100,821 research outputs found
Preoperative carbohydrates: what is new?
No full textPurpose of reviewThe aim of this review is to give an overview of recently published articles covering preoperative carbohydrate loading in surgical patients.Recent findingsBetween January 1, 2017, and December 31, 2019, 26 publications addressing the effect of carbohydrate load were retrieved through a systematic search. Seventeen were randomized clinical trials, three prospective observational studies and six retrospective series with case-control comparison. Most of the studies were underpowered, addressed surrogate endpoints, and variability among dose and timing of carbohydrate (CHO) treatment was high. The most recent literature endorses preoperative carbohydrate loading up to 2 h before operations as a safe treatment. The new evidence confirm that this strategy is effective in reducing perioperative insulin resistance and the proportion of hyperglycemia episodes, and improving patient well-being and comfort but without affecting surgery-related morbidity.SummaryFurther properly designed randomized clinical trials, addressing more clinically relevant endpoints such as length of hospitalization and morbidity rate, are warrant. © 2020 Lippincott Williams and Wilkins. All rights reserved
X-Ray Structure Determination Of A Dimeric Hemoglobin From Caudina arenicola
No full textThe X-ray structure of a dimeric, cyanomet-liganded hemoglobin D-chain (Hb-D) from Caudina arenicola has been determined by the molecular-replacement method. The search model was a concatenated model of three hemoglobin structures superimposed on the backbone of monomeric, hemichrome hemoglobin C-chain (Hb-C) from the same organism. Hb-D crystallizes in space group P4(1)2(1)2 with cell constants a = b = 77.0 and c = 61.5 Angstrom with one subunit in the asymmetric unit. The dimer twofold axis corresponds to a crystallographic twofold along one of the body diagonals of the unit cell. Rotation and translation searches as well as model refinement were carried out in X-PLOR with the final model having an R value of 0.19 using the data from 5.0 to 2.9 Angstrom resolution (R = 0.26 for 10.0 to 2.9 Angstrom resolution). The homodimeric structure of Caudina Hb-D features close heme-heme contacts with an Fe-Fe distance of 19.0 Angstrom. The subunit-subunit interface involves both the E and F helices from each subunit with the E helices oriented antiparallel at 50 degrees with respect to one another, similar to the quaternary structure observed for the homodimeric hemoglobin from Scapharca inaequivalvis.NIH GM 30105Robert A. Welch FoundationChemistryBiochemistr
Letter, [Author unclear] to Paulina T. Merritt
No full textHandwritten letter to Paulina Merritt from an unknown author, October 1, 1876.
Management of Pancreatic Fistula in Acute Pancreatitis
No full textSevere acute necrotizing pancreatitis can cause destruction of the main pancreatic duct, smaller ducts or pancreatic parenchyma and can lead to leakage of pancreatic juice in terms of a pancreatic fistula formation. Internal fistulas to the gastrointestinal tract, bronchi, pleural, mediastinal space, pericardium, and other organs have to be differentiated from external cutaneous fistulas. As internal fistulas are often clinically asymptomatic, they are more difficult to diagnose and may not immediately be detected. In contrast, external fistulas are observed more often and can be easily be diagnosed by analyzing the pancreatic enzyme content of the respective fluid. To differentiate between simple and complex fistulas radiological imaging should be performed. Conventional fistulography, computed tomography, magnetic resonance cholangiopancreatography, and endoscopic retrograde cholangiopancreatography (ERCP) can be used for this purpose. ERCP has the additional therapeutic value in terms of placement of a stent to bridge the leak site, which may contribute to the definitive resolution of partial pancreatic duct disruption. Simple internal and external fistulas tend to close spontaneously. Therefore, these fistulas are usually managed conservatively in the beginning using supportive regimens. If leaks do not resolve endoscopic stenting or percutaneous drainage is recommended in the majority of cases. Persistent fistulas require surgery as an alternative treatment option. Surgery usually requires a resection of the fistula-bearing pancreatic region and should be postponed as long as possible
Pre-operative dysglycemia is associated with decreased survival in patients with pancreatic neuroendocrine neoplasms
