Robotic-assisted laparoscopic surgery for recurrent diverticulitis: experience in consecutive cases and a review of the literature

Background  

Robotic-assisted laparoscopic surgery has recently gained enthusiasm for application in colorectal surgery. We present the safety and feasibility of using the da Vinci^? robotic system for the surgical treatment of sigmoid diverticulitis.     

18F-FDG PET/CT of cervical carcinoma

OBJECTIVE: This article outlines the role of FDG PET/CT in patients with cervical carcinoma for evaluating tumor extent, assessing treatment response, and detecting disease recurrence. CONCLUSION: There is increasing evidence that FDG PET/CT has a role in the primary evaluation of cervical carcinoma-in particular, for evaluating lymph node status and distant metastatic disease. PET/CT is also helpful to determine prognosis, assess treatment response, and evaluate disease recurrence.     

Effect of angiotensin-converting enzyme inhibitors on arterial stiffness in hypertension: systematic review and meta-analysis

Arterial stiffness is an independent cardiovascular prognostic factor and is modulated by angiotensin-converting enzyme inhibitors (ACEIs). The authors performed a meta-analysis of clinical trials investigating the effects of ACEIs on pulse wave velocity (PWV) or augmentation index. The search included randomized clinical trials as well as uncontrolled studies that measured in-treatment changes in arterial stiffness. The authors performed separate analyses for carotid-femoral PWV, brachioradial PWV, and augmentation index. Average absolute and relative reduction in mean arterial pressure and PWV were -15.4 mm Hg and -13.04% and -1.15 m/s and -9.74% for carotid-femoral PWV studies; and -11.2 mm Hg and -9.3% and -1.9 m/s and -16.7% for brachioradial PWV studies. There was a greater reduction in augmentation index by ACEIs when compared with controls (-1.0% to -5.3%). The authors conclude that ACEIs have modest beneficial effects on arterial stiffness measured as PWV and augmentation index, and this effect is at least partly independent of changes in blood pressure.     

Coagulation activation in sickle cell trait: an exploratory study

Recent epidemiologic data suggest that sickle cell trait (HbAS; AS) is a risk factor for venous thromboembolism. We conducted an exploratory study of healthy subjects with AS under baseline conditions to determine whether a chronic basal hyperactivation of coagulation exists, and if so, what mechanism(s) contribute to this state. Eighteen healthy AS individuals were compared to 22 African‐American controls with a normal haemoglobin profile (HbAA; AA) and 17 patients with sickle cell disease (HbSS; SS). Plasma thrombin‐antithrombin complexes and D‐dimer levels were elevated in AS relative to AA patients (P = 0·0385 and P = 0·017, respectively), and as expected, were much higher in SSversusAA (P < 0·0001 for both). Thrombin generation in platelet poor plasma was indistinguishable between AA and AS subjects, whereas a paradoxical decrease in endogenous thrombin potential was observed in SS (P ≤ 0·0001). Whole blood tissue factor was elevated in SS compared to AA (P = 0·005), but did not differ between AA and AS. Plasma microparticle tissue factor activity was non‐significantly elevated in AS (P = 0·051), but was clearly elevated in SS patients (P = 0·004) when compared to AA controls. Further studies in larger cohorts of subjects with sickle cell trait are needed to confirm the results of this preliminary investigation.