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1Assessment of neovascularization within carotid plaques in patients with ischemic stroke显示文摘AIM:To assess neovascularization within human ca-rotid atherosclerotic soft plaques in patients with isch-emic stroke.METHODS:Eighty-one patients with ischemic stroke and 95 patients without stroke who had soft athero-sclerotic plaques in the internal carotid artery were studied.The thickest soft plaque in each patient was examined using contrast-enhanced ultrasound.Time-intensity curves were collected from 5 s to 3 min after contrast injection.The neovascularization within the plaques in the internal carotid artery was evaluated using the ACQ software built into the scanner by 2 of the experienced investigators who were blinded to the clinical history of the patients.RESULTS:Ischemic stroke was present in 7 of 33 patients(21%) with grade Ⅰ plaque,in 14 of 51 pa-tients(28%) with grade Ⅱ plaque,in 26 of 43 patients(61%) with grade Ⅲ plaque,and in 34 of 49 patients(69%) with grade Ⅳ plaque(P < 0.001 comparing grade Ⅳ plaque with grade I plaque and with grade Ⅱ plaque and P = 0.001 comparing grade Ⅲ plaque with grade Ⅰ plaque and with grade Ⅱ plaque).Analysis of the time intensity curves revealed that patients with ischemic stroke had a significantly higher intensity of enhancement(IE) than those without ischemic stroke(P < 0.01).The wash-in time(WT) of plaque was signifi-cantly shorter in stroke patients(P < 0.05).The sensi-tivity and specificity for IE in the plaque were 82% and 80%,respectively,and for WT were 68% and 74%,respectively.There was no significant difference in the peak intensity or time to peak between the 2 groups.CONCLUSION:This study shows that the higher the grade of plaque enhancement,the higher the risk of ischemic stroke.The data suggest that the presence of neovascularization is a marker for unstable plaque.Wilbert S Aronow Chandra K Nair David Cosgrove 2010World Journal of Cardiology2010,2,4:29
2Diagnosis of Helicobacter pylori : What should be the gold standard?显示文摘Since the discovery of Helicobacter pylori(H. pylori) in 1983, numerous detection methods for the presence of the bacterium have been developed. Each one of them has been associated with advantages and disadvantages. Noninvasive tests such as serology, 13 C urea breath test(UBT) and stool antigen tests are usually preferred by the clinicians. Serology has its own limitation especially in endemic areas while 13 C UBT is technically very demanding. The stool antigen detection method, although specific, is usually associated with poor sensitivity. The 13 C UBT is believed to be specific, but with present revelation of the fact that stomach is colonized by many other urease producing bacteria makes it questionable. Histology, culture, rapid urease test and polymerase chain reaction(PCR) are the tests which are carried out on antral biopsies collected by invasive means. Histology has been proposed to be very sensitive and specific but the question is how by simply looking the morphology of the bacteria in the microscope, one can claim that the curved bacterium is exclusively H. pylori. Rapid urease test(RUT), the doctor's test, is also challenged because the presence of other urease producing bacteria in the stomach cannot be denied. Moreover, RUT has been reported with poor sensitivity specially, when density of the bacterium is low. Isolation of H. pylori is essential to investigate its growth requirements, antibiotic susceptibility testing, studying virulence factor to develop vaccine and many more explorations. It has also got several disadvantages i.e., special condition for transporting, media, incubation and few days waiting for the colonies to appear, apart from the speed essentially needed to process the specimens. Till date, majority of the microbiological laboratories in the world are not equipped and trained to isolate such fastidious bacterium. The option left is PCR methods to detect H. pylori 's DNA