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Surgical site infection following pancreaticoduodenectomy in a referral cancer center in Mexico

Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 502-508页

作者： Rodrigo Villaseñor-Echavarri Javier Melchor-Ruan mercedes aranda-audelo Gabriela Arredondo-Saldaña Patricia Volkow-Fernandez Maria del Carmen Manzano-Robleda Alejandro E Padilla-Rosciano Diana Vilar-Compte Department of Infectious Diseases Instituto Nacional de CancerologíaAv.San Fernando 22Belisario Domínguez Secc 16TlalpanMexico CityMexico School of Medicine Universidad PanamericanaAugusto Rodin No.498Insurgentes MixcoacBenito JuárezMexico CityMexico Department of Digestive Tube and Hepatopancreatobiliary Tumors Instituto Nacional de CancerologíaAv.San Fernando 22Belisario Domínguez Secc 16TlalpanMexico CityMexico Department of Infectious Diseases Hospital Manuel Gea GonzálezCalz.de Tlalpan 4800Belisario Domínguez Secc 16TlalpanMexico CityMexico Gastrointestinal and Endoscopy Department Instituto Nacional de CancerologíaAv.San Fernando 22Belisario Domínguez Secc 16TlalpanMexico CityMexico

Background: Pancreaticoduodenectomy is the standard treatment for resectable periampullary cancer. Surgical site infections(SSI) are common complications with increased morbidity. The study aimed to describe the prevalence, risk factors, microbiology, and outcomes of SSI among patients undergoing pancreaticoduodenectomy. Methods: We conducted a retrospective study in a referral cancer center between January 2015 and June 2021. We analyzed baseline patient characteristics and SSI occurrence. Culture results and susceptibility patterns were described. Multivariate logistic regression was used to determine risk factors, proportional hazards model to evaluate mortality, and Kaplan-Meier analysis to assess long-term survival. Results: A total of 219 patients were enrolled in the study;101(46%) developed SSI. Independent factors for SSI were diabetes mellitus, preoperative albumin level, biliary drainage, biliary prostheses, and clinically relevant postoperative pancreatic fistula. The main pathogens were Enterobacteria and Enterococci. Multidrug-resistance rate in SSI was high but not associated with increased mortality. Infected patients had higher odds of sepsis, longer hospital stay and intensive care unit stay, and readmission rate. Neither 30-day mortality nor long-term survival was significantly different between infected and non-infected patients. Conclusions: SSI prevalence among patients undergoing pancreaticoduodenectomy was high and largely caused by resistant microorganisms. Most risk factors were related to preoperative instrumentation of the biliary tree. SSI was associated with greater risk of unfavorable outcomes;however, survival was unaffected.

关键词： Surgical site infection Pancreaticoduodenectomy Pancreatic cancer Endoscopic biliary drainage Biliary prosthesis

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The Maximal Graded Left Quotient Algebra of a Graded Algebra

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Acta Mathematica Sinica,English Series 2006年第1期22卷 261-270页

作者： Gonzalo aranda PINO mercedes SILES MOLINA Departamcnto de Algebra Geometriay Topologia Universidad de Mdlaga 29071 Mdlaga Espana

We construct the maximal graded left quotient algebra of every graded algebra A without homogeneous total right zero divisors as the direct limit of graded homomorphisms （of left A-modules） from graded dense left ideals of A into a graded left quotient algebra of A. In the case of a superalgebra, and with some extra hypothesis, we prove that the component in the neutral element of the group of the maximal graded left quotient algebra coincides with the maximal left quotient algebra of the component in the neutral element of the group of the superalgebra.

关键词： graded algebra graded left quotient algebra maximal graded left quotient algebra left quotieat algebra maximal left quotient algebra superalgebra

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COMPLEX CONCEPT LATTICES FOR SIMULATING HUMAN PREDICTION IN SPORT

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Journal of Systems Science & Complexity 2013年第1期26卷 117-136页

作者： aranda-CORRAL Gonzalo A BORREGO-DíAZ Joaquín GALáN-PáEZ Juan Universidad de Huelva.Department of Information Technology Crta.Palos de La Frontera s/n.21819 Palos de La Frontera Universidad de Sevilla.Department of Computer Science and Artificial Intelligence Avda.Reina mercedes s/n.41012 Sevilla

In order to address the study of complex systems,the detection of patterns in their dynamics could play a key role in understanding their *** particular,global patterns are required to detect emergent concepts and trends,some of them of a qualitative *** concept analysis(FCA) is a theory whose goal is to discover and extract knowledge from qualitative data(organized in concept lattices).In complex environments,such as sport competitions,the large amount of information currently available turns concept lattices into complex *** authors analyze how to apply FCA reasoning in order to increase confidence in sports predictions by means of detecting regularities from data through the management of intuitive and natural attributes extracted from publicly available *** complexity of concept lattices-considered as networks with complex topological structure- is *** is applied to building a knowledge based system for confidence-based reasoning,which simulates how humans tend to avoid the complexity of concept networks by means of bounded reasoning skills.

关键词： Bounded rationality complex networks formal concept analysis sport forecasting.

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