The mechanisms involved in the development of hepatic encephalopathy still remain uncertain. The rodent portacaval shunt is a model that reproduces many of the pathological features observed in humans (1), but is a te...The mechanisms involved in the development of hepatic encephalopathy still remain uncertain. The rodent portacaval shunt is a model that reproduces many of the pathological features observed in humans (1), but is a technically demanding exercise. While the traditional technique involves complete occlusion of the IVC, a c-clamp was fashioned to partially clamp the IVC thereby sustaining venous return and cardiac output. The aim of this study is to determine if the c-clamp technique provides greater hemodynamic stability and enhances the success rate of the portacaval shunt procedure. To answer this question, two experimental groups, c-clamp (N = 7) and cross-clamp (N = 7), and a sham group (N = 3) were included. Intraoperative hemodynamic parameters were recorded at specific times during the procedure. The c-clamp group showed greater hemodynamic stability when compared to the cross-clamp group. It was manifested by 1) significantly higher mean arterial blood pressure [63 (range, 8) vs 47 (range, 10) mmHg, p < 0.05], 2) faster capillary refill [4 (range, 2) vs 6 (range, 2) seconds, p < 0.05], 3) higher urinary output [0.18 (range, 0.02) vs 0.14 (range, 0.02) ml, p < 0.05], and 4) lower bowel wet-to-dry ratio [4.168 (range, 0.258) vs 4.731 (range, 0.271), p<0.05]. We conclude partial IVC clamping improves hemodynamic stability during the construction of the rat portacaval shunt model.展开更多
Background:Colorectal cancer(CRC)is a common form of malignancy and a leading cause of death in the United States.Screening decreases CRC incidence and mortality.African Americans are at an increased risk of developin...Background:Colorectal cancer(CRC)is a common form of malignancy and a leading cause of death in the United States.Screening decreases CRC incidence and mortality.African Americans are at an increased risk of developing CRC,and recommendations are to initiate screening at the age of 45.This study aims to assess the rate of screening for colorectal cancer in African Americans between the ages of 45–49.Methods:African Americans between the ages of 45–49 were identified in the Explorys national database.Patients who completed a colonoscopy,sigmoidoscopy or fecal occult blood test were identified and stratified by sex and insurance status.A P value<0.05 was considered significant.Results:A total of 181200 African Americans were identified as eligible for screening.Only 31480 patients(17.4%)received at least one screening procedure for CRC.The majority of patients(66.7%)were screened via colonoscopy.African American females were more likely to complete a screening test(17.8%vs 16.7%;P<0.01).The majority of patients(66.0%)who completed a screening test had private insurance.Conclusion:Race,gender and barriers to medical care contribute to disparities in CRC screening rates.Among African Americans,CRC screening remains suboptimal.Tailored public health initiatives,medical record alerts and improved communication between providers and patients are fundamental to addressing issues that impact poor adherence to CRC screening in African Americans.展开更多
文摘The mechanisms involved in the development of hepatic encephalopathy still remain uncertain. The rodent portacaval shunt is a model that reproduces many of the pathological features observed in humans (1), but is a technically demanding exercise. While the traditional technique involves complete occlusion of the IVC, a c-clamp was fashioned to partially clamp the IVC thereby sustaining venous return and cardiac output. The aim of this study is to determine if the c-clamp technique provides greater hemodynamic stability and enhances the success rate of the portacaval shunt procedure. To answer this question, two experimental groups, c-clamp (N = 7) and cross-clamp (N = 7), and a sham group (N = 3) were included. Intraoperative hemodynamic parameters were recorded at specific times during the procedure. The c-clamp group showed greater hemodynamic stability when compared to the cross-clamp group. It was manifested by 1) significantly higher mean arterial blood pressure [63 (range, 8) vs 47 (range, 10) mmHg, p < 0.05], 2) faster capillary refill [4 (range, 2) vs 6 (range, 2) seconds, p < 0.05], 3) higher urinary output [0.18 (range, 0.02) vs 0.14 (range, 0.02) ml, p < 0.05], and 4) lower bowel wet-to-dry ratio [4.168 (range, 0.258) vs 4.731 (range, 0.271), p<0.05]. We conclude partial IVC clamping improves hemodynamic stability during the construction of the rat portacaval shunt model.
文摘Background:Colorectal cancer(CRC)is a common form of malignancy and a leading cause of death in the United States.Screening decreases CRC incidence and mortality.African Americans are at an increased risk of developing CRC,and recommendations are to initiate screening at the age of 45.This study aims to assess the rate of screening for colorectal cancer in African Americans between the ages of 45–49.Methods:African Americans between the ages of 45–49 were identified in the Explorys national database.Patients who completed a colonoscopy,sigmoidoscopy or fecal occult blood test were identified and stratified by sex and insurance status.A P value<0.05 was considered significant.Results:A total of 181200 African Americans were identified as eligible for screening.Only 31480 patients(17.4%)received at least one screening procedure for CRC.The majority of patients(66.7%)were screened via colonoscopy.African American females were more likely to complete a screening test(17.8%vs 16.7%;P<0.01).The majority of patients(66.0%)who completed a screening test had private insurance.Conclusion:Race,gender and barriers to medical care contribute to disparities in CRC screening rates.Among African Americans,CRC screening remains suboptimal.Tailored public health initiatives,medical record alerts and improved communication between providers and patients are fundamental to addressing issues that impact poor adherence to CRC screening in African Americans.
