Minerva medica
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Meta Analysis
Combined resection for hepatocellular carcinoma with diaphragmatic invasion: a systematic review and meta-analysis.
According to the Staging System of Barcelona Clinic Liver Cancer (BCLC), diaphragmatic invasion (DI) is generally considered to be a manifestation of advanced hepatocellular carcinoma (HCC) with nearly no cure. However, some studies have indicated that combined liver and diaphragmatic resection may be a reasonably safe treatment option for HCC patients with diaphragmatic invasion. In this article, we conduct a systematic review to compare the short- and long-term surgical outcomes between HCC patients without diaphragmatic involvement who underwent hepatectomy alone and HCC patients with diaphragmatic involvement who underwent combined liver and diaphragmatic resection. ⋯ For HCC patients with diaphragmatic involvement, combined liver and diaphragmatic resection might be considered no matter whether its diaphragmatic invasion or not.
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Acute liver failure (ALF) is a rare but often lethal syndrome. In Italy, recent data on its incidence and causes are lacking. We report here the epidemiological analysis of ALF cases observed in Campania, a Southern Italian region, over the last 25 years. ⋯ A decrease in ALF incidence and a changing in its etiology were observed in Campania during 1992-2018. Both results were likely mainly due to 1991 introduction of HBV universal vaccination and may be considered generalizable nationwide.
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Review Comparative Study
Critical review on the use and abuse of alcohol. When the dose makes the difference.
Nowadays harmful alcohol consumption represents one of the most important risk factors for the development of several type of chronic and acute diseases in the western countries, contributing to a great number of deaths. Focusing the attention on cancer development and progression, the scientific community has a large consensus in declaring the existence of a harmful association between alcohol consumption and liver, breast, upper aerodigestive tract (mouth, oropharynx, hypopharynx, and esophagus), pancreas and colon cancer appearance. ⋯ In this review, we examine the relationship between alcohol dosage and associated diseases, with focus on alcohol-related cancers. Furthermore, to understand the potential molecular mechanisms of these diseases, the results of in vivo experiments on animal models were discussed.
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To date, the European experience with COVID-19 mortality has been different to that observed in China and Asia. We aimed to forecast mortality trends in the 27 countries of the European Union (EU), plus Switzerland and the UK, where lockdown dates and confinement interventions have been heterogeneous, and to explore its determinants. ⋯ The European experience confirms that early, effective interventions of lockdown are fundamental to minimizing the COVID-19 death toll.
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Currently, there are no approved specific antiviral agents for novel coronavirus disease (COVID-19). Hyper-immune/convalescent plasma derived from recently recovered donors seems to be useful to treat COVID-19 patients, an addition to maximal supportive care and antiviral agents. ⋯ However, the efficacy of hyper-immune/convalescent plasma treatment for severe infectious diseases is still controversial. The optimal dose and time point, as well as the clinical benefit of hyper-immune/convalescent plasma therapy, needs further investigation in larger well-controlled trials.