Acute mesenteric ischemia of arterial origin: importance of early revascularization

GOAL: The goal of our study was to show that survival was better when early revascularization was performed rather than gastrointestinal resection in the management of acute mesenteric ischemia of arterial origin. METHODS: The reports of patients managed in our center between January 2005 and May 2012 for acute mesenteric ischemia of arterial origin were analyzed retrospectively. Data on clinical, laboratory and radiologic findings, the interval before treatment, the operative findings and the surgical procedures were collected. Follow-up information included the postoperative course, and mortality at 48 h, 30 days and 1 year, the latter being compared between patients undergoing revascularization versus gastrointestinal resection. RESULTS: Of 43 patients treated during this period, 20 had gastrointestinal lesions deemed to be beyond all therapeutic resources, 13 were treated with gastrointestinal resection without revascularization, while 10 underwent early revascularization. There were no statistically significant differences found in the extent of involvement between the two groups (P=0.22). Mortality at 48 h, 30 days and 1 year was 8% (n=1), 30% (n=4) and 68% (n=8) in patients who underwent enterectomy vs. 0% (n=0), 0% (n=0) and 10% (n=1) in patients who underwent revascularization procedures. The difference at 1 year was statistically significant (P=0.02). At 1 year, two patients in the revascularized group had a short bowel syndrome vs. one in the non-revascularized group. CONCLUSION: Acute mesenteric ischemia of arterial origin is associated with high morbidity and mortality. Optimal management should include early revascularization

Hypoxia In The Lower St. Lawrence Estuary: How Physics Controls Spatial Patterns

ISI Document Delivery No.: 980RD Times Cited: 1 Cited Reference Count: 57 Cited References: Anschutz P, 2000, GEOCHIM COSMOCHIM AC, V64, P2751, DOI 10.1016/S0016-7037(00)00400-2 Benoit P, 2006, MAR CHEM, V102, P13, DOI 10.1016/j.marchem.2005.09.015 Bograd SJ, 2008, GEOPHYS RES LETT, V35, DOI 10.1029/2008GL034185 Bugden G.L., 1991, CANADIAN SPECIAL PUB, V113, P139 CHAPMAN DC, 1985, J PHYS OCEANOGR, V15, P1060, DOI 10.1175/1520-0485(1985)0152.0.CO;2 Cloern JE, 2001, MAR ECOL PROG SER, V210, P223, DOI 10.3354/meps210223 Colombo JC, 1996, MAR CHEM, V51, P277, DOI 10.1016/0304-4203(95)00059-3 Colombo JC, 1996, MAR CHEM, V51, P295, DOI 10.1016/0304-4203(95)00060-7 Craig J, 2008, AZMP B PMZA, V7, P37 Czeschel R, 2011, J GEOPHYS RES-OCEANS, V116, DOI 10.1029/2010JC006565 Diaz R. 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Gratton, Y. Mucci, A. Dadou, I. Gilbert, D. Gilbert, Denis/A-3067-2010 Gilbert, Denis/0000-0002-9554-9594 NSERC Strategic grant; DFO CCSI (Climate Change Science Initiative) grant; Department of Earth and Planetary Sciences/McGill; GEOTOP-UQAM-McGill research center; LEGOS laboratory; University of Toulouse III (Paul Sabatier, France) This research was funded by a NSERC Strategic grant to A.M., D.G. and Y.G, and a DFO CCSI (Climate Change Science Initiative) grant to D.G. Additional financial support to S.L. was provided by the Department of Earth and Planetary Sciences/McGill, the GEOTOP-UQAM-McGill research center, the LEGOS laboratory and the University of Toulouse III (Paul Sabatier, France). We thank the captains and crew of R/V Alcide C. Horth and R/V Coriolis II for their help during the numerous cruises between 2002 and 2011. We acknowledge the two anonymous reviewers for their insightful comments. 1 AMER GEOPHYSICAL UNION WASHINGTON J GEOPHYS RES-OCEANSA laterally integrated advection-diffusion two-dimensional model was implemented to simulate the spatial distribution of dissolved oxygen and the development of hypoxic conditions in the deep waters of the Laurentian Channel (Estuary and Gulf of St. Lawrence, Eastern Canada). Our simulations reveal that the horizontal distribution of dissolved oxygen in the bottom waters of the Laurentian Channel is determined by a combination of physical and biogeochemical processes, whereas its vertical distribution is governed by the deep water circulation. This result strongly suggests that the physics of the system and the source water properties are mostly responsible for the generation of a mid-water column oxygen minimum and the oxygen distribution pattern in the deep water column

