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Validation of the updated Bosniak classification (2019) in pathologically confirmed CT-categorised cysts. 在病理确诊的 CT 分类囊肿中验证更新的 Bosniak 分类(2019)。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-02-01 Epub Date: 2023-12-18 DOI: 10.1177/00369330231221235
James Lucocq, Leo Morgan, Ketan Rathod, Magdalena Szewczyk-Bieda, Ghulam Nabi

Introduction: The updated Bosniak classification in 2019 (v2019) addresses vague imaging terms and revises the criteria with the intent to categorise a higher proportion of cysts in lower-risk groups and reduce benign cyst resections. The aim of the present study was to compare the diagnostic accuracy and inter-observer agreement rate of the original (v2005) and updated classifications (v2019).

Method: Resected/biopsied cysts were categorised according to Bosniak classifications (v2005 and v2019) and the diagnostic accuracy was assessed with reference to histopathological analysis. The inter-observer agreement of v2005 and v2019 was determined.

Results: The malignancy rate of the cohort was 83.6% (51/61). Using v2019, a higher proportion of malignant cysts were categorised as Bosniak ≥ III (88.2% vs 84.3%) and a significantly higher percentage were categorised as Bosniak IV (68.9% vs 47.1%; p = 0.049) in comparison to v2005. v2019 would have resulted in less benign cyst resections (13.5% vs 15.7%). Calcified versus non-calcified cysts had lower rates of malignancy (57.1% vs 91.5%; RR,0.62; p = 0.002). The inter-observer agreement of v2005 was higher than that of v2019 (kappa, 0.70 vs kappa, 0.43).

Discussion: The updated classification improves the categorisation of malignant cysts and reduces benign cyst resection. The low inter-observer agreement remains a challenge to the updated classification system.

导言:2019 年更新的 Bosniak 分类(v2019)解决了成像术语模糊的问题,并修订了标准,旨在将更高比例的囊肿归入低风险组,减少良性囊肿切除。本研究旨在比较原始分类标准(v2005)和更新后的分类标准(v2019)的诊断准确性和观察者之间的一致率:根据波什尼亚克分类法(v2005 和 v2019)对切除/活检的囊肿进行分类,并参照组织病理学分析评估诊断准确性。结果表明,v2005 和 v2019 的观察者间一致性良好:结果:队列中的恶性肿瘤率为83.6%(51/61)。使用 v2019,与 v2005 相比,恶性囊肿被归类为 Bosniak ≥ III 的比例更高(88.2% vs 84.3%),被归类为 Bosniak IV 的比例明显更高(68.9% vs 47.1%;p = 0.049)。钙化与非钙化囊肿的恶性率较低(57.1% vs 91.5%;RR,0.62;p = 0.002)。v2005的观察者间一致性高于v2019(kappa, 0.70 vs kappa, 0.43):讨论:更新后的分类改进了恶性囊肿的分类,减少了良性囊肿的切除。观察者之间的一致性较低仍是更新版分类系统面临的挑战。
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引用次数: 0
Abstract. 摘要
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-12-27 DOI: 10.1177/00369330231222798
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引用次数: 0
Can inflammatory indexes predict the spontaneous passage of common bile duct stones? 炎症指标能否预测胆总管结石的自发通过?
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-11-01 Epub Date: 2023-09-11 DOI: 10.1177/00369330231186434
İrfan Küçük, Yusuf Yazgan, Ersin Tural, İdris Yıldırım, Tuğba Akbaş Şimşek, Başak Çakır Güney, Mustafa Kaplan

Objectives: We aimed to determine whether inflammatory indexes (II), including the neutrophil-lymphocyte ratio (NLR), the C-reactive protein (CRP) to albumin ratio (CAR), the CRP-lymphocyte ratio (CLR), and the systemic immune-inflammation index (SIII) can be diagnostic for common bile duct stones (CBDSs) excretion before endoscopic retrograde cholangiopancreatography (ERCP).

