Background: The incidence of smuggling and illegal transport of substances by internal concealment, also known as body packing, is increasing. The clinical approach to body packers has changed significantly over the past two decades. In addition, the mortality of body packers is an important issue in patient management. The purpose of the current study is to determine the statistics and mortality related to body packing. Methods: In this cross-sectional study, all body packer patients who referred to Loghman Hakim hospital were evaluated from 2010 to 2017. Demographic characteristics, findings of clinical imaging, treatment, and outcome of the patients were recorded. The data were analyzed using SPSS version 21. Results: A total of 303 patients were enrolled in the study after the diagnosis of body packing by abdominal CT scanning without contrast. Conservative treatment including whole bowel irrigation (WBI) accompanied by close monitoring was done for 78% (n = 236) of patients; moreover, 26 patients (8.5%) underwent surgery after WBI, and 41 patients (13.5%) underwent surgery without bowel irrigation. Mortality was observed in eight patients (2.7%) five of whom (62.5%) died before surgery and had the clinical manifestation of crystal (methamphetamine) and cannabis toxicity. Furthermore, three patients (37.5%) died due to the complications of surgery such as gastrointestinal leakage of an abdominal abscess. Conclusion: Conservative treatment seems to be better for the management of body packers. In addition, it is necessary to monitor patients for possible signs and symptoms of intoxication and gastrointestinal obstruction.
Circular RNAs (circRNAs) are a group of transcripts with enclosed configurations which can regulate gene expression. These transcripts have important roles in normal development and in the pathogenesis of disorders. Recent evidence has supported involvement of circRNAs in the development of bladder cancer. Several circRNAs such as circ_0058063, hsa-circRNA-403658, circPDSS1, circCASC15, circRNA-MYLK, and circRNA_103809 have been upregulated in bladder cancer samples. On the other hand, hsa_circ_0137606, BCRC-3, circFUT8, hsa_circ_001598, circSLC8A1, hsa_circ_0077837, hsa_circ_0004826, and circACVR2A are among downregulated circRNAs in bladder cancer. Numerous circRNAs have diagnostic or prognostic value in bladder cancer. In this review, we aim to outline the latest findings about the role of circRNAs in bladder cancer and introduce circRNAs for further investigations as therapeutic targets.
Introduction — High mortality and morbidity rate of empyema, despite effective antibiotic therapy, highlights the need to determine the optimal drainage method as a first-line surgical intervention. Controversies behind the treatment choice for empyema encouraged us to conduct this study aimed at demonstrating efficacy and differences of two techniques of clinical approach to empyema, chest tube and video-assisted thoracoscopic surgery (VATS) with respect to outcomes. Material and Methods — We recruited 60 eligible patients with empyema and distributed them among two groups according to applied treatment strategies, either chest tube treatment method (Group I, 30 subjects) or VATS (Group II, 30 patients). Data were statistically analyzed by SPSS software, version 19. Then, the one-sample Kolmogorov–Smirnov test confirmed the normality of data distribution, and independent samples t-test was performed. Statistical significance was assumed at p<0.05. Results — We established that the length of hospital stay (p=0.002), the need for second intervention (p<0.001), and rate of recurrence (readmission) (p=0.001) were significantly lower in patients treated with VATS, compared with patients who were subjected to chest tube drainage. Additionally, patients who underwent VATS exhibited higher satisfaction level (p=0.03) and improved clinical condition at the time of discharge (discharged without chest tube) (p<0.001), than those from Group I. Radiographic examination on postoperative day 7 revealed a higher rate of complete cure (normal lung expansion) in the VATS group (p=0.004). Conclusion — According to the results of our study, VATS is a better treatment technique of empyema, compared with chest tube.
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