Retrospective Analysis Research Articles

Modified hepatic left lateral lobe inversion in laparoscopic proximal gastrectomy: An analysis of 13 cases

BACKGROUND In laparoscopic proximal gastrectomy (LPG), the prolapse of the hepatic left lateral lobe near the lesser curvature and esophageal hiatus can obstruct the field of vision and operation. Therefore, it is necessary to retract or obstruct the hepatic left lateral lobe to ensure a clear field of vision. AIM To investigate the safety and clinical efficacy of the modified hepatic left lateral lobe inversion technique for LPG. METHODS A retrospective analysis was conducted on the clinical data of 13 consecutive patients with early-stage upper gastric adenocarcinoma or adenocarcinoma of the esophagogastric junction treated with LPG from January to December 2023 at the Department of Gastrointestinal Surgery, Second Affiliated Hospital of Fujian Medical University. The modified hepatic left lateral lobe inversion technique was used to expose the surgical field in all patients, and short-term outcomes were observed. RESULTS In all 13 patients, the modified hepatic left lateral lobe inversion technique was successful during surgery without the need for re-retraction or alteration of the liver traction method. There were no instances of esophageal hiatus occlusion, eliminating the need for forceps to assist in exposure. There was no occurrence of intraoperative hepatic hemorrhage, hepatic vein injury, or hepatic congestion. No postoperative digestive complications of Clavien-Dindo grade ≥ II occurred within 30 days after surgery, except for a single case of pulmonary infection. Some patients experienced increases in alanine aminotransferase and aspartate aminotransferase levels on the first day after surgery, which significantly decreased by the third day and returned to normal by the seventh day after surgery. CONCLUSION The modified hepatic left lateral lobe inversion technique has demonstrated satisfactory results, offering advantages in terms of facilitating surgical procedures, reducing surgical trauma, and protecting the liver.

Мультидисциплинарный подход в лечении рецидива рака прямой кишки с вовлечением мочевых путей

Aim. To evaluate immediate and long-term oncological results ofsurgical treatment of recurrent rectal cancer involving the urinary tractsystem to show the need for a multidisciplinary treatment approach for locally advanced recurrent rectal cancer. Material and methods. Retrospective cohort analysis with prospective supported database. Analyzed 14 cases: all patients with locally advanced rectal cancer recurrence involving urinary tract system were operated at the Clinic of Coloproctology and Minimally Invasive Surgery in 2013-2022. Results. The age of the patients was 51.6 ± 13.0 years, 6 men, 8 women. The greatest recurrence number was (88%) finded in group of primary colorectal cancer of the lower and middle parts of the rectum. In 57.2% observations patients received preoperative chemotherapy or combination with radiotherapy. Approximately 64% of primary operations were performed using an open approach. Recurrence of CRC with pT3-T4 invasion was diagnosed in 72% of cases. Metastatic damage of lymphatic nodes after primary surgery were identified in 57.2% of cases. In 2 observations primary surgery was performed with R2 resection margin, relapse in that cases was detected after 11 and 13 months. One histopathological report indicated R1 resection, relapse noted after 6 months. Adjuvant chemotherapy was performed in 10 cases (71.4%), in two cases (14.3%) – postoperative radiation therapy. Average time for recurrence detecting after primary operation was 16.5 [12-28] months. Advanced combined interventions including recurrence removal with colon resection, gynecological and urological stages (RR+CR+GR+UR) amounted to 36%, recurrence removal with resection colon and urological stage (RR+CR+UR) was performed in 43% of cases, recurrence removal without the colonic stage (RR+GR+UR and RR+UR) - 3 (21%) patients. Reconstructive surgery to restore urine derivation were performed in 12 (85.7%) cases. The average duration of the procedures was 412.5[205-490] minutes, intraoperative blood loss - 275 [150-400] ml. Early postoperative complications are classified as Clavien-Dindo III. One patient with SIRS was classified as a complication Clavien-Dindo IV. The duration of the postoperative period was 25.5 [14-30] days. Postoperative mortality was 0%. According pathohistological examination R1 resection was detected in 3 (21.4%) cases. Adjuvant chemotherapy was performed 8 (57.1%) patients, in 1 case (7.1%) combination with a course of radiotherapy. During the period 24 months after surgery the mortality rate was 14.3%, repeated relapses diagnosed in 3 (21.4%) patients, one was reoperated. Distant metastases was noted in 4 (28.6%) patients, of which in 1 case with repeated recurrence. Discussion. Our urogenital bacterial diversity analysisshowed that human testicular tissue is not a microbiologically sterile environment and also presented new data associated with testicular tissue and its possible relations with male infertility. Conclusion. The main treatment method for locally advanced rectal cancer recurrence involving the urinary tract system is surgical. Multidisciplinary approach with the involvement in the surgical team urologist oncologist made it possible to perform a one-stage radical intervention for locally advanced recurrence of rectal cancer with restoration of derivation urine without the need for subsequent reconstructive procedures on the urinary system. Keywords: rectal cancer, urinary tract, multidisciplinary approach, surgical treatment, recurrence.

