Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

War, plague and exploitation in DR Congo

Late in autumn 2006 one of the headlines in world media was the first democratic elections in DR Congo. They took place after 30 years of Mobutu Sese Seko’s dictatorship and bloody civil wars in the period 1996-2002. These conflicts, which took approximately 4 million human lives, are called "The First African World War". Elections were held but they did not guarantee the end of trouble for the divided and tormented people in the northeast of Congo, the real scene of bloodshed. The area is still turbulent because it abounds in mineral wealth - gold, diamonds and raw materials for nuclear technology. For a whole decade, unscrupulous actors of the African crisis were fighting there, for illegal profits (achievable in the chaos of bloodshed) rather than for democracy, defense of tribal interests, security, etc. as they claimed. In the mines of Eastern Congo unprecedented exploitation of people is still going on, especially of children, victims of conflicts, who suffer in great numbers from violence, starvation and diseases. These slaves of the crisis make local "warlords" and their mentors rich. The looting of the mines has stabilized the crisis because it makes possible enormous accumulation of wealth among armed decision-makers - which also includes availability of countless slaves-miners who have lost everything except their bare lives. Eastern Congo is, however, one of world’s three old focuses of plague; wild exploitation of ores in the area of this endemic disease has activated a sleepy focus and added pneumonic plague to the burdens suffered by the population of the rich but ill-fated region. This was to be expected because endemic plague in the gold-bearing evil circumstances impedes safe mining - and this will be the crucial challenge in the future of Congo. This article is an anthropological outline of the area where gold, plague, weapons and incomparable suffering of people merge together just because of cynic greed producing abuse and death, including the plague

Genetics of Lafora progressive myoclonic epilepsy: current perspectives

Miljana Kecmanović,1 Milica Keckarević-Marković,1 Dušan Keckarević,1 Galina Stevanović,2 Nebojša Jović,2 Stanka Romac,1,† 1Faculty of Biology, Center for Human Molecular Genetics, 2Clinic of Neurology and Psychiatry for Children and Youth, School of Medicine, University of Belgrade, Belgrade, Serbia †Stanka Romac passed away on December 13, 2015 Abstract: Lafora disease (LD) is a fatal neurodegenerative disorder caused by loss-of-function mutations in either laforin glycogen phosphatase gene (EPM2A) or malin E3 ubiquitin ligase gene (NHLRC1). LD is associated with gradual accumulation of Lafora bodies (LBs). LBs are aggregates of polyglucosan, a long, linear, poorly branched, hyperphosphorylated, insoluble form of glycogen. Loss-of-function mutations either in the EPM2A or in the NHLRC1 gene lead to polyglucosan formation. One hypothesis on LB formation is based on findings that laforin–malin complex downregulates glycogen synthase (GS) through malin-mediated ubiquitination, and the other one is based on findings that laforin dephosphorylates glycogen. According to the first hypothesis, polyglucosan formation is a result of increased GS activity, and according to the second, an increased glycogen phosphate leads to glycogen conformational change, unfolding, precipitation, and conversion to polyglucosan, while GS remains bound to the precipitating glycogen. In this review, we summarize all the recent findings that have important implications for the treatment of LD, all of them showing that partial inhibition of GS activity may be sufficient to prevent the progression of the disease. The current perspective in LD is high-throughput screening for small molecules that act on the disease pathway, that is, partial inhibitors of GS, which opens a therapeutic window for potential treatment of this fatal disease. Keywords: Lafora disease, glycogen synthase, treatmen

Delaying surgery for patients with a previous SARS-CoV-2 infection

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The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AimThe SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery.MethodsThis was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin.ResultsOverall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P ConclusionOne in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease