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Advantages of early cholecystectomy in clinical practice of a terciary care center

Hepatobiliary & Pancreatic diseases International 2013年第1期12卷 87-93页

作者： Marta Barceló dulce María Cruz-Santamaría cristina Alba-López María José devesa-Medina Manuel díaz-Rubio Enrique Rey Health Research Institute San Carlos Clinical HospitalDepartment of MedicineSchool of MedicineComplutense University

BACKGROUNd:despite a number of studies show the superiority of early over delayed cholecystectomy in the treatment of acute cholecystitis,there is still controversy over the time for *** study aimed to assess the use of early versus delayed cholecystectomy for the treatment of acute cholecystitis in terms of complications,conversion to open surgery and mean hospital ***:We collected patients with acute cholecystitis treated at a referral center for a year,and retrospectively analyzed the chosen therapeutic approach,the percentage of conversion of early cholecystectomy to open surgery,appearance of surgical complications,and mean hospital ***:The study included 117 patients,44 women and 73 men,who had a mean age of 67.36±15.74 *** cholecystectomy was chosen in 31(26.5%) and delayed cholecystectomy in 74 patients(63.2%).Of the 74 patients,28(37.8%) required emergency performance of delayed cholecystectomy,and 19(25.7%) had not undergone surgery by the end of the *** no differences were observed between early and delayed cholecystectomy in terms of surgical complications and conversion to open surgery,mean hospital stay was nevertheless significantly shorter in the early versus the delayed cholecystectomy group(8.32±4.98 vs 15.96±8.89 days).CONCLUSION:Under the routine working conditions of a hospital that is neither specially dedicated to the surgical treatment of acute cholecystitis nor provided with specific management guidelines,early cholecystectomy can reduce the hospital stay without increase of the conversion rate or complications.

关键词： acute cholecystitis cholecystectomy complications

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Safety and visual outcomes following posterior chamber phakic intraocular lens bilensectomy

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Eye and Vision 2020年第1期7卷 328-335页

作者： Veronica Vargas Jorge L.Alió Rafael I.Barraquer Justin Christopher d’Antin cristina García Francisco duch Joan Balgos Jorge LAliódel Barrio Vissum Instituto Oftalmológico de Alicante AlicanteSpain division of Ophthalmology Universidad Miguel HernándezAlicanteSpain Institut Universitari Barraquer Universitat Autònoma de BarcelonaBarcelonaSpain Centro de Oftalmología Barraquer BarcelonaSpain Universitat Internacional de Catalunya BarcelonaSpain Clínica Real Vision MadridSpain Instituto Catalán de Retina(ICR)unidad de Cirugía Refractiva BarcelonaSpain

Background:To evaluate the safety,efficacy,refractive outcomes and causes for bilensectomy(phakic intraocular lens–pIOL–explantation with cataract surgery and pseudophakic intraocular lens implantation)in patients previously implanted with posterior chamber ***:This multi-center retrospective study included 87 eyes of 55 patients who underwent bilensectomy for posterior chamber pIOL with a follow up time of 12 *** uncorrected and best corrected distance visual acuities(UdVA,CdVA),endothelial cell density before and after bilensectomy were assessed,as well as the cause of bilensectomy and intra or postoperative ***:There was a statistically significant improvement in uncorrected and best corrected visual acuities after bilensectomy(p=0.00).The main reason for bilensectomy was cataract development(93.1%of the cases),followed by miscalculation of lens size,and corneal *** endothelial cell count remained stable without a statistically significant change after surgery(p=0.67).The refractive efficacy index was 0.8,none of the patients lost lines of CdVA after surgery,73%of the patients were within±1 d(spherical equivalent)of the target *** complications were one posterior capsule rupture with the intraocular lens(IOL)implanted in the sulcus,and 3 eyes required the use of pupil expanders for adequate pupil ***,one eye developed retinal *** three pIOLs models explanted were the Implantable Collamer Lens(ICL),Implantable Phakic Contact Lens(IPCL)and the Phakic Refractive Lens(PRL).Conclusions:Good safety and visual outcomes were observed 1 year after bilensectomy for posterior chamber phakic intraocular lenses(PC pIOLs).There were few intra and postoperative complications and there was no significant endothelial cell loss after the bilensectomy procedure.

