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121.
Katharina Joechle Claire Goumard Eduardo A. Vega Masayuki Okuno Yun-Shin Chun Ching-Wei D. Tzeng Jean-Nicolas Vauthey Claudius Conrad 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2019,21(3):361-369
Background
While post-hepatectomy liver failure (PHLF) accurately predicts short-term mortality, its role in prognosticating long-term overall survival (OS) remains unclear.Methods
Patients who underwent hepatectomy for colorectal liver metastases (CRLM) after portal vein embolization during 1999–2015 were evaluated retrospectively. PHLF was defined per International Study Group of Liver Surgery (ISGLS) criteria and as PeakBil >7 mg/dl. Survival was analyzed using log-rank statistic and Cox regression; patient mortality within 90 days was excluded.Results
Of 175 patients, 68 (39%) had PHLF according to ISGLS criteria, including 40 (23%) with ISGLS grade B/C, and 14 (8%) had PeakBil >7 mg/dl. Patients with PeakBil >7 mg/dl had significantly worse OS than patients without PHLF (median OS, 16 vs 58 months, p = 0.001). Patients with ISGLS defined PHLF (p = 0.251) and patients with ISGLS grade B/C PHLF (p = 0.220) did not have worse OS than patients without PHLF.Conclusion
Peak bilirubin >7 mg/dl impacts on long-term survival after hepatectomy for CRLM and is a better predictor of long-term survival than ISGLS-defined PHLF. 相似文献122.
Protection of humans against malaria by immunization with radiation-attenuated Plasmodium falciparum sporozoites 总被引:12,自引:0,他引:12
Hoffman SL Goh LM Luke TC Schneider I Le TP Doolan DL Sacci J de la Vega P Dowler M Paul C Gordon DM Stoute JA Church LW Sedegah M Heppner DG Ballou WR Richie TL 《The Journal of infectious diseases》2002,185(8):1155-1164
During 1989-1999, 11 volunteers were immunized by the bites of 1001-2927 irradiated mosquitoes harboring infectious sporozoites of Plasmodium falciparum (Pf) strain NF54 or clone 3D7/NF54. Ten volunteers were first challenged by the bites of Pf-infected mosquitoes 2-9 weeks after the last immunization, and all were protected. A volunteer challenged 10 weeks after the last immunization was not protected. Five previously protected volunteers were rechallenged 23-42 weeks after a secondary immunization, and 4 were protected. Two volunteers were protected when rechallenged with a heterologous Pf strain (7G8). In total, there was protection in 24 of 26 challenges. These results expand published findings demonstrating that immunization by exposure to thousands of mosquitoes carrying radiation-attenuated Pf sporozoites is safe and well tolerated and elicits strain-transcendent protective immunity that persists for at least 42 weeks. 相似文献
123.
C. A. Navascués M. D. Dr. M. Rodríguez M. D. N. G. Sotorrío M. D. P. Leiva M. D. A. Martínez M. D. R. Pérez M. D. Ph. D. J. de la Vega M. D. L. Rodrigo M. D. Ph. D. 《Infection》1994,22(4):252-257
Summary Serially collected serum samples from 81 patients with acute non-A, non-B hepatitis were tested for the presence of antibodies to hepatitis C virus (anti-HCV) by a second-generation enzyme immunoassay (EIA) test. Anti-HCV was detected in 56 cases (69%) during the first month, in 61 cases (75%) at 3 months and in 63 cases (78%) at 6 months. In those 18 patients showing anti-HCV negative results in the three determinations, hepatitis C virus (HCV) RNA was tested using a nested polymerase chain reaction (PCR) in the first serum sample and was detected in only one case. Anti-HCV or HCV-RNA positive episodes were considered as acute hepatitis C, while those negative for both markers were classified as acute non-A, non-B, non-C hepatitis. On comparing acute hepatitis C with the non-A, non-B, non-C episodes, no significant differences were found in the presence of jaundice, mean maximum alanine-aminotransferase (ALT) levels and positivity of markers of past hepatitis B virus (HBV) infection. However, patients with hepatitis C were significantly younger than those with non-A, non-B, non-C hepatitis (p=0.002). Male sex (78.1% vs. 35.3%; p=0.001), history of parenteral exposure (90.6% vs. 11.8%; p=0.0001), and progression to chronicity (73.4% vs. 5.9%; p=0.0001) were significantly more frequent in the HCV-related group. Although other possibilities cannot be excluded, these results suggest that there might be a different infectious agent implicated in the etiology of acute non-A, non-B, non-C hepatitis. This unidentified agent appears to be transmitted by the parenteral route with a lower frequency than HCV and to be responsible for acute hepatitis with a severity similar to that of acute hepatitis C but with a lower chronicity rate.
