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Hematological abnormalities in liver cirrhosis

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World Journal of Hepatology 2024年第9期16卷 1229-1244页

作者： Oscar Manuel Fierro-Angulo JoséAlberto González-Regueiro Ariana Pereira-García Astrid Ruiz-Margáin fernando Solis-Huerta Ricardo Ulises Macías-Rodríguez Department of Gastroenterology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico 14080Mexico Department of Hematology Instituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico 14080Mexico

Hematological abnormalities are common in cirrhosis and are associated with various pathophysiological *** have documented a prevalence of thrombocytopenia,leukopenia,and anemia in patients with compensated cirrhosis of 77.9%,23.5%,and 21.1%,*** abnormalities carry significant clinical implications,including considerations for invasive procedures,infection risk,bleeding risk,and ***,cirrhosis was believed to predispose patients to bleeding due to alterations observed in classical coagula-tion tests such as prothrombin time,partial thromboplastin time,international normalized ratio,and ***,this understanding has evol-ved,and cirrhosis patients are now also acknowledged as being at a high risk for thrombotic *** in cirrhosis patients presents a complex pheno-type,with procoagulant and anticoagulant abnormalities offsetting each *** multifactorial phenomenon is inadequately reflected by routine laboratory *** complications are more prevalent in decompensated cirrhosis and may correlate with disease *** is primarily associated with portal hypertension,endothelial dysfunction,mechanical vessel injury,dissem-inated intravascular coagulation,endotoxemia,and renal *** review comprehensively outlines hematologic index abnormalities,mechanisms of hemostasis,coagulation,and fibrinolysis abnormalities,limitations of laboratory testing,and clinical manifestations of bleeding and thrombosis in patients with liver cirrhosis.

关键词： Cirrhosis Anemia Leukopenia Thrombocytopenia Coagulopathy Bleeding Thrombosis

Management of lateral pelvic lymph nodes in rectal cancer:Is it time to reach an Agreement?

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World Journal of Clinical Oncology 2024年第4期15卷 472-477页

作者： Sigfredo E Romero-Zoghbi fernando López-Campos Felipe Couñago Department of Radiation Oncology GenesisCareTalavera de la Reina 45600ToledoSpain Department of Radiation Oncology Hospital Universitario Ramón Y CajalMadrid 28034Spain Department of Radiation Oncology GenesisCare-Hospital Universitario Vithas Madrid La MilagrosaMadrid 28010Spain

In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal *** treatment of this nodal area sparks significant controversy due to the strategic differences followed by Eastern and Western physicians,albeit with a higher degree of convergence in recent *** dissection of lateral pelvic lymph nodes without neoadjuvant therapy is a standard practice in Eastern *** contrast,in the West,preference leans towards opting for neoadjuvant therapy with chemoradiotherapy or radiotherapy,that would cover the treatment of this area without the need to add the dissection of these nodes to the total mesorectal *** the presence of high-risk nodal characteristics for mLLN related to radiological imaging and lack of response to neoadjuvant therapy,the risk of lateral local recurrence increases,suggesting the appropriate selection of strategies to reduce the risk of recurrence in each patient *** the heterogeneous and retrospective nature of studies addressing this area,an international consensus is necessary to approach this clinical scenario uniformly.

关键词： Rectal cancer Lateral pelvic lymph node metastases Pelvic lymph node dissection Total neoadjuvant therapy Selective management of the lateral pelvic nodes Prophylactic management of the lateral pelvic nodes Chemoradiotherapy Total mesorectal excision

Impact Containment Barriers with Geotextile Tubes

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Journal of Geoscience and Environment Protection 2024年第5期12卷 325-344页

作者： Flávio da Silva Ornelas Luís fernando Martins Ribeiro Rafael Cerqueira Silva Instituto Federal de Educaç &#227o Ci&#234ncia e Tecnologia&#8212IFTO Palmas Brasil Departamento de Engenharia Civil e Ambiental Programa de p&#243s gradua&#231&#227o em Geotecnia Universidade de Bras&#237lia&#8212UnB/Campus Universit&#225rio Darcy Ribeiro Bras&#237lia Brasil

Recently, tragic tailings dam collapses in Brazil have caused deaths and major destruction and the need to develop technologies capable of preventing damage to people and the environment. Brazilian tailings dams are in a situation of uncertainty due to new legislation that even requires decommissioning, an activity that involves many problems and where the risk of failure is the main one. An impact containment structure downstream of these dams can be effective and geotextile tubes, in a new approach, have emerged as an option with advantages in terms of execution, costs and safety. The technology is versatile and can bring many benefits such as the reuse of tailings or filling with low-energy or reused materials. In this research, geotextile tubes were tested as free containment barriers, experiencing impacts in reduced models. The safety factor for the stability of the structure was constructed using an equation which is the ratio between the self-weight of the barrier structure and its coefficient of static friction and the impact pressure, where the data showed an adequate correlation which suggests the viability of mitigating risks.

