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| 1 | Risk-adjustment in hepatobiliarypancreatic surgery显示文摘AIM: The present study evaluates the performance of the POSSUM, the American Society of Anesthetists (ASA),APACHE and Childs classification in predicting mortality and morbidity in hepatopancreaticobiliary (HPB) surgery.We describe especially the limitations and advantages of risk in stratifying the patients.METHODS: We investigated 177 randomly chosen patients undergoing eledive complex HPB surgery in a single institution with a total of 71 pre-operative and intra-operative risk factors.Primary endpoint was in-hospital mortality and morbidity.Ordered logistic regression analysis was used to identify individual predictors of operative morbidity and mortality.RESULTS: The operative mortality in the series was 3.95% .This compared well with the p-POSSUM and APACHE predicted mortality of 4.31% and 4.29% respectively. Postoperative complications amounted to 45% with 24 (13.6%)patients having a major adverse event. On multivariate analysis the pre-operative POSSUM physiological score (OR = 1.18,P = 0.009) was superior in predicting complications compared to the ASA (P = 0.108), APACHE (P = 0.117)or Childs classification (P = 0.136). In addition, serum sodium, creatinine, international normalized ratio (INR),pulse rate, and intra-operative blood loss were independent risk factors. A combination of the POSSUM variables and INR offered the optimal combination of risk factors for risk prognostication in HPB surgery.CONCLUSION: Morbidity for elective HPB surgery can be accurately predicted and applied in everyday surgical practice as an adjunct in the process of informed consent and for effective allocation of resources for intensive and high-dependency care facilities. | Hemant M Kocher Paris P Tekkis Palepu Gopal Ameet G Patel Simon Cottam Irving S Benjamin | 2005 | World Journal of Gastroenterology2005，11，16： | 3 |
| 2 | Anticoagulation in simultaneous pancreas kidney transplantation - On what basis?显示文摘BACKGROUND Despite technical refinements,early pancreas graft loss due to thrombosis continues to occur.Conventional coagulation tests(CCT)do not detect hypercoagulability and hence the hypercoagulable state due to diabetes is left untreated.Thromboelastogram(TEG)is an in-vitro diagnostic test which is used in liver transplantation,and in various intensive care settings to guide anticoagulation.TEG is better than CCT because it is dynamic and provides a global hemostatic profile including fibrinolysis.AIM To compare the outcomes between TEG and CCT(prothrombin time,activated partial thromboplastin time and international normalized ratio)directed anticoagulation in simultaneous pancreas and kidney(SPK)transplant recipients.METHODS A single center retrospective analysis comparing the outcomes between TEG and CCT-directed anticoagulation in SPK recipients,who were matched for donor age and graft type(donors after brainstem death and donors after circulatory death).Anticoagulation consisted of intravenous(IV)heparin titrated up to a maximum of 500 IU/h based on CCT in conjunction with various clinical parameters or directed by TEG results.Graft loss due to thrombosis,anticoagulation related bleeding,radiological incidence of partial thrombi in the pancreas graft,thrombus resolution rate after anticoagulation dose escalation,length of the hospital stays and,1-year pancreas and kidney graft survival between the two groups were compared.RESULTS Seventeen patients who received TEG-directed anticoagulation were compared against 51 contemporaneous SPK recipients(ratio of 1:3)who were anticoagulated based on CCT.No graft losses occurred in the TEG group,whereas 11 grafts(7 pancreases and 4 kidneys)were lost due to thrombosis in the CCT group(P=0.06,Fisher’s exact test).The overall incidence of anticoagulation related bleeding(hematoma/gastrointestinal bleeding/hematuria/nose bleeding/re-exploration for bleeding/post-operative blood transfusion)was 17.65%in the TEG group and 45.10%in the CCT group(P=0.05,Fisher’s exact test).The incidence of radiologically confirmed partial thrombus in pancreas allograft was 41.18%in the TEG and 25.50%in the CCT group(P=0.23,Fisher’s exact test).All recipients with partial thrombi detected in computed tomography(CT)scan had an anticoagulation dose escalation.The thrombus resolution rates in subsequent scan were 85.71%and 63.64%in the TEG group vs the CCT group(P=0.59,Fisher’s exact test).The TEG group had reduced blood product usage{10 packed red blood cell(PRBC)and 2 fresh frozen plasma(FFP)}compared to the CCT group(71 PRBC/10 FFP/2 cryoprecipitate and 2 platelets).The proportion