关键词： Bilensectomy Posterior chamber phakic intraocular lenses Cataract Endothelial cell count Visual outcomes Postoperative complications Intraoperative complications

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Autoimmune hepatitis in childhood: The role of genetic and immune factors

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World Journal of Gastroenterology 2013年第28期19卷 4455-4463页

作者： Priscila Menezes Ferri Liu débora Marques de Miranda Eleonora druve Tavares Fagundes Alexandre Rodrigues Ferreira Ana cristina Simoes e Silva department of Pediatrics Interdisciplinary Laboratory of Medical Investigation Federal University of Minas Gerais Belo Horizonte Minas Gerais 30130-100 Brazil National Institute of Science and Technology of Molecular Medicine (INCT-MM) CNPq-FAPEMIG Federal University of Minas Gerais Belo Horizonte Minas Gerais 30130-100 Brazil

Autoimmune hepatitis (AIH) is a rare chronic inflammatory disease of the liver, which affects a group of patients who lost their immunological tolerance to antigens of the liver. It is clinically characterized by hypergammaglobulinemia, elevated liver enzymes, presence of autoantibodies and histological changes. Although being rare in children, it represents a serious cause of chronic hepatic disease that can lead to cirrhosis and hepatic failure. Clinical findings, exclusion of more common liver disorders and the detection of antibodies antinuclear antibodies, smooth muscle antibodies and anti-LKM1 are usually enough for diagnosis on clinical practice. The pathogenic mechanisms that lead to AIH remain obscure, but some research findings suggest the participation of immunologic and genetic factors. It is not yet knew the triggering factor or factors that stimulate inflammatory response. Several mechanisms proposed partially explain the immunologic findings of AIH. The knowledge of immune factors evolved might result in better markers of prognosis and response to treatment. In this review, we aim to evaluate the findings of research about genetic and immune markers and their perspectives of application in clinical practice especially in pediatric population.

关键词： Autoimmune hepatitis Genetics Clinical practice Immunophenotype

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Acupuncture Treatment for Idiopathic Trigeminal Neuralgia:A Longitudinal Case-Control double Blinded Study

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Chinese Journal of Integrative Medicine 2017年第11期23卷 829-836页

作者： Michelle cristina Ichida mariana Zemuner Jorge Hosomi Hong Jin Pai Manoel Jacobsen Teixeira JoséTadeu Tesseroli de Siqueira Silvia R d T de Siqueira Neurology department Medical SchoolUniversity of Sao PauloSao Paulo(05403-010)Brazil Group of Acupuncture Interdisciplinary Pain Group of the Neurology DivisionClinical HospitalMedical SchoolUniversity of Sao PauloSao Paulo(05403-010)Brazil Interdisciplinary Pain Center of Hospital das Clinicas Neurology DepartmentMedical SchoolUniversity of Sao PauloSao Paulo(05403-010)Brazil Neurosurgery division Psychiatry InstituteClinical HospitalMedical SchoolUniversity of Sao PauloS&o Paulo(05403-010)Brazil Orofacial Pain Team Dentistry DivisionClinical HospitalMedical SchoolUniversity of Sao PauloSao Paulo(05403-010)Brazil Group of Oral Medicine and Neuroscience of the dentistry division Psychiatry InstituteClinical HospitalMedical SchoolUniversity of Sao PauloSao Paulo(05403-010)Brazil School of Arts Science and HumanitiesUniversity of Sao PauloSao Paulo(05403-010)Brazil

Objective： To evaluate the treatment effect of acupuncture on patients with idiopathic trigeminal neuralgia（ITN） by case-control longitudinal blinded study. Methods： Sixty ITN patients and 30 healthy subjects were included. The ITN patients were randomly assigned to acupuncture group（15 cases）, sham-acupuncture group（15 cases） and carbamazepine group（30 cases）, respectively. Clinical orofacial evaluation（including pain intensity and medication doses）, research diagnostic criteria for temporomandibular disorders（RdC/TMd） and Helkimo indexes（for functional evaluation of the masticatory system）, and quantitative sensory testing for sensory thresholds（gustative, olfactory, cold, warm, touch, vibration and superficial and deep pain） were evaluated before treatment, immediately after treatment, and 6 months after treatment. Results： The mean pain intensity by the Visual Analogue Scale only decreased in the acupuncture group at the last evaluation（P=0.012）. Patients in the sham-acupuncture group had an increase in carbamazepine doses according to the prescriptions（P〈0.01）. There was a reduction in secondary myofascial pain and mandibular limitations at the acupuncture and sham-acupuncture groups, however only the acupuncture group kept the changes after 6 months（P〈0.01, P=0.023）. There was a decrease in mechanical thresholds in the acupuncture group（tactile, P〈0.01; vibration, P=0.027） and an increase in deep pain thresholds in both acupuncture and sham-acupuncture groups（P=0.013）. Conclusion： Acupuncture can be an option in the treatment of ITN due to its analgesic effect in both ITN and secondary myofascial pain associated with it.

