Background Diabetes mellitus is associated with an increased incidence of colorectal cancer, but the impact of diabetes on colorectal cancer prognosis is not clear. Objective We conducted a meta-analysis of observational studies to examine the association between pre-existing diabetes and colorectal cancer all-cause mortality, cancer-specific mortality and recurrence. Data Sources Medline and Embase were searched through August 22, 2012. Study Selection We included studies reporting all-cause mortality, cancer-specific mortality, disease-free survival, or recurrence in colorectal cancer patients according to diabetic status. Intervention Meta-analyses performed using random effects models. Main Outcome Measures All-cause mortality, cancer-specific mortality, diseases free survival. Results Twenty-six articles met our inclusion criteria. Colorectal cancer patients with diabetes had a 17% increased risk of all-cause mortality (RR = 1.17; 95% CI: 1.09-1.25) and a 12% increased risk of cancer-specific mortality (RR = 1.12; 95% CI: 1.01-1.24) compared to those without diabetes. Those with diabetes also had poorer disease-free survival (RR = 1.54; 95% CI: 1.08-2.18) compared to their non-diabetic counterparts. In subgroup analyses, diabetes was associated with all-cause mortality in both rectal (RR = 1.24; 95% CI: 1.07-1.29) and colon cancer patients (RR = 1.17; 95% CI: 1.07-1.29). Sensitivity analyses including only patients with non-metastatic disease identified stronger associations between diabetes and both all-cause (RR = 1.32; 95% CI: 1.21-1.44) and cancer-specific (RR = 1.27; 95% CI: 1.06-1.52) mortality. Limitations Some studies had short follow-up or did not report mean or median follow-up. The included studies were heterogeneous in study population, diabetes diagnostic criteria and outcome ascertainment. Conclusion Colorectal cancer patients with diabetes are at greater risk for all-cause and cancer-specific mortality and have worse disease-free survival compared to those without diabetes. Studies are warranted to determine if proper treatment could attenuate the excess mortality among diabetic colorectal cancer patients.

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Surgeons often encounter the challenge of treating acquired abdominal wall defects following abdominal surgery. The current standard of practice is to repair most defects using permanent synthetic mesh material. Mesh augments the strength of the weakened abdominal wall fascia and enables the hernia repair to be performed in a tension-free manner. However, there is a risk of acute and/or chronic infection, fistula formation and chronic abdominal wall pain with the use of permanent mesh materials, which can lead to more complex operations. As a means to avoid such problems, surgeons are turning increasingly to the use of xenogenic and allogenic materials for the repair of abdominal wall defects. Their rapid evolution and introduction into the clinical operating room is leading to a new era in abdominal wall reconstruction. There are promising, albeit limited, clinical data with short-term follow-up for only a few of the many biological tissue grafts that are being promoted currently for the repair of abdominal hernias. Additional clinical studies are required to better understand the long-term efficacy and limitations of these materials.

Introduction of proximal SAE in NOM of HDS splenic trauma patients with active extravasation did not alter mortality rates at a Level 1 Trauma Center. Increased incidence of ARDS and association of failure of NOM with higher splenic organ injury score identify areas for cautionary application of proximal SAE in the more severely injured trauma patient population. Better patient selection guidelines for proximal SAE are needed. Without these guidelines, outcomes from SAE will still lack transparency.

Obesity complicates a number of diseases through mechanisms that are poorly defined. Mobilization and recruitment of progenitor cells to pathological sites is an important factor in disease progression. Here, we analyzed the influence of obesity on the systemic circulation of CD34+ cell populations and correlated frequencies of cells displaying previously established cell marker signatures with the BMI. Comparative analysis of peripheral blood mononuclear cells (PBMC) from 12 nonobese (BMI <30 kg/m2) and 14 obese (BMI >30 kg/m2) disease-free donors by flow cytometry revealed that obesity is associated with a fivefold increased frequency of circulating progenitor cells (CPC), a population consisting of hematopoietic and endothelial precursors. Our data also indicate that obesity is associated with increased frequency of circulating mesenchymal stromal progenitor cells (MSC). In contrast, the frequencies of mature endothelial cells (EC) and CD34-bright leukocytes are unaffected by obesity. Combined, our results indicate that obesity promotes mobilization of progenitor cells, which may have clinical relevance.

Overall survival time for African-Americans with cutaneous melanoma is significantly shorter than for caucasians with this disease. This trend may be attributable to the fact that African-Americans present with advanced disease. An increased level of awareness among both patients and health-care providers is necessary to identify African-Americans with melanoma at earlier stages of disease and to improve survival.

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Our study indicates that 3D imaging offers significant advantages in the teaching of laparoscopic skills to inexperienced individuals.