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Laparoscopic distal pancreatectomy (LDP) is widely performed [1,2]. However, LDP with regional lymphadenectomy for locally advanced pancreatic cancer (LAPC) is technically demanding [3]. We previously reported a new strategy named "retroperitoneal-first laparoscopic approach (Retlap)" for distal pancreatectomy with en bloc celiac axis resection [4]. In this study, Retlap is applied during LDP with regional lymphadenectomy (seeFig. DisodiumPhosphate 1).

This video demonstrates the case of a 70-year-old woman with a 100×40-mm LAPC. Preoperative computed tomography revealed a large tumor near the root of the celiac axis and acute pancreatitis in the pancreatic head. An ample dorsal margin should be secured and regional lymphadenectomy performed because of the large tumor. In Retlap, the celiac axis was exposed using the retroperitoneal approach from the dorsal side of the pancreatic body, and then the left adrenal grand and left celiac ganglion were removed. Without interfering with the tumor, the root of the splenic artery was identified, facilitating easy performance of lymphadenectomy around the celiac axis and superior mesenteric artery in Retlap. After dividing the splenic artery, the procedure was converted to laparoscopic approach and resection was completed.

The operative time and estimated blood loss were 487 min and 45 mL, respectively. Pathological examination confirmed a negative surgical margin, and R0 resection was achieved with uneventful postoperative course.

Retlap was technically feasible and useful for achieving adequate and secure surgical margin and regional lymphadenectomy. Retlap can help secure the operative field of view in difficult cases of LAPC.

Retlap was technically feasible and useful for achieving adequate and secure surgical margin and regional lymphadenectomy. Retlap can help secure the operative field of view in difficult cases of LAPC.There are several topical ectoparasiticides, drugs, supplements and vaccines that protect dogs against sand fly bites and/or reduce the risk of Leishmania infantum infection. This large variety of products and the absence of comparative studies mean that veterinarians are often faced with uncertainty. The aim of the study was to characterise the attitudes of veterinarians towards leishmaniosis prevention in client-owned dogs in Italy. A web-based questionnaire was prepared with 28 questions covering the working environment of veterinarians, advice given to owners regarding topical ectoparasiticides, advice on systemic prevention, and the use of diagnostic tests on which to base advice for prevention. The questionnaire was emailed to 9,426 veterinarians and answers were collected after 100 days. A total of 542 questionnaires were returned (response percentage 5.8 %) 54.8 % of the veterinarians considered their working area to be endemic, 29.3 % examined dogs from urban areas, and 42.3 % diagnosed ≥10 dogs/year.

The COVID-19 pandemic has given rise to stress worldwide, especially in vulnerable people like those suffering from mental illness. This study aims to investigate the psychological distress perceived by a cohort of patients with Major Depressive Disorder (MDD) or Bipolar Disorder (BD) after a seven-week period of lockdown measures, and to analyze serum 25-hydroxyvitamin D [25(OH)D] levels as a potential predictor of distress severity.

Fifty-nine remitted MDD and fifty-three euthymic BD patients were enrolled. An online dedicated survey was administered to obtain lockdown-related information and to evaluate COVID-19 related distress by using the Kessler 10 Psychological Distress Scale (K10). Patients' medical records were reviewed to collect sociodemographic and clinical data, including serum 25(OH)D levels dosed in the three months preceding the outbreak. A multivariate general linear model was adopted to test the effect of factors of interest on psychological distress.

In our sample (n = 112), 29 subjefactor mediating the psychological response to stress in individuals with affective disorders and provide further insight into tailoring intervention strategies.

Focal Cortical Dysplasia (FCD) represents a broad spectrum of histopathological entities that cause drug-resistant epilepsy. Surgery has been shown to be the treatment of choice, but incomplete resection represents the leading cause of seizure persistence. Preliminary experiences with intraoperative ultrasound (ioUS) have proven its potential in defining and characterizing the lesion. In this study we analyzed the feasibility of advanced ultrasound techniques such as sono-elastography (SE) and contrast enhancement ultrasound (CEUS) in a small cohort of patients with FCD.

We retrospectively reviewed all clinical records and images of patients with drug resistant epilepsy who underwent at least one advanced sonographic technique (SE and/or CEUS) during ioUS guided surgery between November 2014 and October 2017. We excluded from our analysis all patients with lesions other than FCD or those who had FCD associated with other pathological entities.

Four patients with type IIb FCD in the right frontal lobe weperative ultrasound techniques in patients with FCD.

The efficacy of anti- programmed cell death 1 (PD-1)/PD-1 ligand (PD-L1) immune checkpoint inhibitors remains controversial in patients with KRAS mutation. In addition, whether and how KRAS gene and its mutant subtypes might influence immunity has not been clarified yet. Here we examine some important biomarkers for the efficacy of immunotherapy in specific KRAS subtypes.

We conducted a bioinformatics analysis on somatic mutations data, transcriptome sequencing data and proteomic data from The Cancer Genome Atlas (TCGA) database. CIBERSORT was used to provide an estimation of the abundances of immune cells using gene expression data.

From a cohort of 567 patients with lung adenocarcinoma (LUAD) based on TCGA, the overall mutation rate of KRAS was 26.29 %, including KRAS/TP53 co-mutation rate of 9.7 %. We observed increased Tumor mutation burden (TMB) in KRAS mutant group compared with wild type, while no difference in PD-L1 expression and immune cell infiltration. More importantly, TP53 and KRAS/TP53 co-mutation group not only significantly increased tumor mutation burden, but also had higher PD-L1 protein level and immune cell infiltration.