Correction to: Dexketoprofen/tramadol 25 mg/75 mg: randomised double-blind trial in moderate-to-severe acute pain after abdominal hysterectomy.

CORRECTION: Following publication of the original article [1], the authors reported that additional file 10 contained a typing error in the table "Percentage of responders (≥50% max TOTPAR) over two, four, six and eight hours (single-dose phase) (ITT Population)". The table is to be read as follows.

Dexketoprofen/tramadol 25 mg/75 mg: randomised double-blind trial in moderate-to-severe acute pain after abdominal hysterectomy.

BACKGROUND: Dexketoprofen trometamol plus tramadol hydrochloride is a new oral combination of two analgesics, which have different mechanisms of action for the treatment of moderate to severe acute pain. METHODS: Randomised, double-blind, parallel, placebo and active-controlled, single and multiple-dose study to evaluate the analgesic efficacy and safety of dexketoprofen/tramadol 25 mg/75 mg in comparison with the single agents (dexketoprofen 25 mg and tramadol 100 mg) in moderate to severe acute pain after abdominal hysterectomy. Patients received seven consecutive doses of study drug within a 3-day period, each dose separated by an 8-hour interval. A placebo arm was included during the single-dose phase to validate the pain model. Efficacy assessments included pain intensity, pain relief, patient global evaluation and use of rescue medication. The primary endpoint was the mean sum of pain intensity differences over the first 8 h (SPID8). RESULTS: The efficacy analysis included 606 patients, with a mean age of 48 years (range 25-73). The study results confirmed the superiority of the combination over the single agents in terms of the primary endpoint (p <0.001). Secondary endpoints were generally supportive of the superiority of the combination for both single and multiple doses. Most common adverse drug reactions (ADRs) were nausea (4.6%) and vomiting (2.3%). All other ADRs were experienced by less than 2% of patients. CONCLUSIONS: The study results provided robust evidence of the superiority of dexketoprofen/tramadol 25 mg/75 mg over the single components in the management of moderate to severe acute pain, as confirmed by the single-dose efficacy, repeated-dose sustained effect and good safety profile observed. TRIAL REGISTRATION: EU Clinical Trials Register (EudraCT number 2012-004545-32, registered 04 October 2012); Clinicaltrials.gov ( NCT01904149, registered 17 July 2013).

Prehepatocholedochal proper hepatic artery. Rare anatomical variant. Surgical considerations. Case report.

In classical anatomic variants, the proper hepatic artery (PHA)continues the common hepatic artery (CHA) after the gastroduodenal artery (GDA) detaches itself and divides into the right hepatic artery (RHA) and left hepatic artery (LHA), the proper hepatic artery being located to the left of the hepatocholedochal duct (HCD). This paper presents an abnormal positioning of the PHA placed before the HCD with an increased diameter of about 5-7 mm, which could be confused with the HCD. We present the case of a 57 year-old woman diagnosed with acute lithiasic cholecystitis, associated with hypersplenism and hypertension. The literature mentions manifold anatomical variants of arterial liver vascularization,including PHA. For this reason, this paper presents an overview of similar cases that can be found in medical literature. The aforementioned case is a rare topographic anatomy for the PHA that can easily pass for HCD especially during celioscopy, therefore it is crucial for this to be acknowledged by all surgeons.

A rare case of acute abdomen: Garengeot hernia.

The association of acute appendicitis with femoral hernia,strangulated or incarcerated, represents a rare but well documented pathology in the specialized medical literature,also known as Garengeot hernia. The development of an acute appendicitis in the femoral hernia sac becomes a surgical emergency of acute abdomen. The diagnosis is always mistaken for the one of incarcerated or strangled hernia, the correct diagnosis being established intraoperatively, occasion which exposes the cecal appendix by opening the herniary bag, found in different morphological stages of inflammation that can go as far as gangrene or even perforation. In this paper, we have reported the case of a 76 year-old female that presented with femoral tumours, incarcerated, painful and initially considered as an incarcerated femoral hernia, the final diagnosis being made intraoperatively. The treatment for these "hernias" is generally simple, when there are no complications of acute appendicitis as the presence of pus in the hernia sac, and consists in appendectomy and herniorrhaphy. The absence of symptoms for an acute appendicitis often delays the surgery which leads to frequent complications and increased rate of morbidity.

