Rosemary and neem: an insight into their combined anti-dandruff and anti-hair loss efficacy.

Dandruff, a common scalp disorder characterized by flaking dead skin, is often treated with conventional topical products. However, limitations exist due to potential side effects and high costs. Therefore, searching for natural, cost-effective solutions for dandruff and hair loss is crucial. Rosemary herb and neem tree, both cultivated in Egypt, possess well-documented anti-inflammatory properties derived from their rich phenolic phytoconstituents. This study formulated a standardized combined extract of rosemary and neem (RN-E 2:1) into hair gel and leave-in tonic formats. This extract demonstrated superior efficacy against Malassezia furfur (a causative agent of dandruff) and Trichophyton rubrum (associated with scalp disorders) compared to the conventional antifungal agent, ketoconazole. The combined extract (RN-E 2:1) also exhibited potent anti-inflammatory activity. Additionally, the suppression of iNOS expression is considered concentration-dependent. Quality control verified formulation stability, and ex-vivo studies confirmed effective ingredient penetration into the epidermis, the primary site of fungal presence. Remarkably, both formulations outperformed the standard treatment, minoxidil in hair growth trials. These findings highlight the potential of natural extracts for scalp and hair health.

[Extrahepatic and extrapulmonary hydatidosis]. / Hidatidosis extrahepática y extrapulmonar.

BACKGROUND: Cystic echinococcosis is a zoonosis caused by larvae of the parasite Echinococcus that is endemic in many countries of the Mediterranean area. It can affect any organ, with the most common sites being liver (70%) and lung (20%). Splenic hydatid disease, despite being rare, is the third most common location. Other locations such as bone, skin, or kidney are exceptional. OBJECTIVE: To present our experience in extrahepatic and extrapulmonary hydatidosis. MATERIAL AND METHODS: Period: May 2007-December 2014. Health area: 251,000 inhabitants. During that period, a total of 136 patients with hydatid disease were evaluated in our Hepato-pancreatic-biliary Surgery Unit. Extrahepatic and extrapulmonary hydatid disease was found in 18 (13%) patients. A retrospective review was performed on all medical records, laboratory results, serology, diagnostic methods, and therapeutic measurements of all patients. An abdominal ultrasound and CT, as well as hydatid serology was also performed on all patients. RESULTS: The mean age of the patients was 44.5 years, with a range of 33-80 years. Half the patients (50%) had concomitant hepatic echinococcosis. Of the 18 patients with hydatid disease, 13 underwent surgery (radical surgery in 12 cases), and one underwent (endoscopic retrograde cholangiopancreatography)+puncture, aspiration, injection and re-aspiration. The remaining 4did not have surgery due to patient refusal (3), or advanced cancer (1). No recurrences have been observed. CONCLUSION: The best surgical treatment in these cases is closed total cystectomy to prevent recurrence, except in the spleen where splenectomy is preferred. Conservative techniques are indicated in cases of multiple hydatid disease and in patients with high surgical risk.

Hiperplasia nodular regenerativa hepática múltiple asociada a oxaliplatino / Regenerative multiple hepatic nodular hyperplasia associated with oxalyplati

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Remodeling of Noncrosslinked Acellular Dermal Matrices in a Rabbit Model of Ventral Hernia Repair.

BACKGROUND: Bioprostheses represent a significant advance in the abdominal wall reconstruction since they become degraded until their complete elimination in the recipient organism. This study examines remodeling in the host of three noncrosslinked porcine dermal collagen biomeshes: Strattice™ (St; LifeCell Corp.), XCM Biologic® Tissue Matrix (XCM; Synthes CMF) and Protexa® (Pr; Deco Med S.R.L.). METHODS: Partial ventral hernia defects created in New Zealand White rabbits were repaired using the biomeshes that were placed in an inlay, preperitoneal position. At 14 and 90 days after implantation, explants were assessed in terms of their host tissue incorporation by morphological studies, collagen gene/protein expression (quantitative real-time PCR/immunofluorescence), macrophage response (immunohistochemistry) and biomechanical strength. RESULTS: There were no cases of mortality or infection. Among our macroscopic findings, the mesh detachment detected in one third of the Pr implants at 90 days was of note. The host tissue response to all the biomeshes was similar at both time points, with a tendency observed for their encapsulation. There were no appreciable signs of mesh degradation. The extent of host tissue infiltration and collagenization was greater for St and Pr than for XCM. Macrophages were observed in zones of inflammation and tissue infiltration inside the mesh. XCM showed a greater macrophage response at 90 days (p < 0.05). Improved tensile strength was observed for St (p < 0.05) over Pr and unrepaired defects. CONCLUSIONS: St showed the best behavior, featuring good collagenization and tensile strength while also inducing a minimal foreign body reaction.

