12 The huge demand for the Bcl-2 inhibitor services of pain clinics lies far above their ability to supply this demand. This problem is definitely not singular to Israel. Researchers from around the world have reported on similar disproportionate supply for the demand of specialist pain medicine services. The average time on the waiting list in Australia

is 5 months, 13 in Spain 6 months, and in Canada 3 months to 5 years. 14 There is no argument that these waiting list times are far too long, but how long should the waiting list time for a pain specialist consultation be? There are very few data to suggest an answer to Inhibitors,research,lifescience,medical this question; however, in England, for example, a waiting list time of 13 weeks has been defined to be maximal. 15 In Canada a task force has been set up to decide upon the maximal acceptable waiting list time. 14 Until a solution is found, the problem of patients suffering from chronic pain will remain well within the realm of the family practitioner, frustrated by the lack of appropriate resources to treat these patients and ease their suffering. 16 A solution to this problem that has been Inhibitors,research,lifescience,medical deemed by the World Health Organization as a health crisis of primary priority Inhibitors,research,lifescience,medical 6 calls for a new approach. In this article, we will describe the crisis in which the pain clinics in Israel (and worldwide) have found themselves from epidemiological, medical, and economic viewpoints. We will offer a possible solution based

upon multi-tiered intervention and the empowerment of community medical teams treating chronic pain patients. We will also present data of the initial 3 years of implementing this model in the Rambam School of Pain Medicine. THE Inhibitors,research,lifescience,medical CAUSES FOR THE CRISIS IN PAIN MEDICINE IN ISRAEL The world crisis facing pain medicine stems from the high prevalence of chronic pain, but its severity is augmented by the insufficient treatment of chronic pain in the community in combination with the low availability Inhibitors,research,lifescience,medical of pain consultation. The paucity of pain consultation services is striking: in Israel only 50 physicians are board-certified in pain medicine, and approximately 20 others work

predominantly in this field. The discrepancy between the small number of pain physicians and the huge number of pain patients is striking. The burden of treating pain patients therefore lies almost entirely on the shoulders of community primary care physicians. But the solution given by community-based medicine is often unsatisfactory. In a survey conducted among family practitioners, barriers to effective treatment of pain Mannose-binding protein-associated serine protease were reported, including lack of consultation services (77% of the responses), lack of knowledge (64% of the responses), and concern about the use and side effects of opiate drugs. 16 The long waiting lists for pain clinic services result in many doctors ceasing to refer to these clinics. 5 , 17 Thus we can see that many physicians in the primary care setting feel that they lack adequate clinical skills in treating chronic pain.

v. injection. Therefore the authors concluded that although PAMAM polyplexes were trapped within the lung due to charge interactions, the occlusion of capillaries might not be effective enough to induce effects similar to LPEI in lung, and transfection signals are

not detectable. At any rate, the PAMAM-G5 dendrimer could be a potential candidate for loading pDNA onto echogenic PLGA NP since, as PEI, it promises to have highly desirable characteristics of enhanced gene delivery that is restricted to tumors and a reduced off-target (lung) reporter gene expression in vivo. Inhibitors,research,lifescience,medical Finally, another promising new cationic polymer that could be a great candidate for complexing with PLGA is one containing a branched oligoethyleneimine (OEI, 800Da) core, diacrylate esters as linkers, and oligoamines as surface modifications [48]. Although complex in structure, these are also promising since they exhibit low cytotoxicity in vivo Inhibitors,research,lifescience,medical and were shown to transfect tumor tissue at levels comparable to those with PEI but were better tolerated Inhibitors,research,lifescience,medical with no change in liver histology or liver enzymes, while LPEI and BPEI resulted in an increase in liver enzyme levels, suggesting

early necrotic stages in liver 24h after treatment. OEI also exhibited a more tumor-specific gene expression profile than when PEI was used, with lower lung transgene expression. Finally, dendrimers also can be used to target nucleic acid delivery to particular cells or tissues Inhibitors,research,lifescience,medical using cell-penetrating peptides. For Bortezomib research buy example, PAMAM-G5 dendrimers displaying cyclic RGD targeting peptides (PAMAM-RGD) improved transport

