Salvage Liver Transplantation Is a Reasonable Option for Selected Patients Who Have Recurrent Hepatocellular Carcinoma after Liver Resection

Background: Salvage liver transplantation (SLT) has been reported as being feasible for patients who develop recurrent hepatocellular carcinoma (HCC) after primary liver resection, but this finding remains controversial. We retrospectively studied the clinical characteristics of SLT recipients and conducted a comparison between SLT recipients and primary liver transplantation (PLT) recipients. Methodology and Principal Findings: A retrospective study examined data from the China Liver Transplant Registry (CLTR) for 6,975 transplants performed from January 1999 to December 2009. A total of 6,087 patients underwent PLT and 888 patients underwent SLT for recurrence. Living donor liver transplantation (LDLT) was performed in 389 patients, while 6,586 patients underwent deceased donor liver transplantation (DDLT). Kaplan-Meier curves were used to compare survival rates. The 1-year, 3-year, and 5-year overall survival of SLT recipients was similar to that of PLT recipients: 73.00%, 51.77%, and 45.84 % vs. 74.49%, 55.10%, and 48.81%, respectively (P = 0.260). The 1-year, 3-year and 5-year disease-free survival of SLT recipients was inferior to that of PLT recipients: 64.79%, 45.57%, and 37.78 % vs. 66.39%, 50.39%, and 43.50%, respectively (P = 0.048). Similar survival results were observed for SLT and PLT within both the LDLT and DDLT recipients. Within the SLT group, the 1-year, 3-year, and 5-year overall survival for LDLT and DDLT recipients was similar: 93.33%, 74.67%, and 74.67 % vs. 80.13%, 62.10%, and 54.18 % (P = 0.281), as was the disease-free survival: 84.85%, 62.85%, an

Personalizing Cancer Pain Therapy: Insights from the Rational Use of Analgesics (RUA) Group

Introduction: A previous Delphi survey from the Rational Use of Analgesics (RUA) project involving Italian palliative care specialists revealed some discrepancies between current guidelines and clinical practice with a lack of consensus on items regarding the use of strong opioids in treating cancer pain. Those results represented the basis for a new Delphi study addressing a better approach to pain treatment in patients with cancer. Methods: The study consisted of a two-round multidisciplinary Delphi study. Specialists rated their agreement with a set of 17 statements using a 5-point Likert scale (0 = totally disagree and 4 = totally agree). Consensus on a statement was achieved if the median consensus score (MCS) (expressed as value at which at least 50% of participants agreed) was at least 4 and the interquartile range (IQR) was 3–4. Results: This survey included input from 186 palliative care specialists representing all Italian territory. Consensus was reached on seven statements. More than 70% of participants agreed with the use of low dose of strong opioids in moderate pain treatment and valued transdermal route as an effective option when the oral route is not available. There was strong consensus on the importance of knowing opioid pharmacokinetics for therapy personalization and on identifying immediate-release opioids as key for tailoring therapy to patients’ needs. Limited agreement was reached on items regarding breakthrough pain and the management of opioid-induced bowel dysfunction. Conclusion: These findings may assist clinicians in applying clinical evidence to routine care settings and call for a reappraisal of current pain treatment recommendations with the final aim of optimizing the clinical use of strong opioids in patients with cancer

Nuevas variedades de Lilium: Método de obtención y caracterización

Se realizaron cruzamientos entre Lilium x formolongi y tres híbridos asiáticos en la búsqueda de nuevos fenotipos y variedades adaptadas a las condiciones de Buenos Aires. Para superar las barreras pre y post cigóticas se utilizaron los métodos de corte del estilo previo a la polinización y cultivo de discos de ovarios. Esta metodología resultó satisfactoria, especialmente en una combinación de cruzamientos. Se rescataron 281 híbridos provenientes del cruzamiento con Montreaux, el 53.4% floreció en el primer ciclo de cultivo en condiciones naturales presentando gran variabilidad morfológica. Se seleccionaron tres clones, dos de ellos aptos para flor de corte: Vesna INTA-JICA y Melani INTA-JICA y uno para maceta: Bárbara INTA-JICA

Combinación de técnicas in vitro y ex vitro para la micropropagación de Santa Rita (Hibr) Una arbustiva de relevancia ornamental

