6,787 research outputs found
Systematic Review and Meta-Analysis of Surgical Treatment for Isolated Local Recurrence of Pancreatic Cancer
No full textPurpose: To perform a systematic review and meta-analysis on the outcome of surgical treatment for isolated local recurrence of pancreatic cancer. Methods: A systematic review and meta-analysis based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines was conducted in PubMed, Scopus, and Web of Science. Results: Six studies concerning 431 patients with recurrent pancreatic cancer met the inclusion criteria and were included in the analysis: 176 underwent redo surgery, and 255 received non-surgical treatments. Overall survival and post-recurrence survival were significantly longer in the re-resected group (ratio of means (ROM) 1.99; 95% confidence interval (CI), 1.54–2.56, I2 = 75.89%, p = 0.006, and ROM = 2.05; 95% CI, 1.48–2.83, I2 = 76.39%, p = 0.002, respectively) with a median overall survival benefit of 28.7 months (mean difference (MD) 28.7; 95% CI, 10.3–47.0, I2 = 89.27%, p < 0.001) and median survival benefit of 15.2 months after re-resection (MD 15.2; 95% CI, 8.6–21.8, I2 = 58.22%, p = 0.048). Conclusion: Resection of isolated pancreatic cancer recurrences is safe and feasible and may offer a survival benefit. Selection of patients and assessment of time and site of recurrence are mandatory
Extended Distal Pancreatectomy for Cancer of the Body and Tail of the Pancreas: Analysis of Early and Late Results
No full textCancer of the body-tail of the pancreas often involves adjacent structures. Thus, surgical treatment may be extended to other organs or vessels in order to achieve radical resection. The aim of this study is to evaluate the safety and efficacy of extended distal pancreatectomy for ductal adenocarcinoma of the body and tail of the pancreas. Between January 2000 and December 2016, 101 patients underwent distal pancreatectomy (DP) for pancreatic cancer: 65 patients underwent standard-DP and 36 extended-DP, including the resection of the partial stomach (n = 12), adrenal gland (n = 7), liver (n = 7), colon (n = 8), celiac axis (n = 6), portal vein (n = 5), jejunum (n = 4) and kidney (n = 4). The two groups were compared in terms of their TNM classification, pathological grade, nodal status, state of resection margins, age, sex and levels of preoperative serum carbohydrate antigen 19-9 (CA 19.9). The morbidity and mortality were not statistically different in the two groups. The two groups disease-free and overall survival rates were significantly influenced by the tumor's stage, nodal status, pathological features and resection margins. Survival was not influenced by the extent of the surgical resection. However, when patients were stratified according to the type of extended resection, survival was worse in the group of patients undergoing vascular resection. Multivariate analysis showed that the stage and resection margins are independent predictors of disease-free and overall survival. Extended distal pancreatectomy may be performed with acceptable morbidity and mortality rates. Survival is not significantly different after standard or extended resection. However, the rate of tumor recurrence is high, and long-term survival is a rare event, especially in those patients who undergo distal pancreatectomy associated with vascular resection
Prognostic Implications of 18-FDG Positron Emission Tomography/Computed Tomography in Resectable Pancreatic Cancer
No full textThere are currently no known preoperative factors for determining the prognosis in
pancreatic cancer. The aim of this study was to examine the role of 18-fluorodeoxyglucose (18-FDG)
positron emission tomography/computed tomography (18-FDG-PET/CT) as a prognostic factor for
patients with resectable pancreatic cancer. Data were obtained from a retrospective analysis of
patients who had a preoperative PET scan and then underwent pancreatic resection from January
2007 to December 2015. The maximum standardized uptake value (SUVmax) of 18-FDG-PET/CT was
calculated. Patients were divided into high (>3.65) and low (3.65) SUVmax groups, and compared in
terms of their TNM classification (Union for International Cancer Contro classification), pathological
grade, surgical treatment, state of resection margins, lymph node involvement, age, sex, diabetes and
serum Carbohydrate Antigen 19-9 (CA 19-9) levels. The study involved 144 patients, 82 with high
SUVmax pancreatic cancer and 62 with low SUVmax disease. The two groups’ disease-free and overall
survival rates were significantly influenced by tumor stage, lymph node involvement, pathological
grade, resection margins and SUVmax. Patients with an SUVmax 3.65 had a significantly better
survival than those with SUVmax > 3.65 (p < 0.001). The same variables were independent predictors
of survival on multivariate analysis. The SUVmax calculated with 18-FDG-PET/CT is an important
prognostic factor for patients with pancreatic cancer, and may be useful in decisions concerning
patients’ therapeutic management
[Poesia] Três poemas de Alberto Secama