in gastric mucosa, gastric juice, saliva, dental plaques and environmental specimens. There are speculations for false positivity due to detection of non-pylori Helicobacters due to genetic sharing; and false negativity due to low bacterial counts and presence of PCR inhibitors. However, specimen collection, transportation and processing do not require speed and special conditions. PCR based diagnosis may be considered as gold standard by designing primers extremely specific to H. pylori and targeting at least more than one conserved genes. Similarly specificity of PCR may be improved by use of internal Primers. Further, nested PCR will take care of false negatives by countering the effect of PCR inhibitors and low bacterial counts. Therefore, nested PCR based methods if performed properly, may be proposed as gold standard test.Saurabh Kumar Patel Chandra Bhan Pratap Ashok Kumar Jain Anil Kumar Gulati Gopal Nath 2014World Journal of Gastroenterology2014,20,36:30
3美国对华反倾销的出口产品种类溢出效应探究显示文摘本文基于2000-2006年企业-产品微观数据,使用面板双重差分模型考察美国对华反倾销措施是否导致了企业内部出口产品种类发生变化。结果发现,美国对华反倾销措施显著增加了受影响企业销至美国的非倾销产品出口额和出口量,即存在出口产品种类的溢出效应,这一效应随企业所有制不同以及是否为多行业企业有所不同。进一步的研究发现,美国对华反倾销措施仅增加了非倾销产品至企业原有出口渠道的出口。因此,企业积极应对国外反倾销措施的一个有效途径是扩展新产品种类,将出口更多转移至非倾销产品上,从而稳定出口,减少反倾销措施带来的不利影响。龙小宁 方菲菲 Chandra Piyush 2018世界经济2018,0,5:26
4New-found link between microbiota and obesity显示文摘Due to the grave pathological role of obesity, worldwide research is being continued to find out the causative factors involved in it. Recent advances in this field reveal a possible relationship between the compositional pattern of gut microbiota and genesis of obesity. Several study results have shown that short-chain fatty acids(SCFAs, microbiota-induced fermentation products) and lipopolysaccharides(LPS, an integral component of Gram negative microorganisms) play the key role in linking the two. Though several SCFAs are produced as microbiota-fermentation products, three of them, i.e., butyrate, propionate and acetate have been found to be definitely involved in obesity; though individually they are neither purely obesogenic nor antiobesogenic. Out of these, butyrate and propionate are predominantly antiobesogenic. Butyrate, though a major energy source for colonocytes, has been found to increase mitochondrial activity, prevent metabolic endotoxemia, improve insulin sensitivity, possess antiinflammatory potential, increase intestinal barrier function and protect against diet-induced obesity without causing hypophagia. Propionate has been found to inhibit cholesterol synthesis, thereby antagonizing the cholesterol increasing action of acetate, and to inhibit the expression of resistin in adipocytes. Moreover, both these SCFAs have been found to cause weight regulation through their stimulatory effect on anorexigenic gut hormones and to increase the synthesis of leptin. Unlike butyrate and propionate, acetate, which is substantially absorbed, shows more obesogenic potential, as it acts as a substrate for hepatic and adipocyte lipogenesis. High fat diet increases the absorption of LPS, which, in turn, has been found to be associated with metabolic endotoxemia and to induce inflammation resulting in obesity. Multiple independent and interrelated mechanisms have been found to be involved in such linking processes which are discussed in this review work along with some possible remedial measures for prevention of weight gain and obesity.Chandra Kanti Chakraborti 2015World Journal of Gastrointestinal Pathophysiology2015,6,4:22
