Notes

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The benefits of pure laparoscopic and robot-assisted liver resections (LLR and RALR) are known in comparison to open surgery. The aim of the present retrospective comparative study is to investigate the role of RALR and LLR according to different levels of difficulty.

The institutional databases of six high-volume hepatobiliary centers were retrospectively reviewed. The study population was divided in two groups LLR and RALR. The procedures were stratified for difficulty levels accordingly to three classifications. A propensity score matching was implemented to mitigate selection bias. Short-term outcomes were the object of comparison.

Nine hundred and thirty-six LLR and 403 RALR were collected. selleck kinase inhibitor RALR exhibited fewer cases of intraoperative blood loss, lower transfusion and conversion rates (especially for oncological radicality) than LLR in the setting of highly difficult operations, whereas LLR had lower postoperative morbidity and fewer low-grade complications. For intermediate and low-difficulty resections, the intraoperative advantages of RALR gradually decreased to nonsignificant results and LLR remained associated with lower postoperative morbidity.

Robot-assisted liver resections do not show operative nor clinically significant benefits over LLR for low- and intermediate-difficulty resections. By reducing conversion rates, RALR can favour the operative feasibility of difficult resections possibly extending the indications of minimally invasive approaches for liver resection.
Robot-assisted liver resections do not show operative nor clinically significant benefits over LLR for low- and intermediate-difficulty resections. By reducing conversion rates, RALR can favour the operative feasibility of difficult resections possibly extending the indications of minimally invasive approaches for liver resection.
Visual hallucinations are common in patients with Parkinson's disease and represent probably the major independent predictor for cognitive deterioration and nursing home placement.

To investigate if treatment of minor visual hallucinations in Parkinson's disease with rivastigmine delays the progression to psychosis.

A multicenter, randomized, double-blind, placebo-controlled trial was conducted which aimed to recruit 168 patients with Parkinson's disease reporting minor visual hallucinations 4 weeks before it. Important exclusion criteria were Parkinson's disease dementia, current delirium, and treatment with antipsychotics or drugs that have significant anti-cholinergic side effects. Subjects were randomized to rivastigmine capsules, 3-6mg twice a day, or placebo for 24months. The primary outcome was the time to Parkinson's disease psychosis, which was defined as the need to start with antipsychotics.

The trial was stopped prematurely because of slow recruitment. Ninety-one patients were randomized 46 patients were assigned to rivastigmine and 45 patients to placebo. No effect of rivastigmine could be demonstrated on the transition time to psychosis or dementia during the 24-month follow-up period. After 6months of study treatment, cognition, mood, motor performance, and non-motor performance did not differ significantly between the rivastigmine-group and the placebo-group.

Because the study was terminated early, it was insufficiently powered to properly evaluate the primary outcome. The limited data of the study favor a wait and see approach instead of early treatment with rivastigmine in PD patients with minor VH.
Because the study was terminated early, it was insufficiently powered to properly evaluate the primary outcome. The limited data of the study favor a wait and see approach instead of early treatment with rivastigmine in PD patients with minor VH.
To assess the three-dimensional outer retina thickness and choroid in eyes with white matter lesions (WMLs) using swept-source optical coherence tomography (SS-OCT).

Participants without dementia and stroke with cerebral WMLs were enrolled in our study. Optical coherence tomography (OCT) and OCT angiography (OCTA) were used to image and evaluate the outer retinal layer, choroidal structure, and perfusion of the choriocapillaris, microvessels of the choroid, respectively. Measurement of the outer retinal thickness, choroidal thickness and perfusion of the choriocapillaris was done by the SS-OCT tool.

Thirty-one eyes from 16 WMLs and 40 eyes from 20 healthy controls were included in the data analyses. Outer retinal thickness was significantly reduced (P < .001) in WMLs participants when compared to healthy controls. Choroidal thickness was also significantly reduced (P < .001) in WMLs participants when compared to healthy controls. Choriocapillaris perfusion was significantly reduced (P = .002) in WMLs when compared to healthy controls. A significant correlation (Rho = .392, P = .032) was seen between the outer retinal thickness and choriocapillaris perfusion in WMLs participants.

Assessing retinal thickness and choroidal changes with the SS-OCTA as a proxy for WML could prove to be a potentially valuable tool for early detection of cognitive decline and other neurodegenerative diseases.
Assessing retinal thickness and choroidal changes with the SS-OCTA as a proxy for WML could prove to be a potentially valuable tool for early detection of cognitive decline and other neurodegenerative diseases.
Previous studies showed inconsistent results regarding associations between diabetes mellitus (DM) and risk of Parkinson's disease (PD). The study aimed to make a meta-analysis to clarify whether DM is a risk factor for PD.

We searched for articles regarding the effect of DM on risk of PD and published before July 2020 with search terms as follows ("diabetes mellitus" OR "diabetes") AND ("Parkinson's disease" OR "PD") in the following databases PubMed, Web of Science, MEDLINE, EMBASE, and Google Scholar. We used STATA 12.0 software to compute multivariate odds ratio (OR) or relative risk (RR) and 95% confidence intervals (CI) regarding the association between DM and risk of PD.

The present study finally included 7 case-control studies (including 26,654 PD patients) and 9 cohort studies (including 3,819,006 DM patients) exploring the association between DM and risk of PD. The meta-analysis indicated that DM was related to elevated risk of PD (OR/RR=1.15, 95% CI 1.03-1.28, I
=92.4%, p<.001). Subgroup study showed that DM was associated with higher risk of PD in cohort studies (RR=1.
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