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Operative Time as a measure of Quality in Pancreaticoduodenectomy: Is Faster Better? A Retrospective Review Using the ACS NSQIP Database

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Surgical Science 2015年第9期6卷 418-426页

作者： Gwendolyn m. Garnett Lynne Wilkens Whitney Limm linda L. Wong Department of Surgery John A. Burns School of Medicine University of Hawaii Honolulu USA Department of Surgery Queens Medical Center Honolulu USA

Objective: To determine if pancreaticoduodenectomy operative time can provide insight into surgeon performance and thus be considered for use as a quality indicator. Background: Case volume is the traditional quality metric for complex pancreatic surgery, with studies showing better outcomes for high-volume providers. However, there are surgeons performing fewer cases with good quality who are overlooked for referrals directed to high-volume “centers of excellence”. Additional quality metrics are needed. methods: The ACS NSQIP database (2005-2011) was used to identify 4805 pancreaticoduodenectomy patients. Cases were divided at the mean operative time (ORtime) into those ≤373 (n = 2638, 54.9%) vs ≥373 minutes in duration. Complications and outcome measures were compared and predictors of 30-day mortality were assessed. Results: Age ≤ 65 years, male sex, prior chemotherapy, prior radiation, disseminated cancer, diabetes, recent mI, no prior TIA, lower bilirubin and platelet count, and higher prothrombin time were associated with ORtime > 373 minutes. Patients with ORtime > 373 minutes demonstrated more intra-abdominal and superficial infections, wound dehiscence, bleeding requiring transfusion, need for reintubation, septic shock, and returns to OR. ORtime > 373 minutes was associated with longer hospital stay and increased 30-day mortality. ORtime > 373 minutes was a significant and independent predictor in a stepwise model of 30-day mortality. Conclusions: Shorter pancreaticoduodenectomy operative time is associated with fewer complications, shorter hospital stays and lower 30-day mortality after adjusting for patient factors. This may imply that shorter operative time is associated with superior surgical outcome. Operative time may provide insight into surgeon performance and be considered for use as a quality metric.

关键词： Pancreaticoduodenectomy Operative Time

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非洲猪瘟病毒(malawi LIL 20/1株)k8R基因的表达与鉴定

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江苏农学院学报 1998年第2期19卷 1-7页

作者：孙怀昌 linda K Dixon Parkhouse R m E 江苏农学院动物科学系

蛋白多肽二级结构的电脑预测表明，非洲猪瘟病毒（ＭａｌａｗｉＬＩＬ２０／１株）ｋ８Ｒ基因编码带有多个疏水氨基酸小区的２７ｋＤａ蛋白质。该基因的ＰＣＲ产物克隆入质粒ｐＧＥＸ－２Ｔ后，在大肠杆菌中表达４２～５４ｋＤａ不溶性... 详细信息

蛋白多肽二级结构的电脑预测表明，非洲猪瘟病毒（ＭａｌａｗｉＬＩＬ２０／１株）ｋ８Ｒ基因编码带有多个疏水氨基酸小区的２７ｋＤａ蛋白质。该基因的ＰＣＲ产物克隆入质粒ｐＧＥＸ－２Ｔ后，在大肠杆菌中表达４２～５４ｋＤａ不溶性ＧＳＴ－ｋ８Ｒ融合蛋白。此表达蛋白能被针对不同非洲猪瘟病毒株的猪免疫血清识别。在非洲猪瘟病毒细胞适应株感染的细胞中，针对ｋ８Ｒ大肠杆菌表达产物的单抗能检测出２７ｋＤａ特异病毒蛋白。进一步鉴定表明，ｋ８Ｒ基因编码的蛋白质为病毒非结构蛋白，不发生糖基化，出现于病毒感染周期的晚期，主要集中于靠近细胞核的病毒复制部位。用大肠杆菌表达的ＧＳＴ－ｋ８Ｒ融合蛋白免疫猪未能抵抗ＭａｌａｗｉＬＩＬ２０／１强毒株攻击。

关键词：猪基因表达鉴定/非洲猪瘟病毒

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The Effect of Curcumin on Patients with Chronic Fatigue Syndrome/myalgic Encephalomyelitis: An Open Label Study

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International Journal of Clinical medicine 2018年第5期9卷 356-366页

