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Minimally Invasive Surgery for Necrotizing Pancreatitis: A Case Report

Surgical Science 2024年第9期15卷 514-521页

作者： Néstor Veriel Méndez Huerta Luis Fernando Zorrilla Núñez Noelia Obregón Gaxiola César Jair Treviño Arizmendi Gerardo Iván Muñoz Morales marco Alejandro Arizmendi Villarreal Pamela Denisse Valdez Navarro marco antonio hernández guedea Gerardo Enrique Muñoz Maldonado Service of General Surgery Hospital Universitario Dr. Jos Eleuterio Gonzlez Universidad Autnoma de Nuevo Len Monterrey Mxico

Introduction: Necrotizing pancreatitis management is complex and varies significantly among clinicians. Minimally invasive approaches like transgastric necrosectomy via laparoscopy are emerging as effective treatment options. This case report underscores the technique’s efficacy, clinical outcomes, and role in reducing complications. Clinical Observation: A 59-year-old male with a history of smoking and alcoholism presented with severe abdominal pain, nausea, and vomiting. Over the following weeks, he developed symptoms including asthenia, weight loss, and melena. Diagnostic workup revealed severe anemia and Balthazar E necrotizing pancreatitis, with significant intra-abdominal fluid collections and signs of infection. After initial conservative management, the patient underwent transgastric necrosectomy via laparoscopy due to deteriorating clinical status. The procedure involved removing necrotic tissue and performing a cystogastroanastomosis and jejunostomy. Postoperative care included fasting, parenteral nutrition, broad-spectrum antibiotics, and enzymatic replacement. The patient recovered well, with reduced necrotic tissue on follow-up imaging, and was discharged twelve days post-surgery [1]. Conclusion: Transgastric necrosectomy by laparoscopy is a valuable first-line surgical option for patients with symptomatic necrotizing pancreatitis, particularly in cases without prior interventions. This minimally invasive technique helps reduce major complications and mortality, offering a less invasive alternative to traditional open necrosectomy. The multidisciplinary approach and careful postoperative management were crucial to the patient’s favorable outcome. The case highlights the potential of transgastric necrosectomy as an effective treatment strategy in managing complex pancreatitis cases, including those with associated duodenal perforation [2].

关键词： Necrotizing Transgastric Pancreatic Necrosectomy Pancreatitis Case Report

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Influence of manufacturing process-induced geometrical defects on the energy absorption capacity of polymer lattice structures

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Defence Technology（防务技术） 2024年第5期35卷 47-59页

作者： Alexandre Riot Enrico Panettieri antonio Cosculluela marco Montemurro Universite de Bordeaux Arts et Metiers Institute of TechnologyCNRSINRABordeaux INPHESAM UniversiteI2M UMR 5295F-33405 TalenceFrance French Atomic Energy Commission Route des GargailsCedexF-33114Le BarpFrance

Modern additive manufacturing processes enable fabricating architected cellular materials of complex shape,which can be used for different *** them,lattice structures are increasingly used in applications requiring a compromise among lightness and suited mechanical properties,like improved energy absorption capacity and specific stiffness-to-weight and strength-to-weight ratios.A dedicated modeling strategy to assess the energy absorption capacity of lattice structures under uni-axial compression loading is presented in this *** numerical model is developed in a non-linear framework accounting for the strain rate effect on the mechanical responses of the lattice *** geometries,i.e.,cubic body centered cell,octet cell,rhombic-dodecahedron and truncated cuboctahedron 2+,are ***,the influence of the relative density of the representative volume element of each geometry,the strain-rate dependency of the bulk material and of the presence of the manufacturing process-induced geometrical imperfections on the energy absorption capacity of the lattice structure is *** main outcome of this study points out the importance of correctly integrating geometrical imperfections into the modeling strategy when shock absorption applications are aimed for.

