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c subtotal gastrectomy is safe and feasible. In particular, we found that the da Vinci platform improves surgeon abilities to perform an adequate lymphadenectomy and digestive reconstruction. Further studies are necessary to better clarify the role of this high-cost technology in minimally invasive treatment of gastric cancer.

The objectives of this study conducted in the University Hospital of North Tees, UK were to (i) Identify if the current hip arthroplasty documentation met good compliance with the Getting It Right First Time (GIRFT) hip arthroplasty guidance (ii) Improve current documentation with a transition from hand-written notes to an online typed personalised operative hip arthroplasty template (iii) Improve the quality of documentation and adherence to GIRFT guidance in hip arthroplasty.

We led a team of 7 doctors to review University Hospital of North Tees compliance against 24 criteria laid out by GIRFT. After examining 20 operative records retrospectively at random from a spread of orthopaedic consultants in the department, it was shown that there was poor compliance against GIRFT guidelines. We proposed a pragmatic solution of incorporating a pre-populated hip arthroplasty online template adhering to GIRFT guidance into our local 'Trackcare' system. Following that, we closed the audit loop by prospectively reviars promising in minimising medico-legal claims for surgeons and the Trust.

The damaging effects of thermal burns need to be managed holistically in order to create a suitable environment for wound healing. The purpose of our study was to investigate the effects of hyperbaric oxygen therapy (HBOT) on the healing of thermal burns and its relationship with intercellular adhesion molecule 1 (ICAM-1).

Twenty patients with thermal burns were randomly divided into two groups the group to receive HBOT and the control group. this website Levels of the

1 mRNA gene and ICAM-1 serum along with the degree of wound epithelialization were examined before and after treatment. Laboratory and physical findings between the groups were compared.

In the HBOT group compared with the control group, thermal wound complications were significantly reduced (

=.006), while length of stay in hospital was substantially reduced (

=.001). ICAM-1 serum levels strongly correlated with

1 mRNA gene expression (



=0.909,

<.001). The expression of the

1 mRNA gene (12.32±1.31 vs. 10.79±1.38) and ICAM-1 serum level (231.46±37.20 vs. 158.23±68.30) in patients with at least a 50% burn area exceeded those of patients with a smaller burn area. HBOT significantly decreased (

<.05) the expression of the

1 mRNA gene and ICAM-1 serum level (

=.004). The number of HBOT sessions strongly correlated with ICAM-1 serum level (

=.043) but poorly correlated with

1 mRNA gene expression (

=.22). The expression of the gene, however, strongly correlated with ICAM-1 serum level (

=-0.988,

<.001).

HBOT can reduce thermal wound complications, length of stay in hospitals due to thermal burns,

1 mRNA gene expression, and ICAM-1 serum level.

HBOT can reduce thermal wound complications, length of stay in hospitals due to thermal burns, ICAM-1 mRNA gene expression, and ICAM-1 serum level.

and importance Retroperitoneal ganglioneuromas that cause lower back and leg pain are extremely rare and are often misdiagnosed. Surgical resection has excellent prognosis in long-term survival.

We present an 80-year-old man with two-year worsening left lower back and leg pain. He was treated as presumed lumbar spine spondylosis with several courses of physical therapy together with medical treatment. An abdomen CT scan disclosed a tumour in the left retrorenal space. The tumour was resected and the histopathologic examination suggested a completely excised retroperitoneal ganglioneuroma. During one-year follow-up the patient is free of pain without any local recurrence.

Retroperitoneal ganglioneuromas are rare benign tumors that originate from neural crest-derived cells of the paravertebral sympathetic plexus and sometimes from the adrenal medulla. They are usually asymptomatic and discovered on routine clinical examination or on autopsy. Occasionally they may show symptoms due to local pressure effect or rarely they are hormonally active and present with adrenergic symptoms. Complete resection of the tumor is important in order establish the final diagnosis and alleviate symptoms from pressure effects.

This case highlights the need for great vigilance among physicians in order to consider any possible retroperitoneal pathology when indicated in the differential diagnosis of lower back and leg pain, before establishing other more common diagnosis, especially in the older population.

This case highlights the need for great vigilance among physicians in order to consider any possible retroperitoneal pathology when indicated in the differential diagnosis of lower back and leg pain, before establishing other more common diagnosis, especially in the older population.

The classification for HD was developed by Goligher in 1980 and does not contemplate important aspects of this disease, which limits its use in guiding treatment. The aim of this study if to apply in clinical practice the new classification for hemorrhoids named BPRST (bleeding, prolapse, reduction, skin tags, thrombosis), to compare it with the original classification proposed by Goligher and to propose an algorithm for treatment.

This is a prospective study conducted at the University of São Paulo's teaching hospital and

. Patients with HD treated from March 2011 to July 2013 were included. Patients were classified according to BPRST and Goligher classifications and treated according to personal experience and most updated guidelines. The association between both classifications and the treatment adopted was compared and an algorithm for treatment was developed.

229 patients were included in this study and 28 patients were lost due to follow-up. According to Goligher, 29, 61, 85 and 26 were classifi Our algorithm for treatment contemplates the most commonly used techniques and can help to guide the treatment of this complex disease.

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