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Primary liver transplantation vs transplant after Kasai portoenterostomy in children with biliary atresia: A retrospective Brazilian single-center cohort

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World Journal of Transplantation 2024年第1期14卷 112-119页

作者： Melina Utz Melere Valberto Sanha marco Farina Carolina Soares da Silva Luiza Nader Cristine Trein Angelica Maria Lucchese Cristina Ferreira Antonio Nocchi Kalil Flavia Heinz Feier Department of Hepatology and Liver Transplantation Santa Casa de Porto AlegrePorto Alegre 90050170Brazil Department of Hepato-biliary-pancreatic Surgery and Liver Transplantation Irmandade Santa Casa de Misericórdia de Porto AlegrePorto Alegre 90020-090Brazil Department of Surgical Oncology Santa Rita Hospital/Santa Casa de Misericórdia de Porto AlegrePorto Alegre 90050-170Rio Grande do SulBrazil

BACKGROUND Biliary atresia(BA)is the most common indication for pediatric liver transplantation,although portoenterostomy is usually performed ***,due to the high failure rate of portoenterostomy,liver transplantation has been advocated as the primary procedure for patients with *** is still unclear if a previous portoenterostomy has a negative impact on liver transplantation *** To investigate the effect of prior portoenterostomy in infants un-dergoing liver transplantation for *** This was a retrospective cohort study of 42 pediatric patients with BA who underwent primary liver transplantation from 2013 to 2023 at a single tertiary center in *** with BA were divided into two groups:Those undergoing primary liver transplantation without portoenterostomy and those undergoing liver transplantation with prior *** variables were compared using the Student’s t-test or the Kruskal-Wallis test,and categorical variables were compared using theχ2 or Fisher’s exact test,as *** Cox regression analysis was performed to determine risk factors for portal vein *** and graft survival analyses were conducted with the Kaplan–Meier product-limit estimator,and patient subgroups were compared using the two-sided log-rank *** Forty-two patients were included in the study(25[60%]girls),23 undergoing liver transplantation without prior portoenterostomy,and 19 undergoing liver transplantation with prior *** with prior portoenterostomy were older(12 vs 8 months;P=0.02)at the time of liver transplantation and had lower Pediatric End-Stage Liver Disease scores(13.2 vs 21.4;P=0.01).The majority of the patients(35/42,83%)underwent livingdonor liver *** group of patients without prior portoenterostomy appeared to have a higher incidence of portal vein thrombosis(39 vs 11%),but this result did not reach statistical *** portoenterostomy

关键词： Hepatic portoenterostomy Biliary atresia Liver transplantation Patient outcome assessment Portal vein Survival

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The Brazilian public healthcare system and its participation in medical training

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Health 2012年第8期4卷 500-505页

作者： Patricia Alves de Souza marco aurélio Da Ros Angélica Maria Bicudo Zeferino Universidade do Vale do Itajaí Itajaí Brasil Universidade Estadual de Campinas Campinas Brasil

Introduction: In Brazil, in a joint initiative of the Ministries of Health and of Education and Culture, the Program for the Promotion of Changes in Medical School Curricula (PROMED) was created, in order to give financial support to medical schools for the development and implementation of curricular changes to the medicine courses. Objective: To ascertain the influence of PROMED on the interaction between the Brazilian public healthcare system (SUS) and the universities. Method: Using the qualitative method by way of content analysis of the Bardin, interviews with 19 coordinators of the medicine courses which received financial support from PROMED were carried out and analyzed. Results: Subcategories which express the current relation between SUS and the universities were found: the need to train SUS professionals and the teaching staff involved, the lines of research directed toward SUS and partnership relations as part of the student learning process, the strengthening of SUS and the internal problems. Conclusions: Observing the needs of the relationship between SUS and the curricular changes it was noted that the public health services are of extreme importance as part of the training process of the medical student. Besides favoring practice, it establishes student activities within the health services, the evaluation of the policies, planning and management of the health services in activities of training and social communication in healthcare, linked to community organizations or diverse social entities. Thus, problems associated with the healthcare service can be identified, as well as the health conditions and life style of the population.

