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Challenges in transplantation for alcoholic liver disease

World Journal of Gastroenterology 2014年第25期20卷 8033-8039页

作者： Gabriela A Berlakovich Department of Surgery Division of Transplantation Medical University of ViennaVienna A-1090Austria

Transplantation for the treatment of alcoholic cirrhosis is more controversially discussed than it is for any other indication. The crucial aspect in this setting is abstinence before and after liver transplantation. We established pre-transplant selection criteria for potential transplant candidates. Provided that the underlying disease can be treated, there is no reason to withhold liver transplantation in a patient suffering from alcoholic cirrhosis. Evaluation of the patient by a multidisciplinary team, including an addiction specialist, is considered to be the gold standard. However, several centers demand a specified period of abstinence- usually 6 mo- irrespective of the specialist's assessment. The 6-mo rule is viewed critically because liver transplantation was found to clearly benefit selected patients with acute alcoholic hepatitis; the benefit was similar to that achieved for other acute indications. However, the discussion may well be an academic one because the waiting time for liver transplantation exceeds six months at the majority of centers. The actual challenge in liver transplantation for alcoholic cirrhosis may well be the need for lifelong post-transplant follow-up rather than the patient's pretransplant evaluation. A small number of recipients experience a relapse of alcoholism; these patients are at risk for organ damage and graft-related death. Posttransplant surveillance protocols should demonstratealcohol relapse at an early stage, thus permitting the initiation of adequate treatment. Patients with alcoholic cirrhosis are at high risk of developing head and neck, esophageal, or lung cancer. The higher risk of malignancies should be considered in the routine assessment of patients suffering from alcoholic cirrhosis. Tumor surveillance protocols for liver transplant recipients, currently being developed, should become a part of standard care; these will improve survival by permitting diagnosis at an early stage. In conclusion, the key factor

关键词： Alcoholic liver disease Liver transplantation

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Nano-revolution in hepatocellular carcinoma:A multidisciplinary odyssey-Are we there yet?

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World Journal of Hepatology 2024年第5期16卷 684-687页

作者： Howard D Lee Li-Yun Yuan Department of Medicine Division of Gastrointestinal and Liver DiseasesKeck School of Medicine of University of Southern CaliforniaLos AngelesCA 90033United States

In this editorial we comment on the review by Zhou et al reviewing the landscape of nanomedicine in the treatment of hepatocellular carcinoma(HCC).We focus on the immense potential of nanotechnology,particularly ligand-receptor mediated nanotherapy,in revolutionizing the treatment landscape of *** advan-cements in multidisciplinary treatment,HCC remains a significant global health ***-mediated nanotherapy offers the opportunity for precise drug delivery to tumor sites,targeting specific receptors overexpressed in HCC cells,thereby enhancing efficacy and minimizing side *** drug resistance and aggressive tumor biology is facilitated by nanomedicine,bypassing traditional hurdles encountered in *** include targeting glypican-3,asialoglycoprotein,transferrin receptor or folic acid receptors,capitalizing on their over-expression in tumor *** ability for multi-receptor targeting through dual-ligand nanoparticle modification holds the prospect of further enhancement in specificity and efficacy of directed ***,challenges including immune responses,reproducibility in nanoparticle synthesis,and production scalability *** directions involve refining targeting strategies,improving drug release mechanisms,and streamlining production processes to enable personalized and multifunctional ***,the integration of nanotherapy in HCC treatment holds immense promise,but continued partnership and effort are needed in offering hope for more effective,precise,and accessible clinical care in the management of HCC.