关键词： Geotextile Tube Debris Flow Barriers Impact Mining

Neoadjuvant treatment of rectal cancer: Where we are and where we are going

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World Journal of Clinical Oncology 2024年第7期15卷 790-795页

作者： Elísabet González Del Portillo Felipe Couñago fernando López-Campos Department of Radiation Oncología Hospital Universitario La PazMadrid 28046Spain Department of Radiation Oncology GenesisCare MadridMadrid 28010Spain Department of Radiation Oncology Hospital Universitario Ramón Y CajalMadrid 28034Spain

Locally advanced rectal cancer requires a multidisciplinary approach based on total neoadjuvant treatment with radiotherapy(RT)and chemotherapy(ChT),followed by deferred ***,alternatives to the standard total neoadjuvant therapy(TNT)are being explored,such as new ChT regimens or the introduction of *** standard TNT,up to a third of patients may achieve a complete pathological response(CPR),potentially avoiding ***,as of now,we lack predictive markers of response that would allow us to define criteria for a conservative organ *** presence of muta-tions,genes,or new imaging tests is helping to define these *** example of this is the diffusion coefficient in the diffusion-weighted sequence of magnetic resonance imaging and the integration of this imaging technique into RT *** allows for the monitoring of the evolution of this coefficient over successive RT sessions,helping to determine which patients will achieve CPR or those who may require intensification of neoadjuvant therapy.

关键词： Locally advanced rectal cancer Total neoadyuvant treatment Radiotherapy Biomarker Magnetic resonance imaging Conservative organ strategy Watch and wait

Supervised vs home-based exercise program in kidney transplant recipients: A pilot pragmatic non-randomized study

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World Journal of Transplantation 2024年第4期14卷 123-132页

作者： Anna Crepaldi Giovanni Piva Nicola Lamberti Michele Felisatti Luca Pomidori Yuri Battaglia Fabio Manfredini Alda Storari Pablo Jesús López-soto Unit of Nephrology University Hospital of FerraraFerrara 44121Emilia-RomagnaItaly Department of Nursing Instituto Maimónides de Investigación Biomédica de CórdobaCordoba 14004AndalusiaSpain Department of Neuroscience and Rehabilitation University of FerraraFerrara 44121Emilia-RomagnaItaly Esercizio Vita Medical Fitness Ferrara 44124Emilia-RomagnaItaly Department of Medicine University of VeronaVerona 37100VenetoItaly Department of Nursing Maimonides Biomedical Research Institute of CordobaUniversity of CordobaReina Sofía University HospitalCordoba 14004AndalusiaSpain

BACKGROUND Although the benefits of exercise for kidney transplant recipients(KTRs)have been widely demonstrated,these patients experience several barriers in undertaking a structured exercise program in hospital and non-hospital *** To compare the effects of a supervised moderate-intensity gym-based intervention with a home-based low-intensity walking program on exercise capacity in *** KTRs were asked to choose between two six-month *** first group performed a low-intensity interval walking intervention at home-based exercise intervention (HBex). The second group performed a supervised training program at an adapted physical activitygym (Sgym), including aerobic and resistance training. The outcomes, collected at baseline and at the end of theprograms, included the 6-minute walking test, the peak oxygen consumption (VO_(2)peak) during a treadmill test,the 5-time sit-to-stand test, and blood *** patients agreed to participate and self-selected into the HBex (n = 9) and Sgym (n = 8) groups. Twopatients in the Sgym group dropped out because of familial problems. At baseline, patients in the HBex group weresignificantly older and had lower walking distance, VO_(2)peak, and lower limb strength. Primary outcome changeswere significantly greater in the HBex group than in the Sgym group (52 ± 23 m vs 8 ± 34;P = 0.005). No othersignificant differences between groups were observed. Both groups improved most of the outcomes in the withingroupcomparisons, with significant variations in VO_(2) ***-month moderate-intensity supervised or low-intensity home-based training programs effectively improvedexercise capacity in KTRs. Gym-based programs combine aerobic and resistance training;however, in-homewalking may be proposed for frail KTRs.

