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Three-dimensional visualization technology (3DVT) has been recently introduced to achieve a precise preoperative planning of liver surgery. The aim of this observational study was to assess the accuracy of 3DVT for complex liver resections. 3DVT with hyper accuracy three-dimensional (HA3D™) technology was introduced at our institution on February 2020. Anatomical characteristics were collected from two-dimensional imaging (2DI) and 3DVT, while intraoperative and postoperative outcomes were recorded prospectively. A total of 62 patients were enrolled into the study. 3DVT was able to study tumor extension and liver anatomy, identifying at least one vascular variation in 37 patients (59.7%). Future remnant liver volume (FRLV) was measured using 2DI and 3DVT. The paired samples t test assessed positive correlation between the two methods (p Graphical abstract

Analyses of potentiometric measurements were conducted on ternary complexes of copper(II) with dipicolinic acid and quinolinic acid, as well as lactic acid, oxalic acid, citric acid, and phosphoric acid, which are components of blood plasma. Studies on chemical speciation showed that ternary compounds were more likely to be formed. In systems with quinolinic acid, the solubility was small, and most complexes precipitated at pH ≤ 2. In situ isolated ternary and binary complexes of CuDiPic(H2O)2 were evaluated for antioxidant activity, as shown by their inhibiting activity of superoxide anion (O2.−), which demonstrates copper(II) complexes provide protective effects. Docking studies of ligands with a protein kinase revealed that the Cu(II) metal centre is crucial for the successful interaction of the complex with the receptor’s active site.

The nonclinical branch of regulatory pharmacology has traditionally relied on the sensitivity and specificity of regulatorily recommended bioassays. Nonetheless, any predictive testing (eg, safety pharmacology) with less than 100% sensitivity or 100% specificity is prone to deliver false positive or negative results (namely, outcomes discordant to the clinical gold standard). It was recently suggested that the statistics-based and regulatory pertinent "predictive values approach" (PVA) might help to reach a more predictive use of preclinical testing data. To resolve the associated probability of carcinogenicity to humans, the PVA was applied to 37 pharmaceuticals bearing inadequate epidemiological evidence of carcinogenicity, but identifiable as unequivocal mutagens. According to current knowledge, a 98.9% (or more) probability of carcinogenicity to humans was reckoned for those 37 genotoxic drugs. Accordingly, these pharmaceutical drugs might be either scientifically or regulatorily regarded as "carcinogenic to humans." In the USA, European Union, or Canada as examples, the great majority of these 37 pharmaceuticals are authorized for medical use in humans. From the results of the present appraisal, the following is suggested (1) for the pharmaceuticals listed in this report, to include significant carcinogenicity warnings in their prescribing information; (2) to conduct pharmacoepidemiology studies or risk-benefit analyses (if warranted), and (3) based on the respective risk-benefit analyses, to re-evaluate the authorization of hydralazine and phenoxybenzamine as antihypertensives, oxcarbazepine as an anticonvulsant, and phenazopyridine as a urinary tract antimicrobial or analgesic. For the four latter drugs (eg, phenoxybenzamine), a 99.5% probability of carcinogenicity to humans was estimated.

Background Although isolated caudate lobe (CL) liver resection is not a contraindication for minimally invasive liver surgery (MILS), feasibility and safety of the procedure are still poorly investigated. To address this gap, we evaluate data on the Italian prospective maintained database on laparoscopic liver surgery (IgoMILS) and compare outcomes between MILS and open group. Methods Perioperative data of patients with malignancies, as colorectal liver metastases (CRLM), hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), non-colorectal liver metastases (NCRLM) and benign liver disease, were retrospectively analyzed. A propensity score matching (PSM) analysis was performed to balance the potential selection bias for MILS and open group. Results A total of 224 patients were included in the study, 47 and 177 patients underwent MILS and open isolated CL resection, respectively. The overall complication rate was comparable between the two groups; however, severe complication rate (Dindo–Clavien grade ≥ 3) was lower in the MILS group (0% versus 6.8%, P = ns). In-hospital mortality was 0% in both groups and mean hospital stay was significantly shorter in the MILS group (P = 0.01). After selection of 42 MILS and 43 open CL resections by PSM analysis, intraoperative and postoperative outcomes remained similar except for the hospital stay which was not significantly shorter in MILS group. Conclusions This multi-institutional cohort study shows that MILS CL resection is feasible and safe. The surgical procedure can be technically demanding compared to open resection, whereas good perioperative outcomes can be achieved in highly selected patients.

