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Current Cardiology Reviews Mar 2024Pericardial effusion is associated with amyloidosis, specifically amyloid light chain (AL) and transthyretin (ATTR) subtypes. However, the patients might present with...
BACKGROUND
Pericardial effusion is associated with amyloidosis, specifically amyloid light chain (AL) and transthyretin (ATTR) subtypes. However, the patients might present with different clinical symptoms.
OBJECTIVE
To determine the characteristics and associations of patients with pericardial effusion owing to either AL or ATTR amyloidosis.
METHODS
This study reviewed 26 studies from databases such as PubMed, MEDLINE, Web of Science, Google Scholar and CINAHL databases after protocol registration. The data were analyzed in IBM SPSS 21. Many statistical tests, such as Student t- and the Mann-Whitney U tests, were used. Multivariate logistic regression analysis was also performed. A p-value< 0.05 was considered significant.
RESULTS
A total of 531 patients with pericardial effusion secondary to amyloidosis were included. The mean age was 58.4±24.5 years. Most of the patients were male (72.9%). Common co-morbid conditions included hypertension (16.8%) and active smoking (12.9%). The most common time from symptom onset to the clinical presentation was less than 1 week (45%). ATTR amyloidosis was more common in older patients (p<0.05). Abdominal and chest discomfort were commonly associated with AL and ATTR amyloidosis, respectively (p<0.05). Patients with AL amyloidosis had a higher association with interventricular septal thickening and increased posterior wall thickness (p<0.05). First-degree atrioventricular block, left bundle branch block (LBBB), and atrial fibrillation (AF) were more associated with ATTR amyloidosis (p<0.05).
CONCLUSION
Pericardial effusion in patients with AL amyloidosis was associated with hypertrophic remodeling, while conduction abnormalities were associated with ATTR amyloidosis.
PubMed: 38465427
DOI: 10.2174/011573403X280737240221060630 -
Parasitology Research Mar 2024Although rare, Angiostrongylus costaricensis infection may be a more prevalent etiology of inflammatory bowel disease than ulcerative colitis and Chron's disease in...
Although rare, Angiostrongylus costaricensis infection may be a more prevalent etiology of inflammatory bowel disease than ulcerative colitis and Chron's disease in endemic areas in Central and South America. The present study reviewed the occurrence of A. costaricensis in Brazil, its clinical presentation and pathology; and proposed diagnostic criteria and case definitions for abdominal angiostrongyliasis (AA). Southern and southeastern Brazilian regions are the main endemic areas, and AA affects both genders and all age groups. A review of all 23 published reports of 51 Brazilian patients highlighted the following features that were subsequently classified as minor diagnostic criteria: abdominal pain, palpable mass in the right lower abdominal quadrant, history of exposure, ileocecal tumor, and intestinal perforation with wall thickening. Proposed major criteria include right lower quadrant abdominal pain, blood eosinophilia, positive serology (antibody detection), intense eosinophilic infiltration that involves all strata of the intestinal wall, eosinophilic granulomatous reaction, and eosinophilic vasculitis. In addition to the definitions of suspected and possible cases according to increasing strength of evidence of this infection, demonstration of worms/eggs/larvae in tissues or Angiostrongylus DNA in tissues or serum are required for a confirmed diagnosis. The application of the proposed criteria and definitions may improve patient management, epidemiologic surveillance, and identification of new endemic areas.
Topics: Animals; Humans; Abdominal Pain; Angiostrongylus; Brazil; Strongylida Infections
PubMed: 38446236
DOI: 10.1007/s00436-024-08177-2 -
JPRAS Open Jun 2024Dermal fillers containing copolyamide are used for breast augmentation and are marketed under different labels, such as Aquafilling, Los Deline, Aqualift, and Activegel....
BACKGROUND
Dermal fillers containing copolyamide are used for breast augmentation and are marketed under different labels, such as Aquafilling, Los Deline, Aqualift, and Activegel. In recent years, the number of publications reporting complications after use of these fillers has increased.
METHODS
Through a computerized search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of published studies on complications, treatment options, and radiological findings related to breast augmentation with dermal fillers containing copolyamide was performed. Publications between January 1, 2007, and January 23, 2023, were included. Retrieved studies were screened for inclusion and quality assessment. The Joanna Briggs checklist for case reports and the Strengthening the Reporting of Observational Studies in Epidemiology checklist for cross-sectional studies were used.
RESULTS
Sixteen studies met the inclusion criteria: 14 case reports and 2 retrospective cohort studies, including 196 women and 333 complications. Long-term complications (≥30 days after surgery) were described in 15 studies. The most commonly reported complications were nodules in the breast (130 patients), pain (92 patients), inflammation and/or infection (43 patients), breast deformities (35 patients), and migration of the filler to the pectoralis muscle, abdominal wall, thoracic wall, pubic area, back, or upper extremity (27 patients). The median time between injection of the dermal filler and any complication was 18 months, and the majority of patients with complications required surgical intervention.