[49] and also could deliver siRNA in polyplex complexes of ~200nm, mediating more efficient nucleic acid delivery through multicellular Inhibitors,research,lifescience,medical 3D U87 glioma spheroids than that of native PAMAM dendrimers, presumably by interfering with integrin-ECM contacts present in a three-dimensional tumor model [50]. Figure 5 PAMAM-dendrimer-based complexes may be an alternative to PEI for pDNA delivery in vivo using NP. (a) PLGA:PAMAM-G5 gives higher tumor expression of reporter Histone demethylase pDNA and lower nonspecific lung transfection for a more favorable biocompatible profile in vivo … Although highly efficient nonviral gene carriers, one common drawback of LPEI, PLL, and PAMAM dendrimer cationic polymers is that these may present a high toxicity in vivo, even if a relatively low cytotoxicity is initially observed in vitro. Therefore, some solutions have included surface modification to significantly help reduce their toxicity [51–53]. For example, to help expand the in vivo applications of PAMAM, one study attempted to improve characteristics of this polymer as a gene delivery carrier by incorporation of polyethylene glycol (PEG, molecular weight 5,000).

2 Since the time of Kraepelin and Bleuler, an increasing number of environmental risk factors have been proposed and investigated. This has followed the realization that genes are necessary, but not generally sufficient,

to cause schizophrenia; indeed, concordance rates in monozygotic twins are far from 100%.3 Of course, the investigation of environmental risk certainly does not negate the importance of genetics. Perhaps the most important modern concept in understanding the etiology of Selleck AZD4547 schizophrenia is gene-environment interaction.4,5 Thus, schizophrenia Inhibitors,research,lifescience,medical is an illness in which various environmental risk factors act on a complex set of susceptibility genes. In this discussion, we consider environmental risk factors that may act through the period from conception to onset of illness. We divide this preillness risk period into early life, childhood, and later life for ease Inhibitors,research,lifescience,medical of presentation

(Table I). The divisions are somewhat arbitrary and certainly several of the risk factors are thought to act at various points throughout the period. Table I Environmental risk factors that have been proposed for schizophrenia. Early life environment The discovery of risk factors acting before Inhibitors,research,lifescience,medical and shortly after birth has been central to the neurodevelopmental hypothesis of schizophrenia.6 The hypothesis proposes that environmental risk factors interact with genetic factors during this crucial phase in the formation of the nervous system causing

subtle abnormalities, which leave the individual vulnerable to psychosis later in life. Indicators of neurodevelopmental deviance associated with schizophrenia include the presence of developmental Inhibitors,research,lifescience,medical abnormalities on structural brain imaging, an excess of minor physical anomalies and neurological signs, and behavioral problems in childhood.7-9 This evidence Inhibitors,research,lifescience,medical has been enhanced by the recognition of environmental risk factors for schizophrenia that act in early life, long before any signs of illness are apparent. These are detailed below and include: obstetric complications, prenatal and postnatal infection, and other factors possibly acting during this crucial period of brain development. Obstetric new complications Although “birth trauma” was first proposed as a causative factor for schizophrenia in the 1930s,10 it took a further three decades for the first case-control studies in adults to emerge. Cannon and coworkers11 have recently reviewed the historical development of research in this area, and describe the progression from early-high-risk and casecontrol studies through to the phase of population-based studies, which began in the 1990s and continues today. There were clearly a number of methodological problems associated with the earlier studies and the results were often inconsistent.

In such case, the existence of cavities of very low urodynamic efficacy, as observed in the present study, were decisive in the formation of such calculi. It is important to emphasize that we observed a thin epithelium covering such cavities (Fig. 3), demonstrating that this epithelium may be formed after the development of the calculi Modulators through a re-epithelialization process. The re-epithelialization is a posterior process of an epithelial lesion, it finalizes with the formation

of a scarring. The scar formation consists in the proliferation in all directions of epithelial cell rest present in inflamed lesions that form strands or islands of epithelium, which then are invaded by vascular fibrous connective tissue. The existence of COD calculi can be explained selleck considering that because of the elevated calcium concentrations detected in urine of 24 hours, this must involve periods of higher values (formation of COD) and periods with low values (formation of COM). It is interesting that almost all stones developed in the same kidney (right). This clearly implies morphoanatomic

