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Berlin Brandenburg

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  • Health Reference Center Academic (Gale)  (22)
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  • 1
    Language: English
    In: Expert Review of Anticancer Therapy, 01 April 2011, Vol.11(4), pp.601-612
    Description: Lymph node status is the most important single prognostic factor in esophageal cancer. The detection of involved lymph nodes is therefore the key to cure. This article will provide a meta-analysis and metaregression analysis on the diagnostic performances of current lymph node-detection devices;...
    Keywords: Esophageal Cancer ; Imaging Devices ; Lymph Node Metastasis ; Meta-Analysis ; Micrometastasis ; Molecular Markers ; Sentinel Lymph Node Navigation ; Systematic Review ; Medicine
    ISSN: 1473-7140
    E-ISSN: 1744-8328
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  • 2
    Language: English
    In: Surgical endoscopy, July 2013, Vol.27(7), pp.2526-41
    Description: The aim of this study is to evaluate the most cost-effective treatment strategy using preperitoneal mesh for patients with recurrent inguinal hernia. Currently, the issue of cost-effectiveness is entirely unresolved. A decision analysis was carried out based on the results of a systematic literature review of articles concerning recurrent inguinal hernia repair that were published between 1979 and 2011. A virtual cohort was programmed to undergo three different treatment procedures: (1) laparoscopic totally extraperitoneal hernia repair (TEP), (2) open preperitoneal mesh repair according to Stoppa, and (3) open preperitoneal mesh repair according to Nyhus. We carried out a base-case analysis and varied all variables over a broad range of reasonable hypotheses in multiple one-way and two-way sensitivity analyses. The average cost-effectiveness ratio of Nyhus, Stoppa, and TEP per quality-adjusted life year was US $ ($)1,942, $1,948, and $2,011, respectively. In terms of the incremental cost-effectiveness ratio (ICER), Stoppa was dominated. The choice between TEP or Nyhus procedure depends on the combination of a specific center's rates of recurrence and morbidity as disclosed by three-way sensitivity analysis. Nyhus and TEP repairs are possible optimal choices depending primarily on the institution's rates of recurrence and morbidity. Based on our net benefit-related decision analysis, a hypothetical "fixed budget trade-off" suggests potential annual incremental health system cost savings of $200,000 attained by shifting care for 1,000 patients from TEP to Nyhus repair (depending on clinical end-points, which is a decisive factor).
    Keywords: Decision Trees ; Surgical Mesh ; Hernia, Inguinal -- Economics ; Laparoscopy -- Economics
    ISSN: 09302794
    E-ISSN: 1432-2218
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  • 3
    Language: English
    In: Expert Review of Anticancer Therapy, 01 September 2010, Vol.10(9), pp.1345-1347
    Keywords: Endoscopic Resection ; Endoscopic Submucosal Dissection ; Radical Oncologic Surgery ; Superficial Esophageal Cancer ; Medicine
    ISSN: 1473-7140
    E-ISSN: 1744-8328
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  • 4
    In: The Indian Journal of Medical Research, 2012, Vol.136(2), p.272-279
    Description: Background & objectives: Ischaemia/reperfusion (I/R) associated with major liver surgery compromises liver function. Ischaemic preconditioning (IPC) may be effective in minimizing hepatic I/R injury. This study aimed to investigate the impact of liver ischaemic manipulations on lipid metabolism in rat during the process of liver recovery after liver surgery. Methods: Sixty three male Wistar rats were assigned to three groups: the sham group, the I/R group which underwent warm ischaemia and reperfusion (I/R), and the IPC group. The animals were subdivided in 3 groups [1st, 3rd and 7th postoperative day (PO)]. Hepatic lipase (HL) and total lipase (TL) activity and the levels of aspartate and alanine transaminases (AST, ALT), triglycerides, HDL and cholesterol were measured in plasma. Results: There was no significant difference in the activity of HL and TL between the groups. Significant higher levels of HDL (P〈0.0001) were observed in the IPC group when compared to the other groups on the 3rd PO day. Triglycerides (P〈0.0001) and HDL (P=0.003) in the IPC group were higher than the sham group on the 7th PO day while HDL was also higher in the I/R group. Significantly higher cholesterol levels were found in the I/R and IPC groups on the 7th PO day, which were not observed in the sham group. There was a similar curve for triglycerides in the sham and IPC groups while there were significantly higher levels of triglycerides on day 7 for the I/R group. The levels of HDL in the IPC group were higher on the 3rd and 7th PO day, compared to day 1. Interpretation & conclusion: Warm ischaemia and I/R injury do not seem to affect lipolytic enzyme activity after the 1st PO day despite the effects on plasma lipids. IPC seems to prevent accumulation of triglycerides and cholesterol in plasma. Key words Hepatic lipase--lipid metabolism--preconditioning--rat liver--warm ischaemia
    Keywords: Cholesterol;
    ISSN: 0971-5916
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  • 5
    Language: English
    In: Expert Review of Anticancer Therapy, 01 April 2011, Vol.11(4), pp.571-578
    Description: There has been much recent debate regarding the best surgical procedure to treat esophageal cancer, in particular with regard to the optimum extent of lymphadenectomy to improve survival while minimizing morbidity. No results obtained by prospective, randomized studies on the comparison of...
