Are glucose and insulin levels at all time points during OGTT a reliable marker of diabetes mellitus risk in pediatric obesity?

PURPOSE: Childhood overweight and obesity associated with insulin resistance and metabolic syndrome represent the new global pandemic and the main causative factors for dysglycemia, prediabetes, and Type 2 Diabetes Mellitus (T2DM). Predictors, such as HOMA-IR, HOMA-ß%, and QUICKI lack specific reference values in children. OGTT is a gold standard for glycometabolic assessment. Recently, a glycemic level higher than 155 mg/dl at + 60' after glucose ingestion has been defined as a risk factor for T2DM in obese adolescents. We aim to analyze and correlate fasting insulin-resistance markers with OGTT results in overweight/obese children and adolescents. METHODS: We retrospectively evaluated glucose and insulin values during a 2-h OGTT every 30 min in 236 overweight/obese patients. Glucose values and insulin sum during OGTT were compared to glycometabolic indexes and different cut-off values for insulin sum. RESULTS: A 1-h glucose > 155 mg/dl and insulin sum > 535 microU/ml at all times during OGTT are the best predictors of diabetes risk in obese youths. A1-h glucose > 155 mg/dl is significantly associated with HbA1c > 5.7%, while no association was observed between HbA1c > 5.7% and glucose levels at baseline and 2 h. The ability of the standardized HOMA-IR to predict the prediabetes status is clearly lower than the total insulin sum at OGTT. CONCLUSION: Our study demonstrates that also 1-h post-OGTT glucose, together with HbA1c, is an effective diabetes predictor.

High dose craniospinal irradiation as independent risk factor of permanent alopecia in childhood medulloblastoma survivors: cohort study and literature review.

PURPOSE: Our aim was to determine the main risk factors related to the occurrence of permanent alopecia in childhood medulloblastoma (MB) survivors. METHODS: We retrospectively analyzed the clinical features of all consecutive MB survivors treated at our institute. We divided the patients into 3 groups depending on the craniospinal irradiation (CSI) dose received and defined permanent alopecia first in terms of the skin region affected (whole scalp and nape region), then on the basis of the toxicity degree (G). Any relationship between permanent alopecia and other characteristics was investigated by a univariate and multivariate analysis and Odds ratio (OR) with confidence interval (CI) was reported. RESULTS: We included 41 patients with a mean10-year follow-up. High dose CSI resulted as an independent factor leading to permanent hair loss in both groups: alopecia of the whole scalp (G1 p-value 0.030, G2 p-value 0.003) and of the nape region (G1 p-value 0.038, G2 p-value 0.006). The posterior cranial fossa (PCF) boost volume and dose were not significant factors at multivariate analysis neither in permanent hair loss of the whole scalp nor only in the nuchal region. CONCLUSION: In pediatric patients with MB, the development of permanent alopecia seems to depend only on the CSI dose ≥ 36 Gy. Acute damage to the hair follicle is dose dependent, but in terms of late side effects, constant and homogeneous daily irradiation of a large volume may have a stronger effect than a higher but focal dose of radiotherapy.

Does dietary insect meal affect the fish immune system? The case of mealworm, Tenebrio molitor on European sea bass, Dicentrarchus labrax.

Feeding small European sea bass, Dicentrarchus labrax, for 6 weeks with Tenebrio molitor larval meal showed significant anti-inflammatory responses (ceruloplasmin, myeloperoxidase and nitric oxide). Serum bacteriolytic activity against a Gram negative bacterium was not significantly affected by dietary Tenebrio, while both lysozyme antibacterial activity and serum trypsin inhibition usually linked to the anti-parasite activity of the fish, were significantly enhanced. The latter may be due to the similarities in the composition of the exoskeleton of parasites and insects that may therefore act as an immunostimulant potentially increasing the anti-parasitic activity. The addition of exogenous proteases significantly decreased both trypsin-inhibition and serum bacteriolytic activity probably through direct inhibition of the proteins responsible for these immune functions. Further investigation involving bacterial or parasitic challenges will be necessary to assess if the effects of dietary mealworm meal on the immune system observed in the present study are translated into an improved resistance to diseases.

