Laparoscopic resection of uncinate process of the pancreas

Solid pseudopapillary neoplasm of the pancreas is an uncommon but distinctive pancreatic neoplasm with low metastatic potential [1]. Therefore, whenever feasible, an organ-preserving operation should be performed. As previously reported, women with solid pseudopapillary neoplasm of the pancreas may be best treated by more conservative procedures [2]. Recently, laparoscopic pancreatic resections became more common and are being performed in highly specialized centers. There are only six cases of laparoscopic resection for solid pseudopapillary neoplasm of pancreas published in the English literature and, to our knowledge, laparoscopic resection of uncinate process of the pancreas has never been reported [3-6]. This video demonstrates the technical aspects of a totally laparoscopic resection of the uncinate process of the pancreas in a patient with solid pseudopapillary neoplasm. A 26-year-old woman with a 4-cm solid pseudopapillary pancreatic neoplasm was referred for surgical treatment. According to preoperative echoendoscopy, there was a safe margin between neoplasm and main pancreatic duct. The patient was placed in supine position with the surgeon standing between her legs. Four trocars, one 10-mm and three 5-mm, were used. At inspection, the inferior vena cava, transverse colon, duodenum, and pancreas are clearly identified. A Kocher maneuver was performed with complete exposure of pancreatic head and uncinate process. The uncinate process was dissected from the superior mesenteric vein and venous branches were divided between metallic clips or by use of laparoscopic coagulation shears (LCS; Ethicon Endo Surgery Industries, Cincinnati, OH, USA). Blood supply of the duodenum was preserved by ligature of small pancreatic branches from inferior pancreatoduodenal artery. Transection of pancreatic parenchyma was performed using laparoscopic coagulation shears, which is an effective tool for cutting the pancreas [7, 8]. Surgical specimen was removed through a suprapubic incision inside a retrieval bag. A hemostatic absorbable tissue (Surgicel; Ethicon Inc., Cincinnati, OH) was placed in the cutting pancreatic surface, and one round 19F Blake abdominal drain (Ethicon) was left in place. Operative time was 180 minutes and blood loss estimated in 40 ml with no blood transfusion. Hospital stay was 4 days. The patient did not have postoperative pancreatitis or pancreatic leakage, and the abdominal drain was removed on the tenth postoperative day. Final pathology confirmed the diagnosis of solid pseudopapillary neoplasm of pancreas with free surgical margins. The patient was well and asymptomatic 2 months after the procedure. Laparoscopic resection of uncinate process of the pancreas is safe and feasible and should be considered for patients suffering from pancreatic neoplasms.

Anti-pneumoscystis carinni activitiy of primaquine imidazolidin-4-ones

Pneumocystis pneumonia (PCP) is one of the most frequent causes of mortality among HIV-infected patients. Primaquine (PQ) is an antimalarial 8-aminoquinoline effective against PCP when given in combination with clindamycin. This has drawn the attention of Medicinal Chemists towards the anti-PCP activity of 8-aminoquinolines, not only confined to those exhibiting antimalarial activity [1]. It is thought that anti-PCP 8-aminoquinolines exert their anti-PCP activity by acting on the electronic transport and redox system of the P. carinii pathogen [1]. Recently, our research group has been developing imidazolidin-4-one derivatives of PQ (Scheme 1), targeting novel compounds with improved therapeutic action, namely, higher resistance to metabolic inactivation, lower toxicity and equal or higher antimalarial activity than that of the parent drug [2,3]. These imidazolidin-4-ones were seen to block the transmission of rodent malaria, caused by Plasmodium berghei on BalbC mice, to the mosquito vector Anopheles stephensi [3]. The anti-PCP activity of our PQ derivatives is now under study and preliminary in vitro assays [4] show that some of the compounds exhibit slight to moderate activity after a 72 h incubation period against P. carinii. In one case, the IC50 was comparable to that of parent PQ. Both these studies and forthcoming results from ongoing biological assays will be presented and discussed.

