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71.
Avinash Bhakta Owen Glotzer Ashar Ata Marcel Tafen Steven C. Stain Paul T. Singh 《American journal of surgery》2018,215(4):643-646
Background
Postoperative pain management is a major contributor to recovery and discharge in bariatric surgery. Local anesthetic agents are of particular interest: they're non-sedating and may reduce postoperative pain and hospital length of stay (LOS).Design
Researchers queried the Bariatric Surgery Service Database for patients undergoing laparoscopic weight loss surgery from January 2012–December 2014. Patients were divided between those who did and did not receive liposomal bupivacaine intra-operatively. Measures included demographics, narcotic use, LOS, antiemetic use, and pain scales.Results
The liposomal group consisted of 233 patients and the PCA group consisted of 243 patients. The liposomal group had significantly less narcotic use than the PCA group in terms of IV morphine equivalents. This did not translate into a reduction in LOS in the liposomal group.Conclusions
TAP block using liposomal bupivacaine provides effective analgesia comparable to PCA. 相似文献72.
Joseph L. Bryant Poornachander R. Guda Sugata Ray Girma Asemu Avinash R. Sagi Fahad Mubariz Muhammed I. Arvas Omar S. Khalid Vivek Shukla Vamshi K.C. Nimmagadda Tapas K. Makar 《Experimental and molecular pathology》2018,104(3):239-249
Human immunodeficiency virus-associated nephropathy (HIVAN) is a leading cause of end-stage renal disease in HIV patients, which is characterized by glomerulosclerosis and renal tubular dysfunction. Aquaporin-4 (AQP-4) is a membrane bound water channel protein that plays a distinct role in water reabsorption from renal tubular fluid. It has been proven that failure of AQP-4 insertion into the renal tubular membrane leads to renal dysfunction. However, the role of AQP-4 in HIVAN is unclear. We hypothesize that impaired water reabsorption leads to renal injury in HIVAN, where AQP-4 plays a crucial role. Renal function is assessed by urinary protein and serum blood urea nitrogen (BUN). Kidneys from HIV Transgenic (TG26) mice (HIVAN animal model) were compared to wild type mice by immunostaining, immunoblotting and quantitative RT-PCR. TG26 mice had increased proteinuria and BUN. We found decreased AQP-4 levels in the renal medulla, increased endothelin-1, endothelin receptor A and reduced Sirtuin1 (SIRT-1) levels in TG26 mice. Also, oxidative and endoplasmic reticulum stress was enhanced in kidneys of TG26 mice. We provide the first evidence that AQP-4 is inhibited due to induction of HIV associated stress in the kidneys of TG26 mice which limits water reabsorption in the kidney which may be one of the cause associated with HIVAN, impairing kidney physiology. AQP-4 dysregulation in TG26 mice suggests that similar changes may occur in HIVAN patients. This work may identify new therapeutic targets to be evaluated in HIVAN. 相似文献
73.
74.
Avinash Ramyead Erich Studerus Michael Kometer Ulrike Heitz Ute Gschwandtner Peter Fuhr 《The world journal of biological psychiatry》2016,17(4):296-307
Objectives: In chronic schizophrenic psychoses, oscillatory abnormalities predominantly occur in prefrontal cortical regions and are associated with reduced communication across cortical areas. Nevertheless, it remains unclear whether similar alterations can be observed in patients with a first episode of psychosis (FEP), a state characterised by pathological features occurring in both late prodromal patients and initial phases of frank schizophrenic psychoses. Methods: We assessed resting-state electroencephalographic data of 31 antipsychotic-naïve FEP patients and 29 healthy controls (HC). We investigated the three-dimensional (3D) current source density (CSD) distribution and lagged phase synchronisation (LPS) of oscillations across small-scale and large-scale brain networks. We additionally investigated LPS relationships with clinical symptoms using linear mixed-effects models. Results: Compared to HC, FEP patients demonstrated abnormal CSD distributions in frontal areas of the brain; while decreased oscillations were found in the low frequencies, an increase was reported in the high frequencies (P?<?0.01). Patients also exhibited deviant LPS in the high frequencies, whose dynamics changed over increasing 3D cortico-cortical distances and increasing psychotic symptoms. Conclusions: These results indicate that in addition to prefrontal cortical abnormalities, altered synchronised neural oscillations are also present, suggesting possible disruptions in cortico-cortical communications. These findings provide new insights into the pathophysiological mechanisms of emerging schizophrenic psychoses. 相似文献
75.
In vitro evidence that cytokine receptor signals are required for differentiation of double positive thymocytes into functionally mature CD8+ T cells 下载免费PDF全文
Yu Q Erman B Bhandoola A Sharrow SO Singer A 《The Journal of experimental medicine》2003,197(4):475-487
CD4(+)8(+) double positive (DP) thymocytes differentiate into CD4(+) and CD8(+) mature T cells in response to TCR signals. However, TCR signals that are initiated in DP thymocytes are unlikely to persist throughout all subsequent differentiation steps, suggesting that other signals must sustain thymocyte differentiation after TCR signaling has ceased. Using an in vitro experimental system, we now demonstrate that cytokine receptor signals, such as those transduced by IL-7 receptors, are required for differentiation of signaled DP thymocytes into functionally mature CD8(+) T cells as they: (a) up-regulate Bcl-2 expression to maintain thymocyte viability; (b) enhance CD4 gene silencing; (c) promote functional maturation;and (d) up-regulate surface expression of glucose transporter molecules, which improve nutrient uptake and increase metabolic activity. IL-7Rs appear to be unique among cytokine receptors in maintaining the viability of newly generated CD4(-)8(+) thymocytes, whereas several different cytokine receptors can provide the trophic/differentiative signals for subsequent CD8(+) thymocyte differentiation and maturation. Thus, cytokine receptors provide both survival and trophic/differentiative signals with varying degrees of redundancy that are required for differentiation of signaled DP thymocytes into functionally mature CD8(+) T cells. 相似文献
76.