Backgrounds: Because of the spontaneous clearance, it is mandatory to ascertain the presence of CBDSs before ERCP.

Methods: Retrospectively, we evaluated two groups. Group A included 96 records in which CBDSs existed in magnetic resonance cholangiopancreatography (MRCP) and ERCP. Group B included 36 records in which CBDSs existed in MRCP but not ERCP. IIs were calculated on presentation and before ERCP.

Results: Stone detection in ERCP had a 3.992-fold (95% 1.769-9.007) higher probability with a stone larger than 3.25 mm in MRCP. Before ERCP, CAR, and CLR values were higher in group A than in group B (3.88 [1.25-14.14] and 1.24 [0.50-9.66], p = 0.027 versus 8.79 [2.19-35] and 2.67 [1.02-20.05], p = 0.029, respectively). Higher CRP, CAR, and CLR values were considered significant for detecting a stone in ERCP (AUC: 0.627 [0.519-0.739], 0.625 [0.513-0.737], and 0.624 [0.514-0.734], respectively).

Conclusion: Low CRP, CAR, and CLR values might associate with the spontaneous migration of CBDS.

目的:我们旨在确定炎症指标(II),包括中性粒细胞-淋巴细胞比率(NLR), c反应蛋白(CRP)与白蛋白比率(CAR), CRP-淋巴细胞比率(CLR)和全身免疫炎症指数(SIII)是否可以在内镜逆行胆管造影术(ERCP)前诊断胆总管结石(cbds)排泄。背景:由于自发性清除,在ERCP前必须确定cbds的存在。方法:回顾性评价两组患者。A组包括96例磁共振胆管造影(MRCP)和ERCP中存在cbds的记录。B组包括36例MRCP存在cbds而ERCP不存在cbds的记录。在提交时和ERCP前计算i。结果:MRCP结石大于3.25 mm时,ERCP结石检出率比MRCP高3.992倍(95% 1.769 ~ 9.007)。ERCP前,A组CAR、CLR值均高于B组(分别为3.88[1.25-14.14]、1.24 [0.50-9.66],p = 0.027、8.79[2.19-35]、2.67 [1.02-20.05],p = 0.029)。较高的CRP、CAR和CLR值对于ERCP中结石的检测具有重要意义(AUC分别为0.627[0.519-0.739]、0.625[0.513-0.737]和0.624[0.514-0.734])。结论:低CRP、CAR和CLR值可能与CBDS的自发迁移有关。
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引用次数: 0
Retraction notice. 收回通知。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-11-01 Epub Date: 2023-09-05 DOI: 10.1177/00369330231200382
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引用次数: 0
Retraction of manuscripts: An exercise to ensure scholarly correctness and academic integrity. 撤回稿件:一项确保学术正确性和学术完整性的实践。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-11-01 DOI: 10.1177/00369330231211415
Ghulam Nabi
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引用次数: 0
Admission on weekends does not increase mortality after hip fracture: a meta-analysis of 1.4 million patients. 周末入院不会增加髋部骨折后的死亡率:一项对140万患者的荟萃分析。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-11-01 Epub Date: 2023-07-10 DOI: 10.1177/00369330231186433
Siyuan Guo, Hao Liu

Background: The "weekend" effect resulting in increased complication rates in patients admitted on weekends has been noted in many diseases.

Objective: This systematic review and meta-analysis aimed to collate adjusted data from published studies to assess if admission on weekends as compared to weekdays increases mortality rates in hip fracture patients.

Methods: Databases of PubMed, CENTRAL, Scopus, Web of Science, and Embase were searched up to 31st December 2022 for studies comparing mortality between weekend versus weekday admission of hip fracture patients. Adjusted hazard ratios (HR) were pooled.

