Articles: cations.
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A large number of studies have examined the potential complications of calf deep vein thrombosis (DVT). There is no consensus on when or how to treat patients to prevent these complications. This systematic review assessed the rate of proximal propagation, pulmonary embolism, major bleeding and recurrence in patients with isolated calf DVT. ⋯ The literature on calf DVT is heterogeneous, limiting conclusions from data analysis. Adverse outcomes are infrequent and studies do not suggest that they are reduced by anticoagulation.
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The objectives of this systematic review and pooled analysis were to examine long-term survival, morbidity, and mortality following surgical resection of gastric cancer hepatic metastases and to identify prognostic factors that improve survival. ⋯ The observed improved survival rates following the resection of hepatic metastasis from gastric adenocarcinoma in selected patients merit a prospective study to formally address the survival benefits and the influence on quality of life of such approach.
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We aim to systematically review the bariatric surgery literature with regards to adequacy of patient follow-up, meeting the McMaster criteria of ≥80% follow-up. ⋯ Only 40% of studies in the bariatric surgery literature meet criteria for adequate follow-up. On average, studies have 30% of patients lost to follow-up at the stated end-point. Identified study characteristics associated with high quality follow-up included shorter study duration and studies performed in the US.
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Review Meta Analysis
Meta-analysis of antibiotics versus appendicectomy for non-perforated acute appendicitis.
For more than a century, appendicectomy has been the treatment of choice for appendicitis. Recent trials have challenged this view. This study assessed the benefits and harms of antibiotic therapy compared with appendicectomy in patients with non-perforated appendicitis. ⋯ The choice of medical versus surgical management in patients with clearly uncomplicated appendicitis is value- and preference-dependent, suggesting a change in practice towards shared decision-making is necessary.
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Review Meta Analysis
Systematic review and meta-analysis of the diagnostic accuracy of ductoscopy in patients with pathological nipple discharge.
Invasive surgery remains the standard for diagnosis of pathological nipple discharge (PND). Only a minority of patients with nipple discharge and an unsuspicious finding on conventional breast imaging have cancer. Ductoscopy is a minimally invasive alternative for evaluation of PND. This systematic review and meta-analysis was designed to evaluate the diagnostic accuracy of ductoscopy in patients with PND. ⋯ Ductoscopy detects about 94 per cent of all underlying malignancies in patients with PND, but does not permit reliable discrimination between malignant and benign findings.