Upper gastrointestinal bleeding (UGIB) in COVID‐19 presents challenges in patient management. Existing studies lack comprehensive review due to varied designs, samples, and demographics. A ...meta‐analysis can provide valuable insights into the incidence, features, and outcomes of UGIB in COVID‐19. A comprehensive literature search was carried out using several databases. We considered all appropriate observational studies from all over the world. Mantel‐Haenszel odds ratios and associated 95% confidence intervals (CIs) were produced to report the overall effect size using random effect models. Besides, Random effects models were used to calculate the overall pooled prevalence. Funnel plots, Egger regression tests, and Begg‐Mazumdar's rank correlation test were used to appraise publication bias. Data from 21 articles consisting of 26,933 COVID‐19 patients were considered. The pooled estimate of UGIB prevalence in patients admitted with COVID‐19 across studies was 2.10% (95% CI, 1.23–3.13). Similarly, the overall pooled estimate for severity, mortality, and rebleeding in COVID‐19 patients with UGIB was 55% (95% CI, 37.01–72.68), 29% (95% CI, 19.26–40.20) and 12.7% (95% CI, 7.88–18.42) respectively. Further, UGIB in COVID‐19 patients was associated with increased odds of severity (OR = 3.52, 95% CI 1.80–6.88, P = 0.001) and mortality (OR = 2.16, 95% CI 1.33–3.51, P = 0.002) compared with patients without UGIB. No significant publication bias was evident in the meta‐analysis. The results of our study indicate that UGIB in individuals with COVID‐19 is linked to negative outcomes such as severe illness, higher mortality rates, and an increased risk of re‐bleeding. These findings highlight the significance of identifying UGIB as a significant complication in COVID‐19 cases and emphasise the importance of timely clinical assessment and proper treatment.
There is a scarcity of scientific evidence addressing the outcomes of COVID‐19 in celiac disease (CD) patients. This systematic review and meta‐analysis aimed to evaluate the correlation between ...pre‐existing CD and COVID‐19. A rigorous literature search was conducted using multiple databases. All eligible observational studies were included from around the globe. The random effect model calculated the pooled prevalence and associated 95% confidence intervals (CI). Mantel‐Haenszel odds ratios were produced to report the overall effect size using random effect models for severity and mortality outcomes. Funnel plots, Egger regression tests, and Begg‐Mazumdar's rank correlation test were used to appraise publication bias. Data from 11 articles consisting of 44,378 CD patients were obtained. Overall pooled random‐effects estimate of SARS‐CoV‐2 infection in CD patients was 4.25% (95% CI, I2 = 98%). Our findings also indicated that pre‐existing CD was not associated with an increased risk of hospitalisation with COVID‐19 illness (OR = 1.04, 95% CI 0.87–1.24, I2 = 0%) and mortality due to illness (OR = 0.92, 95% CI 0.56–1.5, I2 = 45%) compared with patients without pre‐existing CD. No significant publication bias was evident in the meta‐analysis. The preliminary data from our analysis suggest that SARS‐CoV‐2 infection in patients with pre‐existing CD is not associated with an increased risk of hospitalisation or mortality. Additional studies are required to overcome the restrictions of the limited data available at present.
When splenectomy is performed, autotransplantation is the only method to preserve splenic function. The most frequently used technique for splenic autotransplantation in humans is the implantation of ...multiple sections of the splenic parenchyma into pouches created in the greater omentum. However, this technique of autotransplantation is associated with complications. For this reason, a technique in which only one 35-g slice of spleen is transplanted into the greater omentum but positioned within the native hypochondrium can be considered safe and useful for patients. Experimental studies continue to add valuable information to the ongoing research in the field of autotransplantation, providing a baseline for future studies in humans and adding arguments in favor of autotransplantation when the spleen cannot be preserved.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
AbstractHepatic cavernous hemangioma accounts for 73% of all benign liver tumors with a frequency of 0.4-7.3% at autopsy and is the second most common tumor seen in the liver after metastases. ...Patients affected by hemangioma usually have their tumor diagnosed by ultrasound abdominal examination for a not well defined pain, but pain persist after treatment of the hemangioma. The causes of pain can be various gastrointestinal pathologies including cholelithiasis and peptic ulcer disease.The malignant trasformation is pratically inexistent. Different imaging modalities are used to diagnosis liver hemangioma including ultrasonography, computed tomography (CT), magnetic resonance (MR) imaging, and less frequently scintigraphy, positron-emission tomography combined with CT (PET/CT) and angiography. Imaging-guided biopsy of hemangioma is usually not resorted to except in extremely atypical cases. The right indications for surgery remain rupture, intratumoral bleeding, Kasabach-Merritt syndrome and organ or vessels compression (gastric outlet obstruction, Budd-Chiari syndrome, etc.) represents the valid indication for surgery and at the same time they are all complications of the tumor itself. The size of the tumor do not represent a valid indication for treatment. Liver hemangiomas, when indication exist, have to be treated firstly by surgery (hepatic resection or enucleation, open, laproscopic or robotic), but in the recent years other therapies like liver transplantation, radiofrequency ablation, radiotherapy, trans-arterial embolization, and chemotherapy have been applied.
