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Intrahepatic cholestasis of pregnancy is associated with increased risk of hepatobiliary disease and adverse fetal outcomes: A systematic review and meta-analysis

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iLIVER 2023年第4期2卷 219-226页

作者： Peter Olujimi Odutola Peter Oluwatobi Olorunyomi Olanrewaju Olamide Olatawura Ifeoluwapo Olorunyomi Olukayode Madojutimi Ayomide O.Fatunsin Uju Okeke Harvard University CambridgeMassachusetts 02138USA The Robert Gordon University GarthdeeAberdeenScotlandAB107QBUK College of Medicine Olabisi Onabanjo UniversitySagamuOgun State 120107Nigeria College of Health Professions Chamberlain UniversityDowners GroveIllinois 60515-5683USA College of Public Health Northeastern Illinois UniversityChicagoIllinois 60625USA ssm healthcare Saint LouisMissouri 63104USA Texas A&M University College StationTexas 77843USA

Background and aims:The aim of this study was to review the literature and perform a meta-analysis to clarify the association between intrahepatic cholestasis of pregnancy and risks of long-term maternal hepatobiliary disease as well as adverse fetal outcomes including preterm birth,meconium-stained amniotic fluid,and ***:This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.A comprehensive literature search was performed using Cochrane,Embase,and PubMed databases to identify observational or cohort studies comparing pregnant women with intrahepatic cholestasis of pregnancy(ICP)to pregnant women without *** from the included studies were analyzed using the Review Manager 5.4.1 ***:The meta-analysis showed a significant association between ICP and the risk of hepatobiliary diseases(pooled risk ratio[RR]:2.81,95%confidence interval[CI]:2.66–2.97,p<0.00001),hepatitis C(HC):a significant association between ICP and risk of HC(pooled RR:4.02,95%CI:3.12–5.19,p<0.00001),meconium-stained amniotic fluid(MSAF):ICP was significantly associated with an increased risk of MSAF(pooled RR:1.91,95%CI:1.65–2.21,p<0.00001),and preterm birth:the meta-analysis demonstrated a significant association between ICP and preterm birth(pooled RR:2.11,95%CI:2.01–2.21,p<0.00001).Conclusion:ICP demonstrated statistically significant associations with increased risks of hepatobiliary disease,HC,MSAF,and preterm birth.

关键词： Intrahepatic Cholestasis Hepatobiliary Fetal

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Effect of neoadjuvant chemotherapy on skin-sparing mastectomy and breast reconstruction modalities in 409 patients

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Plastic and Aesthetic Research 2015年第1期2卷 17-21页

作者： Sameh Goubran Jon Ver Halen Department of Plastic Surgery University of Tennessee Health Science CenterMemphisTN 38103USA Department of Surgery Division of PlasticReconstructiveand Hand SurgeryBaptist Memorial Healthcare CorporationMemphisTN 38120USA Department of Surgery Vanderbilt-Ingram Cancer CenterNashvilleTN 37232USA Department of Surgery St.Jude Children’s Research HospitalMemphisTN 38105USA

Aim:While skin-sparing mastectomy(ssm)can be performed in patients with stage II-III breast cancer,the impact of neoadjuvant chemotherapy(NAC)on ssm rates and reconstructive modalities in these patients is not ***:Between January 2007 and December 2009,409 immediate breast reconstructions(IBRs)were performed in patients with Stage II-III breast *** were collected on preoperative,operative,and postoperative ***:There was a statistically significant relationship between clinical stage of disease and the utilization of ssm or non-ssm(Pssm;similarly,75.5%of patients with stage II and 49.1%of patients with stage III disease who received NAC underwent ssm with immediate reconstruction,in spite of having a greater proportion of stage III patients(Pssm with IBR had larger tumors(mean,3.5 cm vs.3.1 cm,Pssm or non-ssm(P=0.001,Pssm in nearly half of cases,thus improving reconstructive outcomes and patient well-being.

关键词： Immediate breast reconstruction neoadjuvant chemotherapy review skin‑sparing mastectomy

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