关键词： Curricular Changes Medical Training Brazilian Healthcare System (SUS) PROMED

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Medical schools that received the PROMED (program for the encouragement of curricular changes in medical courses)—Preconditions and change process

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Health 2012年第5期4卷 279-284页

作者： Patricia Alves de Souza marco aurélio Da Ros Angélica Maria Bicudo Zeferino Universidade do Vale do Itajaí (UNIVALI) Itajaí Brazil Universidade Estadual de Campinas (UNICAMP) Campinas

Since the Curriculum Guidelines (CG) which were created in 2001 and PROMED (Program for the Encouragement of Curricular Changes in Medical Courses), several schools have applied for this incentive. Medical Schools (MS) have faced important changes in their curriculum throughout the years. The purpose is to verify if medical schools that received PROMED already had a historical of curricular changes. Several interviews, which were carried out with PROMED coordinators, were recorded, transcribed and analyzed according to the Bardin’s content analysis technique. Later, these interviews were later categorized into nine themes. This paper analyses the Medical School History category which encompasses three subcategories: existence of a former changing history;need to overcome the model and changing period. It is highlighted that medical schools that received PROMED had a previous changing historical which was sometimes located in anti-hegemonic niches. It is noticeable, however, that such changes were not enough to affect the comprehension of healthillness process and its consequent results. PROMED was, effectively, the reference for medical schools implementing the C.G. which represents, now, a benchmarking for all new and old schools in the country.

关键词： Curriculum Guidelines Medical Schools

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具有Ruddlesden-Popper结构的杂化非本征铁电体(Ca_(1-x)Sm_(x))_(3)Ti_(2)O_(7)陶瓷的制备及其物理性能

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天津师范大学学报（自然科学版） 2024年第2期44卷 19-25页

作者： marco Antonio López-Aguila 柳志旭王守宇黄聪刘卫芳天津大学理学院天津300350 天津师范大学物理与材料科学学院天津300387

为探究稀土离子掺杂对Ca_(3)Ti_(2)O_(7)物理性能的调控,采用固相反应法制备了Sm^(3+)掺杂的(Ca_(1-x)Sm_(x))_(3)Ti_(2)O_(7)(x=0,0.02,0.04)陶瓷样品,通过XRD、XPS、紫外-可见光吸收光谱以及第一性原理计算等方法对样品的晶体结构、... 详细信息

为探究稀土离子掺杂对Ca_(3)Ti_(2)O_(7)物理性能的调控,采用固相反应法制备了Sm^(3+)掺杂的(Ca_(1-x)Sm_(x))_(3)Ti_(2)O_(7)(x=0,0.02,0.04)陶瓷样品,通过XRD、XPS、紫外-可见光吸收光谱以及第一性原理计算等方法对样品的晶体结构、光学性能、电学性能和磁学性能进行分析.结果表明:随着Sm^(3+)含量的增加,(Ca_(1-x)Sm_(x))_(3)Ti_(2)O_(7)的晶胞参数逐渐增大.Sm^(3+)掺杂导致氧空位减少,因此样品的漏电流随着Sm^(3+)掺杂量的增加而减小.同时,随着Sm^(3+)掺杂量的增加,样品的光学带隙呈现增大趋势.此外,第一性原理研究表明,Sm^(3+)掺杂可在体系中诱导出磁性能,进一步丰富了该材料的物理性能.

