Splenic and concomitant liver abscess after laparoscopic sleeve gastrectomy

Introduction: Laparoscopic sleeve gastrectomy (LSG) is a safe and effective procedure for losing weight and gaining control of obesity-related comorbidities. However, it is associated with postoperative complications such as bleeding, leak, and midgastric stenosis. Splenic and hepatic abscesses have been reported as unusual and rare complications after primary LSG. We report a case of splenic and concomitant hepatic abscesses after primary LSG, successful minimally invasive management, and midterm follow-up. Case Description: We report a complex case of splenic abscess with satellite hepatic abscess plus splenic thrombosis (0.1%) diagnosed 67 days after LSG. This unusual complication was managed by a minimally invasive approach (spleen sparing) with complete resolution after 35 days. After 18 months of follow-up, the patient showed complete resolution of the splenic and liver abscesses and progressive loss of excess weight. Conclusion: In high-volume centers, rare and life-threatening complications such as splenic and hepatic abscesses may be observed. The minimally invasive approach could represent an effective option of avoiding splenectomy in selected case

Building a more robust framework on revisionism. A reply to Lawson and Legrenzi

The comments by Lawson and Legrenzi to our RISP/IPSR article ‘Tracing the modes of China’s revisionism in the Indo-Pacific: a comparison with pre-1941 Shōwa Japan’ contribute to moving the debate on revisionism in international politics a step forward. Their notes on the several issues affecting the International Relations understanding of the phenomenon are on the same page as ours and we appear to share similar doubts and a like-minded curiosity on the subject. While grasping some key topics and shedding light on crucial shortcomings in the literature on international change, power transitions and international order, however, their observations do not come unproblematic. In this reply to their timely remarks, we highlight the perks of their argument but also stress how this falls through in providing a complete framework to understand revisionism in international politics

Migraine auras and the eyes of the mind

2openNappi, G; Termine, C.Nappi, G; Termine, Cristian

25th International Congress of the European Association for Endoscopic Surgery (EAES) Frankfurt, Germany, 14-17 June 2017 : Oral Presentations

Introduction: Ouyang has recently proposed hiatal surface area (HSA) calculation by multiplanar multislice computer tomography (MDCT) scan as a useful tool for planning treatment of hiatus defects with hiatal hernia (HH), with or without gastroesophageal reflux (MRGE). Preoperative upper endoscopy or barium swallow cannot predict the HSA and pillars conditions. Aim to asses the efficacy of MDCT’s calculation of HSA for planning the best approach for the hiatal defects treatment. Methods: We retrospectively analyzed 25 patients, candidates to laparoscopic antireflux surgery as primary surgery or hiatus repair concomitant with or after bariatric surgery. Patients were analyzed preoperatively and after one-year follow-up by MDCT scan measurement of esophageal hiatus surface. Five normal patients were enrolled as control group. The HSA’s intraoperative calculation was performed after complete dissection of the area considered a triangle. Postoperative CT-scan was done after 12 months or any time reflux symptoms appeared. Results: (1) Mean HSA in control patients with no HH, no MRGE was cm2 and similar in non-complicated patients with previous LSG and cruroplasty. (2) Mean HSA in patients candidates to cruroplasty was 7.40 cm2. (3) Mean HSA in patients candidates to redo cruroplasty for recurrence was 10.11 cm2. Discussion. MDCT scan offer the possibility to obtain an objective measurement of the HSA and the correlation with endoscopic findings and symptoms. The preoperative information allow to discuss with patients the proper technique when a HSA[5 cm2 is detected. During the follow-up a correlation between symptoms and failure of cruroplasty can be assessed. Conclusions: MDCT scan seems to be an effective non-invasive method to plan hiatal defect treatment and to check during the follow-up the potential recurrence. Future research should correlate in larger series imaging data with intraoperative findings

Physico-chemical and thermochemical studies of the hydrolytic conversion of amorphous tricalcium phosphate into apatite

The conversion of amorphous tricalcium phosphate with different hydration ratio into apatite in water at 25 °C has been studied by microcalorimetry and several physical–chemical methods. The hydrolytic transformation was dominated by two strong exothermic events. A fast, relatively weak, wetting process and a very slow but strong heat release assigned to a slow internal rehydration and the crystallization of the amorphous phase into an apatite. The exothermic phenomenon related to the rehydration exceeded the crystalline transformation enthalpy. Rehydration occurred before the conversion of the amorphous phase into apatite and determined the advancement of the hydrolytic reaction. The apatitic phases formed evolved slightly with time after their formation. The crystallinity increased whereas the amount of HPO4 2− ion decreased. These data allow a better understanding of the behavior of biomaterials involving amorphous phases such as hydroxyapatite plasma-sprayed coating

First evidence of an egg-laying attempt of feral Trachemys scripta (Schoepff, 1792) in Sicily (Lake Pergusa, Italy)

First evidence of an egg-laying attempt of feral Trachemys scripta in Sicil

First evidence of an egg-laying attempt of feral trachemys scripta (Schoepff, 1792) in sicily (lake pergusa, Italy)

First evidence of an egg-laying attempt of feral Trachemys scripta (Schoepff, 1792) in Sicily (Lake Pergusa, Italy

South American Voting Patterns in the UNGA and Economic Dependence on China

SINCE 1978 – WHEN THE REFORM AND OPENING UP PROCESS first began – Chinese GDP on constant 2015 prices (US dollars) has grown at an average rate of over 10% each year and as a result China has already overtaken the US as the world’s largest goods trader. 1 This has provided the Asian power with an economic projection reaching every nook and cranny of the world and made several distant countries heavily reliant on the People’s Republic of China (PRC) for large sections of their national output