The ability to point to well-known places in young and older adults.

BACKGROUND AND AIMS: A mental map of well-known places is organized according to a specific orientation where spatial information located in front of a person is more accessible than information located at the back (front-back effect). This study investigated age-related differences between young and older adults in building a mental map of well-known places when front and back pointing were required. METHODS: Thirty young (20-30 year olds) and 29 older (60-72 year olds) adults living in the same Italian town were compared in their ability to point to places inside their own town, and surrounding villages located in the front and back of their physical position in the city. A series of visuo-spatial tasks were also administered. RESULTS: Our results showed that young and older adults' performance in pointing to well-known places did not differ significantly, and that participants were affected by the pointing direction (i.e. forwards vs. backwards) and the type of place (i.e. in town vs. surrounding villages). It was easier for both young and older adults to point to places in town that were in front of them rather than behind them; there were no differences between pointing forwards or backwards in the surrounding villages. The influence of visuo-spatial abilities on pointing performance changed as a function of age: it was only in the older adults (not in the younger) that a spatial visualization task correlated with pointing performance. CONCLUSIONS: This study showed that older adults, despite their spatial cognitive decline shown by visuo-spatial tasks, retained the ability to build a mental representation of well-known places and were specifically sustained by spatial visualization ability.

Age differences in verbal and visuo-spatial working memory updating: evidence from analysis of serial position curves.

Memory updating is the ability to select and update relevant information and suppress no-longer-relevant data. The few studies in this area, targeting mainly the verbal domain, have investigated and confirmed an age-related decline in working memory updating ability (De Beni & Palladino, 2004; Van der Linden, Bredart, & Beerten, 1994). The present research examines the ability of younger and older adults to update information in verbal and visuo-spatial running memory tasks. Results showed that the participants' performance was higher in the verbal than in the visuo-spatial task. Nonetheless, independently of the task domain, an age-related decline in updating performance was found. Moreover, analysis of serial positions suggested that, in the updating procedure, the participants were not attempting to actively maintain items, preferring to adopt a low-effort, "recency-based" strategy. The use of this type of strategy is more evident in older participants, as shown in both the accuracy performance and the proportion of intrusion errors.

Goblet Cell Carcinoma of the Appendix with Synchronous Adenocarcinoma of the Cecum: Distinct or Related Entities?

Goblet cell carcinoma (GCC) is a rare primary tumor of the appendix characterized by both epithelial and neuroendocrine components containing goblet cells. While in the past, the GCC has been associated with neuroendocrine tumors, recent studies consider that GCC is closer to adenocarcinoma than a neuroendocrine component. The association between gastro-intestinal (GI) carcinoids and second primary malignancies (SPMs) is widely described in the literature, but there is no reported case of GCC and synchronous adjacent adenocarcinoma of the colon. We describe the first case in the literature, to our knowledge, of synchronous colorectal adenocarcinoma of the cecum and GCC of the appendix that are incidentally discovered in the resected primary cancer specimen. The association between the two neoplasms seems to be not causal and maybe the "paracrine-effect theory" may explain the development of a second tumor close to the primary.

Predictors of Long-Term Outcomes of Video-Laparoscopic Versus Open Surgery in Obese Patients with Colorectal Cancer: A Propensity Score Matching Study.

Background: Minimally invasive methods in colorectal surgery offer unquestionable advantages, especially in the context of obesity. The current study addresses the lack of scientific evidence on the long-term oncologic safety of video-laparoscopic (VL) approaches in excess-weight CRC patients undergoing surgery. Methods: We retrospectively analyzed a surgical database consisting of 138 CRC patients undergoing VL (n = 87, 63%) and open CRC surgery (n = 51, 37%). To reduce selection bias, a propensity score matching was applied as a preliminary step to balance the comparison between the two surgery groups, i.e., VL and open surgery. Data from patients treated by the same surgeon were used.to minimize bias. Additional Cox regression models were run on the matched sample (N = 98) to explore the observed benefits of VL surgery in terms of overall and cancer-free survival. The nonparametric Kaplan-Meier method was used to compare the two surgical approaches and assess the likelihood of survival and cancer relapse. Results: The study sample was mostly male (N = 86, 62.3%), and VL outnumbered open surgery (63% versus 37%). Both before and after the matching, the VL-allocated group showed better overall survival (p < 0.01) with comparable cancer-free survival over more than five years of median observation time (66 months). Kaplan Meier survival probability curves corroborated the VL significant protective effect on survival (HR of 0.32; 95% CI: 0.13 to 0.81) even after adjusting for major confounding factors (age, gender, comorbidity index, BMI, tumor localization, tumor staging, tumor grading, clearance, CRM). Findings on oncologic performance by tumor relapse were comparable but lacked significance due to the small number of events observed. Conclusions: Comparing CRC surgical approaches, VL allocation showed comparable cancer-free survival but also a better performance on overall mortality than open surgery over more than five years of median observation.

Video-Laparoscopic versus Open Surgery in Obese Patients with Colorectal Cancer: A Propensity Score Matching Study.

Background: Minimally invasive surgery in obese patients is still challenging, so exploring one more item in this research field ranks among the main goals of this research. We aimed to compare short-term postoperative outcomes of open and video-laparoscopic (VL) approaches in CRC obese patients undergoing colorectal resection. Methods: We performed a retrospective analysis of a surgical database including 138 patients diagnosed with CRC, undergoing VL (n = 87, 63%) and open (n = 51, 37%) colorectal surgery. As a first step, propensity score matching was performed to balance the comparison between the two intervention groups (VL and open) in order to avoid selection bias. The matched sample (N = 98) was used to run further regression models in order to analyze the observed VL surgery advantages in terms of postoperative outcome, focusing on hospitalization and severity of postoperative complications, according to the Clavien-Dindo classification. Results: The study sample was predominantly male (N = 86, 62.3%), and VL was more frequent than open surgery (63% versus 37%). The two subgroup results obtained before and after the propensity score matching showed comparable findings for age, gender, BMI, and tumor staging. The specimen length and postoperative time before discharge were longer in open surgery (OS) patients; the number of harvested lymph nodes was higher than in VL patients as well (p < 0.01). Linear regression models applied separately on the outcomes of interest showed that VL-treated patients had a shorter hospital stay by almost two days and about one point less Clavien-Dindo severity than OS patients on average, given the same exposure to confounding variables. Tumor staging was not found to have a significant role in influencing the short-term outcomes investigated. Conclusion: Comparing open and VL surgery, improved postoperative outcomes were observed for VL surgery in obese patients after surgical resection for CRC. Both postoperative recovery time and Clavien-Dindo severity were better with VL surgery.

Doege-Potter syndrome by malignant solitary fibrous tumor of the liver: A case report and review of literature.

BACKGROUND: Solitary fibrous tumor of the liver (SFTL) is a rare occurrence with a low number of cases reported in literature. SFTL is usually benign but, 10%-20% cases are reported to be malignant with a tendency to metastasize. The majority of malignant SFTL cases are associated with a paraneoplastic hypoglycaemia defined as Doege-Potter syndrome. Surgery is the best therapeutic treatment, however, long- life follow-up is recommended. CASE SUMMARY: A 74-year-old man, was admitted to the emergency department after a syncopal episode with detection of hypoglycaemia resistant to medical treatment. The computed tomography revealed a solid mass measuring 15 cm of the left liver. An open left hepatectomy was performed with complete resection of tumor. Histopathological analyses confirmed a malignant SFTL. CONCLUSION: Large series with long-term follow-up have not been published neither have clinical trials been undertaken. Consequently, the methodical long-term follow-up of surgically treated SFTLs is strongly recommended.