Results: Fourteen studies including 1,487,986 patients were analyzed. Most studies were from Europe and North America. Results showed no difference in mortality rates of hip fracture patients admitted on weekends versus weekdays (HR: 1.00 95% 0.96, 1.04 I2 = 75%). There was no publication bias and results did not change on the leave-one-out analysis. Subgroup analysis based on sample size and treatment did not change outcomes.

Conclusion: This meta-analysis has shown no apparent weekend effect in cases of hip fractures. Patients admitted on weekends had similar mortality rates as compared to those admitted on weekdays. Current data has high heterogeneity and is mostly from developed countries.

背景:在许多疾病中,“周末”效应导致周末入院患者并发症发生率增加。目的:本系统综述和荟萃分析旨在整理已发表研究的调整数据,以评估与工作日相比,周末住院是否会增加髋部骨折患者的死亡率。方法:检索截至2022年12月31日的PubMed、CENTRAL、Scopus、Web of Science和Embase数据库,比较周末和工作日住院髋部骨折患者的死亡率。合并调整后的风险比(HR)。结果:14项研究共纳入1487986例患者。大多数研究来自欧洲和北美。结果显示,周末与工作日入院的髋部骨折患者死亡率无差异(HR: 1.00 95% 0.96, 1.04 I2 = 75%)。在留一分析中没有发表偏倚,结果没有改变。基于样本量和治疗的亚组分析没有改变结果。结论:本荟萃分析显示髋部骨折病例没有明显的周末效应。周末入院的患者死亡率与工作日入院的患者相似。目前的数据具有较高的异质性,且大多来自发达国家。
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引用次数: 0
The impact of sarcopenia on prognosis of patients with pancreatic cancer: A systematic review and meta-analysis. 肌肉减少症对胰腺癌患者预后的影响:一项系统综述和荟萃分析。
IF 1.4 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-11-01 Epub Date: 2023-07-14 DOI: 10.1177/00369330231187655
Hui Gan, Jiarong Lan, Hongxia Bei, Guangxing Xu

Objective: To summarize recent findings on the association of low skeletal muscle mass and muscle quality with overall survival and recurrence-free survival in patients with pancreatic cancer.

Methods: A systematic search was conducted using Medline (via PubMed), Embase and Scopus databases for observational studies reporting on the overall survival and recurrence-free survival. Pooled effect sizes were reported as hazards ratio along with 95% confidence intervals.

Results: A total of 34 studies were included. Low skeletal muscle index (indicating muscle mass) was associated with poor overall survival (hazards ratio: 1.50; 95% confidence interval: 1.34, 1.67) and lower recurrence-free survival (hazards ratio: 1.28, 95% confidence interval: 1.15, 1.43). Low skeletal muscle attenuation (indicating muscle quality) was associated with poor overall survival (hazards ratio: 1.32; 95% confidence interval: 1.05, 1.66). Recurrence-free survival was similar in patients with low and normal/high skeletal muscle attenuation (hazards ratio: 1.12, 95% confidence interval: 0.89, 1.40).

Conclusion: Both low skeletal muscle mass and poor muscle quality are associated with poor long-term survival. Low skeletal muscle index, but not low skeletal muscle attenuation, are associated with poor recurrence-free survival.

目的:总结胰腺癌患者骨骼肌质量和骨骼肌质量与总生存期和无复发生存期之间的关系。方法:使用Medline(通过PubMed)、Embase和Scopus数据库系统检索报告总生存期和无复发生存期的观察性研究。汇总效应量以风险比和95%置信区间报告。结果:共纳入34项研究。低骨骼肌指数(表明肌肉质量)与较差的总生存率相关(风险比:1.50;95%可信区间:1.34,1.67)和更低的无复发生存率(风险比:1.28,95%可信区间:1.15,1.43)。低骨骼肌衰减(表明肌肉质量)与较差的总生存率相关(风险比:1.32;95%置信区间:1.05,1.66)。骨骼肌衰减低和正常/高的患者无复发生存率相似(风险比:1.12,95%可信区间:0.89,1.40)。结论:骨骼肌质量低和肌肉质量差与长期生存率差有关。低骨骼肌指数,而不是低骨骼肌衰减,与不良的无复发生存相关。
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引用次数: 0
Do we need a co-pilot in the operating theatre? A cross-sectional study on surgeons' perceptions. 手术室需要副驾驶吗?一项关于外科医生认知的横断面研究。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-11-01 Epub Date: 2023-10-18 DOI: 10.1177/00369330231207989
Priyal Taribagil, Timing Liu, Vish Bhattacharya, Sanjay Taribagil

