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Despite decades of studies, it is still an open question on how and where simple multiplications are solved by the brain. This fragmented picture is mostly related to the different tasks employed. While in neuropsychological studies patients are asked to perform and report simple oral calculations, neuroimaging and neurophysiological studies often use verification tasks, in which the result is shown, and the participant must verify the correctness. This MEG study aims to unify the sources of evidence, investigating how brain activation unfolds in time using a single-digit multiplication production task. We compared the participants' brain activity—focusing on the parietal lobes—based on response efficiency, dividing their responses in fast and slow. Results showed higher activation for fast, as compared to slow, responses in the left angular gyrus starting after the first operand, and in the right supramarginal gyrus only after the second operand. A whole-brain analysis showed that fast responses had higher activation in the right dorsolateral prefrontal cortex. We show a timing difference of both hemispheres during simple multiplications. Results suggest that while the left parietal lobe may allow an initial retrieval of several possible solutions, the right one may be engaged later, helping to identify the solution based on magnitude checking. [ABSTRACT FROM AUTHOR]

Introduction: The stapled hemorrhoidopexy (SH) and the Doppler-guided transanal hemorrhoidal dearterialization (DG-THD) are minimally invasive procedures for the surgical treatment of hemorrhoids. This study aims to verify the efficacy of the DG-THD versus the SH in the treatment of third-degree hemorrhoids.Method: One hundred consecutive patients were causally allocated to either procedure, obtaining two groups of 50 pts. A clinical examination was performed at 3, 7, 15, and 30 days after the operation. Quality of life, anal symptoms, recurrence of hemorrhoids, and reoperation were assessed by means of a questionnaire and of a clinical examination at long-term follow-up (7.0 year average).Results: At short-term follow-up, the median postoperative pain score was significantly lower in DG-THD group compared to SH group, (V.A.S 2 vs 6; t = 2.65, p < 0.01). The morbidity rate and the return to normal life and work were similar after the two procedures. At long-term follow-up, the incidence of piles was not statistically different between the two groups (DG-THD 10.0 %; SH 14.0 %). No differences were reported by patients in terms of satisfaction for surgery.Conclusion: SH and DG-THD procedures do not show significantly different results with regard to the patients outcome. However, considering the lower p. o. pain, the DG-THD might be proposed as the first line treatment in third-degree hemorrhoids. [ABSTRACT FROM AUTHOR]

The effect of transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) on psychopathological symptoms and resting state brain activity was assessed in a patient with obsessive-compulsive disorder (OCD). tDCS and rTMS had no effect on OC symptoms. tDCS, however, improved depression and anxiety. Functional magnetic resonance imaging at baseline showed an interhemispheric asymmetry with hyperactivation of the left and hypoactivation of the right anterior neural circuits. A reduction of interhemispheric imbalance was detected after tDCS but not after rTMS. tDCS seems to be more effective than rTMS in restoring interhemispheric imbalance and improving anxiety and depression in OCD. [ABSTRACT FROM AUTHOR]

The effect of transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) on psychopathological symptoms and resting state brain activity was assessed in a patient with obsessive–compulsive disorder (OCD). tDCS and rTMS had no effect on OC symptoms. tDCS, however, improved depression and anxiety. Functional magnetic resonance imaging at baseline showed an interhemispheric asymmetry with hyperactivation of the left and hypoactivation of the right anterior neural circuits. A reduction of interhemispheric imbalance was detected after tDCS but not after rTMS. tDCS seems to be more effective than rTMS in restoring interhemispheric imbalance and improving anxiety and depression in OCD. [ABSTRACT FROM PUBLISHER]

Background: The role of supplemental oxygen therapy in the healing of colorectal anastomosis is still very much at an experimental stage. The aim of the present study, prospective randomized, was to assess the effect of administration of perioperative supplemental oxygen therapy on infraperitoneal anastomosis, where the risk of leakage is higher.Methods: We enrolled 72 patients between February, 2008 and February, 2011, who underwent elective open infraperitoneal anastomosis for rectal cancer (middle and low). Patients were assigned randomly to an oxygen/air mixture with a fraction of inspired oxygen (FiO2) of 30% (n = 37) or 80% (n = 35). Administration was commenced after induction of anesthesia and maintained for 6 h after surgery.Results: The overall anastomotic leak rate was 16.6% (12 out of 72); 8 patients (21.6%) had an anastomotic dehiscence in the 30% FiO2 group and 4 (11.4%) in the 80% FiO2 group (p < 0.05). The risk of anastomotic leak was 46% lower in the 80% FiO2 group (RR, 0.63; 95% confidence interval, 0.42–0.98) vs. the 30% FiO2.Conclusion: Therefore, supplemental 80% FiO2 during and for 6 h after major rectal cancer surgery, reducing postoperative anastomotic dehiscence, should be considered part of ongoing quality improvement activities related to surgical care, with few risks to the patient and little associated cost. [ABSTRACT FROM AUTHOR]

