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Extrahepatic cholestasis associated with paracoccidioidomycosis:Challenges in the differential diagnosis of biliopancreatic neoplasia

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World Journal of Gastrointestinal Oncology 2024年第6期16卷 2531-2540页

作者： Jose Sebastiao dos Santos Vitor de Moura Arrais William Jose Rosseto Ferreira ricardo Ribeiro Correa Filho Mariangela Ottoboni Brunaldi Rafael Kemp Ajith Kumar Sankanrakutty Jorge Elias Junior Fernando Bellissimo-Rodrigues Roberto Martinez Edson Zangiacomi Martinez Jose Celso Ardengh Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP) Departamento de Cirurgia e AnatomiaRibeirao Preto 14049-900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de PatologiaRibeirao Preto 14048900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Imagens MédicasHematologia e Oncologia ClínicaRibeirao Preto 14048900Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Medicina SocialRibeirao Preto 14015-010Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Clínica MédicaRibeirao Preto 14015-010Sao PauloBrazil Universidade de Sao Paulo Faculdade de Medicina de Ribeirao Preto da Universidade de Sao Paulo(FMRP-USP)Departamento de Cirurgia e AnatomiaRibeirao Preto 14049-900Sao PauloBrazil and Hospital MoriahServico de Endoscopia DigestivaSao Paulo 04084-002Sao PauloBrazil

BACKGROUND Paracoccidioidomycosis(PCM)may involve the hepatic pedicle and peripan creatic lymph nodes,cause damage to the bile duct and manifest,exceptionally,in combination with extrahepatic cholestasis(EHC),making investigation and treatment *** To investigate the management of patients with visceral PCM admitted with *** All patients diagnosed with PCM treated in a public,tertiary teaching hospital between 1982 and 2020 were retrospectively *** also identified with EHC were allocated to two groups according to the treatment approach for the purpose of comparing clinical,laboratory,and imaging findings,resources used for etiological diagnosis,treatment results,and *** analyses were performed using the linear mixed-effects model(random and fixed effects),which was adjusted using the PROC MIXED procedure of the SAS®9.0 software,and Fisher’s exact *** Of 1645 patients diagnosed with PCM,40(2.4%)had *** these,20(50.0%)lived in the rural area and 29(72.5%)were men,with a mean age of 27.1 years(3-65 years).Jaundice as first symptom and weight loss of at least 10 kg were observed in 16 patients(40.0%),and a mass in the head of the pancreas was observed in 8(20.0%).The etiological diagnosis was made by tissue collection during surgery in 4 cases(10.0%)and by endoscopic methods in 3 cases(7.5%).Twenty-seven patients(67.5%)received drug treatment alone(Group 1),whereas 13(32.5%)underwent endoscopic and/or surgical procedures in combination with drug treatment(Group 2).EHC was significantly reduced in both groups(40.7% in Group 1,with a mean time of 3 months;and 38.4% in Group 2,with a mean time of 7.5 months),with no statistically significant difference between *** recurrence rates,associated mainly with treatment nonadherence,were similar in both groups:37% in Group 1 and 15.4% in Group *** mortality rate was 18.5% in Group 1 and 23% in Group 2,with survival estimates of 71.3% and 72.5%,respectively,with

关键词： Cholestasis Jaundice Obstructive Blastomycosis Paracoccidioides Diagnosis Treatment

The Nikola Tesla Constant and Its Relation to the Circumference Inscribed in a Square

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Journal of Applied Mathematics and Physics 2024年第1期12卷 277-283页

作者： Javier Mendoza Navarrete José Ismael Ojeda Campaña Huetzin Perez Gabriel Luna-Sandoval Victor Verdugo ricardo Jiménez Garcia Departamento de Matemáticas CBTis 256 DGETI Cabo San Lucas México División de Ingeniería en Sistemas Computacionales Tecnológico Nacional de México/ITES de Los Cabos Cabo San Lucas México DCI Departamento de Física Médica Universidad de Guanajuato León México Departamento de Ingeniería Industrial en Manufactura Universidad Estatal de Sonora Navojoa México Departamento de Eléctrica-Electrónica Tecnológico Nacional de México Campus Mexicali Mexicali México

This research work relates the surface of a square and the area circumscribed by a circle, resulting in a value called Nikola Tesla constant. This constant starts with the calculation of the areas of the square and the inscribed circle, giving a ratio of 9/40 and from which a residual area of the area proportions of the geometric figures described is obtained. Plotting smooth curves, particularly those in round shapes, can be represented efficiently with the use of Nikola Tesla constant, reducing complex mathematical calculus.