Total Thyroidectomy: the first, the best. The recurrent goiter issue.

BACKGROUND: Redo surgery for recurrent goiter is still now, even in experienced hands, followed by higher morbidity than primary total thyroidectomy. Suppressive Levothyroxine therapy failed to improve the recurrence rate, while inducing a subclinical hyperthyroidism. Aim of this study is to verify morbidity after total thyroidectomy for benign thyroid diseases, both primary and after recurrence. MATERIALS AND METHODS: A series of 20 cases of total thyroidectomy for recurrent benign diseases (RG), performed between January 2001 and December 2013 was compared with 225 cases of primary total thyroidectomy (PT) . Cancers, even incidentally diagnosed, were excluded. At least a 12 months follow up was accomplished. Due to the small size of the sample for RG, statistical analysis was performed by Fisher test only. RESULTS: Postoperative complications were Transient hypocalcemia: 5 (25%) in RG and 18 (8%) in PT, Permanent hypocalcemia only 2 (10%) in RG (significant for p <0,05), Transient RLN deficit 5 (25 %) in RG and 6 (2.6%) in PT (significant for p< 0.05). CONCLUSIONS: Differences in incidence of perioperative complications cannot be advocated to justify a less than total thyroidectomy even in benign disease setting. The need for a redo surgery with its burden of morbidity is per se a good reason to avoid a conservative surgery. Further, suppressive therapy with Levothyroxine often fails to avoid recurrence, inducing in some cases a specific morbidity. Our experience confirms the results of our previous experiences and of literature on this topic: the best management of recurrent goiter is its prevention by primary total thyroidectomy.

Productive performance and blood profiles of laying hens fed Hermetia illucens larvae meal as total replacement of soybean meal from 24 to 45 weeks of age.

The aim of the research was to study the effects of an insect meal from Hermetia illucens larvae (HILM) as complete replacement of soybean meal (SBM) on productive performance and blood profiles of laying hens, from 24 to 45 wk of age. A total of 108 24-week-old Lohmann Brown Classic laying hens was equally divided into 2 groups (54 hens/group, 9 replicates of 6 hens/group). From 24 to 45 wk of age, the groups were fed 2 different isoproteic and isoenergetic diets: the control group (SBM) was fed a corn-soybean meal based diet, while in the HILM group the soybean meal was completely replaced by Hermetia illucens larvae meal. Feed intake, number of eggs produced, and egg weight were recorded weekly along the trial. At 45 wk of age, blood samples were collected from 2 hens per replicate. The use of HIML led to a more favorable (P < 0.01) feed conversion ratio in hens but lay percentage, feed intake, average egg weight, and egg mass were higher (P < 0.01) in hens fed the SBM diet. Hens fed insect meal produced a higher percentage of eggs from small (S), medium (M), and extra-large (XL) classes (P < 0.01) than SBM, while the SBM group had a higher percentage of eggs from the large (L) class (P < 0.01). The levels of globulin and albumin to globulin ratio were, respectively, higher and lower (P < 0.05) in HILM than the SBM group. Cholesterol and triglycerides were higher (P < 0.05 and P < 0.01, respectively) in hens from SBM than in the HILM group. Blood levels of Ca were higher (P < 0.01) in hens fed insect meal, while creatinine was higher (P < 0.01) in blood of hens fed SBM. Hermetia illucens larvae meal can be a suitable alternative protein source for laying hens even if the complete replacement of soybean meal needs further investigation to avoid the negative effects on feed intake.

Laryngeal and phrenic nerve involvement in a patient with hereditary neuropathy with liability to pressure palsies (HNPP).

