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1Acute calculous cholecystitis: Review of current best practices显示文摘Acute calculous cholecystitis(ACC) is the most frequent complication of cholelithiasis and represents one-third of all surgical emergency hospital admissions, many aspects of the disease are still a matter of debate. Knowledge of the current evidence may allow the surgical team to develop practical bedside decision-making strategies, aiming at a less demanding procedure and lower frequency of complications. In this regard, recommendations on the diagnosis supported by specific criteria and severity scores are being implemented, to prioritize patients eligible for urgency surgery. Laparoscopic cholecystectomy is the best treatment for ACC and the procedure should ideally be performed within 72h. Early surgery is associated with better results in comparison to delayed surgery. In addition, when to suspect associated common bile duct stones and how to treat them when found are still debated. The antimicrobial agents are indicated for high-risk patients and especially in the presence of gallbladder necrosis. The use of broad-spectrum antibiotics and in some cases with antifungal agents is related to better prognosis. Moreover, an emerging strategy of not converting to open, a difficult laparoscopic cholecystectomy and performing a subtotal cholecystectomy is recommended by adept surgical teams. Some authors support the use of percutaneous cholecystostomy as an alternative emergency treatment for acute Cholecystitis for patients with severe comorbidities.Carlos Augusto Gomes Cleber Soares Junior Salomone Di Saveiro Massimo Sartelli Michel Denis Kelly Camila Couto Gomes Felipe Couto Gomes Lívia Dornellas Correa Camila Brandao Alves Samuel de Fádel Guimaraes 2017World Journal of Gastrointestinal Surgery2017,9,5:18
2Using old liver grafts for liver transplantation: Where are the limits?显示文摘The scarcity of ideal liver grafts for orthotopic liver transplantation(OLT) has led transplant teams to investigate other sources of grafts in order to augment the donor liver pool. One way to get more liver grafts is to use marginal donors, a not well-defined group which includes mainly donors > 60 years, donors with hypernatremia or macrosteatosis > 30%, donors with hepatitis C virus or hepatitis B virus positive serologies, cold ischemia time > 12 h, non-heart-beating donors, and grafts from split-livers or living-related donations. Perhaps the most practical and frequent measure to increase the liver pool, and thus to reduce waiting list mortality, is to use older livers. In the past years the results of OLT with old livers have improved, mainly due to better selection and maintenance of donors, improvements in surgical techniques in donors and recipients, and intra- and post-OLT management. At the present time, sexagenarian livers are generally accepted, but there still exists some controversy regarding the use of septuagenarian and octogenarian liver grafts. The aim of this paper is to briefly review the aging process of the liver and reported experiences using old livers for OLT. Fundamentally, the series of septuagenarian and octogenarian livers will be addressed to see if there is a limit to using these aged grafts.Carlos Jiménez-Romero Oscar Caso Maestro Félix Cambra Molero Iago Justo Alonso Cristina Alegre Torrado Alejandro Manrique Municio Jorge Calvo Pulido Carmelo Loinaz Segurola Enrique Moreno González 2014World Journal of Gastroenterology2014,20,31:11
