Laparoscopic Cholecystectomy Under Combined Spinal and Epidural Anesthesia in the First Trimester of Pregnancy-Case Report and Literature Review.

Can combined spinal and epidural anesthesia be the gold standard for laparoscopic surgery for pregnant patients? This case report presents a first trimester pregnant patient who was admitted for obstructive jaundice syndrome (pain in the right hypochondrium, nausea, and vomiting). Initially, because of the risk/benefit ratio of pregnancy, the treatment was medical and the patient was immediately discharged because her clinical condition improved, but she was rapidly readmitted to the surgery department because of worsening symptoms. Emergency surgical intervention (laparoscopic cholecystectomy) under combined spinal and epidural anesthesia (CSEA) was performed to reduce the patient's risks.

Risk Factors and Prognostic Factors in GBC.

: Gallbladder cancer (GBC) is a rare entity with a poor prognosis, usually discovered late due to nonspecific symptoms; therefore, over the last years, attention has been focused on identifying the risk factors for developing this malignancy in order to provide an early diagnosis, as well as new prognostic factors in order to modulate the long-term evolution of such cases. The aim of this review is to discuss both major risk factors and prognostic factors in GBC for a better understanding and integration of relevant and currently available information. : A literature search was performed using Cochrane Library, PubMed, Google Scholar, Elsevier, and Web of Science; studies published after the year of 2000, in English, were reviewed.

Artificial Intelligence in Sports Medicine: Reshaping Electrocardiogram Analysis for Athlete Safety-A Narrative Review.

Artificial Intelligence (AI) is redefining electrocardiogram (ECG) analysis in pre-participation examination (PPE) of athletes, enhancing the detection and monitoring of cardiovascular health. Cardiovascular concerns, including sudden cardiac death, pose significant risks during sports activities. Traditional ECG, essential yet limited, often fails to distinguish between benign cardiac adaptations and serious conditions.

Predictors of anastomotic leak and conduit necrosis after oesophagectomy: Results from the oesophago-gastric anastomosis audit (OGAA).

Background: Both anastomotic leak (AL) and conduit necrosis (CN) after oesophagectomy are associated with high morbidity and mortality. Therefore, the identification of preoperative, modifiable risk factors is desirable. The aim of this study was to generate a risk scoring model for AL and CN after oesophagectomy.

Prognostic Significance of Preoperative Inflammation Markers on the Long-Term Outcomes in Peritoneal Carcinomatosis from Ovarian Cancer.

Ovarian cancer remains one of the most lethal gynaecological malignancies affecting women worldwide; therefore, attention has been focused on identifying new prognostic factors which might help the clinician to select cases who could benefit most from surgery versus cases in which neoadjuvant systemic therapy followed by interval debulking surgery should be performed. The aim of the current paper is to identify whether preoperative inflammation could serve as a prognostic factor for advanced-stage ovarian cancer. Material and methods: The data of 57 patients who underwent to surgery for advanced-stage ovarian cancer between 2014 and 2020 at the Cantacuzino Clinical Hospital were retrospectively reviewed.

Spontaneous Pulmonary Hematoma: Case Report of a Giant Post-COVID-19 Hematoma and Literature Review.

Pulmonary hematomas are a rare pathology. Although they are usually reported post-traumatically, there are also spontaneous forms in pulmonary pathologies or during drug therapy. In these spontaneous entities, primitive forms are rarely described, although the contributory local pulmonary pathological terrain or a specific associated medication has not yet been identified.

Uterovesical fistulas as obstetric complications: Diagnosis, management and prognosis (Review).

Urogenital fistulas are abnormal communications between the female genital and urinary tract; while such fistulas, which are the most commonly encountered, are located between the vagina and urinary bladder and are caused by the local extension of a tumoral process. Another frequently encountered cause is represented by the obstetric one, leading to the development of uterovesical fistulas. However, many questions regarding the diagnosis and management of uterovesical fistulas remain unanswered.

Acquired benign tracheo‑oesophageal fistula secondary to oesophageal stenting for post lye ingestion stenosis: A case report.

Acquired benign trachea-oesophageal fistula is a rare benign pathological entity with varying aetiologies that most often occurs post-intubation. This case report presents the case of a female patient, 31 years old, admitted to the emergency room with sepsis syndrome following bilateral aspiration pneumonia caused by a large trachea-oesophageal fistula. The fistula was the result of intra-tracheal migration of an oesophageal stent placed for post lye ingestion stenosis.