5MicroRNA aberrations:An emerging field for gallbladdercancer management显示文摘Gallbladder cancer(GBC) is infrequent but most lethal biliary tract malignancy characterized by an advanced stage diagnosis and poor survival rates attributed to absence of specific symptoms and effective treatment options. These necessitate development of early prognostic/predictive markers and novel therapeutic interventions. Micro RNAs(mi RNAs) are small, noncoding RNA molecules that play a key role in tumor biology by functioning like tumor suppressor- or oncogenes and their aberrant expression are associated with the pathogenesis of several neoplasms with overwhelming clinical implications. Since mi RNA signature is tissue specific, here, we focused on current data concerning the mi RNAs abberations in GBC pathogenesis. In GBC, mi RNAs with tumor suppressor activity(mi R-135-5p, mi R-335, mi R-34 a, mi R-26 a, mi R-146b-5p, Mir-218-5p, mi R-1, mi R-145, mir-130a) were found downregulated, while those with oncogenic property(mi R-20 a, mi R-182, mir-155) were upregulated. The expression profile of mi RNAs was significantly associated with GBC prognosis and prediction, and forced over-expression/ inhibition of these mi RNAs was shown to affect tumor growth and development. Further, differential expression of mi RNAs in the blood samples of GBC patients suggest mi RNAs as promising noninvasive biomarker. Thus, mi RNAs represent potential candidate for GBC management, though many hurdles need to be overcome before mi RNAs therapy can be clinically applied to GBC prevention and treatment.Vishal Chandra Jong Joo Kim Balraj Mittal Rajani Rai 2016World Journal of Gastroenterology2016,22,5:14
6Effect of preoperative biliary drainage on outcome of classical pancreaticoduodenectomy显示文摘AIM: To investigate the role of preoperative biliary drainage (PBD) in the outcome of classical pancreaticodu odenectomy. METHODS: A 10-year retrospective data analysis was performed on patients (n = 48) undergoing pancreaticoduodenectomy from March 1994 to March 2004 in department of surgery at SMS medical college, Jaipur, India. Demographic variables, details of preoperative stenting, operative procedure and post operative complications were noted. RESULTS: Preoperative biliary drainage was performed in 21 patients (43.5%). The incidence of septic complications was significantly higher in patients with biliary stent placement (P < 0.05, 0 vs 4). This group of patients also had a significantly higher minor biliary leak rate. Mortality and hospital stay in each group was comparable. CONCLUSION: Within this study population the use of PBD by endoscopic stenting was associated with a high incidence of infective complications. These findings do not support the routine use of biliary stenting in patients prior to pancreatico-duodenectomy.Chandra Shekhar Bhati Chandrashekhar Kubal Pankaj Kumar Sihag Ankur Atal Gupta Raj Kamal Jenav Nicholas G Inston Jagdish M Mehta 2007World Journal of Gastroenterology2007,13,8:12
7Role of adiponectin and some other factors linking type 2 diabetes mellitus and obesity显示文摘Because of the intimate association of obesity with type 2 diabetes mellitus(T2DM), during the last two decades, extensive research work is being conducted to find out whether the coexistence of the two is a simple association or there is a positive correlating link between the two. In this article, an attempt has been made to collect and analyse the recent developments in this field and to arrive at a conclusion on the subject. The possible role of several important factors(obtained from adipocytes/not of adipocyte origin) in linking the two has been discussed in detail. Some of the agents, specifically adiponectin, are beneficial(i.e., reduce the incidence of both), while others are harmful(i.e., increase their incidence). From the analysis, it appears that obesity and T2 DM are intimately linked.Chandra Kanti Chakraborti 2015World Journal of Diabetes2015,6,15:11