Metabolomic Biomarkers of Prostate Cancer: Prediction, Diagnosis, Progression, Prognosis, and Recurrence

Metabolite profiling is being increasing employed in the study of prostate cancer as a means of identifying predictive, diagnostic, and prognostic biomarkers. This review provides a summary and critique of the current literature. Thirty-three human case-control studies of prostate cancer exploring disease prediction, diagnosis, progression, or treatment response were identified. All but one demonstrated the ability of metabolite profiling to distinguish cancer from benign, tumor aggressiveness, cases who recurred, and those who responded well to therapy. In the subset of studies where biomarker discriminatory ability was quantified, high AUCs were reported that would potentially outperform the current gold standards in diagnosis, prognosis, and disease recurrence, including PSA testing. There were substantial similarities between the metabolites and the associated pathways reported as significant by independent studies, and important roles for abnormal cell growth, intensive cell proliferation, and dysregulation of lipid metabolism were highlighted. The weight of the evidence therefore suggests metabolic alterations specific to prostate carcinogenesis and progression that may represent potential metabolic biomarkers. However, replication and validation of the most promising biomarkers is currently lacking and a number of outstanding methodologic issues remain to be addressed to maximize the utility of metabolomics in the study of prostate cancer.National Institutes of Health (U.S.) (Grant P01 CA055075)National Institutes of Health (U.S.) (Grant CA133891)National Institutes of Health (U.S.) (Grant CA141298)National Institutes of Health (U.S.) (Grant CA136578)National Institutes of Health (U.S.) (Grant UM1 CA167552

Rectal metastasis of prostate cancer: about a case

Prostate adenocarcinomas present a high risk of metastasis. We report a case of an atypical prostate cancer metastasis. A male patient presented a prostatic adenocarcinoma treated by surgery. A biological recurrence was discovered during the follow-up by an increased rate of Prostate Specific Antigen (PSA) and was treated by hormonotherapy. Several months later, there was a re-increase of the PSA rate. The CT scan showed a radiation proctitis aspect. An intermittent hormonotherapy was decided. Six months later, he presented abdominal pain. Examinations were performed and showed a rectal carcinosarcoma with prostate origins. A surgical management was realised. The outcomes were an early recurrence. A symptomatic treatment was decided. There are not any rectal localisations reported in the literature. Only loco-regional invasions of the rectum are described and no histological modification of metastasis compared to the primitive tumor has been reported. So, we report a metastasis of a prostate adenocarcinoma which transformed into a carcinosarcoma. KEYWORDS: Adenocarcinoma; Carcinosarcoma; Metastasis; Prostate; Rectal neoplasm

Central pancreatectomy: comparison of results according to the type of anastomosis

INTRODUCTION: The mild pancreatic tumors are more and more treated by central pancreatectomy (CP) in alternative with the widened pancreatectomies. Indeed, their morbidity is lesser but they are however burdened by a rate of important postoperative fistulas. The purpose of our study is to compare pancreatico-jejunal anastomosis and pancreatico-gastric anastomosis. METHODS: This work was realized in a bicentric retrospective way. Twenty-five CP were included and classified according to two groups according to the pancreatic anastomosis (group 1 for pancreatico-jejunal anastomosis and group 2 for the pancreatico-gastric anastomosis). CP was realized according to a protocol standardized in both centers and the complications were classified according to the classification of Clavien and Dindo and the fistulas according to the classification of Bassi. RESULTS: Both groups were comparable. The duration operating and the blood losses were equivalent in both groups. There was a significant difference (P=0,014) as regards the rate of fistula. The pancreatico-gastric anastomosis complicated more often of a low-grade fistula. However, in both groups, the treatment was mainly medical. Our results were comparable with those found in the literature and confirmed the advantages of the CP with regard to the cephalic duodeno-pancreatectomy (DPC) or to the distal pancreatectomy (DP). However, in the literature, a meta-analysis did not report difference between both types of anastomosis but this one concerned only the DPC. CONCLUSIONS: This work showed a less important incidence of low-grade fistula after pancreatico-jejunal anastomosis in the fall of a PM. This result should be confirmed by a later study on a more important sample of PM

