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Liver transplantation for hepatocellular carcinoma in India: Are we ready for 2040?

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World Journal of Transplantation 2024年第1期14卷 141-153页

作者： Hirak Pahari Amruth Raj Ambreen Sawant Dipak S Ahire Raosaheb Rathod Chetan Rathi Tushar Sankalecha Sachin Palnitkar Vikram Raut Department of Liver Transplant and HPB Surgery Medicover HospitalsNavi Mumbai 410210MaharashtraIndia Department of Liver Transplant Anaesthesia Medicover HospitalsNavi Mumbai 410210MaharashtraIndia Department of Gastroenterology and Hepatology Medicover HospitalsNavi Mumbai 410210India Department of Gastroenterology and Hepatology Medicover HospitalsNavi Mumbai 410210MaharashtraIndia Department of Gastroenterology and Hepatology Medicover HospitalsAurangabad 431003India Department of Gastroenterology and Hepatology Medicover HospitalsNashik 422009India Department of Gastroenterology and Hepatology Medicover HospitalsPune 411026India

BACKGROUND Liver transplantation(LT)for hepatocellular carcinoma(HCC)has been widely researched and is well established *** cornerstone of this treatment lies in the various criteria formulated by expert consensus and *** variations among the criteria are staggering,and the short-and long-term outcomes are *** To study the differences in the current practices of LT for HCC at different centers in India and discuss their clinical implications in the *** We conducted a survey of major centers in India that performed LT in December 2022.A total of 23 responses were *** centers were classified as high-and low-volume,and the current trend of care for patients undergoing LT for HCC was *** Of the 23 centers,35%were high volume center(>500 Liver transplants)while 52%were high-volume centers that performed more than 50 transplants/*** 39%of centers had performed>50 LT for HCC while the percent distribution for HCC in LT patients was 5%–15%in approximately 73%of the *** a few,most centers were divided equally between University of California,San Francisco(UCSF)and center-specific criteria when choosing patients with HCC for LT,and most(65%)did not have separate transplant criteria for deceased donor LT and living donor LT(LDLT).Most centers(56%)preferred surgical resection over LT for a Child A cirrhosis patient with a resectable 4 cm HCC ***-emission tomography-computed tomography(CT)was the modality of choice for metastatic workup in the majority of centers(74%).Downstaging was the preferred option for over 90%of the centers and included transarterial chemoembolization,transarterial radioembolization,stereotactic body radiotherapy and atezolizumab/bevacizumab with varied *** alphafetoprotein(AFP)cut-off was used by 74%of centers to decide on transplantation as well as to downstage tumors,even if they met the *** criteria for successful downstaging v

关键词： Hepatocellular carcinoma Liver transplant India Downstaging Survey Milan University of California,San Francisco Portal vein tumor thrombus Expanded criteria

Laparoscopic management of remnant gall bladder with stones: Lessons from a tertiary care centre's experience

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Laparoscopic, Endoscopic and Robotic Surgery 2024年第1期7卷 27-33页

作者： Gilbert Samuel Jebakumar Jeevanandham Muthiah Loganathan Jayapal R.Santhosh Kumar Siddhesh Tasgaonkar K.S.Santhosh Anand J.K.A.Jameel Sudeepta Kumar Swain K.J.Raghunath Prasanna Kumar Reddy Tirupporur Govindaswamy Balachandar Department of Surgical Gastroenterology Apollo HospitalsChennai 600006India Department of General Surgery Apollo HospitalsChennai 600006India Department of Minimal Access Surgery Apollo HospitalsChennai 600006India

Objective:Laparoscopic cholecystectomy is currently the gold standard for treating symptomatic gallstone *** its success,approximately 10%of patients may experience persistent biliary symptoms,leading to the post-cholecystectomy syndrome.A remnant gallbladder with cystic duct or bile duct stones is one of the causes of this *** objective of this study was to shed light on the clinical manifestations,evaluation,therapeutic strategies,and outcomes associated with laparoscopic management of symptomatic remnant ***:This was a retrospective study,conducted over a five-year period(January 2017 to December 2022)at Apollo hospitals in South *** patients who underwent laparoscopic completion cholecystectomy for a remnant gall bladder were *** following data were collected:patient demographics,symptoms,preoperative investigations,intraoperative details and post operative ***:In total,36 patients were included and *** majority of patients were male(25,69.4%),with a mean age of 50.7±12.1 *** most common presentation was pain in the upper abdomen or right upper quadrant region(24,66.7%).The laparoscopic approach was attempted in all patients,with a success rate of 94.4%.Two patients required conversion to open *** fistula to the colon was observed in one *** was observed in 7 patients(19.4%),and stone clearance was successfully achieved using endoscopic retrograde cholangiopancreatography in all patients ***:Incomplete gall bladder removal either intentionally or unintentionally leaves a remnant gall bladder that is at risk for stone formation and *** who have this clinical entity with symptoms require a redo or complete cholecystectomy,a complex procedure associated with certain *** study highlights the feasibility and safety of laparoscopic completion cholecystectomy for the management of remnant gallbladder

