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Laura Groseanu, Violeta Bojinca, Tania Gudu, Ioana Saulescu, Denisa Predeteanu, Andra Balanescu, Florian Berghea, Daniela Opris, Andreea Borangiu, Cosmin Constantinescu, Magda Negru, Ruxandra Ionescu
OBJECTIVE: Vitamin D has pleiotropic effects including immunomodulatory, cardioprotective, and antifibrotic properties and is thus able to modulate the three main links in scleroderma pathogenesis. The aim of the study was to evaluate the level of vitamin D in patients with systemic sclerosis and to analyze the associations between the concentration of vitamin D and the features of systemic sclerosis. MATERIAL AND METHODS: Fifty-one consecutive patients were evaluated for visceral involvement, immunological profile, activity, severity scores, and quality of life...
June 2016: Eur J Rheumatol
Martina Fabbi, Stefano Di Palma, Sabrina Manfredi, Giacomo Gnudi, Francesca Miduri, Eleonora Daga, Gabriele Costantino Melis, Ezio Bianchi, Simone Voccia, Antonella Volta
A 13-year-old spayed female German shepherd dog was presented for acute onset of lethargy, anorexia, and disseminated erythematous skin lesions. Thoracic radiographs and abdominal ultrasonographic findings were consistent with metastatic hemangiosarcoma. Multiple, ill-defined, irregularly shaped hypoechoic nodules were also detected within the thoracic and abdominal wall. Hemangiosarcoma metastases to the skeletal muscle were confirmed based on histopathological examination. Multivisceral involvement was also confirmed by necropsy...
October 4, 2016: Veterinary Radiology & Ultrasound
Minna Räsänen, Ari Ristimäki, Ritja Savolainen, Laura Renkonen-Sinisalo, Anna Lepistö
AIM: The primary purpose of this study was to analyse the overall survival and local recurrence rate after extended resection of locally advanced rectal cancer. The second aim was to determine the ability of radiological irradiation response to predict R0 resection. METHOD: A retrospective study was performed of 94 consecutive patients with locally advanced rectal cancer operated on at the Helsinki University Hospital, Helsinki, Finland during 2005-2013. Data were collected from patient records...
September 13, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Sjors Klompmaker, Desley van Zoggel, Ammara A Watkins, Mariam F Eskander, Jennifer F Tseng, Marc G Besselink, A James Moser
OBJECTIVE: To assess current nationwide case selection factors for minimally invasive distal pancreatectomy (MIDP) and identify actual risk factors for adverse outcomes compared with open distal pancreatectomy (ODP). BACKGROUND: Patient selection criteria that predict outcomes after MIDP remain unknown. As a result, widespread adoption of this surgical technique may have been delayed and its potential benefits possibly under-exploited. METHODS: Retrospective cohort study of elective ODP and MIDP performed at 106 centers in 2014, using the pancreas-targeted American College of Surgeons' National Quality Improvement Program (ACS-NSQIP) database...
September 6, 2016: Annals of Surgery
Jon M Gerry, Thuy B Tran, Lauren M Postlewait, Shishir K Maithel, Jason D Prescott, Tracy S Wang, Jason A Glenn, John E Phay, Kara Keplinger, Ryan C Fields, Linda X Jin, Sharon M Weber, Ahmed Salem, Jason K Sicklick, Shady Gad, Adam C Yopp, John C Mansour, Quan-Yang Duh, Natalie Seiser, Carmen C Solorzano, Colleen M Kiernan, Konstantinos I Votanopoulos, Edward A Levine, Ioannis Hatzaras, Rivfka Shenoy, Timothy M Pawlik, Jeffrey A Norton, George A Poultsides
BACKGROUND: Lymph node metastasis is an established predictor of poor outcome for adrenocortical carcinoma (ACC); however, routine lymphadenectomy during surgical resection of ACC is not widely performed and its therapeutic role remains unclear. METHODS: Patients undergoing margin-negative resection for localized ACC were identified from a multi-institutional database. Patients were stratified into 2 groups based on the surgeon's effort or not to perform a lymphadenectomy as documented in the operative note...
September 2, 2016: Annals of Surgical Oncology
S Nasser, A Lazaridis, M Evangelou, B Jones, K Nixon, M Kyrgiou, H Gabra, A Rockall, C Fotopoulou
OBJECTIVES: Computed tomography (CT) is an essential part of preoperative planning prior to cytoreductive surgery for primary and relapsed epithelial ovarian cancer (EOC). Our aim is to correlate pre-operative CT results with intraoperative surgical and histopathological findings at debulking surgery. METHODS: We performed a systematic comparison of intraoperative tumor dissemination patterns and surgical resections with preoperative CT assessments of infiltrative disease at key resection sites, in women who underwent multivisceral debulking surgery due to EOC between January 2013 and December 2014 at a tertiary referral center...
