introduction/objective The objective was to assess the effectiveness of laparoscopic gastrectomy, analyzing short-term outcomes of laparoscopic radical gastrectomy in treatment of advanced gastric neoplasms. Methods We performed a prospective cohort observational study, which included 30 patients who underwent elective radical laparoscopic gastrectomy (total or subtotal) for stomach neoplasms, performed in the period between March 2013 and February 2017. results Thirteen patients (43%) had been diagnosed with distal gastric tumors, seven (23%) with proximal gastric tumors, four (13%) with pangastric tumors, four (13%) with mediogastric tumors, and two (7%) with bicentric tumors. Mean operation duration was 286 minutes. The average blood loss was 183 mL. Conversion rate was 10% (three patients). Total of seven (23%) patients had postoperative complications, and mean intensive care unit stay was 1 day. Mean hospital stay after surgery was 13.08 days. The average number of harvested lymph nodes was 33.9, and R0 resection was performed in 87% patients. The overall 30-day mortality rate was 0%. Conclusion Although technically challenging, laparoscopic gastrectomy is a safe and oncologically adequate procedure in the radical surgical treatment of advanced gastric neoplasms.
IntroductionMyotonic dystrophy type 2 (DM2) is a rare autosomal dominant multisystemic disease with highly variable clinical presentation. Several case reports and one cohort study suggested a significant association between DM2 and autoimmune diseases (AIDs).AimThe aim of this study is to analyze the frequency and type of AIDs in patients with DM2 from the Serbian DM registry.Patients and MethodsA total of 131 patients with DM2 from 108 families were included, [62.6% women, mean age at DM2 onset 40.4 (with standard deviation 13) years, age at entering the registry 52 (12.8) years, and age at analysis 58.4 (12.8) years]. Data were obtained from Akhenaten, the Serbian registry for DM, and through the hospital electronic data system.ResultsUpon entering the registry, 35 (26.7%) of the 131 patients with DM2 had AIDs including Hashimoto thyroiditis (18.1%), rheumatoid arthritis, diabetes mellitus type 1, systemic lupus, Sjogren's disease, localized scleroderma, psoriasis, celiac disease, Graves's disease, neuromyelitis optica, myasthenia gravis, and Guillain-Barre syndrome. At the time of data analysis, one additional patient developed new AIDs, so eventually, 36 (28.8%) of 125 DM2 survivors had AIDs. Antinuclear antibodies (ANAs) were found in 14 (10.7%) of 63 tested patients, including 12 without defined corresponding AID (all in low titers, 1:40 to 1:160). Antineutrophil cytoplasmic antibodies (ANCAs) were negative in all 50 tested cases. The percentage of women was significantly higher among patients with AIDs (82.9% vs. 55.2%, p <0.01).ConclusionAIDs were present in as high as 30% of the patients with DM2. Thus, screening for AIDs in DM2 seems reasonable. Presence of AIDs and/or ANAs may lead to under-diagnosis of DM2.
Cardiovascular manifestations are common (35-100%) in the multisystem inflammatory syndrome in children. Our study aimed to analyze treatment impact and cardiovascular involvement in patients with multisystem inflammatory syndrome in children. The retrospective cohort included 81 patients treated between April 2020 and December 2021 (9.3±4.6 years).Elevated cardiac troponin I and pro-B-type natriuretic peptide were observed in 34.2% and 88.5% of patients, respectively. Myocardial dysfunction was observed in 50.6%. Children older than 10 years had a 4-fold increased risk of myocardial dysfunction (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.4-8.9; p=0.006). A moderate negative correlation was proved between left ventricular ejection fraction and C-reactive protein (rr = -0.48; p < 0.001). More than one-fifth of the patients presented with shock. Coronary artery dilatation was observed in 6.2% of patients.Mild pericardial effusion was detected in 27.1% of children. On standard electrocardiogram, 52.6% of children had negative T waves in the inferior and/or precordial leads; transient QTc prolongation was registered in 43% of patients. Treatment failure was observed in 19 patients.Patients initially treated with intravenous immunoglobulins had 10-fold higher chances for treatment failure than patients treated with corticosteroids (OR 10.6, 95% CI 3,; p < 0.001). Cardiovascular manifestations were observed in more than half of the patients, with acute myocardial dysfunction being the most common, especially in children older than 10 years. We established a negative association between the degree of elevation of inflammatory markers and left ventricular ejection fraction. Patients treated with intravenous immunoglobulins who had cardiovascular manifestations had treatment failures more frequently than patients treated with corticosteroids.
Introduction/Objective Recently published studies have addressed the significant impairment of healthrelated quality of life (HRQoL) in patients suffering from gastroesophageal reflux disease (GERD) and functional dyspepsia (FD). To the best of our knowledge, none of the previously published studies have compared the impact of GERD and FD on HRQoL. The aim of the study was to determine the impact of GERD and FD on HRQoL. Methods The current sample was extrapolated from a large cross-sectional population-based study conducted in primary health care facilities. Primary care physicians and general internists diagnosed GERD according to the Montreal definition for population-based studies. Also, primary care physicians and general internists diagnosed FD based on the Rome III criteria. The Serbian version of the generic self-administered Center for Disease Control and Prevention questionnaire was used. We used the propensity score method to match GERD and FD samples on variables such as age, gender, education, and adherence to therapy. Results Regarding self-rated health, similar results were obtained from both groups. The Center for Disease Control and Prevention HRQoL questionnaire version 4 further revealed that functional dyspepsia led to greater disturbances of everyday functioning in regard to the criteria of physically healthy, mentally healthy, and activity limitation days. Conclusion The results of the study have shown significant impairment of HRQoL in both groups, but, surprisingly, patients with FD experienced more limitations to their everyday functioning compared to patients with GERD.
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