Effect of antithrombotic therapy on postoperative outcome of 538 consecutive emergency laparoscopic cholecystectomies for acute cholecystitis. Two Italian center’s study

The risk of developing hemorrhagic complications during or after emergency cholecystectomy (EC) for acute cholecystitis (AC) in patients with antithrombotic therapy (ATT) remains uncertain. In this double-center study, we evaluated post-operative outcomes in patients with ATT undergoing EC. We retrospectively evaluated 538 patients who underwent laparoscopic EC for AC between May 2015 and December 2019 at two referral centers. 89 of them (17%) were on ATT. We defined postoperative complication rates, including bleeding, as our primary outcome. Mortality was higher in the ATT group. Morbidity was higher in the ATT group as well; however, the difference was not statistically significant. 12 patients (2%) experienced intraoperative blood loss over 500 ml and ten (2%) had postoperative bleeding complications. Two patients (< 1%) experienced both intraoperative and postoperative bleeding. On multivariate analysis, ATT was not significantly associated with worse postoperative outcomes. Antithrombotic therapy is not an independently associated factor of severe postoperative complications (including bleeding) or mortality. However, these patients still represent a challenging group and must be carefully managed to avoid postoperative bleeding complications

Servizio Civile Nazionale, Associazionismo e Volontariato

il contributo contiene una analisi del percorso che ha condotto all'istituzione del Servizio Civile Nazionale ed una riflessione sugli scenari sociali e politici che ne hanno determinato lo sviluppo. Particolare attenzione è stata data inoltre al ruolo del volontariato e dell'associazionismo ed alla loro capacità di innescare meccanismi di autocoscientizzazione, di autogoverno e di partecipazione alla cittadinanza attiva

Transanal total mesorectal excision (TaTME) : tips and tricks of a new surgical technique

Laparoscopic total mesorectal excision (TME) can be technically challenging especially in obese and patients with narrow pelvis. Transanal TME (TaTME) is a technique that combines abdominal and transanal endoscopic approach to overcome limitations and facilitate standard laparoscopic TME. The authors present some specific tips and tricks to perform this complex procedure using a double team approach and a new reusable transanal port

Correlation between Fusarium graminearum and deoxynivalenol during the 2012/13 wheat Fusarium head blight outbreak in Argentina

Fusarium graminearum (Schwabe) is reported as the main causal agent of Fusarium head blight in Argentina. The disease causes great losses in humid and semi-humid regions of the world, reducing grain yield and quality. During 2012/13 harvest season, a severe epidemic occurred in Argentina. The aims of this work were to determine the F. graminearum incidence and deoxynivalenol accumulation in wheat grain and flour samples obtained from two of the main wheat growing regions from Argentina. Levels of the pathogen and deoxynivalenol content were correlated in heads, grains and flour. Out of 69 wheat grain samples, 55 (79.7%) showed deoxynivalenol levels between 0.4 and 8.5 μg/kg. Fusarium graminearum was the main species isolated, the isolation frequency ranged from 30 to 52% of the total grains analyzed. Correlations were observed between deoxynivalenol content, % of F. graminearum infection, presence of the pathogen in heads, grain and flour

Incomplete echocardiographic recovery at 6\ua0months predicts long-term sequelae after intermediate-risk pulmonary embolism. A post-hoc analysis of the Pulmonary Embolism Thrombolysis (PEITHO) trial

Introduction: Symptoms and functional limitation are frequently reported by survivors of acute pulmonary embolism (PE). However, current guidelines provide no specific recommendations on which patients should be followed after acute PE, when follow-up should be performed, and which tests it should include. Definition and classification of late PE sequelae are evolving, and their predictors remain to be determined. Methods: In a post hoc analysis of the Pulmonary Embolism Thrombolysis (PEITHO) trial, we focused on 219 survivors of acute intermediate-risk PE with clinical and echocardiographic follow-up 6 months after randomisation as well as over the long term (median, 3 years after acute PE). The primary outcome was a composite of (1) confirmed chronic thromboembolic pulmonary hypertension (CTEPH) or (2) \u2018post-PE impairment\u2019 (PPEI), defined by echocardiographic findings indicating an intermediate or high probability of pulmonary hypertension along with New York Heart Association functional class II\u2013IV. Results: Confirmed CTEPH or PPEI occurred in 29 (13.2%) patients, (6 with CTEPH and 23 with PPEI). A history of chronic heart failure at baseline and incomplete or absent recovery of echocardiographic parameters at 6 months predicted CTEPH or PPEI at long-term follow-up. Conclusions: CTEPH or PPEI occurs in almost one out of seven patients after acute intermediate-risk PE. Six-month echocardiographic follow-up may be useful for timely detection of late sequelae

CALCOLOSI COLECISTO COLEDOCICA QUALE TRATTAMENTO?

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