8Virtual reality simulation in endoscopy training:Current evidence and future directions显示文摘Virtual reality simulation is becoming the standard when beginning endoscopic training. It offers various benefits including learning in a low-stakes environment, improvement of patient safety and optimization of valuable endoscopy time. This is a review of the evidence surrounding virtual reality simulation and its efficacy in teaching endoscopic techniques. There have been 21 randomized controlled trials(RCTs) that have investigated virtual reality simulation as a teaching tool in endoscopy. 10 RCTs studied virtual reality in colonoscopy, 3 in flexible sigmoidoscopy, 5 in esophagogastroduodenoscopy, and 3 in endoscopic retrograde cholangiopancreatography. RCTs reported many outcomes including distance advanced in colonoscopy, comprehensive assessment of technical and non-technical skills, and patient comfort. Generally, these RCTs reveal that trainees with virtual reality simulation based learning improve in all of these areas in the beginning of the learning process. Virtual reality simulation was not effective as a replacement of conventional teaching methods. Additionally, feedback was shown to be an essential part of the learning process. Overall, virtual reality endoscopic simulation is emerging as a necessary augment to conventional learning given the ever increasing importance of patient safety and increasingly valuable endoscopy time; although work is still needed to study the nuances surrounding its integration into curriculum.Tahrin Mahmood Michael Anthony Scaffidi Rishad Khan Samir ChANDra Grover 2018World Journal of Gastroenterology2018,24,48:10
9Over expression of resistin in adipose tissue of the obese induces insulin resistance显示文摘AIM: To compare resistin mRNA expression in subcutaneous adipose tissue (SAT) and its correlation with insulin resistance (IR) in postmenopausal obese women. METHODS: A total of 68 postmenopausal women (non obese = 34 and obese = 34) were enrolled for the study. The women of the two groups were age matched (49-70 years). Fasting blood samples were collected at admission and abdominal SAT was obtained during surgery for gall bladder stones or hysterectomy. Physical parameters [age, height, weight, body mass index (BMI)] were measured. Biochemical (plasma insulin and plasma glucose) parameters were estimated by enzymatic methods. RNA was isolated by the Trizol method.SAT resistin mRNA expression was done by real time- reverse transcription polymerase chain reaction (RT-PCR) by using Quanti Tect SYBR Green RT-PCR master mix. Data was analyzed using independent Student's t test, correlation and simple linear regression analysis. RESULTS: The mean weight (52.81 ± 8.04 kg vs 79.56 ± 9.91 kg; P < 0.001), BMI (20.23 ± 3.05 kg/m 2 vs 32.19 ± 4.86 kg/m 2 ; P < 0.001), insulin (8.47 ± 3.24 U/mL vs 14.67 ± 2.18 U/mL; P < 0.001), glucose (97.44 ± 11.31 mg/dL vs 109.67 ± 8.02 mg/dL; P < 0.001) and homeostasis model assessment index (2.01 ± 0.73 vs 3.96 ± 0.61; P < 0.001) were significantly higher in postmenopausal obese women compared to postmenopausal non obese women. The mean serum resistin level was also significantly higher in postmeno-pausal obese women compared to postmenopausal non obese women (9.05 ± 5.15 vs 13.92 ± 6.32, P < 0.001). Furthermore, the mean SAT resistin mRNA expression was also significantly (0.023 ± 0.008 vs 0.036 ± 0.009; P < 0.001) higher and over expressed 1.62 fold (upregulated) in postmenopausal obese women compared to postmenopausal non obese women. In postmeno-pausal obese women, the relative SAT resistin mRNA expression showed positive (direct) and significant correlation with BMI (r = 0.78, P < 0.001) and serum resistin (r = 0.76, P < 0.001). Furthermore, the SAT resistin mRNA expression in postmenopausal obese women also showed significant and direct association (r = 0.45, P < 0.01) with IR, while in postmenopausal non obese women it did not show any association (r = -0.04, P > 0.05). CONCLUSION: Increased SAT resistin mRNA expres-sion probably leads to inducing insulin resistance and thus may be associated with obesity-related disorders in postmenopausal obese women.Sadashiv Sunita Tiwari S Dhananjai Bhola N Paul Sandeep Kumar Abhijit Chandra Mahendra PS Negi 2012World Journal of Diabetes2012,3,7:10
