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Hepatocellular carcinoma presenting as an extrahepatic mass:A case report and review of literature

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World Journal of Gastrointestinal Oncology 2024年第5期16卷 2241-2252页

作者： Wei kelly Wu Krutika Patel chandrasekhar Padmanabhan Kamran Idrees Department of surgery Vanderbilt University Medical CenterNashvilleTN 37232United States Department of Pathology Microbiology and ImmunologyVanderbilt University Medical CenterNashvilleTN 37232United States Division of surgical Oncology and Endocrine surgery Department of SurgeryVanderbilt University Medical CenterNashvilleTN 37232United States

BAcKGROUND Hepatocellular carcinoma(Hcc)is a primary liver tumor generally diagnosed based on radiographic *** disease is typically associated with increased tumor diameter,multifocality,and vascular *** report a case of a patient who presented with extrahepatic Hcc metastasis to a portocaval lymph node with occult hepatic primary on computed tomography(cT).We review the literature for cases of extrahepatic Hcc presentation without known hepatic lesions and discuss strategies to differentiate between metastatic and ectopic *** sUMMARY A 67-year-old male with remotely treated hepatis c was referred for evaluation of an enlarging portocaval,mixed cystic-solid *** cT evaluations demonstrated steatosis,but no cirrhosis or liver *** ultrasound demonstrated a normal-appearing pancreas,biliary tree,and *** needle aspiration yielded atypical *** differential diagnosis included duodenal or pancreatic cyst,lymphoproliferative cyst,stromal or mesenchymal lesions,nodal involvement from gastrointestinal or hematologic malignancy,or duodenal gastrointestinal stromal *** review by a multidisciplinary tumor board,the patient underwent open surgical resection of a 5.2 cm×5.5 cm retroperitoneal mass with pathology consistent with moderately-differentiated *** resonance imaging(MRI)subsequently demonstrated a 1.2 cm segment VIII hepatic lesion with late arterial enhancement,fatty sparing,and intrinsic T1 *** fetoprotein was 23.3 ng/*** patient was diagnosed with Hcc with portocaval nodal ***:We surveyed the literature for Hcc presenting as extrahepatic masses without history of concurrent or prior intrahepatic *** identified 18 cases of extrahepatic Hcc ultimately found to represent metastatic lesions,and 30 cases of extrahepatic Hcc found to be primary,ectopic *** Hepatocellular carcinoma can seldomly present with extrahepatic metastasis in the setting of

关键词： Extrahepatic Metastasis Portocaval Lymph node case report

A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world

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Journal of sport and Health science 2024年第4期13卷 472-483,F0003页

作者： kelly R.Evenson Wendy J.Brown Alison K.Brinson Emily Budzynski-seymour Melanie Hayman Department of Epidemiology Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillNC 27599-8050USA Faculty of Health sciences and Medicine Bond UniversityGold CoastQLD 4226Australia school of Human Movement and Nutrition sciences The University of QueenslandBrisbaneQLD 4072Australia Department of Anthropology University of North Carolina at Chapel HillChapel HillNC 27599-3115USA carolina Population center University of North Carolina at Chapel HillChapel HillNC 27599-8120USA Faculty of sport Health and Social SciencesSolent UniversitySouthamptonSO140YNUK Appleton Institute School of HealthMedical and Applied SciencesCentral Queensland UniversityRockhamptonQLD 4701Australia

