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Clinical Validity of Tumor-Informed Circulating Tumor DNA Analysis in Patients Undergoing Surgery of Colorectal Metastases.

BACKGROUND: Accurate biomarkers to monitor tumor load and response in metastatic colorectal cancer patients undergoing surgery could optimize treatment regimens. OBJECTIVE: This study aimed to explore the clinical validity of tumor-informed quantification of circulating tumor DNA in blood using ultradeep sequencing. DESIGN: Resection specimens from 53 colorectal cancer patients were analyzed for tumor-specific mutations in 15 genes. These mutations were used to measure the presence of circulating tumor DNA in preoperatively collected plasma samples using hybrid capture-based sequencing. Addi

Hyperactive Distal Colonic Motility and Recovery Patterns Following Right Colectomy: A High-Resolution Manometry Study.

BACKGROUND: Postoperative ileus results in morbidity, prolonged hospitalization, and increased health care expenditure. However, the underlying abnormalities in motility remain poorly understood. Recent high-resolution manometry studies demonstrated that the distal colon becomes hyperactive with a cyclic motor pattern postoperatively, but they did not track this activity beyond 16 hours after surgery. OBJECTIVE: This study used high-resolution manometry to evaluate distal colonic motility during the first 4 days after right-sided colectomy. DESIGN: An observational study of perioperative hig

Rectal Prolapse Pathological Features: Findings in Patients With Outlet Obstruction Treated With Stapled Transanal Rectal Resection.

BACKGROUND: Obstructed defecation syndrome is a common multifactorial disease for which treatment is based primarily on clinic presentation for the lack of reliable instrumental and anatomopathological criteria. OBJECTIVE: The study aimed to analyze the pathological findings of the resected rectal specimens after stapled transanal rectal resection in patients affected by outlet obstruction. DESIGN: Retrospective cohort study. SETTINGS: University hospital. PATIENTS: Patients who underwent rectal resection for obstructed defecation syndrome due to internal rectal prolapse were included. IN

Leaks From the Tip of the J-pouch: Diagnosis, Management, and Long-term Pouch Survival.

BACKGROUND: The standard of care for surgical treatment of ulcerative colitis is restorative proctocolectomy with ileal J-pouch. Leaks from the tip of the J-pouch are a known complication, but there is a paucity of literature regarding this type of leak. OBJECTIVE: We aimed to describe the diagnosis, management, and long-term clinical outcomes of leaks from the tip of the J-pouch at our institution. DESIGN: This was a retrospective study of a prospectively maintained pouch registry. SETTING: This study was conducted at a quaternary IBD referral center. PATIENTS: Patients included those wit

Idiopathic Myointimal Hyperplasia of the Mesenteric Veins Is a Peculiar Venous Ischemia That May Be Diagnosed Before Surgery.

BACKGROUND: Idiopathic myointimal hyperplasia of the mesenteric veins is a segmental ischemia associated with noninflammatory hyperplasia of the intimal smooth muscle of the mesenteric veins. Owing to its rarity, timely diagnosis is often difficult. OBJECTIVE: The goal of this study was to improve clinical practice in terms of the diagnosis of idiopathic myointimal hyperplasia of the mesenteric veins. DESIGN: This was a retrospective observational study. SETTINGS: This study was conducted in a single institution with case collection from clinical archives. PATIENTS: Data from 12 cases of i

Gracilis Muscle Interposition for Treatment of Complex Anal Fistula: Experience With 119 Consecutive Patients.

BACKGROUND: Treatment of complex anal fistula is challenging, often mandating multiple procedures. The gracilis muscle has been used to treat perineal fistulas and to repair perineal defects. OBJECTIVE: This study aims to report the results of gracilis muscle interposition for complex anal fistula, including prognostic factors for success. DESIGN: This is a retrospective analysis of a prospective database for patients who underwent gracilis muscle interposition for complex anal fistula from 2000 to 2018. SETTING: Patient demographics, operative data, and postoperative outcome were obtained

Crohn's Disease after Proctocolectomy and IPAA for Ulcerative Colitis.

BACKGROUND: Proctocolectomy with IPAA is considered curative for ulcerative colitis. However, signs of Crohn's disease can develop postoperatively in some cases. OBJECTIVE: Our aim was to document the postoperative diagnosis of Crohn's disease, to identify potential preoperative predictive factors, and to review the evolution of patients on treatment. DESIGN: This is a retrospective cohort study. SETTINGS: This study was conducted at a tertiary care center in Montreal, Canada. PATIENTS: A total of 301 patients underwent an IPAA for ulcerative colitis between 1985 and 2014. MAIN OUTCOME ME

Pharmaceutical Prevention and Management of Cardiotoxicity in Hematological Malignancies.