作者： C. (linda) m. C. van Campen K. Riepma Frans C. Visser Stichting Cardiozorg Hoofddorp Netherlands Curesupport Valkenburg Netherlands

myalgic encephalomyelitis/chronic fatigue syndrome (mE/CFS), recently renamed as systemic exertion intolerance disease (SEID), is a chronic and often disabling disease. Although the exact pathophysiological mechanism of mE/CFS is unknown, immunological abnormalities may play an important role. Curcumin is a herb with powerful anti-oxidative, and anti-inflammatory properties. Therefore, we hypothesized that curcumin has favorable effects on symptomatology in mE/CFS patients. In total 52 patients participated, nine stopped the use of curcumin because of side effects. All remaining patients (n = 43) met the criteria for CFS;72% met the criteria for mE. Before and 8 weeks after the use of curcumin complexed with phosphatidyl choline, 500 mg bid, the CDC inventory for assessment of Chronic Fatigue Syndrome was filled in. The CDC questions (n = 19) were scored and divided into 2 parts: the first being specific for CFS complaints (n = 9), the second being scores of less specific symptoms (n = 10);denoted as CDC rest score. Results showed that 8 weeks curcumin use significantly decreased the CFS related symptom scores, but not the CDC rest scores. Analyzing the data separately for mE and CFS patients, the same significance for the CFS symptom scores was present. Conclusion: in this open-labeled study, 8 weeks curcumin use in a phosphatidyl choline complex reduced mE/CFS symptomatology. Therefore, a randomized placebo controlled study is warranted to assess its efficacy in mE/CFS patients.

关键词： Curcumin Chronic Fatigue Syndrome myalgic Encephalomyelitis CDC CFS Symptom Inventory

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Functional magnetic resonance imaging in an animal model of pancreatic cancer

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World Journal of Gastroenterology 2010年第26期16卷 3292-3298页

作者： Robert J Lewandowski Aaron C Eifler David J Bentrem Johnathan C Chung Gayle E Woloschak Robert Ryu Riad Salem Andrew C Larson reed A Omary Department of Radiology Northwestern University Feinberg School of Medicine Chicago IL 60611 United States Department of Surgical Oncology Northwestern University Feinberg School of Medicine Chicago IL 60611 United States Department of Radiation Oncology Northwestern University Feinberg School of Medicine Chicago IL 60611 United States

AIm: To test the hypotheses that diffusion weighed (DW)and transcatheter intraarterial perfusion (TRIP)magnetic resonance imaging (mRI) can each be used to assess regional differences in tumor function in an animal pancreatic cancer ***: VX2 tumors were implanted in pancreata of 6 rabbits. mRI and digital subtraction angiography (DSA) were performed 3 wk following implantation. With a 2-French catheter secured in the rabbit's gastroduodenal artery, each rabbit was transferred to an adjacent 1.5T mRI scanner. DWand TRIP-mRI were performed to determine if necrotic tumor core could be differentiated from viable tumor periphery. For each, we compared mean differences between tumor core/ periphery using a 2-tailed paired t-test (α = 0.05). Imaging was correlated with histopathology. RESULTS: Tumors were successfully grown in all rabbits, confirmed by necropsy. On DW-mRI, mean apparent diffusion coeffi cient (ADC) value was higher in necrotic tumor core (2.1 ± 0.3 mm2/s) than in viable tumor periphery (1.4 ± 0.5 mm2/s) (P mRI, mean perfusion values was higher in tumor periphery (110 ± 47 relative units) than in tumor core (66 ± 31 relative units) (P mRI can be used to differentiate necrotic from viable tumor cells in an animal pancreatic cancer model using ADC (DW-mRI) and perfusion (TRIP-mRI) values.

关键词： Animal model Functional magnetic resonance imaging Pancreatic cancer

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Prescott微生物学原理影印版

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丛书名：国外优秀生命科学教学用书

2009年

作者：（美）Joanne m. Willey （美）linda m. Sherwood （美）Christopher J. Woolverton

Prescott’s微生物学原理是在Prescott，Harley，andKlein’smicrobiology（第7版），（简称《PHK微生物学》）的基础上发展出来的精简版。本书秉承《PHK微生物学》博大精深、新颖、系统的特点，为我们提供了涵盖微生物学所有领域的干... 详细信息

ISBN: (纸本)9787040256819

Prescott’s微生物学原理是在Prescott，Harley，andKlein’smicrobiology（第7版），（简称《PHK微生物学》）的基础上发展出来的精简版。本书秉承《PHK微生物学》博大精深、新颖、系统的特点，为我们提供了涵盖微生物学所有领域的干净流畅的知识精要。作者在易读性上下了很多功夫，以进化、生态和多样性为主线将一些重要论题再次进行了综合和整理。每章集中介绍重要概念，并将...

