Firenze, Italy
Firenze, Italy

Time filter

Source Type

El-kholy T.A.,King Abdulaziz University | Al Abbadi H.A.,King Abdulaziz University | Al Abbadi H.A.,Experimental Surgery Unit | Alghamidi A.K.,King Abdulaziz University | And 3 more authors.
Life Science Journal | Year: 2012

Background and Objective: The nutritional status of oncological patients has become a subject of growing scientific interest because of its prognostic significance and the resulting therapeutic possibilities. Colorectal cancer ranks the third highest in cancer incidence and fourth in cancer mortality in both sexes combined worldwide. The role of dietary and other lifestyle factors in colorectal cancer recurrence and survival is largely unknown. The present study aimed to determine the extent of malnutrition in pre and post operative or other treatments of colorectal cancer patients. Methods: A cross- sectional descriptive study was carried out among (30) Patients, (17) males (56.7%) while the other (13) females (43.3%) at King Abdul Aziz University Hospital (KAUH) with diagnosed colorectal cancer to be included in the study at their first visit to the outpatient Surgery and Oncology department between October 2011 and April 2012 were included in a retrospective review of the patients' medical record. Patients were enrolled consecutively from outpatients 2-4 weeks prior to surgery for study. Demographics characteristics including performance status (PS), assessments included weight history, body mass index (BMI), and percentage of weight loss. Laboratory investigations includes blood analysis, U&E (urine and electrolyte) and albumin,also the CEA (Carcinoembryonic Antigen) as a diagnostic tool Cancer staging and hospital length of stay were recorded, nutritional status and assigning the level of risk for malnutrition by, using Simple Screening tool for Malnutrition (SSM), were collected and correlated with different modulates of treatment. Results: Majority of patients (83.33%) have the tumor in the colon while only (16.66%) in the rectum. About (43.33%) treated with both Surgery and chemotherapy while (26.66%) surgery only, (13.33%) received only chemotherapy;(13.33%) received a combination of Chemotherapy and Radiotherapy, and only (3.33%) treated with both Surgery and Radiotherapy. Malnutrition was defined by full nutritional assessment in the participating patients using SSM which revealed that 21 of the 30 patients (70%) were malnourished before treatment and 20 patients (66.6%) after treatment. SSM had high sensitivity and specificity indeticting in patients with colorectal cancer. Declining nutritional status of the patients as seen in serum albumin before and after treatment for all participants which was below reference value of (30.75±0.14 and 29.95±1.93) respectively. The Mean ±SD weight loss (unintentional weight loss) was in male patients (13.61±1.83kg) less than females (15.05±1.75kg). The duration for a unintential weight loss was (50% of participate) had through 3 months; (16. 7 %) after 6 months and (16.7%) had change during one year. Conclusion: Colorectal cancer Patients does have a real nutritional problem that surely can influence their disease course and length of hospital stay after surgery and long duration of receiving other treatment. Most patients with malignancies are considered to be at risk for malnutrition, and therefore require further nutritional support. Nutritional screening would be beneficial in this group preoperatively to identify weight-losing patients at an early stage in the care pathway when they initially enter the secondary care system. Screening (SSM) for malnutrition in cancer patients is a valid simple approach to define cancer patients for nutritional care. More patients regard themselves in need for nutritional counseling than the number of patients really achieving any.


Garcia-Perez R.,Experimental Surgery Unit | Revilla-Nuin B.,Experimental Surgery Unit | Revilla-Nuin B.,CIBER ISCIII | Martinez C.M.,Experimental Surgery Unit | And 5 more authors.
PLoS ONE | Year: 2015

Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a two-stage hepatectomy technique which can be associated with a hypertrophic stimulus on the future liver remnant (FLR) stronger than other techniques-such as portal vein ligation (PVL). However, the reason of such hypertrophy is still unclear, but it is suggested that liver transection combined with portal vein ligation (ALPPS) during the first stage of this technique may play a key role. The aim of this study is to compare the hypertrophic stimulus on the FLR and the clinical changes associated with both ALPPS and PVL in a rat surgical model. For this purpose, three groups of SD rats were used, namely ALPPS (n = 30), PVL (n = 30) and sham-treated (n = 30). The second stage of ALPPS (hepatectomy of the atrophic lobes), was performed at day 8. Blood and FLR samples were collected at 1, 24, 48 hours, 8 days and 12 weeks after the surgeries. ALPPS provoked a greater degree of hypertrophy of the FLR than the PVL at 48 hours and 8 days (p<0.05). The molecular pattern was also different, with the highest expression of IL-1β at 24h, IL-6 at 8 days, and HGF and TNF-α at 48 hours and 8 days (p<0.05). ALPPS also brought about a mild proliferative stimulus at 12 weeks, with a higher expression of HGF and TGF-β (p<0.05) than PVL. Clinically, ALPPS caused a significant liver damage during the first 48 hours, with a recovery of liver function at day 8. In conclusion, ALPPS seems to induce higher functional hypertrophy on the FLR than PVL at day 8. Such regenerative response seems to be leaded by a complex interaction between promitogenic (IL-6, HGF, TNF-α) and antiproliferative (IL1-β and TGF-β) cytokines. © 2015 García-Pérez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Gelsomino S.,Experimental Surgery Unit | Lorusso R.,Civic Hospital | De Cicco G.,Civic Hospital | Bille G.,Experimental Surgery Unit | And 6 more authors.
International Journal of Cardiology | Year: 2010

