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Pancreatic insulinomas: Our 15-year surgical experience. 胰腺胰岛素瘤:我们 15 年的手术经验
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-16 DOI: 10.1177/00369330241289009
Furkan Karahan, Serkan Karaıslı, Arif Atay, Osman Nuri Dilek, Mehmet Hacıyanlı

Background: Insulinomas are rare endocrine tumors of the pancreas. The majority are benign, sporadic, and solitary. Surgery is the only curative treatment. In this study, we present our experiences with the perioperative management of sporadic and benign pancreatic insulinomas.

Methods: Patients who underwent surgery for pancreatic insulinoma in our clinic between 2008 and 2023 were retrospectively reviewed. Demographic data, preferred radiological methods, surgical procedures, and morbidity and mortality data were evaluated. Patients with malignant, invasive, or familial multiple endocrine neoplasia mutations were excluded from the study.

Results: Nineteen patients underwent surgery, with a median age of 49 years (range: 33-85). Symptoms related to hypoglycemia were the most commonly observed. The tumor location was identified preoperatively in 74% of cases using computed tomography. Palpation and intraoperative ultrasound identified the tumor location in 88% of patients. Enucleation (53%) were the most common surgical procedures. Pancreatic fistula occurred in three patients (17%). While serious morbidity was lower in patients who underwent enucleation, the rate of fistula formation was higher.

Conclusion: The accurate localization of insulinomas plays a crucial role in determining the appropriate surgical procedure. With high success rates and lower morbidity, enucleation is the recommended procedure for suitable patients.

背景:胰岛素瘤是一种罕见的胰腺内分泌肿瘤:胰岛素瘤是一种罕见的胰腺内分泌肿瘤。大多数是良性、散发性和单发的。手术是唯一可治愈的治疗方法。在本研究中,我们介绍了散发性和良性胰岛素瘤围手术期的治疗经验:方法:我们对 2008 年至 2023 年期间在本诊所接受胰岛素瘤手术的患者进行了回顾性研究。对人口统计学数据、首选放射学方法、手术方法以及发病率和死亡率数据进行了评估。研究排除了恶性、侵袭性或家族性多发性内分泌肿瘤突变的患者:19名患者接受了手术,中位年龄为49岁(33-85岁)。最常见的症状是低血糖。74%的病例在术前通过计算机断层扫描确定了肿瘤位置。88%的患者通过触诊和术中超声检查确定了肿瘤位置。最常见的手术方法是切除肿瘤(53%)。三名患者(17%)出现胰瘘。虽然接受去核手术的患者严重发病率较低,但瘘管形成率较高:结论:胰岛素瘤的准确定位对确定适当的手术方法至关重要。去核手术成功率高、发病率低,是适合患者的推荐手术方式。
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引用次数: 0
Efficacy and outcomes of a highland prehospital trauma response team. 高原院前创伤应对小组的功效和成果。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-05 DOI: 10.1177/00369330241277895
Reuben Burgess, Tom Mallinson, Luke Regan

Background and aims: The Scottish Highlands face unique prehospital care challenges due to population dispersity, mountainous terrain, seasonal weather, and higher trauma burden compared to the nearest Major Trauma Centres (MTCs) as highlighted by the Scottish Trauma Audit Group (STAG). Primary road/air transfer from scene to nearest designated MTC averages 1-5 hours, making prompt and informed utilisation of prehospital and in-hospital resources within the Highlands critical - comparative to other UK metropolitan regions where the trauma population majority lay within 20-45 minute transfer windows. This paper reviews the Highland pre-hospital immediate care and trauma (PICT) Team's trauma response through a retrospective review of PICT patient report forms (PRFs).

Methods and results: The analysis highlighted increased trauma response by the team in the nature of attended callouts and interventions utilised. Improving trends of patient outcomes, increased advanced analgesia and medico-surgical intervention utilisation, and relative increase of road traffic collision attendance and trauma-specific calls were noted.

Conclusion: Results highlight the Scottish Highlands' trauma burden and PICT's added value; with increased trauma response and improving outcomes. Despite the rate and ratio of major trauma not reducing PICT Team utilisation has, potentially led to fewer patients over narrower geography at later stages in emergency calls accessing the enhanced care doctor and advanced physician team than was achieved previously.

