8,799 research outputs found
Interpatient heterogeneity in hepatic microvascular blood flow during vascular inflow occlusion (Pringle manoeuvre).
No full textHepatic inflow occlusion (Pringle manoeuvre), is a widely used technique, consisting in temporary intermittent or continuous clamping of the hepatic pedicle. This technique was described in 1908 by Pringle to minimize blood loss during emergency surgery for liver trauma. Therefore, in hepatobiliary surgery, the Pringle manoeuvre assumes a primary role especially in complex liver resections where an intraoperative blood loss could be significant. Afterwards, selective vascular occlusions, notably the glissonean approach described by Takasaki (1), were proposed as an alternative to the Pringle manoeuvre to decrease oxidative stress and postoperative complications in major and minor liver resections. However, this technique also presents some drawbacks as it can increase post-hepatectomy liver failure (PHLF) secondary to prolonged ischemia, especially on fibrotic or cirrhotic livers
The counterclock-clockwise approach for central hepatectomy: A useful strategy for a safe vascular control.
No full textn
Active Courts and Menu Contracts
No full textWe describe and analyze a contractual environment that allows a role for an active court. The model we analyze is the same as in Anderlini, Felli, and Postlewaite (2006). An active court can improve on the outcome that the parties would achieve without it. The institutional role of the court is to maximize the parties’ welfare under a veil of ignorance. In Anderlini, Felli, and Postlewaite (2006) the possibility of “menu contracts” between the informed buyer and the uninformed seller is described but not analyzed. Here, we fully analyze this case. We find that if we maintain the assumption that one of the potential objects of trade is not contractible ex-ante, the results of Anderlini, Felli, and Postlewaite (2006) survive intact. If however we let all “widgets” be contractible ex-ante, then multiple equilibria obtain. In this case the role for an active court is to ensure the inefficient pooling equilibria do not exist alongside the superior ones in which separation occurs.optimal courts, informational externalities, ex-ante welfare, informed principal, menu contracts
Treatment strategies for neuroendocrine liver metastases: a systematic review.
No full textBACKGROUND
Gastroenteropancreatic neuroendocrine tumors are often diagnosed when metastatic. The liver is the main site of metastases. Unfortunately, optimal management of neuroendocrine liver metastases remains a topic of debate. The aim of this study was to make a systematic review of the current literature about the results of the different treatments of neuroendocrine liver metastases.
METHODS
A systematic review was conducted for English language publications from 1995 to 2021. Outcomes were analyzed according to survival, disease-free survival, and in the case of systemic therapies, progression-free survival.
RESULTS
5509 patients were analyzed in the review. 67% of patients underwent surgery achieving 5 years overall survival despite only 30% percent without a recurrence. 60% of patients that had received a transplant reached 5 years survival with a low disease-free survival rate (20%). Five-year survival rate was 36.2% for patients undergoing loco-regional therapies.
CONCLUSION
Surgical resection is the best treatment when metastases are resectable, with the highest rate of survival, although liver transplantation shows good results for patients not eligible for surgery. Loco-regional therapies may be useful when surgical resection is contraindicated, or selectively used as a bridge to surgery or transplantation. Systemic therapies are indicated in patients for whom curative treatment cannot be obtained
ROSENTHAL, Eric Inventory of documents
No full textCOVERAGE 1904; 1 File; 011 metre.Private papers of Eric Rosenthal, author, journalist and broadcaster
Prepancreatic common hepatic artery arising from superior mesenteric artery: an exceptional but important finding during pancreaticoduodenectomy.
No full textPURPOSE
The hepato-mesenteric trunk is an extremely rare condition in which the common hepatic artery (CHA) originates from the superior mesenteric artery (SMA). Usually, CHA passes behind the head of the pancreas. A systematic review was performed to provide guidelines for the perioperative management of patients with this anatomical variation who underwent a pancreaticoduodenectomy (PD). A case report was also included.
METHODS
A systematic search of the literature was conducted and the manuscript was structured following point-by-point the PRISMA guidelines. The risk of bias within individual studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist tools. Case report was structured according to the CARE guidelines.
RESULTS
After an initial selection of 141 titles, 9 articles were included in the study (n = 10 patients). A postoperative surgical complication which required a reintervention occurred only one time. In four patients, CHA had a posterior position relative to pancreas, while in three cases, it was anterior. The remaining three patients had an intrapancreatic course. The CHA was resected in two patients, with an end-to-end reconstruction or using the splenic artery stump. In only three patients, a preoperative multidisciplinary presentation was performed and in four cases, the CHA variation was not described by radiologists in formal CT-scan reports.
CONCLUSION
Although there are no definitive guidelines, improvements in the preoperative knowledge of such a rare anatomical variation may ensure better postoperative outcomes, avoiding intraoperative accidents and life-threatening postoperative complications
Liver ischemia-reperfusion injury: From trigger loading to shot firing.
No full textAn ischemia-reperfusion injury (IRI) results from a prolonged ischemic insult followed by the restoration of blood perfusion, being a common cause of morbidity and mortality, especially in liver transplantation. At the maximum of the potential damage, IRI is characterized by 2 main phases. The first is the ischemic phase, where the hypoxia and vascular stasis induces cell damage and the accumulation of damage-associated molecular patterns and cytokines. The second is the reperfusion phase, where the local sterile inflammatory response driven by innate immunity leads to a massive cell death and impaired liver functionality. The ischemic time becomes crucial in patients with underlying pathophysiological conditions. It is possible to compare this process to a shooting gun, where the loading trigger is the ischemia period and the firing shot is the reperfusion phase. In this optic, this article aims at reviewing the main ischemic events following the phases of the surgical timeline, considering the consequent reperfusion damage
tritrophic-dispersal-model: Code used for creating figures for "Non-hierarchical dispersal promotes stability and resilience in a tri-trophic metacommunity"
No full text<p>This is the commented code used for creating figures for the paper. Any questions regarding the code should be directed to the corresponding author and repository owner (Eric Pedersen). </p>
Eric Velazquez Spanish Language Picture Book Award 2022 Acceptance Speech
No full textAuthor Eric Velazquez gives his Silver Medal acceptance speech for Pulpo Guisado (Holiday House)https://educate.bankstreet.edu/spanishlanguageaward/1001/thumbnail.jp
Eric C. Lincoln, Professor of Sociology and Religion, 1971
No full textThis is an interview with Eric C. Lincoln. Eric was a Professor of Sociology and religion, Union Theological Seminary and author of many books and articles on Negro history. In this recording the contributors discuss local memphis politics, sociology, and race relations compared to that of other cities in the South and the rest of the country
- …