differences between the 2 kidneys in such manner that one exhibits a complex internal structure with presence of narrow cavities of low urodynamic efficacy. This demonstrates the importance of morphoanatomy as a factor involved in lithogenesis. No similar cases have been previously see more described in the literature. This work was supported by the project CTQ2010-18271 from the Ministerio de Ciencia e Innovación (Gobierno de España), FEDER funds (European Union) and Metalloexopeptidase the project grant 9/2011 from the Conselleria d’Educació, Cultura i Universitat (Govern

de les Illes Balears). “
“Historically, those who had penile amputation have been pushed toward gender reassignment surgery because of the poor outcomes of historic attempts at phalloplasty.1 Since the first radial artery free flap (RAFF) phalloplasty technique was performed in 1984, the number of patients with full phalloplasty has been rising, and the challenges and complications of treatment within this patient population have become worthy of study. The use of hair-bearing skin for the phalloplasty carries extra complications because of the introduction of skin epithelial elements into a previously urothelium-exclusive environment. These patients are generally followed up very closely, as the complications of such a major surgery are frequent and often requiring quick correction.2 and 3 We present a case of a patient who presented after >2 years of no follow-up for complications of his procedure. The patient is a 35-year-old male with a past medical history of assault with traumatic amputation of penis and testicles in February 2011. The patient had no other medical, surgical, or social history. In May 2011 a RAFF phalloplasty was performed. Patient course after initial repair was complicated by wound dehiscence and fistula formation with stricturing.

119 For example, multimodal experimental design, as in Egan et al,93 would permit incorporation of tests of cognition from separable domains120-122 embedded in, for example,

EEG or fMRI, in conjunction with corresponding data from molecular genetics. This view is supported by early unimodal studies of the N-back working memory paradigm, which tended to find well-matched siblings and healthy controls performed equivalently; Inhibitors,research,lifescience,medical addition of fMRI activation data showed sibling groups use increased neural resources in doing so. It is conceivable that collecting EEG/magnetoencephalogram (MEG) data indexing the temporal evolution of a paradigm such as the N-back would allow an increased understanding of the role of

spectral coherence and stimulus-locked phase synchrony in distinguishing group differences in the cognitive process, particularly in Inhibitors,research,lifescience,medical light of a developing consensus on a battery of cognitive instruments that may reliably distinguish patients with schizophrenia from comparison groups.123,124 Finally, the weight of convergent evidence supports initial assumptions that intermediate phenotypes Inhibitors,research,lifescience,medical indexing disruptions of cognition would enhance the search for susceptibility genes in schizophrenia. Such developments support the continuing search for intermediate phenotypes, and suggest this will be an increasingly effective strategy empowering the identification of risk alleles in schizophrenia. selleck inhibitor Selected abbreviations and acronyms DLPFC dorsolateral prefrontal cortex DZ dizygotic (twin) ERP event-related potential MZ monozygotic (twin) NAA N-acetylaspartate SNP single nucleotide polymorphism
Alcohol Inhibitors,research,lifescience,medical is a common “addictive” substance. As a psychoactive compound, it can elicit a spectrum of behavioral effects, which include gregariousness, aggression, loss of executive function, and cognitive deficits. While pharmacokinetic factors (absorption, distribution in the tissues, and rate of metabolism, primarily in the liver) contribute to the Inhibitors,research,lifescience,medical intensity and duration of ethanoPs actions,

the behavioral manifestations Unoprostone are a consequence of the effects of ethanol on the brain. The spectrum of behavioral effects is attributed to the ability of ethanol to inhibit or activate multiple neural pathways, and how one responds to alcohol will ultimately depend on how the neural pathways are organized in an individual, and the extent to which certain pathways are inhibited or activated. It is known that there is substantial variability in the response to alcohol, and differences in cognitive evaluation of ethanol’s effects are likely to play a significant role in the predisposition to alcohol abuse and dependence. Although the diagnoses for alcohol use disorders are based on a range of reported symptoms, they are typically treated as a binary outcome (affected or unaffected).