背景和目的:苏格兰高地由于人口分散、多山地形、季节性天气以及与最近的主要创伤中心 (MTC) 相比更高的创伤负担,面临着独特的院前护理挑战,苏格兰创伤审计小组 (STAG) 强调了这一点。从现场到最近的指定 MTC 的初级公路/空中转运平均需要 1-5 个小时,这使得高地院前和院内资源的及时和知情利用变得至关重要--与英国其他大都会地区相比,在这些地区,大多数创伤患者的转运时间在 20-45 分钟之内。本文通过对高地院前即时护理和创伤(PICT)小组的患者报告表(PRFs)进行回顾性审查,回顾了高地院前即时护理和创伤(PICT)小组的创伤响应情况:方法和结果:分析结果表明,该小组在出诊性质和干预措施方面的创伤应对能力有所提高。分析结果表明,患者治疗效果呈改善趋势,高级镇痛和医疗外科干预措施的使用率有所提高,道路交通事故出诊和特定创伤出诊相对增加:结果凸显了苏格兰高地的创伤负担和 PICT 的附加价值,即提高了创伤应对能力并改善了治疗效果。尽管重大创伤的发生率和比例没有降低,但 PICT 团队的使用率可能会导致在紧急呼叫的后期阶段,在较窄地域范围内获得强化护理医生和高级医师团队服务的病人数量比以前更少。
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引用次数: 0
A pilot study of performance enhancement coaching for newly appointed urology registrars. 对新任命的泌尿外科注册医师进行绩效提升辅导的试点研究。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 Epub Date: 2024-05-20 DOI: 10.1177/00369330241252715
Lilli Cooper, Karan Wadhwa, Mark Rochester, Chandra Shekhar Biyani, Ruth Doherty

Objectives: To assess the feasibility of performance enhancement coaching (PEC) for newly appointed Urology registrars (ST3s), specifically: whether the concept appealed, and which areas beyond technical skills acquisition were felt to be most relevant or useful.

Subjects and methods: All delegates on the Urology Bootcamp 2023 were invited to take part in an online survey before and after a 2-hour PEC workshop, collecting: basic demographic data, performance challenges, and the important aspects to include in, and consider with, a coaching programme. The workshop was delivered by a surgeon with a professional coaching qualification, to groups of four delegates at a time over 4 days. Ten pre-defined areas were offered during the session.

Results: On a scale of 1 (poor) to 10 (excellent), the 62 participants' overall health was reported as a median of 8/10 (physical) and 7/10 (mental). Anxiety during performance was the most common concern (63%) and was accompanied by a tremor in 55%. The next most popular concerns, with 19% of responses each, were: sleep, insufficient operative skill or expertise, and worry about relationships with trainers. The commonest topics discussed were 'the inner critic' (100%), 'autonomic modulation' (69%), 'not working, well' (13%) and 'optimising study' (6%). Seventy-seven per cent were unaware of PEC for practising surgeons. All respondents felt that they would benefit from PEC to some extent (80% ≥8/10 where 10/10 was 'very useful'), ideally at the ST3 level. Sixty-two percent of respondents said there should be a fee for trainees, whereas 38% thought it should be free and paid for by their training authorities.

Conclusion: The concept of PEC is acceptable to ST3 Urology trainees, with particular interest in techniques to mitigate negative self-talk and autonomic modulation techniques. Existing barriers to coaching for the surgical community would need to be addressed in designing an acceptable coaching programme.

