Predictive model of biliocystic communication in liver hydatid cysts using classification and regression tree analysis

<p>Abstract</p> <p>Background</p> <p>Incidence of liver hydatid cyst (LHC) rupture ranged 15%-40% of all cases and most of them concern the bile duct tree. Patients with biliocystic communication (BCC) had specific clinic and therapeutic aspect. The purpose of this study was to determine witch patients with LHC may develop BCC using classification and regression tree (CART) analysis</p> <p>Methods</p> <p>A retrospective study of 672 patients with liver hydatid cyst treated at the surgery department "A" at Ibn Sina University Hospital, Rabat Morocco. Four-teen risk factors for BCC occurrence were entered into CART analysis to build an algorithm that can predict at the best way the occurrence of BCC.</p> <p>Results</p> <p><b>I</b>ncidence of BCC was 24.5%. Subgroups with high risk were patients with jaundice and thick pericyst risk at 73.2% and patients with thick pericyst, with no jaundice 36.5 years and younger with no past history of LHC risk at 40.5%. Our developed CART model has sensitivity at 39.6%, specificity at 93.3%, positive predictive value at 65.6%, a negative predictive value at 82.6% and accuracy of good classification at 80.1%. Discriminating ability of the model was good 82%.</p> <p>Conclusion</p> <p>we developed a simple classification tool to identify LHC patients with high risk BCC during a routine clinic visit (only on clinical history and examination followed by an ultrasonography). Predictive factors were based on pericyst aspect, jaundice, age, past history of liver hydatidosis and morphological Gharbi cyst aspect. We think that this classification can be useful with efficacy to direct patients at appropriated medical struct's.</p

The effect of L-Tryptophan on hemorrhagic shock induced bacterial translocation

Hemorrhagic shock causes mucosal damage in intestine and it results in translocation of bacteria to distant organs. In this study, effects of various doses of L-Tryptophan on the prevention of bacterial translocation in hemorrhagic shock induced rabbits were investigated

Effects of bariatric surgery on urinary incontinence

Nurullah Bulbuller,1 Mani Habibi,1,2 Mustafa Yuksel,3 Onur Ozener,1 Mehmet Tahir Oruc,1 Osman Zekai Oner,1 Mehmet Altug Kazak1 1General Surgery Department, Antalya Training and Research Hospital, Antalya, 2General Surgery Department, Esenler Maternity and Child Health Hospital, Istanbul, 3Urology Department, Antalya Training and Research Hospital, Antalya, Turkey Introduction: Obesity is an important modifiable etiological factor associated with several diseases. There is strong evidence that urinary incontinence (UI) is positively correlated with body mass index (BMI). Aim: One of the many benefits experienced by obese patients after bariatric surgery is decrease in UI. To investigate this correlation, we aimed to examine the effects of weight loss on UI in female patients who had undergone laparoscopic sleeve gastrectomy (LSG). Materials and methods: Obese female patients (n=120), &ge;18&nbsp;years of age, and planning to undergo LSG were included in this prospective study. We administered the International Consultation on Incontinence Questionnaire-Urinary Incontinence-Short Form (ICIQ-UI-SF) and Incontinence Impact Questionnaire (IIQ-7) to the patients prior to surgery and 6&nbsp;months after the surgery. Using the collected data, we determined the incidence of UI and examined the relationship between the preoperative and postoperative BMI and UI values. Results: The mean age of the patients was 39.19 (standard deviation [SD] =9.94)&nbsp;years and the mean preoperative BMI was 46.17 (SD =5.35). Of the 120 patients, 72 (60%) complained of UI preoperatively. Among these 72 patients, 23 (31.95%) described urge incontinence, 18 (25%) stress incontinence, and 31 (43.05%) mixed-type incontinence. At 6&nbsp;months postoperatively, the percentage of excess weight loss was 70.33% (SD =14.84%). For all three UI subtypes, the 6-month postoperative ICIQ-UI-SF and IIQ-7 scores decreased significantly compared to the preoperative scores (P&lt;0.05). Conclusion: LSG results in a clinically significant improvement in most common types of UI, regardless of patient reproductive history, existence of comorbid conditions, and smoking status. Keywords: bariatric surgery, obesity, urinary incontinenc