Comparing Subcuticular and Transdermal Appendectomy Repairs: A Randomized Clinical Trial

Background: Appendectomy is one of the most common abdominal operations. The prevalence of appendicitis increases with increased lymphatic tissue with the maximum prevalence at the beginning of adulthood. Owing to the high prevalence of appendectomy, patients will be benefited from a better method with improvement of surgical site and management of postoperative pain and infection. Subcuticular repair method due to better scar formation and less pain is preferred to the routine repair method, if the infection rate is comparable.Methods: The current study was conducted on appendectomy candidates in 2017. After providing the necessary explanations, the interested patients signed the informed consent forms and voluntarily participated in the study. The subjects were randomly assigned into two groups of randomized clinical trial with parallel design and 1:1 ratio. The sample size was 120 individuals based on previous studies. Subjects were assigned into two groups of 105 subjects each: the first group as subcuticular and the second group as transdermal accordingly. Then, they were studied and followed up.Results: One week after operation, 8.5% of subcuticular and 5.7% of transdermal repairs developed localized infection, and no significant difference was observed between the two groups. One week after surgery in the first group, 10% had no pain, 36% mild pain, 27% moderate pain, and 27% severe pain. In the second group, 7% had no pain, 36% mild pain, 30% moderate pain, and 27% severe pain. Therefore, there was no significant difference between two groups in this regard.Conclusion: There was no significant difference in the surgical wound infection rate between two methods. Accordingly, subcuticular repair was suggested as the preferred method owing to its better scar formation

Relation between transcranial doppler findings, neuroimaging and functional state in the first days of acute cerebrovascular accidents- hemorrhagic and ischemic in patients admitted to the Ardabil city hospital during 2015-2016

Background: Cerebrovascular accident (CVA) is the third leading cause of death in the United States. Considering the diagnostic and clinical value of sonography of extra cranial vessels of the brain, identifying findings obtained from patients suspected of having CVA and Transient Ischemic Attack (TIA) and their prevalence is of great importance. The aim of this study was to investigate the relation between TCD finding, neuroimaging and functional state of ischemic and hemorrhagic CVA patients.Methods: This was a cross-sectional study that has been done on 100 stroke patients admitted to Ardabil city hospital from March 2015 to March 2016. Patients underwent to CT-scan, doppler sonography, and TCD. The obtained data were analyzed by statistical methods in SPSS version 21.Results: The mean age of the patients was 66.3±11 years and 53% were women. High blood pressure, history of heart disease, smoking, and diabetes were the major risk factors in the present study. Fifty eight percent of the patients had moderate to severe disability in their functional status. Atheroma plaques, intima-media thickening, and the change of speed in the external carotid artery were most frequent in doppler sonography investigations. There was no significant correlation between the obtained results from TCD and the functional status of the patients.Conclusions: Considering the non-significant correlation between TCD results and the functional state of the patients in this study, for exactly study of this topic, study the TCD of patients on several different days and after starting treatment is essential

Severity of post-Roux-en-Y gastric bypass dumping syndrome and weight loss outcomes: is there any correlation?

Bariatric surgery; Gastric bypass; Weight lossCirugía bariátrica; Bypass gástrico; Pérdida de pesoCirurgia bariàtrica; Bypass gàstric; Pèrdua de pesPurpose The present research was conducted to evaluate the effect of the severity of dumping syndrome (DS) on weight loss outcomes after Roux-en-Y gastric bypass (RYGB) in patients with class III obesity. Methods The present retrospective cohort study used the dumping symptom rating scale (DSRS) to evaluate the severity of DS and its correlation with weight loss outcomes in 207 patients 1 year after their RYGB. The patients were assigned to group A with mild-to-moderate DS or group B with severe DS. Results The mean age of the patients was 42.18 ± 10.46 years and their mean preoperative BMI 42.74 ± 5.59 kg/m2. The total weight loss percentage (%TWL) in group B was insignificantly higher than that in group A, but besides that was not significantly different in the two groups. Conclusion The present findings suggested insignificant relationships between the presence and severity of DS after RYGB and adequate postoperative weight loss.Open Access Funding provided by Universitat Autonoma de Barcelona

The effect of a low versus high sodium diet on blood pressure in diabetic patients:A systematic review and meta‐analysis of clinical trials