关键词： acupuncture idiopathic trigeminal neuralgia orofacial pain temporomandibular disorders quantitative sensory testing case-control study

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Characterization of hepatitis B virus X gene quasispecies complexity in mono-infection and hepatitis delta virus superinfection

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World Journal of Gastroenterology 2019年第13期25卷 1566-1579页

作者： cristina Godoy david Tabernero Sara Sopena Josep Gregori maria Francesca Cortese Carolina González Rosario Casillas Mar?al Yll Ariadna Rando Rosa López-Martínez Josep Quer Gloria González-Aseguinolaza Rafael Esteban Mar Riveiro-Barciela maria Buti Francisco Rodríguez-Frías Liver Pathology Unit Departments of Biochemistry and Microbiology Hospital Universitari Vall d’Hebron Universitat Autònoma de Barcelona Liver Unit Liver Disease Laboratory-Viral Hepatitis Vall d’Hebron Institut Recerca-Hospital Universitari Vall d'Hebron Universitat Autònoma de Barcelona Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y digestivas (CIBERehd) Instituto de Salud Carlos Ⅲ Roche diagnostics SL Centro de Investigación Médica Aplicada (CIMA) Universidad de Navarra Liver Unit Department of Internal MedicineHospital Universitari Vall d’Hebron Universitat Autònoma de Barcelona (UAB)

Hepatitis delta virus(HdV) seems to strongly suppress hepatitis B virus(HBV)replication, although little is known about the mechanism of this interaction. Both these viruses show a dynamic distribution of mutants, resulting in viral quasispecies. Next-generation sequencing is a viable approach for analyzing the composition of these mutant spectra. As the regulatory hepatitis B X protein(HBx) is essential for HBV replication, determination of HBV X gene(HBX)quasispecies complexity in HBV/HdV infection compared to HBV monoinfection may provide information on the interactions between these two *** To compare HBV quasispecies complexity in the HBX 5' region between chronic hepatitis delta(CHd) and chronic HBV mono-infected *** Twenty-four untreated patients were included: 7/24(29.2%) with HBeAgnegative chronic HBV infection(CI, previously termed inactive carriers), 8/24(33.3%) with HBeAg-negative chronic hepatitis B(CHB) and 9/24(37.5%) with CHd. A serum sample from each patient was first tested for HBV dNA *** HBX 5' region [nucleotides(nt) 1255-1611] was then PCR-amplified for subsequent next-generation sequencing(MiSeq, Illumina, United States). HBV quasispecies complexity in the region analyzed was evaluated using incidencebased indices(number of haplotypes and number of mutations), abundancebased indices(Hill numbers of order 1 and 2), and functional indices(mutation frequency and nucleotide diversity). We also evaluated the pattern of nucleotide changes to investigate which of them could be the cause of the quasispecies *** CHB patients showed higher median HBV-dNA levels [5.4 logIU/mL,interquartile range(IQR) 3.5-7.9] than CHd(3.4 logIU/mL, IQR 3-7.6)(P = n.s.)or CI(3.2 logIU/mL, IQR 2.3-3.5)(P dence and abundance indices indicated that HBV quasispecies complexity was significantly greater in CI than CHB. A similar trend was observed in CHd patients, although only Hill numbers of order 2 showed

关键词： Hepatitis B virus Hepatitis delta virus Hepatitis B X gene Next-generation sequencing Viral quasispecies Hepatitis B virus-hepatitis delta virus interaction

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Conservation and variability of hepatitis B core at different chronic hepatitis stages

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World Journal of Gastroenterology 2020年第20期26卷 2584-2598页

作者： Marcal Yll maria Francesca Cortese Mercedes Guerrero-Murillo Gerard Orriols Josep Gregori Rosario Casillas Carolina González Sara Sopena cristina Godoy Marta Vila david Tabernero Josep Quer Ariadna Rando Rosa Lopez-Martinez Rafael Esteban Mar Riveiro-Barciela maria Buti Francisco Rodríguez-Frías Liver Pathology Unit Departments of Biochemistry and MicrobiologyHospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelona 08035Spain Liver Unit Liver Disease Laboratory-Viral HepatitisVall d'Hebron Institut Recerca-Hospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelona 08035Spain department of Microbiology Hospital Universitari Vall d'HebronUniversitat Autònoma de BarcelonaBarcelona 08035Spain Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y digestivas Instituto de Salud Carlos ⅢMadrid 28029Spain Liver Unit Department of Internal MedicineHospital Universitari Vall d'HebronUniversitat Autónoma de BarcelonaBarcelona 08035Spain