关键词： Exercise Transplantation Walking Training Nephrology Kidney disease

Influence of Omega 3 Fatty Acid Supplementation on Phase Angle Values of People Living with HIV/AIDS with Lipodystrophy Secondary to Antiretroviral Therapy: A Randomized Clinical Trial

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Food and Nutrition Sciences 2024年第1期15卷 58-70页

作者： Thalita Bandeira Dantas Alline Peralta Castro fernando de Souza Flexa Ribeiro Filho Rosana Maria Feio Libonati Núcleo de Medicina Tropical do Pará Programa de Pós gradua&ccedil&atildeo em Patologia das Doen&ccedilas Tropicais Universidade Federal do Pará Pará Brasil Instituto de Ciências Biológicas e da Saúde Faculdade de Medicina Universidade Federal do Pará Pará Brasil Centro de Ciências Biológicas e da Saúde Universidade Estadual do Pará Pará Brasil

Objective: The measurement of phase angles is an important monitoring parameter and supplementation with omega-3 could promote benefits by modulating the electrical potential of membranes and increasing body cell mass. This study aimed to evaluate the effectiveness of omega-3 fatty acid supplementation on the phase angle of people living with HIV/AIDS. Methods: In this study, 63 individuals of all genders who were undergoing outpatient follow-up and showed lipodystrophy due to highly active antiretroviral therapy were analyzed. Our sample consisted of two groups, one that received supplementation containing 2550 mg of omega-3/day (1080 mg of eicosapentaenoic acid and 720 mg of docosahexaenoic acid) for three months (n = 32) and another that underwent nutrition guidance (n = 31). Phase angle and body cell mass were assessed for both groups and compared at the beginning of research (T0) and after our intervention (T1) for each group separately. Results: Phase angle averaged 6.45° ± 1.06 SD. The comparison between T0 and T1 showed a significant increase in phase angle and body cell mass, whereas the guidance group showed a decrease in body cell mass at T1 in relation to T0, with a significant p-value. Variance in phase angle between moments showed significant values between T0 and T1 in the supplementation group for all genders. Conclusion: Omega-3 positively modulated patients phase angle and body cell mass, but we emphasize the need for other studies that can solidify knowledge about supplementation dosage and intervention time.

关键词： HIV Lipodystrophy Omega-3 Phase Angle

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A Powerful Message

The Boao Forum Accentuates China’s Appeal

今日中国（英文版） 2024年第1期

作者： AUGUSTO soto

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Pyloric Sympathectomy: A Novel Way to Get Pylorus Relaxation? Report of Two Bariatric Cases

今日中国（英文版） 2024年第5期 20页

作者： AUGUSTO soto

来源：博看期刊评论

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Surgical Science 2024年第6期15卷 381-395页

作者： Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso Rui Ribeiro Paulo Reis Esselin de Melo fernando Fornari Victor Dib Institute Manaus Brazil Gastrobese Clinic Passo Fundo Brazil Lusadas Amadora Hospital Lisboa Portugal Paulo Reis Institute Goinia Brazil Alfredo Nasser University Center (UNIFAN) Goinia Brazil Faculdade de Medicina Universidade de Passo Fundo Passo Fundo Brazil Faculdade de Medicina Universidade Federal da Fronteira do Sul Chapec Brazil

Objective: This case report aimed to demonstrate a possible neuromuscular effect of pyloric sympathectomy on the pylorus motility, leading to its permanent relaxation, observed in two bariatric surgical cases, one primary and the other, revisional. Background: Pyloric sphincter is a physiological barrier to free gastric emptying. In sleeve gastrectomy and in Roux-en-Y gastric bypass revisions, that put the remnant stomach in transit, the pylorus can contribute to generate a high intragastric pressure, which could lead to acute gastric fistulas and/or chronic gastroesophageal reflux disease. The possibility of functionally relaxing the pylorus, promoting intragastric pressure reduction, could represent a protective maneuver against these complications. Methods: We describe herein a surgical maneuver applied in two cases of bariatric surgeries, with the intention of facilitating antrum-duodenal region exposure, in a sleeve gastrectomy and in a Roux-en-Y gastric bypass conversion to SADI-S. For this, a ligation of terminal peripyloric vessels was done, allowing a passage of a tape, which surrounded the pylorus, for its traction. In both cases, 30-day and 1-year endoscopic evaluations were done, to assess esophagitis signs, anastomosis healing and anatomical pouch aspect. A clinical evaluation was also done, to assess gastroesophageal symptoms (validated questionnaire). Results: In the postoperative endoscopic evaluations, no esophagitis were observed in any case and the gastric pouches had normal aspect, with the expected anatomical findings, compatible with the surgeries performed. The anastomosis healed without problems, in the revisional case. Interestingly, in both cases, it was observed a complete pyloric sphincter relaxation, which lasted until 1-year endoscopic evaluation. There were no fistulas, nor esophagitis in any of these cases. Clinically, there were no symptoms of gastroesophageal reflux disease (validated questionnaire). Conclusion: The observation of a

关键词： Roux-en-Y Gastric Bypass Sleeve Gastrectomy Sympathectomy Bariatric Surgery