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Cumulative positive fluid balance is a risk factor for acute kidney injury and requirement for renal replacement therapy after liver transplantation

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World Journal of Transplantation 2018年第2期8卷 44-51页

作者： Liana Codes Ygor Gomes de Souza Ricardo Azevedo Cruz d'Oliveira Jorge Luiz andrade Bastos Paulo Lisboa Bittencourt Unit of Gastroenterology and Hepatology Portuguese Hospital of Salvador Medical School of Bahia Federal University of Bahia

AIM To analyze whether fluid overload is an independent risk factor of adverse outcomes after liver transplantation(LT).METHOdS One hundred and twenty-one patients submitted to LT were retrospectively *** regarding perioperative and postoperative variables previously associated with adverse outcomes after LT were *** fluid balance(FB) in the first 12 h and 4 d after surgery were compared with major adverse outcomes after *** Most of the patients were submitted to a liberal approach of fluid administration with a mean cumulative FBover 5 L and 10 L,respectively,in the first 12 h and 4 d after *** FB in 4 d was independently associated with occurrence of both AKI and requirement for renal replacement therapy(RRT)(OR = 2.3;95%CI:1.37-3.86,P = 0.02 and OR = 2.89;95%CI:1.52-5.49,P = 0.001 respectively).Other variables on multivariate analysis associated with AKI and RRT were,respectively,male sex and Acute Physiology and Chronic Health disease Classification System(APACHE II) levels and sepsis or septic *** was shown to be independently related to AST and APACHE II levels(OR = 2.35;95%CI:1.1-5.05,P = 0.02 and 2.63;95%CI:1.0-6.87,P = 0.04 respectively),probably reflecting the degree of graft dysfunction and severity of early postoperative course of *** effect of FB on mortality after LT was *** Cumulative positive FB over 4 d after LT is independently associated with the development of AKI and the requirement of *** was not independently related to FB,but to surrogate markers of graft dysfunction and severity of postoperative course of LT.

关键词： Liver transplantation Fluid balance Acute kidney injury

Retrospective self-reported weight changes during childhood and adolescence are not good predictors of metabolic syndrome risk factors in Mexican young adults

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Open Journal of Preventive Medicine 2013年第8期3卷 479-486页

作者： Flávia C. d. andrade Michelle Jiménez Marcela Raffaelli Margarita Teran-García Celia Aradillas-García department of Food Sciences and Human Nutrition University of Illinois at Urbana-Champaign Urbana USA department of Human and Community development University of Illinois at Urbana-Champaign Urbana USA department of Kinesiology and Community Health University of Illinois at Urbana-Champaign Urbana USA Faculty of Medicine University Autonomous of San Luis Potosí San Luis Potosí Mexico

The purpose of the study was to examine whether retrospective self-reported weight changes during childhood and adolescence were associated with metabolic syndrome (MetS) risk factors in Mexican young adults. Mexican college applicants to the Universidad Autónoma de San Luis Potosí, Mexico, 18 to 25 years old (n = 4187) who had applied for the 2009 academic year were included in the study. Participants underwent a health screening—anthropometrics and blood drawn—and completed a questionnaire. Five major weight change categories were defined based on self-reported weight during childhood and adolescence: consistently normal, consistently underweight, consistently overweight/ obese, weight gain, and weight loss. Most participants self-reported being normal weight during childhood (58.7%) and adolescence (58.3%). Only a small proportion reported being overweight or obese during childhood (10.1%) or adolescence (15.9%). Weight change patterns during childhood and adolescence were marked by overall stability: 40.1% of participants were consistently normal, 15.6% underweight and 3.6% overweight/obese. Among those whose weight changed, 25.0% gained weight and 15.7% lost weight. In regression analyses, weight change categories based on self-reported weight statuses during childhood and adolescence were not associated with current metabolic syndrome risk factors after controlling for measured current BMI. Studies addressing the association between weight gains in early life with metabolic syndrome outcomes in early adulthood should not rely on recalled weight status during early life alone.