Background: We hypothesized that a preoperative symmetric pattern with anterior mitral leaflet (AML) tethering predominance is related to lack of LVRR after restrictive annuloplasty. Methods: In 300 patients with surgical annuloplasty for chronic ischemic mitral regurgitation the AML and posterior mitral leaflet (PML) tethering angles were quantified and patients were divided on the basis of the preoperative anterior/posterior tethering angle ratio: there were 144 patients with symmetric (Group 1) and 156 with asymmetric (Group 2) preoperative tethering pattern patients underwent echocardiography preoperatively, at discharge and at follow-up appointments (6 months [IQR 5-8 months]; late, 48 months [15-63 months]). Reverse remodeling was defined as a reduction in left ventricular end systolic volume index > 15%. Results: LVRR was higher in the asymmetric group at discharge (69.2% vs. 9.7%, p < 0.001), early (70.55% vs. 10.45%, p < 0.001 and late follow up (81.4% vs. 4.8%, p < 0.001). At multivariable regression analysis corrected by significant key factors of LVRR, symmetric leaflet tethering (OR, 4.8 [95% CI 2.9-5.6], p < 0.001), anterior tethering angle α′ < 39.5° (OR, 5.0 [95% CI 2.0-6.6], p < 0.001), coaptation height < 11 mm (OR, 2.5 [95% CI 1.1-3.3], p = 0.006) and coaptation length ≥ 8 mm at the end of procedure (OR, 2.0 [CI 0.8-3.0], p = 0.01) were independent predictors of LVRR. Compared with patients with asymmetric pattern (adjusted OR 0.2 [95% CI 0.03-1.6), those with symmetric pattern had > 4-fold odds for lack of LVRR. Conclusions: The preoperative symmetric pattern with AML prevalence was strongly associated with lack of reverse remodeling after annuloplasty. An accurate echocardiographic evaluation of the tethering mechanisms should be incorporated into clinical risk assessment and prediction models. © 2008.


Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) is a two-stage hepatectomy technique which can be associated with a hypertrophic stimulus on the future liver remnant (FLR) stronger than other techniques--such as portal vein ligation (PVL). However, the reason of such hypertrophy is still unclear, but it is suggested that liver transection combined with portal vein ligation (ALPPS) during the first stage of this technique may play a key role. The aim of this study is to compare the hypertrophic stimulus on the FLR and the clinical changes associated with both ALPPS and PVL in a rat surgical model. For this purpose, three groups of SD rats were used, namely ALPPS (n = 30), PVL (n = 30) and sham-treated (n = 30). The second stage of ALPPS (hepatectomy of the atrophic lobes), was performed at day 8. Blood and FLR samples were collected at 1, 24, 48 hours, 8 days and 12 weeks after the surgeries. ALPPS provoked a greater degree of hypertrophy of the FLR than the PVL at 48 hours and 8 days (p<0.05). The molecular pattern was also different, with the highest expression of IL-1 at 24h, IL-6 at 8 days, and HGF and TNF- at 48 hours and 8 days (p<0.05). ALPPS also brought about a mild proliferative stimulus at 12 weeks, with a higher expression of HGF and TGF- (p<0.05) than PVL. Clinically, ALPPS caused a significant liver damage during the first 48 hours, with a recovery of liver function at day 8. In conclusion, ALPPS seems to induce higher functional hypertrophy on the FLR than PVL at day 8. Such regenerative response seems to be leaded by a complex interaction between pro-mitogenic (IL-6, HGF, TNF-) and antiproliferative (IL1- and TGF-) cytokines.

Loading Experimental Surgery Unit collaborators
Loading Experimental Surgery Unit collaborators