Avoidable blood transfusions

Si discute l'importanza di una analisi accurata nel definire il fattore di rischio di trasfusioni nella genesi della trombosi profonda delle vene degli arti inferior

Inflammatory cytokines and atherosclerotic plaque progression. therapeutic implications

Inflammatory cytokines play a major role in atherosclerotic plaque progression. This review summarizes the rationale for personalized anti-inflammatory therapy

Leonardo da Vinci (1452-1519). A modern scientist

Vengono descritte le difficoltà di Leonardo da Vinci nel fare accettare le sue ide

Training in Surgery

LA LETTERA FA NOTARE L'IMPORTANZA DI UNA APPROPRIATA SELEZIONE DEGLI SPECIALIZZANDI IN CHIRUGI

Progress in the Study of Cardiovascular Physiology During the Italian Renaissance

This short report underlines the importance of collaboration and communication among scientists. The ideals of progress in medicine and in the care of suffering people have represented continuous stimuli allowing to overcome prejudices, religious and political differences. The modern concepts of blood circulation have been established through a close collaboration and exchanges of ideas among scientists coming from different countries, different religious and political backgrounds. In those days Europe was theater of continuous wars based on political and religious contrasts. There were continuous outbreaks of Plague in several countries. Religious contrasts occurred inside the Christianity and between the Christianity and Islam; contrasts which were based on theological disputes associated with economic and expansionist ambitions, resulting in extreme and rigid religious orthodoxy. Despite these difficulties, medical scientists collaborated overcoming the close boundaries of everyday general confrontations. The ambition for advancement in science and for progress with the potential consequent common good inspired a general sense of community and drove to overcome the boundaries based on contrasts. Science, scientific thinking, dedication to research and to improve knowledge represented yesterday and continue to represent today the common ambition to break down cultural, religious and economic walls. The generosity of science is superior to the superstition of contrasts and arrogance. A message we can bring from the past back to the future and back to today

Systematic review and metanalysis of clinical outcomes after enucleation of pancreatic metastases from renal cell carcinoma

Introduction: A systematic review of the literature was carried out to determine the clinical and oncological outcome of patients who had enucleation of solitary pancreatic metastases from renal cell carcinoma. Methods: Operative mortality, postoperative complications, observed survival and disease free survival were analyzed. The clinical outcomes of patients who had enucleation were compared to those of 857 patients collected from the literature who had standard or atypical pancreatic resection for the same disease using propensity score matching Results: There was no postoperative mortality in the 56 patients who had enucleation of pancreatic metastases from renal cell carcinoma . In 51 patients postoperative complications could be analyzed. Ten patients (10/51=19.6%) had postoperative complications. Three patients (3/51 = 5.9%) had major complications (Clavien-Dindo III or more). Five year observed survival rates and disease free survival for patients with enucleation were 92% and 79% respectively. These results compared favourably with those obtained in patients who had standard resection and other forms of atypical resection (also using propensity score matching). Patients who had partial pancreatic resection (atypical or not) with pancreatic-jejunal anastomosis had increased rates of postoperative complications and local recurrences. Conclusions: Enucleation of pancreatic metastases offers a valid solution in selected patients

Risk factors for adenocarcinoma in the surgically transposed colon not exposed to the fecal stream. Etiological considerations extrapolated to sporadic colon carcinoma in the general population

The aim of the study was to analyze the clinical characteristics and outcomes of patients with de novo secondary adenocarcinoma arising in the operatively transposed colon not exposed to the fecal stream

Basic fibroblast growth factor mediates carotid plaque instability through metalloproteinase-2 and –9 expression

OBJECTIVE(S): We hypothesized that basic fibroblast growth factor (bFGF) may exert a role in carotid plaque instability by regulating the expression of matrix metalloproteinases (MMP). METHODS: Plaques obtained from 40 consecutive patients undergoing carotid endarterectomy were preoperatively classified as soft or hard. Serum bFGF was pre- and postoperatively measured. The release of MMP-2 and MMP-9 in the blood serum, and the activity, production and expression in the carotid specimens was analyzed. Specific anti-bFGF inhibition tests were performed in vitro on human umbilical artery smooth muscle cells (HUASMC) to evaluate the role of bFGF in the activity, production and expression of MMP-2 and -9. RESULTS: Twenty-one (53%) patients had a soft carotid plaque and 19 (48%) a hard plaque. Preoperative bFGF serum levels were higher in patients with soft plaques [soft=34 (28-39) pg/mL and hard=20 (17-22) pg/mL-p<0.001] and postoperatively returned to normal values (when compared to 10 healthy volunteers). The serum levels of MMP-2 in patients' with soft plaques were higher than those in patients' with hard plaques [soft=1222 (1190-1252) ng/mL and hard=748 (656-793)ng/mL-p<0.0001]. MMP-9 serum values were 26 (22-29) ng/mL for soft plaques and 18 (15-21) ng/mL for hard plaques (p<0.0001). We found increased activity, production and expression of MMP-2 and -9 in soft plaques compared to hard plaques (p<0.001). In vitro inhibition tests on HUASMC showed the direct influence of bFGF on the activity, production and expression of MMP-2 and -9 (p<0.001). CONCLUSIONS: bFGF seems to exert a key role in carotid plaque instability regulating the activity, production and expression of MMP thus altering the physiologic homeostasis of the carotid plaque

Aortic septotomy with scissor-technique

Viene descritta tecnica innovativa per il ridurre le complicanze legate alla dissezione aorta toracic

The negative effects of reduced attention to standard guidelines for screening and surgery of abdominal aortic aneurysms during the coronavirus disease 2019 pandemic

Si pone in evidenza l'importanza dello screening nella popolazione per aneurismi dell'aorta addominale