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Function: strpos
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Introduction: There are no established indications for Liver transplant (LT) in patients with a Klatskin tumour (KT) due to the differences in the published results.
Objective: To report on our patients who have non-disseminated unresectable KT and who were given a LT, and to compare results with those of patients who have had tumour resection and those who have not.
Patients And Method: We have treated 75 patients diagnosed with KT. The mean age was 62 + or - 11 years (range: 38-88 years) and 50 were males (66%). Twenty patients were inoperable. Of the 55 patients who underwent surgery: tumour resection (TR) was performed in 29 cases; there was no tumour dissemination in 11 unresectable cases and therefore these patients were added to the LT waiting list and the remaining 15 unresectable cases had tumour dissemination and remained on palliative treatment.
Results: In the LT group there was no postoperative mortality (during the first month) and the survival rate was 95%, 59% and 36% with a disease-free survival of 75%, 40% and 20%; whereas the patients given RT had a survival rate of 80%, 52% and 38% at 1, 3 and 5 years, with a disease-free survival of 65%, 35% and 19%, without any differences compared to the LT group. Patients with unresectable tumour left on palliative therapy had a lower survival than the unresectable who underwent LT (p<0.001).
Conclusions: In patients with non-disseminated unresectable KT, LT has a similar survival to that obtained in cases with resectable R0 liver resection. LT improves the survival rate achieved using palliative treatment in patients with non-disseminated unresectable KT.
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http://dx.doi.org/10.1016/j.ciresp.2009.11.005 | DOI Listing |
Asian J Endosc Surg
December 2024
Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan.
We report a case in which a giant hepatic cyst located at the hepatic hilum and compressing the inferior vena cava was safely treated laparoscopically with careful attention to hemodynamics in a difficult fenestrated resection in a patient with severe kyphosis. The anatomic location of the cyst was evaluated preoperatively via 3D reconstruction of computed tomography images to identify a site where safe fenestrated resection could be performed. This was challenging because the surgical field was narrow due to the presence of severe kyphosis, and there was a risk of damage to surrounding organs during fenestrated resection.
View Article and Find Full Text PDFJMIR Med Inform
December 2024
Department of Neurology, Beth Israel Deaconess Medical Center, Boston, US.
Background: Delirium is common in hospitalized patients and correlated with increased morbidity and mortality. Despite this, delirium is underdiagnosed, and many institutions do not have sufficient resources to consistently apply effective screening and prevention.
Objective: To develop a machine learning algorithm to identify patients at highest risk of delirium in the hospital each day in an automated fashion based on data available in the electronic medical record, reducing the barrier to large-scale delirium screening.
J Physician Assist Educ
December 2024
Chelsey Hoffmann, PA-C, MS, RD, Division of Pain Medicine, Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota.
Introduction: Physician Assistant/Associate (PA) clinicians face a major learning curve when transitioning from patient provider to PA educator. Furthermore, PA educators juggle multiple responsibilities including teaching, grading, advising, mentoring, interviewing, researching, writing, and more. Recently published research has indicated that 52.
View Article and Find Full Text PDFProsthet Orthot Int
December 2024
Clinic for Orthopedics, Heidelberg University Hospital, Heidelberg, Germany.
Background: Foot drop is a common condition for patients with upper motor neuron syndrome such as cerebral palsy (CP). This study aimed to investigate the effects of functional electrical stimulation (FES) on gait function, quality of life, and FES satisfaction in adults with CP and foot drop. To analyze effects over time, an observational, longitudinal study was performed.
View Article and Find Full Text PDFRom J Intern Med
December 2024
Department of Internal Medicine Goztepe Training and Research Hospital, Istanbul Medeniyet University, Kadikoy/Istanbul, Türkiye.
Introduction: The aim of the study was to assess the etiological distribution of patients with an erythrocyte sedimentation rate (ESR) over 100 mm/hour and to evaluate differences in demographic, comorbidity, laboratory characteristics, and clinical outcomes.
Methods: This retrospective observational clinical study included patients aged 18 years and older who were admitted to the internal medicine inpatient clinic between May 1, 2015 and June 1, 2021 and had ESR values above 100 mm/h. Demographic data, comorbidities, laboratory parameters, imaging studies, histopathological findings, microbiological and serological data, along with in-hospital and post-discharge mortality, were collected from the hospital's electronic database.
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