Robot-Assisted Radical Hysterectomy for Cervical Cancer: Review of Surgical and Oncological Outcomes

Robot-assisted procedures are being increasingly incorporated in gynaecologic oncology. Several studies have confirmed the feasibility and safety of robotic radical hysterectomy for selected patients with early-stage cervical cancer. It has been demonstrated that robotic radical hysterectomy offers an advantage over other surgical approaches with regard to operative time, blood loss, and hospital stay. Also initial evidences concerning oncological outcomes seem to confirm the equivalence to traditional open technique. Despite the fact that costs of robotic system are still high, they could be partially offset by several health-related and social benefits: less pain, faster dismissal, and return to full activity than other surgical approaches. The development of robotic technology may facilitate the spread of minimally invasive surgery in gynaecological oncology, overcoming some drawbacks of laparoscopic technique for challenging intervention such as radical hysterectomy. Further studies are needed to evaluate overall and disease-free survival of this technique and associated morbidity after adjuvant therapies

Does laparoscopic management of deep infiltrating endometriosis improve quality of life? A prospective study

<p>Abstract</p> <p>Background</p> <p>Deep infiltrating endometriosis (DIE) can affect importantly patients' quality of life (QOL). The aim of this study is to evaluate the impact of the laparoscopic management of DIE on QOL after six months from treatment.</p> <p>Methods</p> <p>It is a prospective cohort study. In a tertiary care university hospital, between April 2008 and December 2009, 100 patients underwent laparoscopic management of DIE and completed preoperatively and 6-months postoperatively a QOL questionnaire, the short form 36 (SF-36).</p> <p>Quality of life was measured through the SF-36 scores. Intra-operative details of disease site, number of lesions, type of intervention, period of hospital stay and peri-operative complications were noted.</p> <p>Results</p> <p>Six months postoperatively all the women had a significant improvement in every scale of the SF-36 (p < 0,0005). Among patients with intestinal DIE, significant differences in postoperative scores of SF-36 were not detected between patients submitted to nodule shaving and segmental resection (p > 0.05). There was no significant difference in the SF-36 scores at 6 months from surgery between patients who received postoperative medical treatment and patients who did not (p > 0.05).</p> <p>Conclusions</p> <p>Laparoscopic excision of DIE lesions significantly improves general health and psycho-emotional status at six months from surgery without differences between patients submitted to intestinal segmental resection or intestinal nodule shaving.</p

Synthesis and evaluation of new Hsp90 inhibitors based on a 1,4,5-trisubstituted 1,2,3-triazole scaffold

Abstract: Ruthenium catalyzed 1,3-cycloaddition (click chemistry) of an azido moiety installed on dihydroxycumene scaffold with differently substituted aryl propiolates, gave a new family of 1,4,5-trisubstitued triazole carboxylic acid derivatives that showed high affinity towards Hsp90 associated with cell proliferation inhibition, both in nanomolar range. The 1,5 arrangement of the resorcinol, the aryl moieties, and the presence of an alkyl (secondary) amide in position 4 of the triazole ring, were essential to get high activity. Docking simulations suggested that the triazoles penetrate the Hsp90 ATP binding site. Some 1,4,5-trisubstitued triazole carboxamides induced dramatic depletion of the examined client proteins and a very strong increase in the expression levels of the chaperone Hsp70. In vitro metabolic stability and in vivo preliminary studies on selected compounds have shown promising results comparable to the potent Hsp90 inhibitor NVP-AUY922. One of them, (compound 18; SST0287CL1) was selected for further investigation as the most promising drug candidate

Position Paper on Water, Energy, Food and Ecosystem (WEFE) Nexus and Sustainable development Goals (SDGs)

The EU and the international community is realising that the Water, Energy, Food and Ecosystem components are interlinked and require a joint planning in order to meet the daunting global challenges related to Water, Energy and Food security and maintaining the ecosystem health and in this way, reach the SDGs. If not dealt with, the world will not be able to meet the demand for water, energy and food in a not too far future and, in any case, in a not sustainable way. The strain on the ecosystems resulting from unsustainable single-sector planning will lead to increasing poverty, inequality and instability. The Nexus approach is fully aligned with and supportive of the EU Consensus on Development. Key elements of the Consensus will require collaborative efforts across sectors in ways that can be supported/implemented by a Nexus approach. In this way, transparent and accountable decision-making, involving the civil society is key and common to the European Consensus on Development and the Nexus approach. The Nexus approach will support the implementation of the SDG in particular SDG 2 (Food), SDG 6 (Water) and SDG 7 (Energy), but most SDGs have elements that link to food, water and energy in one or other way, and will benefit from a Nexus approach. The SDGs are designed to be cross-cutting and be implemented together, which is also reflected in a WEFE Nexus approach. A Nexus approach offers a sustainable way of addressing the effects of Climate Change and increase resilience. The WEFE Nexus has in it the main drivers of climate change (water, energy and food security) and the main affected sectors (water and the environment). Decisions around policy, infrastructure, … developed based on the WEFE Nexus assessments will be suitable as elements of climate change mitigation and adaptation. In fact, it is difficult to imagine solutions to the climate change issue that are not built on a form of Nexus approach. The Nexus approach is being implemented around the world, as examples in the literature demonstrate. These examples together with more examples from EU and member state development cooperation will help build experience that can be consolidated and become an important contribution to a Toolkit for WEFE Nexus Implementation. From the expert discussions, it appears that because of the novelty of the approach, a Toolkit will be an important element in getting the Nexus approach widely used. This should build on experiences from practical examples of NEXUS projects or similar inter-sectorial collaboration projects; and, there are already policy, regulation and practical experience to allow institutions and countries to start applying the Nexus concept.JRC.D.2-Water and Marine Resource

[4+2]Cycloaddition on densely functionalized cyclopentadiene

3nononeThe Diels-Alder (DA) and hetero-Diels-Alder (HDA) reaction of N-(2,4-dicyano-1,5-dimethyl-3-phenylcyclopenta-2,4-dienyl)-2,2,2-trifluoroacetamide 1 can be conveniently used for the synthesis of biarylic and polycyclic compounds, depending on whether you use alkynes or alkenes as dienophiles. We observe a totally regioselectivity and endo-diastereoselectivity of the cycloaddition reactions.noneFusi, Stefania; Ferrini, Serena; Ponticelli, FabioFusi, Stefania; Ferrini, Serena; Ponticelli, Fabi