Lower cranial and phrenic nerve involvement is exceptional in hereditary neuropathy with liability to pressure palsies (HNPP). Here we report the occurrence of reversible laryngeal and phrenic nerve involvement in a patient with HNPP. The patient recalled several episodes of reversible weakness and numbness of his feet and hands since the age of 30 years. His medical history was uneventful, apart from chronic obstructive pulmonary disease (COPD). At age 44, following severe weight loss, he presented with progressive dysphonia and hoarseness. EMG of cricoarytenoid and thyroarytenoid muscles and laryngeal fibroscopy confirmed vocal cord paralysis. These speech disturbances gradually regressed. Two years later, he reported rapidly worsening dyspnea. Electroneurography showed increased distal latency of the right phrenic nerve and diaphragm ultrasonography documented reduced right hemi-diaphragm excursion. Six months later and after optimization of CODP treatment, his respiratory function had improved and both phrenic nerve conduction and diaphragm excursion were completely restored. We hypothesize that chronic cough and nerve stretching in the context of CODP, together with severe weight loss, may have triggered the nerve paralysis in this patient. Our report highlights the need for optimal management of comorbidities such as CODP as well as careful control of weight in HNPP patients to avoid potentially harmful complications.

Use of larvae meal as protein source in broiler diet: Effect on growth performance, nutrient digestibility, and carcass and meat traits.

The aim of this research was to study the effect of insect meal from larvae ( larvae meal [TML]) as complete replacement of soybean meal (SBM) on growth performance, nutrient digestibility, and carcass and meat traits of broilers. A total of eighty 30-d-old male Shaver brown broilers were homogenously divided into 2 groups (each consisting of 8 replicates of 5 birds). Up to 62 d of age, the groups were fed 2 isoproteic and isoenergetic diets differing for the ingredient used as the main protein source: the control group was fed a corn-SBM-based diet, whereas in the TML group, the SBM was completely replaced by TML. Broiler growth performance was measured during the trial. At 62 d of age, 2 broilers per replicate (16 per group) were slaughtered and apparent ileal digestibility coefficients and carcass and meat traits were determined. The use of TML as the main protein source in the broiler diet had no significant effect on most growth performance and carcass traits and chemical and physical properties of meat, the latter being important for marketing purposes. The feed conversion ratio in the entire experimental period (from 30 to 62 d) was improved in the TML group compared with the SBM group ( < 0.05). The apparent ileal digestibility coefficients of DM, OM, and CP in broilers fed the SBM diet were greater ( < 0.01) than the other group. The full digestive system in broilers fed SBM had a lower ( < 0.05) absolute and relative weight than that of broilers fed TML. Also, the weight and the percentage of the spleen in the SBM group were lower ( < 0.05) than those in the TML group. The length of the entire intestine in the group fed TML was greater ( < 0.05) than the other group and the same happened when intestinal length was expressed as percentage of broiler BW ( < 0.05). Among the different intestinal tracts, the ileum and ceca of broilers fed TML had a greater ( < 0.05) length than that of broilers fed SBM. Also, ceca weight (as an absolute value or percentage on live weight) in broilers fed TML was greater ( < 0.05) than that of broilers fed SBM. Breast pH and cooking losses in broilers fed TML were greater ( < 0.05) than those of broilers fed SBM. Chemical characteristic of meat obtained from right breast of slaughtered broilers were unaffected by dietary treatments. larvae meal can be a suitable alternative protein source for growing broilers and also when used as principal protein contributor to the diet.

Combined central and peripheral demyelination: Clinical features, diagnostic findings, and treatment.