关键词： Hepatocellular carcinoma Nanomedicine Ligand-receptor mediated nanotherapy Precision medicine Personalized medicine Targeting

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A data directory to facilitate investigations on worldwide wildlife trafficking

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Big Earth Data 2023年第2期7卷 338-348页

作者： Meredith L.Gore rowan Hilend Jonathan OPrell Emily Griffin John r.Macdonald Burcu B.Keskin Aaron Ferber Bistra Dilkina Department of Geographical Sciences University of MarylandCollege ParkUSA Department of Supply Chain Management Michigan State UniversityEast LansingUSA Department of Information Sciences Statisticsand Management ScienceUniversity of AlabamaTuscaloosaUSA Operations and Information Management division Babson CollegeWellesleyUSA Supply Chain Management Department of ManagementColorado State UniversityFort CollinsUSA Verterbi School of Engineering University of Southern CaliforniaLos AngelesUSA

Wildlife trafficking is a global phenomenon posing many negative impacts on socio-environmental *** exploration of wildlife trafficking trends and the impact of interventions is significantly encumbered by a suite of data reuse *** describe a novel,open-access data directory on wildlife trafficking and a corresponding visualization tool that can be used to identify data for multiple purposes,such as exploring wildlife trafficking hotspots and convergence points with other crime,discovering key drivers or deterrents of wildlife trafficking,and uncovering structural *** searches,expert elicitation,and peer-reviewed publications were used to search for extant sources used by industry and non-profit organizations,as well as those leveraged to publish academic research *** open-access data directory is designed to be a living document and searchable according to multiple *** directory can be instrumental in the data-driven analysis of unsustainable illegal wildlife trade,supply chain structure via link prediction models,the value of demand and supply reduction initiatives via multi-item knapsack problems,or trafficking behavior and transportation choices via network interdiction problems.

关键词： Illegal wildlife trade supply chain operations management interdiction conservation

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比较OCT检测的视网膜神经纤维层厚度和光盘算法对青光眼的检测性能

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世界核心医学期刊文摘(眼科学分册) 2006年第4期 6-7页

作者： Manassakorn A. Nouri-Mahdavi K. Caprioli J. 张磊 Dr.Glaucoma division Jules Stein Eye Institute University of California Los Angeles Los Angeles CA United States

PUrPosE: To compare the performance of the retinal nerve fiber layer (rNFL) thickness and optic disk algorithms as determined by optical coherence tomography to detect glaucoma. DESIGN: Observational cross-sectional study. METHODS: setting: academic tertiary-care center. study population: One eye from 42 control subjects and 65 patients with openangle glaucoma with visual acuity of ≥20/40, and no other ocular pathologic condition. observation procedures: Two optical coherence tomography algorithms were used: “fast rNFL thickness”and “fast optic disk.”main outcome measures: Area under the receiver operating characteristic curves and sensitivities at fixed specificities were used. Discriminating ability of the average rNFL thickness and rNFL thickness in clock-hour sectors and quadrants was compared with the parameters that were derived from the fast optic disk algorithm. Classification and regression trees were used to determine the best combination of parameters for the detection of glaucoma. rESULTS: The average visual field mean deviation (±SD) was 0.0±1.3 and -5.3±5.0 dB in the control and glaucoma groups, respectively. The rNFL thickness at the 7 o’clock sector, inferior quadrant, and the vertical C/D ratio had the highest area under the receiver operating characteristic curves(0.93±0.02, 0.92±0.03, and 0.90±0.03, respectively). At 90%specificity, the best sensitivities (±SE) from each algorithm were 86%±3%for rNFL thickness at the 7 o’clock sector and 79%±4%for horizontal integrated rim width (estimated rim area). The combination of inferior quadrant rNFL thickness and vertical C/D ratio achieved the best classification (misclassi-fication rate, 6.2%). CONCLUSION: The fast optic disk algorithm performs as well as the fast rNFL thickness algorithm for discrimination of glaucoma from normal eyes. A combination of the two algorithms may provide enhanced diagnostic performance.

