Search results for " Middle"

showing 10 items of 1097 documents

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

2019

Background: End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods: This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associ…

Malemodelos logísticosmedicine.medical_treatmenthumanossurgial careColorectal Neoplasmpaíses desarrolladosLogistic regressionoutcomesGlobal Healthurgencias médicas0302 clinical medicinepaíses en desarrolloSurgicalestudios prospectivosColostomy80 and overglobalsurg030212 general & internal medicineProspective StudiesProspective cohort studyMultivariate Analysimediana edadCancerAged 80 and overEmergencieancianoAnastomosis colorectal resection colostomyAnastomosis SurgicalColostomyGeneral MedicineMiddle Agedadultocolostomy; colorectal cancer; human developlment index3. Good healthColo-Rectal Cancertraditional healersElective Surgical Procedures030220 oncology & carcinogenesisFemaleColorectal Neoplasms6.4 Surgerylow incomeCohort studyHumanDeveloped CountrieAdultAdult; Aged; Aged 80 and over; Anastomosis Surgical; Colorectal Neoplasms; Colostomy; Elective Surgical Procedures; Emergencies; Female; Global Health; Humans; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prospective Studies; Developed Countries; Developing Countriesmedicine.medical_specialtyneoplasias colorrectalesLogistic Modelcancer anastomosis surgical income stomas colostomy procedure colorectal resection end colostomy emergency surgical procedure human development indexdelayAnastomosishuman developlment indexPerforation (oil well)lcsh:Surgerycolorectal cancerAnastomosisGlobalSurg CollaborativeNO03 medical and health sciencesCase mix indexClinical ResearchmedicinecancerHumansanálisis multifactorialDeveloping CountriesAgedemergency abdominal surgery low income surgial care traditional healers cancer mortality outcomes delayElective Surgical Procedurebusiness.industryKirurgiDeveloped Countriesleft colon resection anastomosis end colostomyEvaluation of treatments and therapeutic interventionslcsh:RD1-811Odds ratiomortalitySurgeryProspective StudieLogistic ModelsMultivariate AnalysisSurgeryEmergenciesbusinessDigestive Diseasescolostomíaemergency abdominal surgery

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A rare case of Enchondromatosis of the knees and hands with involvement of Hoffa's fat pad and peri-articular soft-tissues

2013

We report a case of a 56-year old man with chronic pain in both knees for several years. This patient had already undergone surgery on his left knee in 2002 after an x-ray showed multiple lytic and well margined lesions in the distal femur and proximal tibia with ground-glass matrix, involving Hoffa's fat pad and the patellar ligament. Histology was consistent with an enchondroma. The most recent MRI examination showed enchondromatosis involving both knees with bilateral extension into Hoffa's fat pad and the patellar ligament. Subsequently, we performed an additional radiographic examination of the hands and feet, as well as an MRI of both hands to identify other possible enchondromas in t…

Malemusculoskeletal diseasesRadiographyEnchondromaOllier diseaseFat padPatellar LigamentEnchondromamedicineEnchondromatosisHumansKneeRadiology Nuclear Medicine and imagingOllier diseaseEnchondromatosibusiness.industryPatellar ligamentSoft tissueBenign hyaline tumour; Chondroma; Enchondroma; Enchondromatosis; Hoffa's fat pad; Ollier disease; Adipose Tissue; Enchondromatosis; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Patellar Ligament; Hand; Knee; Radiology Nuclear Medicine and ImagingEnchondromatosisAnatomyMiddle AgedHandmusculoskeletal systemmedicine.diseaseMagnetic Resonance Imagingmedicine.anatomical_structureAdipose TissueMusculoskeletal RadiologyBenign hyaline tumourHoffa's fat padbusinessChondromaHumanChondromaJournal of Radiology Case Reports

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Body mass index and complications following major gastrointestinal surgery

2018

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a meta-analysis of all available prospective data.Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien-Dindo Grades III-V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastroint…