Occurrence of Cryptosporidium oocysts and Giardia cysts in raw water from the Atibaia river, Campinas, Brazil

Cryptosporidium parvum and Giardia duodenalis are waterborne parasites that have caused several outbreaks of gastrointestinal disease associated with drinking water. Due to the lack of studies about the occurrence of these protozoa in water in the Southeast of Brazil, an investigation was conducted to verify the presence of cysts and oocysts in superficial raw water of the Atibaia River. The water samples were submitted to membrane filtration (3.0 mum) and elution was processed by (1) scraping and rinsing of membrane (RM method) and (2) acetone-dissolution (ADM method). Microbiologic and chemical parameters were analyzed. Aliquots of the pellets were examined by immunofluorescence (Merifluor, Meridian Diagnostics, Cincinnati, Ohio). All water samples were positive for Cryptosporidium and Giardia, in spite of the high turbidity. Higher recovery rates occurred in samples treated by the RM method than by the ADM technique. The goal for future work is the assessment of viability of cysts and oocysts to determine the public health significance of this finding.

Os romances juvenis de A��lvaro Magalha��es

With his works translated in countries such as Spain, France and Brazil, ��lvaro Magalh��es is not only one of the great writers of Portuguese and Lusophone juvenile fiction, but also one of the most prominent names in European and world literature. Through the various thematic and narrative resources that he employs in the creation of a unique language, among the multiple and unusual senses of serious and humorous, among the elements of various domains of knowledge and universal culture that he invokes and contrasts, this author has a unique place in universe of novels aimed primarily at young readers.

Toxoplasmose humana: meningoencefalomielite toxoplasmica: ocorr��ncia em adulto e recemnascido

Desde 1914, com o trabalho inicial de Castellani, pesquisadores de diversos pa��ses teem assinado o encontro de toxoplasmose humana, o que foi at�� recentemente objeto de controv��rsias. Como resultado dos trabalhos de Torres, Levaditi & coL, Wolf, Cowen & Paige, Pinkerton & Henderson e Sabin, a quest��o do parasitismo do homem por Toxoplasma, deve ser encarada considerando-se que teem sido descritos casos duvidosos e casos n��o duvidosos: a) Duvidosos, s��o os casos referidos por Castellani (Ceil��o, 1914); Fedorovitch (Mar Negro, 1916); Chalmers & Kamar (Sud��o, 1920); e Bland (Londres, 1930-31). b) N��o duvidosos s��o os relatados por Janku (Praga, 1923); Torres, (Rio de Janeiro, 1927); Wolf & Cowen (New-York, 1937); Richter (Chicago, 1936: diagn��sticado por Wolf & Cowen em 1938); Wolf, Cowen & Paige (New-York, 1939); Hertig (Massachusetts, 1935: diagn��sticado por Pinkerton & Weinman em 1940); Pinkerton & Weinman (Lima-Peru, 1940); Sabin (dois casos, Cincinnati, 1941); Pinkerton & Henderson (dois casos, St. Louis, 1941); Paige, Cowen & Wolf (tr��s casos, New-York, 1942); e De Lange (Amsterdam, 1929: diagn��sticado por Paige, Cowen & Wolf em 1942). Destes relatos considerados como casos n��o duvidosos de toxoplasmose humana, 10 representam uma doen��a cong��nita (Torres e Paige, Wolf & Cowen) ocorrendo em crian��as recemnascidas ou de poucos meses de vida. Como nas vezes em que foi possivel examinar as m��es dessas crian��as tratava-se de mulheres com aspecto sadio, concluiu-se que a mol��stia, embora sumamente grave e mortal, pode apresentar uma forma inaparente. Em dois casos, provas de soro prote����o demonstraram essa infec����o materna inaparente, pelo encontro de anticorpos neutralizantes para Toxoplasma (Paige, Cowen & Wolf). Nada obstante n��o ter sido feito um estudo microsc��pico detalhado em todos os casos, a doen��a caracteriza-se por uma meningoence falomielite granulomatosa (Wolf & Cowen), associada frequentemente �� miocardite e corioretinite. Os sintomas apresentados pelos pacientes, foram: febre, convuls��es, dist��rbios respirat��rios, hidrocefalia, cianose, v��mitos, labidade de temperatura, etc., sendo sinal diagn��stico de m��xima import��ncia, o encontro de focos de calcifica����o cerebral profunda e corioretinite em recem nascido (Dyke, Wolf, Cowen, Paige & Caffey) . Em dois casos de toxoplasmose verificados em pacientes de seis e oito anos respectivamente, foi encontrada uma encefalite clinicamente at��pica, sendo que um deles sarou (Sabin). Os tr��s casos restantes foram descritos em adultos; num deles as les��es n��o eram t��picas (havia concomit��ncia de infec����o por Bartonella bacilliformis) e nos outros dois, a doen��a assumiu uma "forma exantem��tica", simulando as febres maculosas (Pinkerton & Henderson), sendo o achado mais importante microscopicamente, uma pneumonia intersticial. Alem da semelhan��a cl��nica, tambem os focos de encefalite encontrados nessa "forma exantem��tica" da toxoplasmose, s��o semelhantes aos descritos nas...

