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Development and internal validation of the Comprehensive ALPPS Preoperative Risk Assessment(CAPRA)score:is the patient suitable for Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS)?

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Hepatobiliary Surgery and Nutrition 2022年第1期11卷 52-66,I0007,I0008页

作者： Ivan Capobianco Karl J.Oldhafer Mohammed-Hossein Fard-Aghaie Ricardo Robles-Campos Roberto Brusadin Henrik Petrowsky Michael Linecker Arianeb Mehrabi Katrin Hoffmann Jun Li Asmus Heumann Roberto Hernandez-Alejandro Mauro Enrique Tun-Abraham Elio Jovine Matteo Serenari Bergthor Bjornsson Per Sandström Ruslan Alikhanov Mikhail Efanov Paolo Muiesan Andrea Schlegel Thomas M.van Gulik Pim B.Olthof Gregor Alexander Stavrou Lina Maria Serna-Higuita Alfred Königsrainer Silvio Nadalin Department of General Visceral and Transplant SurgeryUniversity Hospital TübingenTübingenGermany Department of General and Abdominal Surgery Asklepios Hospital BarmbekHamburgGermany Department of Surgery Virgen de la Arrixaca Clinic and University HospitalMurciaSpain Swiss HPB and Transplantation Center Department of SurgeryZurich University HospitalZurichSwitzerland Department of General Visceraland Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany General Visceral and Thoracic Surgery Department and ClinicHamburg-Eppendorf University Medical CenterHamburgGermany Division of Transplantation and Hepatobiliary Surgery University of RochesterRochesterNYUSA Division of HPB Surgery and Liver Transplantation Department of SurgeryLondon Health Sciences CentreLondonCanada General and Emergency Surgery Unit Azienda Ospedaliero-Universitaria di BolognaMaggiore HospitalBolognaItaly General Surgery and Transplantation Unit Azienda Ospedaliero-Universitaria di BolognaSant’Orsola-Malpighi HospitalBolognaItaly Department of Surgery in Linköping and Department of Biomedical and Clinical SciencesLinköping UniversityLinköpingSweden Department of Hepatopancreatobiliary Surgery Moscow Clinical Scientific CenterMoscowRussia Liver Unit Queen Elizabeth Hospital BirminghamUniversity Hospitals Birmingham NHS Foundation TrustBirminghamUK Department of Surgery Amsterdam UMC(Location AMC)University of AmsterdamAmsterdamThe Netherlands Department of General Abdominal and Thoracic SurgerySurgical OncologySaarbruecken General HospitalSaarbrueckenGermany Department of Clinical Epidemiology and Applied Biometry University of TübingenTübingenGermany

Background:Preoperative patient selection in Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS)is not always reliable with currently available scores,particularly in patients with primary liver *** study aims to(I)to determine whether comorbidities and patients characteristics are a risk factor in ALPPS and(II)to create a score predicting 90-day mortality ***:Thirteen high-volume centers participated in this retrospective multicentric study.A risk analysis based on patient characteristics,underlying disease and procedure type was performed to identify risk factors and model the Comprehensive ALPPS Preoperative Risk Assessment(CAPRA)score.A nonparametric receiver operating characteristic analysis was performed to estimate the predictive ability of our score against the Charlson Comorbidity Index(CCI),the age-adjusted CCI(aCCI),the ALPPS risk score before Stage 1(ALPPS-RS1)and Stage 2(ALPPS-RS2).The model was internally validated applying ***:A total of 451 patients were *** was 14.4%.The CAPRA score is calculated based on the following formula:(0.1×age)−(2×BSA)+1(in the presence of primary liver tumor)+1(in the presence of severe cardiovascular disease)+2(in the presence of moderate or severe diabetes)+2(in the presence of renal disease)+2(if classic ALPPS is planned).The predictive ability was 0.837 for the CAPRA score,0.443 for CCI,0.519 for aCCI,0.693 for ALPPS-RS1 and 0.807 for *** 1,000 cycles of bootstrapping the C statistic was *** accuracy plot revealed a cut-off for optimal prediction of postoperative mortality of ***:Comorbidities play an important role in ALPPS and should be carefully considered when planning the *** assessing the patient’s preoperative condition in relation to ALPPS,the CAPRA score has a very good ability to predict postoperative mortality.

