Risk factors for surgical site infections in rectal cancer patients

Introduction. Rectal cancer surgery is associated with high rates of post-operative complications in which the most common are Surgical Site Infections (SSI). Materials and methods. Factors responsible for SSI incidence were retrospectively analysed in rectal cancer patients who had undergone surgery at a single centre for oncology between July 2012 and July 2016. The study end-point was patients’ contracting SSI. Statistical analyses were performed by the ‘Statistica 12’ package consisting of the Pearson’s Chi-squared test (χ2), the Kruskal-Wallis test and the Mann-Whitney U-test (with continuity correction). Qualitative variables were analysed using log-linear analysis. The likelihoods of SSI incidence were compared by using odds ratios within 95% confidence limits. Results. Amongst the 187 patient subjects under observation during their 30 day follow-up, 44 (23.5%) suffered from post-operative complications of which SSI were the most common at 27 (14.4%). In those patients with advanced stage IV cancer, SSI occurred 3-fold more compared to patients with lower stage cancers; respectively 27.3% vs 11.7%, p = 0.021. Multivariate analysis demonstrated that the highest SSI risk was in patients having a low-lying tumour (≤ 5 cm from the anal rim; OR 2.31 (95% CI of 1.15 to 4.62), p = 0.019 and those patients who had undergone Hartmann’s procedure; OR 1.85 (95% CI of 1.04 to 3.31), p = 0.038. Conclusions. Surgical site infections in rectal cancer patients undergoing surgery occur significantly more in those at advanced stage IV rectal cancer where the tumour is low-lying (0–5 cm from the anal rim) and after having undergone the Hartmann’s procedure

Selected nutritional risk parameters in patients with laryngeal cancer — a comparison with other patients hospitalized in a Department of Laryngology and patients with colorectal cancer

Background: It is assumed that neoplasm greater in size may affect a patients’ nutritional status and prognosisstronger than smaller one. The aim of this study was to compare the nutritional status and prognosisof patients with laryngeal cancer (LC), recognized as tumour smaller in size, and patients with colorectalcancer (CRC) who were hospitalized in our hospital during the one year period. Methods: The retrospective review of medical documentation of all 1,134 patients hospitalized in a Departmentof Otolaryngology. Results: The laryngeal tumour was smaller than colorectal. Nutritional risk concerned 9% of patients withLC, was greater than in patients with other laryngeal disorders (1.4%), and lower than in patients withCRC (37%). A Nutritional Risk Screening (NRS) 2002 score ≥ 3 was the only significant factor influencingthe risk of in-hospital all-cause mortality, 14- and 30-day readmissions in patients with LC, and the risk of14-day rehospitalization in patients with CRC. Conclusions: Risk of malnutrition in patients with LC was lower than in counterparts with CRC, and concern9% and 37% of patients, respectively. Nutritional risk diagnosed in patients with LC had a strongerassociation with the prevalence of the measured outcomes (in-hospital death, the risk of 14-day and30-day readmission, length of hospitalization) than in individuals with CRC

Nutritional and functional status as indices of short- and long-term prognosis in patients undergoing surgery due to colorectal cancer

Introduction: Nutritional status and body composition parameters would seem to be reasonable prognostic factors in patients with colorectal cancer (CRC). The study aimed to investigate the relationships between numerous parameters of nutritional status and prognosis in patients undergoing surgery due to CRC. Material and methods: Clinical nutritional assessment and biochemical determinations were performed on 110 patients who underwent elective surgery due to primary CRC. Body composition was also analyzed using bioelectrical impedance (BIA) and computed tomography (CT) scans at the third lumbar (L3) vertebra using OsiriX software. Results: Patients who failed to attend a visit 3 months after surgery (n = 15; 13.6%) were more likely to be sarcopenic, with lower baseline functional status, handgrip strength, skeletal muscle (SM) parameters in BIA and a smaller SM area in CT. Compared to those who died during, on average, 3.6 years of follow-up (n = 33; 30%), patients who survived had, at baseline, a significantly higher Mini-Nutritional Assessment (MNA) score, lower waist-to-height ratio (WHtR), and higher scores on functional status scales. In a Cox’s proportional-hazards model, in addition to an advanced WHO CRC stage, scores for MNA (HR; 95% CI: 0.85; 0.74–0.98; p = 0.021), Patient-Generated Subjective Global Assessment (PG-SGA), instrumental activities of daily living (IADL), and WHtR (3.68; 1.03–13.13; p = 0.049) were independent risk factors for death. Conclusions: Patients’ functional status 3 months after surgery due to CRC was related to baseline SM strength, mass, and functional performance, whereas 3.5-year mortality was associated with lower MNA and IADL scores and higher WHtR and PG-SGA scores

Super-resolution visualization of chromatin loop folding in human lymphoblastoid cells using interferometric photoactivated localization microscopy.

