Management Approach of Cholangiocarcinoma of Middle Third Bile Duct

Background: Prognosis of middle third cholangiocarcinoma according of recent studies remains poor. However, identifying survival predictors, mentioned a few; stage and patients age, still should take place in clinical practices especially for minor medical facility centers. Case presentation: A 75 years old lady, was assessed and diagnosed with middle third cholangiocarcinoma, patients underwent from laboratory workup; where SGOT, SGPT were almost threefold elevated, as well Total bilirubin, direct and indirect, were four to tenfold higher than normal levels. CRP as well was seen tenfold higher than normal levels. MRCP was seen dilated of biliary ducts, dilatation of common hepatic duct, narrowing of common hepatic and ductus choledochus that goes with cholangiocarcinoma aspect. Thickness of junction lumen with solid mass 7 mm, infiltrates totally the wall that created the blockage, with increased of contrast intake, no infiltration of pancreas head is seen. Closeness of mass with the vena porta There were seen two lymph nodes less than 1 cm in gastro hepatic ligament. No infiltration of inferior vena cava, common pancreatic ductus normal. No infiltration of superior mesenteric vena. After multidisciplinary consultation and patient’s decision informed consent was completed, personalized patients’ treatment was performed, surgical intervention, biopsy and then adjuvant chemotherapy was applied, with a 3-year survival and quality life was achieved. Conclusions: even in advanced cases of highly malignant cases like cholangiocarcinoma, even most of authors and surgeons agree in low survival rate according to study data, we should create a personalized strategy treatment of each patient in order to increase survival and quality of life as well Keywords: Cholangiocarcinoma, surgical, chemotherapy, personalized treatment DOI: 10.7176/ALST/93-06 Publication date: April 30th 202

L'Albania nell'Unione Europea fra tradizione e sviluppo della libertà religiosa

Il prossimo ingresso dell’Albania nell’Unione Europea, richiede l’adeguamento dell’ordinamento albanese ai parametri unionali anche in materia di libertà di coscienza, di libertà religiosa e di diritti umani, secondo gli standard adottati dal Consiglio d’Europa e dalla Convenzione Europea dei Diritti dell’Uomo. D’altra parte l’Albania, che può vantare una tradizione di pace religiosa e pluralismo confessionale, proclama nella sua Costituzione, la laicità dell’ordinamento e la separazione tra Stato e confessioni religiose. I saggi qui pubblicati, frutto dell’omonimo Convegno tenutosi a Ravenna il 22-23 febbraio 2016, analizzano relativamente a queste tematiche il quadro costituzionale albanese, anche nei suoi pro li di sviluppo storico, la tutela del sentimento religioso e della libertà di coscienza in ambito penale, fanno il punto sulla giurisprudenza della Corte Europea dei Diritti dell’Uomo in materia. In questo quadro i relatori si sono chiesti come prevenire l’estremismo violento in Albania, ma al tempo stesso come evitare le discriminazioni religiose relative ai diritti umani nelle scuole, garantire i diritti individuali e collettivi a fronte delle recenti riforme in ambito amministrativo, risolvere il problema della restituzione e compensazione delle proprietà ecclesiastiche confiscate, analizzando gli strumenti di tutela della libertà religiosa e di coscienza del lavoratore e degli adempimenti necessari a renderla possibile. L’analisi di queste problematiche è stata posta in rapporto al ruolo del diritto nella gestione di esse e al contributo dato allo sviluppo della società albanese dalla comunità arbëreshë

The 6th Albanian Congress of Trauma and Emergency Surgery

After a three-year quarantine from the deadliest global pandemic of the last century, ASTES is organizing to gather all health professionals in Tirana, The 6th Albanian Congress of Trauma and Emergency Surgery(ACTES 2022) on 11-12 November 2022, with the topic Trauma & Emergency Surgery and not only...with the aim of providing high quality, the best standards, and the best results, for our patients ...ACTES 2022 is the largest event that ASTES (Albanian Society for Trauma and Emergency Surgery) has organized so far with 230 presentations, and 67 foreign lecturers with enviable geography, making it the largest national and wider scientific event.The scientific program is as strong as ever, thanks to the inclusiveness, where all the participants with a mix of foreign and local lecturers, select the best of the moment in medical science, innovation, and observation.The scientific committee has selected all the presentations so that the participants of each medical discipline will have something to learn, discuss, debate, and agree with updated methods, techniques, and protocols.I hope you will join us on Friday morning, and continue the journey of our two-day event together