Modern treatment modalities in hematology have improved clinical outcomes of patients with hematological malignancies. Nevertheless, many new or conventional anticancer drugs affect the cardiovascular system, resulting in various cardiac disorders, including left ventricular dysfunction, heart failure, arterial hypertension, myocardial ischemia, cardiac rhythm disturbances, and QTc prolongation on electrocardiograms. As these complications may jeopardize the significantly improved outcome of modern anticancer therapies, it is crucial to become familiar with all aspects of cardiotoxicity and pr

Измерения мозжечного объема дифференцируют многочисленные склерозовые падающие от нефаллеров.

ВВЕДЕНИЕ: Мозг является обычным местом поражения у лиц с множественным склерозом (PwMS). Физологические и анатомические исследования выявили топографическую организацию мозжечка, включая функционально различимые области моторных и когнитивных функций. В этом исследовании к выборке PwMS и здоровых средств контроля был применен недавний алгоритм отсечения для изучения взаимосвязей между конкретными мозговыми районами, осенним состоянием и общими клиническими показателями моторных и когнитивных функций. МЕТОДЫ: Thirty-one ПВМС и twenty-nine Контроль по возрастному и половому признакам проходил ск

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… Briefly, the images were inhomogeneity-corrected using N4 [ 45 ] and rigidly registered to the 1 mm isotropic ICBM 2009c template [ 46 ] in MNI space using the ANT registration suite ( http://stnava.github.io/ANTs/ accessed on 8 November 2021). …

Risk Factors Associated with Durable Progression-Free Survival in Patients with Relapsed or Refractory Multiple Myeloma Treated with Anti-BCMA CAR T-cell Therapy.

PurposeB-cell maturation antigen (BCMA) chimeric antigen receptor (CAR) T-cell therapy results in high remission rates in patients with relapsed/refractory (R/R) multiple myeloma. However, the factors associated with prognosis following CAR T-cell therapy are unknown.Patients and methodsBetween July 1, 2018 and July 31, 2020, 61 patients with R/R multiple myeloma received anti-BCMA CAR T-cell therapy (Chictr.org number, ChiCTR1800017404). Step-wise multivariate Cox regression and competing risk analyses were conducted to identify poor prognosis-associated risk factors.ResultsSixty patients (98

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… Supplementary table S4 Univariate analysis for PFS for MM patients with ant-BCMA CAR-T therapy. Click here for additional data file. Supplementary table S5 Univariate analysis for CIR for MM patients with ant-BCMA CAR-T therapy Click here for additional data file. … Supplementary table S6 Univariate analysis for OS for MM patients with ant-BCMA CAR-T therapy. Click here for additional data file. Acknowledgments This work was supported by funding from the National Natural Science Foundation of China (grants 81730008, 81770201, to H. …

Подтверждение ретроактивно полученных значений рассеивания Т1 с 3D T1-weighted - изображения с клиническими и МРТ показателями инвалидности при множественном склерозе.

Количественное картирование Т1 является ценным методом оценки повреждений тканей при множественных повреждениях склероза (MS). Ранее мы ввели новую методологию преобразования анатомических 3D с высоким разрешением T1-weighted (T1W) изображения на параметрических картах Т1. Здесь мы соотносим патологию MS-повреждения с ретроактивным картированием T1 с клиническими и МРТ-метриками инвалидности и с коэффициентом переноса магнитного излучения (MTR). МЕТОДЫ: 38 Были изучены темы с повторным выделением MS (RRMS), что способствовало 587 Уникальные повреждения для анализа. Значения Т1 и ССО сопоставля

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… T1 maps, MTR, tissue segmentations, and anatomical 3DTFE images were registered to their respective FLAIR images using the Advanced Normalization Tools (ANTs) SyNQuick registration module ( https://github.com/ANTsX/ANTs/wiki ). …

Added value of post-mortem computed tomography (PMCT) to clinical findings for cause of death determination in adult "natural deaths".

PurposeThe aim of this study was to investigate whether post-mortem computed tomography (PMCT) provides additional information regarding the cause of death and underlying diseases in a general practitioners' (GP), out-of-hospital population.Methods and materialsBodies donated to our anatomy department between January 2014 and January 2018, who consecutively underwent a total body PMCT and had given permission for retrieval of their medical records during life, were included. PMCT scans were assessed by a radiologist and compared with the cause of death as stated in the medical records. Discrep

Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging - 2023.

Central Illustration : Position Statement on the Use of Myocardial Strain in Cardiology Routines by the Brazilian Society of Cardiology's Department Of Cardiovascular Imaging - 2023 Proposal for including strain in the integrated diastolic function assessment algorithm, adapted from Nagueh et al.67 Am: mitral A-wave duration; Ap: reverse pulmonary A-wave duration; DD: diastolic dysfunction; LA: left atrium; LASr: LA strain reserve; LVGLS: left ventricular global longitudinal strain; TI: tricuspid insufficiency. Confirm concentric remodeling with LVGLS. In LVEF, mitral E wave deceleration time

The Challenges of Outcomes-Based Contract Implementation for Medicines in Europe.