August 29, 2016: Gynecologic Oncology
Y K Kwon, K Etesami, A L Sharp, C S Matsumoto, T M Fishbein, R Girlanda
BACKGROUND: Intestinal transplant recipients require frequent hospital readmission after a successful transplantation, but the reasons for readmission have not been characterized in detail. METHODS: We reviewed our single-center experience to characterize the patterns of readmissions and to identify preventable causes. Among 87 adult patients who received an intestinal or multivisceral transplant, 65 patients (35 males, 30 females; median age, 42 years [range, 19-66]) with a follow-up of at least 1 year were included in this study...
July 2016: Transplantation Proceedings
Marco Chiarelli, Martino Gerosa, Angelo Guttadauro, Francesco Gabrielli, Giuseppe Vertemati, Massimo Cazzaniga, Luca Fumagalli, Matilde De Simone, Ugo Cioffi
BACKGROUND: The majority of patients with severe blunt chest trauma is successfully treated with supportive measures and thoracostomy tube; only few cases need urgent thoracotomy. Lung-sparing techniques are treatments of choice but major pulmonary resections are necessary in case of injuries involving hilar vessels or bronchi. Currently the mortality associated with pulmonary lobectomy performed for chest trauma is 40%. METHODS: Over a 2-year period [2013-2014], 210 patients with chest trauma were hospitalized at our Institution...
July 2016: Journal of Thoracic Disease
James Barnes, Fadi Issa, Georgios Vrakas, Peter Friend, Henk Giele
PURPOSE OF REVIEW: Abdominal wall transplantation is a technique used to achieve abdominal closure after intestinal and multivisceral transplantation. This review focuses on whether there are additional benefits for the skin component as an immune-monitoring tool. RECENT FINDINGS: The largest series of abdominal wall transplants has recently been published. Alongside the physiological advantage gained in abdominal closure, the authors describe the immunological insight that the skin component can provide and how this contributes to the management of patients...
October 2016: Current Opinion in Organ Transplantation
Undine A Gerlach, Nils Lachmann, Giuseppina Ranucci, Birgit Sawitzki, Constanze Schoenemann, Johann Pratschke, Duska Dragun, Andreas Pascher
BACKGROUND: Non-HLA-allo- and autoantibodies are involved in allograft rejection in kidney and heart transplantation. Their role in intestinal transplantation has not yet been described. We examined the development of anti-Angiotensin II type I receptor antibodies (anti-AT1R) and anti-Endothelin-Type A receptor antibodies (anti-ETAR) associated with the clinical course and histopathological findings of ITX-recipients. METHODS: 37 patients underwent intestinal or multivisceral transplantation...
August 5, 2016: Transplantation
J Ciricillo, D Haslam, S Blum, M-O Kim, C Liu, G Paulsen, J Courter, L Danziger-Isakov
BACKGROUND: Morbidity and mortality related to Clostridium difficile infection (CDI) has increased, but epidemiology and risk factors within pediatric solid organ transplant (SOT) recipients are uncertain. METHODS: A retrospective cohort study of SOT recipients age ≤18 years at transplantation from 2010 to 2013 was performed. Patients with CDI were compared with matched CDI-negative controls with diarrhea. RESULTS: Of 202 patients, the majority were male (58%) and Caucasian (77%)...
October 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Marius L Calin, Aziz Sadiq, Gabriel Arevalo, Rocio Fuentes, Vincent L Flanders, Niraj Gupta, Baongoc Nasri, Kirpal Singh
INTRODUCTION: Surgery for liver metastases in pancreatic neuroendocrine tumor (PNET) improves overall survival rate. We present the first case report for robotic multivisceral resection of distal pancreas, spleen, and left liver for metastatic PNET. MATERIALS AND METHODS: We present a case of 52-year-old female diagnosed with PNET in the pancreatic neck metastatic to the liver, responding to somatostatin and bland embolization, who underwent surgical debulking using da Vinci robotic platform...
October 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Kevin M Wymer, Blake B Anderson, Ashley A Wilkens, Mohan S Gundeti
INTRODUCTION: Megacystis microcolon intestinal hypoperistalsis (MMIHS) is a rare disorder characterized by distended nonobstructed bladder, microcolon, and decreased intestinal peristalsis. MMIHS has a particularly poor prognosis; however, when appropriately managed, survival can be prolonged. STUDY DESIGN: A systematic review (1996-2016) was performed with the key words "megacystis microcolon intestinal hypoperistalsis syndrome." In addition, a case series of four patients is presented as well as algorithms for the diagnosis and treatment of MMIHS...