10赤霉素对甘蔗发芽和早期蔗茎生长的潜在调节作用(英文)显示文摘以甘蔗品种CoSe92423单芽为材料,在盘栽条件下研究赤霉素(GA3)对甘蔗生长特点和生化特性的影响。将甘蔗单芽分别浸入10,20,50和100mg·L-1赤霉素溶液中24h,以清水为对照,将处理的芽段种植于网室泥盘中。结果表明,低水平GA3处理(10,20,和50mg·L-1)均可刺激蔗芽生长和甘蔗植株的生长,根数、根和叶片鲜重、蔗茎鲜重、叶面积以及茎长均有所增加。与对照相比(70%),赤霉素可使蔗芽萌发早,发芽率高,其中以50mg·L-1GA3处理的发芽率最高,为90%。经赤霉素处理的甘蔗株高和茎重分别增加90%~110%、252%~282%,其中以20mg·L-1GA3处理最高。此外,赤霉素处理的蔗芽中还原糖和IAA含量也有所增加,且均以20mg·L-1GA3处理最高。因此,低水平赤霉素均对蔗芽萌发和生长具有刺激作用,但高水平赤霉素则对甘蔗生长有抑制作用。Radha Jain S. N. Singh S. Solomon A. Chandra 2010广西农业科学2010,41,9:10
11Reduced EGFR signaling enhances cartilage destruction in a mouse osteoarthritis model显示文摘Osteoarthritis(OA) is a degenerative joint disease and a major cause of pain and disability in older adults. We have previously identified epidermal growth factor receptor(EGFR) signaling as an important regulator of cartilage matrix degradation during epiphyseal cartilage development. To study its function in OA progression, we performed surgical destabilization of the medial meniscus(DMM) to induce OA in two mouse models with reduced EGFR activity, one with genetic modification(EgfrWa5/1mice) and the other one with pharmacological inhibition(gefitinib treatment). Histological analyses and scoring at 3 months post-surgery revealed increased cartilage destruction and accelerated OA progression in both mouse models. TUNEL staining demonstrated that EGFR signaling protects chondrocytes from OA-induced apoptosis, which was further confirmed in primary chondrocyte culture. Immunohistochemistry showed increased aggrecan degradation in these mouse models, which coincides with elevated amounts of ADAMTS5 and matrix metalloproteinase 13(MMP13), the principle proteinases responsible for aggrecan degradation, in the articular cartilage after DMM surgery. Furthermore, hypoxia-inducible factor 2a(HIF2a), a critical catabolic transcription factor stimulating MMP13 expression during OA, was also upregulated in mice with reduced EGFR signaling. Taken together, our findings demonstrate a primarily protective role of EGFR during OA progression by regulating chondrocyte survival and cartilage degradation.Xianrong Zhang Ji Zhu Fei Liu Yumei Li Abhishek Chandra L Scott Levin Frank Beier Motomi Enomoto-Iwamoto Ling Qin 2014Bone Research2014,2,3:9
12Telbivudine vs tenofovir in hepatitis B e antigen-negative chronic hepatitis B patients: OPTIMA roadmap study显示文摘AIM To make efficacy and safety comparison of telbivudineraodmap and tenofovir-roadmap in hepatitis B e antigen(HBe Ag)-negative chronic hepatitis B(CHB) patients.METHODS This was the first prospective, randomised, two-arm, open-label, non-inferiority study in HBe Ag-negative CHB patients that compared telbivudine and tenofovir administered as per roadmap concept. Patients were treated up to 24 wk and, depending on virologic response, continued the same therapy or received addon therapy up to 104 wk. Eligible patients received an additional 52 wk of treatment in the extension period(i.e., up to 156 wk). Patients who developed virologic breakthrough(VB) while on monotherapy also received add-on therapy. The primary efficacy endpoint was the rate of patients achieving hepatitis B virus(HBV) DNA < 300 copies/m L at week 52. Secondary efficacy endpoints included the rates of HBV DNA < 300 and < 169 copies/m L, HBV DNA change from baseline, alanine aminotransferase normalisation, hepatitis B surface antigen(HBs Ag) loss, HBs Ag seroconversion, VB, and emergence of resistance at various timepoints throughout the study. Safety and estimated glomerular filtration rate(e GFR) were also analysed.RESULTS A total of 241 patients were randomised. Non-inferiority of telbivudine arm to tenofovir arm was demonstrated at week 52(± 7 d window), with over 91% of patients in each treatment arm achieving HBV DNA level < 300 copies/m L. Both arms were similar in terms of key secondary efficacy variables at weeks 104 and 156. The percentage of patients achieving HBV DNA < 300 copies/m L remained high and was similar in the telbivudine and tenofovir arms at both weeks 104 and 156. Over 82% of patients in both arms achieved alanine aminotransferase normalisation at week 52, and this percentage remained high at weeks 104 and 156. Telbivudine treatment