Survival Outcomes of Metastatic or Recurrent Cervical Cancer Patients Treated with Palliative Intent Chemotherapy: Real-World Data

ObjectiveTo analyse the outcomes of metastatic or recurrent cervical cancer patients treated with palliative intent chemotherapy, as data on their outcomes are scant from LMIC.MethodsIn this retrospective analysis, 302 upfront metastatic or recurrent cervical cancer patients were treated with palliative intent from 1 January 2015 till 31 March 2020. The demographics, palliative therapy details, progression-free survival (PFS) and overall—survival (OS) were analysed for those receiving chemotherapy.ResultsThe median age was 53 (IQR 48-61) years and 248, (82.0 %) patients belonged to low-socioeconomic strata. Most common histology was squamous cell carcinoma (SCC) in 263 (87.1%) patients. De novo metastatic disease was seen in 119 (39.4 %) and recurrence post-treatment was seen in 183 (60.6 %) patients. Among the 302 patients, 149 (49.3%) patients received palliative chemotherapy, 70 (23.2 %) received palliative radiotherapy and 83 (27.5%) patients were considered for palliative care alone. The most common regimen was paclitaxel and carboplatin in 124 (83.2 %) patients. Eighty (53.7 %) patients completed 6 cycles. Four (2.7 %) received bevacizumab with chemotherapy in the first line and 3 (2.0%) patients received pembrolizumab in second line. The median PFS was 8.5 months (95% CI: 7.12–9.89 months) and median OS was 13.0 months (95% CI: 11.10–14.98 months) with median duration of follow-up of 33.4 months (range 27.9–38.9 months).ConclusionsIn real-world scenario, only half of the metastatic or recurrent cervical patients received any palliative chemotherapy. Paclitaxel and carboplatin are an effective regimen, and there was limited access to targeted therapy and immunotherapy.

Treatment outcomes and their predictors in children hospitalized with varicella complicated by bacterial superinfections after pandemic of COVID-19 – a retrospective multicenter analysis of real-life data in Poland

Treatment outcomes and their predictors in children hospitalized with varicella complicated by bacterial superinfections after pandemic of COVID-19 – a retrospective multicenter analysis of real-life data in Poland

Abstract A157: Age-related disparities in survival following colorectal cancer diagnosis in an underserved community in Georgia