MaleobesityMultivariate analysisGastrointestinal DiseasesIMPACTSettore MED/18 - CHIRURGIA GENERALEBody mass index; Body weight; Digestive tract; Gastrointestinal tract; Obesity; Postoperative complications; Gastroenterologydigestive tractTumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]0302 clinical medicineGastrointestinal tractRisk FactorsMedicineProspective StudiesProspective cohort studyBody mass indexBody mass index; Body weight; Digestive tract; Gastrointestinal tract; Obesity; Postoperative complications; Aged; Europe; Female; Gastrointestinal Diseases; Gastrointestinal Neoplasms; Humans; Male; Middle Aged; Obesity; Postoperative Complications; Prospective Studies; Risk Factors; Body Mass IndexGastrointestinal NeoplasmsOUTCOMESPostoperative complications; body mass index; body weight; digestive tract; gastrointestinal tract; obesityGastroenterologyMiddle AgedBody mass index; Body weight; Digestive tract; Gastrointestinal tract; Obesity; Postoperative complicationsEurope030220 oncology & carcinogenesisMeta-analysisUrological cancers Radboud Institute for Health Sciences [Radboudumc 15]CohortFemale030211 gastroenterology & hepatologyCohort studymedicine.medical_specialtybody mass indexMalignancyNO03 medical and health sciencesPostoperative complicationsbody weightSDG 3 - Good Health and Well-beingHumansDigestive tractObesityAgedbusiness.industrypostoperative complications; obesity; digestive tract; gastrointestinal tract; body mass index; body weightMORTALITYBody weightmedicine.diseaseObesitySettore MED/18SurgeryPostoperative complicationPostoperative Complications Obesity Digestive Tract Gastrointestinal Tract Body Mass Index Body Weight.gastrointestinal tractbusinessBody mass indexColorectal Disease

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Role of abdominal obesity for functional outcomes and complications in men treated with radical prostatectomy for prostate cancer: results of the Mul…

2014

Objective. This study aimed to evaluate the impact of abdominal obesity on preoperative features, complications and functional outcomes of men treated with radical prostatectomy (RP) for prostate cancer. Material and methods. In 2006 a multicentre Italian report on RP evaluated the surgical and functional characteristics of prostate cancer and RP outcomes. Age and waist circumference (WC) were recorded. Abdominal obesity was defined as a WC of at least 102 cm. International Index of Erectile Function (IIEF) score, prostate-specific antigen, prostate volume, tumour characteristics, presence/absence of perioperative complications and the number of blood units transfused were recorded. Preoper…

Maleobesitymedicine.medical_treatmentLogistic regressionsurgeryProstate cancerPostoperative ComplicationsErectile DysfunctionProstateProspective StudiesProspective cohort studyAbdominal obesityProstatectomyMiddle Agedprostate cancerTreatment Outcomemedicine.anatomical_structureItalyNephrologyObesity AbdominalabdominalepidemiologyWaist Circumferencemedicine.symptomHumanmedicine.medical_specialtyWaistcomplicationsUrologyUrologymethodsabdominal obesityincontinenceepidemiology/etiologymedicineHumansAgedProstatectomybusiness.industryfunctional outcomes and complicationProstatic Neoplasmsmethods; abdominal; prospective studies; erectile dysfunction; male; obesity; epidemiology; middle aged; treatment outcome; humans; prostatic neoplasms; epidemiology/etiology; surgery; aged; incontinence; complications; waist circumference; prostatectomy; postoperative complications; prostate cancer; urinary incontinence; italyPerioperativemedicine.diseaseradical prostatectomyMIRRORProspective StudieUrinary IncontinenceProstatic NeoplasmPostoperative ComplicationbusinessComplicationScandinavian Journal of Urology

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Diagnostic accuracy of computed tomographic colonography for the detection of advanced neoplasia in individuals at increased risk of colorectal cance…

2009

CONTEXT: Computed tomographic (CT) colonography has been recognized as an alternative for colorectal cancer (CRC) screening in average-risk individuals, but less information is available on its performance in individuals at increased risk of CRC. OBJECTIVE: To assess the accuracy of CT colonography in detecting advanced colorectal neoplasia in asymptomatic individuals at increased risk of CRC using unblinded colonoscopy as the reference standard. DESIGN, SETTING, AND PARTICIPANTS: This was a multicenter, cross-sectional study. Individuals at increased risk of CRC due to either family history of advanced neoplasia in first-degree relatives, personal history of colorectal adenomas, or positiv…

