Such an effect could increase our understanding of why quitting s

Such an effect could increase our understanding of why quitting smoking is so difficult, why lapses after a quit attempt strongly

predict failure of that attempt, and why nicotine replacement therapy aids cessation. Although speculative, low SES smokers may find smoking particularly hard to give up if doing so results in an overall decline in reinforcement, but they may gain more relative benefit from nicotine replacement therapy during quit attempts. (C) 2008 Elsevier Ireland Ltd. All rights reserved.”
“Adult intussusception is rare and usually associated with carcinoma in 50% of the cases. These have traditionally been managed using an open technique. We herein describe a laparoscopic extended right hemicolectomy in a 62-year-old lady with an intussuception secondary to a transverse colonic tumor.

The patient presented with 6 weeks of crampy, colicky, abdominal MLN2238 in vivo BEZ235 pain. Her CT scan reported intussuception of the proximal

large bowel. She underwent an extended laparoscopic right hemicolectomy with primary anastomosis.

Her post-operative recovery was uneventful and the histology reported a large bowel adenocarcinoma (pT4, N0, M0) with none out of 25 nodes involved.

When operative intervention is required, intussuception may be managed using a minimally invasive technique. However, large bowel intussuception in adults may have a malignant cause thus laparoscopic resection should only be performed by surgeons experienced in laparoscopic resections for colorectal malignancies as oncological safety must be the primary concern. This laparoscopic approach facilitates rapid recovery and earlier time to adjuvant therapy if required.”
“A 63-yr-old Japanese woman on 18-yr hemodialysis (HD) program underwent cadaveric kidney transplantation from non-heart beating donor. Pre-transplant lymphocytotoxicity test was negative, but flow cytometric cross-match ATR activation and flow-cytometric panel reactive antibody (PRA) screening tests were positive. Flow-PRA

single-antigen test revealed several anti-HLA antibodies including donor-specific antibody (DSA). She was treated with plasma exchange (PEX) and rituximab to prevent antibody-mediated rejection (AMR). Urinary output increased from post-operative day (POD) 5 and HD was discontinued from POD8. Graft biopsy performed on POD11 showed severe peritubular capillaritis (PTCitis), numerous polymorphonuclear neutrophils (PMNs), and moderate glomerulitis. Although C4d immunostaining on PTC was negative, the case was diagnosed as subclinical AMR based on the presence of pre-transplant DSA and PTCitis with predominant PMNs. The patient was treated with additional PEX and rituximab, which increased urinary output and reduced serum creatinine (sCr).

Comments are closed.