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Pelvic exenterations for primary rectal cancer:Analysis from a 10-year national prospective database

World Journal of Gastroenterology 2018年第45期24卷 5144-5153页

作者： Gianluca Pellino Sebastiano Biondo Antonio Codina Cazador JoséMaría Enríquez-Navascues Eloy Espín-Basany Jose Vicente Roig-Vila eduardo garcía-granero Colorectal Unit Hospital Universitario y Politecnico La FeUniversity of ValenciaValencia 46026Spain Department of General and Digestive Surgery Colorectal UnitBellvitge University HospitalUniversity of Barcelona and IDIBELLL’Hospitalet de LlobregatBarcelona 08907Spain Department of General and Digestive Surgery--Colorectal Unit Josep Trueta University HospitalGirona 17001Spain General and Digestive Surgery Department Donostia University HospitalDonostia 20014Spain Department of General Surgery Colorectal Surgery UnitHospital Valle de HebronAutonomous University of BarcelonaBarcelona 08035Spain Unit of Coloproctology Hospital Vithas-Nisa 9 de OctubreValencia 46015Spain

AIM To identify short-term and oncologic outcomes of pelvic exenterations(PE) for locally advanced primary rectal cancer(LAPRC) in patients included in a national prospective *** Few studies report on PE in patients with LAPRC. For this study, we included PE for LAPRC performed between 2006 and 2017, as available, from the Rectal Cancer Registry of the Spanish Association of Surgeons [Asociación Espa?ola de Cirujanos(AEC)]. Primary endpoints included procedure-associated complications, 5-year local recurrence(LR), disease-free survival(DFS) and overall survival(OS). A propensitymatched comparison with patients who underwent non-exenterative surgery for low rectal cancers was performed as a secondary *** Eight-two patients were included. The mean age was 61.8 ± 11.5 years. More than half of the patients experienced at least one complication. Surgical site infections were the most common complication(abdominal wound 18.3%, perineal closure 19.4%). Thirty-three multivisceral resections were performed, including two hepatectomies and four metastasectomies. The long-term outcomes of the 64 patients operated on before 2013 were assessed. The five-year LR was 15.6%, the distant recurrence rate was 21.9%, and OS was 67.2%, with a mean survival of 43.8 mo. R+ve resection increased LR [hazard ratio(HR) = 5.58, 95%CI: 1.04-30.07, P = 0.04]. The quality of the mesorectum was associated with DFS. Perioperative complications were independent predictors of shorter survival(HR = 3.53, 95%CI: 1.12-10.94, P = 0.03). In the propensity-matched analysis, PE was associated with better quality of the specimen and tended to achieve lower LR with similar *** PE is an extensive procedure, justified if disease-free margins can be obtained. Further studies should define indications, accreditation policy, and quality of life in LAPRC.

关键词： Pelvic exenteration Advanced rectal cancer Colorectal surgery Complication Outcome

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Real-time fluorescence image-guided gastrointestinal oncologic surgery:Towards a new era

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World Journal of Gastrointestinal Oncology 2021年第9期13卷 1029-1042页

作者： Elías Martínez-López Aleix Martínez-Pérez Sergio Navarro-Martínez Juan Carlos Sebastián-Tomás Nicola de'Angelis eduardo garcía-granero Department of Surgery University of ValenciaValencia 46010Spain Department of General and Digestive Surgery Hospital Universitario Doctor PesetValencia 46017Spain Faculty of Health Sciences Valencian International UniversityValencia 46002Spain Minimally Invasive and Robotic Digestive Surgery Unit Miulli HospitalAcquaviva delle Fonti 70021Italy Department of General and Digestive Surgery Hospital Universitario y Politécnico La FeValencia 46026Spain

Technological improvements are crucial in the evolution of ***-time fluorescence-guided surgery(FGS)has spread worldwide,mainly because of its usefulness during the intraoperative decision-making *** success of any gastrointestinal oncologic resection is based on the anatomical identification of the primary tumor and its regional lymph *** allows also to evaluate the blood perfusion at the gastrointestinal stumps after colorectal or esophageal ***,a reduction on the anastomotic leak rates has been postulated as one of the foreseeable benefits provided by the use of FGS in these *** the use of fluorescence in lymph node detection was initially described in breast cancer surgery,the technique is currently applied in gastric or splenic flexure cancers,as they both present complex and variable lymphatic *** allows also to perform intraoperative lymphograms or sentinel lymph node *** applications of FGS are being developed to assist in the detection of peritoneal metastases or in the evaluation of the tumor resection *** present review aims to provide a general overview of the current status of real-time FGS in gastrointestinal oncologic *** put a special focus on the different applications of FGS,discussing the main findings and limitations found in the contemporary literature and also the promising near future applications.