关键词： Tesla Numbers Prime Number Circle Binary Area

ITPK1 is an InsP_(6)/ADP phosphotransferase that controls phosphate signaling in Arabidopsis

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Molecular Plant 2024年第7期17卷 1151-1157页

作者： Esther Riemer Danye Qiu Debabrata Laha Robert K.Harmel Philipp Gaugler Verena Gaugler Michael Frei Mohammad-Reza Hajirezaei Nargis Parvin Laha Lukas Krusenbaum Robin Schneider Adolfo Saiardi Dorothea Fiedler Henning J.Jessen Gabriel Schaaf ricardo F.H.Giehi 不详

(Molecular Plant 14,1864-1880;November 12021)We identified a mistake made when calculating the absolute concentrations of inositol(pyro)phosphates derived from CE-ESl-MS measurements reported in the originally published version of our *** to a calculation error when determining concentrations per fresh biomass,the absolute values shown in the manuscript are approximately 30-fold lower than they should *** mistake affects Figures 2D,3C,4C,and 7D and Figures S4,S11B,S13,and *** all conclusions made in the article referred to relative differences between genotypes and treatments,they remained unaffected by these mistakes.

关键词： ipt Arabidopsis absolute

Effect of Turbidity on Semi-Automatic Analysis of Copepod Size and Abundance Distribution in the Water Column

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Advances in Bioscience and Biotechnology 2024年第6期15卷 380-395页

作者： Thiago da Silva Matos Carolina Siqueira dos Reis Laura de Andrade Moura Márcio Abreu ricardo Coutinho Lohengrin Fernandes IEAPM/UFF Marine Biotechnology Post-Graduate Program Arraial do Cabo Brazil Instituto de Estudos do Mar Almirante Paulo Moreira Arraial do Cabo Brazil

Automated image systems to characterize aquatic organisms improve research and enable fast response to environmental risk situations. In November 2015, a dam in Mariana City-MG (Brazil) collapsed and led to the disposal of mud tailings from the mining process to the Doce River. The accident resulted in several casualties and incalculable damage to surrounding communities and the environment. The mud increased water turbidity, an essential condition to the functioning of the image analysis systems, and directly affected the characterization of the organisms, making it impossible to distinguish copepods in the mud, due to the blurred outline. To get a quick response evaluating environmental situations, this work aimed to develop and test different algorithms characterizing and classifying copepods by their size (length and area) using in situ images acquired by the Lightframe On-Sight Keyspecies Investigation device. Field tests were carried out under different turbidity levels throughout the gradient observed in the coastal zone adjacent to the Doce River. The best algorithm reduced nearly 50% of the noise in some images when compared with manual treatment and led to 96% accuracy in measurement and counting. Semi-automated devices that perform post-processing corrections are suitable for fast environmental evaluation under high turbidity scenarios.

关键词： Imaging Zooplankton Doce River LOKI Copepod

Intestinal inflammation and the microbiota:Beyond diversity

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World Journal of Gastroenterology 2022年第26期28卷 3274-3278页

作者： Gabriela Gama Freire Alberca Naiane Samira Souza Cardoso Rosa Liliana solis-Castro Viviane Nakano ricardo Wesley Alberca Department of Microbiology Institute of Biomedical SciencesUniversity of São PauloSão Paulo 05508-000Brazil Departamento Académico de Biología Bioquímica Facultad de Ciencias de la SaludUniversidad Nacional de TumbesPampa Grande 24000TumbesPeru Laboratorio de Dermatologia e Imunodeficiencias Departamento de DermatologiaFaculdade de Medicina FMUSPUniversidade de São PauloSão Paulo 01246-903Brazil

The recent manuscript entitled“Relationship between clinical features and intestinal microbiota in Chinese patients with ulcerative colitis”reported a difference in the intestinal microbiota of patients with ulcerative colitis according to the severity of the *** influence of the intestinal microbiota on the development and progress of gastrointestinal disorders is well *** the diversity in the microbiome,the presence of virulence factors and toxins by commensal bacteria may affect an extensive variety of cellular processes,contributing to the induction of a proinflammatory environment.