Abstract Background: Significantly higher colorectal cancer (CRC) mortality exists in Augusta-Richmond County of Georgia, an area with a large proportion of underserved African Americans. Although age is one of the most important prognostic factors in cancer survival, age disparities in survival following CRC diagnosis have been understudied within geographic areas of Georgia. Thus, we examined overall survival (OS) rates following CRC diagnosis between 18-49, 50-59, 60-69, and 70+ age groups. We also determined whether age-specific differences were associated with OS and examined factors contributing to OS across these four age groups in a cancer center population in Augusta-Richmond County. Methods: A retrospective cohort analysis was performed using 2012-2022 data from the Georgia Cancer Center cancer registry linked with electronic medical records and billing data. OS following CRC diagnosis was the outcome of interest; those who survived until 2023 were censored. Cox proportional hazard regression was used to examine the mentioned associations in different age groups adjusted for sociodemographic characteristics (gender, race, marital status, insurance, county-level poverty), health-related factors (body mass index, smoking status, alcohol use, chronic disease conditions, family history of CRC/cancer), tumor characteristics (tumor grade, stage at diagnosis, primary site), and diagnosis year. Results: Among 839 CRC patients, OS rates were lowest among patients aged 70+ years (52.8%) followed by 60-69 (61.2%), 18-49 (63.7%), and 50-59 (65.2%) years (p <0.001). In the adjusted analysis, CRC patients aged 70+ years had a 2.1-fold increased risk of death due to all causes compared to those aged 18-49 years (HR, 2.1; 95% CI, 1.2-3.7). Regardless of age groups, CRC patients with a late stage at diagnosis were associated with increased risk of all causes of death by 2.0-5.7 times (18-49 year: HR, 4.9; 95% CI,2.7-8.8; 50-59 year: HR, 5.7; 95% CI,3.6-9.0; 60-69 year: HR, 5.3; 95% CI, 3.5-8.0; 70+ year: HR,2.0; 95% CI,1.3-3.0). Among patients aged 60-69 years, those living in poverty areas had an increased risk of all causes of death by 1.8-times (HR, 1.8; 95% CI, 1.2-2.7). However, having private insurance (HR, 0.3; 95% CI,0.2-0.5) was associated with lower risk of mortality by 69% for 50- 59 age group. Conclusion: Patients aged 70+ years reported lower OS rates. Late stage at diagnosis was strongly associated with increased risk of death regardless of age; significantly greater risk was observed at 50-59 age group followed by 60-69, 18-49, and 70+ age groups. In particular, poverty had an negative impact on the risk of death following CRC diagnosis for the 60-69 age group. The high mortality among patients aged 50 and older emphasizes the need for developing strategies for increasing the screening uptake and starting at earlier ages, particularly among the most vulnerable populations. Equally important are strategies to improve access to screening and treatment resources for patients with limited access to healthcare. Citation Format: Meng-Han Tsai, Jorge Cortes, Marlo Vernon, Elinita Pollard, Steven S. Coughlin, Yanbin Dong, Kenneth J. Vega. Age-related disparities in survival following colorectal cancer diagnosis in an underserved community in Georgia [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A157.