We hypothesized that nandrolone (ND)-abuse induces cardiac hypertrophy, increases myocardial susceptibility to ischemia/reperfusion (I/R) injury, and reduces responsiveness to postconditioning (PostC) cardioprotection. Wistar-rats were ND treated for 2 weeks (short_ND) or 10 weeks (long_ND). Vehicle-treated rats served as controls. Hearts were retrogradely perfused and left ventricular pressure (LVP) was measured before and after 30-min global ischemia. In subgroups of hearts, to induce cardioprotection a PostC protocol (five cycles of 10-s reperfusion and 10-s ischemia) was performed. β-adrenoreceptors, kinases (Akt and GSK-3β) and phosphatases (PP2A sub A and PP2A sub B) were examined by Western blot before and after ischemia. After 120-min reperfusion, infarct size was measured. Short_ND slightly increased cardiac/body weight ratio, but did not affect cardiac baseline nor post-ischemic contractile function or infarct size when compared to vehicle hearts. However, PostC limited cardiac dysfunction much more in short_ND hearts than the other groups. Although cardiac/body weight ratio markedly increased after long_ND, baseline LVP was not affected. Yet, post-ischemic contracture and infarct size were exacerbated and PostC was unable to reduce infarct size and ventricular dysfunction. While short_ND increased phosphatases, non-phosphorylated and phosphorylated Akt, long_ND reduced phosphatase-expression and Akt phosphorylation. Both short_ND and long_ND had no effect on the GSK-3β-phosphorylation but increased the expression of β-adrenoreceptors. In reperfusion, PostC increased Akt phosphorylation regardless of protective effects, but reduced phosphatase-expression in protected hearts only. In conclusion, short_ND improves post-ischemic myocardial performance in postconditioned hearts. However, long_ND increases myocardial susceptibility to I/R injury and abolishes cardioprotection by PostC. This increased susceptibility might be related to steroid-induced hypertrophy and/or to altered enzyme expression/phosphorylation. [ABSTRACT FROM AUTHOR]

Background A recent meta-analysis of randomized controlled trials (RCTs) showed that laparoscopic approach to endometrial cancer was effective in terms of overall, disease-free and cancer-related survival [1]. The aim of the current study was to update until September 2009 data from RCTs evaluating the effects of laparoscopic approach to endometrial cancer. Materials and methods Meta-analysis of randomized controlled trials (RCTs). Efficacy and safety data were evaluated. Results Three RCTs evaluating the efficacy and safety outcomes of laparoscopic surgery to treat early stage endometrial cancer were identified and included in the final analysis. No significant difference in intra-operative complications (OR=1.5, 95%CI 0.7 to 3.5, P=0.442) was observed between laparoscopic and laparotomic approach to early stage endometrial cancer. Conversely, significant advantage in terms of post-operative complications (OR=0.5, 95%CI 0.3 to 0.8, P=0.008) were reported after laparoscopic surgery in comparison with laparotomic. A significantly longer operative time was observed for the laparoscopic procedure than for the laparotomic one (OR=35.6, 95%CI 1.9 to 69.3, P=0.038), even if a significant (P<0.001) heterogeneity was present across the analyzed studies. On the other hand, the intra-operative blood loss was significantly lower in patients treated with laparoscopy than in those treated with laparotomy (OR=-214.1, 95%CI -303.8 to -124.4, P<0.001), even if a significant (P<0.001) heterogeneity was again present across the analyzed studies. Pelvic nodes yield resulted similar between two surgical approaches (OR=1.0, 95%CI -0.3 to 2.4, P=0.134), whereas the para-aortic nodes yield was significantly higher after laparoscopic surgery (OR=-100.5, 95%CI -108.4 to 2.4, P=0.134). No significant difference between laparoscopic and laparotomic approach to endometrial cancer in overall [odds ratio (OR)=0.96, 95% confidence index (CI) 0.51 to 1.81, P=0.976] survival was observed (Figure 1) Disease-free (OR=0.95, 95% CI 0.51 to 1.80, P=0.986) and cancer-related (OR=0.91, 95% CI 0.27 to 3.06, P=0.883) survival has been demonstrated to be not different between two surgical approaches. No significant heterogeneity was observed between studies in any efficacy outcome evaluated. Conclusions Both laparoscopy and laparotomy are two effective approaches for treating patients with early stage endometrial cancer. [ABSTRACT FROM AUTHOR]

The article focuses on the guidelines on prevention strategies of most common cancers in women released by the American Cancer Society (ACS). Women are advised to undergo screening for cervical cancer approximately three years after first vaginal intercourse. The guidelines also stressed the need to inform women at average and increased risk about the high genetic risk of ovarian cancer. Also mentioned is the association between vulvar cancer in younger women and human papilloma virus (HPV) infection and smoking.