目标:评估为新任命的泌尿外科注册医师(ST3)提供绩效提升辅导(PEC)的可行性,特别是:这一概念是否具有吸引力,以及在技术技能学习之外,哪些方面被认为是最相关或最有用的:所有参加 2023 年泌尿外科训练营的代表都被邀请在 2 小时 PEC 研讨班前后参加在线调查,调查内容包括:基本人口统计学数据、绩效挑战、辅导计划中应包含和考虑的重要方面。工作坊由一名具有专业教练资格的外科医生主讲,每次四名代表一组,为期四天。培训期间提供了十个预先确定的领域:在 1 分(差)到 10 分(优秀)的评分中,62 名学员的总体健康状况中位数为 8/10(身体)和 7/10(精神)。表演时的焦虑是最常见的问题(63%),55%的人伴有震颤。其次是睡眠、操作技能或专业知识不足以及担心与培训师的关系,各占 19%。最常见的话题是 "内心的批评"(100%)、"自主神经调节"(69%)、"工作不顺利"(13%)和 "优化学习"(6%)。77%的受访者不知道外科医生也可以进行 PEC。所有受访者都认为他们将在一定程度上受益于 PEC(80% ≥8/10,其中 10/10 为 "非常有用"),最好是在 ST3 级别。62% 的受访者认为,受训者应付费,而 38% 的受访者认为,应由培训机构免费支付:结论:ST3 级泌尿外科学员可以接受 "PEC "的概念,他们对减轻负面自言自语的技巧和自主神经调节技巧尤其感兴趣。在设计可接受的辅导计划时,需要解决外科群体在辅导方面的现有障碍。
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引用次数: 0
Scottish Cardiac Society 32nd Annual General Meeting Friday 27 - Saturday 28 October 2023. 苏格兰心脏病学会第 32 届年度大会 2023 年 10 月 27 日星期五至 28 日星期六。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 Epub Date: 2024-07-25 DOI: 10.1177/00369330231225892
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引用次数: 0
Optimising the use of colonoscopy to improve risk stratification for colorectal cancer in symptomatic patients: A decision-curve analysis. 优化结肠镜检查的使用,改善无症状患者的结直肠癌风险分层:决策曲线分析。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 Epub Date: 2024-07-23 DOI: 10.1177/00369330241266080
James Lucocq, Emma Barron, Heather Holmes, Peter D Donnelly, Neil Cruickshank

Objectives: Pressured healthcare resources make risk stratification and patient prioritisation fundamental issues for the investigation of colorectal cancer (CRC) in symptomatic patients. The present study uses machine learning algorithms and decision strategies to improve the appropriate use of colonoscopy.

Design: All symptomatic patients in a single health board (2018-2021) proceeding to colonoscopy to investigate for CRC were included. Machine learning algorithms (NeuralNetwork, randomForest, Logistic regression, Naïve-Bayes and Adaboost) were used to risk-stratify patients for CRC using demographics, symptoms, quantitative faecal immunochemical test (qFIT) and haematological tests. Decision curve analyses were performed to determine the optimal decision strategies.

Results: 3776 patients were included (median age, 65; M:F,0.9:1.0) and CRC was identified in 217 patients (5.7%). qFIT > 400 μg Hb/g was the most important variable (%IncMSE = 78.5). RandomForrest had the highest area under curve (0.91) and accuracy (0.80) for CRC. When utilising decision curve analysis (DCA), 30%, 46% and 54% of colonoscopies were saved at accepted CRC probabilities of 1%, 2% and 3%, respectively. RandomForrest modelling had superior net clinical benefit compared to default colonoscopy strategies.

Conclusions: MLA-derived decision strategies that account for patient and referrer risk preference reduce colonoscopy demand and carry net clinical benefit compared to default colonoscopy strategies.

目的:由于医疗资源紧张,对有症状的患者进行结直肠癌(CRC)检查时,风险分层和患者优先顺序成为基本问题。本研究利用机器学习算法和决策策略来改善结肠镜检查的合理使用:纳入单一卫生局(2018-2021 年)所有接受结肠镜检查以排查 CRC 的无症状患者。使用机器学习算法(NeuralNetwork、randomForest、Logistic回归、Naïve-Bayes和Adaboost),通过人口统计学、症状、粪便免疫化学定量检测(qFIT)和血液学检测对患者进行CRC风险分级。进行决策曲线分析以确定最佳决策策略:结果:共纳入了 3776 名患者(中位年龄为 65 岁;男女比例为 0.9:1.0),其中 217 名患者(5.7%)被确定为 CRC。RandomForrest 对 CRC 的曲线下面积(0.91)和准确率(0.80)最高。在使用决策曲线分析(DCA)时,当接受的 CRC 概率为 1%、2% 和 3% 时,分别有 30%、46% 和 54% 的结肠镜检查得以挽救。与默认的结肠镜检查策略相比,RandomForrest 模型具有更高的净临床效益:结论:与默认结肠镜检查策略相比,考虑到患者和转诊者风险偏好的 MLA 衍生决策策略可减少结肠镜检查需求,并带来净临床效益。
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引用次数: 0
Carbon footprinting and sustainability impact assessment in urological surgical practice - A systematic review. 泌尿外科手术实践中的碳足迹和可持续性影响评估--系统回顾。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.1177/00369330241280206
Mudassir Wani, Sanjeev Madaan, Gareth Brown, Martin Steggall, Ghulam Nabi

Objectives: To systematically synthesize existing reported literature calculating the carbon footprint (CFP) of urological surgical practice and identify opportunities for improving the environmental impact of urology surgical practice.

