Irish Journal of Medical Science最新文献

{"title":"Urethroplasty- a single centre single surgeon experience.","authors":"Daniel Peter McNicholas, Alexander Taylor, Andrew D Baird","doi":"10.1007/s11845-024-03798-z","DOIUrl":"10.1007/s11845-024-03798-z","url":null,"abstract":"<p><strong>Introduction: </strong>Male urethral stricture affects 100 in 100,000 men. These are investigated using uroflowmetry, retrograde urethrography and cystourethroscopy. Management is usually endoscopic with urethral dilation or direct visual internal urethrotomy, although they have high failure rates. It is now recommended that urethroplasty is performed earlier. In this study we have reviewed a single surgeons experience with urethroplasty and patient outcomes.</p><p><strong>Methods: </strong>We retrospectively reviewed a prospectively maintained database of all urethroplasty operations performed in our hospital over a 5 -year period.</p><p><strong>Results: </strong>Forty-five patients were identified, with a mean age of 46. The most common presenting symptom was poor flow (100%). Uroflowmetry was performed in 31 of 45 patients(69%). More patients had a urethrogram (58%) than flexible cystoscopy (38%). Most strictures were idiopathic (67%). Mean stricture length was 2.6 cm. 71% did not require any further intervention. Five patients required repeat surgery. Four required DVIU and one required a repeat urethroplasty.</p><p><strong>Discussion: </strong>The most popular techniques for urethroplasty in the UK are augmentation urethroplasty using a buccal mucosal graft and anastomotic urethroplasty, both of which we describe. There are variations in what is deemed as successful surgery. The most widely used definition is 'the lack of need for any further operative intervention'. We have recently adopted Patient Reported Outcome Measures using a validated questionnaire to measure the patients perception of a successful outcome. Complex strictures have a higher incidence of complications. 42% of our cohort were complex and we describe results comparable to the published literature.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"3059-3064"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142119806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ireland's Mental Health Bill 2024: progress, problems and Procrustean perils.","authors":"Brendan D Kelly","doi":"10.1007/s11845-024-03806-2","DOIUrl":"10.1007/s11845-024-03806-2","url":null,"abstract":"<p><strong>Background: </strong>Ireland's Mental Health Bill 2024 proposes the most significant revision of mental health legislation since the Mental Health Act 2001.</p><p><strong>Aims: </strong>To explore the 2024 Bill and provide suggestions for the subsequent Act.</p><p><strong>Methods: </strong>Review of the 2024 Bill and related literature.</p><p><strong>Results: </strong>The 2024 Bill proposes useful new definitions (e.g., 'mental disorder', 'treatment') and provisions governing specific practices (e.g., 'physical restraint'). Revision is needed to better provide care and protect rights: (a) proposed treatment criteria for involuntary admission should be retained, but 'risk' criteria deleted; (b) treatment provisions should ensure mental health legislation provides for timely, accountable treatment for all patients; (c) detailed provisions about the content of treatment plans do not belong in primary legislation, which is ill-suited to micro-managing individual care and (d) the Mental Health Commission should be incorporated into the Health Information and Quality Authority.</p><p><strong>Conclusions: </strong>The 2024 Bill proposes useful changes but requires revision, especially for involuntary patients who lack decision-making capacity and decline care, for whom the Assisted Decision-Making (Capacity) Act 2015 does not (and was not designed to) provide solutions. Relying on a convoluted combination of the 2015 Act, Circuit Court and High Court would be legally impossible, clinically impracticable and de facto denial of the rights of people with serious mental illness and their families. The final Act can accord with principles of the 2015 Act without relying on its provisions and should benefit patients and support staff in delivering mental health care that is essential and often life-saving.