Abstract B032: Advancing the science of cancer in Latinos conference

Abstract Cancer is the leading cause of mortality within the Latino population. Projections suggest a 142% increase in cancer incidence among Latinos over the next two decades. This trend is concerning given that Latinos, the largest minority group in the United States, are expected to constitute at least 28% of the nation's populace by 2060. To address the need for enhanced comprehension of these trends and to identify equitable interventions targeting Latino health disparities, the Institute of Health Promotion Research and the Mays Cancer Center jointly established the biennial Advancing the Science of Cancer in Latinos (ASCL) Conference. The fourth ASCL Conference convened in San Antonio, TX from February 21-23, 2024. The conference objectives were twofold: 1) Examine the intersection of health equity and biological underpinnings in cancer control, prevention, and treatment; and 2) Foster collaborative initiatives among attendees aimed at addressing cancer-related health disparities within the Latino community. The 2024 conference attracted 286 participants compared to 251 attendees in 2022, encompassing guest speakers, researchers, physicians, healthcare professionals, patient advocates, researchers, and students. It comprised 23 sessions (3 keynotes, 6 plenaries, 6 breakouts, 3 general sessions, 1 special session, 1 lunch panel session) featuring insights from 51 speakers, alongside a poster session highlighting 80 research abstracts and a rapid-fire session tailored for early-career investigators. Sessions encompassed multiple topics relevant to Latino cancer research, spanning health disparities, clinical trials, survivorship, patient advocacy, climate change impacts on cancer, precision medicine, health policy and social determinants of health. A post-conference survey from a cohort of 48 respondents underscored high levels of satisfaction, with 90% expressing pronounced contentment regarding the conference experience, compared to 85% in 2022. Moreover, nearly all respondents (98%) rated the relevance of conference content to Latino cancer science as excellent, with 93% regarding the conference as an exceptional platform for information exchange, compared to 79% in 2022. Impressions regarding session quality were overwhelmingly positive, with 90% of respondents indicating a high level of satisfaction, and all survey respondents acknowledging the objectivity, balance, and absence of commercial bias in the session content. Our results showed that the resounding positivity in attendee feedback reflects the conference's success in fostering meaningful engagement among researchers committed to alleviating Latino cancer health disparities. The ASCL conference facilitated an understanding of cultural nuances and barriers specific to the Latino community, stimulating collaborative efforts aimed at enhancing Latino health outcomes. Overall, this retrospective analysis affirms the conference's success in achieving its stipulated objectives and underscores the need of having consistently coordinated research endeavors to reduce Latino health disparities. Citation Format: Amelie G. Ramirez, Rebecca T. Jones, Matthew P. Banegas, Maria C Camargo, Gerardo Colon-Otero, Cliff Despres, Laura Fejerman, Filipa Lynce, Martin Mendoza, Patricia I. Moreno, Alejandro Recio-Boiles, Barbara Segarra-Vazquez, Sandi Stanford, Mariana Stern, Katherine Y. Tossas, Edward J. Trapido, Nicolette M Orozco. Advancing the science of cancer in Latinos conference [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B032.

Abstract A161: Racial and ethnic differences in receipt of guideline-recommended hepatocellular carcinoma surveillance in a high Risk, diverse primary care patient population: A study in two large integrated healthcare systems in California and Hawai‘i

Abstract Guideline-recommended ultrasounds for hepatocellular carcinoma (HCC) surveillance target patients with cirrhosis and certain liver conditions, yet uptake remains low, particularly among racial/ethnic minority groups. Underuse may be attributed to factors at the patient, provider, healthcare system, and neighborhood levels. However, in-depth analyses identifying contributory factors are lacking. We investigated the presence of racial/ethnic disparities in receipt of recommended surveillance among high-risk patients as a retrospective analysis of electronic health record (EHR) data from Kaiser Permanente Hawai‘i (KPHI) and Sutter Health in California, both of which serve numerous Asian American, Hispanic, Native Hawaiian (NH), other Pacific Islander (PI), and multiracial/ethnic patients. We included patients with ≥1 in-person encounter (2000-2017), no history of liver cancer, and a clinical indication of surveillance eligibility (cirrhosis, chronic hepatitis B or C, or a high FIB-4 score ≥2.67) with a minimum EHR follow-up of 18 months post-eligibility. Recommended surveillance is biannual abdominal imaging (ultrasound, CT, MRI) or alpha-1 fetoprotein tests. We categorized eligible patients as 'ever surveilled' if conducted at least once during follow-up and by the proportion of follow-up time they were up-to-date with surveillance (PTUDS). The cohort includes 54,597 patients (9,488 from KPHI; 45,109 from Sutter); current results are for the KPHI subset only. Among N=9,488 patients (median age: 52; 46% female; 26% NHW, 14% NH, 11% Filipino, 10% multiracial/ethnic) median follow-up was 91 months and 82% were surveilled at least once, with a mean PTUDS of 14% (SD=19%) overall and 19% (SD=21%) among the surveilled. We used sex- and age-adjusted log-risk regression for risk ratio (RR) of ‘ever surveilled’ vs. not and linear regression for PTUDS; NHW is the reference group in all models. We found that NH (RR=0.96, 95%CI 0.93-1.00), PI (RR=0.91, 95%CI 0.97-0.95) and multiracial/ethnic (RR=0.95, 95%CI 0.91-0.99) patients were significantly less likely to be ever surveilled, and that PI (beta=-0.02, 95% CI -0.04-0.01) race/ethnicity was significantly associated with lower PTUDS, while Chinese (beta=0.04, 95% CI 0.02-0.06), Korean (beta=0.04, 95%CI 0.01-0.07), Vietnamese (beta=0.05, 95%CI 0.02-0.09), and other Asian (beta=0.03, 95%CI 0.00-0.07) ethnicities were significantly associated with higher PTUDS. Although not statistically significant, surveillance rates were lower for American Indian/Alaska Native and Black groups, and higher for Japanese and Non-Hispanic Other race/ethnicity groups. Continued analyses will incorporate Sutter data, employ fully adjusted models with clustering by health system, and examine patient, provider, and neighborhood drivers of these disparities. Our findings indicate racial/ethnic disparities in HCC surveillance receipt, particularly noting the heterogeneity within Asian populations, and underscore the importance of analyzing disaggregated data for Asian American groups to fully understand and address these disparities. Citation Format: Enyao Y. Zhang, Mindy DeRouen, Alison J. Canchola, Aly M. Cortella, Pushkar Inamdar, Janet N. Chu, Sixiang Nie, Mai Vu, Ma Somsouk, Michele M. Tana, Anna D. Rubinsky, Iona Cheng, Mi-Ok Kim, Mark Segal, Chanda Ho, Yihe G. Daida, Su-Ying Liang, Hashem B. El-Serag, Scarlett L. Gomez, Salma Shariff-Marco, Caroline A. Thompson. Racial and ethnic differences in receipt of guideline-recommended hepatocellular carcinoma surveillance in a high Risk, diverse primary care patient population: A study in two large integrated healthcare systems in California and Hawai‘i [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A161.