No full textThree poems by Alberto Secama. About the author: Alberto Secama is an Angolan poet who has poems published on many websites and on facebook:https://www.facebook.com/Xungurra/abouthttp://www.pordentrodaafrica.com/cultura/africa-em-verso-rio-kwanza-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/africa-em-verso-zong-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/coluna-africa-em-verso-o-sol-la-fora-por-alberto-secamaTres poemas de Alberto Secama. Sobre el autor: Alberto Secama es un poeta angoleño que tiene poemas publicados en varios sitios y en el facebook:https://www.facebook.com/Xungurra/abouthttp://www.pordentrodaafrica.com/cultura/africa-em-verso-rio-kwanza-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/africa-em-verso-zong-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/coluna-africa-em-verso-o-sol-la-fora-por-alberto-secamaTrês poemas de Alberto Secama. Sobre o autor: Alberto Secama é um poeta angolano que possui poemas publicados em vários sites e no facebook:https://www.facebook.com/Xungurra/abouthttp://www.pordentrodaafrica.com/cultura/africa-em-verso-rio-kwanza-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/africa-em-verso-zong-por-alberto-secamahttp://www.pordentrodaafrica.com/cultura/coluna-africa-em-verso-o-sol-la-fora-por-alberto-secam
Adrenal metastasis from endometrial cancer: A case report
No full textBACKGROUND
Metastases to adrenal glands originate principally from lung, breast, or gastrointestinal cancers, followed by malignant melanoma and thyroid neoplasms. We present an unusual case of uterine cancer metastasizing to the adrenal glands with a review of the English literature on the management of this rare disease.
CASE SUMMARY
A 53-year-old Caucasian woman with a history of endometrial cancer (grade 2; International Federation of Gynecology and Obstetrics III A) was hospitalized in November 2017 for a left adrenal mass found on a follow-up computed tomography scan 3 years after her gynecological surgery. Laboratory test results were normal. A laparoscopic left adrenalectomy was performed. The postoperative course was uneventful, and no chemotherapy was administered. The pathological report confirmed an adrenal endometrioid metastasis. At 36 mo of follow-up, the patient is alive and well, with no evidence of recurrent disease. A literature review identified only 11 previously-published cases of adrenal metastases from uterine cancer.
CONCLUSION
Adrenal metastasis from uterine cancer is very rare. Laparoscopic adrenalectomy may be an effective treatment in selected cases of localized adrenal metastasis
Orizzonti mantovani. Spunti e dinamiche paesaggistiche ne L'Illustrissimo di Alberto Cantoni
No full textIn the literary production of Alberto Cantoni, short story writer and novelist between the nineteenth and twentieth centuries, the novel L'Illustrissimo is highly important both because it is the last publication of the author, from Pomponesco, a small town a few kilometers south of Mantua, both because it summarizes in a single text the different nuances and different directions that his writing has taken over the course of his literary career, also due to a writing and processing time that embraces the entire span of years of his career itself. In the foreground, in addition to the numerous and brilliant characters, one of the protagonists is the Mantuan landscape which, not a simple background, becomes a true literary parameter which in different and significant ways affects the purposes and mechanisms of the novel
Plenary Session: Luis Alberto Urrea
No full texta) Plenary Session: Luis Alberto Urrea, Mexican American Chicago Writer
Luis Alberto Urrea is a 2005 Pulitzer Prize finalist for non-fiction and member of the Latino Literature Hall of Fame. He is a prolific and acclaimed writer who has used his dual-culture life border experiences to explore the complex and interconnected Mexican-US American reality. The critically acclaimed and best-selling Mexican-born author of 13 books, Urrea has won numerous awards for his poetry, fiction and essays.
Moderator: Dr. Héctor García, Loyola University Chicag
Does Pancreatic Fistula Affect Long-Term Survival after Resection for Pancreatic Cancer? A Systematic Review and Meta-Analysis
No full textBackground: The impact of postoperative pancreatic fistula (POPF) on survival after resection for pancreatic ductal adenocarcinoma (PDAC) remains unclear.
Methods: The MEDLINE, Scopus, Embase, Web of Science, and Cochrane Library databases were searched for studies reporting on survival in patients with and without POPF. A meta-analysis was performed to investigate the impact of POPF on disease-free survival (DFS) and overall survival (OS).
Results: Sixteen retrospective cohort studies concerning a total of 5019 patients with an overall clinically relevant POPF (CR-POPF) rate of 12.63% (n = 634 patients) were considered. Five of eleven studies including DFS data reported higher recurrence rates in patients with POPF, and one study showed a higher recurrence rate in the peritoneal cavity. Six of sixteen studies reported worse OS rates in patients with POPF. Sufficient data for a meta-analysis were available in 11 studies for DFS, and in 16 studies for OS. The meta-analysis identified a shorter DFS in patients with CR-POPF (HR 1.59, p = 0.0025), and a worse OS in patients with POPF, CR-POPF (HR 1.15, p = 0.0043), grade-C POPF (HR 2.21, p = 0.0007), or CR-POPF after neoadjuvant therapy.
