In 2012, several Italian surgical societies decided to revisit the clinical recommendations for the role of laparoscopy in the treatment of gallbladder diseases in adults, to update and supplement the existing guidelines with recommendations that reflect what is known and what constitutes good practice concerning LC.
Background Perforated peptic ulcer (PPU) remain a surgical emergency accounting for 37% of all peptic ulcer-related deaths. Surgery remains the standard of care. The benefits of laparoscopic approach have been well-established even in the elderly. However, because of inconsistent results with specific regard to some technical aspects of such technique surgeons questioned the adoption of laparoscopic approach. This leads to choose the type of approach based on personal experience. The aim of our study was to critically appraise the use of the laparoscopic approach in PPU treatment comparing it with open procedure. Methods A retrospective study with propensity score matching analysis of patients underwent surgical procedure for PPU was performed. Patients undergoing PPU repair were divided into: Laparoscopic approach (LapA) and Open approach (OpenA) groups and clinical-pathological features of patients in the both groups were compared. Results A total of 453 patients underwent PPU simple repair. Among these, a LapA was adopted in 49% (222/453 patients). After propensity score matching, 172 patients were included in each group (the LapA and the OpenA). Analysis demonstrated increased operative times in the OpenA [OpenA: 96.4 ± 37.2 vs LapA 88.47 ± 33 min, p = 0.035], with shorter overall length of stay in the LapA group [OpenA 13 ± 12 vs LapA 10.3 ± 11.4 days p = 0.038]. There was no statistically significant difference in mortality [OpenA 26 (15.1%) vs LapA 18 (10.5%), p = 0.258]. Focusing on morbidity, the overall rate of 30-day postoperative morbidity was significantly lower in the LapA group [OpenA 67 patients (39.0%) vs LapA 37 patients (21.5%) p = 0.002]. When stratified using the Clavien–Dindo classification, the severity of postoperative complications was statistically different only for C–D 1–2. Conclusions Based on the present study, we can support that laparoscopic suturing of perforated peptic ulcers, apart from being a safe technique, could provide significant advantages in terms of postoperative complications and hospital stay.
Primary tumors of the heart are rare, with an incidence between 0.001% and 0.33% in autopsy findings, and with fibromas representing about 4% of benign cardiac tumors. We report the case of a cardiac fibroma in a 5-year-old child affected by Sotos syndrome. The mean sign was a ventricular tachycardia.
Seaweeds have been incorporated in the daily diet of several human cultures since ancient times, due to their nutritional characteristics and healthy properties. The brown seaweeds Undaria pinnatifida, Saccharina latissima, Sacchoriza polyschides, and Laminaria ochroleuca were collected in the Viana do Castelo (Portugal) bay to assess their proximate composition analysis. As a result, the algal biomass was dried, and its moisture and ash content were determined. The dried biomass was then analyzed for total nitrogen/total protein (using the Kjeldahl method), total fiber content (through fiber analyzer digestion), total lipids (in a Soxhlet apparatus), and fatty acid characterization (by gas chromatography-mass spectrometry). Apart from phosphorus, which was analyzed by spectrophotometry, the ashes were employed for mineral and trace element characterization via dry mineralization and quantified using flame atomic absorption spectrometry. Moreover, the total phenolic content was assessed spectrophotometrically by the Folin-Ciocalteu method in the algal aqueous extracts. Analyses showed that their protein concentrations ranged from 12 to 24% dry weight (DW), while lipid concentrations varied between 0.51% and 1.52% DW. Regarding the carbohydrate concentration in these seaweeds, a concentration between 48% and 60% DW was observed. The S. polyschides had the highest overall total phenolic content (6.19 × 10−3 g GAE/100 g of dried algae), while L. ochroleuca had the lowest amount (3.72 × 10−3 g GAE/100 g of dried algae). U. pinnatifida had the highest total fatty acid content (35.13 mg/g DW), whereas S. latissima presented the lowest value (22.59 mg/g DW). Significant concentrations of highly unsaturated fatty acids (HUFA) were observed in both seaweeds, with U. pinnatifida having the highest value (10.20 mg/g DW) and S. latissima the lowest content (4.81 mg/g DW). It is also highlighted that these seaweeds have a nutritional relevance as a source of essential nutrients, including nitrogen, potassium, sodium, calcium, magnesium, and iron.
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