3Colorectal cancer risk in hamartomatous polyposis syndromes显示文摘Colorectal cancer(CRC) is a major cause of morbidity and mortality around the world, and approximately 5% of them develop in a context of inherited mutations leading to some form of familial colon cancer syndromes. Recognition and characterization of these patients have contributed to elucidate the genetic basis of CRC. Polyposis Syndromes may be categorized by the predominant histological structure found within the polyps. The aim of the present paper is to review the most important clinical features of the Hamartomatous Polyposis Syndromes, a rare group of genetic disorders formed by the peutz-Jeghers syndrome, juvenil polyposis syndrome and PTEN Hamartoma Tumor Syndrome(Bannayan-Riley-Ruvalacaba and Cowden Syndromes). A literature search was performed in order to retrieve the most recent and important papers(articles, reviews, clinical cases and clinical guidelines) regarding the studied subject. We searched for terms such as 'hamartomatous polyposis syndromes', 'Peutz-Jeghers syndrome', 'juvenile polyposis syndrome', 'juvenile polyp', and 'PTEN hamartoma tumour syndrome'(Cowden syndrome, Bananyan-Riley-Ruvalcaba). The present article reports the wide spectrum of disease severity and extraintestinal manifestations, with a special focus on their potential to develop colorectal and other neoplasia. In the literature, the reported colorectal cancer risk for Juvenile Polyposis, Peutz-Jeghers and PTEN Hamartoma Tumor Syndromes are 39%-68%, 39%-57% and 18%, respectively. A review regarding cancer surveillance recommendations is also presented.Fábio Guilherme Campos Marleny Novaes Figueiredo Carlos Augusto Real Martinez 2015World Journal of Gastrointestinal Surgery2015,7,3:7
4Incidence, risk factors and outcome of de novo tumors in liver transplant recipients focusing on alcoholic cirrhosis显示文摘Orthotopic liver transplantation(OLT) is an established life-saving procedure for alcoholic cirrhotic(AC) patients, but the incidence of de novo tumors ranges between 2.6% and 15.7% and is significantly increased in comparison with patients who undergo OLT for other etiologies. Tobacco, a known carcinogen, has been reported to be between 52% and 83.3% in AC patients before OLT. Other risk factors that contribute to the development of malignancies are dose-dependent immunosuppression, advanced age, viral infections, sun exposure, and premalignant lesions(inflammatory bowel disease, Barrett's esophagus). A significantly more frequent incidence of upper aerodigestive(UAD) tract, lung, skin, and kidney-bladder tumors has been found in OLT recipients for AC in comparison with other etiologies. Liver transplant recipients who develop de novo non-skin tumors have a decreased long-term survival rate compared with controls. This significantly lower survival rate is more evident in AC recipients who develop UAD tract or lung tumors after OLT mainly because the diagnosis is usually performed at an advanced stage. All transplant candidates, especially AC patients, should be encouraged to cease smoking and alcohol consumption in the pre- and postOLT periods, use skin protection, avoid sun exposure and over-immunosuppression, and have a yearly otopharyngolaryngeal exploration and chest computed tomography scan in order to prevent or reduce the incidence of de novo malignancies. Although still under investigation, substitution of calcineurin inhibitors for sirolimus or everolimus may reduce the incidence of de novo tumors after OLT.Carlos Jiménez-Romero Iago Justo-Alonso Félix Cambra-Molero Jorge Calvo-Pulido álvaro García-Sesma Manuel Abradelo-Usera Oscar Caso-Maestro Alejandro Manrique-Municio 2015World Journal of Hepatology2015,7,7:6
5Impact of an acute hemodynamic response-guided protocol for primary prophylaxis of variceal bleeding显示文摘AIM To evaluate the long-term outcome of an acute hemodynamic response-guided protocol in which acute responders to intravenous propranolol received traditional nonselective beta-blockers(NSBBs) and acute nonresponders received carvedilol.METHODS Retrospective review of a protocol for primary prophylaxis of variceal bleeding guided by the acute hemodynamic response to intravenous propranolol. Fifty-two acute responders treated with traditional NSBB(i.e. propranolol or nadolol) were compared with 24 acute nonresponders receiving carvedilol. A second hemodynamic study was performed in 27 and 13 patients, respectively. The primary endpoint was development of first or further