Abstract Objective The aim of this study is to perform a comprehensive evaluation of 5 years of experience with the technique of isolated pancreatic anastomosis reconstruction after ...pancreatoduodenectomy from the perspective of safety and surgical efficacy using a prospective database. Methods The study included all consecutive patients undergoing pancreatoduodenectomy from April 2009 to April 2014 at a single referral center for hepato-pancreato-biliary diseases. The primary endpoint was the safety of the procedures, which was assessed as the occurrence of complications during hospitalization. Ninety-day mortality was also assessed. Postoperative pancreatic fistulas were classified as grade A, B, or C according to the International Study Group of Pancreatic Fistula classification. Results The study group included 214 consecutive patients with a median age of 60 years who underwent pancreatoduodenectomy. Portal vein resection was performed on 41 patients. Indications for resection were 165 pancreatic head tumors, 33 ampullary tumors, 7 chronic pancreatitis, 3 distal bile duct tumors, and 6 duodenal tumors. There was no perioperative or 90-day mortality in this series. Complications occurred in 68 patients (32%), and 42 patients presented with pancreatic fistulas (19.6%). Grade A fistulas were present in 38 patients. Three patients presented persistent pancreatic fistula and were treated with percutaneous drainage. One patient developed combined pancreatic and biliary fistulas and was reoperated on for pancreatic abscess drainage. Conclusions The technique of isolated pancreatic anastomosis by diverting the pancreatic from biliary secretion may contribute to reducing the severity of pancreatic fistulas and therefore the severity of this complication.
Coffee is one of the most consumed beverages in the world and is the second largest traded commodity after petroleum. Due to the great demand of this product, large amounts of residues are generated ...in the coffee industry, which are toxic and represent serious environmental problems. Coffee silverskin and spent coffee grounds are the main coffee industry residues, obtained during the beans roasting, and the process to prepare “instant coffee”, respectively. Recently, some attempts have been made to use these residues for energy or value-added compounds production, as strategies to reduce their toxicity levels, while adding value to them. The present article provides an overview regarding coffee and its main industrial residues. In a first part, the composition of beans and their processing, as well as data about the coffee world production and exportation, are presented. In the sequence, the characteristics, chemical composition, and application of the main coffee industry residues are reviewed. Based on these data, it was concluded that coffee may be considered as one of the most valuable primary products in world trade, crucial to the economies and politics of many developing countries since its cultivation, processing, trading, transportation, and marketing provide employment for millions of people. As a consequence of this big market, the reuse of the main coffee industry residues is of large importance from environmental and economical viewpoints.
Studies on mechanisms underlying the differentiation of dental pulp stem cells are critical for the understanding of the biology of odontogenesis and for dental tissue engineering. Here, we tested ...the hypothesis that stem cells from exfoliated deciduous teeth (SHED) differentiate into functional odontoblasts and endothelial cells. SHED were seeded in tooth slice/scaffolds and implanted subcutaneously into immunodeficient mice. SHED differentiated into functional odontoblasts that generated tubular dentin, as determined by tetracycline staining and confocal microscopy. These cells also differentiated into vascular endothelial cells, as determined by beta-galactosidase staining of LacZ-tagged SHED. In vitro, vascular endothelial growth factor (VEGF) induced SHED to express VEGFR2, CD31, and VE-Cadherin (markers of endothelium) and to organize into capillary-like sprouts. VEGF induced ERK and AKT phosphorylation (indicative of differentiation), while inhibiting phosphorylation of STAT3 (indicative of ‘stemness’). Collectively, this work demonstrates that SHED can differentiate into angiogenic endothelial cells and odontoblasts capable of generating tubular dentin.
Background
Recent advances in laparoscopic techniques have resulted in growing indications for laparoscopic hepatectomy. However, this procedure has not been widely developed, and anatomic segmental ...liver resection is not currently performed due to difficulty controlling the segmental Glissonian pedicles laparoscopically. This study aimed to report a novel technique for laparoscopic anatomic resection of left liver segments using the intrahepatic Glissonian approach based on small incisions according to anatomic landmarks such as Arantius’ and round ligaments.
Methods
Nine consecutive patients underwent laparoscopic liver resection using the intrahepatic Glissonian technique from April 2007 to June 2008. Five patients underwent laparoscopic bisegmentectomy 2–3, one laparoscopic left hemihepatectomy, two resections of segment 3, and one resection of segment 4.
Results
One patient required a blood transfusion. The mean operation time was 180 min (range, 120–300 min), and the median hospital stay was 3 days (range, 1–5 days). No patient had postoperative signs of liver failure or bile leakage. No postoperative mortality was observed.
Conclusion
The main advantage of the intrahepatic Glissonian procedure over other techniques is the possibility of gaining a rapid and precise access to the left Glissonian sheaths facilitating left hemihepatectomy, bisegmentectomy 2–3, and individual resections of segments 2, 3, and 4. The authors believe that the intrahepatic Glissonian technique facilitates laparoscopic liver resection and may increase the development of segment-based laparoscopic liver resection.
Hard gluon evolution in warming medium Ben, F. G.; Machado, M. V. T.
The European physical journal. C, Particles and fields,
2022/1, Letnik:
82, Številka:
1
Journal Article
Recenzirano
Odprti dostop
We describe the energy distribution of hard gluons travelling through a dense quark–gluon plasma whose temperature increases linearly with time, within a probabilistic perturbative approach. The ...results were applied to the thermalization problem in heavy ion collisions. In the weak coupling picture this thermalization occurs from “the bottom up”: high energy partons, formed early in the collision, radiate low energy gluons which then proceed to equilibrate among themselves, forming a thermal bath that brings the high energy sector to equilibrium. We see that, in this scenario, the dynamic we describe must set in around
t
∼
0.5
fm/c after the collision in order to reach a fully thermalized state at
t
∼
1
fm/c. We then look at the entropy density and average temperature of the soft thermal bath, as the system approaches (local) thermal equilibrium.
The role of the host immunity in determining leprosy clinical forms and complications is well recognized, implying that changes in the immune status may interfere with several aspects of the disease. ...Therefore, we hypothesized that the presence of viral co-infections and associated immunological changes will have a clinical impact on leprosy outcomes. The aim of our study was to determine the clinical impact of human immunodeficiency virus (HIV), human T cell lymphotrophic virus type 1 (HTLV-1), hepatitis B virus (HBV) and hepatitis C virus (HCV) co-infection on the development of reactions, neuritis, neuropathy and relapses.
Cohort study in 245 leprosy subjects from Bahia, Brazil. Patients were followed from the time of diagnosis until at least the end of multidrug therapy. Viral co-infection was detected in 36 out of the 245 patients (14.7%). Specific co-infection rates were 10.6% for HBV, 2.9% for HIV, 2.5% for HTLV-1 and 0.8% for HCV. All four groups of co-infected patients had higher rates of neuritis and nerve function impairment compared to non co-infected leprosy subjects. The relapse rate was also higher in the co-infected group (8.3%) versus patients without co-infection (1.9%); relative risk 4.37, 95% confidence interval 1.02-18.74.
Leprosy patients should be screened for HBV, HCV, HIV and HTLV-1 co-infections. Besides contributing to better health care, this measure will facilitate the early detection of severe complications through targeting of higher risk patients.
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