BACKGROUNd Since it is currently not possible to eradicate hepatitis B virus(HBV)infection with existing treatments,research continues to uncover new therapeutic *** core protein,encoded by the HBV core gene(HBC),intervenes in both structural and functional processes,and is a key protein in the HBV life *** this reason,both the protein and the gene could be valuable targets for new therapeutic and diagnostic ***,alterations in the protein sequence could serve as potential markers of disease *** To detect,by next-generation sequencing,HBC hyper-conserved regions that could potentially be prognostic factors and targets for new *** Thirty-eight of 45 patients with chronic HBV initially selected were included and grouped according to liver disease stage[chronic hepatitis B infection without liver damage(CHB,n=16),liver cirrhosis(LC,n=5),and hepatocellular carcinoma(HCC,n=17)].HBV dNA was extracted from patients’plasma.A region between nucleotide(nt)1863 and 2483,which includes HBC,was amplified and analyzed by next-generation sequencing(Illumina Mi Seq platform).Sequences were genotyped by distance-based discriminant *** and intergroup nt and amino acid(aa)conservation was determined by sliding window *** presence of nt insertion and deletions and/or aa substitutions in the different groups was determined by aligning the sequences with genotype-specific consensus *** Three nt(nt 1900-1929,2249-2284,2364-2398)and 2 aa(aa 117-120,159-167)hyper-conserved regions were shared by all the clinical *** groups showed a similar pattern of conservation,except for five nt regions(nt 1946-1992,2060-2095,2145-2175,2230-2250,2270-2293)and one aa region(aa 140-160),where CHB and LC,respectively,were less conserved(Pd regions were also observed at both nt(2306-2334 in CHB and 1935-1976 and 2402-2435 in LC)and aa(between aa 98-103 in CHB and 28-30 and 5

关键词： Hepatitis B virus Hepatitis B core gene Next-generation sequencing Genetic conservation Amino acid substitution Gene therapy Small interfering RNA

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Evaluating the accuracy of American Society for Gastrointestinal Endoscopy guidelines in patients with acute gallstone pancreatitis with choledocholithiasis

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World Journal of Gastroenterology 2022年第16期28卷 1692-1704页

作者： Supisara Tintara Ishani Shah William Yakah Awais Ahmed cristina S Sorrento Cinthana Kandasamy Steven d Freedman darshan J Kothari Sunil G Sheth department of Internal Medicine Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States division of Gastroenterology&Hepatology Beth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMA 02215United States division of Gastroenterology Duke University Medical CenterDurhamNC 27710United States division of Gastroenterology Durham VA Medical CenterDurhamNC 27705United States

BACKGROUNd Acute gallstone pancreatitis(AGP) is the most common cause of acute pancreatitis(AP) in the United States. Patients with AGP may also present with choledocholithiasis. In 2010, the American Society for Gastrointestinal Endoscopy(ASGE) suggested a management algorithm based on probability for choledocholithiasis, recommending additional imaging for patients at intermediate risk and endoscopic retrograde cholangiopancreatography(ERCP) for patients at high risk of choledocholithiasis. In 2019, the ASGE guidelines were updated using more specific criteria to categorize individuals at high risk for choledocholithiasis. Neither ASGE guideline has been studied in AGP to determine the probability of having *** To determine compliance with ASGE guidelines, assess outcomes, and compare 2019 vs 2010 ASGE criteria for suspected choledocholithiasis in *** We conducted a retrospective cohort study of 882 patients admitted with AP to a single tertiary care center from 2008-2018. AP was diagnosed using revised Atlanta criteria and AGP was defined as the presence of gallstones on imaging or with cholestatic pattern of liver injury in the absence of another cause. Patients with chronic pancreatitis and pancreatic malignancy were excluded as were those who went directly to cholecystectomy prior to assessment for choledocholithiasis. Patients were assigned low, intermediate or high risk based on ASGE guidelines. Our primary outcomes of interest were the proportion of patients in the intermediate risk group undergoing magnetic resonance cholangiopancreatography(MRCP) first and the proportion of patients in the high risk group undergoing ERCP directly without preceding imaging. Secondary outcomes of interest included outcome differences based on if guidelines were not adhered to. We then evaluated the diagnostic accuracy of 2019 in comparison to the 2010 ASGE criteria for patients with suspected choledocholithiasis. We performed the t test or Wilcox

关键词： American Society for Gastrointestinal Endoscopy guidelines Choledocholithiasis Acute gallstone pancreatitis Endoscopic retrograde cholangiopancreatography Magnetic resonance cholangiopancreatography