关键词： Surgery Colorectal cancer Esophageal cancer Fluorescence Image-guided surgery Anastomotic leak Lymph node

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Robotic transanal total mesorectal excision:Is the future now?

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World Journal of Gastrointestinal Surgery 2021年第8期13卷 834-847页

作者： Juan Carlos Sebastián-Tomás Aleix Martínez-Pérez Elías Martínez-López Nicola de'Angelis Marcos Gómez Ruiz eduardo garcía-granero Department of Surgery Universidad de ValenciaValencia 46010Spain Department of General and Digestive Surgery Hospital Universitario Doctor PesetValencia 46017Spain Faculty of Health Sciences Valencian International UniversityValencia 46002Spain Minimally Invasive and Robotic Digestive Surgery Unit Miulli HospitalAcquaviva delle Fonti 70021Italy Department of General and Digestive Surgery Hospital Universitario Marqués de ValdecillaSantander 39008Spain Grupo de Investigación en Innovación Quirúrgica Instituto de Investigación Biomédica Valdecilla(IDIVAL)Santander 39008Spain Department of General and Digestive Surgery Hospital Universitarioy Politécnico la FeValencia 46026Spain

Total mesorectal excision(TME)is the standard surgical treatment for the curative radical resection of rectal *** invasive TME has been gaining ground favored by the continuous technological *** procedures,such as transanal TME(TaTME),have been introduced to overcome some technical limitations,especially in low rectal tumors,obese patients,and/or narrow *** earliest TaTME reports showed promising results when compared with the conventional laparoscopic ***,recent publications raised concerns regarding the high rates of anastomotic leaks or local recurrences observed in national *** TaTME(R-TaTME)has been proposed as a novel technique incorporating the potential benefits of a perineal dissection together with precise control of the distal margins,and also offers all those advantages provided by the robotic technology in terms of improved precision and *** short-term results have been reported for R-TaTME,but further studies are needed to assess the real role of the new technique in the long-term oncological or functional *** present review aims to provide a general overview of R-TaTME by analyzing the body of the available literature,with a special focus on the potential benefits,harms,and future perspectives for this novel approach.

关键词： Rectal cancer Minimally-invasive surgery Robotics Total mesorectal excision Transanal approach Natural orifice surgery

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How inflammation influences psychiatric disease

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World Journal of Psychiatry 2024年第3期14卷 342-349页

作者： eduardo Ferat-Osorio JoséLuis Maldonado-garcía Lenin Pavón División de Investigación Clínica de la Coordinación de Investigación en Salud Instituto Mexicano del Seguro SocialMexico City 06720Mexico Departamento de Bioquímica Facultad de MedicinaUniversidad Nacional Autónoma de MéxicoCoyoacán 04510Ciudad de MéxicoMexico Departamento de Inmunología Escuela Nacional de Ciencias BiológicasInstituto Politécnico NacionalMexico City 11340Mexico Laboratorio de Psicoinmunología Instituto Nacional de Psiquiatría Ramón de la Fuente MuñizMexico City 14370Mexico

Recent studies highlight the strong correlation between infectious diseases and the development of neuropsychiatric *** this editorial,we comment on the article“Anti-infective therapy durations predict psychological stress and laparoscopic surgery quality in pelvic abscess patients”by Zhang et al,published in the recent issue of the World Journal of Psychiatry 2023;13(11):*** discussion highlighted the potential consequences of anxiety,depression,and psychosis,which are all linked to bacterial,fungal,and viral infections,which are relevant to the impact of inflammation on the sequelae in mental health as those we are observing after the coronavirus disease 2019 *** focus specifically on the immune mechanisms triggered by inflammation,the primary contributor to psychiatric ***,pathophysiological mechanisms such as organ damage,post-injury inflammation,and infectioninduced endocrine alterations,including hypocortisolism or autoantibody formation,significantly contribute to the development of chronic low-grade inflammation,promoting the emergence or development of psychiatric alterations in susceptible *** inflammation can have long-term effects on patients,a multidisciplinary treatment plan can avoid complications and debilitating health issues,and it is crucial to recognize and address the mental health implications.