Background:The period following pregnancy is a critical time window when future habits with respect to physical activity(PA) and sedentary behavior(sB) are established;therefore,it warrants *** purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and sB guidelines ***:To identity guidelines published since 2010,we performed a(a) systematic search of 4 databases(cINAHL,Global Health,PubMed,and sPORTDiscus),(b) structured repeatable web-based search separately for 194 countries,and(c) separate web-based *** the most recent guideline was included for each ***:We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with sB *** continents with guidelines included Europe(n=12),Asia(n=5),Oceania(n=2),Africa(n=1),North America(n=1),and south America(n=1).The most common benefits recorded for PA included weight control/management(n=10),reducing the risk of postpartum depression or depressive symptoms(n=9),and improving mood/well-being(n=8).Postpartum guidelines specified exercises to engage in,including pelvic floor exercises(n=17);muscle strengthening,weight training,or resistance exercises(n=13);aerobics/general aerobic activity(n=13);walking(n=11);cycling(n=9);and swimming(n=9).Eleven guidelines remarked on the interaction between PA and breastfeeding;several guidelines stated that PA did not impact breast milk quantity(n=7),breast milk quality(n=6),or infant growth(n=3).For sB,suggestions included limiting long-term sitting and interrupting sitting with ***:country-specific postpartum guidelines for PA and sB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.

关键词： Breastfeeding caesarean section Guidelines Postnatal Recommendations

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ZenZone App-One Teenager's Answer to Digital Distractions

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城市漫步（GBA版） 2024年第1期 50-51页

作者： Ned kelly 不详

When shanghai American school Puxi student Luke Penaloza's gaming device broke,he found his academic performance saw a stark *** was a revelation,and one that inspired him to develop ZenZone.

关键词： One Zen App

Multiple myeloma survival in New south Wales, Australia, by treatment era to 2020

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cancer Biology & Medicine 2024年第8期 703-711页

作者： Eleonora Feletto Qingwei Luo Anna kelly Marianne Weber David Goldsbury Katherine Barron Karen canfell Xue Qin Yu The Daffodil centre The University of Sydney A Joint Venture with Cancer Council NSW

Objective: Australia has relatively high multiple myeloma(MM) incidence and mortality rates. Advancements in MM treatment over recent decades have driven improvements in MM survival in high-income countries; however, reporting in Australia is limited. We investigated temporal trends in population-wide MM survival across 3 periods of treatment advancements in New south Wales(NsW), ***: Individuals with an MM diagnosis in the NsW cancer Registry between 1985 and 2015 with vital follow-up to 2020, were categorized into 3 previously defined treatment eras according to their diagnosis date(1985±1995, chemotherapy only; 1996±2007, autologous stem cell transplantation; and 2008±2015, novel agents including proteasome inhibitors and immunomodulatory drugs). Both relative survival and cause-specific survival according to Fine and Gray's competing risks cumulative incidence function were calculated by treatment era and age at ***: Overall, 11,591 individuals were included in the study, with a median age of 70 years at diagnosis. Five-year relative survival improved over the 36-year(1985±2020) study period(31.0% in 1985±1995; 41.9% in 1996±2007; and 56.1% in 2008±2015). For individuals diagnosed before 70 years of age, the 5-year relative survival nearly doubled, from 36.5% in 1985±1995 to 68.5% in 2008±2015. Improvements for those > 70 years of age were less pronounced between 1985±1995 and 1996±2007; however, significant improvements were observed for those diagnosed in 2008±2015. similar overall and age-specific patterns were observed for causespecific survival. After adjustment for gender and age at diagnosis, treatment era was strongly associated with both relative and cause-specific survival(P conclusions: survival of individuals with MM is improving in Australia with treatment advances. However, older age groups continue to experience poor survival outcomes with only modest improvements over time. Given the increasing prevalence of

关键词： Australia Multiple myeloma cancer epidemiology competing risk analysis survival analysis

A rat model of multicompartmental traumatic injury and hemorrhagic shock induces bone marrow dysfunction and profound anemia

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Animal Models and Experimental Medicine 2024年第3期7卷 367-376页

作者： Lauren s.kelly Jennifer A.Munley Erick E.Pons Kolenkode B.Kannan Elizabeth M.Whitley Letitia E.Bible Philip A.Efron Alicia M.Mohr Department of surgery and sepsis and critical Illness Research center University of Florida College of MedicineGainesvilleFloridaUSA Pathogenesis LLCGainesvilleFloridaUSA