关键词： (Ca_(1-x)Sm_(x))_(3)Ti_(2)O_(7)陶瓷铁电性氧空位光学带隙第一性原理

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Cardiovascular Risk Factors and Evidence-Based Health Education

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Health 2014年第7期6卷 625-631页

作者： marco aurélio Lumertz Saffi Simoni Chiarelli da Silva Pokorski Eneida Rejane Rabelo-Silva Cardiovascular Division Hospital de Clínicas de Porto Alegre Porto Alegre Brazil Graduate Program in Cardiology and Cardiovascular Sciences Federal University of Rio Grande do Sul Porto Alegre Brazil

The number of deaths associated with cardiovascular events remains constant in many countries due to new therapeutic approaches for prevention and treatment of atherosclerosis. This condition is widely attributable to unhealthy outcomes in its association with risk factors such as smoking and sedentary behavior. Risk factors play a significant role in the progression of coronary artery disease. We conducted a review of the literature with the purpose of identifying primary risk factors for coronary disease, lifestyle change interventions, and expectations for a reduction in cardiovascular events on the basis of evidence-based health education strategies. In addition, we sought to contextualize this review so that nurses are trained to use these findings in their practice at different levels of care.

关键词： Nursing Coronary Disease Risk Factors Education Nursing Research

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A Structured Method of Teaching Epidural Block reduces the incidence of accidental dural puncture in inexperienced trainees.

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Open Journal of Anesthesiology 2024年第4期14卷 131-135页

作者： marco Scorzoni Gianluigi Gonnella Emanuele Capogna Marina Campione Gaetano Draisci Matteo Velardo Giorgio Capogna Department of Anesthesiology Fondazione Policlinico Gemelli IRCCS Rome Italy Department of Economics and Law Enna Kore University Enna Italy European School of Obstetric Anesthesia Rome Italy

Background: The rate of accidental dural puncture is particularly high during the period of training, especially in novices. The structured epidural teaching model (SETM) includes three standardized video lessons, the construction of a 3D epidural module by trainees and practical training by using an epidural simulator with and without the CompuFlo™ Epidural instrument. In this study we report the retrospective analysis of the accidental dural puncture rate of inexperienced trainees during their 6 months clinical practice rotation in obstetrics before and after the introduction of the SETM in our Institution. Method: We evaluated the incidence of accidental dural puncture before the introduction of the SETM methodology and afterwards by analyzing our departmental database from February 2019 to January 2023. All epidural blocks were executed by trainees who had never previously performed an epidural block and were about to begin their obstetrics rotation. Results: We analyzed 7415 epidurals: 3703 were performed before the introduction of the SETM methodology (control group) and 3712 afterwards (study group). The incidence of accidental dural puncture was 0.37% for the control group and 0.13% for the study group (p<.05). The probability of making an accidental dural puncture was 64% (OR: 0.36) lower for trainees who had the training than for those who did not. Conclusions: After the introduction of the structured teaching method, we observed a significant reduction of accidental dural puncture during the training period. We hope that our observation will encourage a constructive discussion among experts about the need to use standardized and validated tools as a valuable aid in teaching epidural anesthesia.

关键词： teaching epidural Anesthesia obstetrical Anesthesia Anesthesia

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Prognostic role of platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio in patients with non-metastatic and metastatic prostate cancer:A meta-analysis and systematic review

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Asian Journal of Urology 2024年第2期11卷 191-207页

作者： Stefano Salciccia marco Frisenda Giulio Bevilacqua Pietro Viscuso Paolo Casale Ettore De Berardinis Giovanni Battista Di Pierro Susanna Cattarino Gloria Giorgino Davide Rosati Francesco Del Giudice Alessandro Sciarra Gianna Mariotti Alessandro Gentilucci Department of Urology Sapienza Rome UniversityPoliclinico Umberto I00161 RomeItaly Department of Urology Humanitas20089 RozzanoMIItaly