关键词： Inflammation infection Depression Pelvic inflammatory disease Psychiatric complication

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Differential Expression of Genes Related to Fruit Development and Capsaicinoids Synthesis in Habanero Pepper Plants Grown in Contrasting Soil Types

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Phyton-International Journal of Experimental Botany 2024年第2期93卷 151-183页

作者： eduardo Burgos-Valencia Federico garcía-Laynes Ileana Echevarría-Machado Fatima Medina-Lara Miriam Monforte-González JoséNarváez-Zapata Manuel Martínez-Estévez Unidad de Bioquímica y Biología Molecular de Plantas Centro de Investigación Científica de YucatánCalle 43#130Chuburnáde HidalgoMéridaYucatán97205México Instituto Politécnico Nacional-Centro de Biotecnología Genómica Blvd Del Maestro esq.Elias PiñaReynosaTamaulipas88710México

Habanero pepper(Capsicum chinense Jacq.)is a crop of economic relevance in the Peninsula of *** fruits have a high level of capsaicinoids compared to peppers grown in other regions of the world,which gives them industrial *** is an important factor that affects pepper development,nutritional quality,and capsaicinoid ***,the effect of soil type on fruit development and capsaicinoid metabolism has been little *** work aimed to compare the effect of soils with contrasting characteristics,black soil(BS)and red soil(RS),on the expression of genes related to the development of fruits,and capsaicinoid synthesis using a transcriptomic analysis of the habanero pepper *** growing in RS had bigger fruits and higher expression of genes related to floral development,fruit abscission,and softening which suggests that RS stimulates fruit development from early stages until maturation *** from plants growing in BS had enrichment in metabolic pathways related to growth,sugars,and ***,these fruits had higher capsaicinoid accumulation at 25 days post-anthesis,and higher expression of genes related to the branched-chain amino acids metabolism(ketol-acid reductisomerase KARI),pentose phosphate pathway and production of NADPH(glucose-6-phosphate-1-dehydrogenase G6PDH),and proteasome and vesicular traffic in cells(26S proteasome regulatory subunit T4 RPT4),which suggest that BS is better in the early stimulation of pathways related to the nutritional quality and capsaicinoid metabolism in the fruits.

关键词： Capsicum chinense jacq soil types plant growth environmental conditions fruit quality capsaicinoid metabolism transcriptome

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Assembly structures of coastal woody species of eastern South America:Patterns and drivers

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Plant Diversity 2024年第5期46卷 611-620页

作者： eduardo Vinícius da Silva Oliveira Myrna Friederichs Landim Sidney F.Gouveia Graduate Program in Ecology and Conservation Federal University of SergipeSão CristovãoSergipeBrazil National Institute of Science and Technology Ecology Evolution and Conservation of Biodiversity(INCT-EECBio)GoiâniaGoiasBrazil Department of Biology Federal University of SergipeSão CristóvãoSergipeBrazil Department of Ecology Federal University of SergipeSão CristóvãoSergipeBrazil

Tropical regions have provided new insights into how ecological communities are *** dry coastal communities,water stress has been hypothesized to determine plant assembly structure by favoring preadapted lineages from neighboring ecosystems,consistent with functional ***,it is unclear whether this hypothesis is sufficient to explain how coastal communities in tropical ecosystems are ***,we test whether water stress or other factors drive community assembly in woody plant communities across the coastal zone of Brazil,a tropical *** characterized functional and phylogenetic structures of these communities and determined the underlying environmental factors(e.g.,water stress,historical climate stability,edaphic constraints,and habitat heterogeneity)that drive their community *** of coastal woody species show geographically varied patterns,including stochastic arrangements,clustering,and overdispersion of species relative to their traits and phylogenetic *** complexity,water vapor pressure,and soil nutrient availability best explained the gradient in the functional *** deficit,water vapor pressure,and soil organic carbon were the best predictors of variation in phylogenetic *** results support the water-stress conservatism hypothesis on functional and phylogenetic structure,as well as the effect of habitat heterogeneity on functional structure and edaphic constraints on functional and phylogenetic *** effects are associated with increased phenotypic and phylogenetic divergence of woody plant assemblages,which is likely mediated by abiotic filtering and niche opportunities,suggesting a complex pattern of ecological assembly.