Maleoccult blood testColorectal cancerColonoscopycancer riskprediction and forecastingGastroenterologyRisk Factorscancer diagnosisPositive predicative valueadvanced cancerMedicineFamily historycomparative studycolorectal adenomafamily historyeducation.field_of_studymedicine.diagnostic_testarticleclinical trialGeneral MedicineColonoscopyMiddle Agedpriority journalrisk factorPredictive value of testsdiagnostic accuracyFemalediagnostic valueColorectal NeoplasmsColonography Computed TomographicradiographyComputed TomographicAdultmedicine.medical_specialtySettore MED/12 - GASTROENTEROLOGIAPopulationcolorectal cancerSensitivity and SpecificityPredictive Value of TestsInternal medicineadult; advanced cancer; aged; article; cancer classification; cancer diagnosis; cancer risk; clinical trial; colonoscopy; colorectal adenoma; colorectal cancer; computed tomographic colonography; controlled clinical trial; controlled study; cross-sectional study; diagnostic accuracy; diagnostic value; family history; female; human; major clinical study; male; multicenter study; occult blood test; predictive validity; priority journal; colorectal tumor; comparative study; middle aged; prediction and forecasting; radiography; risk factor; sensitivity and specificity; Adult; Aged; Colonography Computed Tomographic; Colonoscopy; Colorectal Neoplasms; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Risk Factors; Sensitivity and Specificitycross-sectional studyHumanscontrolled studyhumaneducationAgedcontrolled clinical trialbusiness.industryFecal occult bloodSigmoidoscopyColonographymedicine.diseasecancer classificationcomputed tomographic colonographymajor clinical studypredictive validitymulticenter studyCross-Sectional StudiesCT colonography colorectal cancer screeningSettore MED/36 - Diagnostica Per Immagini E Radioterapiabusinesscolorectal tumorJAMA

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Injectable Versus Oral First-Line Disease-Modifying Therapies: Results from the Italian MS Register

2021

AbstractThe current study aims to compare injectable and oral first-line disease-modifying therapies (DMTs) for time to first relapse, time to confirmed disability progression (CDP), and time to discontinuation using a cohort of relapsing remitting multiple sclerosis (RRMS) patients, with data extracted from the Italian MS Register. This multicenter, observational, retrospectively acquired, and propensity-adjusted cohort study utilized RRMS-naïve patients from the Italian MS Register who started either injectable or oral first-line DMTs between January 1, 2010, and December 31, 2017, to evaluate the impact on disability outcomes in patients. Enrolled patients were divided into two groups, n…

Maleoral DMTsoral DMTAdministration OralDiseaseRelapsing-RemittingCohort Studies0302 clinical medicineImmunologicinjectable DMTPharmacology (medical)030212 general & internal medicineRegistriesSubcutaneousMiddle AgedItalyEDSS score; injectable DMTs; Multiple sclerosis; oral DMTs; real-world setting; Adjuvants Immunologic; Administration Oral; Adult; Cohort Studies; Female; Follow-Up Studies; Glatiramer Acetate; Humans; Immunologic Factors; Injections Subcutaneous; Interferon-beta; Italy; Male; Middle Aged; Multiple Sclerosis Relapsing-Remitting; Retrospective Studies; RegistriesAdministrationCohortSettore MED/26 - NeurologiaOriginal ArticleFemaleNeurosurgeryCohort studyOralAdultmedicine.medical_specialtyEDSS scoreInjections SubcutaneousLower riskInjectionsMultiple sclerosis03 medical and health sciencesMultiple Sclerosis Relapsing-RemittingAdjuvants ImmunologicInternal medicinereal-world settingmedicineHumansImmunologic FactorsMultiple sclerosiAdjuvantsinjectable DMTsRetrospective StudiesPharmacologybusiness.industryMultiple sclerosisGlatiramer AcetateInterferon-betamedicine.diseaseDiscontinuationObservational studyNeurology (clinical)business030217 neurology & neurosurgeryFollow-Up Studies

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Efficacy of switching between tumor necrosis factor-alfa inhibitors in psoriasis: results from the Italian Psocare registry