关键词：视网膜神经纤维层厚度 rNFL OCT 青光眼光盘检测性能算法

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Improved Outcomes Following Hepatocellular Carcinoma(HCC)Diagnosis in Patients Screened for HCC in a Large academic Liver Center versus Patients Identified in the Community

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Journal of Clinical and Translational Hepatology 2017年第1期5卷 31-34页

作者： Nneoma Okoronkwo Yucai Wang Capecomorin Pitchumoni Baburao Koneru Nikolaos Pyrsopoulos Department of Medicine Rutgers New Jersey Medical SchoolNew JerseyUSA division of Gastroenterology Hepatology and Clinical NutritionSaint Peters University HospitalNew JerseyUSA Department of Surgery Rutgers New Jersey Medical SchoolNew JerseyUSA division of Gastroenterology and Hepatology Rutgers New Jersey Medical SchoolNew JerseyUSA

Background and Aims:Hepatocellularcarcinoma(HCC)isthe sixth most commonly occurring cancer *** and adherence to HCC surveillance guidelines has been associated with earlier *** sought to evaluate characteristics and outcomes following HCC diagnosis in patients screened for HCC in a large academic liver center versus patients diagnosed and referred from the ***:We reviewed the records of patients diagnosed with HCC in the liver center of an academic institution from January 1999 till December *** were classified into two groups:patients followed in our hepatology clinic and patients with HCC recently referred to our *** analysis was performed using chi-squared test and multivariate analysis was performed using SPSS ***:The records of 410 patients were reviewed,and included 77.3%of patients referred from the community and 22.7%of patients followed in our *** the clinic group,75.6%were identified with one nodule at initial diagnosis,compared to 65.6%in the referral *** in the referral group were more likely to present with tumors≥5 cm at diagnosis,with 28.7%compared to 5.4%in the clinic group(Preferred from the community were also less likely to undergo transplant,with 32.2%as compared to 48.4%of the clinic group(Pronic liver disease managed in an academic liver center present in the early stage of HCC diagnosis and are more likely to meet the Milan criteria and undergo *** referral to a specialized transplant center,if feasible,where a multidisciplinary approach is utilized might be essential in the management of chronic liver disease.

关键词： Hepatocellular carcinoma Liver transplant Tumor

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New imaging technologies for robotic kidney cancer surgery

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Asian Journal of Urology 2022年第3期9卷 253-262页

作者： Stefano Puliatti Ahmed Eissa Enrico Checcucci Pietro Piazza Marco Amato Stefania Ferretti Simone Scarcella Juan Gomez rivas Mark Taratkin Jose Marenco Ines Belenchon rivero Karl-Friedrich Kowalewski Giovanni Cacciamani Ahmed El-Sherbiny Ahmed Zoeir Abdelhamid MEl-Bahnasy ruben De Groote Alexandre Mottrie Salvatore Micali Urology Department University of Modena&Reggio EmiliaModenaItaly OrSI Academy MelleBelgium Urology Department Faculty of MedicineTanta UniversityTantaEgypt Department of Surgery Candiolo Cancer InstituteFPO-IRCCSCandioloTurinItaly division of Urology IRCCS Azienda Ospedaliero-Universitaria di BolognaBolognaItaly Department of Urology Polytechnic University of Marche RegionUmberto I Hospital“Ospedali Riuniti”AnconaItaly Uro-technology and SoMe Working Group of the Young academic Urologists Working Party European Association of UrologyArnhemthe Netherlands Department of Urology Hospital Clinico San CarlosMadridSpain Institute for Urology and reproductive Health Sechenov UniversityMoscowRussia Department of Urology Fundacio´n Instituto Valenciano de Oncologı´aValenciaSpain Urology and Nephrology Department Virgen del Rocı´o University HospitalManuel Siurot Sin NumeroSevilleSpain Department of Urology and Urological Surgery University Medical Centre MannheimMannheimGermany USC Institute of Urology University of Southern CaliforniaLos AngelesCAUSA Department of Urology Onze-Lieve-VrouwziekenhuisAalstBelgium

