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Bacterobilia in pancreatic surgery-conclusions for perioperative antibiotic prophylaxis

World Journal of Gastroenterology 2019年第41期25卷 6238-6247页

作者： colin markus kruger Ulrich Adam Thomas Adam Axel Kramer Claus D Heidecke Frank Makowiec Hartwig Riediger Department of Surgery Immanuel Hospital RüdersdorfBerlin 15562Germany Department of General Surgery Vivantes-Humboldt hospitalBerlin 13503Germany Department of Microbiology Labor Berlin GmbHBerlin 13353Germany Institute of Hygiene and Environmental Medicine University Medicine GreifswaldGreifswald 17495Mecklenburg VorpommernGermany Department of Surgery Clinic of GeneralVisceralVascular and Thoracic SurgeryUniversity Medicine GreifswaldGreifswald 17475Mecklenburg VorpommernGermany Section of clinical risk assessment University hospital of FreiburgFreiburg 79106Baden-WürttembergGermany

BACKGROUND Jaundice or preoperative cholestasis(PC)are typical symptoms of pancreatic *** 50%of patients undergo preoperative biliary drainage(PBD)*** is a common cause of bacterobilia(BB)and is a known surgical site infection risk *** adjustment of preoperative antibiotic prophylaxis(PAP)may be reasonable according to the profile of *** this,we examined the microbiological findings in routine series of *** To investigate the incidence and profile of biliary bacterial colonization in patients undergoing pancreatic head *** In the period from January 2009 to December 2015,285 consecutive pancreatic head resections were *** for surgery were malignancy(71%),chronic pancreatitis(18%),and others(11%).A PBD was in 51%and PC was in 42%.The standard PAP was ampicillin/***,a smear was taken from the hepatic *** analysis of the isolated species and resistograms was *** were categorized according to the presence or absence of PC(PC+/PC-)and PBD(PBD+/PBD-)into four *** efficiency was analyzed for standard PAP and possible *** BB was present in 150 patients(53%).BB was significantly more frequent in PBD+(n=120)than in PBD-(n=30),P<*** was present both in patients with PC and without PC:(PBD-/PC-:18%,PBD-/PC+:30%,PBD+/PC-:88%,PBD+/PC+:80%).BB was more frequent in malignancy(56%)than in chronic pancreatitis(45%).PBD,however,was the only independent risk factor in multivariate *** total,357 pathogens(342 bacteria and 15 fungi)were *** five most common groups(n=256,74.8%)were Enterococcus spp.(28.4%),Streptococcus spp.(16.9%),Klebsiella spp.(12.6%),Escherichia coli(10.5%),and Enterobacter spp.(6.4%).A polymicrobial BB(PBD+:77% vs PBD-:40%,P<0.01)and a more frequent detection of Enterococcus(P<0.05)was significantly associated with PBD+.In PBD+,the efficiency of imipenem and piperacillin/tazobactam was significantl

关键词： Pancreatic surgery Bacteriobilia Antibiotic prophylaxis Cholestasis Cholangiopancreatography Endoscopic retrograde

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Subsequent total joint arthroplasty: Are we learning from the first stage?

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World Journal of Orthopedics 2024年第3期15卷 230-237页

作者： Christine Jiang Wu colin Penrose Sean Patrick Ryan Michael Paul Bolognesi Thorsten markus Seyler Samuel Secord Wellman Department of Orthopaedic Surgery Duke University HospitalDurhamNC 27710United States Department of Orthopaedic Surgery Midwest Center for Joint ReplacementIndianapolisIN 46241United States

BACKGROUND With the increasing incidence of total joint arthroplasty(TJA),there is a desire to reduce peri-operative complications and resource *** degenerative conditions progress in multiple joints,many patients undergo multiple *** To determine if both physicians and patients learn from the patient’s initial arth-roplasty,resulting in improved outcomes following the second *** The institutional database was retrospectively queried for primary total hip arth-roplasty(THA)and total knee arthroplasty(TKA).Patients with only unilateral THA or TKA,and patients undergoing same-day bilateral TJA,were *** demographics,comorbidities,and implant sizes were collected at the time of each procedure and patients were stratified by first vs second *** metrics evaluated included operative time,length of stay(LOS),disposition,90-d readmissions and emergency department(ED)*** A total of 642 patients,including 364 undergoing staged bilateral TKA and 278 undergoing bilateral THA,were *** was no significant difference in demographics or comorbidities between the first and second procedure,which were separated by a mean of 285 *** THA and TKA,LOS was significantly less for the second surgery,with 66%of patients having a shorter hospitalization(P<0.001).THA patients had significantly decreased operative time only when the same sized implant was utilized(P=0.025).The vast majority(93.3%)of patients were discharged to the same type of location following their second ***,when a change in disposition was present from the first surgery,patients were significantly more likely to be discharged to home after the second procedure(P=0.033).There was no difference between procedures for post-operative readmissions(P=0.438)or ED visits(P=0.915).CONCLUSION After gaining valuable experience recovering from the initial surgery,a patient’s perioperative outcomes are improved for their second *** may

