Development and validation of a difficulty score to predict intraoperative complications during laparoscopic liver resection.

Background: Previous studies have demonstrated that patient, surgical, tumour and operative variables affect the complexity of laparoscopic liver resections. However, current difficulty scoring systems address only tumour factors. The aim of this study was to develop and validate a predictive model for the risk of intraoperative complications during laparoscopic liver resections.

Are the current difficulty scores for laparoscopic liver surgery telling the whole story? An international survey and recommendations for the future.

Background: Recent studies have suggested that the difficulty of laparoscopic liver resections are related to both patient and tumour factors, however the available difficulty scoring systems only incorporate tumour factors. The aim of this study was to assess the opinion of laparoscopic liver surgeons regarding the factors that affect the perceived difficulty of laparoscopic liver resections.

Method: Using a Visual Analogue Scale an international survey of laparoscopic liver surgeons was undertaken to assess the perceived difficulty of 26 factors previously demonstrated to affect the difficulty of a laparoscopic liver resection.

Conversion for Unfavorable Intraoperative Events Results in Significantly Worse Outcomes During Laparoscopic Liver Resection: Lessons Learned From a Multicenter Review of 2861 Cases.

Objective: To investigate the risk factors for conversion during laparoscopic liver resection and its effect on patient outcome in a large cohort of patients. Additional analysis of outcomes in patients who required conversion for unfavorable intraoperative findings and conversion for unfavorable intraoperative events will be performed to establish if the cause of conversion effects outcome.

Summary Background Data: Multiple previous studies demonstrate that laparoscopic liver surgery reduces intraoperative blood loss, hospital stay, and morbidity while maintaining comparable oncological and survival outcomes when compared with open liver resections.

Respiratory motion prediction and prospective correction for free-breathing arterial spin-labeled perfusion MRI of the kidneys.

Purpose: Respiratory motion prediction using an artificial neural network (ANN) was integrated with pseudocontinuous arterial spin labeling (pCASL) MRI to allow free-breathing perfusion measurements in the kidney. In this study, we evaluated the performance of the ANN to accurately predict the location of the kidneys during image acquisition.

Methods: A pencil-beam navigator was integrated with a pCASL sequence to measure lung/diaphragm motion during ANN training and the pCASL transit delay.

Calibrated bold fMRI with an optimized ASL-BOLD dual-acquisition sequence.

Calibrated fMRI techniques estimate task-induced changes in the cerebral metabolic rate of oxygen (CMRO) based on simultaneous measurements of cerebral blood flow (CBF) and blood-oxygen-level-dependent (BOLD) signal changes evoked by stimulation. To determine the calibration factor M (corresponding to the maximum possible BOLD signal increase), BOLD signal and CBF are measured in response to a gas breathing challenge (usually CO or O). Here we describe an ASL dual-acquisition sequence that combines a background-suppressed 3D-GRASE readout with 2D multi-slice EPI.

Motor sequence learning in the elderly: differential activity patterns as a function of hand modality.

Previous research on motor sequence learning (MSL) in the elderly has focused mainly on unilateral tasks, even though bilateral coordination might be impaired in this age group. In this fMRI study, 28 right-handed elderly subjects were recruited. The paradigm consisted of a Novel and a simple Control sequence executed with the right (R), left (L) and both hands (B).

Integrated palliative care in Europe: a qualitative systematic literature review of empirically-tested models in cancer and chronic disease.

Background: Integrated Palliative Care (PC) strategies are often implemented following models, namely standardized designs that provide frameworks for the organization of care for people with a progressive life-threatening illness and/or for their (in)formal caregivers. The aim of this qualitative systematic review is to identify empirically-evaluated models of PC in cancer and chronic disease in Europe. Further, develop a generic framework that will consist of the basis for the design of future models for integrated PC in Europe.

Association of telomere length with IL-6 levels during an obesity treatment in adolescents: interaction with the-174G/C polymorphism in the IL-6gene.

Background: Shorter telomeres have been associated with elevated risk for age-related diseases. However, little is known about the biomarker role of telomere length (TL) for predicting inflammation and glucose alterations.

Objective: The objective of this research is to evaluate the association between TL, inflammatory markers and glucose levels after a 2-month weight-loss programme in obese adolescents.

To what degree is palliative care integrated in guidelines and pathways for adult cancer patients in Europe: a systematic literature review.

Background: Palliative Care (PC) aims to improve the quality of life for patients with cancer and their families and its benefits have been demonstrated by several studies. The objective of this systematic review is to assess the integration of PC in the content of guidelines/pathways of adult cancer patients in Europe.

Methods: We included studies of adult patients with cancer published from 01/01/1995 and 31/12/2013 in Europe in six languages.

Towards integration of palliative care in patients with chronic heart failure and chronic obstructive pulmonary disease: a systematic literature review of European guidelines and pathways.

