Gastric gastrointestinal stromal tumors (GISTs) are the most common sarcoma of the gastrointestinal tract, and surgical resection is the primary treatment of early disease. Limited data exist concerning laparoscopic resections of these neoplasms. This systematic review was designed to evaluate the literature comparing laparoscopic and open surgical resection of gastric GISTs and to assess the effectiveness and safety of this minimally invasive technique. We performed a systematic search of MEDLINE, the Cochrane Library, PubMed, Embase, Scopus, Web of Science, Google Scholar, the clinical trials database and ProQuest Dissertations and Theses as well as the past 3 years of conference abstracts from the Society of American Gastrointestinal and Endoscopic Surgeons Annual Meetings. Studies comparing the open and the laparoscopic approaches to the resection of gastric GISTs were included in this systematic review. Two reviewers independently performed the screen of titles and abstracts, the full manuscript review, the data extraction and the risk of bias assessment. A quantitative analysis was performed. Of the 189 studies identified, seven studies were included. The laparoscopic approach was associated with a significantly lower length of hospital stay (3.82 days (2.14 - 5.49)). There was no observed difference in operative time, adverse events, estimated blood loss, overall survival and recurrence rates. This study supports that laparoscopic resection is safe and effective for gastric GISTs and is associated with a significantly lower length of hospital stay. Further trials are needed for cost analysis and to rigorously assess oncologic outcomes.

Methodological and statistical heterogeneity precluded consensus on the optimal treatment strategy. Given the common use and significant cost of radioembolization in this setting, a more robust prospective comparative trial is warranted.

Vasopressin is an essential hormone involved in the maintenance of cardiovascular homeostasis. It has been in use therapeutically for many decades, with an emphasis on its vasoconstrictive and antidiuretic properties. However, this hormone has a ubiquitous influence and has specific effects on the heart. Although difficult to separate from its powerful vascular effects in the clinical setting, a better understanding of vasopressin's direct cardiac effects could lead to its more effective clinical use for a variety of shock states by maximizing its therapeutic benefit. The cardiac-specific effects of vasopressin are complex and require further elucidation. Complicating our understanding include the various receptors and secondary messengers involved in vasopressin's effects, which may lead to various results based on differing doses and varying environmental conditions. Thus, there have been contradictory reports on vasopressin's action on the coronary vasculature and on its effect on inotropy. However, beneficial results have been found and warrant further study to expand the potential therapeutic role of vasopressin. This review outlines the effect of vasopressin on the coronary vasculature, cardiac contractility, and on hypertrophy and cardioprotection. These cardiac-specific effects of vasopressin represent an interesting area for further study for potentially important therapeutic benefits.

Background: All-terrain vehicles (ATVs) are frequently associated with injuries and deaths. In spite of this, very few guidelines, let alone legal restrictions, exist to guide users of these machines. Methods:We conducted a standardized review of prospectively collected data from the Alberta Trauma Registry. All patients who were involved in ATV-related traumas from 2003 to 2008 with an Injury Severity Score (ISS) greater than 12 were included. The variables studied were age, sex, type of vehicle, purpose of use, person injured (driver or passenger), ISS, distribution of injuries, length of hospital stay, helmet use and death. Results:We evaluated 435 patients with ATV-related injuries and ISS greater than 12. The average ISS was 22.8, with an overall mortality of 4.6%; 55% of patients were not wearing helmets, and most of the deaths (85%) occurred among these individuals. Helmet use was associated with a lower risk of mechanical ventilation and of injury to the head and/or cervical spine. Children accounted for 18.9% of all patients and 15% of deaths; 57% of them were wearing helmets at the time of their accidents. Conclusion:All-terrain vehicle use in Alberta carries a significant risk of injury and

Our systematic review suggests robotic-assisted hepatic resection is safe and feasible, with low mortality and morbidity rates. Further research is needed to determine if oncological outcomes are similar.