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2897-2914"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper endoscopy in elderly patients: a multicentre, cross-sectional study.","authors":"Angelo Zullo, Vincenzo De Francesco, Arnaldo Amato, Irene Bergna, Emanuele Bendia, Giorgia Giorgini, Elisabetta Buscarini, Guido Manfredi, Sergio Cadoni, Renato Cannizzaro, Stefano Realdon, Mario Ciuffi, Orazio Ignomirelli, Paola Da Massa Carrara, Giovanni Finucci, Antonietta Di Somma, Chiara Frandina, Mariafrancesca Loria, Francesca Galeazzi, Francesco Ferrara, Carlo Gemme, Noemi Sara Bertetti, Federica Gentili, Antonio Lotito, Bastianello Germanà, Nunzia Russo, Giuseppe Grande, Rita Conigliaro, Federico Cravero, Giovanna Venezia, Riccardo Marmo, Piera Senneca, Angelo Milano, Konstantinos Efthymakis, Fabio Monica, Paolo Montalto, Mario Lombardi, Olivia Morelli, Danilo Castellani, Daniela Nigro, Roberto Festa, Sergio Peralta, Maria Grasso, Antonello Privitera, Maria Emanuela Di Stefano, Giuseppe Scaccianoce, Mariangela Loiacono, Sergio Segato, Marco Balzarini, Paolo Usai Satta, Mariantonia Lai, Francesca Fortunato, Raffaele Manta","doi":"10.1007/s11845-024-03774-7","DOIUrl":"10.1007/s11845-024-03774-7","url":null,"abstract":"<p><strong>Background: </strong>Both macroscopic and histological lesions are frequently detected at upper endoscopy in elderly patients. We assessed the prevalence of main endoscopic and histological alterations in elderly (> 65 years old) patients.</p><p><strong>Methods: </strong>In this study, clinical, endoscopic and histological features of patients referred for upper endoscopy in clinical practice were retrieved. Both univariate and multivariate analyses were executed. Comparisons with previous data were performed.</p><p><strong>Results: </strong>A total of 1336 underwent upper endoscopy in the 28 participating centres. At endoscopy, at least one macroscopic lesion was present in overall 420 (31.4%) patients. Erosive gastritis (13.3%) and erosive oesophagitis (9.8%) were the most prevalent lesions, whilst Barrett's oesophagus, gastric ulcer, duodenal ulcer and erosive duodenitis were observed in 1.8%, 2%, 1.4% and 3.1% patients, respectively. Nine (0.6%) cases of oesophageal, 25 (1.8%) gastric and 2 (0.1%) duodenal neoplasia were detected. At histology, Helicobacter pylori infection was diagnosed in 99 (15.9%) patients, and extensive precancerous lesions on gastric mucosa were detected in 80 (14.5%) patients. Endoscopic lesions were more frequent in males, at first endoscopy and in those with alarm symptoms and lower during PPI therapy. At multivariate analysis, PPI therapy significantly reduced the probability of finding endoscopic lesions (OR: 0.68, 95% CI: 0.46-0.99; P = 0.04), whilst neoplastic lesions were associated with presence of alarm symptoms (OR: 1.5, 95% CI: 1.1-2.1; P = 0.005).</p><p><strong>Conclusions: </strong>We found that the frequency of erosive and neoplastic lesions remained high in elderly patients, whilst the prevalence of both H. pylori infection and peptic ulcer was decreased.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2661-2667"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation dose to the eye of physicians during radio frequency catheter ablation: a small-scale study.","authors":"Yoshiaki Morishima, Koichi Chida, Hiroo Chiba, Koji Kumagai","doi":"10.1007/s11845-024-03802-6","DOIUrl":"10.1007/s11845-024-03802-6","url":null,"abstract":"<p><strong>Background: </strong>Radio frequency catheter ablation (RFCA), a treatment for arrhythmia, requires a long fluoroscopy time that increases the radiation exposure dose to the physician, particularly to the lens of the eye. It is recommended that a lens-specific dosimeter such as DOSIRIS® is used to measure the dose to the lens.</p><p><strong>Aims: </strong>In this study, we investigated whether conventional glass badges can be used as an alternative to lens dosimeters.</p><p><strong>Methods: </strong>The doses to the lenses of two physicians (physician A, main operator; physician B, assistant; physician B was further away from the patient than physician A) were measured for 126 RFCA procedures performed over a 6-month period (fluoroscopy rate of 3.0 p/s with use of a ceiling-hanging shield).</p><p><strong>Results: </strong>The cumulative value measured by a lens dosimeter attached to the inside of Pb glasses (0.07-mm dose equivalent) next to the left eye was 4.7 mSv for physician A, and 0.8 mSv for physician B. The reading on the glass badge worn on the left side of the neck was 4.7 mSv for physician A and 1.3 mSv for physician B. Lens dosimeter and glass badge values showed a good correlation for the left eye and left neck (r = 0.86, p < 0.01).