Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these ar...Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections(alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum-a major contributor to fracture healing- in the femoral neck. In extracapsularfractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients.展开更多
AIM： To determine whether the hematocrit （Hct） at admission or at 24 h after admission was associated with severe acute pancreatitis （AP）, organ failure （OF）, and pancreatic necrosis. METHODS： A total of 336 c...AIM： To determine whether the hematocrit （Hct） at admission or at 24 h after admission was associated with severe acute pancreatitis （AP）, organ failure （OF）, and pancreatic necrosis. METHODS： A total of 336 consecutive patients with a first AP episode were studied. Etiology, Hct values at admission and at 24 h, development of severe AP according to Atlanta＇s criteria, pancreatic necrosis, OF and mortality were recorded. Hemoconcentration was defined as Hct level 〉44% for males and 〉40% for females. The t-test and ;x^2 test were used to assess the association of hemoconcentration to the severity, necrosis and OF. Diagnostic accuracy was also determined. RESULTS： Biliary disease was the most frequent etiology （n = 148）. Mean Hct levels at admission were 41±6% for females and 46±7% for males （P〈0.01）. Seventyeight （23%） patients had severe AP, and OF developed in 45 （13%） patients. According to contrast-enhanced computed tomography scan, 36% （54/150） patients showed pancreatic necrosis. Hct levels were elevated in 58% （55/96） and 61% （33/54） patients with interstitial and necrotizing pancreatitis, respectively. Neither Hct levels at admission nor hemoconcentration at 24 h were associated with the severity, necrosis or OF. Sensitivity, specificity and positive predictive values for both determinations were very low; and negative predictive values were between 61% and 86%, being the highest value for OF. CONCLUSION： Hct is not a useful marker to predict a worse outcome in acute pancreatitis. In spite of the high negative predictive value of hemoconcentration, the prognosis gain is limited due to an already high incidence of mild disease.展开更多
The association between diabetes and hyperglycemia and the associated increased risk of several solid and hematologic malignancies has been the subject of investigation for many years.Although the association is not f...The association between diabetes and hyperglycemia and the associated increased risk of several solid and hematologic malignancies has been the subject of investigation for many years.Although the association is not fully understood,current knowledge clearly indicates that diabetes may influence malignant cell transformation by several mechanisms,including hyperinsulinemia,hyperglycemia and chronic inflammation.In this context,the receptor for advanced glycation end-products (RAGE) has emerged as a focal point in its contribution to malignant transformation and tumor growth.We high-light how RAGE,once activated,as it manifests itself in conditions such as diabetes or hyperglycemia,is able to continuously bring about an inflammatory milieu,thus supporting the contribution of chronic inflammation to the development of malignancies.展开更多
The adsorption of Mn2＋ onto immobilized Mn-oxide and Fe-oxide adsorbent such as manganese oxide-coated sand 1 （MOCS1）, manganese oxide-coated sand2 （MOCS2）, iron oxide-coated sand2 （IOCS2）, and manganese and ir...The adsorption of Mn2＋ onto immobilized Mn-oxide and Fe-oxide adsorbent such as manganese oxide-coated sand 1 （MOCS1）, manganese oxide-coated sand2 （MOCS2）, iron oxide-coated sand2 （IOCS2）, and manganese and iron oxide-coated sand （MIOCS）was investigated. The effects of pH （5.5 to 8.0） and temperature （25 to45°C） on the equilibrium capacitywere examined. Equilibrium studies showed that there is a good fitwith both Freundlich and Langmuir isotherm,which indicates surface heterogeneity and monolayer adsorption of the adsorbents. Kineticdata showed high correlationwith the pseudo second-order model,which signifies a chemisorption-controlled mechanism. The activation energies, activation parameters （ΔG＊,ΔH＊,ΔS＊）, and thermodynamic parameters （ΔG0 , ΔH0 , ΔS0 ） confirmed that adsorptionwith MIOCSwas endothermic and more spontaneous at higher temperaturewhile an opposite trendwas observed for the other adsorbents. Thermodynamic studies showed that adsorption involved formation of activated complex,where MOCS1 and MIOCS follow a physical-chemical mechanism,while MOCS2 and IOCS2 follows purely chemical mechanism.展开更多
BACKGROUND Helicobacter pylori(H.pylori)is a widespread microorganism related to gastric adenocarcinoma(AC).In contrast,it has been reported that an inverse association exists between H.pylori infection and esophageal...BACKGROUND Helicobacter pylori(H.pylori)is a widespread microorganism related to gastric adenocarcinoma(AC).In contrast,it has been reported that an inverse association exists between H.pylori infection and esophageal carcinoma.The mechanisms underlying this supposedly protective effect remain controversial.AIM To determine the prevalence of H.pylori infection in esophageal carcinoma patients,we performed a retrospective observational study of esophageal tumors diagnosed in our hospital.METHODS We retrospectively reviewed the prevalence of H.pylori infection in a cohort of patients diagnosed with esophageal carcinoma.Concomitant or previous proton pump inhibitor(PPI)usage was also recorded.RESULTS A total of 89 patients with esophageal carcinoma(69 males,77.5%),with a mean age of 66 years(range,26-93 years)were included.AC was the most frequent pathological variant(n=47,52.8%),followed by squamous cell carcinoma(n=37,41.6%).Fourteen ACs(29.8%)originated in the gastroesophageal junction and 33(70.2%)in the esophageal body.Overall,54 patients(60.7%)presented at stages III and IV.Previous H.pylori infection occurred only in 4 patients(4.5%),3 with AC(6.3%of all ACs)and 1 with squamous cell carcinoma(2.7%of all squamous cell tumors).All patients with previous H.pylori infection had stage III-IV.Only one patient had received prior H.pylori eradication therapy,whereas 86(96.6%)had received previous or concomitant PPI treatment.CONCLUSION In our cohort of patients,and after histologic evaluation of paraffin-embedded primary tumors,we found a very low prevalence of previous H.pylori infection.We also reviewed the medical history of the patients,concluding that the majority had received or were on PPI treatment.The minimal prevalence of H.pylori infection found in this cohort of patients with esophageal carcinoma suggests a protective role.展开更多