decompensation. Secondary endpoints included death from any cause, association between acute and chronic hemodynamic response, and baseline clinical and laboratory variables related to the acute hemodynamic response.RESULTS Acute responders and acute nonresponders presented similar 1, 2, and 3-year probabilities of first decompensation(NSBB: 0%, 13.7%, 26.1% vs carvedilol: 0%, 20%, 20%, P = 0.968) or further decompensation(21.2%, 26.1%, 40.9% vs 21.2%, 50.0%, 50.0%, P = 0.525). A previous episode of hepatic encephalopathy was the only independent predictor of decompensation [hazard ratio(95% confidence interval): 8.03(2.76-23.37)]. Mortality rates were similar in acute responders and acute nonresponders with compensated(P = 0.428) or decompensated cirrhosis(P = 0.429). No clinical, laboratory, endoscopic or hemodynamic parameter predicted the acute hemodynamic response. In patients receiving traditional NSBB, the acute and chronic changes of hepatic venous pressure gradient were correlated(r = 0.59, P = 0.001). Up to 69.2% of acute nonresponders gained chronic response with carvedilol.CONCLUSION Early identification and treatment with carvedilol of acute nonresponders to intravenous propranolol improves the clinical outcome of this high-risk group of patients, probably due to its greater effects for reducing portal pressure.José Ignacio Fortea ángela Puente Patricia Ruiz Iranzu Ezcurra Javier Vaquero Antonio Cuadrado María Teresa Arias-Loste Joaquín Cabezas Susana Llerena Paula Iruzubieta Carlos Rodríguez-Lope Patricia Huelin Fernando Casafont Emilio Fábrega Javier Crespo 2018World Journal of Clinical Cases2018,6,13:6
6Embolization of splenorenal shunt associated to portal vein thrombosis and hepatic encephalopathy显示文摘Hepatic encephalopathy(HE)is a cognitive disturbance characterized by neuropsychiatric alterations.It occurs in acute and chronic hepatic disease and also in patients with portosystemic shunts.The presence of these portosystemic shunts allows the passage of nitrogenous substances from the intestines through systemic veins without liver depuration.Therefore,the embolization of these shunts has been performed tocontrol HE manifestations,but the presence of portal vein thrombosis is considered a contraindication.In this presentation we show a cirrhotic patient with severe HE and portal vein thrombosis who was submitted to embolization of a large portosystemic shunt.Case report:a 57 years-old cirrhotic patient who had been hospitalized many times for persistent HE and hepatic coma,even without precipitant factors.She had a wide portosystemic shunt and also portal vein thrombosis.The abdominal angiography confirmed the splenorenal shunt and showed other shunts.The larger shunt was embolized through placement of microcoils,and the patient had no recurrence of overt HE.There was a little increase of esophageal and gastric varices,but no endoscopic treatment was needed.Since portosystemic shunts are frequent causes of recurrent HE in cirrhotic patients,portal vein thrombosis should be considered a relative contraindication to perform a shunt embolization.However,in particular cases with many shunts and severe HE,we found that one of these shunts can be safely embolized and this procedure can be sufficient to obtain a good HE recovery.In conclusion,we reported a case of persistent HE due to a wide portosystemic shunt associated with portal vein thrombosis.As the patient had other shunts,she was successfully treated by embolization of the larger shunt.Letícia de Campos Franzoni Fábio Cardoso de Carvalho Rafael Gomes de Almeida Garzon Fábio da Silva Yamashiro Laís Augusti Lívia Alves Amaral Santos Mariana de Souza Dorna Júlio Pinheiro Baima Talles Bazeia Lima Carlos Antonio Caramori Giovanni Faria Silva Fernando Gomes Romeiro 2014World Journal of Gastroenterology2014,20,42:6