Epidemiologische, klinische und biologische Charakteristika der akuten Non-A-, Non-B-Hepatitis mit und ohne Beteiligung des Hepatitis C Virus
Zusammenfassung Serielle Serumproben von 81 Patienten mit akuter Non-A-, Non-B-Hepatitis wurden mit einem Enzym-Immunassay (EIA) der zweiten Generation auf Antikörper gegen das Hepatitis C Virus (anti-HCV) getestet. Im ersten Monat waren 65 Fälle (69%) anti-HCV positiv, in 61 Fällen (75%) nach 3 Monaten und in 63 Fällen (78%) nach 6 Monaten. Bei 18 Fällen mit negativen Testergebnissen bei allen drei Terminen wurde Hepatitis C Virus (HCV) RNA mittels geschachtelter PCR in der ersten Serumprobe nur in einem Fall gefunden. Anti-HCV oder HCV-RNA positive Fälle wurden als akute Hepatitis C klassifiziert. Fälle, die bei beiden Testverfahren negativ blieben, als akute Non-A-, Non-B-Hepatitis. Diese beiden Kategorien unterschieden sich nicht signifikant hinsichtlich des Auftretens von Ikterus, maximalen ALT-Spiegeln und positivem Testausfall für zurückliegende Infektionen mit dem Hepatitis B Virus (HBV). Patienten mit Hepatitis C waren jedoch signifikant jünger als Patienten mit Non-A-, Non-B-Hepatitis (p=0,002). Männliches Geschlecht war ebenso häufiger (78,1% vs. 35,3%; p=0,001) wie Vorgeschichte parenteraler Exposition (90,6% vs. 11,8%; p=0,0001) und Progression zur Chronizität (73,4% vs. 5,9%; p=0,0001) in der durch HCV infizierten Gruppe. Möglicherweise ist in der Ätiologie der Non-A-, Non-B-Hepatitis ein weiteres infektiöses Agens involviert, obwohl sich andere Möglichkeiten nicht ausschließen lassen. Der unbekannte Erreger scheint seltener parenteral übertragen zu werden als HCV und für eine akute Hepatitis verantwortlich zu sein, die in ihrem Schweregrad der akuten Hepatitis C ähnlich ist, aber seltener einen chronischen Verlauf nimmt.相似文献
124.
125.
Scott M. Grundy Corbin Williams Gloria L. Vega 《European journal of clinical investigation》2018,48(7)
Background
The metabolic syndrome is a constellation of risk factors including dyslipidemia, dysglycemia, hypertension, a pro‐inflammatory state, and a prothrombotic state. All of these factors are accentuated by obesity. However, obesity can be defined by body mass index (BMI), percent body fat, or by body fat distribution. The latter consists of upper body fat (subcutaneous and visceral fat) and lower body fat (gluteofemoral fat). Waist circumference is a common surrogate marker for upper body fat.Methods
Data from the National Health and Nutrition Examination Survey (NHANES) for the years 1999‐2006 was examined for associations of metabolic risk factors with percent body fat, waist circumference, and BMI.Results
Associations between absolute measures of waist circumference and risk factors were similiar for men and women. The similarities of associations between waist circumference and risk factors suggests that greater visceral fat in men does not accentuate the influence of upper body fat on risk factors.Conclusions
Different waist concumference values should not be used to define abdominal obesity in men and women. 相似文献126.
Daniel H. Montes-Cortés José L. Novelo-Del Valle Ivonne M. Olivares-Corichi José V. Rosas-Barrientos Luis J. Jara María Pilar Cruz-Domínguez 《The American journal of emergency medicine》2018,36(9):1570-1576
Hyperammonemia results from hepatic inability to remove nitrogenous products generated by protein metabolism of intestinal microbiota, which leads to hepatic encephalopathy (HE) in chronic liver disease (CLD). In ammonium neurotoxicity, oxidative stress (OxS) plays a pathogenic role. Our objective was to evaluate if intestinal mannitol is as effective and safe as conventional treatment for diminishing hyperammonemia, OxS, and HE in patients with CLD.