Background: Despite the positive impact of Palliative Care (PC) on the quality of life for patients and their relatives, the implementation of PC in non-cancer health-care delivery in the EU seems scarcely addressed. The aim of this study is to assess guidelines/pathways for integrated PC in patients with advanced Chronic Heart Failure (CHF) and Chronic Obstructive Pulmonary Disease (COPD) in Europe via a systematic literature review.

Methods: Search results were screened by two reviewers.

Spanish Version of the Patient Dignity Inventory: Translation and Validation in Patients With Advanced Cancer.

Context: The Patient Dignity Inventory (PDI) is an instrument to measure sources of distress related to dignity at the end of life.

Objectives: To obtain a Spanish version of the PDI and measure psychometric aspects in patients with advanced cancer.

Methods: A back-translation method was used to obtain the Spanish version.

Common variants in genes related to lipid and energy metabolism are associated with weight loss after an intervention in overweight/obese adolescents.

Background: Some SNPs related to lipid and energy metabolism may be implicated not only in the development of obesity and associated comorbidities, but also in the weight loss response after a nutritional intervention.

Objective: In this context, the present study analyzed four SNPs located within four genes known to be associated with obesity and other obesity-related complications, and their putative role in a weight-loss intervention in overweight/obese adolescents.

Methods: The study population consisted of 199 overweight/obese adolescents (13-16 yr old) undergoing 10 weeks of a weight loss multidisciplinary intervention: the EVASYON programme (www.

Idiotype vaccine production using hybridoma technology.

Non-Hodgkin's lymphoma (NHL) is the most common hematological malignancy both in Europe and in the United States. Follicular lymphoma (FL), a tumor comprised of mature B cells, represents one fourth of all NHL and, despite good response rates to standard treatments, tends to frequently relapse to such an extent that it is still considered incurable. Among several alternative therapeutic options actively being pursued, immunotherapy by idiotypic vaccination is in the forefront of clinical experimental medicine.

Telomere length as a biomarker for adiposity changes after a multidisciplinary intervention in overweight/obese adolescents: the EVASYON study.

Context: Telomeres are biomarkers of biological aging. Shorter telomeres have been associated with increased adiposity in adults. However, this relationship remains unclear in children and adolescents.

Dendritic cell vaccination in glioblastoma after fluorescence-guided resection.

Aim: To assess whether the addition of a customized, active immunotherapy to standard of care including fluorescence-guided surgery, may provide hints of an improved survival for patients with poor-prognosis, incurable glioblastoma multiform.

Methods: Preliminary to our ongoing, phase-II clinical trial, we conducted a small pilot study enrolling five consecutive patients with resectable glioblastoma. In terms of Recursive Partitioning Analysis, four patients were class V and one was class IV.

Promontorial cochleostomy in nonhuman primates. Is it atraumatic?

The purpose of this study is to determine if surgical approach to the inner ear is feasible without generating a hearing loss in an animal model. Five Macaca fascicularis were used as experimental animals and followed up for 27 months. Mastoidectomy, posterior tympanotomy and promontorial cochleostomy were performed on four specimens and one specimen was kept as control animal.

Stem cell transplant and idiotypic vaccination for B-cell malignancies.

Several types of B-cell malignancy, including but not limited to multiple myeloma and follicular lymphoma, are still considered incurable. In a substantial number of cases, patients must undergo either autologous or allogeneic stem cell transplantation as a standard of care procedure for their disease. Among experimental treatments for multiple myeloma and follicular lymphoma, idiotypic vaccination has been attempted over the last two decades with variable degrees of success.

Aiming at a curative strategy for follicular lymphoma.

Follicular lymphoma is often managed as an incurable disease. However, a substantial and growing fraction of patients are achieving long-term disease-free survival from aggressive treatment approaches. The application of novel therapeutic tools, including monoclonal antibodies, radioimmunotherapy, and vaccines, as well as new and more active chemotherapeutic agents, is producing complete responses in the majority of treated patients, with a 2-fold increase in disease- and progression-free survival in randomized trials.

Advantages of cochlear implantation in prelingual deaf children before 2 years of age when compared with later implantation.

Objectives: To compare the auditory abilities and speech performance of children with a profound prelingual bilateral hearing-impairment when subjected to a cochlear implant (CI) before or after 2 years of age. To analyze the complications that arose during, or as a result of, the implantation process in these groups.

Design: Prospective cohort single-subject, repeated-measures study of children with profound bilateral hearing impairment subjected to CI.

Prospective long-term auditory results of cochlear implantation in prelinguistically deafened children: the importance of early implantation.

The objectives of this study were to report the long-term auditory results of prelinguistically deafened children with bilateral profound hearing impairment treated with a cochlear implant (CI); to analyze the role of auditory stimulation in the development of communicating abilities in early implanted children; and to define the limits of the auditory critical period. It was designed as a prospective cohort single-subject repeated-measures study of children with bilateral profound hearing impairment treated with a CI at a tertiary referral center with a pediatric CI program since 1991. A total of 182 children with bilateral prelinguistic hearing impairment of profound degree treated with a Nucleus CI were enrolled in the study.