关键词： Associating Liver Partition and Portal vein ligation for Staged hepatectomy(ALPPS) comorbidity mortality prediction model patient selection

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What factors are important to new patients when selecting an orthopedic oncologist?

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World Journal of Orthopedics 2022年第5期13卷 472-480页

作者： Charles A Gusho Vishal Patel Linus Lee Alan T Blank Department of Orthopedic Surgery Rush University Medical CenterChicagoIL 60612United States

BACKGROUND Understanding how patients choose a provider may improve the overall experience by identifying ways to tailor a clinical *** To identify factors that patients consider important when choosing an orthopedic *** New patients presenting to an orthopedic oncology clinic within a tertiary academic medical center from January 2019 to August 2020 were invited to complete an anonymous *** questionnaire consisted of 27 items including a Likert-type assessment of the importance of selection *** A total of 101 new patients with a median age of 66 years(range,14 years to 91 years)*** were referred by another doctor(n=63,62.4%),and of the referring providers,the most frequent specialty was orthopedic surgery(n=32,51%).Using a Likert-type scale with 1 representing‘least important’and 5 representing‘most important’,the most important factor was the hospital reputation(mean,4.65;SD,0.85).Additional factors of importance were the number of years in practice(3.87±1.3)and a primary care provider referral(3.71±1.6).patients younger than 40 years old found social media(P=0.016)and internet presence(P=0.035)of their surgeon to be more important than older *** contrast,older patients considered care within an academic center to be of greater importance than younger patients(P=0.014).CONCLUSION This investigation suggests a primary care referral,as well as hospital and physician reputation,are among the most important factors when selecting an orthopedic ***,social media utilization appears to be more important for younger patients.

关键词： Advertising patient choice selection patient selection Questionnaire Practice management Orthopedic oncologist

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Precise prediction model and simplified scoring system for sustained combined response to interferon-α

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World Journal of Gastroenterology 2010年第27期16卷 3465-3471页

作者： Qian-Guo Mao Ru-Mian Zhang Jin-Shui Pan Kuang-Nan Fang Jian-Ping Zhu Qing-Yang Hong Hepatology Unit and Department of Infectious Diseases Xiamen Hospital of Traditional Chinese Medicine Xiamen 361000 Fujian Province China Division of Gastroenterology Zhongshan Hospital Xiamen University Gastroenterology Institute of Xiamen University Gastroenterology Center of Xiamen Xiamen 361004 China Department of Planning and Statistics Xiamen University Xiamen 361005 China College of Information Science and Technology Xiamen UniversityXiamen 361005Fujian ProvinceChina

AIM:To establish a predictive algorithm which may serve for selecting optimal candidates for interferon-α(IFN-α) ***:A total of 474 IFN-α treated hepatitis B virus e antigen(HBeAg)-positive patients were enrolled in the present *** patients' baseline characteristics,such as age,gender,blood tests,activity grading(G) of intrahepatic inflammation,score(S) of liver fibrosis,hepatitis B virus(HBV) DNA and genotype were evaluated;therapy duration and response of each patient at the 24th wk after cessation of IFN-α treatment were also recorded.A predictive algorithm and scoring system for a sustained combined response(CR) to IFN-α therapy were *** 10% of the patients were randomly drawn as the test *** to IFN-α therapy were divided into CR,partial response(PR) and non-response(NR).The mixed set of PR and NR was recorded as PR+***:Stratified by therapy duration,the most significant baseline predictive factors were alanine aminotransferase(ALT),HBV DNA level,aspartate aminotransferase(AST),HBV genotype,S,G,age and *** to the established model,the accuracies for sustained CR and PR+NR,respectively,were 86.4% and 93.0% for the training set,81.5% and 91.0% for the test *** the scoring system,the sensitivity and specificity were 78.8% and 80.6%,*** were positive correlations between ALT and AST,and G and S,***:With these models,practitioners may be able to propose individualized decisions that have an integrated foundation on both evidence-based medicine and personal characteristics.

