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Background Ileus is common after elective colorectal surgery, and is associated with increased adverse events and prolonged hospital stay. The aim was to assess the role of non‐steroidal anti‐inflammatory drugs (NSAIDs) for reducing ileus after surgery. Methods A prospective multicentre cohort study was delivered by an international, student‐ and trainee‐led collaborative group. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The primary outcome was time to gastrointestinal recovery, measured using a composite measure of bowel function and tolerance to oral intake. The impact of NSAIDs was explored using Cox regression analyses, including the results of a centre‐specific survey of compliance to enhanced recovery principles. Secondary safety outcomes included anastomotic leak rate and acute kidney injury. Results A total of 4164 patients were included, with a median age of 68 (i.q.r. 57–75) years (54·9 per cent men). Some 1153 (27·7 per cent) received NSAIDs on postoperative days 1–3, of whom 1061 (92·0 per cent) received non‐selective cyclo‐oxygenase inhibitors. After adjustment for baseline differences, the mean time to gastrointestinal recovery did not differ significantly between patients who received NSAIDs and those who did not (4·6 versus 4·8 days; hazard ratio 1·04, 95 per cent c.i. 0·96 to 1·12; P = 0·360). There were no significant differences in anastomotic leak rate (5·4 versus 4·6 per cent; P = 0·349) or acute kidney injury (14·3 versus 13·8 per cent; P = 0·666) between the groups. Significantly fewer patients receiving NSAIDs required strong opioid analgesia (35·3 versus 56·7 per cent; P < 0·001). Conclusion NSAIDs did not reduce the time for gastrointestinal recovery after colorectal surgery, but they were safe and associated with reduced postoperative opioid requirement.

Cancer cells are mainly dependent on glycolysis for their growth and survival. Dietary carbohydrates play a critical role in the growth and proliferation of cancer and a low-carbohydrate diet may help slow down the growth of tumours. However, the exact mechanisms behind this effect are unclear. This review study aimed to investigate the effect of fat mass and obesity-associated (FTO) gene in the association between dietary carbohydrates and cancer. This study was carried out using keywords such as polymorphism and/or cancer and/or dietary carbohydrate and/or FTO gene. PubMed and Science Direct databases were used to collect all related articles published from 1990 to 2018. Recent studies showed that the level of FTO gene expression in cancer cells is dramatically increased and may play a role in the growth of these cells through the regulation of the cellular metabolic pathways, including the phosphoinositide 3-kinases/protein kinaseB (PI3K/AKT) signaling pathway. Dietary carbohydrate may influence the FTO gene expression by eliminating the inhibitory effect of adenosine monophosphate-activated protein kinase (AMPK) on the FTO gene expression. This review summarised what has been recently discovered about the effects of dietary carbohydrate on cancer cells and tried to determine the mediating role of the FTO gene in these effects.

SummaryBreast cancer is the most common cancer in women worldwide. The standard for detecting it includes clinical exam, mammography and fine-needle aspiration cytology. Our aim was to establish the role of the tru-cut biopsy in the diagnosis of malignant breast lesions. We provide a two-year retrospective clinical study defining 98.67% sensitivity, 100% specificity, 100% positive predictive value, 80% negative predictive value and an overall diagnostic accuracy of 98.73%. In 89.1% of the malignant lesions, the sample was adequate to define the receptor status. Therefore, tru-cut biopsy is an easy, cheap, safe and accurate alternative to fine-needle aspiration cytology in the diagnosis of breast lesions.

In the last decades the treatment for many diseases has changed dramatically. Open surgery procedures with high morbidity and complication rates, suboptimal clinical results based on large impairment for the patients were replaced by drug treatment or minimally invasive techniques. Examples such as interventional cardiology procedures in acute myocardial infarction, interventional endoscopies in the treatment of hepato-biliary tract diseases, eradication of Helicobacter pylori for gastric ulcer using drugs are good evidence that the words of William Osler "Diseases that harm require therapies that harm less" are valid now-a-days. 1Pancreatic Cancer (PC) is one of the most aggressive malignant diseases which survival rate, clinical results and treatment has not improved substantially in the past 40 years. Radical surgery is still the only curative method for pancreatic cancer in early stage. Estimated, only 20% of all cases with PC in early stage are suitable for surgical resection at the time of diagnosis, still the expected 5-year survival rate remains 5-20%. The other 80% of cases with advanced PC (including locally and systemically advanced pancreatic cancer) have an expected median survival time of only a few months and almost 0% of 5 year-survival rate when effective alternative treatment methods are missing. 2,3 In those patients with unresectable advanced pancreatic cancer, there is still an urgent need for effective therapies that should not only achieve sufficient local tumor control but also improve local symptoms and quality of life as well as alleviate tumor-associated pain.