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diversity of Filamentous Fungi of Area from Brazilian Caatinga and High-Level Tannase Production Using Mango (<i>Mangifera indica</i>L.) and Surinam Cherry (<i>Eugenia uniflora</i>L.) Leaves under SSF

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Advances in Microbiology 2013年第8期3卷 52-60页

作者： Roberta Cruz Juliana Silva de Lima Julyana Cordoville Fonseca maria José dos Santos Fernandes débora maria Massa Lima Gustavo Pereira duda Keila Aparecida Moreira cristina maria de Souza Motta Academic Unit of Garanhuns Federal Rural University of Pernambuco Garanhuns Brazil department of Mycology Federal University of Pernambuco Recife Brazil

Tannase is a biotechnologically important enzyme that can be produced during fungal fermentation of organic matter. The Caatinga is an exclusive Brazilian ecosystem that has been largely unexplored by science, particularly its filamentous fungal diversity. This study evaluated the diversity of filamentous fungi in the Caatinga soils of Pernambuco, Brazil, and their potential for tannase production by solid-state fermentation (SSF) of mango (Mangifera indica L.) and Surinam cherry (Eugenia uniflora L.) leaves. A total of 4711 isolates were obtained, 2090 during the rainy seasonand 2621 during the dry season. The isolates belonged to 18 genera and 66 species, with Aspergillus and Penicillium having the highest species richness. The dry season had a higher diversity index. Aspergillus was the dominant genus, and A. flavus, A. sclerotiorum, and A. ochraceus the most abundant species. A representative of each species was tested for tannase production using dried mango and Surinam cherry leaves as substrates;the leaves contained 14.28 and 7.0 g/L tannin, respectively. Most fungal species produced tannase, but the highest yields were obtained when mango leaves were used as substrate for Penicillium restrictum (accession URM 6044), Aspergillus flavofurcatus (URM 6142), and A. stromatoides (URM 6609), which produced 104.16, 87.51, and 81.83 U/mL tannase, respectively. These yields exceeded previously published reports. Filamentous fungi from Caatinga soils have great potential for producing tannase by SSF, and low-cost mango leaves make excellent substrate.

关键词： Caatinga Filamentous Fungi Tannase Solid-State Fermentation Mangifera indicaL.

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Serum 25-hydroxyvitamin d concentration and inflammatory bowel disease characteristics in Romania

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World Journal of Gastroenterology 2014年第9期20卷 2392-2396页

作者： Gabriela dumitrescu Catalina Mihai Mihaela dranga cristina Cijevschi Prelipcean department of Medical Sciences Grigore T. Popa University of Medicine and Pharmacy Iasi 700115 Romania

AIM: To describe the relationship between vitamin d levels and inflammatory bowel disease (IBd) characteristics in northeastern Romanian patients.

关键词： Inflammatory bowel disease, Vitamin d level, Northeastern Romania, Crohn’ s disease activity, Seasonality

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Cerium alleviates drought-induced stress in Phaseolus vulgaris

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Journal of Rare Earths 2020年第3期38卷 324-331页

作者： Olívia Graziela Gelioli Salgado Jéssica cristina Teodoro Joyce Pereira Alvarenga Cynthia de Oliveira Teotonio Soares de Carvalho débora domiciano Paulo Eduardo Ribeiro Marchiori Luiz Roberto Guimaraes Guilherme department of Soil Science Federal University of LavrasCP 3037Campus UFLALavras37200-000Brazil department of Biology Federal University of LavrasCP 3037Campus UFLALavras37200-000Brazil

Extreme drought events are expected to be one of the main challenges for tropical agriculture and,consequently,for global food *** this reason,it is urgent to develop strategies to increase water use efficiency,as well as to increase crops’ ability to cope with *** rare earth elements(REEs) are known to alleviate damages in plants under abiotic stresses,we hypothesized that addition of Ce^3+to nutrient solution would promote the growth of common bean,especially under simulated drought *** test this hypothesis,we conducted an experiment evaluating the effect of six Ce^3+concentrations on the development and physiological traits of common bean grown in nutrient solution under normal condition and under induced drought stress,caused by the addition of polyethylene glycol6000 to the nutrient *** results show that Ce^3+alleviates water stress in common bean plants,increasing their survival rate and *** addition,Ce^3+application increases photosynthesis rate,chlorophyll content and water use efficiency under water ***,we observe no significant effect of Ce^3+on plants growing under normal ***,Ce3+seems to be a promising attenuator of drought stress for common bean.

关键词： Water stress Polyethylene glycol Rare earth elements Cerium nitrate Mitigation Common bean

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