Methods: A systematic review was performed following PRISMA guidelines. The Cochrane, Embase, Ovid MEDLINE, and PubMed were searched between 1971 and 2023, with inclusion and exclusion criteria. The outcome measures were mapped across the included studies including assessment of risk of bias.

Results: A total of 345 studies with titles were identified from an initial search, however only 5 were included. Three studies compared singleuse with reusable cystoscopes concluded that single-use cystoscopes are non-inferior to reusable cystoscopes environmentally due to the carbon footprint associated with decontamination and repackaging. Similarly, in a single study, the CFP of single-use and reusable ureteroscopes is comparable. Lastly, a single study concluded that robotics-assisted surgery in prostate cancer may be a better option than other approaches in terms of environmental sustainability.

Conclusions: In conclusion, although minimally invasive (including robotic approaches) and endoscopic surgeries offer significant opportunities to improve healthcare we do need to consider the environmental impact. However, there is a paucity of good-quality literature to guide urological surgical practice to reduce the CFP and improve sustainability.

目的系统综合计算泌尿外科手术实践碳足迹(CFP)的现有文献报道,确定改善泌尿外科手术实践对环境影响的机会:方法: 按照 PRISMA 指南进行系统综述。方法:按照 PRISMA 指南进行了系统性综述,检索了 1971 年至 2023 年间的 Cochrane、Embase、Ovid MEDLINE 和 PubMed,并制定了纳入和排除标准。对纳入研究的结果指标进行了映射,包括偏倚风险评估:初步检索共发现 345 项有标题的研究,但只有 5 项被纳入。三项研究对一次性膀胱镜和可重复使用膀胱镜进行了比较,结论是一次性膀胱镜在环保方面并不优于可重复使用膀胱镜,因为去污和重新包装会产生碳足迹。同样,在一项研究中,一次性输尿管镜和可重复使用输尿管镜的 CFP 值相当。最后,一项研究认为,就环境可持续性而言,机器人辅助前列腺癌手术可能比其他方法更好:总之,尽管微创(包括机器人方法)和内窥镜手术为改善医疗保健提供了重要机会,但我们确实需要考虑其对环境的影响。然而,目前还缺乏高质量的文献来指导泌尿外科手术实践,以减少CFP并提高可持续性。
{"title":"Carbon footprinting and sustainability impact assessment in urological surgical practice - A systematic review.","authors":"Mudassir Wani, Sanjeev Madaan, Gareth Brown, Martin Steggall, Ghulam Nabi","doi":"10.1177/00369330241280206","DOIUrl":"https://doi.org/10.1177/00369330241280206","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically synthesize existing reported literature calculating the carbon footprint (CFP) of urological surgical practice and identify opportunities for improving the environmental impact of urology surgical practice.</p><p><strong>Methods: </strong>A systematic review was performed following PRISMA guidelines. The Cochrane, Embase, Ovid MEDLINE, and PubMed were searched between 1971 and 2023, with inclusion and exclusion criteria. The outcome measures were mapped across the included studies including assessment of risk of bias.</p><p><strong>Results: </strong>A total of 345 studies with titles were identified from an initial search, however only 5 were included. Three studies compared singleuse with reusable cystoscopes concluded that single-use cystoscopes are non-inferior to reusable cystoscopes environmentally due to the carbon footprint associated with decontamination and repackaging. Similarly, in a single study, the CFP of single-use and reusable ureteroscopes is comparable. Lastly, a single study concluded that robotics-assisted surgery in prostate cancer may be a better option than other approaches in terms of environmental sustainability.</p><p><strong>Conclusions: </strong>In conclusion, although minimally invasive (including robotic approaches) and endoscopic surgeries offer significant opportunities to improve healthcare we do need to consider the environmental impact. However, there is a paucity of good-quality literature to guide urological surgical practice to reduce the CFP and improve sustainability.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is it time to phase out digital rectal examination (DRE) in prostate cancer screening and diagnosis? 在前列腺癌筛查和诊断中逐步淘汰数字直肠检查 (DRE) 的时机是否成熟?
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.1177/00369330241279889
Danny Darlington Carbin, Sidharth Misra, Krishnaji Patil, Venkata Ramana Murthy Kusuma
{"title":"Is it time to phase out digital rectal examination (DRE) in prostate cancer screening and diagnosis?","authors":"Danny Darlington Carbin, Sidharth Misra, Krishnaji Patil, Venkata Ramana Murthy Kusuma","doi":"10.1177/00369330241279889","DOIUrl":"https://doi.org/10.1177/00369330241279889","url":null,"abstract":"","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ribosome-binding protein-1 (RRBP1) expression in prostate carcinomas and its relationship with clinicopathological prognostic factors. 前列腺癌中核糖体结合蛋白-1(RRBP1)的表达及其与临床病理预后因素的关系。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 Epub Date: 2024-05-06 DOI: 10.1177/00369330241245730
Didar Gursoy Kuzuluk, Ilke Evrim Secinti, Tugce Erturk, Sibel Hakverdi, Sadik Gorur, Dilan Ozatlan