关键词： microbiology.

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Gestational diabetes mellitus and COVID-19:The epidemic during the pandemic

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World Journal of Diabetes 2023年第8期14卷 1178-1193页

作者： Yamely mendez linda A Alpuing Radilla Luis Eduardo Delgadillo Chabolla Alejandra Castillo Cruz Johanan Luna Salim Surani Department of Obstetrics and Gynecology Baylor College of MedicineHoustonTX 77030United States Department of medicine Xochicalco UniversityMexicali 21376BCMexico Department of medicine Mt.Olympus Medical ResearchSugarlandTX 77479United States Department of medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

During the global coronavirus disease 2019(COVID-19)pandemic,people worldwide have experienced an unprecedented rise in psychological distress and *** addition to this challenging situation,the prevalence of diabetes mellitus(Dm),a hidden epidemic,has been steadily increasing in recent ***-middle-income countries have faced significant barriers in providing accessible prenatal care and promoting a healthy diet for pregnant women,and the pandemic has made these challenges even more difficult to *** women are at a higher risk of developing complications such as hypertension,preeclampsia,and gestational diabetes,all of which can have adverse implications for both maternal and fetal *** occurrence of gestational diabetes has been on the rise,and it is possible that the pandemic has worsened its *** data is limited,studies conducted in Italy and Canada suggest that the pandemic has had an impact on gestational diabetes rates,especially among women in their first trimester of *** significant disruptions to daily routines caused by the pandemic,such as limited exercise options,indicate a possible link between COVID-19 and an increased likelihood of experiencing higher levels of weight gain during ***,individuals in the United States with singleton pregnancies are at a significantly higher risk of excessive gestational weight gain,making this association particularly important to *** comprehensive data is currently lacking,it is important for clinical researchers to explore the possibility of establishing correlations between the stress experienced during the pandemic,its consequences such as gestational gain weight,and the increasing incidence of gestational *** knowledge would contribute to better preventive measures and support for pregnant individuals during challenging times.

关键词： Pregnancy Gestational diabetes Stress Social determinants Pandemic COVID-19 Diabetes type 1 Diabetes type 2 Insulin Diabetes mellitus treatment

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A bio-instructive parylene-based conformal coating suppresses thrombosis and intimal hyperplasia of implantable vascular devices

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Bioactive materials 2023年第10期28卷 467-479页

作者： Dake Hao Jonathan Lin Ruiwu Liu Christopher Pivetti Kaeli Yamashiro linda m.Schutzman Junichiro Sageshima mimmie Kwong Nataliya Bahatyrevich Diana L.Farmer misty D.Humphries Kit S.Lam Alyssa Panitch Aijun Wang Department of Surgery School of MedicineUniversity of California DavisSacramentoCA95817United States Institute for Pediatric Regenerative medicine Shriners Hospitals for ChildrenSacramentoCA95817United States Department of Biochemistry and molecular medicine School of MedicineUniversity of California DavisSacramentoCA95817United States Wallace H.Coulter Department of Biomedical Engineering Georgia Institute of Technology and Emory UniversityAtlant1GA30332United States Department of Biomedical Engineering University of California DavisDavisCA95616United States

Implantable vascular devices are widely used in clinical treatments for various vascular diseases. However, current approved clinical implantable vascular devices generally have high failure rates primarily due to their surface lacking inherent functional endothelium. Here, inspired by the pathological mechanisms of vascular device failure and physiological functions of native endothelium, we developed a new generation of bioactive parylene (poly(p-xylylene))-based conformal coating to address these challenges of the vascular devices. This coating used a polyethylene glycol (PEG) linker to introduce an endothelial progenitor cell (EPC) specific binding ligand LXW7 (cGRGDdvc) onto the vascular devices for preventing platelet adhesion and selectively capturing endogenous EPCs. Also, we confirmed the long-term stability and function of this coating in human serum. Using two vascular disease-related large animal models, a porcine carotid artery interposition model and a porcine carotid artery-jugular vein arteriovenous graft model, we demonstrated that this coating enabled rapid generation of self-renewable “living” endothelium on the blood contacting surface of the expanded polytetrafluoroethylene (ePTFE) grafts after implantation. We expect this easy-to-apply conformal coating will present a promising avenue to engineer surface properties of “off-the-shelf” implantable vascular devices for long-lasting performance in the clinical settings.