Combined central and peripheral demyelination (CCPD) is rare, and current knowledge is based on case reports and small case series. The aim of our study was to describe the clinical features, diagnostic results, treatment and outcomes in a large cohort of patients with CCPD. Thirty-one patients entered this retrospective, observational, two-center study. In 20 patients (65%) CCPD presented, after an infection, as myeloradiculoneuropathy, encephalopathy, cranial neuropathy, length-dependent peripheral neuropathy, or pseudo-Guillain-Barré syndrome. Demyelinating features of peripheral nerve damage fulfilling European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) electrodiagnostic criteria for CIDP were found in 23 patients (74%), and spatial dissemination of demyelinating lesions on brain MRI fulfilling the 2010 McDonald criteria for multiple sclerosis (MS) in 11 (46%). Two thirds of the patients had a relapsing or progressive disease course, usually related to the appearance of new spinal cord lesions or worsening of the peripheral neuropathy, and showed unsatisfactory responses to high-dose corticosteroids and intravenous immunoglobulins. The clinical presentation of CCPD was severe in 22 patients (71%), who were left significantly disabled. Our data suggest that CCPD has heterogeneous features and shows frequent post-infectious onset, primary peripheral nervous system or central nervous system involvement, a monophasic or chronic disease course, inadequate response to treatments, and a generally poor outcome. We therefore conclude that the current diagnostic criteria for MS and CIDP may not fully encompass the spectrum of possible manifestations of CCPD, whose pathogenesis remains largely unknown.

A pilot study about the oncologic safety of colonic self-expandable metal stents (SEMS) in obstructive colon cancer: is occlusion always better than "silent" perforation?

OBJECTIVE: To evaluate the oncologic safety of colonic self-expandable metal stents (SEMS) in obstructive colon cancer. PATIENTS AND METHODS: We retrospectively reviewed all the patients who were treated with endoscopic placement of a self-expandable metallic stent (SEMS) at our institution. RESULTS: A total of 26 patients were identified during the study period, of which 24 patients (92.30%) were treated with SEMS as a bridge-to-surgery and 2 (7.69%) as palliation. In 22 cases (80.76%), the stenosis was localized to the left side. Clinical success with resolution of bowel obstructions was achieved in 22 (84.61%) patients within a short period of time. Among patients treated successfully with SEMS insertion as bridge to surgery (n = 22), 20 (90.9%) underwent one-stage surgery with primary anastomosis while 2 patients (9.09%) underwent colostomy due to intraoperative evidence of a covered perforation by cancer tissue in the pelvis. Patients with subclinical perforation developed an early peritoneal carcinomatosis, 10 patients treated with curative intent subsequently developed liver metastasis after 24 months. CONCLUSIONS: We reported an overall poor outcome among patients treated with the insertion of SEMS. This led us to think that, in some cases, occlusion may be better than a "silent" perforation.

Yellow mealworm larvae (Tenebrio molitor, L.) as a possible alternative to soybean meal in broiler diets.

The aim of the study was to evaluate the feasibility of replacing soybean meal (SBM) with Tenebrio molitor larvae (TML) meal in broiler diets. A total of 80 30-d-old male Shaver brown broilers were divided into two groups fed on two isoproteic and isoenergetic diets differing for protein source (SBM vs. TML). Up to 62 d of age, body weight and feed intake were recorded weekly and body weight gain, feed conversion ratio (FCR), protein efficiency ratio (PER) and European efficiency factor (EEF) were calculated. At 62 d, blood samples were collected from 16 birds/group for evaluation of blood profiles. Feed intake was not different between groups considering the entire period of the trial. The FCR was more favourable in the TML than SBM group from 46 d of age and in the entire period of the trial (4.13 vs. 3.62). The PER was higher in the SBM than in the TML group (1.92 vs. 1.37) while the EEF was higher in broilers fed on the TML diet (132.6 vs. 156.2). Albumin-to-globulin ratio was higher in broilers fed on SBM than in the other group (0.44 vs. 0.30). aspartate aminotransferase and alanine aminotransferase were higher in TML than SBM (195.1 vs. 178.6 U/l and 82.07 vs. 46.71 U/l, respectively). Uric acid was higher in broilers fed on SBM than TML (5.40 vs. 4.16 mg/dl). TML did not affect feed intake and growth rate of broilers from 30 to 62 d of age when compared to an isoproteic and isoenergetic SBM diet, but FCR of the TML group was more favourable than that of the SBM group. The lowest albumin-to-globulin ratio in broilers fed on TML suggests a higher immune response, probably due to the prebiotic effects of chitin.

