Background: Diagnosis and management of non-obstetric abdominal pathologies during pregnancy are clinically challenging for both obstetricians and general surgeons. Our aim was to evaluate the outcome of pregnant patients who had undergone non-obstetric abdominal surgery. Methods: We retrospectively reviewed 76 pregnant patients who had required surgery for non-obstetric abdominal pathologies during pregnancy at our department from January 2005 to December 2015. Data were collected retrospectively from medical records as well as from our institutional perinatal database. We evaluated data for clinical presentation, perioperative management, preterm labor, and maternal and fetal outcomes. Results: The patients' mean age was 29 (interquartile range IQR 25-33) years. Indications for surgery were acute appendicitis in 63%, adnexal pathology in 11%, cholecystolithiasis in 5% and other indications in 21%; surgery was performed in an elective setting in 18% and in an emergent/urgent setting in 82%. In five cases, complications, three of them oncological, called for further surgery. Ninety-seven percent of operations were conducted under general anesthesia. Median skin-to-skin time was 50 (37-80) minutes, median in-hospital stay was 4 (3.5-6) days, and 5 % required postoperative intensive care. Preterm labor occurred in 15%, miscarriage in 7% (none of them directly related to abdominal surgery). Conclusion: Abdominal surgery for non-obstetric pathology during pregnancy can be performed safely, if mandatory, without increases in maternal and fetal pathology, miscarriage, and preterm birth rates.

Background/Aim: Prognostic factors like the CRP-to-albumin ratio (CAR) represent potential predictors for survival of pancreatic cancer patients. We aimed to investigate the prognostic strength of the CAR for overall survival of patients with pancreatic cancer undergoing pancreatic resection. Patients and Methods: Data from a total of 202 patients with pancreatic adenocarcinoma who had undergone curative pancreatic resection were subjected to a retrospective review. Overall survival was calculated according to the Kaplan-Meier method, and multivariate Cox regression analysis was used for calculating the prognostic strength of CAR. Results: CAR was an independent prognostic factor of overall survival in univariate and multivariate Cox regression analysis. Elevated CAR was associated with a higher median value of Charlson Index, higher Union for International Cancer Control (UICC) classification and increased carcinoembryonic antigen (CEA) levels. Conclusion: CAR is a useful prognostic factor for the prediction of overall survival for patients undergoing pancreatic surgery. The impact of CAR in individual risk assessment should be evaluated in further studies. Pancreatic cancer represents three to four percent of all malignant tumors, but is responsible for approximately 6% of all cancer-related deaths in Austria. Every year, around 1,500 individuals are diagnosed with pancreatic cancer in Austria (1); pancreatic ductal adenocarcinoma (PDAC) presents in general at a median age of 70 years (2). One of the factors that contributes to this high mortality rate is the fact that most cases are detected in an advanced tumor stage. The factors that contribute to genesis of pancreatic cancer are heredity, lifestyle, smoking, alcohol usage, obesity, diabetes, chronic pancreatitis, and increased use of industrial chemical substances (3-5). Inflammatory processes have been shown to be key mediators of the development and progression of pancreatic cancer (6-8). Furthermore, there is novel evidence that intracellular accumulation in perisinusoidal cells in the liver can lead to activation of carcinogenic development in genetically predisposed individuals (8). Systemic inflammatory reactions play an important role in carcinogenesis and tumor progression (9). CAR (CRP-to-albumin ratio) is related to tumor-free survival and the overall outcome of cancer patients (10, 11), but its role in patients with pancreatic ductal adenocarcinoma (PDA) undergoing pancreatic resection has been investigated only in a few reports (12, 13). At this point, there is no inflammation-based score predicting outcome in patients with PDAC after surgical resection. Our main goal was to determine if CAR could represent a useful prognostic factor for the outcome of patients diagnosed with PDAC.

: Background: The white blood cell count to mean platelet volume ratio (WMR) is increasingly gaining importance as a promising prognostic marker in atherosclerotic disease, but data on lower extremity artery disease (LEAD) are not yet available. The principle aim of this study was to assess the association of the WMR with the occurrence of CLTI (chronic limb-threatening ischemia) as the most advanced stage of disease. Methods: This study was performed as a retrospective analysis on 2121 patients with a diagnosis of LEAD. Patients were admitted to the hospital for the reason of LEAD and received conservative or endovascular treatment. Blood sampling, in order to obtain the required values for this analysis, was implemented at admission. Statistical analysis was conducted by univariate regression in a first step and, in case of significance, by multivariate regression additionally. Results: Multivariate regression revealed an increased WMR (p < 0.001, OR (95%CI) 2.258 (1.460–3.492)), but also advanced age (p < 0.001, OR (95%CI) 1.050 (1.040–1.061)), increased CRP (p < 0.001, OR (95%CI) 1.010 (1.007–1.014)), and diabetes (p < 0.001, OR (95%CI) 2.386 (1.933–2.946)) as independent predictors for CLTI. Conclusions: The WMR presents an easily obtainable and cost-effective parameter to identify LEAD patients at high risk for CLTI.

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[4,7] and the modified hysteroscope in amnioscopic research [14]. Drawing upon the studies mentioned above and our own favorable experience with over 3,500 amnioscopic examinations, our interest has been directed towards a further evaluation of the amnioscopy. This has resulted in an examination of the frequency with which meconium staining of the amniotic fluid is found at the onset of labor in cases of normal pregnancy [13]. Of 536 parturients studied at the onset of labor after completely normal pregnancies. 7 cases or 1.3% were found to have meconium-stained amniotic fluid. This is in contrast to 7-8% found in cases of high risk pregnancy where fetal hypoxia was to be expected. Analysis of these data concerning meconium staining of the amniotic fluid at the onset of labor has shown that there exist possible causes for the appearance of meconium in spite of the lack of obvious clinical manifestations. In the present study, we have extended our interest to include the amnioscopic determination of the time of possible occurrence of meconium staining during the last weeks of normal pregnancy.