7Psychotropic drugs and liver disease:A critical review of pharmacokinetics and liver toxicity显示文摘The liver is the organ by which the majority of sub-stances are metabolized, including psychotropic drugs. There are several pharmacokinetic changes in end-stage liver disease that can interfere with the metabolization of psychotropic drugs. This fact is particularly true in drugs with extensive first--pass metabolism, highly protein bound drugs and drugs depending on phase I hepatic metabolic reactions. Psychopharmacological agents are also associated with a risk of hepatotoxicity. The evidence is insufficient for definite conclusions regarding the prevalence and severity of psychiatric drug-induced liver injury. High-risk psychotropics are not advised when there is pre-existing liver disease, and after starting a psychotropic agent in a patient with hepatic impairment, frequent liver function/lesion monitoring is advised. The authors carefully review the pharmacokinetic disturbances induced by end-stage liver disease and the potential of psychopharmacological agents for liver toxicity.Diogo Telles-Correia António Barbosa Helena Cortez-Pinto Carlos Campos Nuno B F Rocha Sérgio Machado 2017World Journal of Gastrointestinal Pharmacology and Therapeutics2017,8,1:3
8Duodenal adenoma surveillance in patients with familial adenomatous polyposis显示文摘Familial adenomatous polyposis(FAP) is a hereditary disorder caused by Adenomatous Polyposis Gene mutations that lead to the development of colorectal polyps with great malignant risk throughout life. Moreover, numerous extracolonic manifestations incorporate different clinical features to produce varied individual phenotypes. Among them, the occurrence of duodenal adenomatous polyps is considered an almost inevitable event, and their incidence rates increase as a patient's age advances. Although the majority of patients exhibit different grades of duodenal adenomatosis as they age, only a small proportion(1%-5%) of patients will ultimately develop duodenal carcinoma. Within this context, the aim of the present study was to review the data regarding the epidemiology, classification, genetic features, endoscopic features, carcinogenesis, surveillance and management of duodenal polyps in patients with FAP.Fábio Guilherme Campos Marianny Sulbaran Adriana Vaz Safatle-Ribeiro Carlos Augusto Real Martinez 2015World Journal of Gastrointestinal Endoscopy2015,7,10:3
9Acute fatty liver of pregnancy associated with severe acute pancreatitis:A case report显示文摘Acute fatty liver of pregnancy is a rare disease that affects women in the third trimester of pregnancy. Although infrequent, the disease can cause maternal mortality. The diagnosis is not always clear until the pregnancy is terminated, and significant complications, such as acute pancreatitis, can occur. Pancreatic involvement typically only occurs in severe cases after the development of hepatic and renal impairment. To date, little knowledge is available regarding how the disease causes pancreatitis. Treatment involves supportive measures and pregnancy interruption. In this report, we describe a case of a previously healthy 26-year-old woman at a gestational age of 27 wk and 6 d who was admitted with severe abdominal pain and vomiting. This case illustrates the clinical and laboratory overlap between acute fatty liver of pregnancy and pancreatitis, highlighting the difficulties in differentiating each disease. Furthermore, the hypothesis for this overlapping is presented, and the therapeutic options are discussed.Cássio Vieira de Oliveira Alecsro Moreira Julio P Baima Leticia de C Franzoni Talles B Lima Fabio da S Yamashiro Kunie Yabuki Rabelo Coelho Ligia Y Sassaki Carlos Antonio Caramori Ferno G Romeiro Giovanni F Silva 2014World Journal of Hepatology2014,6,7:3
10Efficacy of azacitidine compared with that of conventional care regimens in the treatment of higher-risk myelodysplastic syndromes: a randomised, open-label, phase III study显示文摘Pierre Fenaux Ghulam J Mufti Eva Hellstrom-Lindberg Valeria Santini Carlo Finelli Aristoteles Giagounidis Robert Schoch Norbert Gattermann Guillermo Sanz Alan List Steven D Gore John F Seymour John M Bennett John Byrd Jay Backstrom Linda Zimmerman David M 2009Lancet Oncology2009,,:2
