Percorsi mariani in Abruzzo. Memoria storica e prospettiva di valorizzazione

The rediscovery of authentic places expressed by a post-industrial culture is encouraging - among others factors - the revival of the so-called "cultural" routes and their use through slow travels. Amongst these latter ones, religious journeys (in particular Marian paths) play a central role. Although in the Abruzzi there are no sanctuaries of significant extra-regional interest, it is nevertheless a land strongly marked by traces, architectures and routes connected with the figure of Mary. It is actually demonstrated by the numerous cultural buildings which are dedicated to Her and situated along the streets of transhumance. Any systematic evaluation of their presence would nowadays ensure attention upon territory by those enjoying authentic travels. At the same time, it would re-enhance a tangible and intangible heritage which very often threatens to disappear

Promotion of proliferation and metastasis of hepatocellular carcinoma by LncRNA00673 based on the targeted-regulation of notch signaling pathway

we read with great interest the paper by Dr. Chen et al1, recently published in European Review for Medical and Pharmacological Sciences and titled ‘‘Promotion of proliferation and metastasis of hepatocellular carcinoma by LncRNA00673 based on the targeted-regulation of notch signaling pathway’’. Authors concluded that lncRNA00673 is highly expressed and may be a potential target for the treatment of Hepatocellular Carcinoma (HCC). Moreover, according to authors, it can promote the proliferation and metastasis of HCC by the regulation of Notch signaling pathway. We congratulate the authors for their interesting work

Improving Outcomes Defending Patient Safety: The Learning Journey in Robotic Liver Resections

Background. While laparoscopy is currently adopted for hepatic resections, robotic approaches to the liver have not gained wide acceptance. We decided to analyze the learning curve in the field of robotic liver surgery comparing short-term outcomes between the first and the second half of our series. Methods. We retrospectively reviewed demographics and clinical data of patients who underwent robotic liver resection at our institution from July 2014 through September 2017. 60 patients diagnosed with primary or secondary liver neoplasms or hydatid disease were included in this study. ASA PS >3, heart failure, respiratory insufficiency, and general contraindication to pneumoperitoneum were exclusion criteria. Results. 60 patients were included. We observed a statistically significant decrease in operative time (p<0.001), intraoperative blood loss (p=0.01), and postoperative complications (p<0.001) after 30 cases. From the interpretation of the CUSUM curve, the time of operation appears to be significantly reduced after the first 30 operations. Discussion. This is the first European analysis of the learning curve for robotic liver resection in an HPB and liver transplant referral center. However, more studies are needed to confirm such results outside a HPB referral center. This is crucial to develop formal credentialing protocols for both junior and senior surgeons

Cartografia speditiva delle tracce di valanga sui versanti meridionali delle Malacoste (catena del Gran Sasso, Abruzzo) ai fini di una migliore conoscenza del rischio ambientale

Fast mapping of the avalanche tracks on the Southern side of Malacoste (Gran Sasso Range, Abruzzi) for a better knowledge of environmental risk. – This note shows the results of a research, conducted in the Gran Sasso area, on the risk of avalanches and related territorial consequences. The study is based on a geological and geographic approach and uses techniques of fast mapping and field research. It was possible to identify the traces of 85 events that occurred between 2007 and 2017, which are many more than those officially registered. This made it possible to specify, at least for the type of wet-snow avalanches, the areas most subject to the phenomenon and highlighted the environmental risks and possible dangers for the visitors in the area. Therefore, it provided useful indications for a more prudent management of risk and better territorial planning

Multimodal approach of advanced gastric cancer: Based therapeutic algorithm

Gastric cancer (GC) is the third leading cause of cancer death in both sexes worldwide, with the highest estimated mortality rates in Eastern Asia and the lowest in Northern America. However, the availability of modern treatment has improved the survival and the prognosis is often poor due to biological characteristics of the disease. In oncology, we are living in the "Era" of target treatment and, to know biological aspects, prognostic factors and predictive response informations to therapy in GC is mandatory to apply the best strategy of treatment. The purpose of this review, according to the recently published English literature, is to summarize existing data on prognostic aspects and predictive factors to response to therapy in GC and to analyze also others therapeutic approaches (surgery and radiotherapy) in locally, locally advanced and advanced GC. Moreover, the multidisciplinary approach (chemotherapy, surgery and radiotherapy) can improve the prognosis of GC

Gastric Mucormycosis in a Liver and Kidney Transplant Recipient: Case Report and Concise Review of Literature

Mucormycosis is an uncommonly encountered fungal infection in solid organ transplantation. The infection is severe and often results in a fatal outcome. The most common presentations are rhino-sino-orbital and pulmonary disease. We describe a rare case of gastric mucormycosis in a patient with a combined liver-kidney transplant affected by glycogen storage disease type Ia. A 42-year-old female patient presented with gastric pain and melena 26 days after transplantation. Evaluation with upper endoscopy showed two bleeding gastric ulcers. Histological examination of gastric specimens revealed fungal hyphae with evidence of Mucormycetes at subsequent molecular analysis. Immunosuppressive therapy was reduced and antifungal therapy consisting of liposomal amphotericin B and posaconazole was promptly introduced. Gastrointestinal side effects of posaconazole and acute T-cell rejection of renal graft complicated further management of the case. A prolonged course of daily injections of amphotericin B together with a slight increase of immunosuppression favored successful treatment of mucormycosis as well as of graft rejection. After 2-year follow-up examination, the woman was found to have maintained normal renal and liver function tests. We conclude that judicious personalization of antimicrobial and antirejection therapy should be considered to resolve every life-threatening case of mucormycosis in solid organ transplantation