The drugs used in this approach aim at retarding the formation of the lysosomal substance to a rate at which the residual enzyme activity can catabolize find more stored and incoming lysosomal substance. Two main classes of inhibitors of glycosphingolipid biosynthesis have at present been described. Both inhibit the ceramide-specific glucosyltransferase: the first class of inhibitors is made of analogues of ceramide; the second one of N-alkylated

iminosugars (9). N-butyldeoxynojirimycin Inhibitors,research,lifescience,medical (Miglustat) was approved for patients with mild to moderate type 1 Gaucher disease unwilling or unable to receive ERT (10). The use of hydrophobic iminosugars seemed to be promising in mouse models of Tay-Sachs disease, Sandhoff disease, GM1 gangliosidosis and Niemann-Pick disease type C (11, 12). At present many more trails Inhibitors,research,lifescience,medical with miglustat are being carried out in patients with Niemann-Pick disease type C, late-onset Tay-Sachs disease and juvenile Sandhoff disease (GM2

gangliosidosis). A new therapeutic strategy has been recently undertaken for some LSDs; it is based on the use of “chaperone” substances, that have the function of binding and stabilizing misfolding-prone proteins, thus increasing the residual enzyme activity (7). In particular, it has been proved that the infusion of galactose or certain reversible Inhibitors,research,lifescience,medical competitive inhibitors of α-galactosidase A (such as 1-deoxy-galactonojirimycin) can increase the residual enzyme activity in cultures of fibroblasts from patients with the cardiac variant of Fabry Inhibitors,research,lifescience,medical disease (13). An active site-directed chemical chaperone for α-galactosidase A to treat Fabry disease is currently in phase I clinical trial. Matsuda and coworkers have synthesized a galactose derivative for the chaperone chemical therapy of GM1-gangliosidosis

(14). At present, chemical chaperoning has shown to be effective in increasing Inhibitors,research,lifescience,medical the activity of the highly prevalent N370S and the less common G202R glucocerebrosidase variants, by culturing Gaucher patient’s fibroblasts with a variety of iminosugar compounds (15). Finally, in the last few years, many studies have been carried out in vitro as well as on animal models to evaluate the effectiveness of gene therapy in LSDs. This therapeutic strategy is based many on the idea of directly transfering the normal gene into the defective cells in order to supply the active enzyme and, consequently, reduce the intralysosomal undegraded substances. This can be achieved by either ex vivo or direct in vivo gene therapy strategies. Table ​Table33 lists the viral vectors tested so far for in vivo gene transfer (16, 17) and references therein. Table 3 Gene therapy strategies ((16, 17) and references therein). Experiments on animal models have been carried out in Mucopolysaccharidosis I, II, III, VI, VII, in many Lipidoses, such as Gaucher disease, Fabry disease, Metachromatic leukodystrophy, GM1 and GM2 Gangliosidosis, Niemann-Pick disease, Farber disease and Pompe disease.

The mean CDT in patients with colon cancer who had never received any chemotherapy was 0.067 ± 0.025% (n= 12). No significant difference in mean baseline CDT was observed between healthy subjects and patients with colon cancer. In addition, no serious adverse events occurred during the study and all doses of menthol were well tolerated. Changes in the CDT before and after oxaliplatin administration (experiment 2) Figure 2a shows the CDTs that were obtained before and after the first oxaliplatin administration in patients who had never received chemotherapy. All Inhibitors,research,lifescience,medical but one patient were hypersensitive to menthol as indicated by a significant decrease in the CDT from 0.067 ± 0.025% to

0.028 ± 0.029% (n= 12, P= 0.0025). The CDTs were also measured before and after oxaliplatin administration in patients who had previously received oxaliplatin (n= 24, median, 330 mg/m2; range, 85 − 2450 mg/m2). Under these conditions, the CDT significantly decreased from 0.151 ± 0.263% to 0.083 ± 0.198% (n= 24, P= 0.0004) (Fig. 2b). Taken together, these findings show that the Inhibitors,research,lifescience,medical mean baseline CDT was significantly higher in patients previously treated with oxaliplatin (n= 24) than in untreated subjects (n= 52) (0.151% vs. 0.066%, P= 0.0225). Figure 2 Changes in the cold sensation detection threshold (CDT) before and after oxaliplatin administration. Inhibitors,research,lifescience,medical (a) The CDT was determined by applying menthol before and after the Inhibitors,research,lifescience,medical first

oxaliplatin administration. The CDT significantly decreased from 0.067 ± … When the relationship between the CDTs and the CTCAE neurotoxicity ratings in oxaliplatin-treated patients was High Content Screening evaluated, the CDTs were found to be significantly decreased in patients who had grade 1 or less neurotoxicity (from 0.073% to 0.028%) (n= 9, P= 0.0126) (Fig. 2d), and grade 2 (from 0.183% to 0.036%) (n= 8, P= 0.022) (Fig. 2e), but not in those with grade 3 neurotoxicity (from 0.214% to 0.209%) (n= 7, P= 1.0) (Fig. 2f). Discussion Our results indicate a potential Inhibitors,research,lifescience,medical correlation between TRPM8 activity and OPN, especially in acute hypersensitivity to CS, and that acute changes in CDT may facilitate the identification of early OPN. In chemotherapy-naïve patients, the significant