progressively reduced serum HBs Ag levels from baseline while no change was reported in quantitative HBs Ag during therapy with tenofovir. Both treaments showed acceptable safety profiles. The telbivudine arm showed e GFR improvement unlike the tenofovir arm.CONCLUSION Efficacy was shown for both telbivudine-roadmap and tenofovir-roadmap regimens in HBe Ag-negative CHB patients over 156 wk. Telbivudine arm was associated with renal improvement.Zahari Krastev Diana Petrova Iskren Kotzev Mustafa Kemal Celen Meryl Mendelson Richa Chandra Priti Pandey Kamal Hamed 2016World Journal of Hepatology2016,8,32:9
13Cr_2O_3对高放核废料磷酸盐玻璃固化体的影响显示文摘在含高放核废料的玻璃固化体中添加了不同含量的Cr2O3,以考察其对玻璃固化体的结构和性质的影响.对添加Cr2O3的玻璃固化体进行了各种方法(溶出速率法,蒸汽水化侵蚀和试样坚固性法)的化学稳定性的测试.测试结果表明,Cr2O3的引入不会对玻璃固化体的化学稳定性产生不良的影响.与此相反,Cr2O3能抑制各种离子自玻璃固化体中沥析出来, 改善玻璃固化体的化学耐蚀性. XRD内标法测定,Cr2O3在铁磷酸盐玻璃中的溶解度可达4.1%,是其在硼硅酸盐玻璃的3倍. FTIR和DTA的结果表明,不同含量的Cr2O3的引入, 不会对玻璃固化体的网络结构造成显著的变化. Mossbauer谱表明,Fe2+/Fe3+的比值随着Cr2O3的含量的增加而增大,说明Cr离子和Fe离子在玻璃熔制过程中发生氧化还原反应, 形成的Cr+6有利于提高玻璃固化体的化学耐蚀性.黄文旵 周萘 Day Delbert E Ray Chandra S 2005无机材料学报2005,20,4:9
14Mineralogy and carbothermal reduction behaviour of vanadium-bearing titaniferous magnetite ore in Eastern India显示文摘Vanadium-bearing titaniferous magnetite bands hosted by Precambrian gabbro-norite-anorthositic rocks or their metamorphic equivalents were discovered in some parts of Eastern Indian Shield,containing 48%-49%Fe(total),10%-25%TiO2,and 0.3%-2.20%V2O5by mass.Mineralogical and petrological study,composition,and characterization of the vanadium-bearing titaniferous magnetite ore were carried out by scanning electron microscopy-energy dispersive X-ray(SEM-EDX),wave length X-ray florescence(WDXRF),inductively coupled plasma-atomic emission spectroscopy(ICP-AES),X-ray difraction(XRD),etc.Chemical beneficiation for valuable metals,such as Fe,Ti,and V,was performed by reduction roasting.The direct and indirect reduction were investigated by mixing the lump ore with solid activated charcoal in a closed reactor and purging the reducing gas mixture in standard reducibility index apparatus at diferent temperatures and time intervals.The reduction roasting parameters were optimized.Finally,the reduced samples were crushed and upgraded by magnetic separation.The results show that,the maximum mass fractions of magnetic and nonmagnetic parts achieved are 69.36%and 30.64%,respectively,which contain 10.6%TiO2and 0.84%V2O5in the magnetic part and 36.5%TiO2and 0.22%V2O5in the nonmagnetic part.Saikat Samanta Manik Chandra Goswami Tapan Kumar Baidya Siddhartha Mukherjee Rajib Dey 2013International Journal of Minerals,Metallurgy and Materials2013,20,10:9
15Significant increase in HBV, HCV, HIV and syphilis infections among blood donors in West Bengal, Eastern India 2004-2005: Exploratory screening reveals high frequency of occult HBV infection显示文摘AIM: To evaluate the prevalence of markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) and human immunodeficiency virus (HIV) among blood donors in Kolkata, Eastern India for two consecutive years and to conduct a pilot study to explore the presence of HBV DNA among hepatitis B surface antigen (HBsAg) negative but anti-HBc positive blood donors. METHODS: Seroprevalence of HBsAg, anti-HCV and anti-HIV was studied among 113 051 and 106 695 voluntary blood donors screened in 2004 and 2005, respectively. Moreover, a pilot study on 1027 HBsAg negative donors was carried out for evaluating the presence of HBV DNA by PCR on HBsAg negative/anti- HBc positive donors. RESULTS: A statistically significant increase in the prevalence of HBV (1448 vs 1768, P < 0.001), HIV (262 vs 374, P < 0.001), HCV (314 vs 372, P = 0.003) and syphilis (772 vs 853, P = 0.001) infections was noted among blood donors of Kolkata West Bengal in 2005 as compared to 2004. Moreover, the exploratory study on 1027 HBsAg negative donors revealed that 188 (18.3%)of them were anti-HBc positive out of which 21% were positive for HBV DNA. CONCLUSION: The findings of this study underscore the significantly increasing endemicity of hepatitis viruses, syphilis and HIV among the voluntary blood donors of our community. The pilot study indicates a high rate of prevalence of HBV DNA among HBsAg negative/anti-HBc positive donors and thus emphasizes the need for a more sensitive and stringent screening algorithm for blood donations.Prasun Bhattacharya Partha Kumar Chandra Sibnarayan Datta Arup Banerjee Subhashish Chakraborty Krishnan Rajendran Subir Kumar Basu Sujit Kumar Bhattacharya Runu Chakravarty 2007World Journal of Gastroenterology2007,13,27:9