Seasonal variability of water mass distribution in the southeastern Beaufort Sea determined by total alkalinity and delta O-18

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Macdonald, Robie W. Gratton, Yves Macdonald, Robie/A-7896-2012 Macdonald, Robie/0000-0002-1141-8520 CCGS Amundsen; CASES (Canadian Arctic Shelf Exchange Study) NSERC network (Natural Sciences and Engineering Research Council of Canada); Canadian Fund for Innovation; Canadian Coast Guard; Department of Fisheries and Oceans Canada; NSERC Discovery We thank the officers and crew of the CCGS Amundsen for their support and dedication to the CASES expedition. We are indebted to Constance Guignard, Nes Sutherland, Pascale Collin, Simon Belanger, Jens Ehn, Mike Arychuk and Owen Owens for their care and perseverance in collecting and analyzing the TA, TIC and pH samples at sea. Thanks must go to the CTD data acquisition group for these basic but critical measurements and the calibration of the various probes. Most of the plots and maps in this study were created with the ODV Software [Schlitzer, 2009]. We also thank A. Proshutinsky and two anonymous reviewers who provided constructive comments that helped to improve our manuscript. This study was funded through the CASES (Canadian Arctic Shelf Exchange Study) NSERC network (Natural Sciences and Engineering Research Council of Canada) and a Canadian Fund for Innovation grant to support the upgrade and operation of the CCGS Amundsen. Additional financial contributions were provided by the Canadian Coast Guard, the Strategic Science Fund of the Department of Fisheries and Oceans Canada, and NSERC Discovery grants to A. Mucci and Y. Gratton. 10 AMER GEOPHYSICAL UNION WASHINGTON J GEOPHYS RES-OCEANSWe examined the seasonal variability of water mass distributions in the southeastern Beaufort Sea from data collected between September 2003 and August 2004. Salinity, total alkalinity (TA) and isotopic composition (delta O-18) of seawater were used together as tracers of freshwater input, i.e., meteoric water and sea ice meltwater. We used an optimum multiparameter analysis to identify the different water masses, including the Mackenzie River, sea ice melt (SIM), winter polar mixed layer (PML), upper halocline water (UHW) with core salinity of 33.1 psu (Pacific origin) and Atlantic Water. Computed values of CO2 fugacity in seawater (fCO(2)-sw) show that the surface mixed layer (SML) remains mostly undersaturated (328 +/- 55 mu atm, n = 552) with respect to the average atmospheric CO2 concentration (380 +/- 5 mu atm) over the study period. The influence of the Mackenzie River (fCO(2-SW) > 500 mu atm) was relatively small in the southeastern Beaufort Sea, and significant fractions were only observed on the inner Mackenzie Shelf. The contribution of sea ice melt (fCO(2-SW) 600 mu atm) was usually located between 120 and 180 m depth, but could contribute to the SML during wind-driven upwelling events, in summer and autumn, and during brine-driven eddies, in winter

Should pancreaticoduodenectomy be performed in the elderly?

