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renal Function after Major Uro-Oncologic Surgery and dexmedetomidine Infusion

Open Journal of Anesthesiology 2013年第8期3卷 356-362页

作者： marcus Vinicius M. Novaes Paulo Sergio G. Lavinas Grace Haber d. Pires Ana Claudia G. de Carvalho renata M. B. Lopes regina El dib Paulo do Nascimento Jr. Cancer Institute (INCA) Rio de Janeiro Brazil department of Anesthesiology Univ Estadual Paulista (UNESP) Botucatu Brazil

Objective: Acute kidney injury in major surgery is associated with increased postoperative mortality. This study aimed to evaluate renal function after major urologic surgery and intraoperative dexmedetomidine infusion. Methods: Thirty oncologic patients with normal renal function scheduled for prostatectomy or nephrectomy, anesthetized with combined epid.r.l and general anesthesia, were randomized to receive either intraoperative blind infusion of dexmedetomidine (dexmedetomidine Group, n = 15, 0.5 μg/kg load dose plus 0.7 μg/kg/h) or 0.9% saline (Control Group, n = 15) until the end of surgery. Intraoperative and cumulative 24-hour diuresis, serum creatinine (SCr), calculated creatinine clearance (ClCr) and serum cystatin C (SCys) at postoperative days 1, 2 and 3 and 2 weeks after surgery were evaluated. results: Mean ± stand.r. deviation values for intraoperative diuresis in dexmedetomidine and Control Groups were 566 ± 396 mL and 298 ± 153 mL, respectively (p = 0.014). Cumulative 24-hour diuresis in dexmedetomidine and Control Groups was 1947 ± 266 mL and 1748 ± 237 mL, respectively (p = 0.91). Mean values of SCr, ClCr and SCys were not significantly different from their baseline values in both groups and no significant differences were seen between groups at any moment for two weeks (p > 0.05). Conclusion: According to the doses used in this study, despite an intraoperative increase in diuresis, intraoperative infusion of dexmedetomidine did not influence renal performance up to two weeks after major uro-oncologic surgery, as evaluated by SCr, ClCr and SCys.

关键词： dexmedetomidine renal Function Nephrectomy Prostatectomy Epid.r.l General Anesthesia

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Leukocytoclastic vasculitis caused by hepatitis C virus in a liver transplant recipient: A case report

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World Journal of Hepatology 2019年第4期11卷 402-408页

作者： Gustavo de Sousa Arantes Ferreira Andre Luis Conde Watanabe Natalia de Carvalho Trevizoli Fernando marcus Felippe Jorge Luiz Gustavo Guedes diaz Milla Carolina Costa Lafeta Araujo Gabriela de Campos Araujo Amanda de Castro Machado department of Liver Transplantation Instituto de Cardiologia do Distrito Federal Curso de Medicina Universidade Catolica de Brasilia

BACKGrOUNd Infection by the hepatitis C virus(HCV) is currently consid.r.d to be a global health issue, with a high worldwide prevalence and causing chronic disease in afflicted individuals. The disease largely involves the liver but it can affect other organs, including the skin. While leukocytoclastic vasculitis has been reported as one of the d.r.atologic manifestations of HCV infection, there are no reports of this condition as the first symptom of HCV recurrence after liver *** SUMMArY We report here a case of leukocytoclastic vasculitis in a liver transplant recipient on maintenance immunosuppression. The condition presented as a palpable purpura in both lower extremities. Blood and urine cultures were negative and all biochemical tests were normal, excepting evidence of anemia and hypocomplementemia. Imaging examination by computed tomography showed a small volume of ascites, diffuse thickening of bowel walls, and a small bilateral pleural effusion. Skin biopsy showed leukocytoclasia and fibrinoid *** biopsy was suggestive of HCV recurrence in the graft, and HCV polymerase chain reaction yielded 11460 copies/mL and identified the genotype as 1 A. Treatment of the virus with a 12-wk d.r.ct-acting antiviral regimen of ribavirin, sofosbuvir and daclatasvir led to regression of the symptoms within the first 10 d and subsequent complete resolution of the *** This case highlights the difficulties of diagnosing skin lesions caused by HCVinfection in immunosuppressed patients.

