American journal of surgery
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This study examined whether alpha lipoic acid (ALA), an antioxidant with anti-apoptotic properties, synthesized in mitochondria of endothelial cells, would inhibit intrinsic apoptotic signaling and microvascular endothelial cell hyperpermeability. ⋯ These findings suggest that ALA attenuates BAK-induced monolayer hyperpermeability through the inhibition of ROS formation and intrinsic apoptotic signaling.
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Previous studies have explored the effect of fatigue on general psychomotor proficiency. However, studies specifically addressing the effect of fatigue on surgical residents' cognitive skills during simulated surgical exercises are lacking. ⋯ Fatigue and sleep deprivation cause a significant deterioration in the surgical residents' cognitive skills as measured by virtual reality simulation. Psychomotor skills are also negatively impacted during tasks that require a combination of psychomotor and cognitive skills.
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Laparoscopic excision of rectal tumors has gained favor in the last decade and several issues have reported encouraging results: still, the use of laparoscopy remains open to debate. The aim of the current study is to assess the reliability of laparoscopic anterior resection (LAR) for rectal cancer analyzing short-term outcomes and long-term survival. ⋯ The outcomes of this study suggest that LAR for rectal cancer is a reliable procedure. Oncologic requirements were respected; parameters such as length of specimen, distal margin, and number of nodes retrieved were quite acceptable. Incidences of local recurrence and long-term survival were comparable with those of other series.
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Review Comparative Study
Endarterectomy or carotid artery stenting: the quest continues.
Carotid endarterectomy (CEA) is still considered the "gold-standard" of the treatment of patients with significant carotid stenosis and has proven its value during past decades. However, endovascular techniques have recently been evolving. Carotid artery stenting (CAS) is challenging CEA for the best treatment in patients with carotid stenosis. This review presents the development of CAS according to early reports, results of recent randomized trials, and future perspectives regarding CAS. ⋯ CAS performed with or without embolic-protection devices can be an effective treatment for patients with carotid artery stenosis. However, presently there is no evidence that CAS provides better results in the prevention of stroke compared with CEA.
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Comparative Study
Patterns of care analysis among women with ductal carcinoma in situ in North Carolina.
Ductal carcinoma in situ (DCIS) of the breast comprises approximately 25% of new breast cancer cases. The aim of this study was to delineate patterns of care for women with DCIS as related to age, tumor characteristics, and race/ethnicity. Further study goals included the identification of predictors of breast-conserving surgery (BCS), adjuvant radiation, and/or hormonal therapy, as well as breast reconstruction after mastectomy. ⋯ Treatment strategies for primary surgical therapy for DCIS vary significantly by age. Inconsistencies exist surrounding the use of adjuvant radiation therapy after BCS in women with DCIS. Variations in approaches to reconstructive surgery after mastectomy may be related to age, ethnicity, and/or economic constraints.