关键词： Remnant gall bladder Stump cholecystitis Subtotal cholecystectomy Laparoscopic completion cholecystectomy

Pathological and Physiological High-frequency Oscillations on Electroencephalography in Patients with Epilepsy

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Neuroscience Bulletin 2024年第5期40卷 609-620页

作者： Hongyi Ye Cong Chen Shennan A.Weiss Shuang Wang Department of Neurology Epilepsy CenterSecond Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou310009China Department of Neurology State University of New York DownstateBrooklynNY11203USA Department of Physiology and Pharmacology State University of New York DownstateBrooklynNY11203USA Department of Neurology New York City Health+Hospitals/Kings CountyBrooklynNY11203USA

High-frequency oscillations(HFOs)encompass ripples(80 Hz–200 Hz)and fast ripples(200 Hz–600 Hz),serving as a promising biomarker for localizing the epileptogenic zone in *** fast ripples are always pathological,while ripples may be physiological or *** physiological from pathological ripples is important not only for designating epileptogenic brain regions,but also for investigations that study ripples in the context of memory encoding,consolidation,and recall in patients with *** studies have sought to identify distinguishing features between pathological and physiological ripples over the past two *** and pathological ripples differ with respect to their spatial location,cellular mechanisms,morphology,and coupling with background electroencephalographic *** studies have demonstrated that differentiating between pathological and physiological ripples can improve surgical outcome *** this review,we summarize the characteristics,differences,and applications of pathological and physiological HFOs and discuss strategies for their clinical translation.

关键词： Ripples Epilepsy Memory Sleep Surgical outcome

The diagnostic conundrum in necrotizing otitis externa

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2024年第1期10卷 59-65页

作者： Abiya A.Ahmed Shaan Rashid Vinay K.Gupta Neil C.Molony Keshav K.Gupta Bradford Royal Infirmary Bradford Teaching Hospitals NHS Foundation TrustWest BromwichWest YorkshireUK Sandwell and West Birmingham hospitals NHS Trust West BromwichUK Russells Hall Hospital DudleyUK

Necrotizing otitis externa(NOE)is an aggressive and fast‐evolving infection of the external auditory *** diagnoses and untreated cases can lead to severe,even fatal consequences and so early diagnosis and treatment are *** is a notoriously challenging diagnosis to *** is therefore important to understand what diagnostic modalities are available and how otolaryngologists can use them to accurately treat such an aggressive *** review aims to evaluate the different diagnostic options available in NOE and discuss their advantages and limitations,thus,providing an up‐to‐date picture of the multimodal approach required in the diagnosis of this disease.

关键词： diagnostic malignant otitis externa necrotizing osteomyelitis skull base osteomyelitis temporal bone osteomyelitis

Lin28 as a therapeutic target for central nervous system regeneration and repair

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Neural Regeneration Research 2024年第2期19卷 397-398页

作者： Shuo Wang Shuxin Li Shriners hospitals Pediatric Research Center Department of Neural SciencesLewis Katz School of Medicine at Temple UniversityPhiladelphiaPAUSA

Axon disconnection in the central nervous system(CNS) usually causes signal transduction failure and severe functional deficits in patients with neurological disorders. Currently, there is no cure for patients with CNS axon injury and they usually suffer from life-long neurological defects(e.g., paralysis, loss of sensory function, and autonomic dysfunction) and life-threatening complications(e.g., autonomic dysreflexia).

关键词： paralysis therapeutic system

Current concepts in the management of non-cirrhotic non-malignant portal vein thrombosis

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World Journal of Hepatology 2024年第5期16卷 751-765页

作者： Adam J Willington Dhiraj Tripathi Department of Hepatology University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWUnited Kingdom Department of Hepatology University Hospitals BirminghamBirmingham B152THUnited Kingdom

Non-cirrhotic non-malignant portal vein thrombosis(NCPVT)is an uncommon condition characterised by thrombosis of the portal vein,with or without extension into other mesenteric veins,in the absence of cirrhosis or intra-abdominal *** can include intestinal infarction,variceal bleeding and portal *** this article,we address current concepts in the management of NCPVT including identification of risk factors,classification and treatment,and review the latest evidence on medical and interventional management options.

