Panminerva medica
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Robot-assisted surgery emerged and evolved in order to increase the surgical precision and due to the need to overcome the drawbacks of conventional minimally invasive surgery. In thoracic surgery the first reported use of a robotic device was in a series of 12 patients with different lung pathologies with the assistance of the DaVinci Robotic Surgical System in 2002. The DaVinci system has been used for various procedures in the field of thoracic surgery since then. While its advantages for the resection of early stage thymoma have been well documented, its role in the treatment of lung cancer and other pathologies is still under investigation. ⋯ Although numerous studies have shown the feasibility and safety of robotic surgery for various procedures, they were not able to show superior postoperative outcomes in terms of morbidity and mortality in exchange for the higher costs of robotic surgery compared to conventional video-assisted thoracic surgery (VATS), except for early-stage thymoma resection. Therefore, randomized control trials comparing robotic particularly with VATS, but also with open procedures are required to further evaluate this crucial topic.
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Meta Analysis
The association of HOTAIR expression with clinicopathological features and prognosis in gastric cancer patients.
A number of studies in gastric carcinoma have demonstrated that cancerous tissues have a significant higher HOTAIR level than that in noncancerous tissues. Overexpression of HOTAIR is associated with the development in gastric cancer. ⋯ There is an association between HOTAIR expression and clinicopathological features and prognosis in gastric cancer patients. High expression of HOTAIR in cancerous tissue could predict poor clinical outcome in gastric cancer, suggesting HOTAIR abundance may serve as a novel candidate biomarker for the clinical outcome in gastric cancers.
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Impact of metabolic comorbidities on outcomes of patients with acute pancreatitis: a scoping review.
With the increasing prevalence of metabolic comorbidities, their impact on outcomes of patients with acute pancreatitis needs to be considered. Metabolic comorbidities, such as diabetes mellitus, obesity, and metabolic syndrome, have been shown to have a role to play in the course of disease. This scoping review aims to map published clinical studies that have investigated the impact of metabolic comorbidities on outcomes in patients with acute pancreatitis.
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In recent years the efficacy of endovascular venous stenting in idiopathic IIH treatment has been consistently reported, strongly suggesting that sinus stenosis should be viewed as a causative factor rather than a secondary phenomenon. We propose that in subjects carrying one or more collapsible segments of large cerebral venous collectors and exposed to a number of different promoting factors, sinus venous compression and cerebrospinal fluid (CSF) hypertension may influence each other in a circular way, leading to a new relatively stable venous/CSF pressures balance state at higher values. The mechanism relay on self-limiting venous collapse (SVC) feedback-loop between the CSF pressure, that compresses the sinus, and the consequent venous pressure rise, that increases the CSF pressure. ⋯ The SVC model give reason of the high specificity and sensitivity of sinus stenosis as IIH predictor and of the multiplicity of the factors that have been found associated with IIH. Moreover it might explain why, among the sinus stenosis carriers, young and overweight women are at higher risk of developing the disease. Finally, the SVC model fully explain the enigmatic longstanding remissions that can be commonly observed after a single LP with CSF subtraction in IIH with or without papilledema.
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The aim of this paper was to investigate the association of circulating osteoprotegerin (OPG) and receptor activator of the nuclear factor kB ligand (RANKL) levels with carotid intima-media thickness (CIMT) in type 2 diabetes mellitus (T2DM). ⋯ The data would support the role of an increased OPG/RANKL ratio as a possible marker of progression of vascular dysfunction in diabetes.