Objective:Kidney cancers account for approximately 2%of all newly diagnosed cancer in *** the primary treatment options for kidney cancer,urologist may choose between radical or partial nephrectomy,or ablative ***,robotic-assisted partial nephrectomy(rAPN)for the management of renal cancers has gained popularity,up to being considered the gold ***,rAPN is a challenging procedure with a steep learning ***:In this narrative review,different imaging technologies used to guide and aid rAPN are ***:Three-dimensional visualization technology has been extensively discussed in rAPN,showing its value in enhancing robotic-surgery training,patient counseling,surgical planning,and intraoperative *** imaging technologies such as intracorporeal ultrasound,near-infrared fluorescent imaging,and intraoperative pathological examination can also be used to improve the outcomes following ***,artificial intelligence may play a role in the field of rAPN ***:rAPN is a complex surgery;however,many imaging technologies may play an important role in facilitating it.

关键词： Kidney cancer Imaging Technology robotic

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Early vs late oral nutrition in patients with diabetic ketoacidosis admitted to a medical intensive care unit

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World Journal of Diabetes 2019年第1期10卷 57-62页

作者： Kirill Lipatov Kevin K Kurian Courtney Shaver Heath D White Shekhar GhamANDe AlejANDro C Arroliga Salim Surani Department of Internal Medicine Division of Pulmonary Critical Care and Sleep MedicineBaylor Scott and White Health Department of Biostatistics Baylor Scott and White Health Department of Medicine Texas A and M University

BACKGrOUND Diabetic ketoacidosis(DKA) has an associated mortality of 1% to 5%. Upon admission, patients require insulin infusion and close monitoring of electrolyte and blood sugar levels with subsequent transitioning to subcutaneous insulin and oral nutrition. No recommendations exist regarding the appropriate timing for initiation of oral *** To assess short-term outcomes of oral nutrition initiated within 24 h of patients being admitted to a medical intensive care unit(MICU) for *** A retrospective observational cohort study was conducted at a single academic medical center. The patient population consisted of adults admitted to the MICU with the diagnosis of DKA. Baseline characteristics and outcomes were compared between patients receiving oral nutrition within(early nutrition group) and after(late nutrition group) the first 24 h of admission. The primary outcome was 28-d mortality. Secondary outcomes included 90-d mortality, MICU and hospital lengths of stay(los), and time to resolution of *** There were 128 unique admissions to the MICU for DKA with 67 patientsreceiving early nutrition and 61 receiving late nutrition. The APACHE(Acute Physiology and Chronic Health Evaluation) IV mortality and los scores and DKA severity were similar between the groups. No difference in 28-or 90-d mortality was found. Early nutrition was associated with decreased hospital and MICU los but not with prolonged DKA resolution, anion gap closure, or greater rate of DKA *** In patients with DKA, early nutrition was associated with a shorter MICU and hospital los without increasing the rate of DKA complications.

关键词： Diabetes mellitus Diabetic ketoacidosis Diabetic complications Acidosis Ketosis Critical care

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Isolation and Characterization of Multipotent and Pluripotent Stem Cells from Human Peripheral Blood

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Stem Cell Discovery 2015年第3期5卷 19-32页

作者： Ciro Gargiulo Van Hung Pham Nguyen Thuy Hai Kieu C. D. Nguyen Pham Van Phuc Kenji Abe Veronica Flores Melvin Shiffman division of Internal Medicine The Human Medicine International Clinic Ho Chi Minh City Vietnam Molecular Diagnostics Department Nam Khoa-Biotek Laboratory Ho Chi Minh City Vietnam division of Pathology The Human Medicine International Clinic Ho Chi Minh City Vietnam Department of Stem Cells and regenerative Medicine University of Natural Science Ho Chi Minh City Vietnam Department of Pathology National Institute of Infectious Diseases Tokyo Japan Sol Price School of Public Policy University of Southern California Los Angeles USA Section of Surgery Newport Specialty Hospital Tustin USA