关键词： Parylene coating Integrin ligand Thrombosis Intimal hyperplasia Implantable vascular devices

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运动损伤的心理学

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体育科学 2000年第6期20卷 86-89页

作者： Daniel Gould linda m.Petlichkoff Bill Prentice Fred Tedeschi 艾华美国北卡罗来纳格林斯博罗大学运动体育科学系美国爱达荷州博伊西公立大学人体运动学系美国查佩尔希尔市北卡罗来纳大学运动科学系美国伊利诺斯州鹿园芝加哥公牛队运动医学部

1 根据你们的经验和现有的科学资料信息,是否存在与运动损伤有关的重要心理因素或性格类型?

关键词：运动医学运动心理学心理特征运动损伤

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Quantification of the Beneficial Effects of Compression Stockings on Symptoms of Exercise and Orthostatic Intolerance in Chronic Fatigue Syndrome/myalgic Encephalomyelitis Patients

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International Journal of Clinical medicine 2018年第5期9卷 367-376页

作者： C. (linda) m. C. van Campen Freek W. A. Verheugt Frans C. Visser Stichting Cardiozorg Hoofddorp Netherlands Radboud UmC Department of Cardiology Nijmegen Netherlands

Chronic fatigue syndrome and myalgic encephalomyelitis (CFS/mE) are, amongst others, characterized by exercise intolerance, pain, post exertional malaise and orthostatic intolerance. It has been shown in venous disease and sport participation that compression stockings may improve exercise performance and reduce post exercise muscle soreness. moreover, its use is advocated in orthostatic hypotension. Therefore, it was hypothesized that compression stockings may reduce symptomatology in CFS/mE patients. methods: 100 patients used compression stockings class II for minimally 3 weeks and thereafter filled in a questionnaire, based on the Rand 36 physical activity questions (n = 9), whether compression stockings changed perceived symptoms or not. moreover, 7 questions referring to prolonged standing and sitting, to recovery post exercise, muscle pain during or immediately post exercise, and to dizziness/light-headedness during or immediately post exercise, while standing and during prolonged sitting were added. Questions were scored as 1: able to perform activity much less while wearing the stockings, 2: perform activity somewhat less, 3: no perceived change in activity, 4: perform activity slightly better, 5: able to perform activity much better while wearing the stockings. Results: In patients able to answer the question, all mean scores per activity were significantly higher than 3, being no perceived change in activity while wearing the stockings. Subgroup analysis showed that patients with orthostatic intolerance reported higher effects than patients without orthostatic intolerance. Conclusion: This pilot study suggests that compression stockings may be useful to reduce symptomatology of physical activities in CFS/mE patients, especially in patients with orthostatic intolerance. Larger prospective studies with hard endpoints are warranted.

关键词： Chronic Fatigue Syndrome myalgic Encephalomyelitis Compression Stockings Exercise Tolerance Orthostatic Intolerance

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Does Hypothyroidism Cause Hyponatremia?

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Health 2014年第12期6卷 1453-1458页

作者： Jens Hunze linda IJsselstijn Remi W. Wulkan Arjan m. van Alphen Department of Clinical Chemistry Maasstad Hospital Rotterdam The Netherlands Department of Internal medicine Maasstad Hospital Rotterdam The Netherlands

Background: According to most clinical guidelines hypothyroidism should be excluded as a cause in the analysis of euvolemic hyponatremia. Although this axiom has been well established in clinical practice, relatively little evidence supports a relation between hypothyroidism and hyponatremia. The current study was conducted to prove an association between hypothyroidism and the occurrence of hyponatremia. In addition, we sought to determine the effect of L-thyroxine replacement therapy on plasma sodium levels. methods: Data from 2009 to 2011 were retrospectively reviewed. The database included blood samples in which both thyroid function and plasma sodium were determined. Regression analysis and ANOVA were performed to reveal an association between hypothyroidism and hyponatremia. Results: Linear regression analysis of plasma sodium on plasma TSH revealed no relationship (R2 = 0.005). The corresponding gradient belonging to the regression line was ﹣0.427 mmol/log plasma TSH (p = 0.22). No significant relation between plasma sodium and TSH concentration could therefore be found. 32 hypothyroid patients who were treated with L-thyroxine, were identified. No clear change in plasma sodium could be discerned with regression analysis (0.707 mmol/L per year, p = 0.147). Conclusion: Hypothyroidism is not a common cause of hyponatremia. Screening for thyroid function does not seem warranted in the initial analysis of a hyponatremic patient.

关键词： Hyponatremia Hypothyroidism

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