关键词： Lattice structures Architected cellular materials Dynamic simulation Energy absorption Geometrical imperfection Additive manufacturing

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Climate change and human health: Last call to arms for us

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World Journal of Clinical Cases 2024年第11期12卷 1870-1874页

作者： antonio Corrente Maria Caterina Pace marco Fiore Department of Anaesthesiology and Intensive Care Medicine The Anastasia Guerriero HospitalMarcianise 81025CasertaItaly Department of Women Child and General and Specialized SurgeryUniversity of Campania“Luigi Vanvitelli”Naples 80138Italy

Climate change,now the foremost global health hazard,poses multifaceted challenges to human *** editorial elucidates the extensive impact of climate change on health,emphasising the increasing burden of diseases and the exacerbation of health *** highlights the critical role of the healthcare sector,particularly anaesthesia,in both contributing to and mitigating climate *** is a call to action for the medical community to recognise and respond to the health challenges posed by climate change.

关键词： Climate change Carbon footprint Sustainability Greenhouse gases Anaesthetic gases Environmental impact Disposable laryngoscope blades

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Fulminant Hepatitis Associated with Chronic Consumption of 3,4-Methylenedioxy-Methamphetamine;Case Report

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Open Journal of Gastroenterology 2024年第5期14卷 161-166页

作者： Ulises Solis Gomez Gustavo Adolfo hernández Valdez Juan antonio Contreras Escamilla Ivan Alejandro Medina Jimenez Jorge Morales Rojas Jocelyn Nataly Quintero Melendez marco antonio González Villar Department of Internal Medicine ISSSTE APP General Hospital of Tepic Tepic Nayarit Mexico

The amphetamine derivative 3,4-methylenedioxymethamphetamine (MDMA), also called ecstasy, is a neurotoxin widely consumed among young people that has increased in recent years because it is a recreational drug, of which immediate effects are known such as a greater sensation of well-being, extroversion, increased sensory perception. However, its long-term effects have been described very little in the medical literature, including damage to the heart, central nervous system, kidney, etc. One of its little-known effects is hepatotoxicity, of which few cases are known associated with fulminant hepatitis, which is a rapidly deteriorating condition that is generally associated with a syndrome of multiple organ dysfunction and death. Therefore, it is very important to know this type of damage in the short and long term. The following case is of a 39-year-old man who came to our service due to jaundice syndrome and the only history of MDMA consumption, who as the days went by met the criteria for fulminant liver failure, with damage to multiple organs (organ dysfunction syndrome).

关键词： Fulminant Hepatitis Acute Liver Failure Methamphetamine Severe Acute Liver Failure in a User of Drugs of Abuse Hepatology

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Frequency of and reasons behind non-listing in adult patients referred for liver transplantation: Results from a retrospective study

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World Journal of Transplantation 2024年第2期14卷 99-106页

作者： marco Biolato Luca Miele Giuseppe Marrone Claudia Tarli antonio Liguori Rosaria Calia Giovanni Addolorato Salvatore Agnes antonio Gasbarrini Maurizio Pompili antonio Grieco Department of Medical and Surgical Sciences CEMADFondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy Department of Translational Medicine and Surgery Catholic University of Sacred HeartRome 00168Italy

BACKGROUND Few studies have evaluated the frequency of and the reasons behind the refusal of listing liver transplantation *** To assess the ineligibility rate for liver transplantation and its *** A single-center retrospective study was conducted on adult patients which entailed a formal multidisciplinary assessment for liver transplantation *** predictors for listing were evaluated using multivariable logistic *** In our center,314 patients underwent multidisciplinary work-up before liver transplantation enlisting over a three-year *** most frequent reasons for transplant evaluation were decompensated cirrhosis(51.6%)and hepatocellular carcinoma(35.7%).The non-listing rate was 53.8%and the transplant rate was 34.4%for the whole *** hundred and five motivations for ineligibility were *** most common contraindications were psychological(9.3%),cardiovascular(6.8%),and surgical(5.9%).Inappropriate or premature referral accounted for 76(37.1%)*** multivariable analysis,a referral from another hospital(OR:2.113;95%CI:1.259–3.548)served as an independent predictor of *** A non-listing decision occurred in half of our cohort and was based on an inappropriate or premature referral in one case out of *** referral from another hospital was taken as a strong predictor of non-listing.