Background:severe trauma is associated with systemic inflammation and organ *** rodent trauma models are the mainstay of postinjury research but have been criticized for not fully replicating severe human *** aim of this study was to create a rat model of multicompartmental injury which recreates profound traumatic ***:Male sprague-Dawley rats were subjected to unilateral lung contusion and hemorrhagic shock(LcHs),multicompartmental polytrauma(PT)(unilateral lung contusion,hemorrhagic shock,cecectomy,bifemoral pseudofracture),or na?ve ***,plasma toll-l ike receptor 4(TLR4),hemoglobin,spleen to body weight ratio,bone marrow(BM)erythroid progenitor(cFU-GEMM,BFU-E,and cFU-E)growth,plasma granulocyte colony-stimulating factor(G-csF)and right lung histologic injury were assessed on day 7,with significance defined as p valuessults:Polytrauma resulted in markedly more profound inhibition of weight gain compared to LcHs(p=0.0002)along with elevated plasma TLR4(pspleen to body weight ratios(p=0.004).Both LcHs and PT demonstrated suppression of cFU-E and BFU-E growth compared to naive(psma G-csF was elevated in PT compared to both na?ve and LcHs(pcHs and PT demonstrated significant histologic right lung injury with poor alveolar wall integrity and interstitial ***:Multicompartmental injury as described here establishes a reproducible model of multicompartmental injury with worsened anemia,splenic tissue enlargement,weight loss,and increased inflammatory activity compared to a less severe *** may serve as a more effective model to recreate profound traumatic injury to replicate the human inflammatory response postinjury.

关键词： anemia i nflammation polytrauma pseudofracture shock

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Acute colonic Pseudo-Obstruction (AcPO): An Expanding colon with Unusual Risk Factors

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Open Journal of Internal Medicine 2024年第2期14卷 167-174页

作者： kelly schulte Alyson Terry Grace Boyle Dmitriy scherbak HcA Healthone sky Ridge Medical center Lone Tree Colorado USA

The distention of the colon without mechanical or anatomical obstruction, Acute colonic Pseudo-obstruction (AcPO), is a common condition occurring in the critically ill. AcPO in the setting of an acute pulmonary embolism and embolic stroke is a rarity. A 76-year-old female with shortness of breath, left hemiparesis and right-sided paresthesias presented with acute pulmonary embolism and acute infarcts of the left caudate nucleus, thalamus and occipital lobe. Her hospitalization was complicated with persistent distention of the large bowel without dilation of the small bowel. Empiric antibiotics were initiated without improvement and laboratory studies including clostridium difficile were negative. she underwent nasogastric decompression and two decompressive colonoscopies with a resolution of her symptoms. This case illustrates an example of acute abdominal distension, without underlying etiology, in the setting of acute embolism of the pulmonary and cerebral vasculature. Early identification and action with decompressive colonoscopy were key to preventing further bowel damage or rupture.

关键词： Acute colonic Pseudo-Obstruction AcPO Ogilvie’s syndrome colonic Dilation Acute Embolic Infarcts cerebrovascular Accident Pulmonary Embolism PE

Genome and clonal hematopoiesis stability contrasts with immune,cfDNA,mitochondrial,and telomere length changes during short duration spaceflight

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Precision clinical Medicine 2024年第1期7卷 1-13页