A protocol combining in vitro and ex vitro techniques was developed to propagate Bougainvillea sp. To sterilize explants, nodal segments were submerged in commercial sodium hypochlorite (5 %) and Tween 80 (0.1 %) for 20 minutes. Subsequently, they were maintained in Plant Preservative Mixture (2 %) under constant and gentle shaking for 7 hours. Induced and non-induced explants were tested to compare their shoot multiplication rates. The best result was obtained when Murashige-Skoog (MS) basal medium was supplemented with: 5 mg/l 6- benzylaminopurine (BAP), 0.01 mg/l giberellic acid (III), 20 g/l sucrose and a mixture of antibiotics/antimicotics (1x), pH 5.7, as induction medium. Induced and noninduced explants were subsequently transferred to MS basal medium supplemented with constant levels of giberellic acid (III) and decreasing concentration of BAP. Under these culture conditions, induced explants produced 2.5 times more shoots than non-induced ones. Plantlets were rooted cutting the in vitro shoots and inserting them in plugs under hight humidity conditions. Whole plants were recovered 30 to 45 days later and transferred to pots for the acclimatization stage. While rooting percentage was 60 %, rustication percentage was 100 %.Se ha desarrollado un protocolo para la multiplicación de Santa Rita (Bougainvillea sp) que combina técnicas in vitro y ex vitro. Los explantos, segmentos nodales, fueron esterilizados por inmersión en solución de lavandina comercial (5 %) y Tween 80 (0,1 %) por 20 minutos. Una vez enjuagados se mantuvieron en solución de Plant Preservative Mixture (2 %), en agitación suave, durante 7 horas. Con el objeto de evaluar la aptitud para la multiplicación se probaron dos tipos de explantos: inducidos (por eliminación del ápice 15 días antes del inicio del ensayo) y no inducidos. Los mejores resultados se obtuvieron con el medio Murashige-Skoog, suplementado con 5,0 mg/l de 6-bencilaminopurina (BAP), 0,01 mg/l de ácido giberélico (AGIII), 20 g/l de sacarosa y mezcla de antibióticos y antimicóticos de Sigma (1X), el pH se ajustó a 5,7. Los subcultivos se realizaron sobre el mismo medio, con concentraciones decrecientes de BAP. Con estas condiciones de cultivo, en los explantos inducidos se observó una tasa de multiplicación de 2,5:1, mientras que para los no inducidos la tasa fue 1:1. Los brotes fueron enraizados en forma directa en multimacetas bajo condiciones de alta humedad relativa y, una vez enraizados, fueron transferidos a macetas para la etapa de aclimatación. Los porcentajes de enraizamiento y aclimatación fueron 60 % y 100 %, respectivamente

Combinación de técnicas in vitro y ex vitro para la micropropagación de Santa Rita (hibr.) Una arbustiva de relevancia ornamental

Se ha desarrollado un protocolo para la multiplicación de Santa Rita (Bougainvillea sp) que combina técnicas in vitro y ex vitro. Los explantos, segmentos nodales, fueron esterilizados por inmersión en solución de lavandina comercial (5 %) y Tween 80 (0,1 %) por 20 minutos. Una vez enjuagados se mantuvieron en solución de Plant Preservative Mixture (2 %), en agitación suave, durante 7 horas. Con el objeto de evaluar la aptitud para la multiplicación se probaron dos tipos de explantos: inducidos (por eliminación del ápice 15 días antes del inicio del ensayo) y no inducidos. Los mejores resultados se obtuvieron con el medio Murashige-Skoog, suplementado con 5,0 mg/l de 6-bencilaminopurina (BAP), 0,01 mg/l de ácido giberélico (AGIII), 20 g/l de sacarosa y mezcla de antibióticos y antimicóticos de Sigma (1X), el pH se ajustó a 5,7. Los subcultivos se realizaron sobre el mismo medio, con concentraciones decrecientes de BAP. Con estas condiciones de cultivo, en los explantos inducidos se observó una tasa de multiplicación de 2,5:1, mientras que para los no inducidos la tasa fue 1:1. Los brotes fueron enraizados en forma directa en multimacetas bajo condiciones de alta humedad relativa y, una vez enraizados, fueron transferidos a macetas para la etapa de aclimatación. Los porcentajes de enraizamiento y aclimatación fueron 60 % y 100 %, respectivament

Three-Dimensional Craniofacial Bone Reconstruction With SmartBone on Demand

This is a report of a 34-year-old male lacking of bone development in the frontal and orbital part of the skull due to a surgical removal of a right orbital-front osteoma at the age of 5. The integrity of the craniofacial district was important for the young patient also for social acceptance and self-esteem.Based on computed tomography patient images, a skull model was reconstructed, both digitally and on 3-dimensional real model, to best design the needed bone graft. Defect wide extension and surface curvature called for the use of the puzzle technique, where the whole graft is composed by several elements, mechanically slotting into each other. The realization was made possible thanks to the use of a composite xenohybrid bone substitute specifically developed for reconstructive surgery (SmartBone, by Industrie Biomediche Insubri SA). SmartBone technology allowed the realization of custom-made grafts which perfectly joined each other and fitted the bone defect thanks to mechanical strength, also at low thicknesses and wide extensions.The postoperative course was uneventful and computed tomography scans showed new bone formation and complete calvaria continuity already 10 months after surgery, with no signs of inflammation over the entire follow-up.This case study represents a proof of concept that SmartBone on Demand custom-made bone grafts, together with puzzle technique, are effective, easy to handle and provide final excellent functional and aesthetic results