Regarding carcinogenicity testing, the long-term rodent bioassay (RCB) has been the test required by most regulatory agencies across the world. Nonetheless, due to the lack of knowledge about its specificity, it has been argued that the RCB is unspecific or even invalid. Because of the substantial limitations of epidemiology to identify chemicals probably not carcinogenic to humans (PNCH), it has been very difficult to address the specificity of the RCB. Nevertheless, because mechanistic/pharmacological data are currently recognized as a valid stream of evidence for the identification of chemical hazards, the road is now open to gain insight into the specificity of the RCB. Based on sound mechanistic/pharmacological data that support the classification of chemicals as PNCH, 100 PNCH substances were gathered in this investigation. Contrary to what was previously forecast, in this study, the RCB exhibited a functional specificity that ranged from 83% to 91%, depending on the settings of the testing (2-species vs. rats only, and the nominal maximum tolerated dose). Other contributions of this work were: (a) enabling the comparison, in terms of specificity, between the RCB and the alternative methods that could replace it (eg, Tg.AC mouse, rasH2 mouse); (b) disclosing what the specificity is for alternative methods that were developed using the RCB as the reference standard; and (c) expanding the previous narrow (only seven substances) set of chemicals identified as not likely to be carcinogenic to humans by hazard identification programs.

For a significant share of the chemicals, current bioassays mispredicted the outcomes in the reference methods they simulate. For any drug or chemical, and depending on the regulatory or corporate situation, three different approaches calculate the numerical probability by which agreement (or discrepancy) can be statistically expected between (1) the result of a predictive bioassay, and (2) the outcome on its reference method. If such concordance is expected with enough confidence based on a sufficient percentage probability, then specific results from that bioassay can be considered as correctly predictive. The statistical approaches analyzed in this article assist in valuable tasks, including (1) a better translation of the clinical relevance (or insignificance) of specific preclinical findings; (2) waiving unnecessary animal testing (or any other unpredictive testing; e.g., a given in vitro bioassay), and (3) in advancing only the most promising candidates in the pharmaceutical, pesticide, or chemical development process.

Gallbladder volvulus is a rare cause of acalculous cholecystitis which clinically presents as acute abdomen and can rapidly evolve in a severe life-threatening sepsis. Awareness is crucial for differential diagnosis leading to the early and effective treatment. We present the case of an elderly woman who underwent laparoscopic cholecystectomy after pre-operative ultrasound diagnosis of gallbladder volvulus.

Identify the factors related to failure ablation after percutaneous ultrasound guided single electrode radiofrequency ablation (RFA) for hepatocarcinoma (HCC) and propose a score for improving patient selection and treatment allocation.From 2010 to 2020 585 HCC nodules treated with RFA were prospectively collected. Ablation Difficulty Score (ADS) was built-up according to clinical and radiological factors related to failure ablation identified by Cox-logistic regression analysis. The study population was stratified in low risk (ADS 0), intermediate risk (ADS 1), and high risk (ADS ≥ 2) of failure ablation.Overall ablation success rate was 85.5%. Morbidity and mortality rates were 3.5% and 0.0%. According to per nodule analysis the following factors resulted related to failure ablation: size 20 mm (p = 0.002), sub-capsular location (p = 0.008), perivascular location (p = 0.024), isoechoic appearance (p = 0.008), and non-cirrhotic liver (p = 0.009). The ablation success rate was 93.5% in ADS 0, 85.8% in ADS 1 and 71.3% in ADS ≥ 2 (p 0.001). The 1-year local tumor progression (LTP) free survival was 90.2% in ADS 0, 80.6% in ADS 1, and 72.3% in ADS ≥ 2 (p = 0.009). Nodule's size 20 mm (p = 0.014), isoechoic appearance (p = 0.012), perivascular location (p = 0.012) resulted related to lower LTP free survival.Ablation Difficulty Score could be a simple and useful tool for guiding the treatment decision making of HCC. RFA in high risk nodules (ADS ≥ 2) should be carefully evaluated and reserved for patients not suitable for surgery or liver transplantation.