关键词： Inflammation Microbiota Toxins Intestinal Ulcerative Colitis Cancer

Labor Motivation and Its Influence on Workers’Productivity-A Secondary Publication

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Proceedings of Business and Economic Studies 2024年第1期7卷 210-217页

作者： ricardo Molinar University of Panama Panama

The productivity of an institution is achieved,in large part,by creating a harmonious environment that reflects the satisfaction,empowerment,and collaborative spirit of each *** this perspective,management will consider upgrades using all tactics that allow for the achievement of these goals,including direct effort and the involvement of all *** objective of this study was to examine the relationship between work motivation and the productivity of workers in the communal board of the Barrio Sur corregimiento in the province of Coló*** the questionnaire as an instrument,as well as the descriptive method,allowed for the report and evaluation of the characteristics of the workers,indicating interpersonal deficits and distancing in the motivations that drive administrative *** incorporating different approaches previously analyzed and developed by different authors familiar with the subject,it was possible to achieve substantial results,such as the need to implement administrative strategies that harmoniously incorporate workers,showing that,despite motivation problems,the work environment where one works is very important in the performance of their *** to motivate the direct participation of the workers selected as part of the sample,who showed full satisfaction with the results framed within the framework of individual improvement and,above all,the commitment to the institution to improve its work.

关键词： Work motivation Productivity Workers Work environment

Sleeve Gastrectomy with Duodenal Transit Bipartition (S-DTB): Preliminary Results and Technical Aspects of Its Metabolic Structure

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Surgical Science 2024年第4期15卷 244-264页

作者： Paulo Reis Esselin de Melo ricardo Zorron Victor Ramos Mussa Dib Carlos Augusto Scussel Madalosso Rui Ribeiro Thonya Cruz Braga Paula Volpe Carlos Eduardo Domene Paulo Reis Institute Goiania GO Brazil Alfredo Nasser University Center (UNIFAN) Goiania GO Brazil Department of Bariatric and Metabolic Surgery CUF Descobertas Hospital Lisbon Portugal Victor Dib Institute Manaus AM Brazil Gastrobese Clinic Passo Fundo RS Brazil Lusiadas Amadora Hospital Lisbon Portugal Clianest Group Renaissance Hospital Goiania GO Brazil Integrated Center for Advanced Medicine (CIMAMED) Sao Paulo Brazil

Obesity is a significant and escalating health issue both in Brazil and globally, with over 650 million overweight adults worldwide. The treatment of obesity can be performed clinically, endoscopically or surgically;surgical treatment proves to be safe and more effective in terms of weight loss and long-term maintenance. Objective: This study aimed to monitor the progress of weight loss and comorbidity control in patients undergoing sleeve gastrectomy with duodenal bipartition. Methods: This pilot project involved 8 patients divided into 2 arms. In the first arm, patients underwent sleeve gastrectomy with Roux-en-Y duodenoileal transit bipartition (S-RYDITB), while in the second arm, patients underwent sleeve gastrectomy with Roux-en-Y duodenojejunal transit bipartition (S-RYDJTB). Both procedures involved Roux-en-Y reconstruction without duodenal exclusion. In S-RYDITB, the duodenal-ileal anastomosis was performed 300 cm from the ileocecal valve (ICV), creating a 250 cm common channel and a 50 cm alimentary channel. In S-RYDJTB, a biliopancreatic loop was created 200 cm from the angle of Treitz, with a 1 m alimentary channel. Results: Five patients underwent the procedures, with one undergoing S-RYDITB and four undergoing S-RYDJTB. No adverse events such as hospitalizations, readmissions, reoperations, fistulas, bleeding, pulmonary embolism, diarrhea, dumping syndrome, or hypoglycemia occurred during the study period. The mean length of hospital stay was 2 days. The average BMI decreased from 37.27 kg/m2 preoperatively to 29.48 kg/m2 after 6 months. The significant percentage of weight loss was 21.22%, with excess weight loss of 63.6%. Ninety-five percent remission of comorbidities, including hypercholesterolemia, hypertriglyceridemia, diabetes, hypertension, steatosis, and pre-diabetes. Two patients underwent sleeve gastrectomy with duodenal bipartition using a single anastomosis. Conclusion: Duodenal switch surgery has gained worldwide recog