LSI-R Scores: Change Matters, Data Download, Iowa Department of Corrections, April 2009

Past studies have shown the LSI-R risk assessment tool to be accurate in assessing the risk level of Iowa offenders. A more recent study, conducted by the University of Cincinnati, showed that a reduction in the LSI-R score over time results in a lower risk that an Iowa offender will reoffend.

Moving On Moves Recidivism Rates Lower, Data Download, Iowa Department of Corrections, October 2009

The results of a recently conducted evaluation show that a gender-responsive program for women probationers holds promise in significantly reducing recidivism rates. The University of Cincinnati conducted the evaluation of the cognitive-behavioral program, Moving On, in which it compared recidivism outcomes for moderate to high-risk Iowa offenders completing the program with a similar group of offenders not having attended any cognitive program.

LSI-R Assessment is Valid for Iowa Offenders, Data Download, Iowa Department of Corrections, September 2006

Welcome to the first issue of the ICON Data Download, a periodic report intended to communicate findings relevant to those who work directly with offenders, as well as those involved in planning, policy and budgeting. This issue highlights work conducted by research partner Christopher Lowenkamp, Ph.D., of the University of Cincinnati and his research associate, Kristin Bechtel, M.S. Data for this analysis was provided from the Iowa Justice Data Warehouse ��� and takes advantage of the link between ICON and ICIS (the court database) to readily track offender recidivism.

Extending the Hydra Head to Create a Pluggable, Extensible Architecture: Diving into the Technology of Hydramata

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Repository Rant -- Digital Scavenging

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Montr��al �� la belle ��poque

Entre 1898 et 1914, Montr��al constitue un centre d'activit�� dramatique tout �� fait exceptionnel. Tant par la qualit�� des pi��ces que par le nombre de spectacles offerts, Montr��al ne diff��re gu��re des autres one week stands d'Am��rique du Nord tels que Toronto, Cincinnati, Pittsburgh, Washington, etc. Mais, c'est en sa qualit�� de ville bilingue qu'elle acquiert une personnalit�� th����trale particuli��re. [...]

Estudio Costo-Efectividad de Lidoca��na t��pica como adyuvante a Pregabalina y Gabapentina en dolor neurop��tico perif��rico en una I.P.S de Bogot�� 2011.

Introducci��n: el dolor neurop��tico es una patolog��a de considerable prevalencia e impacto socio-econ��mico en la poblaci��n latinoamericana, la evidencia cl��nica sugiere que los ligandos de canales de calcio y el parche de Lidoca��na pueden tratar exitosamente el dolor neurop��tico perif��rico y localizado. Metodolog��a: se realizo una evaluaci��n econ��mica tipo costo-efectividad, observacional y retrospectiva con datos extra��dos de las historias cl��nicas de pacientes atendidos en la cl��nica de dolor de la IPS. La variable primaria de efectividad fue la mejor��a del dolor medida mediante escala visual an��loga. Resultados: se estudiaron 94 pacientes tratados con: Gabapentina (G) 21, Pregabalina (P) 24, Gabapentina+ lidoca��na (G/P) 24, Pregabalina + Lidoca��na (P/L) 25, los costos asociados al tratamiento son los siguientes COP$114.070.835, COP$105.855.920, COP$88.717.481 COP$89.854.712 respectivamente, el n��mero de pacientes con mejor��a significativa de dolor fue: 8,10,9 y 21 pacientes respectivamente. El ICER de G/L con respecto a G fue: COP$ -25.353.354. El ICER de P/L con respecto a P fue: COP$ -1.454.655. Conclusiones: la adici��n del parche de lidoca��na a la terapia regular con P/L represento una disminuci��n de consumo de recursos en salud como uso de medicamentos co-analg��sicos, analg��sicos de rescate y f��rmacos para controlar reacciones adversas, de la misma forma que consultas a profesionales de la salud. Cada paciente manejado con P/L representa un ahorro de COP $1.454.655 al contrario si se manejase con el anticonvulsivante de manera exclusiva, en el caso de G/L este ahorro es de COP $ 25.353.354 frente a G sola.