Stem cells are commonly classified based on the developmental stage from which they are isolated, although this has been a source of debate amongst stem cell scientists. A common approach classifies stem cells into three different groupings: Embryonic Stem Cells (ESCs), Umbilical Cord Stem Cells (UCBSCs) and Adult Stem Cells (ASCs), which include stem cells from bone marrow (BM), fat tissue (FT), engineered induced pluripotent (IP) and peripheral blood (PB). By definition stem cells are progenitor cells capable of self-renewal and differentiation hypothetically “ab infinitum” into more specialized cells and tissue. The main intent of this study was to determine and characterize the different sub-groups of stem cells present within the human PB-SCs that may represent a valid opportunity in the field of clinical regenerative medicine. Stem cells in the isolated mononucleated cells were characterized using a multidisciplinary approach that was based on morphology, the expression of stem cell markers by flowcytometry and fluorescence analysis, rT-PCr and the capacity to self-renew or proliferate and differentiate into specialized cells. This approach was used to identify the expression of hematopoietic, mesenchymal, embryonic and neural stem cell markers. Both isolated adherent and suspension mononucleated cells were able to maintain their stem cell properties during in-vitro culture by holding their capacity for proliferation and differentiation into osteoblast cells, respectively, when exposed to the appropriate induction medium.

关键词： Human Peripheral Blood Stem Cells Mesenchymal Stem Cells Hematopoietic Stem Cells Embryonic Stem Cells Neural Stem Cells

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Assessment of the July effect in post-endoscopic retrograde cholangiopancreatography pancreatitis:Nationwide Inpatient Sample

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World Journal of Gastrointestinal Endoscopy 2017年第7期9卷 296-303页

作者： Allison r Schulman Marwan S Abougergi Christopher C Thompson division of Gastroenterology Hepatology and EndoscopyBrigham and Women’s HospitalHarvard Medical School Catalyst Medical Consulting LLC

To assess incidence of post-endoscopic retrograde cholangiopancreatography (post-ErCP) pancreatitis in the early (July/August/September) vs the late (April/May/June) academic year and evaluate in-hospital mortality, length of stay (los), and total hospitalization charge between these time periods. METHODSThis was a retrospective cohort study using the 2012 Nationwide Inpatient Sample (NIS). Patients with International Classification of Diseases, 9th revision, Clinical Modification (ICD-9 CM) procedure codes for ErCP were included. Patients were excluded from the study if they had an ICD-9 CM code for a principal diagnosis of acute pancreatitis, if the ErCP was performed before or on the day of admission or if they were admitted to non-teaching hospitals. Post-ErCP pancreatitis was defined as an ICD-9 CM code for a secondary diagnosis of acute pancreatitis in patients who received an ErCP as delineated above. ErCPs performed during the months of July, August and September was compared to those performed in April, May and June in academic hospitals. ErCPs performed at academic hospitals during the early vs late year were compared. Primary outcome was incidence of post-ErCP pancreatitis. Secondary outcomes included in-hospital mortality, length los, and total hospitalization charge. Proportions were compared using fisher’s exact test and continuous variables using student t-test. Multivariable regression was performed. rESULTSFrom the 36480032 hospitalizations in 2012 in the United States, 6248 were included in the study (3065 in July/August/September and 3183 in April/May/June) in the 2012 academic year. Compared with patients admitted in July/August/September, patients admitted in April/May/June had no statistical difference in all variables including mean age, percent female, Charleston comorbidity index, race, median income, and hospital characteristics including region, bed size, and location. Incidence of post-ErCP pancreatitis in early vs late academi

关键词： Pancreatitis academic training Endoscopic retrograde cholangiopancreatography Endoscopy July effect

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First-line pazopanib in patients with advanced non-clear cell renal carcinoma:An Italian case series

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World Journal of Clinical Oncology 2021年第11期12卷 1037-1046页