Objective: The aim of this original study was to investigate general surgeons' perceptions on the role of dual surgeon operating for high-risk, elective complex surgical procedures.

Material and methods: A 21-part cross-sectional online survey was self-completed by 85 general surgeons across hospitals in the UK. The survey assessed the perception of dual surgeon operating on patient morbidity and mortality, surgeons' burnout rates, complaints, patient waiting times and overall trainee experience. Statistical analysis was performed using R version 3.6.1.

Results: Overall 78.8% believed that dual surgeon operating could help to overcome these human factors. Sub-analysis includes improve surgeon fatigue (89.4%), improve confidence (83.5%), improve decision-making (76.5%), minimise technical error (69.4%), improve communication, team work and leadership skills (65.9%). 65.9% believed it would reduce surgeons' burnout. There was a statistically significant relationship between the participants believing it would reduce surgeons' burnout and those who felt it would reduce complaints, Chi-squared(4) = [30.8], p = [0.00000342]. A statistically significant relationship was noted between participants believing it would reduce surgeons' burnout and those who felt it would reduce patient mortality/morbidity, Chi-squared(4) = [19.9], p = [0.000517].

Conclusion: The survey has highlighted positive surgeons' perceptions regarding dual surgeon operating.

目的:这项原始研究的目的是调查普通外科医生对双外科医生在高风险、选择性复杂外科手术中的作用的看法。材料和方法:由英国各医院的85名普通外科医生自行完成了一项由21部分组成的横断面在线调查。该调查评估了双外科医生手术对患者发病率和死亡率、外科医生的倦怠率、投诉、患者等待时间和整体实习经历的看法。使用R版本3.6.1进行统计分析。结果:总体而言,78.8%的人认为双外科医生手术有助于克服这些人为因素。子分析包括改善外科医生疲劳(89.4%)、提高信心(83.5%)、改善决策(76.5%)、最大限度地减少技术错误(69.4%)、改善沟通、团队合作和领导技能(65.9%)。65.9%的人认为这将减少外科医生的倦怠。卡方(4)表示,参与者认为这会减少外科医生的倦怠感,而参与者认为这能减少抱怨,这两者之间存在统计学上的显著关系 = [30.8],p = [000000342]。卡方(4)表示,认为这会减少外科医生的倦怠感的参与者和认为这会降低患者死亡率/发病率的参与者之间存在统计学上显著的关系 = [19.9],p = [0000517]。结论:该调查强调了外科医生对双外科医生手术的积极看法。
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引用次数: 1
RETRACTED: Erector spinae plane block for pain control after hip surgeries: A systematic review and meta-analysis. 撤回:用于髋关节手术后疼痛控制的脊肌平面阻滞:系统综述与荟萃分析。
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-08-08 DOI: 10.1177/00369330231193624
Haiyan Pan, Guofang Fei
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引用次数: 0
ChatGPT in academic publishing: An ally or an adversary? 学术出版中的ChatGPT:盟友还是对手?
IF 2.7 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-08-01 Epub Date: 2023-05-07 DOI: 10.1177/00369330231174231
Sisith Ariyaratne, Rajesh Botchu, Karthikeyan P Iyengar
subsequent Academic Publishing
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引用次数: 2
期刊
Scottish Medical Journal
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