A micro- and mesoporous carbon obtained from cherry pit waste and activated with HBPO4 acid has been studied as the sulfur host for Li/S batteries. The carbon has a high specific surface area of 1,662 m2·g-1 （S...A micro- and mesoporous carbon obtained from cherry pit waste and activated with HBPO4 acid has been studied as the sulfur host for Li/S batteries. The carbon has a high specific surface area of 1,662 m2·g-1 （SBET） and micropore and mesopore volumes of 0.57 and 0.40 cm3·g-1, respectively. The S/C composite, with a sulfur content of 57% deposited by the disproportionate reaction of a SaO2- solution in an acid medium without an additional heating step above the S melting point, delivers an initial specific capacity of 1,148 mah·g-1 at a current of C/16. It also has a high capacity retention of 915 mAh·g-1 after 100 cycles and a Coulombic efficiency close to 100%. The good performance of the composite was also observed under higher current rates and long-term cycling tests. The capacities delivered by the cell after 200 cycles were 707 and 410 mAh·g-1 at C/2 and 1C （1C = 1,675 mA·g-1）, respectively, maintaining the high Coulombic efficiency. The overall electrochemical response of this carbon as the sulfur matrix is among the best reported so far among the other biomass-derived carbons, probably because of the micro- and mesopore system formed upon activation.展开更多
We describe common and less common diseases that can cause magnetic resonance signal abnormalities of middle cerebellar peduncles(MCP), offering a systematicapproach correlating imaging findings with clinical clues an...We describe common and less common diseases that can cause magnetic resonance signal abnormalities of middle cerebellar peduncles(MCP), offering a systematicapproach correlating imaging findings with clinical clues and pathologic mechanisms. Myelin abnormalities, different types of edema or neurodegenerative processes, can cause areas of abnormal T2 signal, variable enhancement, and patterns of diffusivity of MCP. Pathologies such as demyelinating disorders or certain neurodegenerative entities(e.g., multiple system atrophy or fragile X-associated tremor-ataxia syndrome) appear to have predilection for MCP. Careful evaluation of concomitant imaging findings in the brain or brainstem; and focused correlation with key clinical findings such as immunosuppression for progressive multifocal leukoencephalopahty; hypertension, post-transplant status or high dose chemotherapy for posterior reversible encephalopathy; electrolyte disorders for myelinolysis or suspected toxic-drug related encephalopathy; would yield an appropriate and accurate differential diagnosis in the majority of cases.展开更多
Spinal cord injury is a very common pathological event that has devastating functional consequences in patients. In recent years, several research groups are trying to find an effective therapy that could be applied i...Spinal cord injury is a very common pathological event that has devastating functional consequences in patients. In recent years, several research groups are trying to find an effective therapy that could be applied in clinical practice. In this study, we analyzed the combination of different strategies as a potential therapy for spinal cord injury. Immunization with neural derived peptides(INDP), inhibition of glial scar formation(dipyridyl: DPY), as well as the use of biocompatible matrix(fibrin glue: FG) impregnated with bone marrow mesenchymal stem cells(MSCs) were combined and then its beneficial effects were evaluated in the induction of neuroprotection and neuroregeneration after acute SCI. Sprague-Dawley female rats were subjected to a moderate spinal cord injury and then randomly allocated into five groups: 1) phosphate buffered saline; 2) DPY; 3) INDP + DPY; 4) DPY+ FG; 5) INDP + DPY + FG + MSCs. In all rats, intervention was performed 72 hours after spinal cord injury. Locomotor and sensibility recovery was assessed in all rats. At 60 days after treatment, histological examinations of the spinal cord(hematoxylin-eosin and Bielschowsky staining) were performed. Our results showed that the combination therapy(DPY+ INDP + FG+ MSCs) was the best strategy to promote motor and sensibility recovery. In addition, significant increases in tissue preservation and axonal density were observed in the combination therapy group. Findings from this study suggest that the combination theapy(DPY+ INDP + FG + MSCs) exhibits potential effects on the protection and regeneration of neural tissue after acute spinal cord injury. All procedures were approved by the Animal Bioethics and Welfare Committee(approval No. 178544; CSNBTBIBAJ 090812960)on August 15, 2016.展开更多
