Obstructing left sided colorectal cancer. A retrospective single center study.

Background: In recent years, with population aging, there has been an increased number of colorectal cancer cases in elderly patients with severe occlusion symptoms. About 75% of obstructions due to malignant colorectal cancer (10-30%) occur distal to splenic flexure. Methods: The authors evaluated the best surgical therapeutic strategy to be used in cases of left-sided colorectal carcinoma in patients over 65 years old, especially considering the emergency condition, age of patients and efficacy in terms of postoperative morbidity, mortality and 5 years survival rate. Results: The management of left-sided obstructing colorectal carcinoma is controversial. Hartmann’s procedure is the best therapeutic choice in elderly patients. However, resection with intraoperative colonic wash-out and primary anastomosis has favorable outcome in low risk patients. Conclusions: A review of the literature reveals that primary resection and anastomosis for left-sided obstructing CRC is the correct therapeutic strategy in low risk patients with localized, resectable carcinoma, without peritonitis; Hartmann’s procedure should be adopted in doubtful cases and in high risk patients

Pharmacokinetics and pharmacodynamics of natalizumab in pediatric patients with RRMS

This phase I study investigated pharmacokinetic (PK) and pharmacodynamic (PD) profiles of natalizumab in pediatric patients with relapsing-remitting MS (RRMS)

Clinical Outcomes in Breast Cancer: Innovations and Ideas Commentary on "Expression of CDK13 was Associated with Clinical Outcomes and Expression of HIF-1 and Beclin1 in Breast Cancer Patients"

The oncogenes underlying the development of breast cancer are not fully understood and careful and rigorous research is still necessary in this area. Before considering the role of these molecules ..

Balloon aortic valvuloplasty as a palliative treatment in patients with severe aortic stenosis and limited life expectancy : a single center experience

Whether balloon aortic valvuloplasty (BAV) may provide an effective palliation in symptomatic high-risk patients is uncertain. Therefore, we aimed to evaluate outcomes in symptomatic high-risk patients with severe aortic stenosis (AS), who underwent BAV. All-cause mortality and length of hospitalization for heart failure (HF) up to death or to 1-year follow up were collected after BAV. One hundred thirty-two (132) patients (62% women), mean age 85±7 years, underwent BAV with a substantial reduction of the peak-to-peak aortic gradient from 53±21 to 29±15 mmHg (p<0.001). The median of days of HF hospitalization prior to BAV was 9 (0-19), and decreased after BAV to 0 (0-9), p<0.001. During 1-year follow-up patients with untreated CAD (85, 64%) had a higher mortality compared to patients with insignificant/treated CAD (47, 36%): 1-year survival: 45±7% vs. 66± 7%; p=0.02. After adjustment for STS risk score and severity of residual AS, patients with untreated CAD remained at higher risk of mortality (adjusted HR 1.74 [1.01-2.91]; p=0.04). Thus, in this series of symptomatic high-risk patients, BAV was associated with a significant reduction in aortic valve gradient and hospitalization time for HF post-BAV. In patients with significant CAD, percutaneous intervention might be considered in order to improve survival

Survival and functional outcome in patients 90 years of age or older after hip fracture

n/

Glucocorticoid-related genetic susceptibility for Alzheimer's disease

Because glucocorticoid excess increases neuronal vulnerability, genetic variations in the glucocorticoid system may be related to the risk for Alzheimer's disease (AD). We analyzed single-nucleotide polymorphisms in 10 glucocorticoid-related genes in a population of 814 AD patients and unrelated control subjects. Set-association analysis revealed that a rare haplotype in the 5′ regulatory region of the gene encoding 11β-hydroxysteroid dehydrogenase type 1 (HSD11B1) was associated with a 6-fold increased risk for sporadic AD. Results of a reporter-gene assay indicated that the rare risk-associated haplotype altered HSD11B1 transcription. HSD11B1 controls tissue levels of biologically active glucocorticoids and thereby influences neuronal vulnerability. Our results indicate that a functional variation in the glucocorticoid system increases the risk for AD, which may have important implications for the diagnosis and treatment of this diseas

Impact of treatment with dimethyl fumarate on sleep quality in patients with relapsing-remitting multiple sclerosis: A multicentre Italian wearable tracker study

BackgroundSleep disorders are common in patients with multiple sclerosis and have a bidirectional interplay with fatigue and depression. ObjectiveTo evaluate the effect of treatment with oral dimethyl fumarate on the quality of sleep in relapsing-remitting multiple sclerosis. MethodsThis was a multicentre observational study with 223 relapsing-remitting multiple sclerosis subjects starting treatment with dimethyl fumarate (n=177) or beta interferon (n=46). All patients underwent subjective (Pittsburgh Sleep Quality Index) and objective (wearable tracker) measurements of quality of sleep. Fatigue, depression, and quality of life were also investigated and physical activity was monitored. ResultsPatients treated with dimethyl fumarate had significant improvement in the quality of sleep as measured with the Pittsburgh Sleep Quality Index (p&lt;0.001). At all-time points, no significant changes in Pittsburgh Sleep Quality Index score were observed in the interferon group. Total and deep sleep measured by wearable tracker decreased at week 12 with both treatments, then remained stable for the total study duration. Depression significantly improved in patients treated with dimethyl fumarate. No significant changes were observed in mobility, fatigue and quality of life. ConclusionIn patients with relapsing-remitting multiple sclerosis, the treatment with dimethyl fumarate was associated with improvements in patient-reported quality of sleep. Further randomised clinical trials are needed to confirm the benefits of long-term treatment with dimethyl fumarate