Emergent dermatological injuries and conditions in skiing and snowboarding: a retrospective analysis of NEISS emergency department data

Emergent dermatological injuries and conditions in skiing and snowboarding: a retrospective analysis of NEISS emergency department data

Letter to the editor for the article “Diagnostic performance of photodynamic diagnosis with oral 5-aminolevulinic acid for upper tract- and bladder urothelial carcinoma: a single-centre, retrospective analysis”

Letter to the editor for the article “Diagnostic performance of photodynamic diagnosis with oral 5-aminolevulinic acid for upper tract- and bladder urothelial carcinoma: a single-centre, retrospective analysis”

Surgical treatment of graft infection combined with aortoesophageal fistula after TEVAR: a retrospective single-center, single-arm study

ObjectiveAortoesophageal fistula (AEF) secondary to thoracic aortic endovascular repair (TEVAR) is rare and fatal. The author reports the treatment methods and outcomes of 10 patients with a TEVAR graft infection and an aortoesophageal fistula.MethodA retrospective analysis was conducted on the clinical data of 10 patients who developed a secondary AEF and a graft infection after TEVAR from March 2018 to March 2024.ResultThe perioperative mortality rate was 70%. Two patients had TEVAR only and all died of bleeding and infection. Eight patients underwent open surgery, five died within 30 days, four of them died due to massive bleeding, the one patient died of a serious infection after surgery. Three patients recovered well and were discharged. One patient died of severe pneumonia 3 months after discharge, and two patients survived for 6 years and 3 months, respectively.ConclusionExtra-anatomical bypass reconstruction is feasible for treating graft infection combined with aortoesophageal fistula after TEVAR but related to bad outcomes in most of the patients. It is reserved for highly select patients and is performed at centers with experience with this procedure.