The trace elements chemistry of Bartlett Pond, a small shallow wetland pond in Laredo, Southern Texas, was sampled to evaluate the dynamics of trace elements impacts on water quality and ecosystems ecology of the pond...The trace elements chemistry of Bartlett Pond, a small shallow wetland pond in Laredo, Southern Texas, was sampled to evaluate the dynamics of trace elements impacts on water quality and ecosystems ecology of the pond. Two types of fish (bass and tilapia) were also sampled to see the trace element accumulation in different parts of their body. The concentrations of trace elements in water samples were found in the following order: Fe ≫Sb > Pb > As ≫Co > Tl > Cr > Cd within Bartlett Pond. Overall, the water quality of the pond is unacceptable for drinking and any other purposes as trace element concentrations (e.g. As, Cd, Co, Cr, Pb, Fe, Sb and Tl) are exceedingly higher (several fold) than the WHO and US EPA guidelines. Predictive and correlation analysis shows that most trace elements exhibit a strong positive correlation among them indicating the same anthropogenic sources and biogeochemical processes regulate these trace elements within the pond. Distributions of the trace elements in water exhibit different shapes mostly as positively skewed distribution for As, Cd, Co, Cr, and Tl, symmetrical distribution for Fe and almost symmetrical distribution for Pb and Sb. Concentrations of As, Co and Tl accumulated much higher in different parts of the Bass than Tilapia fish. The concentrations of As, Tl, Co, and Sb appeared significantly higher in different parts of the body of both Bass and Tilapia than the maximum SRM certified values. Accumulation of these contaminants in fish tissues pose increased health risks to humans who consume these contaminated fish although fishing is prohibited. Anthropogenic activities in the region primarily degrade the whole pond ecosystem ecology of the Bartlett Pond and waters of this pond to be not recommended for any use. These findings may be useful for the scientific community and concerned authorities to improve understanding about these precious natural resources and conservation of the ecosystem ecology.展开更多
Undoubtedly, since its appearance, the interest and use of autologous fat transfer (AFT) as a breast reconstruction technique have been increasing, becoming one of the main surgical alternatives for aesthetic breast a...Undoubtedly, since its appearance, the interest and use of autologous fat transfer (AFT) as a breast reconstruction technique have been increasing, becoming one of the main surgical alternatives for aesthetic breast augmentation. This increase in its popularity has led to the development of new technologies to increase its efficacy and safety, however, it has inherently implied the inadequate use of this procedure, mainly when performed by unqualified medical personnel. We present the case of a patient with complications following a breast AFT for aesthetic purposes, performed by a general practitioner without a specialty in plastic and reconstructive surgery.展开更多
We present an unusual case of portal vein thrombosis with a splanchnic hemangioma secondary to acute biliary pancreatitis. We report a 45-year-old patient, who has systemic arterial hypertension in treatment, was admi...We present an unusual case of portal vein thrombosis with a splanchnic hemangioma secondary to acute biliary pancreatitis. We report a 45-year-old patient, who has systemic arterial hypertension in treatment, was admitted for abdominal pain in the epigastrium, with irradiation to the right hypochondrium, accompanied by nausea and vomiting of 10 occasions of bile content, physical examination with pain in the right hypochondrium, Murphy positive. We have laboratory studies with a lipase of 788, so a diagnosis of pancreatitis is made with an etiology to be determined. The laboratories suggestive of acute biliary pancreatitis (lipase 788.71);an imaging study was subsequently performed (ultrasonography) with the result of stone in the common bile duct. A laparoscopy was performed with relative improvement, so he was discharged and returned 20 days after surgery due to abdominal pain of the same intensity in the left hypochondrium. Ending his hospitalization with a splenectomy for splenic hemangioma with portal vein thrombosis.展开更多
Meningoencephalitis secondary to Listeria monocytogenes (L. monocytogenes) mainly affects newborns, the elderly and immunocompromised people;there are extremely rare cases in which said infection occurs in immunocompe...Meningoencephalitis secondary to Listeria monocytogenes (L. monocytogenes) mainly affects newborns, the elderly and immunocompromised people;there are extremely rare cases in which said infection occurs in immunocompetent individuals. We present the case of a young adult patient without immunocompromise, who developed meningoencephalitis due to L. monocytogenes;This case is exceptional, since it occurred in an individual outside the classic age group, in addition to not having risk factors, which is why it should be considered an atypical causal agent.展开更多
Introduction: Necrotizing pancreatitis management is complex and varies significantly among clinicians. Minimally invasive approaches like transgastric necrosectomy via laparoscopy are emerging as effective treatment ...Introduction: Necrotizing pancreatitis management is complex and varies significantly among clinicians. Minimally invasive approaches like transgastric necrosectomy via laparoscopy are emerging as effective treatment options. This case report underscores the technique’s efficacy, clinical outcomes, and role in reducing complications. Clinical Observation: A 59-year-old male with a history of smoking and alcoholism presented with severe abdominal pain, nausea, and vomiting. Over the following weeks, he developed symptoms including asthenia, weight loss, and melena. Diagnostic workup revealed severe anemia and Balthazar E necrotizing pancreatitis, with significant intra-abdominal fluid collections and signs of infection. After initial conservative management, the patient underwent transgastric necrosectomy via laparoscopy due to deteriorating clinical status. The procedure involved removing necrotic tissue and performing a cystogastroanastomosis and jejunostomy. Postoperative care included fasting, parenteral nutrition, broad-spectrum antibiotics, and enzymatic replacement. The patient recovered well, with reduced necrotic tissue on follow-up imaging, and was discharged twelve days post-surgery [1]. Conclusion: Transgastric necrosectomy by laparoscopy is a valuable first-line surgical option for patients with symptomatic necrotizing pancreatitis, particularly in cases without prior interventions. This minimally invasive technique helps reduce major complications and mortality, offering a less invasive alternative to traditional open necrosectomy. The multidisciplinary approach and careful postoperative management were crucial to the patient’s favorable outcome. The case highlights the potential of transgastric necrosectomy as an effective treatment strategy in managing complex pancreatitis cases, including those with associated duodenal perforation [2].展开更多