2014

Background: Some studies have shown that switching patients from one tumor necrosis factor (TNF)-alfa inhibitor to another may be beneficial when they have an inadequate response or an adverse event. Objective: We sought to assess the variables predicting the efficacy of the second TNF-alfa inhibitor in patients discontinuing the first TNF-alfa inhibitor. Methods: Data from all 5423 consecutive patients starting TNF-alfa inhibitor therapy for psoriasis between September 2005 and September 2010 who were included in the Italian Psocare registry were analyzed. Results: In 105 patients who switched to a second TNF-alfa inhibitor who had complete follow-up data, 75% improvement in the Psoriasis …

Maleprimary inefficacy75% improvement in the Psoriasis Area Severity Index score; PASI; PASI 75; Psoriasis Area Severity Index; TNF; biologics; efficacy; primary inefficacy; psoriasis; secondary loss of efficacy; switching; tumor necrosis factor; tumor necrosis factor-alfa inhibitors; Adult; Analysis of Variance; Antibodies Monoclonal; Antibodies Monoclonal Humanized; Cohort Studies; Confidence Intervals; Dose-Response Relationship Drug; Drug Administration Schedule; Female; Follow-Up Studies; Humans; Immunoglobulin G; Italy; Male; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Proportional Hazards Models; Psoriasis; Receptors Tumor Necrosis Factor; Registries; Retrospective Studies; Risk Assessment; Severity of Illness Index; Treatment Outcome; Tumor Necrosis Factor-alpha; Young AdultSWITHCESefficacyTNFpsoriasis; psoriasis arthritis; pharmachological treatmentPASI 75Severity of Illness IndexReceptors Tumor Necrosis FactorEtanerceptCohort StudiesMonoclonalReceptorsSettore MED/35 - Malattie Cutanee E VenereeRegistriesHumanizedtumor necrosis factor-alfa inhibitors.switchingHazard ratioAntibodies MonoclonalMiddle AgedTreatment OutcomeItalyPredictive value of tests75% improvement in the Psoriasis Area Severity Index scoreFemaleDrugPsoriasis Area Severity IndexbiologicTNF-alphaAdultmedicine.medical_specialtytumor necrosis factorDermatology75% improvement in the Psoriasis Area Severity Index score; PASI; PASI 75; Psoriasis Area Severity Index; TNF; biologics; efficacy; primary inefficacy; psoriasis; secondary loss of efficacy; switching; tumor necrosis factor; tumor necrosis factor-alfa inhibitorsAntibodies Monoclonal Humanizedsecondary loss of efficacyRisk AssessmentAntibodiestumor necrosis factor-alfa inhibitorsDrug Administration ScheduleDose-Response RelationshipYoung AdultSettore MED/35Predictive Value of TestsInternal medicinePsoriasisSeverity of illnessmedicineConfidence IntervalsHumansPsoriasisbiologicsAdverse effectPsoriasis; TNF-alphaProportional Hazards ModelsRetrospective Studiespsoriasibiologics; efficacy; primary inefficacy; psoriasis; secondary loss of efficacy; switching; tumor necrosis factor-alfa inhibitors; Adalimumab; Adult; Analysis of Variance; Antibodies Monoclonal; Antibodies Monoclonal Humanized; Cohort Studies; Confidence Intervals; Dose-Response Relationship Drug; Drug Administration Schedule; Etanercept; Female; Follow-Up Studies; Humans; Immunoglobulin G; Infliximab; Italy; Male; Middle Aged; Multivariate Analysis; Predictive Value of Tests; Proportional Hazards Models; Psoriasis; Receptors Tumor Necrosis Factor; Registries; Retrospective Studies; Risk Assessment; Severity of Illness Index; Treatment Outcome; Tumor Necrosis Factor-alpha; Young Adult; 2708Analysis of Variancepharmachological treatmentDose-Response Relationship DrugProportional hazards modelbusiness.industrytumor necrosis factor-alfa inhibitorTumor Necrosis Factor-alphaPASIAdalimumabRetrospective cohort studypsoriasis arthritismedicine.diseaseConfidence intervalInfliximabSurgeryImmunoglobulin GMultivariate AnalysisANTI-TNFAbusiness2708Follow-Up Studies

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Elective partial nephrectomy is equivalent to radical nephrectomy in patients with clinical T1 renal cell carcinoma: results of a retrospective, comp…

