In an analysis of a large cohort of subjects with IBD, we found a significant association between symptoms of depression or anxiety and clinical recurrence. Patients with IBD should therefore be screened for clinically relevant levels of depression and anxiety and referred to psychologists or psychiatrists for further evaluation and treatment.

PET/CT represents an important staging procedure prior to pancreatic resection for cancer, since it significantly improves patient selection and is cost-effective.

The aim of this study was to assess costs and safety of immediate femoral sheath removal and closure with a suture-mediated closure device (Perclose, Menlo Park, CA) in patients undergoing elective (PCI). A total of 193 patients was prospectively randomized to immediate arterial sheath removal and access site closure with a suture-mediated closure device (SMC; n = 96) or sheath removal 4 hr after PCI followed by manual compression (MC; n = 97). In the SMC group, patients were ambulated 4 hr after elective PCI if hemostasis was achieved. In the MC group, patients were ambulated the day after the procedure. In addition to safety, total direct costs including physician and nursing time, infrastructure, and the device were assessed in both groups. Total direct costs were significantly (all P < 0.001) lower in the SMC group. Successful hemostasis without major complication was achieved in all patients. The time to achieve hemostasis was significantly shorter in the SMC group (7.1 +/- 3.4 vs. 22.9 +/- 14.0 min; P < 0.01) and 85% of SMC patients were ambulated on the day of intervention. Suture-mediated closure allows a reduction in hospitalization time, leading to significant cost savings due to decreased personnel and infrastructural demands. In addition, the use of SMC is safe and convenient to the patients.

Offering living-donor OLT in addition to cadaveric OLT improves survival at costs comparable to accepted therapies in medicine. Cadaveric OLT and living-donor OLT are cost-effective.

Cardiac catheterization is performed routinely in hospitals all around the world. Extensive analysis of complications has been performed in the 1980s and early 1990s. However, because of the new therapeutic innovations based on advanced catheter technologies, these data may not apply to the present situation. Still, there are few data about procedural complications of diagnostic cardiac catheterization over the last 10 years. A total of 7,412 consecutive diagnostic cardiac catheterizations were performed between January 1990 and December 2000 and prospectively assessed in a registry. There were a total of 63 complications, of which 40 were minor and 23 major. Thus, the overall complication rate was 0.8%, with a mortality rate of 0%. Univariate analysis showed lower overall complication rate of senior physicians (> 500 coronary angiographies performed; OR ‫؍‬ 0.58; 95% CI ‫؍‬ 0.34 -0.98; P ‫؍‬ 0.04), smaller catheter size (< 6, 6, > 6 Fr: OR ‫؍‬ 2.6; 95% CI ‫؍‬ 1.53-4.41; P ‫؍‬ 0.0004), and a higher rate in patients having left and right heart catheterization (OR ‫؍‬ 2.62; 95% CI ‫؍‬ 1.46 -4.7; P ‫؍‬ 0.003). Major complications were associated with larger catheters (< 6, 6, > 6 Fr: OR ‫؍‬ 2.35; 95% CI ‫؍‬ 1.0 -5.51; P ‫؍‬ 0.05), whereas vascular complications occurred more often with higher body weight (per 10 kg: OR ‫؍‬ 1.4; 95% CI ‫؍‬ 1.01-1.95; P ‫؍‬ 0.04). Overall complication rate in diagnostic coronary angiography is very low and related to the experience of the performing cardiologist and catheter size. The only predicting risk factors for major complications in coronary angiography were catheter size and body weight. Cathet Cardiovasc Intervent 2003;59: 13-18.