关键词： Non-cirrhotic portal vein thrombosis Portal vein Mesenteric veins Venous thrombosis Portal hypertension

Risk factors for hepatocellular carcinoma associated with hepatitis C genotype 3 infection:A systematic review

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World Journal of Gastrointestinal Oncology 2024年第4期16卷 1596-1612页

作者： Hamzah Z Farooq Michael James Jane Abbott Patrick Oyibo Pip Divall Naheed Choudhry Graham R Foster Blizard Institute Queen Mary University of LondonLondon E12ATUnited Kingdom School of Health and Psychological Sciences University of LondonLondon EC1V 0HBUnited Kingdom University hospitals of Leicester Library University Hospitals of Leicester NHS TrustLeicester LE39QPUnited Kingdom

BACKGROUND Hepatitis C virus(HCV)is a blood-borne virus which globally affects around 79 million people and is associated with high morbidity and *** infection leads to cirrhosis in a large proportion of patients and often causes hepatocellular carcinoma(HCC)in people with *** the 6 HCV genotypes(G1-G6),genotype-3 accounts for 17.9%of *** genotype-3 responds least well to directly-acting antivirals and patients with genotype-3 infection are at increased risk of HCC even if they do not have *** To systematically review and critically appraise all risk factors for HCC secondary to HCV-G3 in all ***,we studied possible risk factors for HCC due to HCV-G3 in the literature from 1946 to *** This systematic review aimed to synthesise existing and published studies of risk factors for HCC secondary to HCV genotype-3 and evaluate their strengths and *** searched Web of Science,Medline,EMBASE,and CENTRAL for publications reporting risk factors for HCC due to HCV genotype-3 in all settings,*** Four thousand one hundred and forty-four records were identified from the four databases with 260 records removed as *** thousand eight hundred and eighty-four records were screened with 3514 *** hundred and seventy-one full-texts were assessed for eligibility with seven studies included for *** the seven studies,three studies were retrospective case-control trials,two retrospective cohort studies,one a prospective cohort study and one a cross-sectional study *** were based in hospital settings with four in Pakistan,two in South Korea and one in the United *** total number of participants were 9621 of which 167 developed HCC(1.7%).All seven studies found cirrhosis to be a risk factor for HCC secondary to HCV genotype-3 followed by higher age(five-studies),with two studies each showing male sex,high alpha feto-protein,directly-acting antivirals trea

关键词： Hepatocellular carcinoma Hepatitis C Genotype 3 Systematic review Blood-borne viruses Liver cancer

Hepatic vein reconstruction during hepatectomy:A feasible and underused technique

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Hepatobiliary & Pancreatic Diseases International 2024年第4期23卷 421-427页

作者： Manish Ahuja Kunal Joshi Chris Coldham Paulo Muiesan Bobby Dasari Manuel Abradelo Ravi Marudanayagam Darius Mirza John Isaac David Bartlett Nikolaos A Chatzizacharias Robert P Sutcliffe Keith J Roberts Department of HPB and Liver Transplant Surgery University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Immunology and Immunotherapy University of BirminghamBirminghamUK

Complete surgical resection(R0)of liver tumors,primary or metastatic,remains the main objective in management of primary and metastatic liver tumors[1].Tumors invading to the proximity of the hepatic venous outflow pose a peculiar challenge to achieve R0 resections,because this location may render a tumor *** median survival of patients with liver tumor without surgery is less than 12 months[2].Even with surgery,post-hepatectomy liver failure and subsequently increased mortality are the main problems associated with complex resection[3].Moreover,when the vein is affected,vein resection and subsequent reconstruction are *** resection is a standard practice in liver resection and transplantation[4],for example,hepatic vein reconstruction during a living-donor liver transplant,porto-mesenteric axis reconstruction during resection of advanced pancreatic cancer and caval reconstruction during resection of retroperitoneal ***,novel techniques like total hepatic vascular exclusion(HVE)[5],veno-venous bypass[6]and ex vivo hepatic resection[7,8]have facilitated curative resections of tumors close to one or more major hepatic veins.

关键词： hepatectomy surgery mortality

Is there sufficient evidence to support the use of antibiotic holiday just before the second stage of an infected total hip or knee arthroplasty revision surgery?

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World Journal of Orthopedics 2024年第5期15卷 483-485页

作者： Konstantinos Tsikopoulos Konstantinos Sidiropoulos Department of Orthopaedics Portsmouth Hospitals NHS University TrustPortsmouth University HospitalsPortsmouth PO63LYUnited Kingdom Emergency Department Papageorgiou General Hospital of ThessalonikiThessaloniki 54635Greece Medical School University of PatrasPatras 26504Greece

The practice of implementing an antibiotic holiday before the second stage of hip or knee arthroplasty is currently controversial due to limited evidence for this approach,as per the International Consensus Meeting 2018 on Musculoskeletal Infection.A greater understanding of this issue could augment the quality of Alrayes and Sukeik’s mini-review(2023)on diagnosing,managing,and treating periprosthetic knee ***,a significant lack of literature exists concerning the optimal duration for the antibiotic holiday,calling for more research before establishing any clinical guidelines.

关键词： Septic knee prosthesis revision Two stages Antibiotic holiday