关键词： Brazil Completeness Clustering Restinga vegetation Water constraints

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How far have we come?Review of main public policies to reduce landslide impacts in Brazil

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Journal of Mountain Science 2024年第9期21卷 2891-2904页

作者： Bianca Carvalho VIEIRA Tiago Damas MARTINS Telma Mendes da SILVA Joséeduardo BONINI Department of Geography University of São PauloAvenida Professor Lineu Prestes 05508-000Brazil Cities Institute Federal University of São PauloAvenida Jacu-Pêssego 08260-001Brazil Department of Geography Federal University of Rio de JaneiroAvenida Athos da Silveira Ramos 21941-916Brazil

During the rainy season in Brazil,landslides can have catastrophic consequences,including loss of life,damage to urban infrastructure and significant economic ***,more than eight million people in Brazil live in disaster-prone *** objective of this article is to present a chronological review of the principal policies and programmes at the national,state,and municipal levels,with an emphasis on their key actions aimed at mitigating the impact of disasters related to natural hazards,particularly *** analysis was based on official records of public policies from the national,state,and municipal *** results show that several initiatives were initially developed at the local and regional ***,it was not until the late 1980s that a comprehensive organisation of civil protection at the national level emerged as a response *** is possible to highlight three phases(understanding,coexistence,and prevention)of institutional action focused on risk management in the face of *** the growing knowledge of risk scenarios,disasters continue to occur in Brazil on an annual basis,revealing several obstacles to reducing their impact,particularly given the social and economic disparities between Brazilian regions and the applicability of public policies that must overcome the limitations of each municipality.

关键词： Disasters Risk Mitigation Prevention Legislation Civil Defense Natural Hazards

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Interactions between maternal parity and feed additives drive the composition of pig gut microbiomes in the post‑weaning period

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Journal of Animal Science and Biotechnology 2024年第3期15卷 1241-1257页

作者： Kayla Law eduardo Rosa Medina garcia Chad Hastad Deborah Murray Pedro E.Urriola Andres Gomez Department of Animal Science University of Minnesota1364 Eckles AvenueSaint PaulMN 55108USA New Fashion Pork 164 Industrial ParkwayJacksonMN 56143USA

Background Nursery pigs undergo stressors in the post-weaning period that result in production and welfare *** challenges disproportionately impact the offspring of primiparous sows compared to those of mul-tiparous *** is known regarding potential interactions between parity and feed additives in the post-weaning period and their effects on nursery pig ***,the objective of this study was to investigate the effects of maternal parity on sow and offspring microbiomes and the influence of sow parity on pig fecal microbi-ome and performance in response to a prebiotic *** weaning,piglets were allotted into three treat-ment groups:a standard nursery diet including pharmacological doses of Zn and Cu(Con),a group fed a commercial prebiotic only(Preb)based on an Aspergillus oryzae fermentation extract,and a group fed the same prebiotic plus Zn and Cu(Preb+ZnCu).Results Although there were no differences in vaginal microbiome composition between primiparous and mul-tiparous sows,fecal microbiome composition was different(R^(2)=0.02,P=0.03).The fecal microbiomes of primiparous offspring displayed significantly higher bacterial diversity compared to multiparous offspring at d 0 and d 21 post-weaning(P<0.01),with differences in community composition observed at d 21(R^(2)=0.03,P=0.04).When analyzing the effects of maternal parity within each treatment,only the Preb diet triggered significant microbiome distinc-tions between primiparous and multiparous offspring(d 21:R^(2)=0.13,P=0.01;d 42:R^(2)=0.19,P=0.001).Composi-tional differences in pig fecal microbiomes between treatments were observed only at d 21(R^(2)=0.12,P=0.001).Pigs in the Con group gained significantly more weight throughout the nursery period when compared to those in the Preb+ZnCu *** Nursery pig gut microbiome composition was influenced by supplementation with an Aspergillus oryzae fermentation extract,with varying effects on performance

关键词： Aspergillus prebiotic Copper Feed additives Maternal Nursery pig microbiome Parity Swine microbiome Trace minerals Zinc

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Sound waves and solutions:Point-of-care ultrasonography for acute kidney injury in cirrhosis