sensitivity to topical menthol developed after the first oxaliplatin infusion, suggesting that oxaliplatin had indeed induced cold hypersensitivity. In contrast, patients with previous oxaliplatin exposure showed reduced cold hypersensitivity. With regard to the relationship between the CDT and neurotoxicity grade, we found that mild or moderate neurotoxicity was associated with significant changes in the CDT, while severe neurotoxicity was not associated with marked changes in the CDT. Whether the CDT remains unaltered in oxaliplatin-treated patients who do not develop OPN despite chronic oxaliplatin exposure requires further investigation. Nonetheless, these findings suggest that the CDT is a sensitive marker of early oxaliplatin-induced sensory disturbances.

The angle of repose was determined by the fixed-based

funnel method. Bulk and tapped densities were measured in 10 mL of a graduated cylinder. The cylinder was IPI-145 price tapped from a height of 2 inches until a constant volume was obtained. The volume occupied by the sample after tapping was recorded and bulk density, tapped density, Carr’s index and Hausner’s ratio was calculated. Microspheres containing equivalent to 10 mg of drug was allowed to equilibrate in 100 mL of phosphate buffer pH 7.4 for 24 h. The solution was filtered using Whatman filter paper (44). The resulting solution was analyzed using a UV spectrophotometric method at 318 nm in the presence of a blank prepared from microspheres containing all materials except the drug. %Drugentrapment=calculateddrugconcentration/theoreticaldrugconcentration×100

DSC studies were performed using a DSC METTLER Switzerland with thermal analyzer. Accurately weighed samples (about 5 mg) were placed in a sealed aluminum pan, before heating under nitrogen flow (20 mL/min) at a scanning rate of 20 °C per min from 40 to 300 °C. An empty aluminum pan was used as reference. DSC thermograms of pure substances, their physical mixtures and drug-loaded microparticles were recorded. In vitro Modulators release study of microspheres was performed in pH progression medium at 37 °C ± 0.5 °C. The drug dissolution test of microspheres was performed by the paddle method check details (USP dissolution apparatus Type II, Electrolab Limited, India). Microspheres equivalent to 100 mg were weighed accurately and put in muslin cloth and tied this to paddle over the surface of 900 mL of dissolution medium. The content was rotated at 100 rpm. The pH of the dissolution medium was kept 1.2 for 2 h using 0.1 N HCl. After 2 h, the pH of the dissolution medium was adjusted to 7.4 with 0.1 N NaOH and maintained up to 8 h. The samples were withdrawn from the dissolution medium at various time intervals using a pipette. The rate of drug release was analyzed using UV spectrophotometer (JASCO, Ahmadabad, India). Design-Expert software (Design Expert trial version 8.0.7.1; State-Ease Inc., Minneapolis, MN, USA) was used. A two-factor

three-level full factorial design was used for systemic study of combination of polymers. Polynomial models including interaction and quadratic Fossariinae terms were generated for the entire response variables using multiple linear regression analysis (MLRA) approach. The general form of the MLRA model is represented in the equation Y=b0+b1X1+b2X2+b12X1X2Y=b0+b1X1+b2X2+b12X1X2Where Y is the dependent variable; b0 is the arithmetic average of all the quantitative outcomes of nine runs. b1, b2, b12 are the estimated coefficients computed from the observed experimental response values of Y and X1 and X2 are the coded levels of the independent variables. The interaction term (X1X2) shows how the response values change when two factors are simultaneously changed.