关键词： Weight Change Metabolic Syndrome Metabolic Risk Factors’ Mexican Young Adults

Octogenarian liver grafts:Is their use for transplant currently justified?

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World Journal of Gastroenterology 2017年第17期23卷 3099-3110页

作者： Carlos Jiménez-Romero Felix Cambra Oscar Caso Alejandro Manrique Jorge Calvo Alejandro Marcacuzco paula Rioja david Lora Iago Justo HPB Surgery and Abdominal Organ Transplantation Unit University Hospital“Doce de Octubre” department of Surgery Facultad de Medicina

AIMTo analyse the impact of octogenarian donors in liver *** present a retrospective single-center study, performed between November 1996 and March 2015, that comprises a sample of 153 liver transplants. Recipients were divided into two groups according to liver donor age: recipients of donors ≤ 65 years (group A; n = 102), and recipients of donors ≥ 80 years (group B; n = 51). A comparative analysis between the groups was performed. Quantitative variables were expressed as mean values and Sd, and qualitative variables as percentages. differences in properties between qualitative variables were assessed by χ2 test. Comparison of quantitative variables was made by t-test. Graft and patient survivals were estimated using the Kaplan-Meier ***, 3 and 5-year overall patient survival was 87.3%, 84% and 75.2%, respectively, in recipients of younger grafts vs 88.2%, 84.1% and 66.4%, respectively, in recipients of octogenarian grafts (P = 0.748). One, 3 and 5-year overall graft survival was 84.3%, 83.1% and 74.2%, respectively, in recipients of younger grafts vs 84.3%, 79.4% and 64.2%, respectively, in recipients of octogenarian grafts (P = 0.524). After excluding the patients with hepatitis C virus cirrhosis (16 in group A and 10 in group B), the 1, 3 and 5-year patient (P = 0.657) and graft (P = 0.419) survivals were practically the same in both groups. Multivariate Cox regression analysis demonstrated that overall patient survival was adversely affected by cerebrovascular donor death, hepatocarcinoma, and recipient preoperative bilirubin, and overall graft survival was adversely influenced by cerebrovascular donor death, and recipient preoperative *** standard criteria for utilization of octogenarian liver grafts are: normal gross appearance and consistency, normal or almost normal liver tests, hemodynamic stability with use of < 10 μg/kg per minute of vasopressors before procurement, intensive care unit s

关键词： Older liver donor age Marginal liver Liver transplant Aging liver

Minimally invasive nephrectomy for inflammatory renal disease

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Asian Journal of Urology 2020年第4期7卷 345-350页

作者： paula Andrea Pena Lynda Torres-Castellanos German Patino Stefania Prada Luis Gabriel Villarraga Nicolas Fernandez Pontificia Universidad Javeriana School of MedicineBogota D.C.Colombia department of Urology Hospital Universitario San IgnacioPontificia Universidad JaverianaSchool of MedicineBogota D.C.Colombia division of Urology Hospital Universitario San IgnacioPontificia Universidad JaverianaBogota D.C.Colombia division of Urology Hospital Universitario San IgnacioPontificia Universidad JaverianaSchool of MedicineBogota D.C.Colombia department of Urology Fundacion Santa Fe de BogotaColombia division of Urology Hospital for SickKidsUniversity of TorontoTorontoCanada

Objective:Once chronic inflammatory renal disease(IRd)develops,it creates a severe peri-fibrotic process,which makes it a relative contraindication for minimally invasive surgery(MIS).Our objective is to show that laparoscopic nephrectomy(LN)is a surgical option in IRd with fewer complications and better ***:Retrospective review of patients who underwent a modified-surgical laparoscopic transperitoneal nephrectomy was *** search included all operated patients between May 2013 and May 2018 that had a pathology result with any renal inflammatory condition(xanthogranulomatous pyelonephritis,chronic nephritis,and renal tuberculosis).We describe intra-operative variables such as operative time,blood loss,conversion rate,postoperative complications and length of hospital ***:There were 51 patients who underwent laparoscopic nephrectomy with a confirmatory pathology report for *** identified four(8%)major complications;three of them required transfusion and one conversion to open *** mean operative time was 233108 *** estimated blood loss was 206242 mL excluding the conversion cases and 281423 mL including *** mean length of hospital stay was 3.02.0 ***:Laparoscopic nephrectomy for IRd can safely be *** is a reproducible technique with low risks and complication *** experience supports that releasing the kidney first and leaving the hilum for the end is a safe approach when vascular structures are embedded into a single block of inflammatory and scar tissue.

