Medial incisional ventral hernia repair with Adhesix® autoadhesive mesh: descriptive study.

Nowadays, the gold standard for the surgical treatment of abdominal wall defects is the use of a mesh. There is an extensive variety of meshes, self-adhesive ones being among the most novel technologies. The literature on the self-adhesive mesh Adhesix® (Cousin Biotech Laboratory, 59117 Wervicq South, France) in medial incisional ventral hernia is scarce. We performed a retrospective descriptive study with prospective data collection from 125 patients who underwent prosthetic repair of medial incisional ventral hernia-M1-M5 classification according to European Hernia Society (EHS)-with self-adhesive mesh Adhesix® between 2013 and 2021. Follow-up was performed 1 month and yearly after the surgery. Postoperative complications and hernia recurrences were recorded. Epidemiological results were average BMI 30.5 kg/m2 (SD 5), highlighting that overweight (41.6%) and obesity type 1 (25.6%) were the most represented groups. 34 patients (27.2%) had already undergone a previous abdominal wall surgery. The epigastric-umbilical (M2-M3 EHS classification, 22.4%) and umbilical (M3 EHS classification, 20%) hernias were the predominant groups. The elective surgery technique was Rives or Rives-Stoppa with an associated supraaponeurotic mesh if the closure of the anterior aponeurosis of the rectus sheath was not surgically closed (13 patients). The most frequent postoperative complication was seroma (26.4%). The recurrence rate was 7.2%. The average follow-up length was 2.6 years (SD 1.6 years). According to the results of this study and the literature available, we consider that the self-adhesive mesh Adhesix® is an appropriate alternative mesh option for the repair of medial incisional ventral hernias.

[Features differentiating comorbidity in elderly patients with Alzheimer-type dementia or with vascular dementia]. / Aspectos diferenciales de comorbilidad en pacientes ancianos con demencia tipo Alzheimer o con demencia vascular.

INTRODUCTION: Alzheimer's disease (AD) and vascular dementia (VD) are the two most common forms of dementia. In the elderly subjects with dementia, there is a significant comorbidity associated and often cause greater morbidity and mortality. AIM: To investigate some aspects of comorbidity in the patients with these two types of dementia in order to analyze possible differences. PATIENTS AND METHODS: A total of 365 patients > 64 years old were prospectively evaluated. Of them 289 patients (79.1%) had probable AD, and 76 patients probable VD. Data were collected on sociodemographic variables, Barthel index, Lawton index), Minimental State Examination, total number of drugs, history of high blood pressure (HBP), diabetes mellitus (DM), dyslipidemia (DL), heart failure (HF), chronic obstructive pulmonary disease (COPD) and cancer. RESULTS: The sample consisted of 264 women (72.3%) and 101 men. Mean age was 81.1 +/- 6 years. Patients were taken an average of 5.5 +/- 2.5 drugs. 54% had HBP, 26.6% DM, 25.8% DL, 12.1% HF, 13.7% COPD and 8.2% cancer. When in multivariate analysis differences were analyzed according the type of dementia, we found a higher percentage of men, taken more than three drugs and lower percentage of taken specific dementia therapy in the VD group. CONCLUSIONS: Our results showed the presence of high comorbidity and chronic drugs prescription in elderly people with dementia. There are some differences according the type of dementia, highlighting a higher percentage of polypharmacy in patients with vascular dementia group.

[Medical comorbidity in elderly patients with dementia. Differences according age and gender]. / Aspectos de comorbilidad en pacientes ancianos con demencia. Diferencias por edad y género.

BACKGROUND: Prevalence of dementia in elderly patients is high. The goal of the study was to assess some aspects of comorbidity in the patients with dementia. We also analyzed comorbidity differences according to age and gender. PATIENTS AND METHODS: A total of 311 patients older than 64 years old with dementia were prospectively evaluated. Data were collected on sociodemographic endpoints, type of dementia, Barthel Index (BI), Lawton Index (LO), Mini-Mental State Examination (MMSE), Charlson Index, total number of drugs, history of high blood pressure (HT), diabetes (DM), dyslipidemia (DL), heart failure (HF), chronic obstructive pulmonary disease (COPD) and cancer. RESULTS: The sample consisted of 222 women (71.4%) and 89 men. Mean age (standard deviation [SD]) was 80.6 (6) years. Patients were taking an average of 5.8 (2.6) drugs. The mean of Charlson Index was of 2.1 (1.3). Fifty-one percent had HT, 24% DM, 24% DL, 13% HF, 11% COPD and 8% cancer. We found better scores in the MMSE, higher comorbidity and percentage of married people and prevalence of vascular dementia in men with respect to women, who had higher percentage of Alzheimer disease, and widowers. When differences were analyzed according to age, we found a higher percentage of widowers and HF diagnosis, a lower LI values and DL percentage in the patients older than 84 years with respect to younger subjects. CONCLUSIONS: Our results showed the presence of high comorbidity and chronic drugs prescription in elderly people with dementia. There are some differences in comorbidity according to age and gender that must be taken into account.

Laminin receptors in differentiated thyroid tumors: restricted expression of the 67-kilodalton laminin receptor in follicular carcinoma cells.