No full textBackground: Diabetes mellitus is associated with increased risk of pancreatic cancer and impaired postresection survival. For pancreatic neuroendocrine neoplasms, no evidence is available for a similar effect of diabetes mellitus. The aim of this study was to evaluate the glycemic profile in patients with pancreatic neuroendocrine neoplasms and to assess the potential impact of glycemic control on the pathology and long-term outcomes in patients undergoing resection of pancreatic neuroendocrine neoplasms. Methods: Pancreatic resections from 2001 to 2017 for pancreatic neuroendocrine neoplasms were analyzed from prospective databases. Blood glucose and HbA1c levels were collected from preoperative tests. Preoperative dysglycemia was defined as a blood glucose ≥140 mg% and/or HbA1c ≥6.5%. Uni- and multivariate analyses were performed according to the presence of perioperative dysglycemia. Survival analyses were performed by Kaplan-Meier curves and Cox-proportional hazards method. Results: Four hundred and seventeen patients were analyzed. Medical history was positive for diabetes mellitus in 88 (21.1%) patients. Blood glucose evaluation identified 30 additional patients without a prior diagnosis of diabetes mellitus who had preoperative dysglycemia. No differences regarding pathologic characteristics or outcomes were detected between diabetics and non-diabetics. Conversely, patients with dysglycemia had greater rates of metastasis (16.8% vs 27.4%; P = .027) as well as vascular, perineural, and lympho-vascular involvement than those with normal blood glucose (89.2% vs 57.4%; P < .001, 90.0% vs 65.1%; P = .046, and 89.3% vs 61.3; P = .006, respectively). Preoperative dysglycemia was associated with impaired overall survival (hazard ratio = 1.57 [1.01–2.46]) and recurrence-free survival (hazard ratio = 1.78 [1.01–3.12]). By multivariate analysis, preoperative dysglycemia was independently associated with recurrence-free survival (hazard ratio 2.32 [1.29–4.17]), together with lymph-node involvement (hazard ratio = 2.01 [1.14–3.57]) and metastatic disease (hazard ratio = 5.10 [2.73–9.55]). Conclusion: Preoperative dysglycemia, but not diabetes mellitus per se, is associated with advanced disease and impaired long-term outcomes in patients undergoing resection for a pancreatic neuroendocrine neoplasm. For those patients, closer surveillance and strict glycemic control are warranted. © 2019 Elsevier Inc
Corrigendum to “The 2016 update of the International Study Group (ISGPF) definition and grading of postoperative pancreatic fistula: eleven years after.” Surgery 2017. Mar; 161 (3):584–591. Epub Dec 28, 2016 (Surgery (2017) 161(3) (584–591), (S0039606016307577), (10.1016/j.surg.2016.11.014))
No full textThe authors regret that the name of author Charles R. Vollmer MD is incorrect in the final published version. The correct name Charles Vollmer. The authors would like to apologise for any inconvenience caused. Below is the correct order of authors: Claudio Bassi, MDa, Giovanni Marchegiani, MDa, Christos Dervenis, MD,b, Micheal Sarr, MDc, Mohammad Abu Hilal, MDd, Mustapha Adham, MDe, Peter Allen, MDf, Roland Andersson, MDg, Horacio J. Asbun, MDh, Marc G. Besselink, MDi, Kevin Conlon, MDj, Marco Del Chiaro, MDk, Massimo Falconi, MDl, Laureano Fernandez-Cruz, MDm, Carlos Fernandez-del Castillo, MDn, Abe Fingerhut, MDo, Helmut Friess, MDp, Dirk J Gouma, MDi, Thilo Hackert, MDq, Jakob Izbicki, MDr, Keith D. Lillemoe, MDn, John P. Neoptolemos, MDs, Attila Olah, MDt, Richard Schulick, MDu, Shailesh V. Shrikhande, MDv, Tadahiro Takada, MDw, Kyoichi Takaori, MDx, William Traverso, MDy, Charles Vollmer, MDz, Christopher L. Wolfgang, MDaa, Charles J. Yeo, MDbb, Roberto Salvia, MDa, Marcus Buchler, MDq, from the International Study Group on Pancreatic Surgery (ISGPS
Handwritten biographical information on Paulina T. McClung Merritt
No full textA handwritten biography of Paulina T. McClung Merritt by an unknown author, 1892.
Heterogeneous and tissue-specific regulation of effector T cell responses by IFN-gamma during Plasmodium berghei ANKA infection.
No full textIFN-γ and T cells are both required for the development of experimental cerebral malaria during Plasmodium berghei ANKA infection. Surprisingly, however, the role of IFN-γ in shaping the effector CD4(+) and CD8(+) T cell response during this infection has not been examined in detail. To address this, we have compared the effector T cell responses in wild-type and IFN-γ(-/-) mice during P. berghei ANKA infection. The expansion of splenic CD4(+) and CD8(+) T cells during P. berghei ANKA infection was unaffected by the absence of IFN-γ, but the contraction phase of the T cell response was significantly attenuated. Splenic T cell activation and effector function were essentially normal in IFN-γ(-/-) mice; however, the migration to, and accumulation of, effector CD4(+) and CD8(+) T cells in the lung, liver, and brain was altered in IFN-γ(-/-) mice. Interestingly, activation and accumulation of T cells in various nonlymphoid organs was differently affected by lack of IFN-γ, suggesting that IFN-γ influences T cell effector function to varying levels in different anatomical locations. Importantly, control of splenic T cell numbers during P. berghei ANKA infection depended on active IFN-γ-dependent environmental signals--leading to T cell apoptosis--rather than upon intrinsic alterations in T cell programming. To our knowledge, this is the first study to fully investigate the role of IFN-γ in modulating T cell function during P. berghei ANKA infection and reveals that IFN-γ is required for efficient contraction of the pool of activated T cells
Dispelling the Myths Behind First-author Citation Counts
No full textWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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