BACKGROUND： Four different sizes （4, 5, 8 and 10 cm in diameter） can be found in the literature to categorize a liver hemangioma as giant. The present review aims to clarify the appropriateness of ...the size category ＂giant＂ for liver heman- gioma. DATA SOURCES： We reviewed the reports on the categoriza- tion of hemangioma published between 1970 and 2014. The number of hemangiomas, size criteria, mean and range of hemangioma sizes, and number of asymptomatic and symp- tomatic patients were investigated in patients aged over 18 years. Liver hemangiomas were divided into four groups： 〈5.0 cm, 5.0-9.9 cm, 10.0-14.9 cm and 〉15.0 cm in diameter. Inclu- sion criteria were noted in 34 articles involving 1972 （43.0%） hemangiomas （〉4.0 cm）. RESULTS： The patients were divided into the following groups： 154 patients （30.0%） with hemangiomas less than 5.0 cm in diameter （small）, 182 （35.5%） between 5.0 cm and 9.9 cm （large）, 75 （14.6%） between 10.0 and 14.9 cm （giant）, and 102 （19.9%） more than 15.0 cm （enormous）. There were 786 （39.9%） asymptomatic patients and 791 （40.1%） symptomatic patients. Indications for surgery related to symptoms were reported in only 75 （3.8%） patients. Operations including 137 non-anatomical resection （12.9%） and 469 enudeation （44.1%） were undearly related to size and symptoms.CONCLUSIONS： The term ＂giant＂ seems to be justified for liver hemangiomas with a diameter of 10 cm. Hemangiomas categorized as ＂giant＂ are not indicated for surgery. Surgery should be performed only when other symptoms are apparent.
The aim of this manuscript is to illustrate a new method permitting safe cholecystectomy in terms of complications with respect to the common bile duct (CBD).
The core of this new technique is ...identification of the continuity of the cystic duct with the infundibulum. The cystic duct can be identified between the inner gallbladder wall and inflamed outer wall.
In the last 2 years, from January 2019 until December 2021, 3 patients have been treated with the reported technique without complications.
Among the various cholecystectomy procedures, this is a new approach that ensures the safety of the structures of Calot's triangle while providing the advantages gained from total removal of the gallbladder.
Objectives
Persistent olfactory dysfunction (OD) after 6 months caused by SARS‐CoV‐2 infection has been reported with a variable prevalence worldwide. This study aimed to determine the prevalence of ...long‐term OD and identify predisposing factors.
Methods
A prospective cohort study was conducted on 100 adults with COVID‐19. Olfactory function was assessed with the University of Pennsylvania Smell Identification Test and a symptom survey at the onset of disease and 30 days later. Patients with persistent quantitative OD at the second assessment were reevaluated after 1 year. Demographic variables, symptoms, and the degree of smell loss were analyzed.
Results
Participants included 100 patients. The mean age was 42.2 ± 15.6 years, 55 (55%) were female, and 56 (56%) were outpatients. Baseline smell loss was identified in 75/100 (75%) patients, decreasing to 39/95 (40%) after 1 month, and persisting in 29 patients after 1 year. Phantosmia at baseline was the only risk factor identified for persistent OD after 1 year (relative risk 2.51; 95% confidence interval 1.53–4.12; p < 0.001). Regardless of the outcome in smell function, a significant decline in olfaction was associated with the presence of phantosmia at 1 month (β = −12.39; 95% CI −19.82 to −4.95; p < 0.01).
Conclusions
SARS‐CoV‐2 (2019–2020 variants) produced a highly frequent OD that persisted in 29% of the patients after 1 year. The presence of phantosmia at baseline and 1 month was associated with a worse evolution, but phantosmia may interfere with the performance in an identification smell test. A longer follow‐up is required in these patients.
Level of Evidence
2 Laryngoscope, 132:2445–2452, 2022
Olfactory dysfunction following COVID‐19 persisted in 29% of the patients after 1 year of infection. Phantosmia at baseline and 1 month were associated with a worse evolution, but their presence may represent ongoing regeneration. Longer follow‐up is required in these patients.
La creciente relevancia del arriendo plantea desafíos para la política habitacional chilena y latinoamericana que ha priorizado la vivienda en propiedad. En este contexto, esta investigación realiza ...una caracterización de los arrendatarios del Área Metropolitana de Santiago mediante un análisis de tipologías; identifica los principales tipos de arrendatarios para posteriormente analizar su distribución geográfica y niveles de vulnerabilidad. Los resultados muestran importantes diferencias: existen grupos con problemas de habitabilidad e ingresos insuficientes para cubrir gastos del arriendo. La política habitacional enfrenta entonces el desafío de reconocer la importancia del arriendo y promover mayor seguridad de tenencia para estos sectores.
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