Lymph node evaluation in gallbladder cancer: which role in the prognostic and therapeutic aspects. Update of the literature.

OBJECTIVE: The widespread use of laparoscopy has changed the outcome of gallbladder cancer as a consequence of increasing referral and incidental discovering of earlier stages cancer. Nevertheless, GBC is still associated with a poor prognosis and lymphnodal involvement is a main prognostic factor, important both for staging and for evaluating surgery quality. No consensus exists about the extension of lymphadenectomy to be performed nor about contraindications to extensive resection. A review of literature was so designed to identify the actual role, extension and limits of lymphadenectomy. MATERIALS AND METHODS: A search on Pubmed and Scopus has been performed using the following keywords: gallbladder cancer, gallbladder neoplasm, surgery, laparoscopy, lymphadenectomy to evaluate the prognostic and the therapeutic role of the lymphadenectomy in gallbladder cancer. The retrieved articles were analyzed aimed to evaluate the impact of lymphectomy and of its extension on overall and disease free survival. RESULTS:  Although no consensus still exists over the extension of ideal lymphadenectomy, some points are already clearly established: a part from T1a neoplasms, that do not require further surgery, and T1b for which a regional lymphectomy (N1) is safe and mandatory, more advanced stages require a more aggressive surgery but the fate of paraortic nodal station is still under evaluation. In fact some Authors still believe that the involvement of these nodes determine a so poor prognosis to make uselessly risky their surgical aggression. Other Authors conversely, show that there is not any difference in survival, among node positive patients, between paraortic node positive and no paraortic node positive patients. CONCLUSIONS: The prognosis of gallbladder cancer remains poor because in most patients the diagnosis is made at an advanced stage. Complete surgical resection provides the only curative treatment option in this disease. In order to improve long-term outcome, several surgeons have advocated aggressive surgical resection, including major hepatectomy, pancreatoduodenectomy and extended lymphadenectomy. Even a para-aortic nodal disease shouldn't discourage from pursuing this objective.

Laparoscopic cholecystectomy: ultrasonic energy versus monopolar electrosurgical energy.

OBJECTIVE: Nowadays, laparoscopic cholecystectomy (LC) is undoubtedly considered the "gold standard" in the surgical treatment of symptomatic gallstones, gallbladder adenomas and acute cholecystitis. Among the alternative energy sources proposed (monopolar, bipolar electric scalpel, radiofrequency sealers) with the aim to dissect and/or seal, the ultrasonic energy has been frequently adopted, however without a widespread acceptance among surgeons for routine or emergency laparoscopic cholecystectomy. This study investigates the possible beneficial aspects of ultrasonic dissection and its efficacy in the closure of the cystic artery and duct. PATIENTS AND METHODS: Patients were retrospectively divided into 2 groups according to the instruments used for division of the cystic artery and duct as well as for dissection of the liver bed: 121 patients in whom dissection and coagulation were performed using monopolar coagulation and 43 patients who were all treated with the ultrasonically activated scalpel harmonic ACE (Ethicon Endo-Surgery) as the sole instrument used in the whole procedure. RESULTS: The mean operative time, was significantly shorter in the harmonic group than in the traditional group (35.36 + 10.15 min vs. 55.6+12.10 vs. respectively; p < 0.0001). The rate of gallbladder perforation was significantly higher in the traditional group than in the harmonic group 20.66% (25 patients) vs. 6.98% (3 patients), respectively; p < 0.05). Intraoperative volume blood loss was significantly more in the traditional group than in the HS group (29.32+14.21 vs. 12.41+8.22; p < 0.0001). The mean amount of postoperative drainage was not significantly different among the two group (18.41+6.54 vs. 15.96+8.69 ml, p > 0.05). No considerable visceral injury has been recorded in either group. The postoperative parameters observed included postoperative hospital stay and morbidity for each group. The hospital stay was not significantly shorter in harmonic group (48.15+4.29 vs. 49.06+2.94 h, p > 0.05). The overall morbidity rate was 14.02 % (not significant). CONCLUSIONS: The use of the harmonic scalpel shows some statistically significant advantages limited to a few intraoperative parameters. We conclude that a wider use of harmonic scalpel not offers such advantages to make it the reference technique.