关键词： Chronic hepatitis B Interferon-α patient selection Predictive model Scoring system Treatment outcome

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selection criteria for preoperative endoscopic retrograde cholangiopancreatography before laparoscopic cholecystectomy and endoscopic treatment of bile duct stones:Results of a retrospective,single center study between 1996-2002

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World Journal of Gastroenterology 2004年第23期10卷 3495-3499页

作者： Laszlo Lakatos Gabor Mester Gyorgy Reti Attila Nagy Peter Laszlo Lakatos 1~(st)Department of Medicine Csolnoky FProvince HospitalVeszpremH-8200 Hungary Department of Surgery Csolnoky FProvince HospitalVeszpremH-8200 Hungary 1~(st)Department of Medicine Semmelweis UniversityBudapestH-8200 Hungary

AIM: The optimal treatment for bile duct stones (in terms of cost, complications and accuracy) is unclear. The aim of our study was to determine the predictive factors for preoperative endoscopic retrograde cholangiopancreatography (ERCP).METHODS: patients undergoing preoperative ERCP (≤90 d before laparoscopic cholecystectomy) were evaluated in this retrospective study from the 1^st of January 1996 to the 31^st of December 2002. The indications for ERCP were elevated serum bilirubin, elevated liver function tests (LFT), dilated bile duct (≥8 mm) and/or stone at US examination, coexisting acute pancreatitis and/or acute pancreatitis or jaundice in patient's history. Suspected prognostic factors and the combination of factors were compared to the result of ERCRRESULTS: Two hundred and six preoperative ERCPs were performed during the observed period. The rate of successful cannulation for ERC was (97.1%). Bile duct stones were detected in 81 patients (39.3%), and successfully removed in 79 (97.5%). The number of prognostic factors correlated with the presence of bile duct stones. The positive predictive value for one prognostic factor was 1.2%, for two 43%,for three 72.5%, for four or more 91.4%.CONCLUSION: Based on our data preoperative ERCP is highly recommended in patients with three or more positive factors (high risk patients). In contrast, ERCP is not indicated in patients with zero or one factor (low risk patients).Preoperative ERCP should be offered to patients with two positive factors (moderate risk patients), however the practice should also be based on the local conditions (*** of the endoscopist, other diagnostic tools).

关键词： Cholangiopancreatography, Endoscopic Retrograde Cholecystectomy, Laparoscopic patient selection Bile Ducts Cholelithiasis Female Humans Male Middle Aged Predictive Value of Tests Preoperative Care Retrospective Studies

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PDE11A negatively regulates lithium responsivity in mice

PDE11A negatively regulates lithium responsivity in mice

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中国神经科学学会第十届全国学术会议

作者： Michy P.Kelly University of South Carolina School of Medicine

Liuiium is a first line treatment for mood stabilization in patients with bipolar disorder,but approximately half of all patients do not respond to Uthium *** would be advantageous to identify genetic or biochemical markers that predict which patients are likely to respond to lithium,but no such test currently *** affects many cell signaling pathways,including the cAMP *** has previously been shown that Uthium both elevates basal cAMP levels and,simultaneously,decreases receptor-mediated changes in cAMP concentration,suggesting a differential effect of lithium across various subcellular *** are responsible for regulating the cAMP pamway by determining the precise temporal and spatial dynamics of cAMP hydrolysis at the subceUular *** 11A（PDE11A） is enriched in the ventral hippocampus,a region implicated in psychotic and mood disorders,and genetic variations in PDEllA have recently been linked to lithium responsiveness in patients with bipolar *** functional effects of these genetic variations are not yet known,so we decided to test the hypothesis that variation in PDEl 1A expression affects Uthium *** do so,we measured PDEl 1A protein expression by Western blot in the hippocampus of various inbred laboratory strains of mice known to respond weU（C57BL/6J）,moderately（129S6/SvEvTac） or poorly（Balb/cJ） to *** found that PDEllA levels were highest in Balb/cJ mice,the strain least responsive to lithium,and PDEllA levels were lowest in C57BL/6J mice,the strain most responsive to ***,we measured PDEllA mRNA levels by in situ hybridization and found that PDEllA mRNA was specifically increased in dorsal CA1 of the Balb/cJ mice relative to the dorsal CA1 of the C57BL/6J *** lower levels of PDEllA correlated with increased lithium responsiveness across mese mouse strains,we next determined if genetic deletion of PDEllA would increase lithium *** tai

关键词： phosphodiesterase PDE11,PDE11A bipolar disorder cyclic AMP CAMP patient selection

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