Younger age, longer delay to surgery and meniscal tears are associated with a smaller ACL remnant: An analysis from the registry of the Francophone Arthroscopic Society

AbstractPurposeThis study aimed to evaluate which preoperative patient, injury or clinical factors were associated with the anterior cruciate ligament (ACL) remnant volume in patients undergoing ACL surgery. It was hypothesized that the main factors determining an insufficient ACL remnant volume at the time of surgery were younger age and longer time to surgery.MethodsA retrospective analysis from the Francophone Arthroscopic Society's registry was conducted, including 1565 patients with an ACL lesion underdoing a primary ACL surgery (reconstruction or repair) between June 2020 and June 2023. Patients were excluded in case of revision surgery and incomplete data. Preoperative factors—including patient demographics, delay to surgery, preoperative laxity and the presence of meniscal tears or cartilage lesions—were analysed to determine their influence on ACL remnant volume (estimated by the surgeon as the percentage of residual volume). Univariate, multivariate and receiver operating characteristic curve analyses were performed to explore these relationships.ResultsMultivariate analyses demonstrated that younger age (<20 years and 20–30 years compared to ≥40, p = 0.02), higher time from injury to surgery (≥12 months compared to <3 months, p = 0.01) and the presence of a medial (p = 0.01) or a lateral meniscal tear (p = 0.02) were significant predictors of an ACL remnant volume ≤ 50%.ConclusionsYounger age (under 30 years of age), a time from injury to surgery above 12 months and the presence of medial and lateral meniscal tears are associated with higher odds of observing a smaller ACL remnant volume at the time of the ACL surgery. These factors should be considered when planning ACL remnant preservation techniques.Level of evidenceLevel III.

Exploring Revision Total Ankle Arthroplasty Failures A Comparison Between Failed and Successful Revision Cases

This study assesses the comorbidities that are associated with failed revision total ankle arthroplasty (TAA) and explores the outcomes following a failed revision TAA. A retrospective analysis was conducted on a cohort of patients who underwent a revision TAA at a single institution from 2008 to 2022. Patients were identified as having revision failure if they required explantation, below-knee amputation (BKA), or a revision of either metal component. Statistical analysis was performed to identify any significant differences and summarize outcomes. The study included a total of 87 patients who underwent revision TAA with 12 patients who subsequently experienced revision failure. The revision TAA failure rate was 13.8%. There were higher rates of former smokers (58.3%; n = 7) and a history of diabetes (33.3%; n = 4) in the failure cohort, although these differences did not reach statistical significance. Limb salvage procedures were achieved in 11 cases (91.7%). Approaches for failed revision TAAs included arthrodesis (n = 5) with 2 isolated ankle arthrodesis (AA) and 3 tibio-talo-calcaneal (TTC) arthrodesis, an additional revision arthroplasty (n = 6), or amputation (n = 1). Ankle arthroplasty retention was successful in 6 cases (50.0%). Our results demonstrate that a second revision approach was chosen in half of the cases, underscoring its viability as a successful intervention according to patient preferences. Level of Evidence: III

Ten-Year Results of the Fitmore® Hip Stem with a Focus on Varus/Valgus Alignment and Subsidence—A Retrospective Monocentric Analysis

Ten-Year Results of the Fitmore® Hip Stem with a Focus on Varus/Valgus Alignment and Subsidence—A Retrospective Monocentric Analysis

Multimodal MRI-based radiomics models for the preoperative prediction of lymphovascular space invasion of endometrial carcinoma

PurposeTo evaluate the predictive capabilities of MRI-based radiomics for detecting lymphovascular space invasion (LVSI) in patients diagnosed with endometrial carcinoma (EC).Materials and methodsA retrospective analysis was conducted on 160 female patients diagnosed with EC. The radiomics model including T2-weighted and dynamic contrast-enhanced MRI (DCE-MRI) images was established. Additionally, a conventional MRI model, which incorporated MRI-reported FIGO stage, deep myometrial infiltration (DMI), adnexal involvement, and vaginal/parametrial involvement, was established. Finally, a combined model was created by integrating the radiomics signature and conventional MRI characteristics. The predictive performance was validated by the area under the curve (AUC) of the receiver operating characteristic (ROC) curves. A stratified analysis was conducted to compare the differences between the three models by Delong test.ResultsIn predicting LVSI, the radiomics model outperformed the clinical model in the training cohort (AUC: 0.899 vs. 0.8862) but not in the test cohort (AUC: 0.812 vs. 0.8758). The combined model demonstrated superior performance in both the training and test cohorts (training cohort: AUC = 0.934, 95% CI: 0.8807–0.9873; testing cohort: AUC = 0.905, 95% CI: 0.7679-1).ConclusionsThe combined model exhibited utility in preoperatively predicting LVSI in patients with EC, offering potential benefits for clinical decision-making.