关键词： Inflammation Kidney diseases Laparoscopy Minimally invasive surgical procedures Nephrectomy Nephritis Nephroureterectomy

Current HPV Vaccination Strategies in Brazil

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Health 2023年第2期15卷 107-121页

作者： durval Silva Tavares Filho Camille Marcele Resende Rocha Elizabeth Bacha Ádamo Newton Marinho andrade daniel diniz Porto Pereira Letícia Mayer Nunes Luma dória Passos Pollyana Thaise Santos Braz paula Andreia Santos Braz Antônia Iva Sampaio Bisneta Francisco Expedito Ramos Aguiar Sobrinho Centro Universitário Tiradentes (UNIT) Maceió Brazil Universidade de Pernambuco (UPE) Recife Brazil

Cervical cancer is one of the most preventable and treatable malignancies, however, it still has high incidence and mortality rates, especially in less developed countries. For Brazil, the estimate is more than 16,000 new cases and more than 6000 deaths annually. despite this, vaccines against HPV (responsible for cervical cancer) are effective and promote a significant decrease in infections and neoplastic lesions of the cervix. As recommended by the World Health Organization, girls aged 9 to 14 should be vaccinated before becoming sexually active. Although the vaccine was developed in 2006, in Brazil immunization only started to be carried out in 2014, initially only for girls between 9 and 11 years old. The present work is an integrative review, with the objective of explaining the current situation of vaccination against HPV throughout the country. Using the PubMed, MEd-LINE and Google Scholar databases, a search for scientific articles was carried out during the year 2022, using the descriptors “Vaccine”, “HPV” and “Brazil”, simultaneously selecting 17 articles. The Brazilian recommendations for vaccination against HPV have undergone several strategic changes over time, in the following points: age group and gender of the target population, major site of application of vaccines and number of doses to be applied. Currently, in Brazil, the recommendation for vaccination against HPV is neutral in gender, between 9 and 14 years old and in immunosuppressed people up to 45 years old, with a vaccination schedule of 2 doses with an interval of 6 months between them, and 3 doses for those from 15 years and immunocompromised individual (0 - 2 - 6 months). The tetravalent vaccine offered by public funding continues to be applied at health centers, despite several favorable criticisms of the return of application in schools. Even though the vaccine is available free of charge, studies point to the difficulty in achieving and maintaining vaccination coverage, especially for

关键词： Brazil HPV Vaccine Update Cervical Cancer

Computed tomography-guided percutaneous core needle biopsy in pancreatic tumor diagnosis

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World Journal of Gastroenterology 2015年第12期21卷 3579-3586页

作者： Chiang J Tyng Maria Fernanda A Almeida paula NV Barbosa Almir GV Bitencourt José Augusto AG Berg Macello S Maciel Felipe JF Coimbra Luiz Henrique O Schiavon Maria dirlei Begnami Marcos d Guimares Charles E Zurstrassen Rubens Chojniak department of Imaging AC Camargo Cancer Center S?o Paulo department of Abdominal Surgery AC Camargo Cancer Center S?o Paulo