CONCLUSION
Given the reports of severe complications months to years after injection of dermal fillers containing copolyamide and the lack of studies evaluating long-term safety, our interpretation is that dermal fillers containing copolyamide should not be used for breast augmentation.
PubMed: 38389650
DOI: 10.1016/j.jpra.2024.01.009 -
Journal of Gastrointestinal Cancer Jun 2024GISTs arising from organs outside GI tract are defined as extragastrointestinal GISTs (EGIST). The majority of EGISTs arise from small intestinal mesentry, mesocolon,... (Review)
Review
PURPOSE
GISTs arising from organs outside GI tract are defined as extragastrointestinal GISTs (EGIST). The majority of EGISTs arise from small intestinal mesentry, mesocolon, omentum, retroperitoneum, abdominal wall, liver and pancreas with pancreas comprising less than 5% of it. Due to limited data, it is unknown if the results of GIST can be generalised for EGISTs. We thereby present the largest single-centre case series of primary pancreatic GIST so far with review of existing literature.
METHODS
A total of 9 patients of primary pancreatic GIST were treated at our institute from September 2016 to February 2023. After literature search for all studies published before February 2023, 51 articles including 57 patients were identified. Their clinicopathological data and survival analysis were assessed.
RESULTS
The median age of patients treated at our centre was 53 years with a female predominance. The most common epicentre was pancreatic head with abdominal pain as the most common presenting symptom. All 57 patients documented in literature belonged to a similar age group with similar gender predilection. The factors impacting DFS were histologic type, mitotic index, NIH risk category and adjuvant therapy. The median DFS was 74 months with a 5-year DFS being 71.9%, while the 5-year OS was 90.4%.
CONCLUSION
Pancreatic GIST is a rare entity. Due to limited evidence and evolving literature, results cannot be generalised to a larger population. Larger case series with longer follow-up data are required to further understand the disease biology and long-term outcomes of pancreatic GIST.
Topics: Humans; Gastrointestinal Stromal Tumors; Middle Aged; Pancreatic Neoplasms; Female; Male; Aged; Adult
PubMed: 38324136
DOI: 10.1007/s12029-024-01024-8 -
Journal of Abdominal Wall Surgery : JAWS 2023To perform a systematic review and meta-analysis on the effectiveness of prophylactic mesh for the prevention of parastomal hernia in end colostomy, with the ultimate...
To perform a systematic review and meta-analysis on the effectiveness of prophylactic mesh for the prevention of parastomal hernia in end colostomy, with the ultimate objective to summarize the evidence for an interdisciplinary, European rapid guideline. We updated a previous systematic review with evidence search of PubMed from inception up to June 2022. Primary outcome was quality of life (QoL). Secondary outcomes were clinical diagnosis of parastomal hernia, surgery for parastomal hernia, and 30 day or in-hospital complications Clavien-Dindo ≥3. We utilised the revised Cochrane Tool for randomised trials (RoB 2 tool) for risk of bias assessment in the included studies. Minimally important differences were set through voting of the panel members. We appraised the evidence using GRADE and we developed GRADE evidence tables. We included 12 randomized trials. Meta-analysis suggested no difference in QoL between prophylactic mesh and no mesh for primary stoma construction (SMD = 0.03, 95% CI [-0.14 to 0.2], I = 0%, low certainty of evidence). With regard to parastomal hernia, the use of prophylactic synthetic mesh resulted in a significant risk reduction of the incidence of the event, according to data from all available randomized trials, irrespective of the follow-up period (OR = 0.33, 95% CI [0.18-0.62], I = 74%, moderate certainty of evidence). Sensitivity analyses according to follow-up period were in line with the primary analysis. Little to no difference in surgery for parastomal hernia was encountered after pooled analysis of 10 randomised trials (OR = 0.52, 95% CI [0.25-1.09], I = 14%). Finally, no significant difference was found in Clavien-Dindo grade 3 and 4 adverse events after surgery with or without the use of a prophylactic mesh (OR = 0.77, 95% CI [0.45-1.30], I = 0%, low certainty of evidence). Prophylactic synthetic mesh placement at the time of permanent end colostomy construction is likely associated with a reduced risk for parastomal hernia and may confer similar risk of peri-operative major morbidity compared to no mesh placement. There may be no difference in quality of life and surgical repair of parastomal hernia with the use of either approach.