Conclusions: CR-POPF after resection for PDAC is significantly associated with worse overall and disease-free survival
O duplo significado do sentir e do pensar nas obras de Alberto Caeiro e Descartes
No full textDissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Comunicação e Expressão. Programa de Pós-Graduação em LiteraturaA pretensão desta dissertação intitulada O duplo significado do sentir e do pensar nas obras de Alberto Caeiro e Descartes é investigar a relação entre o sentir e o puro pensar, usando como referência a poesia O Guardador de Rebanhos, de Alberto Caeiro, que apresenta de forma evidente o tema; e como este assunto é tratado nas Meditações Metafísicas de René Descartes, também de forma claramente visível. Podemos perceber em ambos os autores, uma diplopia, uma espécie de duplo olhar sobre a relação sentir e puro pensar. No primeiro capítulo vou falar sobre a tese do duplo olhar de Descartes, a respeito da relação sentir e puro pensar na leitura de Merleau-Ponty, salientando a visão de natureza. No segundo capítulo, parto da leitura das três primeiras Meditações Metafísicas para caracterizar a tensão que se pode verificar entre Descartes e Alberto Caeiro quando se referem ao puro pensar. O foco principal de Descartes, nas três primeiras Meditações, é o pensar puro, e neste ponto Alberto Caeiro critica o pensar puro. No terceiro capítulo, analisando as três últimas Meditações, percebe-se que há uma virada no pensamento de Descartes, no qual o autor inverte seu ponto de vista, aproximando-se da idéia de Alberto Caeiro. No quarto capítulo, mostrarei a leitura que outros autores fazem acerca do sentir e do pensar na obra de Alberto Caeiro, mostrando que assim como Descartes, este também ostenta uma diplopia, não do sentir, mas do pensar. The pretension of this work entitled O duplo significado do sentir e do pensar nas obras de Alberto Caeiro e Descartes is to investigate the relationship between the feeling and the pure thinking, using as reference the poetry O Guardador de Rebanhos, by Alberto Caeiro, that presents in an evident way this theme; and as this subject is treated in René Descartes' Metaphysical Meditations, also in a clearly visible way. It is possible to notice in both authors, the diplopy, a sort of double look about the relationship between feeling and pure thinking. The thesis about Descartes'double look regarding the relation of feeling and pure thinking, in Merleau-Ponty reading, pointing out the nature vision, will be treated in the first chapter. In the second chapter, I start from the reading of the first three Metaphysical Meditations to characterize the tension that can be verified between Descartes and Alberto Caeiro when they refer to the pure thinking. Descartes' main focus in the first three Meditations is pure thinking and, in this point, Alberto Caeiro criticizes pure thinking. In the third chapter, analyzing the last three Meditations, it is possible to notice that there is an alteration in Descartes' thought, in which the author inverts his point of view, approaching of Alberto Caeiro's idea. In the fourth chapter, I will show the reading that other authors do concerning feeling and thinking in Alberto Caeiro's work, showing that as well as Descartes, this also shows a diplopy, not of feeling, but of thinking
The Ratio of C-Reactive Protein to Albumin Is an Independent Predictor of Malignant Intraductal Papillary Mucinous Neoplasms of the Pancreas
No full textThere is growing evidence to indicate that inflammatory reactions are involved in cancer
progression. The aim of this study is to assess the significance of systemic inflammatory biomarkers,
such as the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the ratio
of C-reactive protein to albumin ratio (CAR), the prognostic nutritional index (PNI) and the modified Glasgow prognostic score (mGps) in the diagnosis and prognosis of malignant intraductal
papillary mucinous neoplasms (IPMNs) of the pancreas. Data were obtained from a retrospective
analysis of patients who underwent pancreatic resection for IPMNs from January 2005 to December
2015. Univariate and multivariate analyses were performed, considering preoperative inflammatory biomarkers, clinicopathological variables, and imaging features. Eighty-three patients with
histologically proven IPMNs of the pancreas were included in the study, 37 cases of low-grade or
intermediate dysplasia and 46 cases of high-grade dysplasia (HGD) or invasive carcinoma. Univariate
analysis showed that obstructive jaundice (p = 0.02) and a CAR of >0.083 (p = 0.001) were predictors
of malignancy. On multivariate analysis, only the CAR was a statistically significant independent
predictor of HGD or invasive carcinoma in pancreatic IPMNs, identifying a subgroup of patients
with a poor prognosis. Combining the CAR with patients’ imaging findings, clinical features and
tumor markers can be useful in the clinical management of IPMNs. Their value should be tested in
prospective studies
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