The three-dimensional (3D) genome structure plays a fundamental role in gene regulation and cellular functions. Recent studies in 3D genomics inferred the very basic functional chromatin folding structures known as chromatin loops, the long-range chromatin interactions that are mediated by protein factors and dynamically extruded by cohesin. We combined the use of FISH staining of a very short (33 kb) chromatin fragment, interferometric photoactivated localization microscopy (iPALM), and traveling salesman problem-based heuristic loop reconstruction algorithm from an image of the one of the strongest CTCF-mediated chromatin loops in human lymphoblastoid cells. In total, we have generated thirteen good quality images of the target chromatin region with 2-22 nm oligo probe localization precision. We visualized the shape of the single chromatin loops with unprecedented genomic resolution which allowed us to study the structural heterogeneity of chromatin looping. We were able to compare the physical distance maps from all reconstructed image-driven computational models with contact frequencies observed by ChIA-PET and Hi-C genomic-driven methods to examine the concordance between single cell imaging and population based genomic data

Czynniki ryzyka wystąpienia zakażenia miejsca operowanego u chorych na raka odbytnicy

Wstęp. Operacja raka odbytnicy związana jest z dużym odsetkiem powikłań pooperacyjnych. Najczęściej występującym powikłaniem jest zakażenie miejsca operowanego (ZMO). Materiał i metody. Retrospektywnej analizie poddano czynniki wystąpienia ZMO u chorych operowanych w jednym ośrodku z powodu raka odbytnicy od czerwca 2012 do czerwca 2016 r. Punktem końcowym badania było wystąpienie ZMO. Do analizy statystycznej zastosowano pakiet Statistica 12: test Chi-kwadrat Pearsona, test Kruskala-Wallisa i test U Manna-Whitneya (z poprawką na ciągłość). Analizę log-liniową zastosowano do analizy zmiennych jakościowych. Do porównania prawdopodobieństwa wystąpienia ZMO zastosowano iloraz szans i jego 95-procentowy przedział ufności. Wyniki. Wśród 187 analizowanych chorych w obserwacji 30-dniowej powikłanie pooperacyjne wystąpiło u 44 (23,5%) chorych. Najczęściej rozpoznawanym powikłaniem było ZMO — 27 (14,4%). Stwierdzono, że w grupie chorych z IV stopniem zaawansowania raka ZMO wystąpiło trzykrotnie częściej w porównaniu do chorych z niższym stopniem zaawansowania (27,3% vs 11,7%; p = 0,021). Na postawie analizy wieloczynnikowej stwierdzono, że największe ryzyko wystąpienia ZMO było u chorych z niską lokalizacją guza nowotworowego (≤ 5 cm od brzegu odbytu) (OR 2,31 [95% CI 1,15–4,62]; p = 0,019) i u chorych po operacji Hartmanna (OR 1,85 [95% CI 1,04–3,31]; p = 0,038). Wniosek. Zakażenie miejsca operowanego u chorych na raka odbytnicy występuje znamiennie częściej w IV stopniu zaawansowania raka odbytnicy, z guzem zlokalizowanym nisko (0–5 cm od brzegu odbytu) i po operacji Hartmanna

Characteristics and results of treatment of patients treated surgically with colorectal cancer in old and senile age

Colorectal cancer (CC) in Poland is the type of cancer with the highest dynamics of disease growth and is epidemiologically related to age. The analysis involved 353 patients operated on due to CC in senile and old age and compared with younger patients. It was found that people at this age are more often diagnosed with CC They were more often women, the patients did not differ in the stage of cancer, while they were significantly more often qualified for surgery due to urgent indications. In patients with colonic cancer, the resectability and radicality of the procedures in comparison with patients with rectal cancer was significantly higher, while there were more complications and deaths in the 30-day follow-up in this group. The overall survival in senile and old age was significantly worse. In the first year of follow-up after surgical treatment of patients in this group, complications and deaths were more frequently observed. However, in patients who survived 12 months after the operation, the overall survival rate did not significantly differ