The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of whi...The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of which immediate effects are known such as a greater sensation of well-being, extroversion, increased sensory perception. However, its long-term effects have been described very little in the medical literature, including damage to the heart, central nervous system, kidney, etc. One of its little-known effects is hepatotoxicity, of which few cases are known associated with fulminant hepatitis, which is a rapidly deteriorating condition that is generally associated with a syndrome of multiple organ dysfunction and death. Therefore, it is very important to know this type of damage in the short and long term. The following case is of a 39-year-old man who came to our service due to jaundice syndrome and the only history of MDMA consumption, who as the days went by met the criteria for fulminant liver failure, with damage to multiple organs (organ dysfunction syndrome).展开更多
Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage ...Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.展开更多
Background Persistent inflammatory response in the brain can lead to tissue damage and neurodegeneration.In Alzheimer’s disease(AD),there is an aberrant activation of inflammasomes,molecular platforms that drive infl...Background Persistent inflammatory response in the brain can lead to tissue damage and neurodegeneration.In Alzheimer’s disease(AD),there is an aberrant activation of inflammasomes,molecular platforms that drive inflammation through caspase-1-mediated proteolytic cleavage of proinflammatory cytokines and gasdermin D(GSDMD),the executor of pyroptosis.However,the mechanisms underlying the sustained activation of inflammasomes in AD are largely unknown.We have previously shown that high brain cholesterol levels promote amyloid-β(Aβ)accumulation and oxidative stress.Here,we investigate whether these cholesterol-mediated changes may regulate the inflam-masome pathway.Methods SIM-A9 microglia and SH-SY5Y neuroblastoma cells were cholesterol-enriched using a water-soluble cholesterol complex.After exposure to lipopolysaccharide(LPS)plus muramyl dipeptide or Aβ,activation of the inflammasome pathway was analyzed by immunofluorescence,ELISA and immunoblotting analysis.Fluorescently-labeled Aβwas employed to monitor changes in microglia phagocytosis.Conditioned medium was used to study how microglia-neuron interrelationship modulates the inflammasome-mediated response.Results In activated microglia,cholesterol enrichment promoted the release of encapsulated IL-1βaccompanied by a switch to a more neuroprotective phenotype,with increased phagocytic capacity and release of neurotrophic factors.In contrast,in SH-SY5Y cells,high cholesterol levels stimulated inflammasome assembly triggered by both bacterial toxins and Aβpeptides,resulting in GSDMD-mediated pyroptosis.Glutathione(GSH)ethyl ester treatment,which recovered the cholesterol-mediated depletion of mitochondrial GSH levels,significantly reduced the Aβ-induced oxidative stress in the neuronal cells,resulting in lower inflammasome activation and cell death.Furthermore,using conditioned media,we showed that neuronal pyroptosis affects the function of the cholesterol-enriched microglia,lowering its phagocytic activity and,therefore,the ability to degrade extracell展开更多
Background::Air pollution and poor ambient air quality are significantly related to multiple health risks.One associated disease is chronic obstructive pulmonary disease(COPD),a preventable disease with several contri...Background::Air pollution and poor ambient air quality are significantly related to multiple health risks.One associated disease is chronic obstructive pulmonary disease(COPD),a preventable disease with several contributing factors and one of the leading causes of morbidity/mortality locally and globally.A potentially high-risk population are traffic enforcers who are constantly exposed to air pollution.In the Philippines,the MMDA has the widest coverage in traffic management.The study determined the risk of COPD among Metro Manila Development Authority(MMDA)traffic enforcers in relation to ambient air quality level,as well as identified other factors that increase the risk of developing COPD.Methods::Fifty-two MMDA traffic enforcers deployed in PM 2.5 air quality sensor areas in Metro Manila from 2016 to 2018 were recruited through stratified sampling.The International Primary Airways Guidelines(IPAG)questionnaire was utilized to measure risk of COPD.Respiratory health and working history were obtained through questionnaires.Department of environment and natural resources provided PM 2.5 ambient air quality data which aided in the construction of the Exposure-Month Index.Ordinal logistic regression was used to examine the association of PM 2.5 together with the relevant factors and the risk of COPD.Results::We found statistically significant associations between PM 2.5 and COPD among high risk category[odds risk(OR):1.24,95%confidence interval(CI):1.07-1.44].Age(Moderate,OR:1.16,95%CI:0.98-1.38 and High,OR:10.06,95%CI:4.02-25.17)and chest pain(Moderate,OR:68.65,95%CI:1.71-2.75×103)were potential risk factors,whereas body mass index(BMI)(OR:0.05,95%CI:0.01-0.53)exhibited protective effect.Conclusions::Exposure to PM 2.5 was associated with an increased risk of COPD among high-risk category MMDA traffic enforcers.Age and chest pain were potential risk factors to risk of COPD,whereas BMI exhibited a potential protective effect.Results of this study can be used for clinical management of high-risk populations,such 展开更多