    Keywords: Esophageal Cancer ; Individualized Lymph Node Dissection Strategies ; Limited Resection and Limited Lymphadenectomy ; Lymph Node Metastasis ; Minimally Invasive Esophagectomy ; Neoadjuvant Therapy ; Three-Field/Two-Field Lymphadenectomy ; Medicine
    ISSN: 1473-7140
    E-ISSN: 1744-8328
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  • 6
    Language: English
    In: BMC Cancer, Feb 15, 2012, Vol.12, p.70
    Description: Background Our aim was to compare survival of the various treatment modality groups of chemotherapy and/or radiotherapy in relation to SEMS (self-expanding metal stents) in a retrospective case-control study. We have made the hypothesis that the administration of combined chemoradiotherapy improves survival in inoperable esophageal cancer patients. Methods All patients were confirmed histologically as having surgically non- resectable esophageal carcinoma. Included were patients with squamous cell carcinoma, undifferentiated carcinoma as well as Siewert type I--but not type II - esophagogastric junctional adenocarcinoma. The decision to proceed with palliative treatments was taken within the context of a multidisciplinary team meeting and full expert review based on patient's wish, co-morbid disease, clinical metastases, distant metastases, M1 nodal metastases, T4-tumor airway, aorta, main stem bronchi, cardiac invasion, and peritoneal disease. Patients not fit enough to tolerate a radical course of definitive chemo- and/or radiation therapy were referred for self-expanding metal stent insertion. Our approach to deal with potential confounders was to match subjects according to their clinical characteristics (contraindications for surgery) and tumor stage according to diagnostic work-up in four groups: SEMS group (A), Chemotherapy group (B), Radiotherapy group (C), and Chemoradiotherapy group (D). Results Esophagectomy was contraindicated in 155 (35.5%) out of 437 patients presenting with esophageal cancer to the Department of General and Abdominal Surgery of the University Hospital of Mainz, Germany, between November 1997 and November 2007. There were 133 males and 22 females with a median age of 64.3 (43-88) years. Out of 155 patients, 123 were assigned to four groups: SEMS group (A) n = 26, Chemotherapy group (B) n = 12, Radiotherapy group (C) n = 23 and Chemoradiotherapy group (D) n = 62. Mean patient survival for the 4 groups was as follows: Group A: 6.92 [+ -] 8.4 months; Group B: 7.75 [+ -] 6.6 months; Group C: 8.56 [+ -] 9.5 months, and Group D: 13.53 [+ -] 14.7 months. Significant differences in overall survival were associated with tumor histology (P = 0.027), tumor localization (P = 0.019), and type of therapy (P = 0.005), respectively, in univariate analysis. Treatment modality (P = 0.043) was the only independent predictor of survival in multivariate analysis. The difference in overall survival between Group A and Group D was highly significant (P [less than] 0.01) and in favor of Group D. As concerns Group D versus Group B and Group D versus Group C there was a trend towards a difference in overall survival in favor of Group D (P = 0.069 and P = 0.059, respectively). Conclusions The prognosis of inoperable esophageal cancer seems to be highly dependent on the suitability of the induction of patient-specific therapeutic measures and is significantly better, when chemoradiotherapy is applied.
    Keywords: Chemotherapy -- Health Aspects ; Chemotherapy -- Patient Outcomes ; Chemotherapy -- Comparative Analysis ; Esophageal Cancer -- Care And Treatment ; Esophageal Cancer -- Patient Outcomes ; Esophageal Cancer -- Research ; Radiotherapy -- Health Aspects ; Radiotherapy -- Patient Outcomes ; Radiotherapy -- Comparative Analysis
    ISSN: 1471-2407
    Source: Cengage Learning, Inc.
