Introduction According to the WHO, an estimated 422 million people are suffering from diabetes worldwide. Among them, the incidence of cholelithiasis is higher than in the healthy population. The aim of this literature review was to summarize the available evidence about acute cholecystitis in patients with diabetes. Materials and methods This study adhered to the PRISMA guidelines. The course of hospitalization of patients with and without diabetes who underwent cholecystectomy due to acute cholecystitis was compared. Following information was abstracted from original studies: general study information, patient characteristics, complications, and recommendations for patients with diabetes Results Initial search provided 1632 results. After full text assessment, 40 studies met the inclusions criteria. Operative and postoperative complication rates were significantly higher among the diabetic patients. Diabetes is a risk factor for conversion from laparoscopic to open cholecystectomy method. The authors' opinions on elective surgery before the onset of acute cholecystitis symptoms are divided. Conclusions Diabetic patients are at greater risk of developing complications. An individualized screening and treatment approach, as well as proper preparation of the diabetic patient for an elective cholecystectomy could have a positive effect on the outcome. However, the low quality of the data from the systematic review does not allow for meta-analysis, which is why we cannot draw strong conclusions.
Introduction: According to the WHO, an estimated 422 million people are suffering from diabetes worldwide. Among them, the incidence of cholelithiasis is higher than in the healthy population. The aim of this literature review was to summarize the available evidence about acute cholecystitis in patients with diabetes. Materials and methods: This study adhered to the PRISMA guidelines. The course of hospitalization of patients with and without diabetes who underwent cholecystectomy due to acute cholecystitis was compared. Following information was abstracted from original studies: general study information, patient characteristics, complications, and recommendations for patients with diabetes. Results: Initial search provided 1632 results. After full text assessment, 40 studies met the inclusions criteria. Operative and postoperative complication rates were significantly higher among the diabetic patients. Diabetes is a risk factor for conversion from laparoscopic to open cholecystectomy method. The authors' opinions on elective surgery before the onset of acute cholecystitis symptoms are divided. Conclusions: Diabetic patients are at greater risk of developing complications. An individualized screening and treatment approach, as well as proper preparation of the diabetic patient for an elective cholecystectomy could have a positive effect on the outcome. However, the low quality of the data from the systematic review does not allow for meta-analysis, which is why we cannot draw strong conclusions.
Introduction: Hospitalization costs of diabetic patients are estimated to be higher than non-diabetic. Literature on the topic is however limited. The aim of this study was to compare the costs of elective and emergency cholecystectomy of diabetic and non-diabetic patients. Material and methods: A retrospective analysis involved diabetic versus non-diabetic age- and sex-matched patients who underwent emergency and elective cholecystectomy at a single center in Poland between 2016-2019. Results: The total costs of an elective cholecystectomy were 739.31 ± 423.07 USD for diabetic patients and 797.14 ± 772.24 USD for non-diabetic patients (p = 0.51). Whereas emergency cholecystectomy total costs were 3950.72 ± 2856.83 USD (diabetic patients) and 2464.31 ± 1718.21 USD (non-diabetic patients) (p = 0.04). The difference in total costs between elective cholecystectomy vs emergency cholecystectomy in both groups (diabetic vs non-diabetic patients) was statistically significant (p < 0.01 vs p < 0.05 respectively). Conclusions: In this study we demonstrated that emergency cholecystectomy is associated with a significant increase in hospitalization costs, particularly in diabetic patients. This suggests that early qualification of diabetic patients for an elective cholecystectomy could be beneficial for both diabetic patients and public health insurers.
Background: Incidence of morbid obesity is rising worldwide. Current clinical practice guidelines for the pre-transplant evaluation of end-stage kidney disease (ESKD) patients lack clear recommendations on morbid obesity. Material and methods: The aim of this review was to summarize the current guidelines on the role and treatment of obesity in kidney transplant recipients. Eight current national and international clinical practice guidelines were identified in a comprehensive literature search. Results: All guidelines underline early detection of obesity and obesity-related comorbidities in ESKD patients. Only two guidelines explored the role of weight-loss surgery, however due to the lack of sufficient evidence no formal recommendation of surgical procedure was given. Conclusions: Diagnosis and treatment of obesity remains underappreciated in the current guidelines, most of which do not include pharmacological and surgical interventions. High-quality evidence is warranted to assess the role of weight-loss including surgery in ESKD patients and to update the recommendations in future guidelines.
Background: We surveyed patients with hemorrhoids about their behavior regarding searching for information about that disease and confronted it with data obtained from Google Trends website and Google searches. We aimed to determine sources of information on hemorrhoids used by patients. Secondary aim was to assess the quality of information provided by Internet in particular. Material and methods: We collected 78 surveys from patients of the outpatient surgical clinic at Medical University of Gdańsk, in which we asked about sources of information about hemorrhoids. We used Google Trends to analyze most often used search queries associated with that topic. In result, we analyzed the content of top 10 Google search results of that queries in order to verify reliability. Results: Over 80% of surveyed patients looked for information about that disease online, 50% of whom were satisfied with the quality of information obtained. Our Google Trends analysis showed that term hemorrhoids has overwhelming prevalence in comparison to remaining terms. Analysis of top 10 Google search results showed that 7 in 10 organic links lead to websites with professional information about hemorrhoids. Conclusions: Patients use the Internet as a source of knowledge about hemorrhoids and find it satisfactory. Moreover, our research indicates that this information is reliable.