关键词： Controindication Eligibility Evaluation Referral Personalized medicine

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Uremic Bleeding in 2 Patients with Dieulafoy’s Lesion: Case Report and Literature Review

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Open Journal of Gastroenterology 2024年第5期14卷 167-173页

作者： Gustavo Adolfo hernández Valdez Diana Estefanía Ibarra García Juan antonio Contreras Escamilla Janette Alejandra Gamiño Gutierrez Francisco Manuel Tonatiuh Carrillo Beltran Ulises Solis Gomez Jocelyn Nataly Quintero Meléndez Ivan Alejandro Medina Jimenez marco antonio González Villar Jorge Rojas Morales Department of Internal Medicine ISSSTE APP General Hospital of Tepic Tepic Nayarit Mexico Hospital Civil de Guadalajara Fray antonio Alcalde Guadalajara Jalisco M&#233xico

Dieulafoy’s lesions are rare vascular malformations of the gastrointestinal tract. A Dieulafoy’s lesion is an aberrant vessel that does not reduce in caliber when it extends from the submucosa to the mucosa. Damage to this artery can cause severe and intermittent arterial bleeding from small vascular stumps that are difficult to visualize. Furthermore, these catastrophic bleeding episodes frequently result in hemodynamic instability and the need for transfusion of multiple blood products. Recently, uremic syndrome has been identified as a risk factor for gastric mucosal lesions. We present two clinical cases of acute digestive bleeding due to Dielafoy lesion with chronic kidney disease as the main cause, where two different therapies were performed endoscopically. We concluded with the results of our patients that the best therapy was the application of the hemostatic hemoclip on the injury vs the injection with adrenaline on the wound site. Uremia is identified as a risk factor for upper gastrointestinal bleeding in patients with pre-existing Dieulafoy’s lesion, as well as a higher incidence of new bleeding.

关键词： Dieulafoy’s Lesion Gastrointestinal Bleeding Endoscopy Endoscopy Hemostatic Clips Kidney Disease Adrenaline Thermal Coagulation Dieulafoy

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Three predictive scores compared in a retrospective multicenter study of nonunion tibial shaft fracture

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World Journal of Orthopedics 2024年第6期15卷 560-569页

作者： Davide Quarta marco Grassi Giuliano Lattanzi antonio Pompilio Gigante Alessio D'Anca Domenico Potena Clinical Orthopedics Department of Clinical and Molecular ScienceUniversitàPolitecnica Delle MarcheAncona 60126Italy Department of Information and Engineering UniversitàPolitecnica delle MarcheAncona 60121Italy

BACKGROUND Delayed union,malunion,and nonunion are serious complications in the healing of *** the risk of nonunion before or after surgery is *** To compare the most prevalent predictive scores of nonunion used in clinical practice to determine the most accurate score for predicting *** We collected data from patients with tibial shaft fractures undergoing surgery from January 2016 to December 2020 in three different trauma *** this retrospective multicenter study,we considered only fractures treated with intramedullary *** calculated the tibia FRACTure prediction healING days(FRACTING)score,Nonunion Risk Determination score,and Leeds-Genoa Nonunion Index(LEG-NUI)score at the time of definitive *** Of the 130 patients enrolled,89(68.4%)healed within 9 months and were classified as *** remaining patients(n=41,31.5%)healed after more than 9 months or underwent other surgical procedures and were classified as *** calculation of the three scores,LEG-NUI and FRACTING were the most accurate at predicting *** LEG-NUI and FRACTING showed the best performances by accurately predicting union and nonunion.