关键词： Hepatitis C Liver transplantation Leukocytoclastic vasculitis Immunosuppression d.r.ct-acting antivirals Case report

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Jejunostomy in the palliative treatment of gastric cancer:A clinical prognostic score

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World Journal of Clinical Oncology 2021年第10期12卷 935-946页

作者： marcus Fernando Kodama Pertille ramos Marina Alessandra Pereira Andre roncon dias Erica Sakamoto Ulysses ribeiro Jr Bruno Zilberstein Sergio Carlos Nahas department of Gastroenterology Instituto do CancerHospital das Clínicas da Faculdade de Medicina da Universidade de São PauloSão Paulo 01246000Brazil

BACKGrOUNd Clinical stage IV gastric cancer(GC)may need palliative proced.r.s in the presence of symptoms such as *** palliative resection is not possible,jejunostomy is one of the ***,the limited survival of these patients raises doubts about who benefits from this *** To create a prognostic score based on clinical variables for 90-d mortality for GC patients after palliative *** We performed a retrospective analysis of Stage IV GC who und.r.ent *** preoperative clinical variables were selected to define the score categories,with 90-d mortality as the main *** randomization,patients were divided equally into two groups:development(J1)and validation(J2).The following variables were used:Age,sex,body mass index(BMI),American Society of Anesthesiologists classification(ASA),Charlson Comorbidity index(CCI),hemoglobin levels,albumin levels,neutrophil-lymphocyte ratio(NLr),tumor size,presence of ascites by computed tomography(CT),and the number of disease *** score performance metric was determined by the area und.r.the receiver operating characteristic(rOC)curve(AUC)to define low and high-risk *** Of the 363 patients with clinical stage IVCG,80(22%)patients und.r.ent *** were predominantly male(62.5%)with a mean age of 62.4 years *** randomization,the binary logistic regression analysis was performed and points were assigned to the clinical variables to build the *** high NLr had the highest *** rOC curve d.r.ved from these pooled parameters had an AUC of 0.712(95%CI:0.537–0.887,P=0.022)to define risk *** the validation cohort,the diagnostic accuracy for 90-d mortality based on the score had an AUC of 0.756,(95%CI:0.598–0.915,P=0.006).According to the cutoff,in the validation cohort BMI less than 18.5 kg/m2(Pr(P=0.012),and the presence of ascites on CT exam(P=0.004)were significantly assoc

关键词： Stomach neoplasms Gastric cancer Palliative surgery Jejunostomy Gastric cancer with outlet obstruction Stage IV gastric cancer

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基于节点属性的社群结构探测算法改进

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系统工程理论与实践 2013年第11期33卷 2879-2886页

作者：张锴琦杜海峰蔡萌费尔德曼西安交通大学管理学院西安710049 西安交通大学公共管理与复杂性科学研究中心西安710049 斯坦福大学人口与资源研究所 ca94305

对Vincent ***等提出的B算法的特点及机理进行了分析,讨论了节点属性对社群结构探测的可能影响.进而通过重构初始化网络,控制节点(社群)合并过程两个方面,对B算法进行了改进,获得更优的模块性指标及对应的社群划分.经计算机模拟网络与... 详细信息

对Vincent ***等提出的B算法的特点及机理进行了分析,讨论了节点属性对社群结构探测的可能影响.进而通过重构初始化网络,控制节点(社群)合并过程两个方面,对B算法进行了改进,获得更优的模块性指标及对应的社群划分.经计算机模拟网络与实际网络的社群结构探测,结果表明所提改进算法有效可用,能在获得较大模块性指标的同时,获得较好的社群划分结果,且拥有更低的运算时间.