</p><p><strong>Conclusions: </strong>We show that glass badges may be a viable alternative to lens-equivalent dosimetry when using low-pulse fluoroscopy and a ceiling-hanging shield.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2745-2751"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142377923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum fibulin-3 as a diagnostic and prognostic biomarker in patients with knee osteoarthritis.","authors":"Maria Abdullah Hassan, Areej Sh Hameed, Ekhlas Khalid Hameed","doi":"10.1007/s11845-024-03780-9","DOIUrl":"10.1007/s11845-024-03780-9","url":null,"abstract":"<p><strong>Background: </strong>Osteoarthritis is a chronic degenerative disorder with rising prevalence. Early detection of structural damage is difficult. Consequently, there is a pressing demand for reliable biomarkers that enable an earlier diagnosis of osteoarthritis. The aim is to investigate the level of serum fibulin-3 in patients with primary knee osteoarthritis and its correlation with disease severity.</p><p><strong>Subjects and methods: </strong>A case-control study was conducted at the Baqubah Teaching Hospital from November 2023 to January 2024. One hundred twenty persons participated in this study (eighty females with the diagnosis of knee osteoarthritis in its early and late stages, and forty age-matched, apparently healthy control. Serum fibulin-3, ESR, CRP, and calcium levels were measured for all participants. Ethical approval was obtained. SPSS was used for data analysis.</p><p><strong>Results: </strong>Patients with osteoarthritis had considerably higher serum levels of fibulin-3. In patients with late-stage knee osteoarthritis, this rise was greater than in earlier stages. Serum fibulin and ESR are positively correlated. Fibulin's area under the curve is 0.830 for diagnosis and 0.709 for differentiating between osteoarthritis's early and late stages.</p><p><strong>Conclusion: </strong>Serum levels of fibulin-3 can act as diagnostic markers for OA and may be useful in determining the severity of knee osteoarthritis.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2923-2927"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141912775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploration of fibre intake and bowel function in a sample of adults at an Irish university campus.","authors":"Ellen Lynch, Sophie Mulligan, Suzanne L Doyle","doi":"10.1007/s11845-024-03764-9","DOIUrl":"10.1007/s11845-024-03764-9","url":null,"abstract":"<p><strong>Background: </strong>Bowel dysfunction can significantly impair quality of life. Adequate fibre intake is associated with good bowel health but intakes have been reported to be low in Ireland.</p><p><strong>Aim: </strong>This study aimed to gather data on fibre intake and bowel habits in a cohort of adults at a university campus in Dublin, Ireland.</p><p><strong>Methods: </strong>An online questionnaire was developed by adapting validated tools to assess habitual fibre intake and bowel function. The questionnaire was circulated through mailing lists and advertised via QR codes on campus in February/March 2023. Data was analysed using SPSS, p < 0.05 was considered statistically significant.</p><p><strong>Results: </strong>In total, 275 valid responses were received. Low fibre intakes (< 19 g/day) were found in 50.5% of participants. A significantly higher proportion of males had low fibre intake compared to females (62.2% vs 44.8%, p = 0.039). Nearly a third (30.2%) of respondents experienced mild symptoms of bowel dysfunction, and 13.1% experienced moderate to severe symptoms. An inverse relationship was observed between fibre intake (g/day) and bowel dysfunction (p = 0.033).</p><p><strong>Conclusions: </strong>In this cohort, low fibre intakes and some degree of bowel dysfunction were prevalent. Public health campaigns to increase fibre intake could prove to be a cost-effective way to improve bowel function and health amongst adults in Ireland.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2753-2760"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyzing quality of life after low anterior resection for rectal cancer.","authors":"Seyed Mostafa Meshkati Yazd, Reza Shahriarirad, Shayan Almasi, Darioush Naddaffard, Saman Sheikhi, Imana Mosayebi, Kimia Goudarzi, Seyed Mohsen Ahmadi Tafti, Behnam Behboudi, Alireza Kazemeini, Mohammad Reza Keramati","doi":"10.1007/s11845-024-03757-8","DOIUrl":"10.1007/s11845-024-03757-8","url":null,"abstract":"<p><strong>Background: </strong>Rectal cancer is one of the most common cancers worldwide that imposes high costs on patients and the healthcare system while also having a significant impact on the patient's quality of life (QoL).