关键词： Trauma Bone Tibial fracture Nonunion Scores Prediction model

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Modeling of recrystallization behaviour of AA6XXX aluminum alloy profile during extrusion process

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Transactions of Nonferrous Metals Society of China 2024年

作者： marco Negozio antonio Segatori Riccardo Pelaccia Barbara Reggiani Sara Di Donato Lorenzo Donati DIN Department of Industrial Engineering – University of Bologna University of Parma-Department of Engineering and Architecture， Parco Area delle Scienze Hydro， Innovation and Technology InterMech-MO.RE – University of Modena and Reggio Emilia DISMI Department of Sciences and Methods for Engineering， University of Modena and Reggio Emilia

An innovative approach was introduced for the development of a AA6063 recrystallization model. This method incorporated a regression-based technique for the determination of material constants and introduced novel equations for assessing the grain size evolution. Calibration and validation of this methodology involved a combination of experimentally acquired microstructural data from the extrusion of three different AA6063 profiles and results from the simulation using the Qform Extrusion UK finite element code. The outcomes proved the agreement between experimental findings and numerical prediction of the microstructural evolution. The trend of the grain size variation based on different process parameters has been accurately simulated， both after dynamic and static recrystallization， with an error rate of less than 25% in almost the whole sampling computations.

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Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

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World Journal of Psychiatry 2024年第4期14卷 489-493页

作者： Edison Iglesias de Oliveira Vidal Luiz Fernando Alvarenga Ribeiro marco antonio de Carvalho-Filho Fernanda Bono Fukushima Internal Medicine Department Botucatu Medical SchoolSao Paulo State University(UNESP)Botucatu 18618-687SPBrazil Wenckebach Institute for Education and Training LEARN-Lifelong LearningEducation and Assessment Research NetworkUniversity Medical Center GroningenGroningen 9713AVGroningenNetherlands Assertiva Mindfulness Botucatu 18603-970SPBrazil Surgical Specialties and Anesthesiology Department Botucatu Medical SchoolSão Paulo State University(UNESP)Botucatu 18618-687SPBrazil

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our *** contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of ***,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational ***,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their *** we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

关键词： Mindfulness Medical education Mental capital Mental health Medical students Resilience

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Treatment for paraganglioma with stereotactic radiotherapy

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World Journal of Clinical Cases 2024年第16期12卷 2729-2737页

作者： antonio Pontoriero Paola Critelli marco Zeppieri Filippo Flavio Angileri Tamara Ius Radiation Oncology Unit Department of BiomedicalDental Science and Morphological and Functional ImagesUniversity of MessinaMessina 98125Italy Department of Ophthalmology University Hospital of UdineUdine 33100Italy Neurosurgery Unit Department of BiomedicalDental Science and Morphological and Functional ImagesUniversity of MessinaMessina 98125Italy Neurosurgery Unit Head-Neck and NeuroScience DepartmentUniversity Hospital of UdineUdine 33100Italy

BACKGROUND Paragangliomas(PG)are rare neoplasms of neuroendocrine origin that tend to be highly vascularized,slow-growing,and usually *** date,common treatment options are surgical resection(SR),with or without radiation therapy(RT),and a watch-and-wait *** To evaluate the local control and effectiveness of exclusive fractionated stereotactic RT(FSRT)treatment in unresectable PG(uPG).METHODS We retrospectively evaluated patients with uPG(medically inoperable or refused SR)treated with FSRT with a Cyberknife System(Accuray Incorporated,Sunnyvale,California).Toxicity and initial efficacy were *** From May 2009 to January 2023,6 patients with a median age of 68(range 20-84)were treated with *** median delivered dose was 21 Gy(range 20-30 Gy)at a median isodose line of 75.5%(range 70%-76%)in 4 fractions(range 3-5 fractions).The median volume was 13.6 mL(range 12.4-65.24 mL).The median cumulative biological effective dose and equivalent dose in 2-Gy fractions were 70 Gy and 37.10 Gy *** of origin involved were the timpa-nojugular glomus(4/6),temporal bone,and cervical *** 1 of the 6 patients,the follow-up was insufficient;5 of 6 patients showed a 5-year overall survival and 5-year progression-free survival of 100%.We observed negligible toxicities during and after *** majority of patients showed stable symptoms during *** 1 patient developed spine *** Our preliminary results on this small cohort of patients suggest that FSRT could be an effective and safe alternative to SR.

关键词： Unresectable paraganglioma Fractionated stereotactic radiation therapy Cyberknife Neurosurgery Metastasis

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