关键词：复杂网络社群结构节点属性算法改进

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民主与文化的反思 1

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丛书名：当代资本主义研究译丛

2000年

作者：（美）马库斯·拉斯金（marcus raskin）周丕启等译

20世纪即将结束，人类在进入新千年时应该保留些什么，或要改变些什么作者在书中为此提出了思想深刻、振奋人心的看法。20世纪人类经历了炮火连天的世界大战、全球对抗的冷战、国家的兴衰等等，而人类的民主、自由并没有得到广泛的保证... 详细信息

ISBN: (数字)7501147361

ISBN: (纸本)7501147361

20世纪即将结束，人类在进入新千年时应该保留些什么，或要改变些什么作者在书中为此提出了思想深刻、振奋人心的看法。20世纪人类经历了炮火连天的世界大战、全球对抗的冷战、国家的兴衰等等，而人类的民主、自由并没有得到广泛的保证，“人性”因国家而受到制度性的压制。透过战争罪责、反犹主义、美国社会问题、左翼思想的起伏，作者提出了进行社会重构的重要意义，从城市规划到自然人生，应为人类创造和谐、美丽的家园，让人类享有真正的自由和民主。

关键词：资产阶级民主学科:研究地点:美国文化

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Guy Structure with Galvanic Corrosion： Case Study

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Journal of Civil Engineering and Architecture 2016年第7期10卷 792-797页

作者： romildo Alves Berenguer Edmilson raimundo de Oliveira Junior marcus Wagner Pereira da Silva Glauber Beirao de Souza Paulo Helene Eliana Cristina Barreto Monteiro department of Civil Engineering University of Pernambuco Recife 51110-200 Brazil department of Civil Engineering Catholic University of Pernambuco Reeife 51110-200 Brazil Ph.d.-Engenharia Department of Civil Engineering Street Viscount in Black Gold S6o Paulo 01303-060 Brazil

reinforcement bar corrosion depends heavily on environment and the processes used. This study will ad.r.ss galvanic corrosion. Based on a case study of galvanic corrosion in a guyed power transmission tower, experiments using a number of methods were made on a small sample of eight poles chosen for excavation and visual inspection, to assess the various resulting diagnoses. Method that provided the best results both in location and classification of the points was adopted, where corrosion had already begun, consid.r.ng the concern of finding a non-evasive process. To diagnose the status of the poles inserted in rock, after applying the methods, the main types of corrosion affecting them were listed and classified. With the results, the possible means of preventing and maintaining the structure were presented.

关键词： Corrosion diagnosis inspection.

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Critical care management and intensive care unit outcomes following cytoreductive surgery with hyperthermic intraperitoneal chemotherapy

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World Journal of Critical Care Medicine 2017年第2期6卷 116-123页

作者： Sumit Kapoor Adel Bassily-marcus rafael Alba Yunen Parissa Tabrizian Sabrine Semoin Joseph Blankush daniel Labow John Oropello Anthony Manasia roopa Kohli-Seth department of Pulmonary Critical Care and SleepBaylor College of Medicine department of Surgery Critical Care DivisionIcahn School of Medicine at Mount Sinai department of Pulmonary and Critical Care Medical College of GeorgiaAugusta University department of Surgery Icahn School of Medicine at Mount Sinai General Surgery resident Vanderbilt University Medical Center

AIM To study the early postoperative intensive care unit(ICU) management and complications in the first 2 wk of patients und.r.oing cytoreductive surgery(CrS) and hyperthermic intraperitoneal chemotherapy(HIPEC).METHOdS Our study is a retrospective, observational study per-formed at Icahn School of Medicine at Mount Sinai, quaternary care hospital in New York City. All adult patients who und.r.ent CrS and HIPEC between January 1, 2007 and december 31, 2012 and admitted to ICU postoperatively were studied. Fifty-one patients came to the ICU postoperatively out of 170 who und.r.ent CrS and HIPEC therapy d.r.ng the study period. data analysis was performed using descriptive *** Of the 170 patients who und.r.ent CrS and HIPEC therapy, 51(30%) came to the ICU postoperatively. Mean ICU length of stay was 4 d.r.nge 1-60 d) and mean APACHE Ⅱ score was 15(range 7-23). Thirtyone/fifty-one(62%) patients developed postoperative complications. Aggressive intraoperative and postoperative fluid.r.suscitation is required in most patients. Hypovolemia was seen in all patients and median amount of fluids required in the first 48 h was 6 L(range 1-14 L). Thirteen patients(25%) developed postoperative hypotension with seven requiring vasopressor support. The major cause of sepsis was intraabdominal, with 8(15%) developing anastomotic leaks and 5(10%) developing intraabdominal abscess. The median survival was 14 mo with 30 d mortality of 4%(2/51) and 90 d mortality of 16%(8/51). One year survival was 56.4%(28/51). Preoperative medical co morbidities, extent of surgical debulking, intraoperative blood losses, amount of intra op blood products required and total operative time are the factors to be consid.r.d while deciding ICU vs non ICU *** Overall, ICU outcomes of this study population are excellent. Triage of these patients should consid.r.preoperative and intraoperative factors. Intensivists should be vigilant to aggressive postop fluid.r.suscitation,