PubMed: 38312423
DOI: 10.3389/jaws.2023.11550 -
Cureus Jan 2024Abdominal wall reconstruction (AWR) is a surgical procedure performed to address various conditions such as hernias, incisional hernias, and complex abdominal wall... (Review)
Review
Abdominal wall reconstruction (AWR) is a surgical procedure performed to address various conditions such as hernias, incisional hernias, and complex abdominal wall defects. Mesh fixation plays a crucial role in providing mechanical reinforcement to the weakened abdominal wall during AWR. Traditionally, suturing has been the preferred method for mesh fixation; however, adhesion techniques using tissue adhesives or glues have gained attention as an alternative approach. This systematic review aims to compare suturing and adhesion techniques for mesh fixation in AWR and assess their effectiveness in preventing hernia recurrence. A comprehensive literature search was conducted across relevant databases, including PubMed, MEDLINE, Embase, and the Cochrane Library. Studies that fulfilled the predetermined eligibility criteria were included. The primary outcome measure of interest was hernia recurrence rates. Secondary outcomes included mesh-related complications, surgical site infections, patient-reported outcomes, and functional outcomes. A risk of bias assessment was performed for the included studies, and data were synthesized qualitatively. Overall, the results of the included studies suggest that atraumatic mesh fixation with glue may have the potential to reduce chronic groin pain (CGP). However, there were significant variations in patient selection criteria, glue administration techniques, and hernia repair methods among the trials, which limited the ability to draw definitive conclusions. Additionally, the definitions of CGP and measurement scales for postoperative pain varied across studies, making it challenging to compare outcomes. The limitations of the review include the small sample sizes in some trials, relatively short follow-up durations, and the lack of standardized criteria for assessing variables such as foreign body sensation and groin compliance. Furthermore, the economic implications of using glue fixation compared to traditional suture fixation need to be considered.
PubMed: 38304671
DOI: 10.7759/cureus.51535 -
Minerva Surgery Jun 2024The optimal management and timing of the abdominal wall reconstruction concomitantly performed with stoma closure are controversial. This study aims to compare... (Meta-Analysis)
Meta-Analysis Comparative Study
BACKGROUND
The optimal management and timing of the abdominal wall reconstruction concomitantly performed with stoma closure are controversial. This study aims to compare short-term postoperative outcomes after concurrent stoma reversal (SR) with incisional hernia repair (IHR) and SR alone.
METHODS
PubMed/MEDLINE, Scopus and Web of Science databases were consulted to identify comparative studies. Random and common-effect models were used for the pooled analysis of the proportions and means.
RESULTS
Three studies met the inclusion criteria and a total of 504 patients who underwent simultaneous SR and IHR (N.=200) or SR alone (N.=304) were included in the meta-analysis. Postoperative morbidity increased after combined stoma and hernia surgery with a pooled OR for Surgical Site Occurrence (SSO) and severe postoperative complications (Clavien-Dindo ≥III) of 1.72 (95% CI 1.02-2.90) and 3.83 (95% CI 1.46-10.02), respectively. No significant difference was found between the two groups in terms of mortality (OR: 1.66; 95% CI 0.64-4.27), length of hospital stay (OR: 1.37; 95% CI 0.73-3.47). and readmission rate (OR: 1.17; 95% CI 0.67-2.06).
CONCLUSIONS
There is limited evidence suggesting that synchronous repair of SR and IH appears to be associated with a higher risk of SSO and severe postoperative complications. Therefore, a stepwise approach may be considered the best strategy in this setting.
Topics: Humans; Incisional Hernia; Postoperative Complications; Surgical Stomas; Herniorrhaphy; Length of Stay; Treatment Outcome; Patient Readmission
PubMed: 38298121
DOI: 10.23736/S2724-5691.23.10171-7 -
Hernia : the Journal of Hernias and... Apr 2024Abdominal surgeries are common surgical procedures worldwide. Incisional hernias commonly develop after abdominal wall surgery. Surgery is the definite treatment for... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Abdominal surgeries are common surgical procedures worldwide. Incisional hernias commonly develop after abdominal wall surgery. Surgery is the definite treatment for most incisional hernias but carries a higher rate of complications. Although frequently used, the real benefit of using drain tubes to reduce surgical complications after incisional hernia repair is uncertain.
METHODS
PubMed and Embase databases were searched for studies that compared the outcomes of drain vs. no-drain placement and the risk of complications in patients undergoing incisional hernia repair. Primary endpoints were infection, seroma formation, length of hospital stay, and readmission rate.
RESULTS
From a total of 771 studies, we included 2 RCTs and 4 non-RCTs. A total of 40,325 patients were included, of which 28 497 (71%) patients used drain tubes, and 11 828 (29%) had no drains. The drain group had a significantly higher infection rate (OR 1.89; CI 1.13-3.16; P = 0.01) and mean length of hospital stay (Mean Difference-MD 2.66; 95% CI 0.81-4.52; P = 0.005). There was no difference in seroma formation and the readmission rate.