11Dendritic cell deficiencies persist seven months after SARS-CoV-2 infection显示文摘Severe Acute Respiratory Syndrome Coronavirus(SARS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity components.Dendritic cells(DCs)play a key role in the defense against viral infections,for instance plasmacytoid DCs(pDCs),have the capacity to produce vast amounts of interferon-alpha(IFN-α).In COVID-19 there is a deficit in DC numbers and IFN-αproduction,which has been associated with disease severity.In this work,we described that in addition to the DC deficiency,several DC activation and homing markers were altered in acute COVID-19 patients,which were associated with multiple inflammatory markers.Remarkably,previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+myeloid DCs and pDCs seven months after SARS-CoV-2 infection.Moreover,the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients,while no restoration of integrinβ7 and indoleamine 2,3-dyoxigenase(IDO)levels were observed.These findings contribute to a better understanding of the immunological sequelae of COVID-19.Alberto Pérez-Gómez Joana Vitallé Carmen Gasca-Capote Alicia Gutierrez-Valencia María Trujillo-Rodriguez Ana Serna-Gallego Esperanza Muñoz-Muela María de los Reyes Jiménez-Leon Mohamed Rafii-El-Idrissi Benhnia Inmaculada Rivas-Jeremias Cesar Sotomayor Cristina Roca-Oporto Nuria Espinosa Carmen Infante-Domínguez Juan Carlos Crespo-Rivas Alberto Fernández-Villar Alexandre Pérez-González Luis Fernando López-Cortés Eva Poveda Ezequiel Ruiz-Mateos JoséMiguel Cisneros Sonsoles Salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-Ledesma Juan Carlos Crespo-Rivas Eduardo Márquez JoséManuel Lomas Claudio Bueno Rosario Amaya JoséAntonio Lepe Jerónimo Pachón Elisa Cordero Javier Sánchez-Céspedes Manuela Aguilar-Guisado Almudena Aguilera Clara Aguilera Teresa Aldabo-Pallas Verónica Alfaro-Lara Cristina Amodeo Javier Ampuero María Dolores Avilés Maribel Asensio Bosco Barón-Franco Lydia Barrera-Pulido Rafael Bellido-Alba Máximo Bernabeu-Wittel Candela Caballero-Eraso Macarena Cabrera Enrique Calderón Jesús Carbajal-Guerrero Manuela Cid-Cumplido Yael Corcia-Palomo Juan Delgado Antonio Domínguez-Petit Alejandro Deniz Reginal Dusseck-Brutus Ana Escoresca-Ortega Fátima Espinosa Nuria Espinosa Michelle Espinoza Carmen Ferrándiz-Millón Marta Ferrer Teresa Ferrer Ignacio Gallego-Texeira Rosa Gámez-Mancera Emilio García Horacio García-Delgado Manuel García-Gutiérrez María Luisa Gascón-Castillo Aurora González-Estrada Demetrio González Carmen Gómez-González Rocío González-León Carmen Grande-Cabrerizo Sonia Gutiérrez Carlos Hernández-Quiles Inmaculada Concepción Herrera-Melero Marta Herrero-Romero Luis Jara Carlos Jiménez-Juan Silvia Jiménez-Jorge Mercedes Jiménez-Sánchez Julia Lanseros-Tenllado Carmina López Isabel López Álvaro López-Barrios Luis F.López-Cortés Rafael Luque-Márquez Daniel Macías-García Guillermo Martín-Gutiérrez Luis Martín-Villén JoséMolina Aurora Morillo María Dolores Navarro-Amuedo Dolores Nieto-Martín Francisco Ortega María Paniagua-García Amelia Peña-Rodríguez Esther Pérez Manuel Poyato Julia Praena-Segovia Rafaela Ríos Cristina Roca-Oporto Jesús F.Rodríguez María Jesús Rodríguez-Hernández Santiago Rodríguez-Suárez Ángel Rodríguez-Villodres Nieves Romero-Rodríguez Ricardo Ruiz Zida Ruiz de Azua Celia Salamanca Sonia Sánchez Víctor Manuel Sánchez-Montagut César Sotomayor Alejandro Suárez Benjumea Javier Toral 2021Cellular & Molecular Immunology2021,18,9:2