Introduction: Studies in recent years have shown that ribosome-binding protein-1 (RRBP1) is expressed at high rates in many cancers and that it may be a potential prognostic biomarker. The objective of the present study is to determine the RRBP1 expression level in prostatic carcinoma and neighboring non-neoplastic prostate tissue, the relationship between its expression level with prognostic factors, and the role of RRBP1 in the development of prostate cancer.

Materials and methods: The study included 45 patients who were diagnosed with prostatic carcinoma and underwent radical prostatectomy in our center between the years 2010 and 2021. Pathology reports were reviewed. Mann-Whitney U test was used for the comparison of RRBP1 and GADPH values of the cases (control and tumoral tissue) between the primary tumor stage (pT) and Gleason score (GS) groups. Hierarchical regression analysis was used to explain the effective variables in explaining the RRBP1 value of the research cases.

Results: According to the Mann-Whitney U test, mean and median RRBP1-T values of the cases with GS ≥ 8 were detected to be statistically significantly higher than the mean and median RRBP1-T values of the cases with GS < 8.

Conclusion: We found out that RRBP1 was expressed at higher rates in patients with high GS and advanced-stage patients. This result indicated that RRBP1 expression may be important in predicting the prognosis of prostate carcinoma.

导言:近年来的研究表明,核糖体结合蛋白-1(RRBP1)在许多癌症中的表达率很高,它可能是一种潜在的预后生物标志物。本研究的目的是确定 RRBP1 在前列腺癌和邻近非肿瘤性前列腺组织中的表达水平、其表达水平与预后因素之间的关系以及 RRBP1 在前列腺癌发病中的作用:研究对象包括 2010 年至 2021 年期间在本中心确诊为前列腺癌并接受前列腺癌根治术的 45 例患者。对病理报告进行了审查。采用 Mann-Whitney U 检验比较原发肿瘤分期(pT)组和格里森评分(GS)组病例(对照组和肿瘤组织)的 RRBP1 和 GADPH 值。采用层次回归分析解释研究病例 RRBP1 值的有效变量:根据 Mann-Whitney U 检验,GS ≥ 8 的病例 RRBP1-T 均值和中位值在统计学上显著高于 GS 的病例 RRBP1-T 均值和中位值:我们发现,RRBP1在高GS患者和晚期患者中的表达率较高。这一结果表明,RRBP1的表达可能对预测前列腺癌的预后有重要作用。
{"title":"Ribosome-binding protein-1 (RRBP1) expression in prostate carcinomas and its relationship with clinicopathological prognostic factors.","authors":"Didar Gursoy Kuzuluk, Ilke Evrim Secinti, Tugce Erturk, Sibel Hakverdi, Sadik Gorur, Dilan Ozatlan","doi":"10.1177/00369330241245730","DOIUrl":"10.1177/00369330241245730","url":null,"abstract":"<p><strong>Introduction: </strong>Studies in recent years have shown that ribosome-binding protein-1 (RRBP1) is expressed at high rates in many cancers and that it may be a potential prognostic biomarker. The objective of the present study is to determine the RRBP1 expression level in prostatic carcinoma and neighboring non-neoplastic prostate tissue, the relationship between its expression level with prognostic factors, and the role of RRBP1 in the development of prostate cancer.