Material and methods
We included 30 patients with HE classified by “Haven Criteria for Hepatic Encephalopathy”. They were randomized into two groups: 1) Mannitol Group (MG) with mannitol 20% administered into the intestine by an enema, 2) conventional group (CG) with lactulose 40?g enema both substances were diluted in 800?mL of double distilled solution every 6?h; all patients received neomycin. We evaluated ammonia concentration, plasma oxidative stress, HE severity, intestinal discomfort and adverse effects.Results
Hyperammonemia (171?±?104 vs 79?±?49?μmol ammonia/L, p?<?0.01), and oxidative stress (MDA 29 vs 27%, formazan 15 vs 11%, carbonyls 16 vs 9% and dityrosines 10 vs 5%) were reduced in MG and CG respectively. The HE severity decreased by two degrees compared to baseline values in both groups. Intestinal discomfort and electrolyte plasma alterations were less frequent (p?<?0.05) in MG than CG.Conclusions
Intestinal mannitol is as effective and safe as conventional treatment for reducing hyperammonemia, oxidative stress, and hepatic encephalopathy of CLD patients in the emergency room. Likewise, mannitol is better tolerated than conventional treatment. 相似文献127.
128.
Pathogenesis of systemic scleroderma: immunological aspects 总被引:3,自引:0,他引:3
Mouthon L García De La Peña-Lefebvre P Chanseaud Y Tamby MC Boissier MC Guillevin L 《Annales de médecine interne》2002,153(3):167-178
Systemic sclerosis (SSc) is a connective tissue disorder that is characterized by excessive collagen synthesis by fibroblasts and by vascular hyperreactivity and obliteration phenomena. Excessive collagen production is the consequence of abnormal interactions between endothelial cells, fibroblasts and mononuclear cells. Immunological abnormalities are present very early in the development of SSc. Mononuclear cells, particularily macrophages and T lymphocytes play a prominent role in fibroblast activation and collagen synthesis through the cytokines they produce. Thus, lymphocytic infiltrates in the skin and in the lung are preferentially composed of CD8+ T lymphocytes, that produce important amounts of interleukin 4 (IL-4). The effects of IL-4 are added to these of transforming growth factor B (TGF-B) and connective tissue growth factor (CTGF) that stimulate collagen synthesis by fibroblasts. T lymphocytes produce important amounts of gamma interferon (INF-gamma) that is the best inhibitor of collagen synthesis by fibroblasts. However, the inhibitory effect of INF-gamma on collagen synthesis is diminished in SSc patients. Numerous autoantibodies can be evidenced in the serum of SSc patients. Three of them are specific for SSc and mutually exclusive: anti-centromere antibodies (Ab) in limited SSc, anti-Scl70 Ab in diffuse SSc and anti-RNA polymerase III Ab in diffuse SSc with renal involvement. These autoantibodies are good prognosis markers but their pathogenic role remains uncertain. 相似文献
129.
Infusion phlebitis in post-operative patients: when and why 总被引:1,自引:0,他引:1
Monreal M Oller B Rodriguez N Vega J Torres T Valero P Mach G Ruiz AE Roca J 《Haemostasis》1999,29(5):247-254
BACKGROUND: The most common complication of intravenous therapy is infusion phlebitis. This study was done to prospectively assess its frequency in a series of consecutive patients who will undergo surgery, and to identify which variables may predict an increased risk for phlebitis. PATIENTS AND METHODS: 400 consecutive patients who will undergo surgery in a general surgery department were included. Only the first catheter, inserted the day before surgery, was taken into account. Eighteen variables (from the infusion, the catheter and from the patient) were prospectively evaluated for their contribution to the occurrence of phlebitis. RESULTS: 60/400 patients (15%) developed phlebitis, and most of them needed insertion of a further catheter. The univariate analysis showed that patients who developed phlebitis were older, and their pre-operative levels of both blood haemoglobin and neutrophil cound were significantly higher than those in patients who did not develop phlebitis. However, the multivariate analysis only confirmed the association with blood haemoglobin levels: the risk of phlebitis sharply increased in the patients with the highest haemoglobin levels. As to the influence of time on phlebitis development, there was a significant decrease in the day-specific risk, from the 5th day on. COMMENTS: In our series, blood haemoglobin levels were found to be the only variable associated to a higher risk of phlebitis. Besides, in contrast with the recommendations by the Centers for Disease Control, no significant increase in the day-specific risk of phlebitis was found. Thus, a guideline to select the type of catheter to be inserted in an individual patient is suggested. 相似文献