作者： J.sebastian Garcia-Medina Karolina sienkiewicz s.Anand Narayanan Eliah G.Overbey Kirill Grigorev Krista A.Ryon Marissa Burke Jacqueline Proszynski Braden Tierney caleb M.schmidt Nuria Mencia-Trinchant Remi Klotz Veronica Ortiz Jonathan Foox christopher chin Deena Najjar Irina Matei Irenaeus chan carlos cruchaga Ashley Kleinman JangKeun Kim Alexander Lucaci conor Loy Omary Mzava Iwijn De Vlaminck Anvita singaraju Lynn E.Taylor Julian c.schmidt Michael A.schmidt kelly Blease Juan Moreno Andrew Boddicker Junhua Zhao Bryan Lajoie Andrew Altomare semyon Kruglyak shawn Levy Min Yu Duane c.Hassane susan M.Bailey kelly Bolton Jaime Mateus christopher E.Mason Department of Physiology and Biophysics Weill Cornell MedicineCornell UniversityNew YorkNY 10021USA The HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for computational Biomedicine Weill Cornell MedicineNew YorkNY 10021USA Department of Immunology Weill Cornell MedicineCornell UniversityNew YorkNY 10021USA Department of stem cell Biology and Regenerative Medicine Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA 90033USA space Exploration Technologies corporation HawthomeCA 90250USA sovaris Aerospace BoulderCO 80302USA Advanced Pattern Analysis&Human Performance Group BoulderCO 80302USA children's cancer and Blood Foundation Laboratories Departments of Pediatrics and Cell and Developmental BiologyDrukier Institute for Children's HealthMeyer Cancer CenterWeill Cornell MedicineNew YorkNY 10021USA Meyer cancer center Weill Cornell MedicineNew YorkNY 10065USA Department of Nutrition and Integrative Physiology Florida State UniversityTallahasseeFL 32306USA Department of systems Engineering Colorado State UniversityFort CollinsCO 80523USA Element Biosciences San DiegoCA 10055USA Department of Environmental and Radiological Health sciences Colorado State UniversityFort CollinsCO 80523USA cell and Molecular Biology Program Colorado State UniversityFort CollinsCO 80523USA BioAstra Inc New YorkNYUSA Washington University st Louis Oncology Division St.LouisMO 63100USA Meinig school of Biomedical Engineering Cornell UniversityIthacaNY 14853USA The Feil Family Brain and Mind Research Institute Weill Cornell MedicineNY 10021USA WorldQuant Initiative for Quantitative Prediction Weill Cornell MedicineNew YorkNY 10021USA

Background The Inspiration4(I4)mission,the first all-civilian orbital flight mission,investigated the physiological effects of short-duration spaceflight through a multi-omic *** advances,there remains much to learn about human adaptation to spaceflight's unique challenges,including microgravity,immune system perturbations,and radiation *** To provide a detailed genetics analysis of the mission,we collected dried blood spots pre-,during,and post-flight for DNA *** length was measured by quantitative PcR,while whole genome and cfDNA sequencing provided insight into genomic stability and immune adaptations.A robust bioinformatic pipeline was used for data analysis,including variant calling to assess mutational *** Telomere elongation occurred during spaceflight and shortened after return to ***-free DNA analysis revealed increased immune cell signatures *** significant clonal hematopoiesis of indeterminate potential(cHIP)or whole-genome instability was *** long-term gene expression changes across immune cells suggested cellular adaptations to the space environment persisting months *** Our findings provide valuable insights into the physiological consequences of short-duration spaceflight,with telomere dynamics and immune cell gene expression adapting to spaceflight and persisting after return to *** sequencing data will serve as a reference point for studying the early development of cHIP in astronauts,an understudied phenomenon as previous studies have focused on career *** study will serve as a reference point for future commercial and non-commercial spaceflight,low Earth orbit(LEO)missions,and deep-space exploration.