Background We surveyed patients with hemorrhoids about their behavior regarding searching for information about that disease and confronted it with data obtained from Google Trends website and Google searches. We aimed to determine sources of information on hemorrhoids used by patients. Secondary aim was to assess the quality of information provided by Internet in particular. Material and methods We collected 78 surveys from patients of the outpatient surgical clinic at Medical University of Gdańsk, in which we asked about sources of information about hemorrhoids. We used Google Trends to analyze most often used search queries associated with that topic. In result, we analyzed the content of top 10 Google search results of that queries in order to verify reliability. Results Over 80% of surveyed patients looked for information about that disease online, 50% of whom were satisfied with the quality of information obtained. Our Google Trends analysis showed that term hemorrhoids has overwhelming prevalence in comparison to remaining terms. Analysis of top 10 Google search results showed that 7 in 10 organic links lead to websites with professional information about hemorrhoids. Conclusions Patients use the Internet as a source of knowledge about hemorrhoids and find it satisfactory. Moreover, our research indicates that this information is reliable.
Adrenal tumors are common neoplasms and majority of them are small, benign, hormonally inactive adrenocortical adenomas. Whereas adrenal cancer (ACC) is a rarely occurring (5% of adrenal tumors) but highly aggressive neoplasm. The early diagnosis and complete surgical resection is the only effective treatment option. Laparoscopic adrenalectomy is the gold standard for small and medium tumors. Whereas for large tumors classic adrenalectomy is considered a procedure of choice with a proven better oncological outcome. We herein report a case of a 57-year-old female diagnosed with a large, advanced left adrenal tumor with invasion of vena cava. It was diagnosed in CT and proven in core biopsy. Open adrenalectomy with thoracotomy was conducted to completely resect the tumor by an interdisciplinary team.
Background Patients with cancer are at risk of malnutrition. The aim of this study is to assess the nutritional status of patients with cancer who are qualified for home enteral nutrition. Secondary aim is to compare the nutritional status of patients with gastric cancer and with esophageal cancer. Material and methods Retrospective analysis of medical documentation of 84 participants with cancer who were qualified for home enteral nutrition in Nutritional Counselling Center Copernicus in Gdansk in 2009-2015 was performed. Assessment of nutritional status included body mass index, the level of total protein and albumin in blood serum, total lymphocyte count, and Nutritional Risk Score 2002 method. Results Patients with gastric cancer most often presented albumin deficiency in comparison with patients with esophageal cancer (p=0.02). The low level of total lymphocyte count in 1mm3 of peripheral blood was observed in 47.6% participants. All the patients qualified for home enteral nutrition received at least 3 points in NRS 2002 method and most often 5 points (40.4%). Conclusions All patients required nutritional treatment. Notwithstanding, the nutritional status of patients varied. Hypoalbuminemia was observed more often in patients with gastric cancer in comparison with patients with esophageal cancer.
Background: Patients with cancer are at risk of malnutrition. The aim of this study is to assess the nutritional status of patients with cancer who are qualified for home enteral nutrition. Secondary aim is to compare the nutritional status of patients with gastric cancer and with esophageal cancer. Material and methods: Retrospective analysis of medical documentation of 84 participants with cancer who were qualified for home enteral nutrition in Nutritional Counselling Center Copernicus in Gdansk in 2009-2015 was performed. Assessment of nutritional status included body mass index, the level of total protein and albumin in blood serum, total lymphocyte count, and Nutritional Risk Score 2002 method. Results: Patients with gastric cancer most often presented albumin deficiency in comparison with patients with esophageal cancer (p=0.02). The low level of total lymphocyte count in 1mm3 of peripheral blood was observed in 47.6% participants. All the patients qualified for home enteral nutrition received at least 3 points in NRS 2002 method and most often 5 points (40.4%). Conclusions: All patients required nutritional treatment. Notwithstanding, the nutritional status of patients varied. Hypoalbuminemia was observed more often in patients with gastric cancer in comparison with patients with esophageal cancer.
Adrenal tumors are common neoplasms and majority of them are small, benign, hormonally inactive adrenocortical adenomas. Whereas adrenal cancer (ACC) is a rarely occurring (5% of adrenal tumors) but highly aggressive neoplasm. The early diagnosis and complete surgical resection is the only effective treatment option. Laparoscopic adrenalectomy is the gold standard for small and medium tumors. Whereas for large tumors classic adrenalectomy is considered a procedure of choice with a proven better oncological outcome. We herein report a case of a 57-year-old female diagnosed with a large, advanced left adrenal tumor with invasion of vena cava. It was diagnosed in CT and proven in core biopsy. Open adrenalectomy with thoracotomy was conducted to completely resect the tumor by an interdisciplinary team.
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