</p><p><strong>Materials and methods: </strong>The study included 45 patients who were diagnosed with prostatic carcinoma and underwent radical prostatectomy in our center between the years 2010 and 2021. Pathology reports were reviewed. Mann-Whitney <i>U</i> test was used for the comparison of RRBP1 and GADPH values of the cases (control and tumoral tissue) between the primary tumor stage (pT) and Gleason score (GS) groups. Hierarchical regression analysis was used to explain the effective variables in explaining the RRBP1 value of the research cases.</p><p><strong>Results: </strong>According to the Mann-Whitney <i>U</i> test, mean and median RRBP1-T values of the cases with GS ≥ 8 were detected to be statistically significantly higher than the mean and median RRBP1-T values of the cases with GS < 8.</p><p><strong>Conclusion: </strong>We found out that RRBP1 was expressed at higher rates in patients with high GS and advanced-stage patients. This result indicated that RRBP1 expression may be important in predicting the prognosis of prostate carcinoma.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of sarcopenia on outcomes of bladder cancer undergoing radical cystectomy: A systematic review and meta-analysis. 肌肉疏松症对接受根治性膀胱切除术的膀胱癌患者预后的影响:系统回顾与荟萃分析。
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2024-05-01 Epub Date: 2024-02-29 DOI: 10.1177/00369330241234690
Fanyi Qin, Jiacheng Wu

Objective: To provide synthesized evidence on the association between sarcopenia and risk of mortality, recurrence and postoperative complications in patients with bladder cancer and undergoing radical cystectomy (RC).

Methods: Only studies with observational design that investigated the association between sarcopenia and outcomes of interest among patients with bladder cancer undergoing RC were included. The outcomes of interest were mortality, recurrence, and postoperative complications. The systematic search was conducted using three large databases, that is, PubMed, EMBASE, and Scopus. A random effects model was used for the analysis and pooled effect sizes were reported as odds ratio (OR) or hazards ratio (HR) along with 95% confidence intervals (CIs).

Results: A total of 21 studies with 4997 patients were included. Compared to non-sarcopenic subjects, those with sarcopenia had increased risk of all-cause mortality (HR 1.45, 95% CI: 1.32, 1.61), cancer-specific mortality (HR 1.74, 95% CI: 1.49, 2.03) and a lower recurrence free survival (HR 1.84, 95% CI: 1.30, 2.62). Patients with sarcopenia also had higher risk of developing complications within 90 days postoperatively (OR 1.77, 95% CI: 1.23, 2.55).

Conclusion: Sarcopenia among patients with bladder cancer and managed using RC is associated with adverse survival outcomes and an increased risk of postoperative complications.