关键词： genomes clonal hematopoiesis stability immune mitochondria ribosomes spaceflight

重症监护室护士限制治疗努力的能力:整合性综述

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International Journal of Nursing sciences 2024年第1期11卷 143-154,I0003页

作者： Elvia R.Lopez-Panza Vanessa c.Pacheco-Roys kelly J.Fernandez-Ahumada Diana c.Díaz-Mass María Y.Exposito-concepcion Elizabeth Villarreal-cantillo cesar I.Aviles Gonzalez Nursing Department Universidad del NorteBarranquillaColombia Nursing Program Faculty of Health SciencesUniversidad Popular del CesarValleduparColombia clínica Valledupar ValleduparColombia Hospital Universidad del Norte SoledadColombia Department of Medical sciences and Public Health University of CagliariCittadella Universitaria di MonserratoCagliariItaly

目的在重症监护病房(IntensivecareUnit,IcU),护土难免会遇到需要限制治疗努力(limiting therapeutie efort,LTE)的患者,尽管多数护士还缺乏为这些临终患者及其家庭提供支持的准备。本综述旨在描述IcU护士在LTE中需要具备的能力。方法对... 详细信息

目的在重症监护病房(IntensivecareUnit,IcU),护土难免会遇到需要限制治疗努力(limiting therapeutie efort,LTE)的患者,尽管多数护士还缺乏为这些临终患者及其家庭提供支持的准备。本综述旨在描述IcU护士在LTE中需要具备的能力。方法对2010年--2023年发表的文献进行综述。系统检索了5个数据库:Medline、Wiley Online Library、sciELO、scienceDirect和Web of science。使用关键评估项目工具西班牙语版(critical Appraisal skills Programme in spanish,cAsPe)作为评判性阅读工具。使用牛津循证医学中心(center for Evidence-Based Medicine.,cEBM)评估工具确定证据级别和推荐强度。结果共纳入25篇文献。IcU护士LTE护理的能力包括对患者的直接护理、以家庭为中心的护理以及护士在团队中的作用。该综述确定了3个类别的能力:作为患者、家庭与跨学科团队之间维护者的能力,在LTE方面的决策能力,在患者生命末期治疗和护理干预的能力。结论IcU护士在LTE方面需要具备相应的能力,这对患者的生活质量死亡尊严以及患者家庭应对悲伤的全面支持至关重要。

关键词：重症监护家庭支持重症监护病房护士的作用安宁疗护专业能力

Psychiatric sequelae of chronic Pruritic Dermatoses

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Open Journal of Medical Psychology 2024年第2期13卷 25-38页

作者： kelly Frasier Vivian Li Kathleen click christina Dudzik Michelle sobotka Evadne Rodriguez Karina stech Nuvance Health/Vassar Brothers Medical center Poughkeepsie NY USA school of Osteopathic Medicine Kansas City University Kansas City MO USA Touro college of Osteopathic Medicine Middleton campus Middletown NY USA Abrazo Health Network Goodyear AZ USA school of Medicine University of Missouri-Columbia Columbia MO USA Lewis Katz school of Medicine at Temple University Philadelphia PA USA

This comprehensive review investigates the significant psychological impact and profound psychological comorbidities found in individuals suffering from chronic pruritic dermatoses, including atopic dermatitis, chronic urticaria, and prurigo nodularis. Highlighting the complex, reciprocal relationship between pruritus and psychiatric conditions such as depression, anxiety, and sleep disturbances, this paper elucidates the comprehensive impact of dermatological disorders on the skin in addition to the far-reaching effects on an individual’s psychological well-being. By evaluating the efficacy of integrated psychodermatological interventions, including cognitive behavioral therapy, mindfulness practices, pharmacological treatments, and innovative telepsychiatry and digital health solutions, this review aims to lay the foundation for a more holistic approach to treatment of concurrent dermatological and psychiatric conditions. Future research endeavors should delve deeper into the mechanistic foundation of the pruritus-psychiatry interface, the refinement of tailored treatment strategies, and the evaluation of long-term patient outcomes. In doing so, this review seeks to contribute to the optimization of patient care and well-being, underscoring the pivotal role of addressing both dermatological and psychological needs in achieving comprehensive health outcomes.

关键词： Psychodermatology chronic Pruritic Dermatoses Psychological comorbidities Integrated Interventions Pruritus-Psychiatry Interface