Punción, aspiración, instilación y re-aspiración en casos complejos de hidatidosis hepática / PAIR for complex hepatic hydatid disease

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Primer tiempo laparoscópico en una cirugía hepática en 2 tiempos / Laparoscopic first stage in a two-stage hepatectomy

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Wrapping in pancreatic surgery: a systematic review.

BACKGROUND: Wrapping in pancreatic surgery involves the use of the omentum or falciform ligament (FL) to wrap the local retroperitoneal vessels, the pancreatojejunal anastomosis or the pancreatic section of distal pancreatectomy. However, there is no clear evidence that wrapping in fact provides benefits. We have performed a systematic review of the literature about this topic. METHODS: We conducted a literature search in the PubMed/MEDLINE database (1966-2012) for any language using various combinations of the following terms: wrapping, omental, omentum, pancreas, pancreatoduodenectomy and falciform ligament. RESULTS: We selected 12 articles. Among five series that included a control group, only one obtained a statistically significant reduction in pancreatic fistula (PF) in the wrapping group and other series showed a lower percentage of post-operative haemorrhage in the wrapping group. In the seven series without control groups, a slight decrease in the rate of post-operative bleeding and PF was observed. CONCLUSIONS: On the basis of the literature available at present, we cannot recommend the use of wrapping with omentum and/or FL in pancreatic surgery. Prospective randomized studies applying a systematic wrapping technique are needed in order to establish whether its use should be generalized.

Ruta de reconstrucción gastroentérica tras duodenopancreatectomía: antecólica versus retrocólica / Gastroenteric reconstruction route after pancreaticoduodenectomy: antecolic versus retrocolic

Resumen: El retraso del vaciamiento gástrico (RVG) es una complicación relativamente frecuente tras duodenopancreatectomía cefálica (DPC). Su etiología no está aclarada y se considera que múltiples factores están relacionados con su aparición (hormonales, aparición de otras complicaciones especialmente la fístula pancreática, y de técnica quirúrgica). Entre los aspectos técnicos relacionados con el RVG se ha postulado que la ruta de reconstrucción gastroentérica (antecólica o retrocólica) pudiera modificar la incidencia de RVG. Material y métodos Hemos realizado una revisión sistemática de la literatura de los artículos que comparan ambas rutas de reconstrucción tras DPC, encontrando solo 11 artículos: 4 ensayos clínicos aleatorizados, un estudio prospectivo y 6 estudios retrospectivos. Las grandes diferencias metodológicas entre ellos no nos han permitido realizar un metaanálisis. Resultados En los 4 estudios aleatorizados, 2 son favorables a la ruta antecólica y 2 no observan diferencias entre ambas. En el único estudio prospectivo, la ruta antecólica obtiene una tasa de RVG muy inferior a la retrocólica. En los estudios retrospectivos, en 4 de ellos la ruta antecólica obtiene una tasa de RVG muy inferior. En otros 2 estudios retrospectivos, los resultados entre ambas rutas son similares, en uno de ellos levemente mejores en la ruta retrocólica. Conclusiones La literatura publicada no permite actualmente determinar que la ruta de reconstrucción gastroentérica se relacione con un menor RVG tras DPC (AU)

Introduction: Delayed gastric emptying (DGE) is a relatively common complication after cephalic pancreaticoduodenectomy (CPD). Its origin is not very clear, and it is believed that its appearance is due to multiple factors (hormones, appearance of other complications, particularly pancreatic fistulas, and the surgical technique). Among the technical aspects associated with DGE, it has been proposed that the route of gastroenteric reconstruction (antecolic or retrocolic) could have an effect on its incidence. Material and methods: A systemic review was made of the literature, searching for articles that compared both reconstruction routes after CPD, finding only 11 (..) (AU)

[Gastroenteric reconstruction route after pancreaticoduodenectomy: antecolic versus retrocolic]. / Ruta de reconstrucción gastroentérica trasduodenopancreatectomía: antecólica versus retrocólica.