Pulmonary Crohn's Disease or Crohn's Disease with Lung Sarcoidosis? A Case Report and Literature Review.

Background: Crohn's disease and ulcerative hemorrhagic colitis are forms of granulomatous inflammatory intestinal disease, which usually affects the gastrointestinal tract. There are also reported rare localizations at the skin, kidney, joints, liver and eye level. Pulmonary involvement is relatively rare, and it is most commonly reported in suppuration with bronchiectasis.

A Study of Biomarkers Associated with Metabolic Dysfunction-Associated Fatty Liver Disease in Patients with Type 2 Diabetes.

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a new term that no longer excludes patients that consume alcohol or present other liver diseases, unlike nonalcoholic fatty liver disease (NAFLD). The aim of this study was to evaluate the role of different biomarkers as predictors of MAFLD in patients with type 2 diabetes mellitus (T2DM). In this regard, a cross-sectional, non-interventional study was conducted over a period of 8 months in patients with T2DM.

Mycobacterium Tuberculosis Infection after Kidney Transplantation: A Comprehensive Review.

Tuberculosis (TB) in kidney transplant (KT) recipients is an important opportunistic infection with higher incidence and prevalence than in the general population and is associated with important morbidity and mortality. We performed an extensive literature review of articles published between 1 January 2000 and 15 June 2022 to provide an evidence-based review of epidemiology, pathogenesis, diagnosis, treatment and outcomes of TB in KT recipients. We included all studies which reported epidemiological and/or outcome data regarding active TB in KT, and we approached the diagnostic and treatment challenges according to the current guidelines.

Pulmonary Alveolar Proteinosis and Pregnancy: A Review of the Literature and Case Presentation.

Pulmonary Alveolar Proteinosis (PAP) is a rare, usually autoimmune, disease, where surfactant accumulates within alveoli due to decreased clearance, causing dyspnea and hypoxemia. The disease is even more rare in pregnancy; nevertheless, it has been reported in pregnant women and can even appear for the first time during pregnancy as an asthma-like illness. Therefore, awareness is important.

Neonatal intensive care unit on-site surgery for congenital diaphragmatic hernia.

The present study presents the experience gained in the Newborn Intensive Care Unit (NICU) of 'Maria S. Curie' Emergency Clinical Hospital for Children in Bucharest (Romania) after performing a series of bedside surgery interventions on newborns with congenital diaphragmatic hernia (CDH). We conducted a retrospective analysis of the data for all patients operated on-site between 2011 and 2020, in terms of pre- and post-operative stability, procedures performed, complications and outcomes.

A Large Thymoma Resected via Left Antero-lateral Thoracotomy.

Background/aim: Thymomas are a rare type of mediastinal tumors with a slow growth rate. Because of this, they are well tolerated and patients usually present with large masses, which can extend in either of the thoracic cavities. The surgical approach for such tumors is dictated by the size and localization of the mass.

Synchronous arterial resection in pancreatic cancer: A case report.

Pancreatic cancer is one of the most lethal malignancies affecting people worldwide. As it is frequently diagnosed in advanced stages of the disease, the 5-year overall survival rate is <10%. Advanced stages are usually characterized by the local invasion of the superior mesenteric axis, celiac axis and portal vein and are considered a sign of unresectable cancer.

Vascular Resections in Association With Pancreatic Resections for Locally Advanced Pancreatic Cancer.

Background/aim: Locally advanced pancreatic cancer has been considered for a long period of time as an unresectable lesion and therefore, all patients have been traditionally addressed to the oncological services for palliative purposes. However, due to the wide usage of newer oncological agents in association with improved surgical techniques, radical surgical procedures became feasible. The aim of this study was to present the different surgical procedures that were performed in locally advanced pancreatic cancer patients in order to achieve radical resections.

Necrotizing fasciitis of the chest wall: A clinical case report and literature review.

Necrotizing fasciitis of the chest wall is a very rare pathology, but with significant mortality, representing a therapeutic challenge. All international reports indicate the need for early diagnosis and an aggressive medical-surgical attitude in order to improve the prognosis. In addition to a review of literature, we present a case developed secondary to a thoracic pleural drainage for pyopneumothorax associated with significant bronchopleural fistula in a destroyed tuberculous left lung.

