Introduction Cirrhosis is a leading cause of morbidity and mortality around the world.  https://www.selleckchem.com/products/protac-tubulin-degrader-1.html  Although cirrhotic patients are considered to have a higher risk for surgical procedures than non-cirrhotic ones, there are certain pathologies such as gallstones cholecystitis that cannot be treated otherwise. The focus of this study is to evaluate the main characteristics of the patients with lithiasic cholecystitis and liver cirrhosis and to assess if there is a correlation between them and postoperative morbidity evaluated with Dindo-Clavien classification. Material and Methods This is a retrospective study. The database from General Surgery Department of Fundeni Clinical Institute was queried between 2014-2018 using as key words "cirrhosis" and "cholecystitis". The initial interrogation reveled 57 cases out of which 3 were excluded since other resections were associated. Results This study identified that Dindo-Clavien classification positively correlates with the open approach (0.405, p=0.002), emergency surgery (0.599, p=0.000), acute cholecystitis (0.476, p=0.000), high MELD score (0.291, p=0.008) and Child score (0.346, p=0.007) and furthermore with high levels of total bilirubin (0.220, p=0.047), high INR (0.286, p=0.010), the presence of ascites (0.303, p=0.022) and portal hypertension (0.266, p=0.044). It also correlates negatively with the levels of hemoglobin (-0.295, p=0.044). Conclusion Adequate estimation of perioperative mortality and morbidity is generally limited by the retrospective nature of most studies and the patient's selection criteria. Emergency surgery, acute cholecystitis and the open approach carry the highest risk for unfavorable results of cholecystectomy in cirrhotic patients.
  To characterize clinical features of early onset pancreatic adenocarcinoma (EOPC) patients and explore prognostic factors affecting their survival. 
  Retrospective review of 95 patients, 45 years old, who presented to the University of Alabama Hospitals with pancreatic adenocarcinoma from September 1998 to June 2018. 
  Median survival time was 12.9 months for all patients. Obesity, male gender, race, and tumor location were not associated with survival. Smoking at time of diagnosis increased risk of death by three folds (HR 3.05, 95% CI, 1.45 - 6.40). Risk of death decreased by 64% (HR 0.36, 95% CI, 0.16 - 0.78) if patients underwent surgery. Median survival was 119.5 months for stage I, 29.9 months for stage II, 23.23 months for stage III, and 6.3 months for stage IV patients. The survival benefit of chemotherapy was only significant with the use of FOLFIRINOX. 
  Some established prognostic features in typical pancreatic adenocarcinoma patients are not predictive of survival in young patients. Cigarette months for stage III, and 6.3 months for stage IV patients. The survival benefit of chemotherapy was only significant with the use of FOLFIRINOX. Conclusions Some established prognostic features in typical pancreatic adenocarcinoma patients are not predictive of survival in young patients. Cigarette smoking, a known risk factor for the development of EOPC, is also a significant predictor of survival in this patient population. Efforts to improve prognosis of EOPC include early detection, tobacco control, individualized treatment protocols, and studying the biological behavior.This review on recently published literature aims to summarize published data on pathologic complete response following neoadjuvant treatment in biopsy proven locally advanced rectal cancer patients. Published articles referring to pCR rectal cancer patients were identified using PubMed search. Eleven relevant articles were selected, based on tumor, treatment, and patient characteristics reporting. As a conclusion, rectal cancer patients with the highest chances of complete clinical or pathological response to neoadjuvant treatment are males, who are around 60 years, diagnosed with well or moderate differentiated locally advanced rectal cancer.Background Robotic bariatric surgery (RBS) has increased in recent years. Many doubts continue to exist regarding its utility in terms of postoperative complications, costs and technical aspects. RBS has increased its number and shows a more technical challenge associated with more post-operative complications compared to primary bariatric surgery. We herein present a single institution experience and review to describe its utility in revisional surgery. Methods A retrospective review of our experience and a review of the literature has been conducted to evaluate the impact of robotic revisional surgery in the bariatric field. Results A total of 17 patients (5 female and 12 male) were operated on. Most frequent surgery was conversion of sleeve gastrectomy to gastric bypass (n=9). No leaks were found nor severe complications. A systematic review showed similar results including a decreased number for complications when performing robotic revisional surgery. Conclusions Revisional robotic surgery shows better results compared to standard laparoscopic revisional bariatric surgery in terms of efficacy, safety and hospital stay. No differences were seen in rates of mortality, morbidity and reintervention between both approaches. We encourage surgeons to learn to perform the robotic technique as part of the process of democratization and standardization of bariatric surgery.
  High fat diet can lead to testicular structural and functional disturbances, spermatogenesis disorders as well as infertility. So, the present investigation was proposed to clarify whether voluntary exercise could prevent high fat diet induced reproductive complications in rats through testicular stress oxidative and apoptosis.
 
  Forty male Wistar rats were randomly divided into four groups; control (C), voluntary exercise (VE), high fat diet (HFD) and high fat diet and voluntary exercise (VE+HFD) groups. The rats in the VE and VE+HFD groups were accommodated in apart cages that had running wheels and the running distance was assessed daily for 10weeks. In VE+HFD group, animals were fed with HFD for five weeks before commencing exercise. The sperm parameters, the expressions of testicular miR-34a gene, and P53 and SIRT1 proteins as well as testicular apoptosis were analyzed in all groups.
 
  The results indicated that voluntary exercise in VE+HFD group led to significantly increased GPX and SOD activities, SIRT1 protein expression, sperm parameters, and decreased the expression of miR34a gene and Acp53 protein, and cellular apoptosis index compared to HFD group (p<0.