12Current trends of liver cirrhosis in Mexico: Similitudes and differences with other world regions显示文摘AIM To investigate the main current etiologies of cirrhosis in Mexico.METHODS We performed a cross-sectional retrospective multicenter study that included eight hospitals in different areas of Mexico. These hospitals provide health care to people of diverse social classes. The inclusion criteria were a histological, clinical, biochemical, endoscopic, or imaging diagnosis of liver cirrhosis. Data were obtained during a 5-year period(January 2012-December 2017). RESULTS A total of 1210 patients were included. The mean age was 62.5 years(SD = 12.1), and the percentages of men and women were similar(52.0% vs 48.0%). The most frequent causes of liver cirrhosis were hepatitis C virus(HCV)(36.2%), alcoholic liver disease(ALD)(31.2%), and nonalcoholic steatohepatitis(23.2%), and the least frequent were hepatitis B virus(1.1%), autoimmune disorders(7.3%), and other conditions(1.0%).CONCLUSION HCV and ALD are the most frequent causes of cirrhosis in Mexico. However, we note that non-alcoholic fatty liver disease(NAFLD) as an etiology of cirrhosis increased by 100% compared with the rate noted previously. We conclude that NAFLD will soon become one of the most frequent etiologies of liver cirrhosis in Mexico.Nahum Méndez-Sánchez Felipe Zamarripa-Dorsey Arturo Panduro Emma Purón-González Edgar Ulises Coronado-Alejandro Carlos Alejandro Cortez-Hernández Fátima Higuera de la Tijera José Luis Pérez-Hernández Eira Cerda-Reyes Heriberto Rodríguez-Hernández Vania César Cruz-Ramón Oscar Lenin Ramírez-Pérez Nancy Edith Aguilar-Olivos Olga Fabiola Rodríguez-Martínez Samantha Cabrera-Palma Guillermo Cabrera-álvarez 2018World Journal of Clinical Cases2018,6,15:2
13Impact of formal training in endoscopic submucosal dissection for early gastrointestinal cancer: A systematic review and a meta-analysis显示文摘AIM: To summarize the clinical impact of a formal training for the effectiveness and safety of endoscopic submucosal dissection for gastrointestinal cancer.METHODS: We searched databases including PubM ed, EMBASE and the Cochrane Library and Science citation Index updated to August 2014 to include eligible articles. In the Meta-analysis, the main outcome measurements were en bloc resection rate, local recurrence rate(R0) and the incidence of procedure-related complications(perforation, bleeding). RESULTS: En bloc resection was high for both, dissecting stomach tumors with an overall percentage of 93.2%(95%CI: 90.5-95.8) and dissecting colorectal tumors with an overall percentage of 89.4%(95%CI: 85.1-93.7). Although the number of studies reporting R0 resection(the dissected specimen was revealed free of tumor in both vertical and lateral margins) was small, the overall estimates for R0 resection were 81.4%(95%CI: 72-90.8) for stomach and 85.9%(95%CI: 77.5-95.5) for colorectal tumors, respectively. The analysis showed that the percentage of immediate perforation and bleeding were very low; 4.96(95%CI: 3.6-6.3) and 1.4%(95%CI: 0.8-1.9) for colorectal tumors and 3.1%(95%CI: 2.0-4.1) and 4.8%(95%CI: 2.8-6.7) for stomach tumors, respectively. CONCLUSION: In order to obtain the same rate of success of the analyzed studies it is a necessity to create training centers in the western countries during the 'several years' of gastroenterology residence first only to teach EGC diagnose and second only to train endoscopic submucosal dissection.Miguel A Tanimoto M Lourdes Guerrero Yoshinori Morita Jonathan Aguirre-Valadez Elisa Gomez Carlos Moctezuma-Velazquez Jose A Estradas-Trujillo Miguel A Valdovinos Luis F Uscanga Rikiya Fujita 2015World Journal of Gastrointestinal Endoscopy2015,7,4:2
1425 Gbps low-voltage hetero-structured silicongermanium waveguide pin photodetectors for monolithic on-chip nanophotonic architectures显示文摘Near-infrared germanium(Ge) photodetectors monolithically integrated on top of silicon-on-insulator substrates are universally regarded as key enablers towards chip-scale nanophotonics, with applications ranging from sensing and health monitoring to object recognition and optical communications. In this work, we report on the highdata-rate performance pin waveguide photodetectors made of a lateral hetero-structured silicon-Ge-silicon(Si-Ge-Si) junction operating under low reverse bias at 1.55 μm. The pin photodetector integration scheme considerably eases device manufacturing and is fully compatible with complementary metal-oxide-semiconductor