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Purpose: To investigate the technical success, efficacy, and safety of a newly designed partially covered bilateral self-expanding metallic stent (SEMS) in patients with malignant biliary obstruction.
Material And Methods: From May 2016 to November 2017, ten patients with malignant hilar biliary stenosis (bismuth type II-IV) underwent stent placement with the newly designed partially covered T/Y-configured SEMS. Technical success, drainage catheter removal, jaundice remission, early and late complications, stent patency, and overall survival were analyzed.
Results: The stent was successfully deployed in all patients. The total bilirubin level significantly decreased one month after stent placement (P < 0.05). Drainage catheter removal rate was 90%. Two cases (20%) experienced early complications (bile duct hemorrhage and cholangitis) and two cases (20%) experienced late complications (hepatic abscess and cholangitis). During the follow-up (mean 276 days; range 57-503 days) stent occlusion occurred in three patients (30%), and two patents died of hepatic failure. The median stent patency and overall survival were 275 days (95% CI 223.8-326.3 days) and 428.9 days (95% CI 347.9-509.8 days), respectively.
Conclusion: The newly designed partially covered T/Y-configured SEMS is technically feasible and clinically effective for biliary trifurcation obstruction.
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http://dx.doi.org/10.1007/s11547-020-01196-w | DOI Listing |
Gerontologist
September 2025
Neuropsychology and Cognitive Health Program, Baycrest Hospital, Toronto, Ontario, Canada.
Background And Objectives: As they age, many people experience memory changes that can impact their everyday functioning. The Memory Impact Questionnaire (MIQ) is a 51-item measure that assesses the negative impact of memory changes on one's lifestyle activities, negative appraisals of the self due to memory changes, perceived negative appraisals from others due to memory changes, and coping approaches intended to compensate for memory changes. To improve the utility of this tool, we developed a short form version of the MIQ and investigated its psychometric properties.
View Article and Find Full Text PDFAdv Physiol Educ
September 2025
Department of Biochemistry, All India Institute of Medical Sciences, Deoghar, India. Email id:
In this article, "Cosmosis" introduces a newly coined metaphorical term that illustrates conceptual parallels between the physiological process of osmosis and the expansive dynamics of the cosmos. Designed as an interdisciplinary teaching framework, Cosmosis provides a novel way to link cellular homeostasis with cosmological principles such as entropy, spacetime curvature, and dark energy. By drawing on core physiological terms such as concentration gradients, osmotic pressure, aquaporins, and membrane selectivity, Cosmosis offers an analogy that may spark curiosity, support integrative thinking, and encourage cross-disciplinary dialogue in physiology and biochemistry education.
View Article and Find Full Text PDFJAMA Dermatol
September 2025
Department of Population Health, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
Importance: Increasingly, strategies to systematically detect melanomas invoke targeted approaches, whereby those at highest risk are prioritized for skin screening. Many tools exist to predict future melanoma risk, but most have limited accuracy and are potentially biased.
Objectives: To develop an improved melanoma risk prediction tool for invasive melanoma.
JAMA Netw Open
September 2025
Oncostat U1018, Institut National de la Santé et de la Recherche Médicale (INSERM), Ligue Contre le Cancer, Paris-Saclay University, Villejuif, France.
Importance: Antibiotics, steroids, and proton pump inhibitors (PPIs) are suspected to decrease the efficacy of immunotherapy.
Objective: To explore the association of comedications with overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC).
Design, Setting, And Participants: This nationwide retrospective cohort study used target trial emulations of patients newly diagnosed with NSCLC from January 2015 to December 2022, identified from the French national health care database.
JAMA Cardiol
September 2025
Department of Cardiology, Inselspital University Hospital of Bern, University of Bern, Bern, Switzerland.
Importance: Right anomalous aortic origin of a coronary artery (R-AAOCA) is a rare congenital condition increasingly diagnosed with the growing use of cardiac imaging. Due to dynamic compression of the anomalous vessel, invasive fractional flow reserve (FFR) during a dobutamine-atropine volume challenge (FFR-dobutamine) is considered the reference standard. A reliable alternative method is needed to reduce extensive invasive testing, but it remains uncertain whether noninvasive imaging can accurately assess the hemodynamic relevance of R-AAOCA.
View Article and Find Full Text PDF