Multiple benign symmetric lipomatosis -- a differential diagnosis of obesity.

Benign symmetrical lipomatosis (BSL), or Madelung's disease, is a rare disease characterized by the progressive growth of diffuse, painless, non-enveloped symmetric lipomas. The etiology of this disease remains unknown, although it was associated in the medical literature with alcohol and nicotine abuse, metabolic disorders and a number of malignancies. It is assumed that there is a genetic predisposition for this affliction. The management in such cases is surgical removal of the lipomas, most times in several sessions, but this is often followed by relapse. However, surgical removal of the lipomas can provide satisfactory patient functionality and cosmetic results. The differential diagnosis is made with morbid obesity, Cushing syndrome, angiolipomatosis, encapsulated lipomas, neurofibromatosis, myxoid liposarcoma, lymphoma, salivary gland disease, Frolich and lipomatosis syndrome in patients infected with HIV. The current paper reports the case of a 55 year-old man, who presented with several large lipomatous masses, arranged symmetrically on the front and back of the trunk, and several smaller lipomas in the upper and lower limbs. Treatment consisted of resection of these lipomas in several sessions, without recurrence at one year after the last operation.

The effects of Sambucus nigrapolyphenols on oxidative stress and metabolic disorders in experimental diabetes mellitus

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The paper focuses on certain natural polyphenolic extracts from common elder fruit (Sambucus nigra), and also on their effects in diabetes mellitus. The results reveal that the glycosylated hemoglobin values are much higher in the diabetic group and they are significantly lower in the group protected by polyphenols. The natural polyphenol compounds reduce the lipids peroxides, neutralize the lipid peroxil radicals and inhibit the LDL oxidation. Following the perturbation of the lipid metabolism in the diabetic rats, atherogen risk has significantly increased values in comparison to the rats from the witness groups. It is found that due to the polyphenolic protection of the rats from the diabetic group treated with polyphenols, the atherogen risk is preserved at normal limits. The serum activity of glutathione-peroxidase and superoxide-dismutase has significantly lower values in the diabetic group as compared to the group protected by polyphenols. Through the hypoglycemiant, hypolipemiant and antioxidant effects,Sambucus nigra represents a possible dietary adjunct for the treatment of diabetes and a potential source for the discovery of new orally active agent(s) for future diabetes therapy. Understanding the mechanism through which the natural polyphenols have effects on the functionality of the endothelium cells, including on the membrane sensitivity and intracellular signalling, could represent a new way of therapeutically approaching chronic metabolic diseases and cardiovascular illnesses (AU)

The effects of Sambucus nigra polyphenols on oxidative stress and metabolic disorders in experimental diabetes mellitus.

The paper focuses on certain natural polyphenolic extracts from common elder fruit (Sambucus nigra), and also on their effects in diabetes mellitus. The results reveal that the glycosylated hemoglobin values are much higher in the diabetic group and they are significantly lower in the group protected by polyphenols. The natural polyphenol compounds reduce the lipids peroxides, neutralize the lipid peroxil radicals and inhibit the LDL oxidation. Following the perturbation of the lipid metabolism in the diabetic rats, atherogen risk has significantly increased values in comparison to the rats from the witness groups. It is found that due to the polyphenolic protection of the rats from the diabetic group treated with polyphenols, the atherogen risk is preserved at normal limits. The serum activity of glutathione-peroxidase and superoxide-dismutase has significantly lower values in the diabetic group as compared to the group protected by polyphenols. Through the hypoglycemiant, hypolipemiant and antioxidant effects,Sambucus nigra represents a possible dietary adjunct for the treatment of diabetes and a potential source for the discovery of new orally active agent(s) for future diabetes therapy. Understanding the mechanism through which the natural polyphenols have effects on the functionality of the endothelium cells, including on the membrane sensitivity and intracellular signalling, could represent a new way of therapeutically approaching chronic metabolic diseases and cardiovascular illnesses.