Radical cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in the treatment of peritoneal sarcomatosis: Results from a reference center and considerations based on current evidence.

Introduction: Peritoneal sarcomatosis is a rare disease, with multiple histological origins and poor overall prognosis. The option of radical cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is controversial. The results of a surgical team experienced in these procedures are analyzed and discussed based on the available evidence.

Effect of routine first-trimester combined screening for pre-eclampsia on small-for-gestational-age birth: secondary interrupted time series analysis.

Objective: To evaluate the impact of a first-trimester combined screening program for pre-eclampsia, based on the Fetal Medicine Foundation (FMF) algorithm, on the rate of small-for-gestational age (SGA) at birth and adverse pregnancy outcome.

Methods: This was a retrospective cohort study of data obtained from a London tertiary hospital between January 2017 and March 2019. The data were derived from a secondary analysis of the cohort evaluated in a clinical-effectiveness study on the implementation of a first-trimester screening program for pre-eclampsia.

Implementation of routine first trimester combined screening for pre-eclampsia: a clinical effectiveness study.

Objective: Evaluate clinical effectiveness of the first trimester combined (FMF) pre-eclampsia screening programme when implemented in a public healthcare setting.

Design: Retrospective cohort study.

Setting: London tertiary hospital from January 2017 to March 2019.

Reactivity patterns for the activation of CO and CS with alumoxane and aluminum hydrides.

Carbon dioxide is readily fixed when reacting with either alumoxane dihydride [{MeLAl(H)}2(μ-O)] (1) or aluminum dihydride [MeLAlH2] (2) (MeL = HC[(CMe)N(2,4,6-Me3C6H2)]2-) to produce bimetallic aluminum formates [(MeLAl)2(μ-OCHO)2(μ-O)] (3) and [(MeLAl)2(μ-OCHO)2(μ-H)2] (5), respectively. Furthermore, [(MeLAl)2(μ-OCHO)2(μ-OH)2] (4) is easily obtained upon the reaction of 3 or 5 with H2O. The stability of the unusual dialuminum diformate dihydride core observed in 5 stems from the proximity of the Al centers allowing the formation of two Al-HAl bridges and precluding further hydride transfer to the HCO2 moieties.

The Role of the DNA Backbone in Minor-Groove Ligand Binding.

Molecular recognition between ligands and nucleic acids plays a key role in therapeutic activity. Some molecules interact with DNA in a nonbonded manner through intercalation or through the DNA grooves. The recognition of minor-groove binders is attributed to a set of hydrogen-bonding interactions between the binders and the hydrogen-bond-acceptor groups on the groove floor and walls.

Laparoscopic common bile duct exploration and antegrade biliary stenting: leaving behind the Kehr tube.

Introduction: single-stage laparoscopic surgery of cholelithiasis and associated common bile duct stones (CL-CBDS) has shown similar results when compared to laparoscopic cholecystectomy combined with ERCP. Classically, choledochorrhaphy has been protected by a T-tube drain to allow external bypass of bile flow. However, its removal is associated with a significant complication rate.

[Analysis of the most appropriate surgical treatment for acute cholecystitis by applying the RAND/UCLA method].

Introduction: Acute cholecystitis (AC) is a common indication for cholecystectomy. Local circumstances and certain patient characteristics lead to high failure rates and complications in laparoscopic cholecystectomy (LC), and despite the experience gained, we still do not have a detailed list of indications which could minimise them.

Material And Method: We used the RAND/UCLA Appropriateness Method (RAM) to evaluate 2 options, LC and open cholecystectomy (OC).

[Blood glucose control and risk of progressing to a diabetic state during clinical follow up after cephalic duodenopancreatectomy].

Introduction: Pancreatic resection carries a theoretical risk of developing diabetes; however few studies have demonstrated the effect of a cephalic duodenopancreatectomy on post-operative blood glucose control.

Material And Methods: An analysis was made of the post-operative clinical follow up of 70 patients subjected to a cephalic duodenopancreatectomy in our Hospital between March 1993 and November 2009. The surgical indication was due to primary pancreatic disease in 30 patients (21 adenocarcinoma of the pancreas, 6 chronic pancreatitis, 1 endocrine carcinoma, 1 cystadenoma and 1 complicated pseudocyst).

[A vacuum assisted closure system in complex wounds: a retrospective study].

Introduction: Vacuum-assisted closure (VAC) therapy is a dynamic and non-invasive system for improving wound healing. This novel therapy is based on applying air suction at a controlled sub-atmospheric pressure. The most important benefits of this therapy include, a reduction in the wound area together with induction of new granulation tissue formation, effective wound cleansing (removal of small tissue by suction), and the continuous removal of wound exudate.

Appropriate management of common bile duct stones: a RAND Corporation/UCLA Appropriateness Method statistical analysis.

Background: Bile duct stones affect 10% of patients who undergo a cholecystectomy and therefore represent a major health problem. Laparoscopic common bile duct exploration, endoscopic sphincterotomy, and open surgical choledocholithotomy are the three available methods for dealing with choledocholithiasis. Though many trials and reviews have compared all three strategies, a list of indications for defined patient profiles is lacking.

Assessing the appropriate use of laparoscopic surgery for hepatobiliary diseases.

Background: The range of indications for laparoscopic surgery has widened since it was first introduced. The aim of the present study was to develop standards for the appropriate use of laparoscopic surgery in patients with choledocholithiasis or cholelithiasis.

Method: We conducted a study following the RAND appropriateness method (RAM) to develop criteria for hepatobiliary laparoscopy.

[Experience with the Bogota bag technique for temporary abdominal closure].

Introduction: The Bogota bag technique is a reliable method for open abdominal closure. The aim of this study was to describe our experience with this technique.

Material And Method: We retrospectively evaluated our experience with the Bogota Bag technique between January 2000 and March 2006.

Phosphate-activated glutaminase activity is enhanced in brain, intestine and kidneys of rats following portacaval anastomosis.

Aim: To assess whether portacaval anastomosis (PCA) in rats affects the protein expression and/or activity of glutaminase in kidneys, intestines and in three brain areas of cortex, basal ganglia and cerebellum and to explain the neurological alterations found in hepatic encephalopathy (HE).

Methods: Sixteen male Wistar rats weighing 250-350 g were grouped into sham-operation control (n=8) or portacaval shunt (n=8). Twenty-eight days after the procedure, the animals were sacrificed.