One position is that compulsive

hoarding should be included in our diagnostic system as an independent syndrome, which is sometimes comorbid with OCD. Including hoarding as a separate syndrome has a number of important practical advantages, well-summarized by Rachman and colleagues.21 For example, it would expand the boundaries of the hoarding population to be consistent with the data showing a high incidence of hoarding not associated with OCD. It would also encourage clinicians and researchers to use hoarding-specific assessment tools rather than Screening Library screening measures designed for OCD, and facilitate the development of new treatment Inhibitors,research,lifescience,medical methods for hoarding. Another possibility is that hoarding may be listed in DSM-5 as both a separate syndrome and as an OCD symptom. Epidemiology Hoarding researchers also have made substantial progress in understanding the Inhibitors,research,lifescience,medical prevalence and manifestation of compulsive hoarding in the population. Until very recently, researchers estimated

the prevalence of hoarding as a subportion of individuals with OCD in the community.22 Similarly, information regarding the burden of hoarding was based on anecdotal evidence and small samples. Recent epidemiological studies, however, suggest that compulsive hoarding may be far more prevalent and burdensome Inhibitors,research,lifescience,medical in the community than previously thought. Data from the Baltimore Epidemiologic Inhibitors,research,lifescience,medical Catchment Area Follow-up survey suggest that 5% of the general population experiences clinically significant hoarding, while data from the National Comorbidity Survey Replication indicate that the lifetime prevalence of compulsive hoarding may be as high as 14%.23,24 These studies estimated hoarding based upon reports of difficulty

discarding, and did not specifically target clutter and excessive acquisition, and thus it is unknown whether cases met criteria for compulsive hoarding as defined by Frost and Hart.11 A recent twin study that utilized a self -report instrument to assess the broad hoarding phenotype found that Inhibitors,research,lifescience,medical 2% of its sample reported clinically significant hoarding symptoms.25 As symptom severity obtained by self-report tends to be lower than clinician-rated severity, the current prevalence of clinically significant compulsive hoarding may be somewhere between 2% and 5%. Importantly, aminophylline a large proportion of individuals who hoard report having at least one first-degree relative who experiences hoarding problems.3,14 In a sample of individuals with OCD, Samuels and colleagues14 reported that probands of individuals with hoarding symptoms were four times more likely to experience hoarding symptoms than probands of individuals who did not report hoarding symptoms. Genetic factors and unshared environmental factors may explain this familial connection.

g. bleeding, obstruction, perforation) or cases where the

hepatic metastases may be rendered resectable. In the latter two groups, the following treatment strategies have been employed: (I) resection of the primary followed by systemic chemotherapy followed by liver resection ± additional systemic chemotherapy (Staged approach), (II) systemic chemotherapy followed by simultaneous resection of the primary and hepatic metastases (Synchronous approach) and (III) systemic chemotherapy followed by resection of hepatic metastases followed by resection of the primary (so-called “Reverse Strategy”) Inhibitors,research,lifescience,medical (5). The potential risks and benefits of synchronous compared to staged resections are summarized in Table 1. Advocates of a staged approach endorse this AZD9291 clinical trial Strategy due to concerns about increased morbidity and mortality associated with simultaneous resection of the colorectal primary and hepatic metastases. Concerns about the potential safety and technical feasibility of rectal

resections and major hepatic resections have been raised as concerns Inhibitors,research,lifescience,medical regarding simultaneous resections (6). In addition, some surgeons and oncologists have pointed to complications associated Inhibitors,research,lifescience,medical with the unresected primary tumor as another reason for not adopting synchronous resections (7,8). In contrast, proponents of synchronous resections point to the morbidity associated with multiple procedures as a major advantage of a simultaneous resection approach. From an oncologic standpoint, synchronous resection following neoadjuvant chemotherapy provides insight into the patient’s tumor biology and prevents a delay in administering systemic therapy which may occur due to complications

following resection of Inhibitors,research,lifescience,medical Inhibitors,research,lifescience,medical the colorectal primary. Table 1 Potential risks and benefits of synchronous versus staged resection. The current discussion will review the existing literature on staged versus synchronous resection of colorectal cancer and isolated hepatic metastases. Two key issues will be considered: the safety of each resection strategy and oncologic outcomes followed a synchronous versus staged resection. Lastly, we will examine the emerging data available regarding a minimally invasive approach to synchronous colorectal disease with hepatic metastases. Safety of simultaneous versus staged resections The first question to be addressed when considering PAK6 a synchronous versus staged resection for colorectal tumors with hepatic metastases is the safety of each approach. A study by Vogt et al. was among the first to examine the safety of synchronous resection for colorectal cancer (9). The authors compared operative mortality between 19 patients who underwent a synchronous resection to 17 patients who had a staged resection (median 2 months between resections). There were no perioperative deaths in either group.