AIM: To evaluate the techniques, results, and complications related to computed tomography(CT)-guided percutaneous core needle biopsies of solid pancreatic ***: CT-guided percutaneous biopsies of solid pancreatic lesions performed at a cancer reference center between January 2012 and September 2013 were retrospectively analyzed. Biopsy material was collected with a 16-20 G Tru-Core needle(10-15 cm; Angiotech, Vancouver, CA) using a coaxial system and automatic biopsy gun. When direct access to the lesion was not possible, indirect(transgastric or transhepatic) access or hydrodissection and/or pneumodissection maneuvers were used. Characteristics of the patients, lesions, procedures, and histologic results were recorded using a standardized form. RESULTS: A total of 103 procedures included in the study were performed on patients with a mean age of 64.8 year(range: 39-94 year). The mean size of the pancreatic lesions was 45.5 mm(range: 15-195 mm). Most(75/103, 72.8%) procedures were performed via direct access, though hydrodissection and/or pneumodissection were used in 22.2%(23/103) of cases and indirect transhepatic or transgastric access was used in 4.8%(5/103) of cases. Histologic analysis was performed on all biopsies, and diagnoses were conclusive in 98.1%(101/103) of cases, confirming3.9%(4/103) of tumors were benign and 94.2%(97/103) were malignant; results were atypical in 1.9%(2/103) of cases, requiring a repeat biopsy to diagnose a neuroendocrine tumor, and surgical resection to confirm a primary adenocarcinoma. Only mild/moderate complications were observed in 9/103 patients(8.7%),and they were more commonly associated with biopsies of lesions located in the head/uncinate process(n =8), than of those located in the body/tail(n = 1) of the pancreas, but this difference was not ***: CT-guided biopsy of a pancreatic lesion is a safe procedure with a high success rate, and is an excellent option for minimally invasive diagnosis.

关键词： Computed tomography Image-guided biopsy Large-core

Profile of People Living with HIV/AIdS in a Large Municipality of Sao Paulo State, Brazil （2012-2013）

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Journal of Health Science 2014年第2期2卷 94-101页

作者： Gabriela Tavares Magnabosco Livia Maria Lopes Mayara Falico Faria Maria Eugenia Firmino Brunello Tiemi Arakawa Aline Araujo Antunes Rubia Laine de paula andrade Aline Aparecida Monroe Tereza Cristina Scatena Villa College of Nursing of Ribeirao Preto University of Sao Paulo Ribeirao Preto 14040-902 Sao Paulo Brazil

HIV/AIdS has brought to light the challenge of incorporating the many influences between living conditions, social characteristics and health services performance to an adequate care for PLWHA （people living with AIdS）. Vulnerability of these populations is under the responsibility of specialized care units whose assistance does not always occur according to their real needs and demands. Therefore, this study aimed to analyze demographic, social and clinical profiles of PLWHA, as well as their follow-up in SS （Specialized Health Services） in Ribeir^o Preto, Brazil. It is a descriptive study conducted by the application of structured questionnaires to 253 patients with HIV/AIdS in follow-up during the years of 2012-2013. Variables were analyzed by descriptive statistics procedures. The findings pointed out gender parity, aging population, low education and economic predominance of class C. Regarding clinical characteristics, there was a predominance of asymptomatic individuals, with no clinical manifestations of AIdS or major comorbidities. The main mode of transmission was through sexual contact. The results led to the need of adequating the assistance provided to the specificities inherent to PLWHA. The care provision should cross an interdisciplinary perspective, targeting recognition of problems and ensuring comprehensive health care adequate to users＇ needs and demands.

关键词： AIdS user profile evaluation of health services comprehensive health care.

Preclinical models of idiosyncratic drug-induced liver injury(idILI):Moving towards prediction

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Acta Pharmaceutica Sinica B 2021年第12期11卷 3685-3726页

作者： Antonio Segovia-Zafra daniel E.di Zeo-Sanchez Carlos Lopez-Gomez Zeus Perez-Valdes Eduardo Garcıa-Fuentes Raul J.andrade M.Isabel Lucena Marina Villanueva-Paz Unidad de Gestio´n Clı´nica de Gastroenterologı´a Servicio de Farmacologıa ClınicaInstituto de Investigacio´n Biomedica de Malaga-IBIMAHospital Universitario Virgen de la VictoriaUniversidad de MalagaMalaga 29071Spain Centro de Investigacion Biomedica en Red en el Area Tematica de Enfermedades Hepaticas y digestivas(CIBERehd) Madrid 28029Spain Platform ISCIII de Ensayos Clınicos UICEC-IBIMAMalaga 29071Spain Unidad de Gestion Clınica de Aparato digestivo Instituto de Investigacion Biomedica de Malaga(IBIMA)Hospital Universitario Virgen de la VictoriaMalaga 29010Spai