INTRODUCTION: Delayed gastric emptying (DGE) is a relatively common complication after cephalic pancreaticoduodenectomy (CPD). Its origin is not very clear, and it is believed that its appearance is due to multiple factors (hormones, appearance of other complications, particularly pancreatic fistulas, and the surgical technique). Among the technical aspects associated with DGE, it has been proposed that the route of gastroenteric reconstruction (antecolic or retrocolic) could have an effect on its incidence. MATERIAL AND METHODS: A systemic review was made of the literature, searching for articles that compared both reconstruction routes after CPD, finding only 11 articles: 4 randomised clinical trials, one prospective study, and 6 retrospective studies. A meta-analysis could not be performed on them, due to the large methodological differences between them. RESULTS: In the 4 randomised studies, 2 were in favour of the antecolic route, and 2 did not observe any differences between either of them. The antecolic route obtained a much lower DGE rate than the retrocolic one in the only prospective study. In 4 of the retrospective studies the antecolic route obtained a very low rate. The results of both routes were similar in another 2 retrospective studies, with the retrocolic route slightly better in one of them. CONCLUSIONS: Using the published literature, the gastric reconstruction route associated with less DGE after CPD cannot currently be determined.

Frank intrabiliary rupture in liver hydatidosis located in the hilar plate: a surgical challenge.

BACKGROUND: Frank intrabiliary rupture (FIR) is a severe complication that occurs in around 30% of patients with liver hydatidosis. When FIR is present, the contents of the cyst may pass into the common bile duct and cause a variety of complications. If the FIR is located in the hilar confluence, surgical repair is a challenge. Currently there are no data regarding its optimum treatment. MATERIAL AND METHODS: Between May 2007 and December 2012, we treated 59 patients with liver hydatidosis. Four patients, all women, with a mean age of 51.7 years, had hydatid cysts located between segments IVb and V and FIR affecting the hilar plate. In 3 cases, the initial clinical condition was obstructive jaundice. The fourth patient presented recurrence after having undergone two operations as a child. RESULTS: In each patient a major hepatectomy was performed with hilar plate reconstruction (3 left and 1 right). Morbidity included mild biliary fistula (1 patient) and abdominal collection resolved by percutaneous drainage (1 patient). There was no mortality. During follow-up (47 months), no recurrences of the disease or biliary strictures were recorded. CONCLUSIONS: FIR is a severe complication of liver hydatidosis. When it is located in the hilar confluence, liver resection may be the best surgical option for definitive resolution of the problem.

Retroperitoneal abscess due to dropped gallstones after laparoscopic cholecystectomy.

Complications of dropped gallstones after laparoscopic cholecystectomy are infrequent but retroperitoneal abscess is extremely rare. We present a new case, discuss causes, diagnostic methods, preventive measures and therapeutical options.

Bilateral very large calcium oxalate stones in the seminal vesicles: case report and literature review.

A 29-year-old man with hypospadias and bilateral undescended testicles presented with recurrent attacks of lower urinary tract infections and painful ejaculation. He was diagnosed to have very large bilateral seminal vesicle stones. The pelvis X-ray showed two radio-densities located in the pelvis with symmetrical appearance while Ultrasound showed them as echogenic structures with posterior acoustic shadowing. In magnetic resonance imaging (MRI) of the pelvis they appeared hypointense in both T1-weighted and T2-weighted images while pelvic computed tomography scan (CT scan) showed bilateral huge stones in the seminal vesicles. The stones were extracted by open surgery through the bladder after transurethral excision of the ejaculatory ducts. Here, we report the first case of bilateral, large, heart-shaped, calcium oxalate monohydrate of seminal vesicle caliculi with brief literature review.