</p><p><strong>Aim: </strong>We aimed to assess the QoL of rectal cancer patients undergoing lower anterior resection (LAR) and evaluate potential confounding factors.</p><p><strong>Methods: </strong>In this cross-sectional study, we included patients undergoing neo-adjuvant chemotherapy followed by LAR, diverting ileostomy, and adjuvant chemotherapy. Six months after stoma reversal, QoL was assessed using a cancer-specific core questionnaire EORTC QLQ-C30 and also a colorectal cancer module EORTC QLQ-CR29. Linear and quantile regression models were used to examine associations of QoL and patients' demographical and clinical features.</p><p><strong>Results: </strong>The study population comprised 210 patients with an average age of 61.9 ± 11.0 (range: 37-85) and 112 (53.3%) male patients. The higher tumor stage increases the QoL of patients by reducing diarrhea, loss of appetite, defecation problems, and stool frequency. Based on the linear regression analysis, a farther distance of the anastomosis from the anal verge (AV) was correlated with lower symptom scores and higher QoL. Also, at the 75th percentile cut-off of the QLQ-CR29 scores, a higher N stage of the tumor was correlated with higher QoL based on functional subscale (coefficient = 3.032, P = 0.016).</p><p><strong>Conclusions: </strong>QoL of patients after LAR for rectal cancer is significantly associated with the distance of the anastomosis site from the AV.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2643-2652"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Asprosin: the potential player in combined double diabetes and hypothyroidism.","authors":"Hussein Jawad Hassan, Ekhlas Khalid Hameed, Taghreed Uloom Mohammad","doi":"10.1007/s11845-024-03758-7","DOIUrl":"10.1007/s11845-024-03758-7","url":null,"abstract":"<p><strong>Background: </strong>Double diabetes is a term used to describe people with type 1 diabetes who are overweight, show signs of insulin resistance, or have a family history of type 2 diabetes. Asprosin is a novel glucogenic adipokine; Asprosin regulates appetite and glucose metabolism. The study aimed to investigate the level of asprosin in people with double diabetes with and without hypothyroidism and its association with markers of insulin resistance.</p><p><strong>Subjects and methods: </strong>This case-control study was conducted in Iraq between March 2022 and January 2023. One hundred sixty participants were enrolled; the selected participants were classified into three age and sex-matched groups. The first group consisted of eighty healthy controls served as the control group. Of eighty participants with newly discovered DD, half (40) have DD alone, and 40 have both DD and hypothyroidism. Serum asprosin, insulin, thyroid, lipid profile, glucose, and glycated hemoglobin were measured. The estimated glucose disposal rate, triglyceride-glucose index, and HOMA-IR were calculated.</p><p><strong>Results: </strong>Participants with double diabetes had significantly (p ≤ 0.001) greater circulation asprosin levels than subjects in the control group. Comparatively, to double diabetes participants without hypothyroidism, asprosin levels were also higher in double diabetes subjects with hypothyroidism (p ≤ 0.001), and the insulin resistance markers increased in a stepwise way across the asprosin quartiles (p ≤ 0.001). Asprosin significantly correlated with insulin resistance markers, eGDR, plasma glucose, HbA1C, triglycerides, HDL-C, and LDL-C.</p><p><strong>Conclusion: </strong>Elevated asprosin levels might be a potential biomarker for the alteration in glucose metabolism, insulin resistance, and double diabetes. It may be the missing link between metabolic and endocrine disorders.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2915-2921"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin administration during pregnancy tends to reduce the risk of gestational diabetes mellitus and improve pregnancy outcomes in previously infertile women with polycystic ovary syndrome who become pregnant.","authors":"Huamei Liu, Yajia Liu, Changhe Wei, Shoujiu Zhang, Yanjie Xu","doi":"10.1007/s11845-024-03760-z","DOIUrl":"10.1007/s11845-024-03760-z","url":null,"abstract":"<p><strong>Objective: </strong>Metformin reduces incidences of miscarriage and preterm delivery in polycystic ovary syndrome (PCOS) women, but its impact on gestational diabetes mellitus (GDM) is conflicting. Hence, this study set up selection criteria to include previously infertile women with PCOS but without pre-existing DM who became pregnant, aiming to minimize confounders and investigate the influence of metformin on GDM, miscarriage, and preterm delivery.