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  • 7
    Language: English
    In: The American Journal of Surgery, 2010, Vol.199(6), pp.776-781
    Description: The aim of this study was to compare the immediately postoperative and follow-up results of open and laparoscopic surgery of hepatic cysts in a tertiary hepatobiliary referral center. From March 1999 to February 2007, 59 patients underwent surgical treatment for nonparasitic liver cysts. Patients were assigned to the laparoscopic (n = 42) or open group (n = 17) for analysis. Three conversions to open procedures had to be performed in the laparoscopic group. One patient had to be reoperated because of a bile leakage in the laparoscopic group. Follow-up examination showed 2 recurrences in the laparoscopic and 3 in the open group. Three out of 17 patients in the open group had to be operated for incisional hernias. Time to previous activities was significantly shorter after laparoscopy. Laparoscopic treatment of symptomatic nonparasitic liver cysts is superior concerning short- and long-term results in a vast majority of cases.
    Keywords: Liver Cysts ; Laparoscopy ; Open Treatment ; Follow-Up ; Recurrence
    ISSN: 0002-9610
    E-ISSN: 1879-1883
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  • 8
    Language: English
    In: The American Journal of Surgery, 2010, Vol.200(2), pp.291-297
    Description: The objective of this study was to examine the outcomes of comparisons between laparoscopic and open mesh repairs in the setting of recurrent inguinal hernia. The electronic databases MEDLINE, Embase, Pubmed, and the Cochrane Library were used to search for articles from 1990 to 2008. The present meta-analysis pooled the effects of outcomes of a total of 1,542 patients enrolled into 5 randomized controlled trials and 7 comparative studies, using classic and modern meta-analytic methods. Significantly fewer cases of hematoma/seroma formation were observed in the laparoscopic group in comparison with the Lichtenstein group (odds ratio, .38; .15–.96; = .04). A matter of great importance is the higher relative risk of overall recurrence in the transabdominal preperitoneal group compared with the totally extraperitoneal group (relative risk, 3.25; 1.32–7.9; = .01). Laparoscopic versus open mesh repair for recurrent inguinal hernia was equivalent in most of the analyzed outcomes.
    Keywords: Meta-Analysis ; Evidence Based ; Publication Bias ; Recurrent Inguinal Hernia ; Totally Extraperitoneal ; Transabdominal Preperitoneal ; OPM ; Open Preperitoneal Mesh ; Stoppa ; Giant Prosthetic Reinforcement of the Visceral Sac ; Lichtenstein Procedure
    ISSN: 0002-9610
    E-ISSN: 1879-1883
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  • 9
    Language: English
    In: Expert Review of Gastroenterology & Hepatology, 01 June 2011, Vol.5(3), pp.371-384
    Description: Objectives: Endoscopic local procedures are increasingly applied in patients with superficial esophageal cancer as an alternative to radical oncologic resection. The objective of this article is to determine the risk of nodal metastases in submucosal (sm) esophageal cancer, comparing the two...
    Keywords: Risk of Lymph Node Metastasis ; Sm1 ; Sm2 ; Sm3 ; Submucosal Depth of Tumor Infiltration ; Submucosal Esophageal Cancer ; Surgically Resected Specimens ; Medicine
    ISSN: 1747-4124
    E-ISSN: 1747-4132
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  • 10
    In: Pancreas, 2018, Vol.47(4), pp.454-458
    Description: OBJECTIVES: This pilot study aimed to determine the feasibility of serum values of osteonectin, adiponectin, transforming growth factor beta 1, and neurotensin being used in clinical practice to predict the severity of acute pancreatitis. METHODS: Blood samples were collected from 45 consecutive newly diagnosed acute pancreatitis patients and 30 matched healthy controls. The 2 groups were matched according to age, sex, weight, height, diabetes, smoking, and alcohol consumption. The aforementioned markers were measured using enzyme-linked immunosorbent assay kits. RESULTS: Characteristics of acute pancreatitis patients and healthy controls were comparable. Osteonectin values differed significantly (P 〈 0.0001). Median/lower quartile/upper quartile of osteonectin levels for acute pancreatitis patients and healthy controls were 263.5/110.3/490.36 and 63.2/46.1/87.2 ng/mL, respectively. Two patients died, 1 patient underwent necrosectomy, and 4 patients had a prolonged intensive care unit/hospital stay. Acute Physiology and Chronic Health Evaluation II and Systemic Inflammatory Response Syndrome scores neither predicted serum values of any of the measured substances nor the clinical outcome (need for intervention, prolonged intensive care unit/hospital stay and mortality). Osteonectin was the only independent predictor for clinical outcome (P = 0.007). CONCLUSIONS: Serum osteonectin strongly discriminates healthy individuals from acute pancreatitis patients. Serum osteonectin shows promise in the prediction of the clinical outcome.
    Keywords: Pancreatitis -- Risk Factors ; Pancreatitis -- Genetic Aspects ; Pancreatitis -- Research ; Transforming Growth Factors -- Research;
    ISSN: 0885-3177
    E-ISSN: 15364828
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