关键词： Obesity Bariatric Surgery Metabolic Surgery Duodenal Switch

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深海之王

商业周刊（中文版） 2024年第9期 54-63页

作者： Kit Chellek Olivia Solon Jonathan Browning ricardo Rey(插图) 杨飞(译) 不详

多年来,世界上最厉害的深海沉船猎人一直在与各国政府及竞争对手争夺海底的财富。他把自己的身份隐藏得很好,一直到现在。冰岛海岸警卫队的官员们在控制室的显示屏上注视着这艘船——在广阔的蓝色海图上,它只是一个孤点。2017年4月,这... 详细信息

多年来,世界上最厉害的深海沉船猎人一直在与各国政府及竞争对手争夺海底的财富。他把自己的身份隐藏得很好,一直到现在。冰岛海岸警卫队的官员们在控制室的显示屏上注视着这艘船——在广阔的蓝色海图上,它只是一个孤点。2017年4月,这个小点在离岸120英里(约193公里)的地方盘旋了好几天,任何理智的水手都不会在当时那种恶劣的天气里闲逛。接近飓风等级的狂风呼啸着穿越凶涌的大海;天空中雨雪交加。

关键词：海岸警卫队控制室显示屏竞争对手

Carpal Tunnel Syndrome: A Marker for Amyloidosis

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World Journal of Neuroscience 2024年第3期14卷 92-101页

作者： Luciana León Cejas Miguel Saucedo Mayra Aldecoa Gustavo Teruya Fabricio Silva Alvaro Muratore Gonzalo Viollaz Cintia Marchesoni Ana Pardal Pablo Dezanzo Alejandro Iotti ricardo Reisin Neurology Department Hospital Britnico de Buenos Aires Buenos Aires Argentina Orthopedics Department Hospital Britnico de Buenos Aires Buenos Aires Argentina Pathology Department Hospital Britnico de Buenos Aires Buenos Aires Argentina

Introduction: Amyloidosis are systemic conditions and carpal tunnel syndrome (CTS) precedes the principal systemic complications and can be used as an early marker. Our objective was to determine the frequency of amyloid deposition in idiopathic CTS and its systemic impact. Methods: We retrospectively evaluated patients with CTS between September 2019 to January 2020. Samples from the anterior carpal ligament were pathologically evaluated and amyloid deposition was confirmed by apple-green birefringence on polarized light using Congo red stain. When amyloid was detected we performed genetic testing for transthyretin variants (ATTRv), immunofixation electrophoresis in serum and urine for light chains and multidisciplinary evaluation. Results: Thirty consecutive patients were included, 19 women, 11 men, mean age 70 years old (range 42 - 89 years). We identified 3 patients (10%) with amyloid deposits (mean age: 78.6 years, 2 men, 1 woman). Genetic testing for ATTRv and light chains studies were negative. During follow-up: The first patient required aortic valve replacement. The second patient developed progressive cardiac failure with syncopal episodes, atrioventricular block and atrial fibrillation and required a pacemaker and anticoagulation. The third patient had unexplained chronic edemas. The cardiac evaluation in all 3 patients revealed left ventricular hypertrophy and myocardial uptake (Perugini Score > 2) in their nuclear bone scintigraphies with technetium pyrophosphate. Two patients were treated with tafamidis and one patient died due to refractory cardiac insufficiency. Discussion: Our findings underline the importance of investigating amyloidosis in idiopathic CTS. The identification of deposits allows early diagnosis of cardiac amyloidosis leading to timely intervention and treatment.

关键词： Carpal Tunnel Amyloid Transthyretin Amyloid Cardiac Transthyretin Variants Light Chains