraductal papillary mucinous neoplasms (A-IPMN) and pancreatic ductal adenocarcinoma (PDAC) after surgical resection.
- Data revealed that A-IPMN patients generally had better survival rates and lower recurrence rates compared to PDAC patients, including longer median survival (39.0 months for A-IPMN vs. 19.5 months for PDAC).
- While A-IPMN showed higher rates of peritoneal and lung recurrence, PDAC had more locoregional recurrences, but overall, systemic recurrence rates were similar between the two groups.
Article Synopsis
- Pancreatic Ductal Adenocarcinoma (PDAC) shows diverse responses to treatment, with RNA gene sequencing revealing different tumor subtypes that influence patient survival.* -
- A review analyzed 15 studies with over 2700 patients, identifying two main tumor subtypes: classical (better outcomes) and basal-like (poorer outcomes), along with other specific subtypes affecting survival rates.* -
- While molecular subtyping can pinpoint high-risk patients, its clinical application is hampered by the high costs of RNA sequencing and the large amounts of data generated.*
Background: The temporal evolution of HRQoL and the importance of other PROs to patients, following resection for pancreatic and peripancreatic malignancy remains unexplored.
Methods: Patients undergoing pancreatic resection between 2021 and 2022 were enrolled from 2 UK HPB centres. Patients completed the EORTC QLQ-C30, QLQ-PAN26 tools and rated 56 PROs preoperatively (T1), at discharge (T2), 6-weeks (T3), 3-months (T4) and 6-months (T5) postoperatively.
Background: Aotearoa New Zealand (AoNZ) guidelines suggest surveillance colonoscopy should be carefully considered after age 75. The authors noted a cluster of patients presenting in their 8th and 9th decade of life with a new colorectal cancer (CRC) having previously been declined surveillance colonoscopy.
Methods: A 7-year retrospective analysis was performed of patients who underwent a colonoscopy aged between 71 and 75 years in the period between 2006 and 2012.