文摘Nowadays, fracture surgery represents a big part of the orthopedic surgeon workload, and usually has associated major clinical and social cost implications. These fractures have several complications. Some of these are medical, and other related to the surgical treatment itself. Medical complications may affect around 20% of patients with hip fracture. Cognitive and neurological alterations, cardiopulmonary affections(alone or combined), venous thromboembolism, gastrointestinal tract bleeding, urinary tract complications, perioperative anemia, electrolytic and metabolic disorders, and pressure scars are the most important medical complications after hip surgery in terms of frequency, increase of length of stay and perioperative mortality. Complications arising from hip fracture surgery are fairly common, and vary depending on whether the fracture is intracapsular or extracapsular. The main problems in intracapsular fractures are biological: vascularization of the femoral head, and lack of periosteum-a major contributor to fracture healing- in the femoral neck. In extracapsularfractures, by contrast, the problem is mechanical, and relates to load-bearing. Early surgical fixation, the role of anti-thromboembolic and anti-infective prophylaxis, good pain control at the perioperative, detection and management of delirium, correct urinary tract management, avoidance of malnutrition, vitamin D supplementation, osteoporosis treatment and advancement of early mobilization to improve functional recovery and falls prevention are basic recommendations for an optimal maintenance of hip fractured patients.
文摘AIM： To determine whether the hematocrit （Hct） at admission or at 24 h after admission was associated with severe acute pancreatitis （AP）, organ failure （OF）, and pancreatic necrosis. METHODS： A total of 336 consecutive patients with a first AP episode were studied. Etiology, Hct values at admission and at 24 h, development of severe AP according to Atlanta＇s criteria, pancreatic necrosis, OF and mortality were recorded. Hemoconcentration was defined as Hct level 〉44% for males and 〉40% for females. The t-test and ;x^2 test were used to assess the association of hemoconcentration to the severity, necrosis and OF. Diagnostic accuracy was also determined. RESULTS： Biliary disease was the most frequent etiology （n = 148）. Mean Hct levels at admission were 41±6% for females and 46±7% for males （P〈0.01）. Seventyeight （23%） patients had severe AP, and OF developed in 45 （13%） patients. According to contrast-enhanced computed tomography scan, 36% （54/150） patients showed pancreatic necrosis. Hct levels were elevated in 58% （55/96） and 61% （33/54） patients with interstitial and necrotizing pancreatitis, respectively. Neither Hct levels at admission nor hemoconcentration at 24 h were associated with the severity, necrosis or OF. Sensitivity, specificity and positive predictive values for both determinations were very low; and negative predictive values were between 61% and 86%, being the highest value for OF. CONCLUSION： Hct is not a useful marker to predict a worse outcome in acute pancreatitis. In spite of the high negative predictive value of hemoconcentration, the prognosis gain is limited due to an already high incidence of mild disease.
文摘The association between diabetes and hyperglycemia and the associated increased risk of several solid and hematologic malignancies has been the subject of investigation for many years.Although the association is not fully understood,current knowledge clearly indicates that diabetes may influence malignant cell transformation by several mechanisms,including hyperinsulinemia,hyperglycemia and chronic inflammation.In this context,the receptor for advanced glycation end-products (RAGE) has emerged as a focal point in its contribution to malignant transformation and tumor growth.We high-light how RAGE,once activated,as it manifests itself in conditions such as diabetes or hyperglycemia,is able to continuously bring about an inflammatory milieu,thus supporting the contribution of chronic inflammation to the development of malignancies.
基金the Philippine ERDT scholarship and Taiwan National Science Council(NSC101-2221-E-041-007)for their financial support
文摘The adsorption of Mn2＋ onto immobilized Mn-oxide and Fe-oxide adsorbent such as manganese oxide-coated sand 1 （MOCS1）, manganese oxide-coated sand2 （MOCS2）, iron oxide-coated sand2 （IOCS2）, and manganese and iron oxide-coated sand （MIOCS）was investigated. The effects of pH （5.5 to 8.0） and temperature （25 to45°C） on the equilibrium capacitywere examined. Equilibrium studies showed that there is a good fitwith both Freundlich and Langmuir isotherm,which indicates surface heterogeneity and monolayer adsorption of the adsorbents. Kineticdata showed high correlationwith the pseudo second-order model,which signifies a chemisorption-controlled mechanism. The activation energies, activation parameters （ΔG＊,ΔH＊,ΔS＊）, and thermodynamic parameters （ΔG0 , ΔH0 , ΔS0 ） confirmed that adsorptionwith MIOCSwas endothermic and more spontaneous at higher temperaturewhile an opposite trendwas observed for the other adsorbents. Thermodynamic studies showed that adsorption involved formation of activated complex,where MOCS1 and MIOCS follow a physical-chemical mechanism,while MOCS2 and IOCS2 follows purely chemical mechanism.