La nefropatia es una de las complicaciones mas importantes de la diabetes, la cual puede conducir a la muerte. Las kinasas activadas por mitogenos (MAPK) son conocidos mediadores del dano renal en la diabetes, cuya activacion (fosforilacion) se encuentra asociada al aumento de la sintesis de proteinas de la matriz extracelular (colageno, fibronectina, entre otras) y a la fibrosis renal. Recientemente, se ha establecido a la planta Ruellia tuberosa L. como antioxidante, antiinflamatoria, antidiabetica y nefroprotectora en varios modelos experimentales. En este trabajo se evaluo el efecto del tratamiento con 10 mg/kg/dia, p.o, del extracto acuoso de la raiz de R. tuberosa (RT) durante cuatro semanas, sobre la fosforilacion de la ERK 1/2 en la corteza renal de ratas control y con diabetes tipo I inducida por la estreptozotocina y se vinculo con los marcadores de la fibrosis renal tales como el aumento del peso del rinon, contenido de proteinas totales y de colageno I. Los resultados demuestran que el tratamiento con RT previno el aumento de la fosforilacion de las ERK 1/2, del peso del rinon, y del contenido de proteinas y de colageno I renal por en la diabetes inducida por ETZ. Los hallazgos contribuyen a la elucidacion de los mecanismos por los cuales R. tuberosa protege al rinon frente a la diabetes, estableciendose asi la actividad antifibrotica de esta especie utilizada en la medicina popular venezolana.

In this work we obtained iron nanoparticles (FeNP) from the aqueous extract of the leaves of E. robusta and to evaluate their antimicrobial activity on different pathogenic microorganisms. Different concentration of iron salt and leaf extract were used; the proportion of precursor to leaf extract was 1:1. The results reveled dependence on the particle size of FeNP and synthesis conditions. Subsequently, the antimicrobial activity was evaluated against the microorganisms Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus and Bacillus subtilis, being a close relationship between the conditions of synthesis and the increase or decrease of the antimicrobial activity. Finally, the quantification of flavonoids and total polyphenols was carried out and the antioxidant activity of the E. robusta extract was evaluated, which allowed associating the antimicrobial activity found in the FeNPs with the components present in the extract.

The relationship between immune-nutritional status and tumor growth, biological aggressiveness and survival, is still debated. Therefore, this study aimed to evaluate the prognostic performance of different inflammatory and immune-nutritional markers in patients who underwent surgery for biliary tract cancer (BTC). The prognostic role of the following inflammatory and immune-nutritional markers were investigated: Glasgow Prognostic Score (GPS), modified Glasgow Prognostic Score (mGPS), Prognostic Index (PI), Neutrophil to Lymphocyte ratio (NLR), Platelet to Lymphocyte ratio (PLR), Lymphocyte to Monocyte ratio (LMR), Prognostic Nutritional Index (PNI). A total of 282 patients undergoing surgery for BTC were included. According to Cox regression and ROC curves analysis for survival, LMR had the best prognostic performances, with hazard ratio (HR) of 1.656 (p = 0.005) and AUC of 0.652. Multivariable survival analysis identified the following independent prognostic factors: type of BTC (p = 0.002), T stage (p = 0.014), N stage (p &lt, 0.001), histological grading (p = 0.045), and LMR (p = 0.025). Conversely, PNI was related to higher risk of severe morbidity (p &lt, 0.001) and postoperative mortality (p = 0.005). In conclusion, LMR appears an independent prognostic factor of long-term survival, whilst PNI seems associated with worse short-term outcomes.