Open and / or laparoscopic surgical treatment of liver hydatic cysts

Hydatid disease is a severe parasitic disease with a widely ranging distribution. In the human being the liver is the most frequent organ affected. 1 The treatment should be individualized to the morphology, size, number and location of the cysts, that is why a variety of surgical operations have been advocated from complete resection like total pericystectomy or partial hepatectomy to laparoscopy to a minimally invasive procedures like percutaneous aspiration of cysts to conservative drug therapy. 3-4 This study compares laparoscopic versus open management of the hydatid cyst of liver the surgical approach to liver echinococcosis is still a controversial issue and shows our results of surgical treatment of liver hydatid cysts during a 3-years period

SGR 0418+5729, Swift J1822.3-1606, and 1E 2259+586 as massive fast rotating highly magnetized white dwarfs

Following Malheiro et al. (2012) we describe the so-called low magnetic field magnetars, SGR 0418+5729, Swift J1822.3--1606, as well as the AXP prototype 1E 2259+586 as massive fast rotating highly magnetized white dwarfs. We give bounds for the mass, radius, moment of inertia, and magnetic field for these sources by requesting the stability of realistic general relativistic uniformly rotating configurations. Based on these parameters, we improve the theoretical prediction of the lower limit of the spindown rate of SGR 0418+5729; for a white dwarf close to its maximum stable we obtain the very stringent interval for the spindown rate of 4.1E-16< dP/dt < 6E-15, where the upper value is the known observational limit. A lower limit has been also set for Swift J1822.3-1606 for which a fully observationally accepted spin-down rate is still lacking. The white dwarf model provides for this source dP/dt> 2.13E-15, if the star is close to its maximum stable mass. We also present the theoretical expectation of the infrared, optical and ultraviolet emission of these objects and show their consistency with the current available observational data. We give in addition the frequencies at which absorption features could be present in the spectrum of these sources as the result of the scattering of photons with the quantized electrons by the surface magnetic field.Comment: to appear in Astronomy & Astrophysic

Which is the most accurate diagnostic procedure in Tamoxifen treated breast cancer patients

Purpose: The aim of this study was to evaluate the diagnostic accuracy of bi-dimensional (2D) and three-dimensional (3D) transvaginal ultrasound (TVUS), hysterosonography (HSSG) and hysteroscopy in the detection of endometrial pathology in women treated with tamoxifen (TMX) for breast cancer. Methods: Forty-two patients, affected by breast cancer under treatment with TMX, underwent 2D-3D TVUS, HSSG and hysteroscopy completed by biopsy, after abnormal findings following a routine 2D TVUS examination. Results: 3D-TVUS was more accurate than 2D-TVUS in the detection of atrophic endometrium confirmed by biopsy and in the detection of endometrial polyps. HSSG and hysteroscopy detected atrophic endometrium and endometrial polyps significantly better than ultrasound scan. Endometrial carcinoma was detected in two cases, and in both HSSG and hysteroscopy were 100% diagnostic. Conclusion: In TMX treated breast cancer patients, HSSG and hysteroscopy provide more accurate diagnosis than 2D-3D ultrasound in the detection of treatment related endometrial lesions

Time-optimal trajectories to circumsolar space using solar electric propulsion

The aim of this paper is to explore the capabilities of a solar electric propelled spacecraft on a mission towards circumsolar space. Using an indirect approach, the paper investigates minimum time of transfer (direct) trajectories from an initial heliocentric parking orbit to a desired final heliocentric target orbit, with a low perihelion radius and a high orbital inclination. The simulation results are then collected into graphs and tables for a trade-off analysis of the main mission parameters. Finally, a comparison of the performance between a solar electric and a (photonic) solar sail based spacecraft is discussed

Prognostic significance of primary-tumor extension, stage and grade of nuclear differentiation in patients with renal cell carcinoma

Surgery remains the preferred therapy for renal cell carcinoma. The various adjunctive or complementary therapies currently yield disappointing results. Identifying reliable prognostic factors could help in selecting patients most likely to benefit from postoperative adjuvant therapies. We reviewed the surgical records of 78 patients who had undergone radical nephrectomy with lymphadenectomy for renal cell carcinoma, matched for type of operation and histology. According to staging (TNM), 5.1% of the patients were classified as stage I, 51.3% as stage II, 29.5% as stage III and 14.5% as stage IV. Of the 78 patients 40 were T2N0 and 21 T3aN0. Tumor grading showed that 39.7% of the patients had well-differentiated tumors(G1), 41.1% moderately-differentiated (G2), and 19.2% poorly-differentiated tumors (G3). Overall actuarial survival at 5 and 10 years was 100% for stage 1; 91.3% at 5 years and 83.1% at 10 years for stage II; 45.5% and 34.1% for stage III; and 29.1% and nil for stage IV (stage II vs stage III p = 0.0001). Patients with tumors confined to the kidney (pT2N0) had better 5- and 10-year survival rates than patients with tumors infiltrating the perirenal fat (pT3aN0) (p = 0.000006). Survival differed according to nuclear grading (G1 vs G3 ; p = 0.000005; G2 vs G3; p = 0.0009). In conclusion our review identified tumor stage, primary-tumor extension, and the grade of nuclear differentiation as reliable prognostic factors in patients with renal cell carcinomas

Antioxidant Supplementation in the Treatment of Aging-Associated Diseases

Oxidative stress is generally considered as the consequence of an imbalance between pro- and antioxidants species, which often results into indiscriminate and global damage at the organismal level. Elderly people are more susceptible to oxidative stress and this depends, almost in part, from a decreased performance of their endogenous antioxidant system. As many studies reported an inverse correlation between systemic levels of antioxidants and several diseases, primarily cardiovascular diseases, but also diabetes and neurological disorders, antioxidant supplementation has been foreseen as an effective preventive and therapeutic intervention for aging-associated pathologies. However, the expectations of this therapeutic approach have often been partially disappointed by clinical trials. The interplay of both endogenous and exogenous antioxidants with the systemic redox system is very complex and represents an issue that is still under debate. In this review a selection of recent clinical studies concerning antioxidants supplementation and the evaluation of their influence in aging-related diseases is analyzed. The controversial outcomes of antioxidants supplementation therapies, which might partially depend from an underestimation of the patient specific metabolic demand and genetic background, are presented

Pancreas divisum. Correlation between anatomical abnormalities and bile precipitation in the gallbladder in seven patients

Pancreas divisum is a genetic defect associated with recurrent acute pancreatitis due to insufficient drainage of the accessory pancreatic duct. Seven young patients diagnosed with pancreatic divisum and thickening of the gallbladder bile as shown on magnetic resonance cholangio-pancreatography without pancreatic ductal changes underwent laparoscopic cholecystectomy. During the mean follow-up of 32 months no episode of pancreatitis was reported. There is an association between PD and higher concentration of bile in the gallbladder. Cholecystectomy can be considered curative in patients with PD in the absence of indications for major surgery