Prediction of digestible energy and gross energy digestibility of feeds and diets in ostriches.

1. The aim of this study was to assess regression equations able to predict the digestible energy (DE) and gross energy digestibility (GEd) of feed ingredients and diets for ostriches. 2. Results of chemical-nutritional characteristics from 17 ingredients (two varieties of maize, two barleys, oat, triticale, wheat bran, soybean meal, sunflower meal, beet pulp, maize silage, alfalfa hay, 4 alfalfa meals and lupin) and 12 experimental diets were used in a stepwise procedure. 3. Acid detergent lignin (ADL) was the first independent variable included in the model to predict the DE of all the samples (R(2) = 0.65 and Residual Standard Deviation (RSD) 1.02). When the concentration of ash, acid detergent fibre (ADF) and crude fibre were included in the model, the R(2) value of the regression equation increased (from 0.65 to 0.85) and RSD decreased (from 1.02 to 0.48). 4. The ADL concentration was also the first independent variable chosen by the stepwise regression analysis for the estimation of GEd from chemical-nutritional characteristics of feeds, explaining 57% of the total GEd variation. The concentrations of crude protein and ADF included at the second and third steps in the model increased the R(2) (up to 0.70 and 0.73, respectively) and decreased the RSD values (from 0.29 to 0.21 and 0.20, respectively). When other variables as crude fibre, ash and gross energy were included in the model, the coefficient of determination and the RSD strongly improved (0.85 and 0.12, respectively).

Molecular modelling of HLA-B*35:132.

Here we describe the molecular modelling of the new variant HLA-B*35:132. This allele shows one mismatch with B*35:01:01:01 in exon 3 at position 575 where a T is substituted by a C, which implies an amino acidic change from Leucine to Proline. This seems not to alter the molecular structure and not to compromise the HLA complex and T-cell receptor interaction.

Description of two new HLA-C alleles: C*08:63 and C*14:44.

Here, we present two new HLA allelic variants at C locus: HLA-C*08:63 and HLA-C*14:44 detected by sequence-based typing. In both cases, a single-nucleotide mutation in exon 3 is responsible for a change in aminoacid translation. The extremely high polymorphism of human leucocyte antigen (HLA) system in human genome is responsible for the capability to recognize different antigens, including non-self-MHC (Major Histocompatibility Complex) molecules. This very high polymorphism and the improving accuracy of genomic HLA typing methods lead to an exponential increasing of known HLA alleles. Here, we describe the characterization of two new HLA-C alleles identified by sequence-based typing (SBT): HLA-C*08:63 and HLA-C*14:44.

Effects of water restriction on growth performance, feed nutrient digestibility, carcass and meat traits of rabbits.

