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Background/purpose: We evaluated the minimally invasive surgery for congenital biliary dilatation (CBD) in adults and children and analyzed the surgical outcomes, especially in children aged <6 years.
Methods: Characteristics and surgical outcomes of patients with CBD who underwent minimally invasive surgery at our hospital between 2013 and 2023 were retrospectively reviewed.
Results: Overall, 129 patients (89 children aged <6 years, 9 children aged between 6 and 18 years, and 21 adults) were included in this study. Children exhibited more protein plug presence and abnormal biochemical data than adults. Incidence of postoperative pancreatic fistulas was highest in the adult group (3.4%, 11%, and 33%, respectively, p < .01). In children aged <6 years, postoperative bile leakage and pancreatic fistulas occurred in 9.0% and 3.4% of patients, respectively. Multivariate logistic regression analysis revealed that the Todani IVA was associated with a decrease in postoperative bile leakage (odds ratio: -1.7; 95% confidence interval: (-3.3)-(-0.22), p = .03).
Conclusion: Adults with CBD required prolonged operative times and had more short-term complications than children with CBD. In children aged <6 years, minimally invasive surgery for CBD can be safely performed; however, a small diameter of the bile duct may be associated with bile leakage.
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http://dx.doi.org/10.1002/jhbp.12069 | DOI Listing |
Physiother Theory Pract
September 2025
School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.
Background: Knee osteoarthritis (OA) causes pain and diminishes quality of life. Backward walking exercise (BWE) has been shown to improve lower muscle strength and reduce knee adduction moment, making it a recommended intervention for knee OA rehabilitation. This study aims to evaluate the effectiveness of BWE combined with conventional rehabilitation programs on pain intensity and disability among individuals with knee OA.
View Article and Find Full Text PDFJAMA Netw Open
September 2025
Division of Cardiology, Duke University Hospital, Durham, North Carolina.
Importance: Previous data suggest that the time changes associated with daylight savings time (DST) may be associated with an increased incidence of acute myocardial infarction (AMI).
Objective: To determine whether the incidence of patients presenting with AMI is greater during the weeks during or after DST and compare the in-hospital clinical events between the week before DST and after DST.
Design, Setting, And Participants: This cross-sectional study examined patients enrolled in the Chest Pain MI Registry from 2013 to 2022.
Patient
September 2025
PPD Evidera Patient-Centered Research, Thermo Fisher Scientific, Waltham, MA, USA.
Background: Migraine care is often suboptimal owing to undertreatment, variation in clinical outcomes and administration methods among existing treatments, and between- and within-individual heterogeneity in the clinical course of migraine. In response to these challenges, preference studies have been increasingly conducted to inform treatment decision-making and development. However, gaps remain in understanding how treatment preferences have been assessed across different migraine studies.
View Article and Find Full Text PDFCurr Atheroscler Rep
September 2025
Department of Medicine, Division of Cardiovascular Disease, University of Alabama at Birmingham, 521 19th Street South-GSB 444, Birmingham, AL, 35233, USA.
Purpose Of Review: This review examines cardiovascular disease (CVD) risk prediction models relevant to older adults, a rapidly expanding population with elevated CVD risk. It discusses model characteristics, performance metrics, and clinical implications.
Recent Findings: Some models have been developed specifically for older adults, while several others consider a broader age range, including some older individuals.
J Nephrol
September 2025
Institute of Nephrology, Madras Medical College, Chennai, India.
Background: IgA nephropathy is a disease with a highly variable natural history, for which there is an increasing understanding of the role of complement activation in its pathogenesis and progression. We aimed to assess the clinical and prognostic implications of C4d staining in the kidney biopsy of IgA nephropathy patients.
Methods: This was a retrospective observational study wherein the medical records of IgA nephropathy patients were reviewed and baseline characteristics, kidney biopsy findings, treatment response and follow-up data were noted.