Distal Pancreatectomy With Celiac Axis Resection for Locally Advanced Pancreatic Body Cancer - A Case Report and Literature Review.

Background: Locally advanced pancreatic cancer invading the surrounding vascular structures has long been considered as unresectable and, therefore, patients were usually submitted to palliative chemotherapy.

Case Report: We present the case of a 44-year-old male investigated for weight loss and abdominal pain and diagnosed with a locally advanced pancreatic tumor invading the celiac axis. An endoscopic ultrasound was performed and a biopsy was retrieved demonstrating the presence of a moderately differentiated pancreatic adenocarcinoma.

A Rare Thymic Tumor - Lipofibroadenoma - Always a Postoperative Surprise.

Background/aim: Thymic lipofibroadenoma is a benign growth of unknown etiology extremely rarely described in the literature, morphologically resembling lipofibroadenoma of the breast. The diagnosis is usually a postoperative surprise and is made by the anatomopathologist. Surgical resection is curative.

Major Hepatectomy En Bloc with Cava Vein Resection for Locally Invasive Caudate Lobe Hepatocarcinoma.

Background/aim: Locally advanced liver tumours with vascular invasion have been considered for a long period of time as unresectable lesions, so the patient was further deferred to oncology services for palliation. However, improvement of the surgical techniques and the results reported so far came to demonstrate that extended hepatic and vascular resections might be safely performed in such cases and might significantly improve the long-term outcomes.

Materials And Methods: A 61-year-old patient was diagnosed with a caudate lobe tumour invading the inferior cava vein and the right hepatic pedicle.

Infra-hepatic caval resection en bloc with right nephrectomy followed by caval reconstruction for locally advanced caval leiomyosarcoma: A case report and literature review.

Retroperitoneal sarcomas often require complex surgical procedures in order to achieve complete resection; in such cases both vascular and visceral resections are needed. When it comes to the need for vascular reconstruction, the type of graft as well as the type of reconstructive process are chosen according to the length and location of the resected segment. Meanwhile, depending on the location of the resected segment, other vascular reconstructions may be needed such as the reimplantation of the renal veins.

Neoadjuvant intraperitoneal chemotherapy for advanced stage gastric cancer (Review).

Gastric cancer remains one of the most lethal malignancies especially when diagnosed in advanced stages of the disease; most often patients diagnosed later during the progression of their disease will present a certain degree of peritoneal contamination such as positive peritoneal cytology or peritoneal metastatic nodules. In such cases most often they then progress to peritoneal carcinomatosis and succumb to the disease within one year. In order to increase the lifespan in such cases multiple therapeutic strategies have been proposed such as radical surgery and intraperitoneal heated chemotherapy or direct intraperitoneal chemotherapy followed by radical surgery.

The Utility of Next-Generation Sequencing in the Treatment Decision-Making for Metastatic Non-Small-Cell Lung Cancer.

Next-generation sequencing (NGS) is a fast and relatively inexpensive method to sequence a large number of genes with crucial importance in cancer medicine. Nowadays, NGS is frequently used in diagnostic and therapeutic decisions in oncology; however, recently, it was demonstrated that only a few cancer sites actually benefit from this assessment. Moreover, the association of a mutant gene with a targeted drug is not always as predicted during in-vitro trials and is often not associated with tumor response.

Extended Venous Resections for Borderline Resectable Pancreatic Head Adenocarcinoma-A Retrospective Studies of Nine Cases.

Background: pancreatic cancer is one of the most lethal malignancies and a leading cause of cancer-related death worldwide. The only chance to improve the long-term outcomes of patients with pancreatic cancer is surgery with radical intent.

Methods: in the present paper, we aim to describe a case series of 9 patients submitted to radical surgery for borderline resectable pancreatic cancer.

Superior Mesenteric Vein Resection Followed by Porto-Jejunal Anastomosis During Pancreatoduodenectomy for Borderline Resectable Pancreatic Cancer - A Case Report and Literature Review.

Background/aim: Pancreatic cancer represents the most lethal abdominal malignancy, the only chance for achieving an improvement in terms of survival being represented by radical surgery. Although it has been considered that venous invasion represents a contraindication for resection, recently it has been demonstrated that in regards to overall survival after radical resection, it is similar to the one reported after standard pancreatoduodenectomy.

Case Report: A 53-year-old patient with no significant medical past was diagnosed with a borderline resectable pancreatic adenocarcinoma invading the superior mesenteric vein.