The expression of integrin laminin receptors was investigated in normal thyroid primary cultures; immortalized normal thyroid cells (TAD-2); papillary (NPA), follicular (WRO), and anaplastic (ARO) thyroid tumor cell lines; seven thyroid tumors (four papillary and three follicular carcinomas); and normal thyroid glands. The expression of alpha1beta1, alpha2beta1, alpha3beta1, alpha6beta1, and alpha6beta4 was found in all tumor specimens and in tumor cell lines, whereas normal thyroid cells and TAD-2 cells lacked the expression of alpha6beta4. Despite the presence of several integrin laminin receptors, adhesion of TAD-2, NPA, and ARO cells to immobilized laminin-1 was poor, whereas WRO cells and follicular carcinoma-derived cells displayed a strong adhesion. Indeed, WRO and follicular carcinoma-derived cells showed expression of a nonintegrin laminin receptor, the 67-kDa high affinity laminin receptor (67LR). TAD-2, NPA, and ARO cells as well as nodular goiter, toxic adenoma, follicular adenoma, and papillary carcinoma-derived cells did not express the 67LR. Adhesion of WRO and follicular carcinoma-derived cells to laminin-1 was specifically inhibited by a recombinant polypeptide containing laminin-binding domains of 67LR, demonstrating that this receptor confers to follicular carcinoma cells attachment capacity to laminin. Moreover, tissue specimens from follicular carcinomas expressed the 67LR, whereas follicular adenomas and normal thyroid tissues were negative. In thyroid tumors, integrin receptors, although abundant, participate weakly in adhesion to laminin. The expression in follicular carcinoma cells of a functional, high affinity 67LR together with nonfunctional integrin LM receptors could be responsible for the tendency of follicular carcinoma cells to metastasize by mediating stable contacts with basal membranes.

Intercellular adhesion molecule-1 is upregulated via the protein kinase C pathway in human thyroid carcinoma cell lines.

Nonantigen specific adhesion systems lymphocyte function-associated antigen 1/intercellular adhesion molecule (LFA-1/ICAM-1) and cluster designation 2/lymphocyte function-associated antigen 3 (CD2/LFA-3) are considered a crucial step in immune-mediated cell-cell adhesion reactions. In particular, the LFA-1/ICAM-1 system is deeply involved in major histocompatibility system (MHC)-restricted and non-MHC-restricted cellular cytotoxicity of effector cells against cancer tissues. We have investigated in human thyroid carcinoma cell lines the role of the protein kinase C (PKC) pathway on ICAM-1 expression. Incubation with tissue plasminogen activator (TPA), an agonist of PKC, of two papillary (NPA and TPC-1) and one anaplastic (ARO) carcinoma cell lines induced an ICAM-1 upregulation of both protein and mRNA production. This phenomenon was dependent on RNA and protein synthesis and was inhibited by PKC antagonists such as staurosporine and H-7. A parallel increase in the soluble form of ICAM-1 followed the upregulation of cellular ICAM-1 levels induced by TPA. In conclusion, the PKC pathway is involved in the regulation of ICAM-1 expression in human thyroid carcinoma cell lines. Further studies are necessary to clarify the effects of the PKC pathway on the diffusion of thyroid tumors.

Pseudotumor cerebri: an unusual complication of brachiocephalic vein thrombosis associated with hemodialysis catheters.

We report a case of pseudotumor cerebri (PC) in a maintenance hemodialysis patient that was associated with thrombosis of the right and left brachiocephalic veins caused by repeated subclavian and jugular vein catheterizations. Symptoms and signs of PC appeared when a right forearm Gortex graft was inserted. PC secondary to intracranial venous outflow obstruction is an important diagnostic consideration for hemodialysis patients with headache, visual disturbance, and papilledema.

Retinoic acid induces intercellular adhesion molecule-1 hyperexpression in human thyroid carcinoma cell lines.

The expression of intercellular adhesion molecule-1 (ICAM-1) in tumoral tissues may promote their interaction with the immune system and cytotoxic effect on tumoral cells. This observation led to the investigation of ICAM-1 expression and modulation in different tumoral cell systems in vitro. Recently, retinoic acid-responsive elements have been found in the 5'-regulatory region of the human ICAM-1 gene. In the present study, we investigated, by flow cytometry, the effect of retinoic acid on the surface expression of ICAM-1 in human thyroid carcinoma cell lines. Two papillary (NPA and TPC-1), one follicular (WRO), one anaplastic (ARO) and one immortalized fetal (TAD-2) cell line have been studied. All of them produced constitutively ICAM-1; its surface expression and specific messenger ribonucleic acid (mRNA) levels were increased significantly by retinoic acid in all except the WRO cell line. ICAM-1 hyperexpression by retinoic acid was time dependent, reversible, and dependent on mRNA and protein synthesis. Furthermore, cytokines, such as interferon-gamma and tumor necrosis factor-alpha, both individually and, to a greater extent, in combination with retinoic acid, increased ICAM-1 surface expression and its mRNA levels. In conclusion, retinoic acid is able to induce ICAM-1 up-regulation via mRNA accumulation in human thyroid carcinoma cell lines.