Abstract There have been numerous clinical trials that have investigated the effect of sodium intake on blood pressure in diabetic patients. The purpose of this systematic review and meta‐analysis was to evaluate the clinical trial studies performed on the effect of low sodium diet (LSD) versus high sodium diet (HSD) on blood pressure in diabetic patients. PubMed, Scopus, and Web of Science were systematically searched from database inception to July 10, 2021. Both type 1 and 2 diabetes was considered. Overall, there were 15 studies included in this meta‐analysis. The weighted (WMD) mean difference with 95% confidence interval (CI) was calculated using a random‐effects model. Risk of bias in the studies was assessed based on the Cochrane collaboration tool and the quality of all the studies was considered as good. Overall, LSD significantly reduced SBP (systolic blood pressure) (WMD: −3.79 mmHg, 95% CI: −6.02, −1.56) and DBP (diastolic blood pressure) (WMD: −1.62 mmHg, 95% CI: −2.84, −0.40), in comparison with HSD, in diabetics. However, LSD had no significant effect on MAP (mean arterial pressure) in comparison with HSD (WMD: −1.81, 95%CI: −5.49, 1.87). Although subgroup analysis could not attenuate heterogeneity in SBP, subgroup analysis in DBP based on duration (≤1 week: WMD: −2.35, 95%CI: −3.69, −1.00, I2 = 48.9%, p = 0.081, >1 week: WMD: −1.04, 95% CI: −2.83, 0.76, I2 = 74.7%, p = 0.003) and study design (cross‐over: WMD: −1.94, 95% CI: −2.71, −1.17, I2 = 32.1%, p = 0.183, parallel: WMD: −2.17, 95% CI: −6.48, 2.13, I2 = 82.4%, p = 0.001) successfully detected sources of heterogeneity. LSD significantly reduced SBP and DBP, however, had no effect on MAP, in comparison with HSD

Severity of post-Roux-en-Y gastric bypass dumping syndrome and weight loss outcomes : is there any correlation?

Altres ajuts: acords transformatius de la UABPurpose: The present research was conducted to evaluate the effect of the severity of dumping syndrome (DS) on weight loss outcomes after Roux-en-Y gastric bypass (RYGB) in patients with class III obesity. Methods: The present retrospective cohort study used the dumping symptom rating scale (DSRS) to evaluate the severity of DS and its correlation with weight loss outcomes in 207 patients 1 year after their RYGB. The patients were assigned to group A with mild-to-moderate DS or group B with severe DS. Results: The mean age of the patients was 42.18 ± 10.46 years and their mean preoperative BMI 42.74 ± 5.59 kg/m2. The total weight loss percentage (%TWL) in group B was insignificantly higher than that in group A, but besides that was not significantly different in the two groups. Conclusion: The present findings suggested insignificant relationships between the presence and severity of DS after RYGB and adequate postoperative weight loss

Global, regional, and national burden of colorectal cancer and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Funding: F Carvalho and E Fernandes acknowledge support from Fundação para a Ciência e a Tecnologia, I.P. (FCT), in the scope of the project UIDP/04378/2020 and UIDB/04378/2020 of the Research Unit on Applied Molecular Biosciences UCIBIO and the project LA/P/0140/2020 of the Associate Laboratory Institute for Health and Bioeconomy i4HB; FCT/MCTES through the project UIDB/50006/2020. J Conde acknowledges the European Research Council Starting Grant (ERC-StG-2019-848325). V M Costa acknowledges the grant SFRH/BHD/110001/2015, received by Portuguese national funds through Fundação para a Ciência e Tecnologia (FCT), IP, under the Norma Transitória DL57/2016/CP1334/CT0006.proofepub_ahead_of_prin

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

The global burden of cancer attributable to risk factors, 2010-19 : a systematic analysis for the Global Burden of Disease Study 2019

Background Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods The GBD 2019 comparative risk assessment framework was used to estimate cancer burden attributable to behavioural, environmental and occupational, and metabolic risk factors. A total of 82 risk-outcome pairs were included on the basis of the World Cancer Research Fund criteria. Estimated cancer deaths and disability-adjusted life-years (DALYs) in 2019 and change in these measures between 2010 and 2019 are presented. Findings Globally, in 2019, the risk factors included in this analysis accounted for 4.45 million (95% uncertainty interval 4.01-4.94) deaths and 105 million (95.0-116) DALYs for both sexes combined, representing 44.4% (41.3-48.4) of all cancer deaths and 42.0% (39.1-45.6) of all DALYs. There were 2.88 million (2.60-3.18) risk-attributable cancer deaths in males (50.6% [47.8-54.1] of all male cancer deaths) and 1.58 million (1.36-1.84) risk-attributable cancer deaths in females (36.3% [32.5-41.3] of all female cancer deaths). The leading risk factors at the most detailed level globally for risk-attributable cancer deaths and DALYs in 2019 for both sexes combined were smoking, followed by alcohol use and high BMI. Risk-attributable cancer burden varied by world region and Socio-demographic Index (SDI), with smoking, unsafe sex, and alcohol use being the three leading risk factors for risk-attributable cancer DALYs in low SDI locations in 2019, whereas DALYs in high SDI locations mirrored the top three global risk factor rankings. From 2010 to 2019, global risk-attributable cancer deaths increased by 20.4% (12.6-28.4) and DALYs by 16.8% (8.8-25.0), with the greatest percentage increase in metabolic risks (34.7% [27.9-42.8] and 33.3% [25.8-42.0]). Interpretation The leading risk factors contributing to global cancer burden in 2019 were behavioural, whereas metabolic risk factors saw the largest increases between 2010 and 2019. Reducing exposure to these modifiable risk factors would decrease cancer mortality and DALY rates worldwide, and policies should be tailored appropriately to local cancer risk factor burden. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.Peer reviewe