关键词： Staged total joint arthroplasty Asynchronous total joint arthroplasty Subsequent total joint arthroplasty Contralateral total joint arthroplasty Perioperative outcomes

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Loss of the vitamin D receptor in human breast and prostate cancers strongly induces cell apoptosis through downregulation of Wnt/β-catenin signaling

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Bone Research 2017年第3期5卷 195-206页

作者： Yu Zheng Trupti Trivedi Ruby CY Lin Colette Fong-Yee Rick Nolte Jeline Manibo Yunzhao Chen Musharraf Hossain Konstantin Horas colin Dunstan Hong Zhou markus J Seibel Bone Research Program ANZAC Research Institute Asbestos Diseases Research Institute Cardiothoracic Genomics School of Medical Sciences University of New South Wales Department of Pathology Shihezi University School of Medicine Biomedical Engineering AMME University of Sydney Concord Clinical School The University of Sydney

Vitamin D co-regulates cell proliferation, differentiation and apoptosis in numerous tissues, including cancers. The known anti-proliferative and pro-apoptotic actions of the active metabolite of vitamin D, 1,25-dihydroxy-vitamin D [1,25（OH）2D] are mediated through binding to the vitamin D receptor （VDR）. Here, we report on the unexpected finding that stable knockdown of VDR expression in the human breast and prostate cancer cell lines, MDA-MB-231 and PC3, strongly induces cell apoptosis and inhibits cell proliferation in vitro. Implantation of these VDR knockdown cells into the mammary fat pad （MDA-MB-231）, subcutaneously （PC3） or intra-tibially （both cell lines） in immune-incompetent nude mice resulted in reduced tumor growth associated with increased apoptosis and reduced cell proliferation compared with controls. These growth-retarding effects of VDR knockdown occur in the presence and absence of vitamin D and are independent of whether cells were grown in bone or soft tissues. Transcriptome analysis of VDR knockdown and non-target control cell lines demonstrated that loss of the VDR was associated with significant attenuation in the Wnt/0-catenin signaling pathway. In particular, cytoplasmic and nuclear β-catenin protein levels were reduced with a corresponding downregulation of downstream genes such as Axin2, Cyclin D1, interleukin-6 （IL-6）, and IL-8. Stabilization of 0-catenin using the GSK-3β inhibitor BIO partly reversed the growth-retarding effects of VDR knockdown. Our results indicate that the unliganded VDR possesses hitherto unknown functions to promote breast and prostate cancer growth, which appear to be operational not only within but also outside the bone environment. These novel functions contrast with the known anti-proliferative nuclear actions of the liganded VDR and may represent targets for new diagnostic and therapeutic approaches in breast and prostate cancer.

关键词： MDA Loss of the vitamin D receptor in human breast and prostate cancers strongly induces cell apoptosis through downregulation of Wnt catenin signaling VDR Wnt

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船只排放物对欧洲空气质量及酸性沉降造成的影响

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AMBIO－人类环境杂志 2005年第1期34卷 54-59页

作者： Richard G.Derwent David S.Stevenson Ruth M.Doherty William J.Collins Michael G.Sanderson colin E.Johnson Janusz Cofala Reinhard Mechler markus Amann Frank J.Dentener 许天虎伦敦皇家学院环境科技部英国爱丁堡大学全国环境研究委员会(NERC)/环境部英国爱丁堡大学 Met办公室哈德利(Hadley)中心埃克塞特的Met办公室哈德利中心奥地利拉克森堡(Laxenburg)的国际应用系统分析研究所奥地利拉克森堡的国际应用系统分析研究所 "跨边界空气污染计划" 意大利Ispra的环境与可持续发展研究所联合研究中心

一个名为"STOCHEM"的三维拉氏化学传输模型被用于描述2000年气候条件下国际海运活动产生的SO_2、NO_x、VOCs和CO排放造成的欧洲大西洋沿岸区域性酸性沉降和臭氧空气质量影响的状况。该模型得出的从西南海域到不列颠群岛和布列塔尼水域... 详细信息

一个名为"STOCHEM"的三维拉氏化学传输模型被用于描述2000年气候条件下国际海运活动产生的SO_2、NO_x、VOCs和CO排放造成的欧洲大西洋沿岸区域性酸性沉降和臭氧空气质量影响的状况。该模型得出的从西南海域到不列颠群岛和布列塔尼水域国际海运活动产生的硫沉降总量高达200mg/m^2·a。夏季国际海运活动对表层臭氧浓度的影响在爱尔兰、布列塔尼和葡萄牙高达约6ppb。在欧洲,海运活动产生的排放物是一种对酸性沉降和臭氧空气质量造成影响的外部因素,并且如果要在将来达到严格的沉降及空气质量目标,就需要采取一系列控制措施。

关键词：酸性沉降空气质量排放物欧洲国际海运船只臭氧浓度传输模型气候条件

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