Idiosyncratic drug-induced liver injury(idILI) encompasses the unexpected harms that prescription and non-prescription drugs,herbal and dietary supplements can cause to the *** remains a major public health problem and a major cause of drug *** the lack of biomarkers for idILI prediction,diagnosis and prognosis,searching new models to predict and study mechanisms of idILI is *** of the major limitations of idILI preclinical assessment has been the lack of correlation between the markers of hepatotoxicity in animal toxicological studies and clinically significant ***,major advances in the understanding of idILI susceptibility and pathogenesis have come from the study of well-phenotyped idILI ***,there are many gaps for explaining all the complexity of idILI susceptibility and ***,there is a need to optimize preclinical human in vitro models to reduce the risk of idILI during drug ***,the current experimental models and the future directions in idILI modelling are thoroughly discussed,focusing on the human cellular models available to study the pathophysiological mechanisms of the disease and the most used in vivo animal idILI *** also comment about in silico approaches and the increasing relevance of patient-derived cellular models.

关键词： drug-induced liver injury Preclinical models Mechanisms Oxidative stress Mitochondrial damage Immune response Personalized medicine

Reduced paraoxonase 1 activities may explain the comorbidities between temporal lobe epilepsy and depression,anxiety and psychosis

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World Journal of Psychiatry 2022年第2期12卷 308-322页

作者： Ana paula Michelin Michael H J Maes Thitiporn Supasitthumrong Chusak Limotai Andressa Keiko Matsumoto Laura de Oliveira Semeão João Victor de Lima Pedrão Estefânia Gastaldello Moreira Buranee Kanchanatawan décio Sabbatini Barbosa Health Sciences Center State University of LondrinaLondrina 86038-440Brazil department of Psychiatry Faculty of MedicineChulalongkorn UniversityBangkok 10330Thailand department of Psychiatry Medical University of PlovdivPlovdiv 4004Bulgaria IMPACT Strategic Research Center Deakin UniversityGeelong 3220Australia Chulalongkorn Comprehensive Epilepsy Center of Excellence King Chulalongkorn Memorial HospitalThe Thai Red Cross SocietyBangkok 10330Thailand division of Neurology Department of MedicineFaculty of MedicineChulalongkorn UniversityBangkok 10330Thailand

BACKGROUNd Temporal lobe epilepsy(TLE)is the most common focal epilepsy subtype in adults and is frequently accompanied by depression,anxiety and *** in total paraoxonase 1(PON1)status may occur in TLE and these psychiatric *** To examine PON1 status,namely Q192R PON1 genotypes and PON1 enzymatic activities,in *** We recruited 40 normal controls and 104 TLE patients,27 without comorbidities and 77 with comorbidities including mood disorders(n=25),anxiety disorders(n=27)and psychosis(n=25).RESULTS Four-(chloromethyl)phenyl acetate hydrolysis(CMPAase)and arylesterase activities were significantly lower in TLE and mesial temporal sclerosis(MTS)with and without psychiatric comorbidities than those in normal *** areas under the receiver operating characteristic curve of CMPAase were 0.893(0.037)for TLE and 0.895(±0.037)for *** least squares path analysis showed that there were specific indirect effects of PON1 genotype on TLE severity(Pd psychopathology(Pdiated by lowered CMPAase activity,while arylesterase activity was not *** severity of TLE was significantly associated with psychopathology ***,PON1 CMPAase activity was inversely associated with Mini Mental State Examination *** The severity of TLE and comorbidities are to a large extent explained by reduced PON1 enzyme activities and by effects of the Q192R genotype,which are mediated by reduced CMPAase *** PON1 status plays a key role in the pathophysiology of TLE,MTS and psychiatric comorbidities by increasing the risk of oxidative ***1 enzyme activities are new drug targets in TLE to treat seizure frequency and psychiatric comorbidities.

关键词： Antioxidants Oxidative stress Neuroimmune Major depression Mood disorders Affective disorders