文摘BACKGROUND Helicobacter pylori(H.pylori)is a widespread microorganism related to gastric adenocarcinoma(AC).In contrast,it has been reported that an inverse association exists between H.pylori infection and esophageal carcinoma.The mechanisms underlying this supposedly protective effect remain controversial.AIM To determine the prevalence of H.pylori infection in esophageal carcinoma patients,we performed a retrospective observational study of esophageal tumors diagnosed in our hospital.METHODS We retrospectively reviewed the prevalence of H.pylori infection in a cohort of patients diagnosed with esophageal carcinoma.Concomitant or previous proton pump inhibitor(PPI)usage was also recorded.RESULTS A total of 89 patients with esophageal carcinoma(69 males,77.5%),with a mean age of 66 years(range,26-93 years)were included.AC was the most frequent pathological variant(n=47,52.8%),followed by squamous cell carcinoma(n=37,41.6%).Fourteen ACs(29.8%)originated in the gastroesophageal junction and 33(70.2%)in the esophageal body.Overall,54 patients(60.7%)presented at stages III and IV.Previous H.pylori infection occurred only in 4 patients(4.5%),3 with AC(6.3%of all ACs)and 1 with squamous cell carcinoma(2.7%of all squamous cell tumors).All patients with previous H.pylori infection had stage III-IV.Only one patient had received prior H.pylori eradication therapy,whereas 86(96.6%)had received previous or concomitant PPI treatment.CONCLUSION In our cohort of patients,and after histologic evaluation of paraffin-embedded primary tumors,we found a very low prevalence of previous H.pylori infection.We also reviewed the medical history of the patients,concluding that the majority had received or were on PPI treatment.The minimal prevalence of H.pylori infection found in this cohort of patients with esophageal carcinoma suggests a protective role.
文摘A micro- and mesoporous carbon obtained from cherry pit waste and activated with HBPO4 acid has been studied as the sulfur host for Li/S batteries. The carbon has a high specific surface area of 1,662 m2·g-1 （SBET） and micropore and mesopore volumes of 0.57 and 0.40 cm3·g-1, respectively. The S/C composite, with a sulfur content of 57% deposited by the disproportionate reaction of a SaO2- solution in an acid medium without an additional heating step above the S melting point, delivers an initial specific capacity of 1,148 mah·g-1 at a current of C/16. It also has a high capacity retention of 915 mAh·g-1 after 100 cycles and a Coulombic efficiency close to 100%. The good performance of the composite was also observed under higher current rates and long-term cycling tests. The capacities delivered by the cell after 200 cycles were 707 and 410 mAh·g-1 at C/2 and 1C （1C = 1,675 mA·g-1）, respectively, maintaining the high Coulombic efficiency. The overall electrochemical response of this carbon as the sulfur matrix is among the best reported so far among the other biomass-derived carbons, probably because of the micro- and mesopore system formed upon activation.
文摘We describe common and less common diseases that can cause magnetic resonance signal abnormalities of middle cerebellar peduncles(MCP), offering a systematicapproach correlating imaging findings with clinical clues and pathologic mechanisms. Myelin abnormalities, different types of edema or neurodegenerative processes, can cause areas of abnormal T2 signal, variable enhancement, and patterns of diffusivity of MCP. Pathologies such as demyelinating disorders or certain neurodegenerative entities(e.g., multiple system atrophy or fragile X-associated tremor-ataxia syndrome) appear to have predilection for MCP. Careful evaluation of concomitant imaging findings in the brain or brainstem; and focused correlation with key clinical findings such as immunosuppression for progressive multifocal leukoencephalopahty; hypertension, post-transplant status or high dose chemotherapy for posterior reversible encephalopathy; electrolyte disorders for myelinolysis or suspected toxic-drug related encephalopathy; would yield an appropriate and accurate differential diagnosis in the majority of cases.
基金supported by the National Council of Science and Technology of Mexico(CONACYT),No.178544(to AI)
文摘Spinal cord injury is a very common pathological event that has devastating functional consequences in patients. In recent years, several research groups are trying to find an effective therapy that could be applied in clinical practice. In this study, we analyzed the combination of different strategies as a potential therapy for spinal cord injury. Immunization with neural derived peptides(INDP), inhibition of glial scar formation(dipyridyl: DPY), as well as the use of biocompatible matrix(fibrin glue: FG) impregnated with bone marrow mesenchymal stem cells(MSCs) were combined and then its beneficial effects were evaluated in the induction of neuroprotection and neuroregeneration after acute SCI. Sprague-Dawley female rats were subjected to a moderate spinal cord injury and then randomly allocated into five groups: 1) phosphate buffered saline; 2) DPY; 3) INDP + DPY; 4) DPY+ FG; 5) INDP + DPY + FG + MSCs. In all rats, intervention was performed 72 hours after spinal cord injury. Locomotor and sensibility recovery was assessed in all rats. At 60 days after treatment, histological examinations of the spinal cord(hematoxylin-eosin and Bielschowsky staining) were performed. Our results showed that the combination therapy(DPY+ INDP + FG+ MSCs) was the best strategy to promote motor and sensibility recovery. In addition, significant increases in tissue preservation and axonal density were observed in the combination therapy group. Findings from this study suggest that the combination theapy(DPY+ INDP + FG + MSCs) exhibits potential effects on the protection and regeneration of neural tissue after acute spinal cord injury. All procedures were approved by the Animal Bioethics and Welfare Committee(approval No. 178544; CSNBTBIBAJ 090812960)on August 15, 2016.