ObjectivesThe aim was to outline the challenges of implementing outcomes-based contracts (OBCs) in Europe.MethodsA scoping review was conducted, building on the searches of a previous systematic review and updating them for December 2017 until May 2021. The combined results were screened, based on inclusion and exclusion criteria. All identified studies published in the English language that described specific OBC schemes for medicines in European countries were included. Insights into the challenges of OBCs were extracted and analysed to develop a conceptual framework.ResultsTen articles from

Preoperative Identification of Lymph Node Metastasis in Colorectal Cancer Using Noninvasive Circulating Tumor DNA Methylation Signatures: Results From a Prospective Study.

BACKGROUND: Lymph node metastasis is important for the management and surgical procedures of patients with colorectal cancer. Preoperative identification of D3 metastasis could help evaluate the necessity of D3 lymphadenectomy. No adequate noninvasive method has been developed to detect the status of lymph nodes. OBJECTIVE: To establish a circulating tumor DNA methylation-based method to preoperatively identify lymph node metastasis and D3 metastasis in colorectal cancer. DESIGN: This is a prospective and paired diagnostic study. After an analysis of the genome-wide DNA methylation landscape

Cost-Effectiveness of Rubber Band Ligation Versus Hemorrhoidectomy for the Treatment of Grade III Hemorrhoids: Analysis Using Evidence From the HOLLAND Randomized Controlled Trial.

BACKGROUND: Hemorrhoids significantly impact quality of life and health care costs. Although rubber band ligation and hemorrhoidectomy are common treatments for grade III hemorrhoids, comparative cost-effectiveness data are limited. OBJECTIVE: To assess the cost-effectiveness and cost-utility of rubber band ligation compared to hemorrhoidectomy from a societal perspective within the context of the HOLLAND trial. DESIGN: Cost-effectiveness and cost-utility analyses using data from a multicenter, randomized controlled trial. SETTINGS: Ten Dutch hospitals participating in the HOLLAND trial. P

What Predicts Complete Response to Total Neoadjuvant Therapy in Locally Advanced Rectal Cancer?

BACKGROUND: Total neoadjuvant therapy in the treatment of stage II and III rectal cancer involves the administration of either induction or consolidation chemotherapy with chemoradiation before surgery. Total neoadjuvant therapy is associated with an increased complete response rate, which is defined as the proportion of patients who either had a pathological complete response after surgery or sustained a clinical complete response for at least 1 year under surveillance. OBJECTIVE: To identify the predictors of complete response to total neoadjuvant therapy and compare different diagnostic to

Understanding the Impact of Enhanced Recovery Programs on Social Vulnerability, Race, and Colorectal Surgery Outcomes.

BACKGROUND: Increasing social vulnerability, measured by the Social Vulnerability Index, has been associated with worse surgical outcomes. However, less is known about the impact of social vulnerability on patients who underwent colorectal surgery under enhanced recovery programs. OBJECTIVE: We hypothesized that increasing social vulnerability is associated with worse outcomes before enhanced recovery implementation, but that after implementation, disparities in outcomes would be reduced. DESIGN: Retrospective cohort study using multivariable logistic regression to identify associations of s

Short-term Outcomes of Elective Surgery Following Self-Expandable Metallic Stent and Neoadjuvant Chemotherapy in Patients With Left-Sided Colon Cancer Obstruction.

BACKGROUND: Colonic stenting reduces morbidity and stoma formation for left-sided colon cancer obstruction, and a prolonged interval between stenting and surgery with neoadjuvant chemotherapy administered might result in a lower stoma rate and tumor reduction. OBJECTIVE: The study aimed to evaluate the short-term outcomes of elective surgery following colonic stenting compared with elective surgery following colonic stenting and neoadjuvant chemotherapy in patients with left-sided colon cancer obstruction. DESIGN: This is a prospective multicenter cohort study. SETTINGS: This study was cond

Self-Expanding Metal Stents Do Not Adversely Affect Long-term Outcomes in Acute Malignant Large-Bowel Obstruction: A Retrospective Analysis.

BACKGROUND: Self-expanding metal stents as a bridge to surgery in acute malignant large-bowel obstruction has gained popularity. However, long-term oncologic outcomes have not been well established. OBJECTIVE: To investigate long-term oncologic outcomes of patients undergoing curative resection after the placement of a colonic stent compared with emergency surgery for acute malignant large-bowel obstruction. DESIGN: This is a retrospective study. SETTING: All patients presenting at 3 tertiary care centers between April 2002 and December 2012 with a diagnosis of complete malignant large-bowe