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| 1 | Embolization 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 | 2014 | World Journal of Gastroenterology2014，20，42： | 6 |
| 2 | Therapeutic drug monitoring in patients with inflammatory bowel disease显示文摘Thiopurine analogs and anti-tumor necrosis factor(TNF)agents have dramatically changed the therapeutics of inflammatory bowel diseases(IBD),improving short and long-term outcomes.Unfortunately some patients do not respond to therapy and others lose response over time.The pharmacokinetic properties of these drugs are complex,with high inter-patient variability.Thiopurine analogs are metabolized through a series of pathways,which vary according to the patients’pharmacogenetic profile.This profile largely determines the ratios of metabolites,which are in turn associated with likelihoods of clinical efficacy and/or toxicity.Understanding these mechanisms allows for manipulation of drug dose,aiming to reduce the development of toxicity while improving the efficacy of treatment.The efficacy of anti-TNF drugs is influenced by many pharmacodynamic variables.Several factors may alter drug clearance,including the concomitant use of immunomodulators(thiopurine analogs and methotrexate),systemic inflammation,the presence of anti-drug antibodies,and body mass.The treatment of IBD has evolved with the understanding of the pharmacologic profiles of immunomodulating and TNF-inhibiting medications,with good evidence for improvement in patient outcomesobserved when measuring metabolic pathway indices.The role of routine measurement of metabolite/drug levels and antibodies warrants further prospective studies as we enter the era of personalized IBD care. | Andres J Yarur Maria T Abreu Amar R Deshpande David H Kerman Daniel A Sussman | 2014 | World Journal of Gastroenterology2014，20，13： | 2 |
| 3 | Prognostic value of baseline FDG uptake on PET-CT in esophageal carcinoma显示文摘AIM: To evaluate the influence of baseline maximum standardized uptake value(SUVmax) on survival in a cohort of patients, undergoing positron emission tomography-computed tomography(PET-CT) scan for esophageal carcinoma. METHODS: The pre-treatment SUVmax numeric reading was determined in patients with confirmed esophageal or junctional cancer having PET-CT scan during the time period 1st January 2007 until 31 st July 2012. A minimum follow up of 12 mo was required. Patients were subdivided into quartiles according to SUVmax value and the influence of SUVmax on survival was assessed using univariate and multivariate analysis. The following pre-treatment factors were investigated: patient characteristics, tumor characteristics and planned treatment. RESULTS: The study population was 271 patients(191male) with esophageal or junctional carcinoma. The median age was 65 years(range 40-85) and histologic subtype was adenocarcinoma in 197 patients and squamous carcinoma in 74 patients. The treatment intent was radical in 182 and palliative in 89 patients. SUVmax was linked to histologic subtype(P = 0.008), tumor site(P = 0.01) and Union for International Cancer Control(UICC) stage(P < 0.001). On univariate analysis, prognosis was significantly associated with SUVmax(P = 0.001), T-stage(P < 0.001) and UICC stage(P < 0.001). On multivariate analysis, only T-stage and UICC stage remained significant. CONCLUSION: Pretreatment SUVmax was not a useful marker in isolation for determining prognosis of patients with esophageal carcinoma. | Omar S Al-Taan Amar Eltweri David Sharpe Peter M Rodgers Sukhbir S Ubhi David J Bowrey | 2014 | World Journal of Gastrointestinal Oncology2014，6，5： | 2 |
| 4 | The use of an up flow fixed bed reactor for treatment of a primary settled domestic sewage显示文摘 | Amar D Partos J | 1986 | Wat Res1986，20，1： | 1 |
| 5 | C-Reactive protein elevation predicts pulse pressure reduction in hypertensive subjects显示文摘 | Amar J Ruidavets JB Peyrieux JC | 2005 | Hypertension2005，46，1： | 1 |
| 6 | Structural and Magnetic Study of Self-doped La1-x-yCaxφyMnO3显示文摘 | Figueiras F Araùjo J P Amaral V S | 2004 | Journal of Magnetism and Magnetic Materials2004，，： | 1 |
| 7 | Development of a finite element analysis tool for fixture design integrity verification and optimization 显示文摘 | Amaral N Rencis J J Rong Y M | 2005 | The International Journal of Advanced Manufacturing Technology2005，25，5： | 1 |
| 8 | A SYBR green real-time PCR assay to detect and quantify pork meat in processed poultry meat products显示文摘 | SOARES S AMARAL J S OLIVEIRA M B P P | 2013 | Meat Science2013，94，： | 1 |
| 9 | Development and verification of a one-dimensional ablation code including pyrolysis gas flow 显示文摘 | Amar A J Blackwell B F Edwards J R | 2009 | Journal of Thermophysics and Heat Transfer2009，23，1： | 1 |
| 10 | C-reactive protein elevation predicts pulse pressure reduction in hypertensive subjects 显示文摘 | Amar J Ruidavets J B Peyfieux J C | 2005 | Hypertension2005，46，1： | 1 |
| 11 | Metabolic endotoxemia initiates obesity and insulin resistance 显示文摘 | CANI P D AMAR J IGLESIAS M A | 2007 | Diabetes2007，56，7： | 1 |
| 12 | Metabolic endotoxemia ini- tiates obesity and insulin resistance显示文摘 | Cani PD Amar J Iglesias MA | 2007 | Diabetes2007，56，7： | 1 |
| 13 | Handgrip strength at ad- mission and time to discharge in medical and surgical inpatients 显示文摘 | Mendes J Azevedo A Amaral T F | 2013 | Journal of Parenteral and Enteral Nutrition2013，，： | 1 |
| 14 | Influence of different surface conditioning protocols on microtensile bond strength of self-adhesive resin cements to dentin显示文摘 | Pisani-Proenga J Erhardt MC Amaral R | 2011 | J Prosthet Dent2011，105，4： | 1 |
| 15 | Efficient multigram synthesis of the repeating unit of gallic aeid-triethylene glycol dendrimers 显示文摘 | AMARAL S P FERNANDEZ-VILLAMARIN M CORREA J | 2011 | Organic Letters2011，13，17： | 1 |
| 16 | Anti-enteropathogenic Escherichia coli immunoglobulin Y isolated from eggs laid by immunized Leghorn chickens显示文摘 | Amaral J A Tino De Franco M Carneiro-Sampaio M M | | 0，，03： | 1 |
| 17 | On-line fault detectionof aluminium electrolytic capacitors in step-down DC-DCconverters using input current and output voltage ripple显示文摘 | Amaral A M R Cardoso A J M | 2012 | IET Power Electronics2012，5，3： | 1 |
| 18 | Relationship between CRP and pulse pressure is not mediated by atherosclerosis or aortic stiffness显示文摘 | Amar J Ruidavets JB Sollier CB | 2004 | J Hypertens2004，22，2： | 1 |
| 19 | Complex networks-augmenting the framework for the study of complex systems显示文摘 | Amaral L A N Ottino J M | 2004 | European Physical Journal B2004，8，2： | 1 |
| 20 | The use of an upflow fixed bed reactor for treatment of a primary settled domestic sewage显示文摘 | Amar D Partos J | 1986 | Wat Res1986，20，1： | 1 |
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