Objective: To analyze data available in the literature regarding a possible prognostic value of the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) in prostate cancer (PCa) patients stratified in non-metastatic and metastatic ***: A literature search process was performed following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. In our meta-analysis, the pooled event rate estimated and the pooled hazard ratio were calculated using a random effect ***: Forty-two articles were selected for our analysis. The pooled risk difference for non-organ confined PCa between high and low NLR cases was 0.06 (95% confidence interval [CI]: −0.03-0.15) and between high and low PLR cases increased to 0.30 (95% CI: 0.16-0.43). In non-metastatic PCa cases, the pooled hazard ratio for overall mortality between high and low NLR was 1.33 (95% CI: 0.78-1.88) and between high and low PLR was 1.47 (95% CI: 0.91-2.03), whereas in metastatic PCa cases, between high and low NLR was 1.79 (95% CI: 1.44-2.13) and between high and low PLR was 1.05 (95% CI: 0.87-1.24).Conclusion: The prognostic values of NLR and PLR in terms of PCa characteristics and responses after treatment show a high level of heterogeneity of results among studies. These two ratios can represent the inflammatory and immunity status of the patient related to several conditions. A higher predictive value is related to a high NLR in terms of risk for overall mortality in metastatic PCa cases under systemic treatments.

关键词： Prostatic neoplasm Neutrophil-to-lymphocyte ratio Platelet-to-lymphocyteratio Meta-analysis Radical prostatectomy Metastatic

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Adherence to Pharmacotherapy in Post-Menopausal Women with Hypertension or Metabolic Syndrome: Real World Experience

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International Journal of Clinical Medicine 2024年第3期15卷 145-154页

作者： Maria Maiello Francesca Amati Vincenzo Ezio Santobuono Andrea Igoren Guaricci Cinzia Forleo marco Matteo Ciccone Pasquale Palmiero Department of Cardiology ASL BR SSN3 Brindisi Italy Cardiovascular Diseases Section Interdisciplinary Department of Medicine (DIM) University of Bari “Aldo Moro” Bari Italy

Background: Adherence to medications is dependent upon a variety of factors, including individual characteristics of the patient, interactions with health care providers, and medication complexity. Even though several studies were conducted to test intervention strategies, results are uncertain. Aim: The aim of the study is to assess if a tailored combined intervention strategy improves medication adherence in a large population of post-menopausal women affected by hypertension or metabolic syndrome. Methods: We enrolled 6833 patients aged 50 to 69 years, 85.7% with hypertension, and 14.3% with metabolic syndrome. A network between patients, general practitioners, and cardiologists was established. Interventions included education, adequate information to patients, a simplified scheme of treatment, and periodic adherence assessment. These were either delivered as healthcare provider supports or using modern technology. Medication adherence was estimated by the proportion of days covered for all classes of drugs after the index date. Results: Non-adherent hypertensive women were 297 (5%), and those with metabolic syndrome were 73 (7.4%) (p Conclusions: The rate of non-adherence in both settings of postmenopausal women was 7.7%, much lower than that described in the literature. This rate was increased in patients with metabolic syndrome;probably it is related to the complexity of the therapeutic scheme or to a poor consciousness of the disease. Therefore, implementing a tailored combined intervention can improve significantly patients’ adherence to medical therapy.

关键词： Adherence Cardiovascular Prevention Postmenopausal Women Hypertensive Metabolic Syndrome

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Herpes simplex keratitis:A brief clinical overview

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World Journal of Virology 2024年第1期13卷 5-32页

作者： Mutali Musa Ehimare Enaholo Gladness Aluyi-Osa George Nnamdi Atuanya Leopoldo Spadea Carlo Salati marco Zeppieri Department of Optometry University of BeninBenin 300283Nigeria Department of Ophthalmology Africa Eye Laser CentreKm 7Benin 300105Nigeria Department of Ophthalmology Centre for Sight AfricaNkpor 434101Nigeria Eye Clinic Policlinico Umberto I"Sapienza"University of RomeRome 00142Italy of Ophthalmology University Hospital of UdineUdine 33100Italy