The study investigates the effects of a post-weaning water restriction on performance, nutrient digestibility, carcass traits and meat quality of 84-day-old rabbits. A total of 1388 weaned rabbits (35 days) were randomly divided into two groups on the basis of BW and sex. The two groups were fed the same diets ad libitum both in the post-weaning (35 to 60 days) and fattening (61 to 84 days) periods. In the post-weaning period, one group (AL) also received drinking water ad libitum, whereas the other (WR) had a water restriction from 35 to 41 days 2 h/day; from 42 to 48 days 2.5 h/day; from 49 to 55 days 3 h/day; and from 56 to 60 days 4 h/day. During the fattening period, both groups had water-free access. Individual live weights and feed intake per cage were recorded weekly for 32 cages randomly chosen per group (64 rabbits) to calculate the BW gain, feed intake and feed conversion ratio (FCR). The apparent digestibility values of nutrients were measured using acid-insoluble ash. Carcass data were collected from 16 rabbits (8 males and 8 females) per group selected for similar final BW in both groups. Mortality from 35 to 60 days was higher in the AL group (10.1% v. 5.2%, for AL and WR, respectively, P < 0.0001). BW gain was higher for the AL group during both the post-weaning (+22.4%, P < 0.01) and the entire period (+7.5%, P < 0.05). Water restriction reduced feed intake both in the post-weaning (-17.4%, P < 0.0001) and in the entire period (-9.9%, P < 0.05). During the fattening period, FCR was lower for the WR group (5.15 v. 5.75 g/g, for WR and AL, respectively, P < 0.05). The apparent digestibilities of dry matter, organic matter, NDF, ADF and cellulose were greater in the restricted rabbits (+4.7%, +4.5%, +10.2%, +18.8% and +12.8%, P < 0.01, P < 0.01, P < 0.05, P < 0.01, P < 0.05, respectively). Perirenal and scapular fat percentages were higher in the AL rabbits (+30.7% and +116.6%, P < 0.01 and P < 0.001, respectively). Water restriction increased saturated fatty acids (C16:0, +12.9%, P < 0.05), lauroleic acid (C12:1, +75.0%, P < 0.01), n-3 polyunsaturated fatty acids (C20:5, +50.0%, P < 0.01 and C22:5, +16.6%, P < 0.05) and the n-3/n-6 ratio (+28.6%, P < 0.05). The applied water restriction between 35 and 60 days executed during the winter months improved the digestive health of rabbits, with no negative effects on carcass traits, or physical and chemical meat characteristics. However, from the animal welfare point of view, a water restriction can be criticized as a method to restrict feed intake.

Dissemination metastasis after laparoscopic colorectal surgery versus conventional open surgery for colorectal cancer: a metanalysis.

PURPOSE: The purpose of this systematic review is to evaluate and compare the risk of dissemination metastasis (wound, port-side metastases and peritoneal seeding) after laparoscopic colorectal surgery and conventional open surgery for colorectal cancer. MATERIALS AND METHODS: The Authors searched relevant randomized controlled trials between January 1998 and July 2012. RESULTS: Wound, port-site metastases and peritoneal seeding were rare and no significant differences occurred between the two groups. The port-site and extraction site recurrence were likely to be the results of suboptimal surgical techniques and occurred in the early phase of the learning curve. The authors also found no significant differences in overall, local and distant recurrences. No significant differences between laparoscopic and open surgery were found in cancer-related mortality during the follow up period of the study (7 RCTs, 3525 patients, 12.8% vs. 14.00%; OR (fixed) 0.83, 95% CI 0.68-1.02), with no significant heterogeneity (p = 0.35). CONCLUSIONS: The literature supports the implementation of laparoscopic surgery into daily practice. Laparoscopic surgery can be used for safe and radical resection of cancer in the right, left, sigmoid colon and rectum. However further studies should address whether laparoscopic surgery is superior to open surgery in this setting.

Identification of two novel HLA-A alleles: A*24:199 and A*02:324.

Here, we describe two new HLA-A alleles: A*24:199 and A*02:324. The two new variants are attributed to a single nucleotide mutation namely A→C for A*24:199 and G→A for A*02:324. Both point mutations are responsible for a change in translated amino acids.

Two novel alleles at HLA-B locus identified in two volunteer bone marrow donors by sequence-based typing.

Two novel human leucocyte antigen (HLA) class I alleles have been identified in two Italian individuals. HLA-B*27:07:02 is identical to HLA-B*27:07:01 except for a nucleotide substitution at position 846 (A->G) resulting in a silent mutation. HLA-B*35:206 differs from the most similar allele, HLA-B*35:08:01, because of a single base mutation at position 149 (G->C) causing an aminoacidic change at codon 26 from Gly to Ala.