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World Journal of Critical Care Medicine 2024年第2期13卷 83-92页

作者： David Aguirre-Villarreal Mario Andrés de Jesús Leal-Villarreal Ignacio garcía-Juárez eduardo R Argaiz Abhilash Koratala Departamento de Gastroenterología Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Cardiología Instituto Nacional de Cardiología Ignacio ChávezMexico City 14080Mexico Unidad de Hepatología y Trasplante Departamento de GastroenterologíaInstituto Nacional de Ciencias Medicas y Nutricion Salvador ZubiranMexico City 14080Mexico Departamento de Nefrología y Metabolismo Mineral Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico City 14080Mexico Tecnológico de Monterrey Escuela de Medicina y Ciencias de la SaludMexico City 64710Mexico Department of Nephrology Medical College of WisconsinMilwaukeeWI 53226United States

This article delves into the intricate challenges of acute kidney injury(AKI)in cirrhosis,a condition fraught with high morbidity and *** complexities arise from distinguishing between various causes of AKI,particularly hemodynamic AKI,in cirrhotic patients,who experience hemodynamic changes due to portal *** term"hepatocardiorenal syndrome"is introduced to encapsulate the intricate interplay among the liver,heart,and *** narrative emphasizes the often-overlooked aspect of cardiac function in AKI assessments in cirrhosis,unveiling the prevalence of cirrhotic cardiomyopathy marked by impaired diastolic *** conventional empiric approach involving volume expansion and vasopressors for hepatorenal syndrome is critically analyzed,highlighting potential risks and variable patient *** advocate for a nuanced algorithm for AKI evaluation in cirrhosis,prominently featuring point-of-care ultrasonography(POCUS).POCUS applications encompass assessing fluid tolerance,detecting venous congestion,and evaluating cardiac function.

关键词： Point-of-care ultrasonography Bedside ultrasound Cirrhosis Congestion Acute kidney injury Congestive nephropathy

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Sex differences in the risk of retinopathy of prematurity:a systematic review,frequentist and Bayesian meta‑analysis,and meta‑regression

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World Journal of Pediatrics 2024年第4期20卷 340-352页

作者： Tamara M.Hundscheid Silvia Gulden Mohamad F.Almutairi František Bartoš Giacomo Cavallaro eduardo Villamor Division of Neonatology Department of PediatricsMosaKids Children’s HospitalMaastricht University Medical Center(MUMC+)School for Oncology and Reproduction(GROW)Maastricht UniversityP.Debyelaan 25.P.O.Box 58006202 AZ MaastrichtThe Netherlands Neonatal Intensive Care Unit Sant’Anna HospitalComoItaly Department of Psychology University of Amsterdam1001 NK AmsterdamThe Netherlands Neonatal Intensive Care Unit Fondazione IRCCS Ca’Granda Ospedale Maggiore PoliclinicoMilanItaly

Background Retinopathy of prematurity(ROP)is generally considered to be more frequent in males than in ***,it is not known whether sex differences in ROP affect all degrees of the condition,are global and have changed as neonatology has *** aimed to conduct a systematic review and meta-analysis of studies addressing sex differences in the risk of developing *** PubMed/MEDLINE and Embase databases were *** frequentist,random-effects risk ratio(RR)and 95%confidence interval(CI)were *** model averaged(BMA)meta-analysis was used to calculate the Bayes factors(BFs).The BF10 is the ratio of the probability of the data under the alternative hypothesis(H1)over the probability of the data under the null hypothesis(H0).Results We included 205 studies(867,252 infants).Frequentist meta-analysis showed a positive association between male sex and severe ROP(113 studies,RR=1.14,95%CI=1.07–1.22)but no association with any ROP(144 studies,RR=1.00,95%CI=0.96–1.03).BMA showed extreme evidence in favor of H1 for severe ROP(BF10=71,174)and strong evidence in favor of H0 for any ROP(BF10=0.05).The association between male sex and severe ROP remained stable over time and was present only in cohorts from countries with a high or high-middle sociodemographic *** Our study confirms the presence of a male disadvantage in severe ROP but not in less severe forms of the *** are variations in the sex differences in ROP,depending on geographical location and sociodemographic level of the countries.

关键词： Oxidative stress Retinopathy of prematurity Sex characteristics

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