Chetan V Kantharia R Y Prabhu A N Dalvi Abhijit Raut R D Bapat Avinash N Supe 《Tropical gastroenterology》2007,28(3):105-108
BACKGROUND AND AIMS: Pancreatic trauma is associated with high morbidity and mortality. Diagnosis is often difficult and surgery poses a formidable challenge. METHOD: Data from 17 patients of pancreatic trauma gathered from a prospectively maintained database were analysed and the following parameters were considered: mode of injury, diagnostic modalities, associated injury, grade of pancreatic trauma and management. Pancreatic trauma was graded from I through IV, as per Modified Lucas Classification. RESULTS: The median age was 39 years (range 19-61). The aetiology of pancreatic trauma was blunt abdominal trauma in 14 patients and penetrating injury in 3. Associated bowel injury was present in 4 cases (3 penetrating injury and 1 blunt trauma) and 1 case had associated vascular injury. 5 patients had grade I, 3 had grade II, 7 had grade III and 2 had grade IV pancreatic trauma. Contrast enhanced computed tomography scan was used to diagnose pancreatic trauma in all patients with blunt abdominal injury. Immediate diagnosis could be reached in only 4 (28.5%) patients. 7 patients responded to conservative treatment. Of the 10 patients who underwent surgery, 6 required it for the pancreas and the duodenum. (distal pancreatectomy with splenectomy-3, pylorus preserving pancreatoduodenectomy-1, debridement with external drainage-1, associated injuries-duodenum-1). Pancreatic fistula, recurrent pancreatitis and pseudocyst formation were seen in 3 (17.05%), 2 (11.7%) and 1 (5.4%) patient respectively. Death occurred in 4 cases (23.5%), 2 each in grades III and IV pancreatic trauma. CONCLUSIONS: Contrast enhanced computed tomography scan is a useful modality for diagnosing, grading and following up patients with pancreatic trauma. Although a majority of cases with pancreatic trauma respond to conservative treatment, patients with penetrating trauma, and associated bowel injury and higher grade pancreatic trauma require surgical intervention and are also associated with higher morbidity and mortality. 相似文献
77.
Stephen R. Lee Aoife Kilcoyne Avinash Kambadakone Ronald Arellano 《Abdominal imaging》2016,41(4):677-705
Percutaneous image-guided ablation is now commonly performed in many institutions for the treatment of hepatocellular carcinoma, liver metastases, and renal cell carcinoma in select patients. Accurate interpretation of post-ablation imaging is of supreme importance because treatment algorithms for these diseases rely heavily on imaging to guide management decisions. The purpose of this pictorial essay is to provide abdominal imagers with a review of the indications for percutaneous ablation in the abdomen, a basic overview of ablation modalities in clinical use today, the expected post-ablation imaging findings in the liver and kidney, and potential complications of hepatic and renal ablation procedures. 相似文献
78.
Nimish Rai Avinash Sharma Vinay Kulkarni Ram Godeshwar Pankaj Harkut 《Indian Journal of Thoracic and Cardiovascular Surgery》2010,26(3):216-218
Aortico Left Ventricular Tunnel (ALVT) is a rare congenital anomaly. It presents as an asymptomatic murmur to severe Aortic
Regurgitation (AR) and heart failure. Most of the patients have heart failure in first year of life. Patient rarely present
beyond second decade of life. Here we report a 42 year male with unusual type of ALVT, who presented with heart failure and
conduction disturbances. 相似文献
79.
Deshpande A Nayar PS Pradhan AM Manchanda RV 《Indian journal of hematology & blood transfusion》2010,26(3):115-117
A two months old male infant, presented with fever, hepatosplenomegaly and pancytopenia. On bone marrow aspirate, hemophagocytosis
was noted. Trephine biopsy showed epithelioid granulomas. ZN stain AFB detected, which confirmed the diagnosis of miliary
tuberculosis. This case highlights the rare association of hemophagocytic syndrome with tuberculosis in infancy. 相似文献
80.
Shankaracharya Odedra D Samanta S Vidyarthi AS 《The review of diabetic studies : RDS》2010,7(4):252-262
The development of an effective diabetes diagnosis system by taking advantage of computational intelligence is regarded as a primary goal nowadays. Many approaches based on artificial network and machine learning algorithms have been developed and tested against diabetes datasets, which were mostly related to individuals of Pima Indian origin. Yet, despite high accuracies of up to 99% in predicting the correct diabetes diagnosis, none of these approaches have reached clinical application so far. One reason for this failure may be that diabetologists or clinical investigators are sparsely informed about, or trained in the use of, computational diagnosis tools. Therefore, this article aims at sketching out an outline of the wide range of options, recent developments, and potentials in machine learning algorithms as diabetes diagnosis tools. One focus is on supervised and unsupervised methods, which have made significant impacts in the detection and diagnosis of diabetes at primary and advanced stages. Particular attention is paid to algorithms that show promise in improving diabetes diagnosis. A key advance has been the development of a more in-depth understanding and theoretical analysis of critical issues related to algorithmic construction and learning theory. These include trade-offs for maximizing generalization performance, use of physically realistic constraints, and incorporation of prior knowledge and uncertainty. The review presents and explains the most accurate algorithms, and discusses advantages and pitfalls of methodologies. This should provide a good resource for researchers from all backgrounds interested in computational intelligence-based diabetes diagnosis methods, and allows them to extend their knowledge into this kind of research. 相似文献