文摘The trace elements chemistry of Bartlett Pond, a small shallow wetland pond in Laredo, Southern Texas, was sampled to evaluate the dynamics of trace elements impacts on water quality and ecosystems ecology of the pond. Two types of fish (bass and tilapia) were also sampled to see the trace element accumulation in different parts of their body. The concentrations of trace elements in water samples were found in the following order: Fe ≫Sb > Pb > As ≫Co > Tl > Cr > Cd within Bartlett Pond. Overall, the water quality of the pond is unacceptable for drinking and any other purposes as trace element concentrations (e.g. As, Cd, Co, Cr, Pb, Fe, Sb and Tl) are exceedingly higher (several fold) than the WHO and US EPA guidelines. Predictive and correlation analysis shows that most trace elements exhibit a strong positive correlation among them indicating the same anthropogenic sources and biogeochemical processes regulate these trace elements within the pond. Distributions of the trace elements in water exhibit different shapes mostly as positively skewed distribution for As, Cd, Co, Cr, and Tl, symmetrical distribution for Fe and almost symmetrical distribution for Pb and Sb. Concentrations of As, Co and Tl accumulated much higher in different parts of the Bass than Tilapia fish. The concentrations of As, Tl, Co, and Sb appeared significantly higher in different parts of the body of both Bass and Tilapia than the maximum SRM certified values. Accumulation of these contaminants in fish tissues pose increased health risks to humans who consume these contaminated fish although fishing is prohibited. Anthropogenic activities in the region primarily degrade the whole pond ecosystem ecology of the Bartlett Pond and waters of this pond to be not recommended for any use. These findings may be useful for the scientific community and concerned authorities to improve understanding about these precious natural resources and conservation of the ecosystem ecology.
文摘Undoubtedly, since its appearance, the interest and use of autologous fat transfer (AFT) as a breast reconstruction technique have been increasing, becoming one of the main surgical alternatives for aesthetic breast augmentation. This increase in its popularity has led to the development of new technologies to increase its efficacy and safety, however, it has inherently implied the inadequate use of this procedure, mainly when performed by unqualified medical personnel. We present the case of a patient with complications following a breast AFT for aesthetic purposes, performed by a general practitioner without a specialty in plastic and reconstructive surgery.
文摘We present an unusual case of portal vein thrombosis with a splanchnic hemangioma secondary to acute biliary pancreatitis. We report a 45-year-old patient, who has systemic arterial hypertension in treatment, was admitted for abdominal pain in the epigastrium, with irradiation to the right hypochondrium, accompanied by nausea and vomiting of 10 occasions of bile content, physical examination with pain in the right hypochondrium, Murphy positive. We have laboratory studies with a lipase of 788, so a diagnosis of pancreatitis is made with an etiology to be determined. The laboratories suggestive of acute biliary pancreatitis (lipase 788.71);an imaging study was subsequently performed (ultrasonography) with the result of stone in the common bile duct. A laparoscopy was performed with relative improvement, so he was discharged and returned 20 days after surgery due to abdominal pain of the same intensity in the left hypochondrium. Ending his hospitalization with a splenectomy for splenic hemangioma with portal vein thrombosis.
文摘Meningoencephalitis secondary to Listeria monocytogenes (L. monocytogenes) mainly affects newborns, the elderly and immunocompromised people;there are extremely rare cases in which said infection occurs in immunocompetent individuals. We present the case of a young adult patient without immunocompromise, who developed meningoencephalitis due to L. monocytogenes;This case is exceptional, since it occurred in an individual outside the classic age group, in addition to not having risk factors, which is why it should be considered an atypical causal agent.
文摘Introduction: Necrotizing pancreatitis management is complex and varies significantly among clinicians. Minimally invasive approaches like transgastric necrosectomy via laparoscopy are emerging as effective treatment options. This case report underscores the technique’s efficacy, clinical outcomes, and role in reducing complications. Clinical Observation: A 59-year-old male with a history of smoking and alcoholism presented with severe abdominal pain, nausea, and vomiting. Over the following weeks, he developed symptoms including asthenia, weight loss, and melena. Diagnostic workup revealed severe anemia and Balthazar E necrotizing pancreatitis, with significant intra-abdominal fluid collections and signs of infection. After initial conservative management, the patient underwent transgastric necrosectomy via laparoscopy due to deteriorating clinical status. The procedure involved removing necrotic tissue and performing a cystogastroanastomosis and jejunostomy. Postoperative care included fasting, parenteral nutrition, broad-spectrum antibiotics, and enzymatic replacement. The patient recovered well, with reduced necrotic tissue on follow-up imaging, and was discharged twelve days post-surgery [1]. Conclusion: Transgastric necrosectomy by laparoscopy is a valuable first-line surgical option for patients with symptomatic necrotizing pancreatitis, particularly in cases without prior interventions. This minimally invasive technique helps reduce major complications and mortality, offering a less invasive alternative to traditional open necrosectomy. The multidisciplinary approach and careful postoperative management were crucial to the patient’s favorable outcome. The case highlights the potential of transgastric necrosectomy as an effective treatment strategy in managing complex pancreatitis cases, including those with associated duodenal perforation [2].