Long-term outcomes of Allium ureteral stent as a treatment for ureteral obstruction

Ureteral obstruction is a prevalent urological condition associated with significant complications. The purpose of our study was to assess the safety and efficacy of a novel self-expanding, large caliber, biocompatible polymer-coated ureteral stent (Allium) for the treatment of ureteral obstructions. We conducted a retrospective analysis of data from patients who underwent Allium ureteral stent placement at our institute between November 2018 and May 2023. Demographic, clinical, and perioperative parameters were collected and analyzed. Logistic regression analyses were performed to identify preoperative factors predicting Allium stent migration. The study cohort comprised 30 patients who received a total of 40 successfully implanted Allium stents. No significant adverse events related to the insertion procedure were observed. During a median follow-up period of 29 months (range: 1–60 months), migration occurred in 11 (27.5%) stents while encrustation was noted in 8 (20%) stents. The median functional duration of the Allium stents was found to be 22 months (range:1–60 months), with an overall functioning rate at last follow-up being recorded as 59.5%. Multivariate analysis revealed that the glomerular filtration rate of the ipsilateral kidney was the sole risk factor predictive of Allium stent migration. With its minimal invasiveness and good tolerability, the Allium stent represents a safe and viable management option for treating ureteric obstructions; however, it should not be considered as definitive treatment but rather as an alternative option for patients unwilling or unsuitable for definitive treatment, particularly high-risk individuals or elderly patients exhibiting decreased ipsilateral glomerular filtration rates.

Does the Webster`s Triangle Preservation Really Matter? A Retrospective Analysis of the Low to Low Osteotomies in the Head of the Inferior Turbinates

Abstract Background Osteotomies are important maneuvers in the plastic surgeon`s arsenal for the nasal dorsum treatment. However, there is a concern regarding a possible medialization of the inferior turbinate`s heads and narrowing of the internal nasal valve if the Webster`s triangle is not preserved. Objectives To analyze the mobilization of the inferior turbinates during primary rhinoplasty after lateral osteotomies. Methods This is a retrospective study in which we analyzed 37 patients who underwent very-low-to-low osteotomies in our service, during primary rhinoplasties. Axial and coronal CT-scans were obtained, and pre-operative and 6 months post-operative images were compared with Radiant DICOM Viewer software (Medixant©) in 3D Multiplanar Reconstruction (MPR). Results There were no statistically significant differences between pre- and post-operative measurements of the lower turbinate`s osseous bases, both in axial (p=0,305) and coronal (p=0,08) images Conclusions Low-to-low osteotomies showed no medialization of the inferior turbinate`s heads or narrowing of the internal nasal valve in this study.

Анализ теории и практики адаптации обучающихся к интерактивным технологиям обучения

The article provides a retrospective analysis of various approaches to the adaptation of students in an interactive educational environment. The characteristics of each of the analyzed approaches highlight the specifics of students' adaptation to the conditions of an interactive learning environment. The purpose of the article is to analyze the theory and practice of students' adaptation to an interactive educational environment. A comparative analysis of various scientific approaches to the adaptation of students to the educational process has allowed us to define pedagogical processes as synergetic systems in which unstable, unexpected and unpredictable situations are constantly created that require an adequate operational response from students. Consideration of pedagogical processes as synergetic systems leads to the need to use interactive educational technologies in the educational process. In an interactive educational environment, adaptation does not manifest itself in a traditional academic form, but takes the form of preadaptation, which requires students to quickly search, build and regulate their attitude and behavior, adequately changing the conditions of the educational environment. Based on the analysis of the dynamics of the development of interactive learning technologies in the study, meaning-creating educational technologies have been experimentally developed and substantiated, allowing creating conditions in the educational process for the openness of thoughts, ideas and meanings of students and the phenomena studied and knowledge about them. The educational technologies proposed in the article are a new direction in the development of an interactive educational environment, and their use in educational practice can significantly increase the adaptability of students to the educational environment.