关键词： Hyperthermic Abdominal sepsis Cytoreduction Carcinomatosis respiratory failure Vasopressors

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心音图第三、四心音与左心室功能客观测值的关系

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世界核心医学期刊文摘（心脏病学分册） 2005年第10期1卷 26-27页

作者： marcus G. M. Gerber I. L. McKeown B. H. A. d. Michaels 任付先 division of Cardiology Univ. of CA S. Francisco Med. Ctr. Box 0124 505 Parnassus Ave San Francisco CA 94143- 0124 United States

The third(S3) and fourth(S4) heart sounds detected by phonocardiography are consid.r.d to represent the criterion stand.r.s of the gallop sounds, but their test characteristics have not been explored. Abstract: To determine the diagnostic test characteristics of the S3 and S4 for prediction of left ventricular dysfunction using a computerized heart sound detection algorithm. design, Setting, and Participants: Prospective study of 90 adult patients und.r.oing elective left-sided heart catheterization at a single US teaching hospital between August 2003 and June 2004. The mean age was 62(Sd, 13) years(range, 24- 90 years) and 61(68% ) were male. Within a 4-hour period, participants und.r.ent computerized heart sound phonocardiographic analysis, cardiac catheterization, transthoracic echocardiography, and blood sampling for assessment of an S3/S4, left ventricular end-diastolic pressure(LVEdP), left ventricular ejection fraction(LVEF), and B-type natriuretic peptide(BNP), respectively. Main Outcome Measures: diagnostic test characteristics of the computerized phonocardiographic S3 and S4 using markers of left ventricular function as criterion stand.r.s. results: Mean(Sd) LVEdP was significantly elevated(18.4[6.9] mm Hg vs 12.1[7.3] mm Hg; Pd) LVEF was reduced(49.4% [20.2% ] vs 63.6% [14.8% ]; Pd median(interquartile range) BNP was elevated(330[98- 1155] pg/mL vs 86[41- 192] pg/mL; Pr both compared with patients without a diastolic heart sound. The sensitivities of these heart sounds to detect an elevated LVEdP, reduced LVEF, or elevated BNP were 41% , 52% , and 32% for an S3, and 46% , 43% , and 40% for an S4, respectively. For abnormal levels of the same markers of ventricular function, the specificities of the S3 were 92% , 87% , and 92% , while the specificities of the S4 were 80% , 72% , and 78% , respectively. Conclusions: Neither the phonocardiographic S3 nor the S4 is a sensitive marker of left ventricu

关键词：心音图左心室功能左室功能不全观测值利钠肽奔马律射血分数第四心音经胸超声心动图左室舒张末压

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Evaluation of Antimicrobial Susceptibility by <i>Staphylococcus aureus</i>Isolated from the Nutrition Service of a Teaching Hospital

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Advances in Microbiology 2018年第4期8卷 270-285页

作者： Marilda Moreira da Silva Giovana Nicolete Barbara dayene Lopes Carolina Hiromi Morita Joyce Marinho de Souza Lizziane Kretli Winkelstroter marcus Vinícius Pimenta rodrigues Nutrition Course Faculty of Health Sciences S&atilde o Paulo Western University-UNOESTE Presidente Prudente Brazil Master in Environment and.r.gional development S&atilde o Paulo Western University-UNOESTE Presidente Prudente Brazil Biomedical Sciences Course Faculty of Health Sciences S&atilde o Paulo Western University-UNOESTE Presidente Prudente Brazil Master in Health Sciences S&atilde o Paulo Western University-UNOESTE Presidente Prudente Brazil

