Improved results of the vacuum assisted closure and Nitinol clips sternal closure after postoperative deep sternal wound infection

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Diagnostic difficulties of Lactobacillus casei bacteraemia in immunocompetent patients: A case report

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Anastomosi vescico-uretrale CAPIO™ RP assisted dopo prostatectomia radicale retropubica.

Vescico-urethral anastomosis following radical retrobupic prostatectomy (RRP) can sometime be extremely difficul due to a short uretheral end or to a narrow and deep pelvis, so that the suture stitches can be wrongly positioned , without passing through the uretheral wall, or the wrong position, and this can produce the onset of a urinary fistula, and sudsequently, stenosis of the anastomotic tract. The CAPIO tm RP suture device allows a perfect vesico-uretheral anastomosis end the suture stitches can be easilu positioned insidethe uretheral wall, and exactly where the surgenon decides to put them according to personal experience. Twenty-six patients age ranged fron 52 to 67 yrs, suffering from localized prostaic cancer, under nerce sparing RRP and subsequent CAPIO tm RP assisted vesico -uretheral anastomosis. In all patients, the catheter was removed 6 days after surgery: 22 patiens (84;6%) showed immediate urinary continence; and for patients (15,4%) had mild stress urinary incontinence , with disappeared after 2 weeks. Medium Qmax during follow-up from 1-8 mounth was 20 mL/sec. The CAPIO tm RP suture deviceis, in our experience, a valid tool in the hands of the urologist that makes any vesico-uretheral anastomosis extremely easy and safe, reducing the risk of complications

Liposarcoma mixoide del funicolo spermatico

The myxoid liposarcoma, a rare form of spermatic cord liposarcoma, is a neoplasia of adult men which arise from adipose tissue, with a slow and subdolous growth, showing good prognosis and low incidence of local or distant recurrence. The case came at our attention is the sixteenth described in literature. Orchifunicolectomy is the gold standard therapy, although in some cases in which this kind of surgery is not radical adjuvant inguinal or retroperithoneal and pelvic nodes radiotheraphy should be taken in consideratio

What are the dangers of biological therapy discontinuation or dose reduction strategies when treating rheumatoid arthritis?

Introduction: Treatment with biological DMARDs (bDMARDs) has meant that remission or low disease activity (LDA) is now a realistic goal for patients with rheumatoid arthritis (RA). However, as in the case of all long-term therapies, potential side-effects give rise to concern. The main reasons for withdrawing or tapering bDMARDs are safety and the sustainability of national healthcare systems. Given these data our review has been focused on important question: whether conventional, including steroids, or bDMARDs can be reduced or even stopped in patients with stable established RA or early RA. Areas covered: The studies included in the evaluation had to be RCTs, observational studies, systematic reviews evaluating the withdrawing or tapering bDMARDs in RA patients who have been on long-term treatment and have achieved remission or LDA. A search was made in the MEDLINE and EMBASE databases from 1980 to May 2016. Expert commentary: There is curently no standardised way of identifying the patients for whom reducing bDMARD therapy is appropriate. Clinical experience and data from de-escalation studies suggest that patients with RA in sustained remission are the best target population for studying drug-tapering regimens, and that LDA should not be considered an adequate indication for bDMARD de-escalation because it could hide a persistent amount of inflammation

Abnormal γ-globin gene arrangements in Sardinians

An extended survey of 8,103 Sardinian newborns has been conducted for the study of abnormal γ-globin gene arrangements. Fetal hemoglobin analysis and globin gene mapping have identified five different arrangements in 24 babies: five (21%) were carriers of the –GAγ- hybrid (thalassemic) gene, directing the synthesis of the Aγ chain and resulting in low 641%) Gγ chain and decreased Hb F levels; two (8%) carried the –Aγ-Aγ-T- duplication, characterized by even lower (37%) Gγ levels; five (21%) carried the –Gγ-AGγ- Aγ- triplication; one (4%) carried the –Gγ-Gγ-Aγ- triplication, and 11 (46%) the –Gγ-Gγ- duplication, all resulting in high Gγ levels (85, 83, and 88%, respectively). Thirty-six additional babies could be phenotypically classified as carriers of the same mutations. Haplotyping and γ-chain composition showed that the crossover event generating the –GAγ- hybrid gene and the corresponding –Gγ-AGγ-Aγ- triplication has occurred on at least three different chromosomes. The –Gγ-Gγ- duplication was associated with the chromosome having haplotype I, and the –Aγ-Aγ-T- with the chromosome of haplotype II. As many as 2,260 babies (28%) were heterozygous, and 254 (3%) homozygous for the AγT mutation. The incidence and relative distribution of these anomalies in Sardinia are different when compared with those of other ethnic groups