The aim of our minireview is to provide a brief overview of the diagnosis,clinical aspects,treatment options,management,and current literature available regarding herpes simplex keratitis(HSK).This type of corneal viral infection is caused by the herpes simplex virus(HSV),which can affect several tissues,including the *** significant aspect of HSK is its potential to cause recurrent episodes of inflammation and damage to the *** the initial infection,the HSV can establish a latent infection in the trigeminal ganglion,a nerve cluster near the *** virus may remain dormant for extended *** reactivation of the virus can occur,leading to recurrent episodes of *** triggering reactivation include stress,illness,immunosuppression,or *** episodes can manifest in different clinical patterns,ranging from mild epithelial involvement to more severe stromal or endothelial *** severity and frequency of recurrences vary among *** cases of HSK,especially those involving the stroma and leading to scarring,can result in vision impairment or even blindness in extreme *** cornea's clarity is crucial for good vision,and scarring can compromise this,potentially leading to visual *** management of HSK involves not only treating acute episodes but also implementing long-term strategies to prevent recurrences and attempt repairs of corneal nerve endings via *** medications,such as oral Acyclovir or topical Ganciclovir,may be prescribed for *** immune response to the virus can contribute to corneal ***,caused by the body's attempt to control the infection,may inadvertently harm the corneal *** should be informed about triggers and advised on measures to minimize the risk of *** summary,the recurrent nature of HSK underscores the importance of both acute and long-term management strategies to preserve corneal health and maintai

关键词： Herpes simplex virus Herpes simplex keratitis Acyclovir Neurotization Reactivation

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Minimally invasive surgical therapies(MISTs)for lower urinary tract symptoms(LUTS):promise or panacea?

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Asian Journal of Andrology 2024年第2期26卷 135-143页

作者： Gian Maria Busetto Andrea Checchia marco Recchia Edoardo Tocci Ugo G Falagario Gennaro Annunziata Pasquale Annese Nicola d'Altilia Vito Mancini Matteo Ferro Felice Crocetto Octavian Sabin Tataru Luca Di Gianfrancesco Angelo Porreca Francesco Del Giudice Ettore De Berardinis Carlo Bettocchi Luigi Cormio Giuseppe Carrieri University of Foggia Foggia 71122Italy Department of Urology and Renal Transplantation Policlinico of FoggiaFoggia 71122Italy Urology Unit "G.Tatarlla"HospitalCerignola 71042Italy Urology Unit European Institute of Oncology(IE0)IRCcSMilan 20141Italy University of Naples Federico Il Naples 80126Italy G.E.Palade University of Medicine PharmacyScienceand Technology of Targu MuresTargu Mures 540142Romania Department of Oncological Urology Veneto Institute of Oncology(IOv)IRccSPadua 35128Italy Department of Maternal-Infant and Urological Sciences Sapienza Rome UniversityRoma 00161Italy Urology Unit "L.Bonomo"HospitalAndria 76123Italy

The increasing importance of treatment of lower urinary tract symptoms(LUTS),while avoiding side effects and maintaining sexual function,has allowed for the development of minimally invasive surgical therapies(MiSTs).Recently,the European Association of Urology guidelines reported a paradigm shift from the management of benign prostatic hyperplasia(BPH)to the management of nonneurogenic male *** aim of the present review was to evaluate the efficacy and safety of the most commonly used MisTs:ablative techniques such as aquablation,prostatic artery embolization,water vapor energy,and transperineal prostate laser ablation,and nonablative techniques such as prostatic urethral lift and temporarily implanted nitinol device(iTIND).MiSTs are becoming a new promise,even if clinical trials with longer follow-up are still *** of them are still under investigation and,to date,only a few options have been given as a recommendation for *** cannot be considered as standard of care and are not suitable for all *** and disadvantages should be underlined,without forgetting our objective:treatment of LUTS and re-treatment avoidance.

关键词： aquablation iTIND prostatic artery embolization prostatic urethral lift transperineal prostate laser ablation water vapor energy

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