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Feasibility of gastric endoscopic submucosal dissection in elderly patients aged≥80 years

World Journal of Gastrointestinal Endoscopy 2022年第1期14卷 49-62页

作者： Yasuhiro Inokuchi Ayaka Ishida Kei Hayashi Yoshihiro Kaneta Hayato Watanabe Kazuki Kano Mitsuhiro Furuta Kosuke Takahashi Hirohito Fujikawa Takanobu Yamada Kouji Yamamoto Nozomu Machida Takashi Ogata Takashi Oshima Shin Maeda Department of Gastroenterology Kanagawa Cancer CenterYokohama 241-8515KanagawaJapan Department of Gastrointestinal Surgery Kanagawa Cancer CenterYokohama 241-8515KanagawaJapan Department of Biostatics Yokohama City University School of Medicine.Yokohama 236-0004KanagawaJapan Department of Gastroenterology Yokohama City UniversityYokohama 236-0004KanagawaJapan

BACKGROUND Endoscopic resection,especially endoscopic submucosal dissection(ESD),is increasingly performed in elderly patients with early gastric cancer,and lesions beyond the expanded indications are also resected endoscopically in some *** is essential to assess whether gastric ESD is safe and suitable for elderly patients and investigate what type of lesions carry an increased risk of ESD-related *** To assess the efficacy and feasibility of gastric ESD for elderly patients,and define high-risk lesions and prognostic *** Among a total of 1169 sessions of gastric ESD performed in Kanagawa Cancer Center Hospital from 2006 to 2014,179 sessions(15.3%)were performed in patients aged≥80 years,and 172 of these sessions were done in patients with a final diagnosis of gastric *** patients were studied retrospectively to evaluate short-term outcomes and *** short-term outcomes included the rates of en bloc resection and curative resection,complications,and procedurerelated *** was assessed according to the Japanese Gastric Cancer Treatment Guidelines ***’s exact test was used to statistically analyze risk *** characteristics of each group were compared using Fisher’s exact test and Mann-Whitney U *** rates at each time point were based on Kaplan-Meier *** survival rates were compared between patients with gastric cancer in each group with use of the log-rank *** identify prognostic factors that jointly predict the hazard of death while controlling for model overfitting,we used the least absolute shrinkage and selection operator(LASSO)Cox regression model including factors curative/noncurative,age,gender,body mass index,prognostic nutritional index,charlson comorbidity index(CCI),Glasgow prognostic score,neutrophil-to-lymphocyte ratio,and antithrombotic agent *** selected the LASSO Cox regression model that resulted in minimal prediction error in 10-f

关键词： Endoscopic submucosal dissection Elderly charlson comorbidity index Early gastric cancer Complications Prognostic indicators

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Prevalence and associated factors of suicide among hospitalized schizophrenic patients

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World Journal of Clinical Cases 2020年第4期8卷 757-770页

作者： Pakapan Woottiluk Benchalak Maneeton Natthanan Jaiyen Wajana Khemawichanurat Suttipong Kawilapat Narong Maneeton Psychiatric Nursing Division Faculty of NursingChiang Mai UniversityChiang Mai 50200Thailand Department of Psychiatry Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Graduate School Chiang Mai UniversityChiang Mai 50200Thailand Suan Prung Psychiatric Hospital Chiang Mai 50100Thailand

BACKGROUND Previous studies found several factors associated with suicide in schizophrenic patients,such as age,sex,education level,history of suicide attempts,psychotic symptoms,social factors,and substance ***,there might be some additional factors that were not considered in previous studies but may be correlated with a greater likelihood of suicide attempts,such as medication and *** To investigate the prevalence of suicide attempts and identify the risk of suicidality in hospitalized schizophrenia *** This is a cross-sectional study of schizophrenic patients admitted to a psychiatric hospital who were 18 years of age or *** outcomes and possible suicide risk factors in these patients were *** current suicide risk was evaluated using the mini-international neuropsychiatric interview module for suicidality and categorized as none(0 points),mild(1-8 points),moderate(9-16 points),or severe(17 or more points).This study used ordinal logistic regression to assess the association of potential risk factors with the current suicide risk in schizophrenic *** Of 228 hospitalized schizophrenia patients,214(93.9%)were included in this *** majority(79.0%)of patients were *** appeared to have a slightly higher suicidality risk than males,with borderline *** regard to the current suicide risk assessed with the mini-international neuropsychiatric interview,172(80.4%)schizophrenic patients scored zero,20(9.4%)had a mild risk,8(3.7%)had a moderate risk,and 14(6.5%)had a severe *** total prevalence of current suicide risk in these schizophrenic patients was 19.6%.Based on multivariable ordinal logistic regression analysis with backward elimination,it was found that younger age,a current major depressive episode,receiving fluoxetine or lithium carbonate in the previous month,or a relatively higher charlson comorbidity index score were all significantly and independently associated with a

关键词： Hospitalization Schizophrenia Prevalence Suicide attempts Suicide risk charlson comorbidity index

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Epidemiology of perforating peptic ulcer:A population-based retrospective study over 40 years

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World Journal of Gastroenterology 2020年第35期26卷 5302-5313页

作者： Aydin Dadfar Tom-Harald Edna Department of Surgery Levanger HospitalNord-Trøndelag Hospital TrustLevanger 7600Norway Institute of Clinical and Molecular Medicine Norwegian University of Science and TechnologyTrondheim 7491Norway

BACKGROUND The incidence of peptic ulcer disease has decreased during the last few decades,but the incidence of reported peptic ulcer complications has not *** peptic ulcer(PPU)is a severe form of the *** To assess trends in the incidence,presentation,and outcome of PPU over a period of 40 *** This was a single-centre,retrospective,cohort study of all patients admitted to Levanger Hospital,Norway,with PPU from 1978 to *** patients were identified in the Patient Administrative System of the hospital using International Classification of Diseases(ICD),revision 8,ICD-9,and ICD-10 codes for perforated gastric and duodenal *** reviewed the medical records of the patients to retrieve *** statistics were available for all *** incidence of PPU was analysed using Poisson regression with perforated ulcer as the dependent variable,and sex,age,and calendar year from 1978 to 2017 as *** survival analysis was performed to compare long-term survival over the four *** Two hundred and nine patients were evaluated,including 113(54%)***(22%)patients were older than 80 *** age increased from the first to the last decade(from 63 to 72 years).The incidence rate increased with increasing age,but we measured a decline in recent decades for both sexes.A significant increase in the use of acetylsalicylic acid,from 5%(2/38)to 18%(8/45),was observed during the study *** increased significantly over the 40 years of the study,with 22%(10/45)of the patients having an American Society of Anaesthesiologists(ASA)score 4-5 in the last decade,compared to 5%(2/38)in the first ***-nine percent(81/209)of the patients had one or more postoperative *** 100-day mortality and long-term survival were associated with ASA score,without significant variations between the *** Declining incidence rates occurred in recent years,but the patients were olde

关键词： Perforated peptic ulcer American Society of Anaesthesiologists classification charlson comorbidity index Gastric ulcer Duodenal ulcer Epidemiology Incidence Clavien-Dindo classification of complications Mortality

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