Background: Gallstone disease (GD) is no longer an exclusive condition of adulthood, and its prevalence is increasing in pediatric age. The management and the extent of the etiological investigation of GD in children and adolescents remains controversial. This study aimed to analyze the difficulties in the work-up and management of pediatric GD patients.
Methods: A retrospective study performed in a single tertiary center enrolled sixty-five patients with GD followed from January 2014 to June 2021. Patients were categorized conveniently according to their age at diagnosis: Group A (<10years, n=35) and Group B (≥10years, n=30). We analyzed demographic, clinical and laboratory data, ultrasonographic findings at presentation, therapeutics and complications.
Results: Symptoms were more frequent in patients >10years old (p=0.001). Cholecystectomy was performed in 31 patients (47.7%). A multivariate regression logistic model identified the age >10years (OR=6.440, p=0.005) and underlying entities (OR=6.823, p=0.017) as independent variables to perform surgery. Spontaneous resolution of GD was more common in children <2years old. A multivariate regression logistic model showed a trend for those >10years old to develop more complications. Two out of 18 patients were diagnosed with ABCB4 gene mutations in heterozygosity.
Conclusions: Decision-making on cholecystectomy remains challenging in asymptomatic patients. Identifying predictive factors for the development of complications has proven difficult. However, we found a trend toward the development of complications in individuals older than 10years.
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http://dx.doi.org/10.1016/j.gastrohep.2024.502228 | DOI Listing |
Hinyokika Kiyo
November 2024
The Department of Urology, Kyoto University Hospital.
We retrospectively analyzed the regions and perioperative outcomes associated with lymph node dissection in patients with prostate cancer. Of 543 patients who underwent robot-assisted radical prostatectomy for prostate cancer with or without lymph node dissection according to the modified D'Amico criteria, 333 (61.3%), 128 (23.
View Article and Find Full Text PDFAnn Biomed Eng
December 2024
Biomedical Engineering and Health Systems, KTH Royal Institute of Technology, Stockholm, Sweden.
Vacuum-assisted delivery (VAD) uses a vacuum cup on the fetal scalp to apply traction during uterine contractions, assisting complicated vaginal deliveries. Despite its widespread use, VAD presents a higher risk of neonatal morbidity compared to natural vaginal delivery and biomechanical evidence for safe VAD traction forces is still limited. The aim of this study is to develop and assess the feasibility of an experimental VAD testing setup, and investigate the impact of traction forces on fetal brain deformation.
View Article and Find Full Text PDFAnn Surg Oncol
December 2024
Department of Biliary-Pancreatic Surgery, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Background: Pancreatic enucleation is a reliable surgical method for treating benign and borderline pancreatic tumors; however, the incidence of postoperative pancreatic fistula (POPF) is high, especially when the tumor is close to the main pancreatic duct. This study aimed to reduce the incidence of pancreatic fistula by preoperative placement of pancreatic stents and to summarize our center's experience with this procedure.
Methods: From June 2020 to July 2023, patients diagnosed with benign or borderline pancreatic tumors at Renji Hospital were included.
Eur J Pediatr
December 2024
Dept. of Research and Development, SeysCentra, Malden, The Netherlands.
Unlabelled: Children with Noonan syndrome-like RASopathies are at increased risk for developing feeding problems due to comorbid organic impairments at an early age, such as gastrointestinal problems or other organicity. Their feeding problems can ultimately often be classified as avoidant/restrictive food intake disorder, for which behavioral therapy is the first-choice treatment. The research question in this study is whether this treatment leads to similar results as in children without these RASopathies.
View Article and Find Full Text PDFEur J Med Res
December 2024
Department of Geriatric Respiratory and Critical Care, Anhui Geriatric Institute, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui, China.
Background: This study aimed to develop predictive models with robust generalization capabilities for assessing the risk of pulmonary embolism in patients with tuberculosis using machine learning algorithms.
Methods: Data were collected from two centers and categorized into development and validation cohorts. Using the development cohort, candidate variables were selected via the Recursive Feature Elimination (RFE) method.
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