Retrospective Analysis of Systemic Steroid and Combined Systemic-Intratympanic Steroid Treatment Results and Prognostic Factors in Sudden Idiopathic Hearing Loss

Retrospective Analysis of Systemic Steroid and Combined Systemic-Intratympanic Steroid Treatment Results and Prognostic Factors in Sudden Idiopathic Hearing Loss

Protein Tyrosine Kinase 7 (PTK7) in Breast Cancer: A Retrospective Analysis of Tumour Expression and Association with Clinical Outcome

Protein tyrosine kinase 7 (PTK7), originally known as colon carcinoma kinase (CCK4), is an evolutionary conserved, catalytically defective transmembrane receptor involved in Wnt signalling. PTK7 has been identified as a potential therapeutic target, and a PTK7 antibody drug conjugate (PF-06647020; cofetuzumab pelidotin) has been investigated in phase I clinical trials for triple-negative breast cancer, ovarian cancer, and non-small cell lung cancer. PTK7 protein expression was evaluated in 1136 early-stage invasive breast tumours by immunohistochemistry. In addition, PTK7 mRNA expression in the METABRIC (n = 1980) and the TCGA breast cancer cohorts (n = 1082) was evaluated. Associations between PTK7 expression and clinicopathological criteria and patient outcome were determined. No association between PTK7 protein expression and breast cancer-specific survival was observed; however, PTK7 mRNA expression in the METABRIC cohort was associated with breast cancer-specific survival (p < 0.001). PTK7 protein and mRNA expression were associated with breast cancer-specific survival of patients with a poor prognostic Nottingham Prognostic Index (NPI) and a moderate prognostic NPI, respectively. Taken together, these data indicate that PTK7 expression is associated with patient outcome in subgroups of breast cancer patients.

A retrospective database analysis of pediatric parathyroidectomies from the United Kingdom registry of endocrine and Thyroid Surgeons

AbstractIntroductionThe United Kingdom Registry of Endocrine and Thyroid Surgery (UKRETS) holds the largest database of pediatric parathyroidectomy cases globally. There are currently no quoted acceptable cure or complication rates in the literature.MethodsThis retrospective database analysis evaluates the efficacy and safety of targeted parathyroidectomy (tPTx) and bilateral neck exploration (BNE) in first‐time parathyroidectomy for pediatric primary hyperparathyroidism (PHPT) through analysis of the UKRETS database (1995–2022). Pre‐, intra‐ and postoperative outcomes were assessed and analyzed.Results168 cases underwent parathyroidectomy; 25 (15%) familial and 143 (85%) sporadic PHPT. 69% were female with a mean age of 10 years (Range 0–17). BNE was the most common operative approach (61%; n = 103/168). The most frequently used imaging modality was US (80%; n = 135/168). Mean number of glands excised in familial cases was three compared to one gland in sporadic cases (p < 0.05). Familial cases had a significantly higher rate of postoperative hypocalcemia (32% vs. 9%, p < 0.05) and all were BNE. Cure rate was 96.9% (n = 127/131), with differences in cure rates that did not reach statistical significance (sporadic 98.2% vs. familial 90.5%, p = 0.06). Preoperative localization (image‐positive or negative) made no difference to cure rates in either familial (90% vs. 91%, p = 0.94) or sporadic (97.5% vs. 100%, p = 0.4) cases.ConclusionsThis analysis demonstrates that first‐time pediatric parathyroidectomy for PHPT is safe and effective. Familial cases have a higher rate of postoperative hypocalcemia; therefore, parents should be informed of this when consented. Targeted parathyroidectomy is safe and effective in both sporadic and familial cases, as long as there is positive preoperative imaging.