BACKGROUND/AIMS: Pancreaticoduodenectomy (PD) is indicated in benign or malignant pancreatic head diseases. It is a difficult operation with high morbidity especially in elderly patients. The aim of our study was to determine whether pancreaticoduodenectomy is associated with higher morbidity and mortality in patients ≥ 70 years old. METHODOLOGY: During 17 years, 173 patients were operated by Whipple intervention, whatever the disease. From a prospective database, patients were divided in 2 groups (Group A ≥ 70 years old, Group B <70). RESULTS: Postoperative mortality was not significantly higher in elderly (12% vs. 4.1%; p=0.06). However, re-intervention and morbidity were more important in univariate analysis (p=0.03 and p=0.002 respectively). In multivariate analysis, age ≥ 70 years old was not an independent prognostic factor of mortality (p=0.27) and re-intervention (p=0.07). Whereas age (p=0.04) and preoperative morbidity (p=0.02) were independent prognostic factors of morbidity. CONCLUSIONS: PD requires careful patient selection. However, age should not be a limiting factor

Socio-demographic and clinical characterization of patients with obsessive-compulsive tic-related disorder (OCTD) : An Italian multicenter study

© Copyright by Pacini Editore SrlIn the DSM-5 a new "tic-related" specifier for obsessive compulsive disorder (OCD) has been introduced, highlighting the importance of an accurate characterization of patients suffering from obsessive-compulsive tic-related disorder ("OCTD"). In order to characterize OCTD from a socio-demographic and clinical perspective, the present multicenter study was carried out. The sample consists of 266 patients, divided in two groups with lifetime diagnoses of OCD and OCTD, respectively. OCTD vs OCD patients showed a significant male prevalence (68.5% vs 48.5%; p < .001), a higher rate of psychiatric comorbidities (69.4 vs 50%; p < .001) - mainly with neurodevelopmental disorders (24 vs 0%; p < .001), a lower education level and professional status (middle school diploma: 25 vs 7.6%; full-Time job 44.4 vs 58%; p < .001). Moreover, OCTD vs OCD patients showed significantly earlier age of OCD and psychiatric comorbidity onsets (16.1 ± 10.8 vs 22.1 ± 9.5 years; p < .001, and 18.3 ± 12.8 vs 25.6 ± 9.4: p < .001, respectively). Patients with OCTD patients were treated mainly with antipsychotic and with a low rate of benzodiazepine (74.2 vs 38.2% and 20.2 vs 31.3%, respectively; p < .001). Finally, OCTD vs OCD patients showed higher rates of partial treatment response (58.1 vs 38%; p < .001), lower rates of current remission (35.5 vs 54.8%; p < .001) and higher rates of suicidal ideation (63.2 vs 41.7%; p < .001) and attempts (28.9 vs 8.3%; p < .001). Patients with OCTD report several unfavorable socio-demographic and clinical characteristics compared to OCD patients without a history of tic. Additional studies on larger sample are needed to further characterize OCTD patients from clinical and therapeutic perspectives.Peer reviewedFinal Published versio

Guidelines for the recording and evaluation of pharmaco-EEG data in man: the International Pharmaco-EEG Society (IPEG)

The International Pharmaco-EEG Society (IPEG) presents updated guidelines summarising the requirements for the recording and computerised evaluation of pharmaco-EEG data in man. Since the publication of the first pharmaco-EEG guidelines in 1982, technical and data processing methods have advanced steadily, thus enhancing data quality and expanding the palette of tools available to investigate the action of drugs on the central nervous system (CNS), determine the pharmacokinetic and pharmacodynamic properties of novel therapeutics and evaluate the CNS penetration or toxicity of compounds. However, a review of the literature reveals inconsistent operating procedures from one study to another. While this fact does not invalidate results per se, the lack of standardisation constitutes a regrettable shortcoming, especially in the context of drug development programmes. Moreover, this shortcoming hampers reliable comparisons between outcomes of studies from different laboratories and hence also prevents pooling of data which is a requirement for sufficiently powering the validation of novel analytical algorithms and EEG-based biomarkers. The present updated guidelines reflect the consensus of a global panel of EEG experts and are intended to assist investigators using pharmaco-EEG in clinical research, by providing clear and concise recommendations and thereby enabling standardisation of methodology and facilitating comparability of data across laboratories