of patients requiring transfusion in the TEG group was 17.65%vs 39.25%in the CCT group(P=0.14,Fisher’s exact test).The median length of hospital stay was 18 days in the TEG group vs 31 days in the CCT group(P=0.03,Mann Whitney test).The 1-year pancreas graft survival was 100%in the TEG group vs 82.35%in the CCT group(P=0.07,log rank test)and,the 1-year kidney graft survival was 100%in the TEG group vs 92.15%in the CCT group(P=0.23,log tank test).CONCLUSION TEG is a promising tool in guiding judicious use of anticoagulation with concomitant prevention of graft loss due to thrombosis,and reduces the length of hospital stay. | Jeevan Prakash Gopal Frank JMF Dor Jeremy S Crane Paul E Herbert Vassilios E Papalois Anand SR Muthusamy | 2020 | World Journal of Transplantation2020，10，7： | 2 |
| 3 | Global land cover mapping from MODIS: algorithms and early results显示文摘 | M.A Friedl D.K McIver J.C.F Hodges X.Y Zhang D Muchoney A.H Strahler C.E Woodcock S Gopal A Schneider A Cooper A Baccini F Gao C Schaaf | 2002 | Remote Sensing of Environment2002，，1： | 2 |
| 4 | Automatic extraction of tank outlets in a sub-watershed using digital elevation models显示文摘 | Nisar A hamed T R Gopal Rao K Murthy J S R | 2002 | Agricultural Water Management2002，57，3： | 1 |
| 5 | Tin dioxide nanoparticles prepared by sol-gel method for an improved hydrogen sulfide sensor显示文摘 | Manorama S V Gopal Reddy C V Rao V J | 1999 | Nanostructured Materials1999，11，5： | 1 |
| 6 | Gaussian Mixture Discriminant Analysis and Sub-pixel Land Cover Characterization in Remote Sensing 显示文摘 | JU J C KOLACZYK E D GOPAL S | 2003 | Remote Sensing Environment2003，84，： | 1 |
| 7 | Development and validation of a sensitive analytical method for the simultaneous determination of buprenorphine and norbuprenorphine in human urine显示文摘 | Gopal S Tzeng T B Cowan A | 2001 | Eur J Pharm Sci2001，51，： | 1 |
| 8 | A double-blind study of paliperidone palmitaite and risperidone long-acting injectable in adults with schizophrenia 显示文摘 | Pandina G Lane R Gopal S | 2011 | Prog Neuropsycopharmacol Biol Psychiatry2011，35，1： | 1 |
| 9 | High efficiency double heterojunction polymer photovoltaic cells using highly ordered TiO2 nanotube arrays 显示文摘 | Gopal K M Karthik S Maggie P | 2007 | Appl Phys Lett2007，91，15： | 1 |
| 10 | Removal of fluoride from drinking water by adsorption onto alum- impregnated activated alumina 显示文摘 | TRIPATHY S S BERSILLONn J L GOPAL K | 2006 | Separation and Purification Technology2006，50，3： | 1 |
| 11 | A 52-week open-label study of the safety and tolerability of paliperidone palmitate in patients with schizophrenia 显示文摘 | Gopal S Vijapurkar U Lim P | 2011 | J Psychopharmacol2011，25，5： | 1 |
| 12 | Oligosacchrides and glycoconjugates in bo- vine milk and colostrum显示文摘 | GOPAL P K GILL H S | 2000 | Br J Nutr2000，84，： | 1 |
| 13 | The crystal structure of a quercetin 2,3-dioxygenase from Bacillus subtilis suggests modulation of enzyme activity by a change in the metal ion at the active site (s)显示文摘 | Gopal B Madan L L Betz S F | 2005 | Biochemistry2005，44，1： | 1 |
| 14 | Chlorination byproducts,their toxicodynamics and removal from drinking water显示文摘 | Gopal K Tripath S S Bersillon J L | | 0，，1： | 1 |
| 15 | Amyloid Precursor Proteins Inhibit Heme Oxygenase Activity and Augment Neurotoxicity in Alzheimer’s Disease显示文摘 | Masaaki Takahashi Sylvain Doré Christopher D Ferris Taisuke Tomita Akira Sawa Herman Wolosker David R Borchelt Takeshi Iwatsubo Seong-Hun Kim Gopal Thinakaran Sangram S Sisodia Solomon H Snyder | 2000 | Neuron2000，，2： | 1 |
| 16 | A review on biodiesel produc tion, combustion, emissions and performance显示文摘 | Basha S A Gopal K R Jebaraj S | 2009 | Renewable and Sustainable Energy Reviews2009，13，6： | 1 |
| 17 | Antibiotic susceptibility profiles of new probiotic Lactobacillus and Bifidobacterium strains显示文摘 | ZHOU J S PILLIDGE C J GOPAL P K | 2005 | International Journal of Food Microbiology2005，98，2： | 1 |
| 18 | comparison of two- and three-dimensional echocardiography with cineventriculography for measurement of left ventricular volume in patients 显示文摘 | SAPIN P M SCHRODER K M GOPAL A S | 1994 | J Am Coll Cardiol1994，24，5： | 1 |
| 19 | Effects of sodium acetate dip treatment and vacuum-packaging on chemical, microbiological, textural and sensory changes of Pearlspot (Etroplus suratensis) during chill storage显示文摘 | MANJU S JOSE L SRIN1VASA GOPAL T K | 2007 | Food Chemistry2007，102，： | 1 |
| 20 | Practi- cal guidance for dosing and switching paliperidone palmitate treat- ment in patients with schizophrenia 显示文摘 | GOPAL S GASSMANN-MAYER C PALUMBO J | 2010 | Curr Med Res Opin2010，26，2： | 1 |
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