16Surgical considerations for ‘intrinsic' brainstem gliomas: proposal of a modification in classification显示文摘Mehta VS Chandra PS Singh PK Garg A Rath GK 2009中国神经肿瘤杂志2009,7,3:9
17Family integrated care:Supporting parents as primary caregivers in the neonatal intensive care unit显示文摘Family integrated care (FICare) is a collaborative model of neonatal care which aims to address the negative impacts of the neonatal intensive care unit (NICU) environment by involving parents as equal partners, minimizing separation, and supporting parent-infant closeness. FICare incorporates psychological, educational, communication, and environmental strategies to support parents to cope with the NICU environment and to prepare them to be able to emotionally, cognitively, and physically care for their infant. FICare has been associated with improved infant feeding, growth, and parent wellbeing and self-efficacy;important mediators for long-term improved infant neurodevelopmental and behavioural outcomes. FICare implementation requires multi-disciplinary commitment, staff motivation, and sufficient time for preparation and readiness for change as professionals relinquish power and control to instead develop collaborative partnerships with parents. Successful FICare implementation and culture change have been applied by neonatal teams internationally, using practical approaches suited to their local environments. Strategies such as parent and staff meetings and relational communication help to break down barriers to change by providing space for the co-creation of knowledge, the negotiation of caregiving roles and the development of trusting relationships. The COVID-19 pandemic highlighted the vulnerability within programs supporting parental presence in neonatal units and the profound impacts of parent-infant separation. New technologies and digital innovations can help to mitigate these challenges, and support renewed efforts to embed FICare philosophy and practice in neonatal care during the COVID-19 recovery and beyond.Chandra Waddington Nicole Rvan Veenendaal Karel O’Brien Neil Patel for the International Steering Committee for Family Integrated Care 2021Pediatric Investigation2021,5,2:9
18Intraoperative blood loss in orthotopic liver transplantation:The predictive factors显示文摘Liver transplantation has been associated with massive blood loss and considerable transfusion requirements. Bleeding in orthotopic liver transplantation is multifactorial. Technical difficulties inherent to this complex surgical procedure and pre operative derangements of the primary and secondary coagulation system are thought to be the principal causes of perioperative hemorrhage. Intraoperative practices such as massive fluid resuscitation and resulting hypothermia and hypocalcemia secondary to citrate toxicity further aggravate the preexisting coagulopathy and worsen the perioperative bleeding. Excessive blood loss and transfusion during orthotopic liver transplant are correlated with diminished graft survival and increased septic episodes and prolonged ICU stay. With improvements in surgical skills, anesthetic technique, graft preservation, use of intraoperative cell savers and overall perioperative management, orthotopic liver transplant is now associated with decreased intra operative blood losses. The purpose of this review is to discuss the risk factors predictive of increased intra operative bleeding in patients undergoing orthotopic liver transplant.Chandra Kant Pandey Anshuman Singh Kamal Kajal Mandeep Dhankhar Manish Tandon Vijay Kant Pandey Sunaina Tejpal Karna 2015World Journal of Gastrointestinal Surgery2015,7,6:8
