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991.
Hiromichi Ito Michael Abramson Kaori Ito Edward Swanson Nancy Cho Daniel T. Ruan Richard S. Swanson Edward E. Whang 《Journal of gastrointestinal surgery》2010,14(5):891-898
Background
The aims of this study were to evaluate contemporary outcomes associated with the surgical management of pancreatic neuroendocrine tumors (PNETs) and to assess the prognostic value of the World Health Organization (WHO) classification and TNM staging for PNETs. 相似文献992.
Sasaki A Kai S Endo Y Iwaki K Uchida H Shibata K Ohta M Kitano S 《Annals of surgical oncology》2007,14(11):3181-3187
Background Although extrahepatic metastasis occurs rarely after hepatic resection for hepatocellular carcinoma (HCC), the prognosis of
these patients is extremely poor. Predictors of extrahepatic metastasis have not been fully investigated.
Methods To identify predictors of extrahepatic metastasis after resection, we retrospectively investigated 77 patients with HCC tumors
>50 mm in diameter who underwent hepatic resection. We investigated correlations between postoperative extrahepatic metastasis
and clinicopathologic factors as well as extrahepatic metastasis-free survival rate by log rank test and predictors of extrahepatic
metastasis by univariate and multivariate logistic regression models.
Results Hepatitis B surface antigen (HBs-Ag) was found in 25 (32.5%) of 77 patients, and extrahepatic metastasis occurred in 26 (33.8%).
Patients with extrahepatic metastasis showed better liver function and a high occurrence of HBs-Ag positivity than those without.
The 5-year extrahepatic metastasis-free survival rate was worse in patients with HBs-Ag positivity, larger tumors (≥70 mm),
higher alfa-fetoprotein level (≥300 ng/mL), and lower indocyanine green retention rate at 15 minutes (ICGR15) (<15%) than in those without. By univariate logistic regression analysis, HBs-Ag positivity, larger HCC tumor (≥70 mm),
lower ICGR15 (<15%), and lower preoperative lymphocyte count (<1000/mm3) were predictors of extrahepatic metastasis (P < .1). By multivariate analysis, HBs-Ag positivity was an independent predictor of postoperative extrahepatic metastasis
(P = .04).
Conclusions In patients positive for HBs-Ag, radiologic examination of extrahepatic organs should be performed as a part of the postoperative
surveillance. Hepatitis B virus infection may promote establishment of extrahepatic metastasis. 相似文献
993.
Maria Carmen S.Tan Mary Stephanie S.Carranza Virgilio C.Linis Raymond S.Malabed Yves Ira A.Reyes Francisco C.FrancoJr Glenn G.Oyong 《Asian Pacific Journal of Tropical Biomedicine》2021,(10):460-468
Objective: To evaluate antioxidant, cytotoxic, and anti-venom capacity of crude bark extracts of Alstonia parvifolia Merr. Methods: Gas chromatography-mass spec... 相似文献
994.
995.
Rodrigo Crdoba García Francisco Camarelles Guillem 《Atencion primaria / Sociedad Espa?ola de Medicina de Familia y Comunitaria》2022,54(7)
La morbilidad asociada al consumo de alcohol incluye patología digestiva, psiquiátrica, neurológica, infecciosa, cáncer de diversos tipos, enfermedades cardiovasculares, lesiones intencionales, no intencionales, patología social y problemas familiares. Las evidencias más recientes no indican que el consumo «moderado» sea beneficioso para la salud. Por lo tanto, debe enfatizarse más bien la idea de evitar los consumos de riego y transmitir a los pacientes que lo más beneficioso para la salud sería no consumir alcohol o hacerlo en dosis de bajo riesgo. El instrumento más adecuado de cribado es el AUDIT-C. Las bases de la intervención breve consisten en estrategias cognitivo-conductuales y motivacionales. Hay que dar una información positiva sobre los beneficios de la moderación e informar sobre el peligro de la ingesta de alcohol. En fases precoces de la dependencia se contempla la oferta de tratamiento farmacológico de desintoxicación, deshabituación y seguimiento. Los casos más graves requieren coordinación con los servicios de adicciones. En España se ha podido comprobar que la intervención breve es efectiva y que disminuye el consumo 100 gramos de alcohol a la semana. Las estrategias comunitarias son el marco normativo adecuado para lograr los mejores resultados de la intervención breve. Estas deberán ir encaminadas a reducir la oferta y la disponibilidad para el consumo, mediante la adopción de medidas legislativas, de manera que se limite tanto la accesibilidad económica como la física. Por otra parte, habrá que implementar medidas para disminuir la demanda del alcohol mediante la educación para la salud a determinados grupos de riesgo.Palabras clave: Alcohol, Intervención breve, Prevención, Atención Primaria 相似文献
996.