2012

Study Type - Therapy (cohort) Level of Evidence 2b What's known on the subject? and What does the study add? Few studies supported the expanded indications for nephron-sparing surgery (NSS) in selected patients with 4.1 cm renal tumours in the size range (T1b). However, all these comparative studies included both imperative and elective partial nephrectomy and patient selection for analysis was based on pathological stage (pT1) and not on clinical stage (cT1). Patients with clinically organ-confined RCC (cT1) who are candidates for elective PN have a limited risk of clinical understaging. NSS is not associated with an increased risk of recurrence and cancer-specific mortality both in cT1a a…

Malerenal cell carcinomapartial nephrectomyrenal cancerNephrectomymethodsElectiveclinical staging; nephron-sparing surgery; partial nephrectomy; radical nephrectomy; renal cancernephrectomyclinical stagingHumansCarcinoma Renal CellSurgical ProceduresElective Surgical ProcedureCarcinomanephron-sparing surgeryRenal CellElective partial nephrectomy is equivalent to radical nephrectomy in patients with clinical T1 renal cell carcinomaKidney NeoplasmMiddle AgedKidney NeoplasmsSurvival Ratemortality/pathology/surgeryElective Surgical Proceduresnephrectomy; renal cell carcinoma; nephron-sparing surgeryFemaleCarcinoma; Renal Cell; mortality/pathology/surgery Female Humans Kidney Neoplasms; mortality/pathology/surgery Male Middle Aged Nephrectomy; methods Surgical Procedures; Elective Survival RateHumanradical nephrectomy

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Safety and efficacy of non-steroidal anti-inflammatory drugs to reduce ileus after colorectal surgery

2019

Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non-steroidal anti-inflammatory drugs (NSAIDs) for reducing ileus after surgery.A prospective multicentre cohort study was delivered by an international, student- and trainee-led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a c…

Malerenal failureTime Factorsmedicine.medical_treatmentAdult; Aged; Anti-Inflammatory Agents Non-Steroidal; Elective Surgical Procedures; Female; Humans; Ileus; Kaplan-Meier Estimate; Male; Middle Aged; Patient Safety; Postoperative Care; Postoperative Complications; Proportional Hazards Models; Prospective Studies; Recovery of Function; Time Factors; Treatment Outcome; Colectomy; ProctectomyAnti-Inflammatory Agentscolorectal surgery; ileus; non-steroidal anti-inflammatory drugs; NSAIDSKaplan-Meier Estimate030230 surgeryTumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]0302 clinical medicinePostoperative ComplicationsProspective StudiesProspective cohort studyColectomyColorectalColectomyRISKProctectomyHazard ratioAnti-Inflammatory Agents Non-SteroidalAcute kidney injuryMiddle AgedColorectal surgeryNSAIDTreatment OutcomeElective Surgical Procedures030220 oncology & carcinogenesisFemalePatient SafetyNon-SteroidalCohort studyAdultcolorectal Surgery ileus non-steroidal anti-inflammatory drugsmedicine.medical_specialtyIleusNon‐steroidal anti‐inflammatory drugs. NSAIDs. Postoperative ileus. Colorectal surgery.ACUTE KIDNEY INJURYanti-inflammatory agents03 medical and health sciencesIleusInternal medicinemedicineHumansAdverse effectAgedProportional Hazards Modelsnon-steroidal anti-inflammatory drugs - ileus - colorectal surgeryPostoperative Carebusiness.industryRecovery of Functionmedicine.diseaseSettore MED/18 - Chirurgia Generalecolorectal cancer.Surgerycolorectal surgerybusiness

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Long-term anti-TNF therapy and the risk of serious infections in a cohort of patients with rheumatoid arthritis: Comparison of adalimumab, etanercept…

2012

Objective: To evaluate the risk of serious infections (SIs) in RA patients receiving anti-TNF therapy on the basis of the data included in the GISEA register. METHODS: The study involved 2769 adult patients with long-standing RA (mean age 53.2±13.4years; mean disease duration 9.0±8.3years) enrolled in the GISEA register, who had been treated for at least 6months with TNF inhibitors or had discontinued therapy due to SI: 837 (30%) treated with infliximab (IFN), 802 (29%) with adalimumab (ADA), and 1130 (41%) with etanercept (ETN). RESULTS: 176 patients had experienced at least one of the 226 Sis during the 9years of treatment with an anti-TNF agent, an overall incidence of 31.8/1000 patient-…

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