作者： Sebastiano Buti Melissa Bersanelli Francesco Massari Ugo De Giorgi Orazio Caffo Gaetano Aurilio Umberto Basso Giacomo Carteni Claudia Caserta Luca Galli Francesco Boccardo Giuseppe Procopio Gaetano Facchini Giuseppe Fornarini Alfredo Berruti Elena Fea Emanuele Naglieri Fausto Petrelli roberto Iacovelli Camillo Porta Alessandra Mosca Medical Oncology Unit University Hospital of ParmaParma 43126Italy Medicine and Surgery Department University of ParmaParma 43126Italy division of Oncology Policlinico Sant’Orsola-Malpighi HospitalBologna 40138Italy Department of Oncology IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori(I.R.S.T.)Meldola 47014Italy Department of Medical Oncology Santa Chiara HospitalTrento 38122Italy Department of Medical Oncology Division of Urogenital and Head and Neck TumoursEuropean Institute of Oncology IRCCSMilan 20141Italy Medical Oncology Unit 3 Istituto Oncologico Veneto IOV IRCCSCastelfranco VenetoPadova 31033Italy division of Oncology Azienda Ospedaliera di Rilievo Nazionale A.CardarelliNapoli 80131Italy Medical Oncology Unit Azienda Ospedaliera S.MariaTerni 05100Italy Oncology Unit 2 University Hospital of PisaPisa 56126Italy academic Unit of Medical Oncology IRCCS San Martino Polyclinic HospitalGenova 16132Italy Medical Oncology Genitourinary Section Fondazione IRCCS Istituto Nazionale Dei TumoriMilan 20133Italy Departmental Unit of Clinical and Experimental Uro-Andrologic Oncology Istituto Nazionale Tumori IRCCS Fondazione G.PascaleNapoli 80131Italy Medical Oncology Unit Istituto di Ricovero e Cura a Carattere Scientifico(IRCCS)Ospedale Policlinico San MartinoGenova 16132Italy University of Brescia ASST-Spedali CiviliBresciaBrescia 25123Italy Medical Oncology Unit S Croce and Carle Teaching HospitalCuneo 12100Italy division of Medical Oncology Istituto Tumori G Paolo IIIRCCSBari 70124Italy Medical Oncology Unit ASST Bergamo OvestTreviglioBergamo 24047Italy Medical Oncology Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00161Italy division of Oncology AOU Consorziale Policlinico di BariBari 70124Italy Department of Biomedical Sciences and Human Oncology University of Bari"A.Moro"Bari 70124Italy multidisciplinary Outpatient Oncology Clinic Candiolo Cancer InstituteFPO-IRCCSCandioloTurin 10060Italy

BACKGrOUND Non-clear cell(ncc)metastatic renal-cell carcinoma(rCC)has dismal results with standard systemic therapies and a generally worse prognosis when compared to its clear-cell *** systemic combination therapies have emerged for metastatic rCC(mrCC),but the pivotal phase III trials excluded patients with nccrCC,which constitute about 30%of metastatic rCC *** To provide a piece of real-life evidence on the use of pazopanib in this patient *** The present study is a multicenter retrospective observational analysis aiming to assess the activity,efficacy,and safety of pazopanib as first-line therapy for advanced nccrCC patients treated in a real-life *** Overall,48 patients were *** the median follow-up of 40.6 mo,the objective response rate was 27.1%,the disease control rate was 83.3%,and the median progression-free survival and overall survival were 12.3(95%confidence interval[CI]:3.6-20.9)and 27.7(95%CI:18.2-37.1)mo,*** 3 adverse events occurred in 20%of patients,and no grade 4 or 5 toxicities were *** Pazopanib should be considered as a good first-line option for metastatic rCC with variant histology.

关键词： Pazopanib Non-clear cell Kidney cancer renal-cell carcinoma Variant histology Tyrosine kinase inhibitors

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