19Electroconvulsive therapy and/or plasmapheresis in autoimmune encephalitis?显示文摘Autoimmune encephalitis is a poorly understood condition that can present with a combination of neurological and psychiatric symptoms, either of which may predominate. There are many autoantibodies associated with a variety of clinical syndromes-anti-N-Methyl-D-Aspartate receptor(NMDAR) is the commonest. Currently, the most widely used therapy is prompt plasmapheresis and steroid treatment(and tumour resection if indicated), followed by second line immunosuppression if this fails. Given the growing awareness of autoimmune encephalitis as an entity, it is increasingly important that we consider it as a potential diagnosis in order to provide timely, effective treatment. We discuss several previously published case reports and one new case. These reports examined the effects of electroconvulsive therapy(ECT) on patients with autoimmune encephalitis, particularly those in whom psychiatric symptoms are especially debilitating and refractory to standard treatment. We also discuss factors predicting good outcome and possible mechanisms by which ECT may be effective. Numerous cases, such as those presented by Wingfield, Tsutsui, Florance, Sansing, Braakman and Matsumoto, demonstrate effective use of ECT in anti-NMDAR encephalitis patients with severe psychiatric symptoms such as catatonia, psychosis, narcolepsy and stupor who had failed to respond to standard treatments alone. We also present a new case of a 71-year-old female who presented to a psychiatric unit initially with depression, which escalated to catatonia, delusions, nihilism and auditory hallucinations. After anti-NMDAR antibodies were isolated, she was treated by the neurology team with plasmapheresis and steroids, with a partial response. She received multiple sessions of ECT and her psychiatric symptoms completely resolved and she returned to her premorbid state. For this reason, we suggest that ECT should be considered, particularly in those patients who are non-responders to standard therapies.Jessica L Gough Jan Coebergh Brunda Chandra Ramin Nilforooshan 2016World Journal of Clinical Cases2016,4,8:8
20Blumgart's technique of pancreaticojejunostomy: Analysis of safety and outcomes显示文摘Background: Blumgart's pancreaticojejunostomy(PJ) has been described with low pancreatic leak rates. This study aimed to evaluate our experience with this technique regarding the pancreatic leak and other perioperative outcomes. Methods: We performed a single-center retrospective analysis of a cohort of 81 patients who underwent pancreaticoduodenectomy in our department from January 2011 to February 2018. The primary endpoint was the occurrence of a clinically relevant postoperative pancreatic fistula(CR-POPF) and analysis of its risk factors. Results: The CR-POPF rate was 12.3%. Fistula risk score(FRS) was the only significant risk factor for the occurrence of overall POPF in multivariate analysis. However, none of the other factors including FRS was found to be significantly associated with CR-POPF risk. A strong positive correlation was found between the CR-POPF and the incidence of delayed gastric emptying, post-pancreatectomy hemorrhage and increased length of hospital stay. Conclusion: Blumgart's technique is a safe technique of pancreatico-enteric anastomosis with low rates of CR-POPF. CR-POPF with this technique is independent of most of the preoperative and intraoperative factors. Therefore, this technique can be used for all types of the pancreas with consistently good results.Vishal Gupta Saket Kumar Vivek Gupta Pradeep Joshi Rahul Rahul Rakesh Kumar Yadav Amit Dangi Abhijit Chandra 2019Hepatobiliary & Pancreatic Diseases International2019,18,2:8
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