Annals of surgery
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Multicenter Study
Multicenter Evaluation of Rectal cancer ReImaging pOst Neoadjuvant (MERRION) Therapy.
The aim of this study was to evaluate the utility of reimaging rectal cancer post-CRT (chemoradiotherapy) with magnetic resonance (MR) imaging of the pelvis for local staging and computed tomography of thorax, abdomen, and pelvis (CT TAP) to identify distant metastases. ⋯ MR reimaging using standard protocols is of limited value in determining surgical approaches; a better modality of local restaging is required.
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Comparative Study Clinical Trial
Effect of gastric bypass versus diet on cardiovascular risk factors.
To assess the effect of Roux-en-Y gastric bypass (RYGB) on high-density lipoprotein cholesterol (HDL-C) concentration and its apolipoprotein A4 (ApoA4) content at 1 year after bariatric surgery in comparison with a hypocaloric diet. Secondary aim was to measure total cholesterol and triglycerides levels and insulin sensitivity after interventions. ⋯ Our study shows that HDL-C and ApoA4 significantly increase after gastric bypass and that this increase is associated with a net improvement in hepatic insulin sensitivity. Furthermore, we speculate that ApoA4, which induces satiety in animals, can eventually play a role on the appetite reduction after RYGB because there is a strict and inverse relationship between weight and ApoA4 changes. (NCT01707771).
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Observational Study
Survivors versus nonsurvivors postburn: differences in inflammatory and hypermetabolic trajectories.
To evaluate whether a panel of common biomedical markers can be utilized as trajectories to determine survival in pediatric burn patients. ⋯ Nonsurvivors have different trajectories in inflammatory, metabolic, and acute phase responses allowing differentiation of nonsurvivors from survivors and now possibly allowing novel predictive models to improve and personalize burn outcomes.
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This aim of this study is to determine the risk factors in failed endoscopic retrograde cholangiography (ERC). ⋯ ERC is highly effective in treating BAS. A success rate of 73%, the highest ever reported, has been achieved. Morphology of stricture is associated with outcome of ERC. Radiological or surgical intervention should be considered for patients with pouched BAS after endoscopic treatment fails for the first time.
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To create a mortality risk model after pancreaticoduodenectomy (PD) using a Web-based national database system. ⋯ We conducted the reported risk stratification study for PD using a nationwide surgical database. PD outcomes in the national population were satisfactory, and the risk model could help improve surgical practice quality.