文摘The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of which immediate effects are known such as a greater sensation of well-being, extroversion, increased sensory perception. However, its long-term effects have been described very little in the medical literature, including damage to the heart, central nervous system, kidney, etc. One of its little-known effects is hepatotoxicity, of which few cases are known associated with fulminant hepatitis, which is a rapidly deteriorating condition that is generally associated with a syndrome of multiple organ dysfunction and death. Therefore, it is very important to know this type of damage in the short and long term. The following case is of a 39-year-old man who came to our service due to jaundice syndrome and the only history of MDMA consumption, who as the days went by met the criteria for fulminant liver failure, with damage to multiple organs (organ dysfunction syndrome).
文摘Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.
基金supported by MCIN/AEI/10.13039/501100011033 and by“ERDF A way of making Europe”[Grant RTI2018-095572-B-100(A.C.)RTI2018-095672-B-I00(A.M.)and PID2020-115091RB-I00(R.T)]the Instituto de Salud Carlos III[Grant PI19/01410(M.M.)]C.D.was granted with a FPU fellowship(FPU15/01305)from Ministerio de Ciencia,Innovación y Universidades,Spain.X.A is granted with a fellowship(FI21-RH042199)from Agencia de Gestiód’Ajuts Universitaris I de Recerca.
文摘Background Persistent inflammatory response in the brain can lead to tissue damage and neurodegeneration.In Alzheimer’s disease(AD),there is an aberrant activation of inflammasomes,molecular platforms that drive inflammation through caspase-1-mediated proteolytic cleavage of proinflammatory cytokines and gasdermin D(GSDMD),the executor of pyroptosis.However,the mechanisms underlying the sustained activation of inflammasomes in AD are largely unknown.We have previously shown that high brain cholesterol levels promote amyloid-β(Aβ)accumulation and oxidative stress.Here,we investigate whether these cholesterol-mediated changes may regulate the inflam-masome pathway.Methods SIM-A9 microglia and SH-SY5Y neuroblastoma cells were cholesterol-enriched using a water-soluble cholesterol complex.After exposure to lipopolysaccharide(LPS)plus muramyl dipeptide or Aβ,activation of the inflammasome pathway was analyzed by immunofluorescence,ELISA and immunoblotting analysis.Fluorescently-labeled Aβwas employed to monitor changes in microglia phagocytosis.Conditioned medium was used to study how microglia-neuron interrelationship modulates the inflammasome-mediated response.Results In activated microglia,cholesterol enrichment promoted the release of encapsulated IL-1βaccompanied by a switch to a more neuroprotective phenotype,with increased phagocytic capacity and release of neurotrophic factors.In contrast,in SH-SY5Y cells,high cholesterol levels stimulated inflammasome assembly triggered by both bacterial toxins and Aβpeptides,resulting in GSDMD-mediated pyroptosis.Glutathione(GSH)ethyl ester treatment,which recovered the cholesterol-mediated depletion of mitochondrial GSH levels,significantly reduced the Aβ-induced oxidative stress in the neuronal cells,resulting in lower inflammasome activation and cell death.Furthermore,using conditioned media,we showed that neuronal pyroptosis affects the function of the cholesterol-enriched microglia,lowering its phagocytic activity and,therefore,the ability to degrade extracell
文摘Background::Air pollution and poor ambient air quality are significantly related to multiple health risks.One associated disease is chronic obstructive pulmonary disease(COPD),a preventable disease with several contributing factors and one of the leading causes of morbidity/mortality locally and globally.A potentially high-risk population are traffic enforcers who are constantly exposed to air pollution.In the Philippines,the MMDA has the widest coverage in traffic management.The study determined the risk of COPD among Metro Manila Development Authority(MMDA)traffic enforcers in relation to ambient air quality level,as well as identified other factors that increase the risk of developing COPD.Methods::Fifty-two MMDA traffic enforcers deployed in PM 2.5 air quality sensor areas in Metro Manila from 2016 to 2018 were recruited through stratified sampling.The International Primary Airways Guidelines(IPAG)questionnaire was utilized to measure risk of COPD.Respiratory health and working history were obtained through questionnaires.Department of environment and natural resources provided PM 2.5 ambient air quality data which aided in the construction of the Exposure-Month Index.Ordinal logistic regression was used to examine the association of PM 2.5 together with the relevant factors and the risk of COPD.Results::We found statistically significant associations between PM 2.5 and COPD among high risk category[odds risk(OR):1.24,95%confidence interval(CI):1.07-1.44].Age(Moderate,OR:1.16,95%CI:0.98-1.38 and High,OR:10.06,95%CI:4.02-25.17)and chest pain(Moderate,OR:68.65,95%CI:1.71-2.75×103)were potential risk factors,whereas body mass index(BMI)(OR:0.05,95%CI:0.01-0.53)exhibited protective effect.Conclusions::Exposure to PM 2.5 was associated with an increased risk of COPD among high-risk category MMDA traffic enforcers.Age and chest pain were potential risk factors to risk of COPD,whereas BMI exhibited a potential protective effect.Results of this study can be used for clinical management of high-risk populations,such