technology. In particular, the hetero-structured Si-Ge-Si photodetectors show efficiency-bandwidth products of^9 GHz at-1 V and ~30 GHz at-3 V, with a leakage dark current as low as ~150 nA, allowing superior signal detection of high-speed data traffic. A bit-error rate of 10-9 is achieved for conventional 10 Gbps, 20 Gbps, and25 Gbps data rates, yielding optical power sensitivities of-13.85 dBm,-12.70 dBm, and-11.25 dBm, respectively. This demonstration opens up new horizons towards cost-effective Ge pin waveguide photodetectors that combine fast device operation at low voltages with standard semiconductor fabrication processes, as desired for reliable on-chip architectures in next-generation nanophotonics integrated circuits.DANIEL BENEDIKOVIC LéOPOLD VIROT GUY AUBIN FARAH AMAR BERTRAND SZELAG BAYRAM KARAKUS JEAN-MICHEL HARTMANN CARLOS ALONSO-RAMOS XAVIER LE ROUX PAUL CROZAT ERIC CASSAN DELPHINE MARRIS-MORINI CHARLES BAUDOT FRéDéRIC BOEUF JEAN-MARC FéDéLI CHRISTOPHE KOPP LAURENT VIVIEN 2019Photonics Research2019,7,4:2
15Multi-objective optimization and multiple constraint handling with evolutionary algorithms-Part Ⅰ: a unified formulation 显示文摘Carlos M F Peter J F 1998IEEE Transactions on Systems Man and Cybernetics-Part A1998,28,1:2
16Analyzing predictors of graft survival in patients undergoing liver transplantation with donors aged 70 years and over显示文摘AIM To increase the number of available grafts.METHODS This is a single-center comparative analysis performed between April 1986 and May 2016. Two hundred and twelve liver transplantation(LT) were performed with donors ≥ 70 years old(study group). Then, we selected the first cases that were performed with donors < 70 years old immediately after the ones that were performed with donors ≥ 70 years old(control group).RESULTS Graft and patient survivals were similar between both groups without increasing the risk of complications, especially primary non-function, vascular complications and biliary complications. We identified 5 risk factors as independent predictors of graft survival: recipient hepatitis C virus(HCV)-positivity [hazard ratio(HR) = 2.35; 95% confidence interval(CI): 1.55-3.56; P = 0.00]; recipient age(HR = 1.04; 95%CI: 1.02-1.06; P = 0.00); donor age X model for end-stage liver disease(D-MELD)(HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); donor value of serum glutamic-pyruvic transaminase(HR = 1.00; 95%CI: 1.00-1.00; P = 0.00); and donor value of serum sodium(HR = 0.96; 95%CI: 0.94-0.99; P = 0.00). After combining D-MELD and recipient age we obtained a new scoring system that we called DR-MELD(donor age X recipient age X MELD). Graft survival significantly decreased in patients with a DR-MELD score ≥ 75000, especially in HCV patients(77% vs 63% at 5 years in HCV-negative patients, P = 0.00; and 61% vs 25% at 5 years in HCV-positive patients; P = 0.00). CONCLUSION A DR-MELD ≥ 75000 must be avoided in order to obtain the best results in LT with donors ≥ 70 years old.Oscar Caso-Maestro Carlos Jiménez-Romero Iago Justo-Alonso Jorge Calvo-Pulido David Lora-Pablos Alberto Marcacuzco-Quinto Félix Cambra-Molero Alvaro García-Sesma Marina Pérez-Flecha Carlos Munoz- Arce Carmelo Loinaz-Segurola Alejandro Manrique-Municio 2018World Journal of Gastroenterology2018,24,47:2
17Growth of Dunaliella viridis Teodoresco:effect of salinity,temperature and nitrogen concentration显示文摘Carlos Jiménez & Niell F X 1991Journal of Applied Phycology1991,3,:1
18Cerebral hemispheric lateralization in cardiac autonomic control显示文摘Byung W Y Carlos A M David F C 1997Arch Neurol1997,54,:1
19Case detection, diagno- sis, and treatment of patients with primary aldosteronism: an en- docrine society clinical practice guideline显示文摘John WF Robert MC Carlos F 2008J Clin Endocrinol Metab2008,93,9:1
20Influence of temperature and nitrogen concentration on photosynthesis of Dunaliella viridis Teodoresco显示文摘Carlos Jiménez & Niell F X 1990Journal of Applied Phycology1990,2,:1
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