Medicine
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Hartmann procedure (HP) often causes severe postoperative adhesions in the pelvic space; therefore, the reversal of Hartmann procedure (RHP) is a challenging surgery. A new spray-type antiadhesion agent, AdSpray, has been reported to be useful in three-dimensional fields such as the liver. However, there are no reports of its use in HP. We present a case of a male patient with rectal cancer who underwent laparoscopic HP with AdSpray to prevent postoperative adhesions. ⋯ In laparoscopic HP, Adspray was easy to use for three-dimensional fields such as the pelvis and effectively prevented postoperative inflammatory adhesions. Thus, RHP may become less risky and be performed more as a minimally invasive surgery.
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Observational Study
Factors associated with prolonged hospitalization among patients transported by emergency medical services: A population-based study in Osaka, Japan.
The emergency medical system, one of the essential elements of public health, has been around for more than 50 years. Although many studies have assessed the factors associated with overcrowding and prolonged length of stay in emergency departments, whether the clinical characteristics and background of a patient are associated with prolonged hospitalization among patients transported by ambulance is unknown. The purpose of this study was to reveal factors associated with the continuation of hospitalization at 21 days after hospital admission among patients transported by ambulance using a population-based patient registry in Osaka, Japan. ⋯ We included 481,886 patients in this study, of whom 158,551 remained hospitalized at 21 days after hospital admission and 323,335 had been discharged home by 21 days after hospital admission. Factors associated with prolonged hospitalization were elderly (AOR: 1.767 [95% CI: 1.730-1.805]), traffic accident (AOR: 1.231 [95% CI: 1.183-1.282]), no fixed address (AOR: 4.494 [95% CI: 3.632-5.314]), need for nursing care (AOR: 1.420 [95% CI: 1.397-1.443]) and solitary person (AOR: 1.085 [95% CI: 1.050-1.120]). In this study, the elderly, traffic accidents, no fixed address, need for nursing care, and solitary person were associated with prolonged hospitalization of patients transported by ambulance in Japan.
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This study aimed to alleviate unhealthy smoking habits among university students and provide the basic data necessary for public health-oriented approaches such as developing regulations and policies on electronic cigarettes by analyzing the relationship between university students' smoking preferences, perceptions of electronic cigarettes, and intention to quit smoking. This study involved 567 college students and conducted frequency and chi-squared analyses of the general characteristics, smoking preferences, and perceptions of electronic cigarettes. This study also performed logistic regression analysis to analyze the relationship between intention to quit smoking stratified by smoking preferences and the perceptions about electronic cigarettes. ⋯ This study showed that regular cigarette smokers were approximately 1.7 to 2.2 times and other smoker 3.3 to 3.9 times more likely to think that electronic cigarettes positively affect smoking cessation attitude than nonsmokers. Those who perceived harmless to the human body, capable of reducing the frequency of smoking, and less harmful than tobacco were approximately 2.6 to 2.9, 11.6 to 12.8, and 3.3 to 3.7 times more likely have intention to quit smoking, respectively. Regular health education, advertising awareness of health hazards, and public health science-oriented approaches and policies for smoking cessation support services are needed to create awareness on electronic cigarettes among university students.
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To determine if anemia can be predicted on enhanced computed tomography (CT) examinations of the thorax using virtual non-contrast (VNC) images, in order to support clinicians especially in diagnosing primary asymptomatic patients in daily routine. In this monocentric study, 100 consecutive patients (50 with proven anemia), who underwent a contrast-enhanced CT examination of the thorax due to various indications were included. Attenuation was measured in the descending thoracic aorta, the intraventricular septum, and the left ventricle cavity both in the conventional contrast-enhanced and in the VNC images. ⋯ Predicting anemia on enhanced CT examinations using VNC is feasible. A threshold value of ≤ 36.5 hounsfield units (left ventricular cavity) best defines anemia. Aortic wall or interventricular septum visualization on VNC is a specific anemia indicator.
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Hepatocellular carcinoma (HCC) is a severe type of primary liver cancer with high postoperative recurrence. The prognosis predictability of tumor-infiltrating leukocytes (TILs) for patients who underwent HCC resection has been widely reported. However, limited information is available about TIL trafficking, which is also crucial for HCC patients. ⋯ No significant relationships regarding iMVD, and infiltration of FoxP3+ cells with overall and disease-free survival were found. Our data suggest that increased iMVD could enrich tumor-infiltrating CD3+ cells. Infiltrated CD3+ cells could help to better predict both the overall and late-phase disease-free survival after resection of HCC.