Impact Of Comorbidities On Outcomes And Healthcare Costs Of Open Inguinal Hernia Repair In Patients With Diabetes Mellitus.

INTRODUCTION: Inguinal hernia management in patients with diabetes mellitus (DM) and comorbidities presents challenges due to potential impacts on wound healing and infection risk. This study evaluates the influence of additional comorbidities on outcomes following open inguinal hernia repair in DM patients. MATERIAL AND METHODS: A retrospective cohort study was conducted at Craiova Emergency Clinical County Hospital from 2015 to 2020. Patients with documented DM undergoing hernia repair were categorized into two groups based on comorbidity status. Data on presentation mode, hernia type, comorbidities, hospitalization, operative details, postoperative outcomes, and costs were collected and analyzed statistically. RESULTS: Among 38 DM patients undergoing hernia repair, 16 were in Group A (DM alone) and 22 in Group B (DM with comorbidities). Group B patients were older (p = 0.0002) and more likely to present emergently (OR: 13.81, p=0.0148) with incarcerated (OR: 22.733, p=0.0339) or strangulated hernias (OR: 9.4545, p=0.0390). Group B had longer hospitalizations (p=0.00132) and higher hospitalization costs (p = 0.00262). CONCLUSIONS: DM patients with comorbidities are at higher risk for complex hernias and prolonged hospitalizations. Pulmonary fibrosis emerges as a significant comorbidity requiring specific perioperative strategies. Tailored preoperative assessments and care plans can optimize outcomes.

Preoperative Immunocyte-Derived Ratios Predict Postoperative Recovery of Gastrointestinal Motility after Colorectal Cancer Surgery.

The aim of this study was to assess the role of immunocyte-derived ratios (IDRs), such as the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), as markers for the postoperative recovery of gastrointestinal function following colorectal cancer surgery. A retrospective analysis was conducted on a consecutive cohort of 260 patients who underwent radical colorectal cancer surgery within the timeframe spanning from January 2016 to December 2022. Data concerning the postoperative recovery of gastrointestinal function included the I-FEED score, time to pass flatus, toleration for liquids in the first 48 h, and the need for nasogastric tube reinsertion in the immediate postoperative period. A special emphasis was allocated towards the examination of IDRs and their interrelation with the postoperative gastrointestinal functional parameters. The I-FEED score exhibited a positive correlation with the NLR, SII, and PLR. The univariate analysis indicated that all IDRs, multiorgan resection, hemoglobin and protein levels, regional nodal extent of the tumor (N), and obesity significantly affected nasogastric tube reinsertion. The multivariate analysis showed that the SII and N1 stages were risk factors for nasogastric tube reinsertion after colorectal cancer surgery. The SII and multiorgan resection were the only classifiers that remained significant in the multivariable analysis for the toleration for liquids. In summation, certain preoperative IDRs, such as the SII, PLR, and NLR, may hold potential as predictive determinants for postoperative gastrointestinal functional recovery following colorectal cancer surgery.

Lichtenstein Repair in Inguinal Hernia- A Retrospective Study on the Impact of In-Hospital Costs of Diabetes Mellitus.

INTRODUCTION: Inguinal hernia is one of the most common conditions in surgical departments and diabetes is known to have a significant impact on both patients' health and healthcare system. The current study aims to evaluate extensively the differences in costs for different subgroups of diabetic patients undergoing inguinal hernia repair in a tertiary care medical center in South-West Romania. MATERIAL AND METHODS: A total number of 195 patients underwent hernia repair for primary or recurrent inguinal hernia between 2015 and 2020 and were included in the analysis. The group was divided into diabetic/non-diabetic patients and each of these subgroups was studied separately according to the presence or absence of comorbidities, sex and place of origin. RESULTS: Statistically significant differences were found in the division of the age group, highlighting the fact that in diabetic patients the average age was around 74.76 years, unlike those without diabetes in which the average age was approximately 61.31 years. Another statistically significant difference was observed in the classification by hospitalization days of the group of patients with incarcerated inguinal hernia, in a sense that diabetic patients required a prolonged hospitalization by 1.5 days as opposed to non-diabetics. CONCLUSIONS: The costs of hospitalization for diabetic patients undergoing hernia repair surgery were marginally higher than in non-diabetic patients, but no statistical difference could be observed between any of the costs subsets in the two patients groups.

Risk Factors and Genetic Predisposition in Colorectal Cancer: A Study on Young and Old Adults.

According to GLOBOCAN 2018 data Colorectal cancer (CRC) represents the third most commonly diagnosed cancer in the world and has the second-highest mortality rate. The incidence of CRC has been rising worldwide, the majority of cases being in developing countries mostly due to the adoption of an unhealthy lifestyle. The main driving factors behind CRC are a sedentary lifestyle, obesity, red meat consumption, alcohol, and tobacco; however, early detection screenings and standardized treatment options have reduced CRC mortality. Better family history and genetic testing can help those with a hereditary predisposition in taking preventative measures.

Metabolic Impact of Diabetes Mellitus Type 2 in Hepatitis C Virus Infected Patients.

OBJECTIVE: Patients with chronic hepatitis C are subjected to a greater risk of cardiovascular disease and difficult to control diabetes mellitus type 2 (T2DM) comparatively to people that have never contracted Hepatitis C Virus (HCV). We aimed to investigate the impact of T2DM on HCV patients with the help of Fibromax test results compared to nonT2DM patients, and the metabolic differences between the 2 study groups. Our long term goals are to observe the long term impact of achieving systemic virusologic response (SVR) by means of Direct-Acting antivirals (DAA) between the 2 cohorts. RESEARCH DESIGN AND METHODS: We selected a lot of 200 patients with HCV that will undergo interferon-free DAA-based antiviral treatment for HCV and we used the results of the Fibromax Test to compare the biological parameters of T2DM and nonT2DM patients. RESULTS Among patients with T2DM compared to NonT2DM there is a significant correlation on Steatotest, NashTest, GGT, Glycemia, body weight, height and BMI. Test also showed that 15,5% of the test group had elevated glycemia, indicating the probability of developing diabetes in the future. CONCLUSIONS: Our results suggest that HCV patients that also have T2DM are subjected to a combined higher risk of accelerated steatosis development, steatohepatitis, added difficulty in controlling glycemic levels. All these previous elements combined with a prevalence for patients to be overweight have a negative metabolic impact. Eradication of HCV with the help of DAA is important in order to help improving the metabolic impact of diabetes on steatosis, steatohepatitis. An added benefit is better management of glycemic control by decreasing insulin use and eliminating one risk factor of T2DM.