Surgical site infection among patients after colorectal cancer surgery

Wstęp: Zakażenie miejsca operowanego występuje u 2,5–22,3% operowanych chorych. Jest ono wykładnikiem jakości leczenia na oddziałach zabiegowych i ma duży wpływ na jego koszt. Materiał i metodyka: Analizie poddano chorych, u których w obserwacji 30-dniowej wystąpiło zakażenie miejsca operowanego. Grupę wyjściową stanowiło 1581 chorych z rozpoznaniem raka jelita grubego poddanych zabiegowi operacyjnemu w jednym ośrodku. Kryteriami wyłączającymi z badania były: brak wiarygodnej dokumentacji leczenia (szpitalnego lub ambulatoryjnego) i zgon chorego przed 30. dniem po operacji bez rozpoznanego zakażenia miejsca operowanego. Analizę statystyczną wykonano przy użyciu programu Statistica 10. Wyniki: Powikłania pooperacyjne wystąpiły u 262 chorych (16,6%). Najczęściej występującym było zakażenie miejsca operowanego (198 pacjentów; 12,52%). Stwierdzono, że wystąpienie tego powikłania zależne było od zaawansowania klinicznego raka, wieku chorych, chorób współtowarzyszących (cukrzyca i choroby kardiologiczne). Ponadto zauważono, że powikłanie to występowało znamiennie częściej u chorych operowanych w trybie pilnym z powodu powikłań oraz u tych, u których wyłoniono stomię jelitową. Nie stwierdzono natomiast zależności wystąpienia tego powikłania od płci chorych i lokalizacji guza nowotworowego. Wniosek: U chorych po operacji raka jelita grubego największe zagrożenie wystąpienia zakażenia miejsca operowanego wystąpiło u chorych po 75. roku życia, obciążonych cukrzycą i chorobami kardiologicznymi, z dużym zaawansowaniem klinicznym raka, operowanych w trybie ostrego dyżuru, u których konieczne było wyłonienie stomii jelitowej (a szczególnie kolostomii)

Charakterystyka i wyniki leczenia chorych z rakiem jelita grubego leczonych operacyjnie w wieku starczym i sędziwym

Nietypowa przyczyna niedrożności przewodu pokarmowego. Przypadek trudny, o nietypowym przebiegu klinicznym. Pomimo zastosowania szerokiej diagnostyki obrazowej (TK, USG, RTG) oraz endoskopii, właściwe rozpoznanie oraz przyczynę choroby odkryto dopiero podczas laparotomii. Przyczyną niedrożności okazał się być bezoar. Masa złożona z przedawkowanego preparatu ziołowego doprowadziła do całkowitego zatkania jelita krętego. Znamiennym jest, iż w wywiadzie pacjent dwukrotnie podawał możliwość związku występujących dolegliwości z zażyciem preparatu ziołowego. Jak się ostatecznie okazało – miał rację

Zakażenie miejsca operowanego u chorych po operacji raka jelita grubego

Introduction: Operative field infection appears among 2,5–22,3% of patients after surgery. It is an indicator of a quality of treatment on operative wards and has significant influence on its cost. Material and methods: The analysed group were patients, who had operative field infection in 30-days observation with colorectal cancer in one clinic.The criteria, that were excluded from the survey were: lack of trustworthy treatment documentation and the death of patient before 30th day after the surgery without operative field infection. The statistic analysis was carried with the usage of Statistica 10. Results: Postoperative complications appeared among 262/16,6% of patients. The most common complication was operative field infection (198/12,52%). It was stated that appearance of this complication depended on how advanced the cancer was, age, comorbidities (diabetes, and cardiological diseases). Morover, it was stated thatthis complication appeared significantly more often among patients with surgery in a matter of urgency and among which stoma had to be revealed. However, there was no dependence stated on appearance of this complication with patients’ sex and the localisation of a tumour. Conclusion: Among patients after colorectal surgery, the biggest threat of surgical site infection was among patients over 75 years, with diabetes and cardiological diseases, with advanced cancer, with surgery in a matter of urgency and among patients with stoma (especially colostomy)