CONCLUSION
This comprehensive systematic meta-analysis concluded that drain tube placement after incisional hernia repair is associated with increased infection rate and length of hospital stay without affecting the rate of seroma formation and readmission rate. Prospective randomized studies are required to confirm these findings.
Topics: Humans; Hernia, Ventral; Herniorrhaphy; Incisional Hernia; Postoperative Complications; Prospective Studies; Seroma; Surgical Mesh
PubMed: 38296872
DOI: 10.1007/s10029-024-02961-w -
Obesity Surgery Feb 2024Although sleeve gastrectomy (SG) is the most performed metabolic and bariatric surgery (MBS) worldwide, some patients require conversional procedures due to weight... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although sleeve gastrectomy (SG) is the most performed metabolic and bariatric surgery (MBS) worldwide, some patients require conversional procedures due to weight recurrence or late complications. Recently, one-anastomosis gastric bypass (OAGB) gained popularity as a viable option to address those problems. The aim of this meta-analysis is to assess the safety and efficacy of conversional OAGB after primary SG in the management of patients with obesity.
METHODS
Cochrane, Embase, PubMed, Scopus, and Web of Science were searched for articles from their inception to February 2023 by two independent reviewers using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) system. The review was registered prospectively with PROSPERO (CRD42023403528).
RESULTS
From 1,117 studies screened, twenty studies met the eligibility criteria, with a total of 1,057 patients with obesity undergoing conversional OAGB after primary SG. The mean age ranged from 28.2 to 49.5 years, and 744 patients (75.2%) were women. At one year after revisional OAGB, the pooled mean percent excess weight loss (%EWL) was 65.2% (95%CI: 56.9, 73.4, I = 97%). The pooled mean %EWL after conversional OAGB was 71.1% (95%CI: 62.2, 80.0, I = 90%) at two years and 71.6% (95%CI: 61.0, 82.2, I = 50%) at five years. Additionally, resolution rates of diabetes and hypertension were 65.4% (95%CI: 0.522, 0.785, I = 65%) and 58.9% (95%CI: 0.415, 0.762, I = 89%), respectively.
CONCLUSIONS
Our meta-analysis demonstrated OAGB as an effective conversional procedure after primary SG in terms of weight loss and obesity-associated medical problems for selected patients. Despite the promising results, further randomized controlled studies with larger sample sizes and more extended follow-up periods are necessary to determine if the OAGB is the best conversional surgery after SG.
Topics: Adult; Female; Humans; Male; Middle Aged; Gastrectomy; Gastric Bypass; Obesity; Retrospective Studies; Treatment Outcome; Weight Loss
PubMed: 38198098
DOI: 10.1007/s11695-024-07056-0 -
The Journal of Surgical Research Mar 2024Surgeons use several quality-of-life instruments to track outcomes following abdominal wall reconstruction (AWR); however, there is no universally agreed upon... (Review)
Review
INTRODUCTION
Surgeons use several quality-of-life instruments to track outcomes following abdominal wall reconstruction (AWR); however, there is no universally agreed upon instrument. We review the instruments used in AWR and report their utilization trends within the literature.
METHODS
This scoping review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews guidelines using the PubMed, Embase, Web of Science, ClinicalTrials.gov, and Cochrane databases. All published articles in the English language that employed a quality-of-life assessment for abdominal wall hernia repair were included. Studies which focused solely on aesthetic abdominoplasty, autologous breast reconstruction, rectus diastasis, pediatric patients, inguinal hernia, or femoral hernias were excluded.
RESULTS
Six hernia-specific tools and six generic health tools were identified. The Hernia-Related Quality-of-Life Survey and Carolinas Comfort Scale are the most common hernia-specific tools, while the Short-Form 36 (SF-36) is the most common generic health tool. Notably, the SF-36 is also the most widely used tool for AWR outcomes overall. Each tool captures a unique set of patient outcomes which ranges from abdominal wall functionality to mental health.
CONCLUSIONS
The outcomes of AWR have been widely studied with several different assessments proposed and used over the past few decades. These instruments allow for patient assessment of pain, quality of life, functional status, and mental health. Commonly used tools include the Hernia-Related Quality-of-Life Survey, Carolinas Comfort Scale, and SF-36. Due to the large heterogeneity of available instruments, future work may seek to determine or develop a standardized instrument for characterizing AWR outcomes.
Topics: Humans; Child; Abdominal Wall; Quality of Life; Hernia, Ventral; Abdominoplasty; Hernia, Inguinal; Herniorrhaphy; Surgical Mesh
PubMed: 38041903
DOI: 10.1016/j.jss.2023.10.013