摘要提供有关肌肉疏松症与接受根治性膀胱切除术(RC)的膀胱癌患者的死亡率、复发率及术后并发症风险之间关系的综合证据:仅纳入了对接受根治性膀胱切除术的膀胱癌患者中肌肉疏松症与相关结果之间关系进行调查的观察性设计研究。相关结果包括死亡率、复发率和术后并发症。系统性检索使用了三个大型数据库,即 PubMed、EMBASE 和 Scopus。分析采用随机效应模型,汇总效应大小以几率比(OR)或危险比(HR)以及 95% 置信区间(CI)的形式报告:结果:共纳入了 21 项研究,4997 名患者。与非肌肉疏松症患者相比,肌肉疏松症患者的全因死亡率(HR 1.45,95% CI:1.32,1.61)、癌症特异性死亡率(HR 1.74,95% CI:1.49,2.03)和无复发生存率(HR 1.84,95% CI:1.30,2.62)均有所增加。肌肉疏松症患者在术后90天内出现并发症的风险也更高(OR 1.77,95% CI:1.23,2.55):膀胱癌患者中的肌肉疏松症与不良的生存结果和术后并发症风险增加有关。
{"title":"Impact of sarcopenia on outcomes of bladder cancer undergoing radical cystectomy: A systematic review and meta-analysis.","authors":"Fanyi Qin, Jiacheng Wu","doi":"10.1177/00369330241234690","DOIUrl":"10.1177/00369330241234690","url":null,"abstract":"<p><strong>Objective: </strong>To provide synthesized evidence on the association between sarcopenia and risk of mortality, recurrence and postoperative complications in patients with bladder cancer and undergoing radical cystectomy (RC).</p><p><strong>Methods: </strong>Only studies with observational design that investigated the association between sarcopenia and outcomes of interest among patients with bladder cancer undergoing RC were included. The outcomes of interest were mortality, recurrence, and postoperative complications. The systematic search was conducted using three large databases, that is, PubMed, EMBASE, and Scopus. A random effects model was used for the analysis and pooled effect sizes were reported as odds ratio (OR) or hazards ratio (HR) along with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of 21 studies with 4997 patients were included. Compared to non-sarcopenic subjects, those with sarcopenia had increased risk of all-cause mortality (HR 1.45, 95% CI: 1.32, 1.61), cancer-specific mortality (HR 1.74, 95% CI: 1.49, 2.03) and a lower recurrence free survival (HR 1.84, 95% CI: 1.30, 2.62). Patients with sarcopenia also had higher risk of developing complications within 90 days postoperatively (OR 1.77, 95% CI: 1.23, 2.55).</p><p><strong>Conclusion: </strong>Sarcopenia among patients with bladder cancer and managed using RC is associated with adverse survival outcomes and an increased risk of postoperative complications.</p>","PeriodicalId":21683,"journal":{"name":"Scottish Medical Journal","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139997389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of virtual reality glasses applied during intrauterine device insertion on pain, anxiety and satisfaction: Randomized controlled study. 放置宫内节育器时使用虚拟现实眼镜对疼痛、焦虑和满意度的影响:随机对照研究。
IF 2.7 4区 医学 Q2 Medicine Pub Date : 2024-05-01 Epub Date: 2024-03-06 DOI: 10.1177/00369330241234688
Tuğba Öz, Nurdan Demirci

Background and aim: This study was carried out to determine the effect of the use of "virtual reality glasses," on anxiety, pain, and satisfaction level in order to reduce anxiety and pain during intrauterine device (IUD) insertion, which is a painful and stressful procedure for women and to divert attention to increase satisfaction.

Methods: This randomized controlled study in the gynecology clinic of a state hospital with 80 women who were accepted to participate in the study. Data were collected using structured patient information form, numerical pain rating scale, state-trait anxiety inventory, patient satisfaction evaluation form, and virtual reality glasses.

Results: Post-procedural pain scores in the control group after IUD application were higher than post-procedural pain in the virtual reality group. Measurements of post-procedure anxiety in the control group were higher than measurements of post-procedural in the virtual reality group. Satisfaction levels of women with virtual reality glasses during IUD insertion were also found to be high.

Conclusions: It was determined that the use of virtual reality glasses, one of the methods of distraction during IUD insertion, was effective in reducing pain and anxiety and increasing patient satisfaction.

背景和目的:本研究旨在确定使用 "虚拟现实眼镜 "对焦虑、疼痛和满意度的影响,以减轻妇女在宫内节育器(IUD)植入过程中的焦虑和疼痛,因为这对妇女来说是一个痛苦而紧张的过程,并转移注意力以提高满意度:这项随机对照研究在一家州立医院的妇科诊所进行,共有 80 名妇女被接受参与研究。采用结构化患者信息表、疼痛评分量表、状态-特质焦虑量表、患者满意度评估表和虚拟现实眼镜收集数据:结果:使用宫内节育器后,对照组的术后疼痛评分高于虚拟现实组。对照组的术后焦虑测量值高于虚拟现实组的术后焦虑测量值。使用虚拟现实眼镜的妇女在宫内节育器植入过程中的满意度也很高:结论:虚拟现实眼镜是宫内节育器植入过程中分散注意力的方法之一,使用虚拟现实眼镜能有效减轻疼痛和焦虑,提高患者满意度。
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引用次数: 0
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Scottish Medical Journal
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