September 2016: Journal of Pediatric Surgery
Antonia Rizzuto, Ilaria Palaia, Giuseppina Vescio, Raffaele Serra, Donatella Malanga, Rosario Sacco
BACKGROUND: The only possibility of curative surgery in primary T4, locally advanced, adherent colorectal carcinoma (LAACRC) or recurrent disease with infiltration of adjacent organs is the en bloc resection of the invaded structures to achieve clear surgical margins (R0). The role of extended resections for occlusive LAACRC remains unclear. We report on our experience on Multivisceral resections (MVR) for LAACRC patients between 2003 and 2012. METHODS: Twenty-two patients, who were treated with MVR with curative purpose for non-metastatic disease were recruited...
September 2016: International Journal of Surgery
Bo Qiu, Pei-Rong Ding, Ling Cai, Wei-Wei Xiao, Zhi-Fan Zeng, Gong Chen, Zhen-Hai Lu, Li-Ren Li, Xiao-Jun Wu, Rene-Olivier Mirimanoff, Zhi-Zhong Pan, Rui-Hua Xu, Yuan-Hong Gao
BACKGROUND: Complete resection of locally advanced sigmoid colon cancer (LASCC) is sometimes difficult. Patients with LASCC have a dismal prognosis and poor quality of life, which has encouraged the evaluation of alternative multimodality treatments. This prospective study aimed to assess the feasibility and efficacy of neoadjuvant chemoradiotherapy (neoCRT) followed by surgery as treatment of selected patients with unresectable LASCC. METHODS: We studied the patients with unresectable LASCC who received neoCRT followed by surgery between October 2010 and December 2012...
2016: Chinese Journal of Cancer
Vishwas D Pai, Sudhir Jatal, Vikas Ostwal, Reena Engineer, Supreeta Arya, Prachi Patil, Munita Bal, Avanish P Saklani
BACKGROUND: Locally advanced rectal cancers (LARCs) involve one or more of the adjacent organs in upto 10-20% patients. The cause of the adhesions may be inflammatory or neoplastic, and the exact causes cannot be determined pre- or intra-operatively. To achieve complete resection, partial or total mesorectal excision (TME) en bloc with the involved organs is essential. The primary objective of this study is to determine short-term oncological and clinical outcomes in these patients undergoing multivisceral resections (MVRs)...
June 2016: Journal of Gastrointestinal Oncology
Ramzi M Helewa, Jason Park
Locally advanced T4 rectal cancer represents a complex clinical condition that requires a well thought-out treatment plan and expertise from multiple specialists. Paramount in the management of patients with locally advanced rectal cancer are accurate preoperative staging, appropriate application of neoadjuvant and adjuvant treatments, and, above all, the provision of high-quality, complete surgical resection in potentially curable cases. Despite the advanced nature of this disease, extended and multivisceral resections with clear margins have been shown to result in good oncological outcomes and offer patients a real chance of cure...
June 2016: Clinics in Colon and Rectal Surgery
Jolene Si Min Wong, Grace Hwei Ching Tan, Richard Quek, Brian Kim Poh Goh, Li Lian Kwok, Mrinal Kumar, Khee Chee Soo, Melissa Ching Ching Teo
BACKGROUND: Gastrointestinal stromal tumours (GISTs) represent the most common mesenchymal tumour of the gastrointestinal tract. Although the efficacy of targeted therapy cannot be over-emphasized, surgery remains the only curative primary treatment for patients with localized disease. The median size of GIST at diagnosis is approximately 5-7 cm; however, it is not uncommon for tumours to be as large as 30-40 cm and involving multiple viscera. METHODS: Data were retrospectively collected from patients with GISTs treated at the Singapore General Hospital and the National Cancer Centre Singapore over a 15-year period...
May 25, 2016: ANZ Journal of Surgery
Deep Dutta, Meha Sharma, Vrushali Mahajan, Prem Chopra
Metastasis to spleen is rare and usually occurs in the setting of extensive multivisceral metastatic disease. A 60-year-old lady with appropriately managed early breast cancer (breast conservative surgery for Grade-2 infiltrative ductal carcinoma [0.7 cm × 0.5 cm diameter]) in 2006, was detected to have splenic incidentaloma (1.4 cm × 0.8 cm) in November 2012, which was fluoro-deoxy-glucose (FDG) avid on positron emission tomography. Fine needle spiration cytology (FNAC) was normal. More than doubling of lesion size by March 2015 (3...
April 2016: Indian Journal of Pathology & Microbiology
Nicholas J Olson, Daniel B Wimmer, Daniel P Croitoru, Dorothea T Barton, Gregory D Seidel, M Shane Chapman, Konstantinos Linos
Abdominal wall transplants are relatively new procedures that are frequently performed in conjunction with multivisceral transplants. The skin of the abdominal wall transplant is often the first site for graft rejection to manifest itself. Prompt recognition can lead to appropriate treatment before the involvement of the underlying viscera. However, the signs of graft rejection are nonspecific and can overlap with other entities. We present a case of a patient who received a multivisceral and abdominal wall transplant from 2 different donors, who presented with acute and eventually chronic graft rejection of the abdominal wall graft...
May 3, 2016: American Journal of Dermatopathology
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