Fabián Matías Caro María Laura Alberti Federico Campins Juan Ignacio Enghelmayer Martín Eduardo Fernández Diana Lancellotti Tulio Papucci Javier Adrián Sebastiani Francisco Paulin 《Archivos de bronconeumologia》2019,55(2):75-80
Introduction
Pirfenidone was the first antifibrotic drug approved in Argentina for idiopathic pulmonary fibrosis (IPF). Outcomes in real life may differ from the results of clinical trials. The primary endpoint was to study the tolerance of pirfenidone in real life. Secondary endpoints were to analyze effectiveness and reasons for discontinuation.Materials and methods
Retrospective observational study conducted in four specialized centers in Argentina. We analyzed the medical records of patients with IPF who received pirfenidone between June 2013 and September 2016. Adverse events (AE) and the variables that could influence these results were analyzed. Forced vital capacity (FVC%) parameters were also compared between the pre-pirfenidone and post-pirfenidone periods.Results
Fifty patients were included, 38 (76%) men, with mean age (SD) 67.8 (8.36) years. Mean (SD) exposure to pirfenidone was 645.68 (428.19) days, with a mean daily dose (SD) of 2064.56 mg (301.49). Nineteen AEs in 15 patients (30%) were reported: nausea (14%), asthenia (10%) and skin rash (8%). A total of 18 patients (36%) interrupted treatment, only 1 definitively. The most frequent reason for discontinuation was failure of suppliers to provide the drug (9 subjects; 18%). We compared the evolution of FVC% between the pre-pirfenidone and post-pirfenidone periods, and found a mean (SD) FVC% decline of 4.03% (7.63) pre-pirfenidone and 2.64% (7.1) post-pirfenidone (P=.534).Conclusions
In our study, pirfenidone was well tolerated and associated with a reduction in FVC decline, although without reaching statistical significance. 相似文献997.
Eduardo Álvarez-Sarrado Fernando Mingol Navarro Raquel J. Rosellón Neus Ballester Pla Francisco Javier Vaqué Urbaneja Carmen Muniesa Gallardo María López Rubio Eduardo García-Granero Ximénez 《American journal of surgery》2019,217(1):114-120
Background
Patients undergoing esophagectomy for cancer usually deal with malnourishment which increases postoperative morbimortality. The objective of this paper is to analyze the nutritional benefits of feeding jejunostomy (FJ) for early postoperative enteral nutrition (EN) and directly-related complications.Material and methods
Retrospective study of 100 patients undergoing esophagectomy for cancer between 2008 and 2016.Results
FJ was placed in 47 patients. 82.98% reached EN requirements in FJ group, with a median EN re-start of 1.9 days and median days to objective requirements of 5 days.51.06% developed directly-related FJ complication, 91.66% of them mild ones (gastrointestinal or catheter-related). 2 patients (4.25%) required re-intervention.No significant differences were shown in total protein and albumin seric levels during first postoperative week and in anastomotic leak rate between both groups (p?>?0.05).Conclusions
Feeding jejunostomies are associated with a great number of complications although most are not life-threatening. Since its nutritional benefit is not proven FJ cannot routinely recommended after esophagectomy. However, the optimal pathway for EN reintroduction, including direct oral intake, is still a matter of debate. 相似文献998.
999.
Raphael Schiffmann 《Journal of inherited metabolic disease》2010,33(4):373-379
Therapy of the central nervous system (CNS) manifestations of lysosomal storage diseases (LSDs) has remained a major challenge
because of its inability to deliver therapeutic agents efficiently across the intact blood–brain barrier. Non-specific therapies
such as hematopoietic stem cell transplantation have been useful in globoid cell leukodystrophy (Krabbe disease) and in some
mucopolysaccharidoses. Anti-inflammatory agents also show promise as adjuvant therapy. High doses of replacement therapy with
native or modified enzyme show renewed promise for correction of CNS cells. Alternatively, small molecules can enter the brain
relatively easily and promote reduction of accumulated substrate or function as pharmacological chaperones to enhance the
level of the deficient enzyme. Gene therapy is still being developed and tested in patients. It is therefore likely that,
thanks to a better understanding of disease mechanism, a variety of therapeutic approaches, used alone or in combination,
will be useful to treat the devastating neurological complications of LSDs. 相似文献
1000.
Adam Abodeely Jorge A. Lagares-Garcia Vincent Duron Matthew Vrees 《Journal of robotic surgery》2010,4(3):161-165
Robotic surgery has recently started to be used for minimally invasive colorectal surgery. Because of limited access and high
cost, very few colorectal units are available in the US. We describe our experience with benign and malignant disease since
September 2008 in a dedicated colorectal practice. A prospective collected robotic database was queried for colon and rectal
procedures. Anonymized demographic, intraoperative, and postoperative data, and pathology information, were collected and
analyzed. A total of 48 robotic procedures for colorectal maladies were performed in the study period. There were 35 females
and 13 males. The average age was 57 years. Twenty-two cases were performed for diverticulitis, 13 for malignancy (10 distal
rectum (<8 cm anal verge), two rectosigmoid, and one ascending colon cancer), 10 for rectal prolapse, two for rectovaginal
fistula, and one for incidental appendiceal mucocele found during a gynecologic resection. The average operating room time
(OR) was 162 min and there were no conversions to open procedures. Blood loss averaged 104 mL. Mean length of hospital stay
(LOS) was 5.4 days. Patient readmission occurred in 27.3% of cases. The anastamotic leak rate was 2.1% (one patient). No mortalities
were reported. When the analysis was performed for colorectal malignancies (13 procedures), there were nine females and four
males. Average age was 59 years. The mean OR time was 191.1 min. Mean intraoperative blood loss was 123 mL and there were
no conversions to open surgery. Average LOS was 7.0 days. There was one anastamotic leak (7.7%). The length of stay was increased
for the patient with anastamotic leak (18 days) and for a patient with high stoma output and postoperative ileus (17 days).
Readmission rate was 30.1%. The total number of lymph nodes retrieved averaged 19.5, with a mean distal margin of 3.0 cm and
in all cases negative radial margins. Robotic colorectal surgery for benign and malignant disease is safe, and short-term
outcomes are comparable with those of traditional and laparoscopic surgery. Oncologic resections were adequate with excellent
lymph node sampling and radial and distal margins. 相似文献