Emergency surgery for recurrent intraabdominal cancer

Recurrent abdominal cancer can manifest in many ways but there are certain situations that are a great challenge to clinicians. Emergency presentation is one such situation. Surgeons are faced with a therapeutic dilemma that on the one hand most of these patients have a limited life expectancy, and on the other surgical procedures are unavoidable. We reviewed our experience of recurrent abdominal cancers presenting with acute abdominal symptoms requiring emergency

\u201cWeekly docetaxel and gemcitabine as first line treatment for metastatic breast cancer: results of a multicenter phase II study\u201d

Objectives: We conducted a multicenter phase II study to evaluate the clinical effi cacy, toxicity, and dose intensity of a new weekly schedule of docetaxel and gemcitabine as fi rst-line treatment of metastatic breast cancer patients. Methods: We enrolled 58 patients, 52% of whom had received a previous anthracycline-containing chemotherapy. The treatment schedule was: docetaxel 35 mg/m 2 and gemcitabine 800 mg/m 2 i.v. on days 1, 8,15 every 28 days. Results: All patients were assessable for toxicity and 56 for effi cacy. Overall response rate was 64.3% with 16.1% of complete responses and 48.2% of partial responses. Median survival was 22.10 months (95% CI: 15.53\u201328.67) and median time to tumor progression was 13.6 months (95% CI: 10.71\u201316.49). The most common hematological toxicity was neutropenia (no febrile neutropenia), which occurred in 28 patients (48.3%) but grade 3\u20134 in only 8 patients (14%). Alopecia, the most common nonhematological toxicity, occurred in 20 (34.5%) patients, but only 5 patients (8.6%) experienced grade 3 alopecia. Conclusion: The activity of docetaxel and gemcitabine in metastatic breast cancer is confirmed. The promising results of the employed schedule,in agreement with other published studies, need to be further confirmed within a phase III study

Efficacy of the combination of cisplatin with either gemcitabine and vinorelbine or gemcitabine and paclitaxel in the treatment of locally advanced or metastatic non-small-cell lung cancer: a phase III randomised trial of the Southern Italy Cooperative Oncology Group (SICOG 0101)

Triplet regimens were occasionally reported to produce a higher response rate (RR) than doublets in locally advanced or metastatic non-small-cell lung cancer (NSCLC). This trial was conducted to assess (i) whether the addition of cisplatin (CDDP) to either gemcitabine (GEM) and vinorelbine (VNR) or GEM and paclitaxel (PTX) significantly prolongs overall survival (OS) and (ii) to compare the toxicity of PTX-containing and VNR-containing combinations

ROLE OF THE DIFFUSION CONTROLLED CURING OF AN AMINO HARDENED EPOXY.

Epoxy matrices of composite materials change their physical properties when exposed to humid environments of relatively high temperature. Aging reflects in a plasticization and microcavities formation as a consequence of the sorbed water. This paper reports on studies that compared the results of liquid water sorption tests at low and high temperature for three different epoxy systems to prove that polymer behaviour and, particularly, aging depends, under the same conditions, on the network morphology. Infrared spectrometric tests have been carried out to specify the curing kinetics of all the examined systems. The more the system structure was inhomogeneous, the more considerable the damaging process has been found from the comparison of the sorption behaviour and curing characteristics

Transient hypoparathyroidism following thyroidectomy: A prospective study and multivariate analysis of 604 consecutive patients

OBJECTIVE: The purpose of this study was to identify the risk factors for postoperative transient hypoparathyroidism in a group of patients undergoing thyroid surgery. STUDY DESIGN: A prospective study was conducted on 604 patients undergoing thyroid surgery. SUBJECTS AND METHODS: Gender, final diagnosis, extent of resection, biology of pathology, intrathoracic involvement, surgery for recurrent multinodular goiter, and presence and number of parathyroid glands in a surgical specimen were analyzed as risk factors for postoperative transient hypoparathyroidism. The chi-square test and a logistic regression analysis were applied. RESULTS: On logistic regression analysis, only the extent of surgery constituted an independent variable for transient hypoparathyroidism (P = 0.001). CONCLUSION: The extent of surgery to central and/or lateral neck lymph nodes is responsible for a high rate of transient hypoparathyroidism owing to a high probability of unplanned parathyroidectomy or parathyroid gland devascularization

Incidence and risk factors of post-operative delirium in elderly

Delirium is a complex psychopathological syndrome with acute onset and fluctuating course. In all hospital setting Delirium occurs in about 15-20% of all general admission. Even if studies report that incidence can vary in different unit. Objective: the aim of the study is to determine , among aged patients admitted in a surgical ward: 1) incidence of Delirium; 2) risk factors predictive for its development. Design: We prospectively followed up a cohort of elederly subjects admitted assessing medical, and psychological factors and using reliable and valid instrument to detect delirium. The setting is a general surgical ward of the University Teaching Hospital. Subjects: 131 Patients, aged 65 years or older consecutively admittted to the ward are recruited. Esclusion criteria are the evidence, at admission, of dementia, psychiatric disorders and severe sensory deprivation (aphasia, bleadness, deafness). 28 subjects do not partecipate (2 refused, 8 do not undergo surgical intervention, 3 died after inervention and 15 was discharged immediatly after oepration). A written consent is obtained. The mean age is 77,41 (+ 7,22; range 66-97); 49 are male and 54 are female. Measures: at the time of admission the baseline data collected are the following: demographic information, current life situation, self reported ADL, cognitive status (SPMSQ), depression (Zung Depression Scale) and clinical assessment including medical history, physical examintion, laboratory test and drug use. Data regarding intra-operative and postoperative aspects are also collected. After surgical intervention, at day 1, 3 and 6, the CAM (Confusion Assessment Method) to detect Delirium and the Delirium Rating Scale to assess the severity of symptoms are used. Statistical Analysis: χ2 test, t-test and descriptive statisitics are used to analyze the data. Results: The overall incidence of delirium was 19%. From data collected at baseline the most important results are that subjects who develop delirium, differ in a significant manner (