</p><p><strong>Methods: </strong>This study included 195 previously infertile women with PCOS who became pregnant. They were divided into metformin (receiving metformin during pregnancy) and control (not receiving metformin) groups without intervention.</p><p><strong>Results: </strong>Metformin group tended to have a lower incidence of GDM versus control group (13.3% versus 23.3%, P = 0.070). A logistic regression model adjusted for all baseline characteristics (demographics, infertile duration, and diabetes mellitus-related features) showed that metformin was associated with a decreased probability of GDM (odds ratio (OR): 0.426, P = 0.037). Metformin group showed a similar incidence of miscarriage (6.7% versus 11.1%, P = 0.273), but decreased incidences of preterm delivery (not statistically significant) (6.7% versus 13.3%, P = 0.091) and miscarriage or preterm delivery (13.3% versus 24.4%, P = 0.046) versus control group. A logistic regression model adjusted for all the aforementioned features revealed that metformin was related to a lower risk of miscarriage or preterm delivery (OR: 0.417, P = 0.040). Fetal outcomes, including birth weight (P = 0.245) and the incidence of 5 min-Apgar score ≤ 7 (P = 0.702), were similar between groups.</p><p><strong>Conclusion: </strong>Metformin administration during pregnancy may reduce GDM, miscarriage, and preterm delivery risks without adverse effects on fetal outcomes in previously infertile women with PCOS.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2843-2849"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The incidence of incidental neoplasia in pathology samples of patient who underwent appendectomy due to acute appendicitis. A single center experience: 6446 cases.","authors":"Nurettin Sahin, Ferman Tevfik Ozyalvac, Turgut Donmez, Ahmet Surek, Emine Ayca Sahin, Goker Calis, Sezer Bulut, Husnu Aydin, Hamit Ahmet Kabuli, Alpen Yahya Gumusoglu","doi":"10.1007/s11845-024-03793-4","DOIUrl":"10.1007/s11845-024-03793-4","url":null,"abstract":"<p><strong>Purpose: </strong>Appendectomy is the standard treatment of acute appendicitis. However, recent advancements have introduced medical treatment as a potential alternative. Within this context, it's important to recognize the rare occurrence of appendiceal tumors, often incidentally discovered during histopathological examination following appendectomy. Consequently, there's a concern about the possibility of overlooking appendiceal neoplasms, particularly in cases where conservative treatment for acute appendicitis is considered.</p><p><strong>Methods: </strong>The files of patients who underwent surgery for acute appendicitis between January 2015 and December 2023 and were diagnosed with neoplasia in their pathology reports were retrospectively registered. Demographic characteristics of the patients, laboratory and imaging features, details of the surgery performed, preoperative and intraoperative suspicion of neoplasm and data from pathology reports were collected and analyzed.</p><p><strong>Results: </strong>A total of 6446 patients were operated for acute appendicitis. Neoplasia was detected in the histopathological examination of 93 patients (1.44%). Acute appendicitis was diagnosed in 51.6% of the patients by computed tomography. Neoplasm suspicion was present in 9.7% of patients in preoperative imaging methods and in 6.5% of patients intraoperatively. Only appendectomy was performed in 94.5% of patients. The most common appendiceal neoplasm is neuroendocrine tumors (40.9%), followed by appendiceal mucinous neoplasm (29%), sessile serrated adenoma (15%), and adenocarcinoma (6.5%).</p><p><strong>Conclusion: </strong>Although appendiceal neoplasms are relatively rare in proportion, they represent a significant numerical value due to the density of cases. Therefore, this information should be taken into consideration when evaluating treatment options for acute appendicitis.</p>","PeriodicalId":14507,"journal":{"name":"Irish Journal of Medical Science","volume":" ","pages":"2669-2679"},"PeriodicalIF":1.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}