Complications of Living Donor Hepatic Lobectomy–A Comprehensive Report

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/91208/1/j.1600-6143.2011.03972.x.pd

Liver regeneration: a spotlight on the novel role of platelets and serotonin

The development of novel approaches in liver surgery in the last decade has saved the lives of a large number of patients via resection of liver tumours previously thought to be non-resectable. Concurrently, living donor liver transplantation has emerged as one of the ways of lowering mortality on the waiting lists. These breakthroughs demanded a rigorous understanding of the mechanisms of liver regeneration after partial hepatectomy. Based on our previous studies on blood platelets and cold ischaemic injury, platelets and serotonin have attracted attention due to their theoretical potential contribution to liver regeneration. Both platelets and serotonin have been proven to be crucially involved in liver regeneration after partial hepatectomy. This review article provides an overview on the process of liver regeneration, with emphasis on its molecular basis and the coordinate contribution of several cells to restoring the organ's original volume and function. The role of platelets and serotonin is highlighted as novel contributors in this process

L'assistant social face au suicide assisté en Valais: quelles stratégies d'action sont adoptées par les assistants sociaux valaisans confrontés au suicide assisté ?

Ce travail de recherche se penche non seulement sur les concepts légaux, éthiques et déontologiques liés à la question de l’assistance au suicide, mais aussi et surtout sur l’accompagnement et la pratique professionnelle des assistants sociaux face à de telles demandes. L’objectif de cette recherche est d’apporter une réflexion sur ce sujet et des pistes d’intervention. A travers les entretiens menés auprès de cinq assistantes sociales valaisannes, des informations et des précisions sur ce type d’accompagnement ont pu être apportées, notamment sur le nombre de situations, l’accompagnement, les directives et les outils à disposition, les connaissances théoriques ainsi que la gestion émotionnelle. Ces entretiens ont permis de mettre en lumière certaines pratiques et certains outils utilisés, mais aussi les difficultés auxquelles les assistants sociaux doivent faire face lors d’une demande de ce type. Il ressort de cette analyse que les suivis professionnels varient grandement en fonction de la personnalité de chacun et des prédispositions personnelles quant à la question de l’assistance au suicide. Enfin, ces recherches sur le terrain ont permis de développer quelques pistes qui pourraient aider ces assistants sociaux dans leurs interventions professionnelles

Altruism across disciplines: one word, multiple meanings

Altruism is a deep and complex phenomenon that is analysed by scholars of various disciplines, including psychology, philosophy, biology, evolutionary anthropology and experimental economics. Much confusion arises in current literature because the term altruism covers variable concepts and processes across disciplines. Here we investigate the sense given to altruism when used in different fields and argumentative contexts. We argue that four distinct but related concepts need to be distinguished: (a) psychological altruism, the genuine motivation to improve others' interests and welfare; (b) reproductive altruism, which involves increasing others' chances of survival and reproduction at the actor's expense; (c) behavioural altruism, which involves bearing some cost in the interest of others; and (d) preference altruism, which is a preference for others' interests. We show how this conceptual clarification permits the identification of overstated claims that stem from an imprecise use of terminology. Distinguishing these four types of altruism will help to solve rhetorical conflicts that currently undermine the interdisciplinary debate about human altruism

Should We Deny Surgery for Malignant Hepato-Pancreatico-Biliary Tumors to Elderly Patients?

Malignant hepato-pancreatico-biliary (HPB) tumors have their highest incidence within the sixth to eighth decades of life. The aging of the world population has resulted in a dramatic increase in the number of elderly patients considered for resection of malignant HPB tumors. Because elderly patients are more likely to have more co-morbidities, cognitive impairment, and decreased life expectancy, the benefit and appropriateness of these procedures must be scrutinized for geriatric patients. Therefore, many surgeons have compared the perioperative and long-term outcome of hepatic and pancreatic resections for elderly and younger patients. In most series the elderly population was defined by an age of 70 years or older. The results demonstrate that hepatic resection for hepatocellular carcinoma and colorectal liver metastases can be safely performed in well-selected elderly patients with long-term outcome comparable to younger patients. Similar findings are also reported for pancreatic resection in elderly patients with either ampullary or pancreatic cancer. Although the survival benefit of pancreatico-duodenectomy is limited in all age groups, the absence of competitive therapy justifies this procedure as the sole curative option in younger as well as older patients. Data on resection of gallbladder cancer and hilar bile duct cancer in the elderly are sparse, but there is evidence from large series on resection of these types of tumors that advanced age per se is not a risk factor for reduced outcome. Therefore, surgical options should not be denied to elderly patients with a malignant HPB tumor, and the evaluation should include surgeons expert in HPB surger