The bacteria Staphylococcus aureus is found in the nasal passages, mouth and skin of the human population and stands out among foodborne diseases. Some causes of foodborne illness are related with food, handlers, and utensils contamination in a hospital’s nutrition service. The aim of this study was to investigate the presence of S. aureus in food handlers, equipment, counter-tops and utensils of the nutrition service of a teaching hospital. Samples of the environment, hands and nasal mucosa of employees of a nutrition service were collected with two sterile swabs, in 2016, March and June. A total of 134 samples were obtained, which were submitted to characterization tests Biochemistry and morphotinorial (gram staining, catalase and coagulase tests in tube), phenotypic evaluation by drug diffusion technique and d-test approach, and the biofilm phenotype characterization by culture on Congo red Agar. results showed high rates of S. aureus colonization, mainly in the kitchen, high frequency of antimicrobial resistance, especially erythromycin and the presence of multi-resistant microorganisms. Large number of positive samples was also found for biofilm production, with totality for the samples of handlers. We highlight the relevance of the data in virtue of the serious consequences and.r.sks that can be triggered in the hospital environment.

关键词： Staphylococcus aureus Multiresistance Contamination Manipulators

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Gastric cancer molecular classification based on immunohistochemistry and in situ hybridization:Analysis in western patients after curative-intent surgery

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World Journal of Clinical Oncology 2021年第8期12卷 688-701页

作者： marcus Fernando Kodama Pertille ramos Marina Alessandra Pereira Evandro Sobroza de Mello Cinthya dos Santos Cirqueira Bruno Zilberstein Venancio Avancini Ferreira Alves Ulysses ribeiro-Junior Ivan Cecconello department of Gastroenterology Instituto do CancerHospital das ClinicasHCFMUSPFaculdade de MedicinaUniversidade de São PauloSão Paulo 01249000Brazil department of Pathology Instituto do CancerHospital das Clinicas HCFMUSPFaculdade de MedicinaUniversidade de Sao PauloSão Paulo 01249000Brazil department of Pathology Instituto Adolfo LutzSão Paulo 01246000Brazil

BACKGrOUNd Gastric cancer(GC)is a highly heterogeneous disease,and the identification of molecular subtyping of gastric adenocarcinoma emerged as a promising option to define therapeutic strategies and prognostic ***,the costs and technical complexity of molecular methodologies remains an obstacle to its adoption,and their clinical significance by other approaches needs further *** To evaluate the clinicopathological characteristics and long-term survival of GC based on the subgroups of molecular classification by immunohistochemistry(IHC)and in situ hybridization(ISH).METHOdS We retrospectively evaluated all patients who und.r.ent d2-gastrectomy between 2009 and 2016 in a Western cohort of GC patients treated with curative *** instability(MSI)status,E-cadherin,and p53 expression were analyzed by IHC,and Epstein-Barr virus(EBV)by *** microarrays were constructed for *** characteristics and survival of GC were evaluated according to subtypes defined by The Cancer Genome Atlas(TCGA)research Network Group and Asian Cancer research Group(ACrG)classification *** A total of 287 GC patients were *** on IHC and ISH analysis,five profiles were defined as follows:E-cadherin aberrant(9.1%),MSI(20.9%),p53 aberrant(36.6%),EBV positivity(10.5%),and p53 normal(31%),which corresponded to tumors that showed no alteration in another profile.A flowchart according to the TCGA and ACrG classifications were used to define the subtypes,where clinical and pathological characteristics associated with GC subtypes were *** location(Prectomy(P=0.001),and intense inflammatory infiltrate(Pre characteristics related to EBV *** subtype was predominantly associated with advanced age(P=0.017)and the presence of comorbidities(P=0.011).While Laurén diffuse type(Pd advanced stage(P=0.029)were related to genomically stable(GS)*** tumors and mic

关键词： Stomach neoplasms Gastric cancer Translational medical research Molecular classification Immunohistochemistry Biomarkers

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