Significant advances in surgical techniques and relevant medium-and long-term outcomes over the past two decades have led to a substantial expansion in the indications for major liver resections.To support these outst...Significant advances in surgical techniques and relevant medium-and long-term outcomes over the past two decades have led to a substantial expansion in the indications for major liver resections.To support these outstanding results and to reduce perioperative complications,anesthesiologists must address and master key perioperative issues(preoperative assessment,proactive intraoperative anesthesia strategies,and implementation of the Enhanced Recovery After Surgery approach).Intensive care unit monitoring immediately following liver surgery remains a subject of active and often unresolved debate.Among postoperative complications,posthepatectomy liver failure(PHLF)occurs in different grades of severity(A-C)and frequency(9%-30%),and it is the main cause of 90-d postoperative mortality.PHLF,recently redefined with pragmatic clinical criteria and perioperative scores,can be predicted,prevented,or anticipated.This review highlights:(1)The systemic consequences of surgical manipulations anesthesiologistsmust respond to or prevent,to positively impact PHLF(a proactive approach);and(2)the maximal intensivetreatment of PHLF,including artificial options,mainly based,so far,on Acute Liver Failure treatment(s),to buytime waiting for the recovery of the native liver or,when appropriate and in very selected cases,toward livertransplant.Such a clinical context requires a strong commitment to surgeons,anesthesiologists,and intensivists towork together,for a fruitful collaboration in a mandatory clinical continuum.展开更多
Objective: Oral mucositis (OM) is a devastating toxicity associated with cytotoxic cancer therapy. The OM pathogenesis and the complex interactions occur in response to tissue insult. Application of this evolving mode...Objective: Oral mucositis (OM) is a devastating toxicity associated with cytotoxic cancer therapy. The OM pathogenesis and the complex interactions occur in response to tissue insult. Application of this evolving model has aided in the development of mechanistically based therapies for the prevention and treatment of mucositis. The present study was to assess the effects of glycine supplementation on chemotherapy-induced oral mucositis. Methods: In a hamster cheek pouch model of chemotherapy-induced oral mucositis, one group of 20 animals received systemic glycine supplementation for 7 days, while another similar control group did not. Clinical mucositis severity and neutrophil infiltrate (on histology) were assessed by blinded examiners. Free radical production was measured as malondialdehyde (MDA) levels. Results: As compared to control animals, glycine-treated animals demonstrated a highly significant reduction in clinical severity of oral mucositis, neutrophil infiltrate, and MDA levels (p < 0.001 for all). Conclusions: Glycine supplementation reduces the severity of chemotherapy-induced oral mucositis in an animal model. This effect is at least partly mediated through inhibition of the inflammatory response and reduced production of damaging free radicals.展开更多
Background:The increasing proportion of the aged population and their fragility are reflected in an increase in geriatric deaths from various causes and modes of death.This study sought to examine several factors rela...Background:The increasing proportion of the aged population and their fragility are reflected in an increase in geriatric deaths from various causes and modes of death.This study sought to examine several factors related to suspicious deaths in the geriatric age group at Zeinhom Morgue in Egypt.Subjects and Methods:Ninety-four elderly individuals aged older than 65 years who were referred to the Zeinhom Morgue in 2018 were enrolled.The demographic data,circumstances of death,cause of death,autopsy findings,and chemical,and toxicological analyses were analyzed.Results:Deaths(n=94)were classified as accidental,suicide,homicide,and unknown.The majority of fatalities(61.7%)were aged 65-70,and all unnatural deaths occurred in metropolitan settings.Homicides accounted for the majority of unnatural fatalities(30.9%),with the motivation being robbery and fighting,and were more common among males.Suicides were limited to males;they occurred primarily in the victim’s house,and a history of psychiatric illnesses was usually revealed.Conclusion:A forensic autopsy is necessary for elderly fatalities without clear diagnoses or unusual circumstances.Male sex,hypertension,unemployment,social isolation,and violent environment are major risk factors among elder suspicious deaths.Cardiovascular failure was the major cause of mortality,with blunt trauma being the most common injury.展开更多
China and India are two long-standing Asian cMlizations, each with a rich history lasting thousands of years. Since ancient times, the two peoples have been connected by land and sea, particularly through the Silk Roa...China and India are two long-standing Asian cMlizations, each with a rich history lasting thousands of years. Since ancient times, the two peoples have been connected by land and sea, particularly through the Silk Road and this connection has allowed for friendly cultural and economic exchanges. The Chinese navy and the Indian navy are also not strangers to one another. As early as 1958, the Indian cruiser INS Mysore had paid a friendly visit to Shanghai for military exchanges at a time when most Western countries had policies of boycotting and containing China. This friendly gesture from the Indian Navy was very encour- aging for the newly born People＇s Republic of China.展开更多
文摘Significant advances in surgical techniques and relevant medium-and long-term outcomes over the past two decades have led to a substantial expansion in the indications for major liver resections.To support these outstanding results and to reduce perioperative complications,anesthesiologists must address and master key perioperative issues(preoperative assessment,proactive intraoperative anesthesia strategies,and implementation of the Enhanced Recovery After Surgery approach).Intensive care unit monitoring immediately following liver surgery remains a subject of active and often unresolved debate.Among postoperative complications,posthepatectomy liver failure(PHLF)occurs in different grades of severity(A-C)and frequency(9%-30%),and it is the main cause of 90-d postoperative mortality.PHLF,recently redefined with pragmatic clinical criteria and perioperative scores,can be predicted,prevented,or anticipated.This review highlights:(1)The systemic consequences of surgical manipulations anesthesiologistsmust respond to or prevent,to positively impact PHLF(a proactive approach);and(2)the maximal intensivetreatment of PHLF,including artificial options,mainly based,so far,on Acute Liver Failure treatment(s),to buytime waiting for the recovery of the native liver or,when appropriate and in very selected cases,toward livertransplant.Such a clinical context requires a strong commitment to surgeons,anesthesiologists,and intensivists towork together,for a fruitful collaboration in a mandatory clinical continuum.
文摘Objective: Oral mucositis (OM) is a devastating toxicity associated with cytotoxic cancer therapy. The OM pathogenesis and the complex interactions occur in response to tissue insult. Application of this evolving model has aided in the development of mechanistically based therapies for the prevention and treatment of mucositis. The present study was to assess the effects of glycine supplementation on chemotherapy-induced oral mucositis. Methods: In a hamster cheek pouch model of chemotherapy-induced oral mucositis, one group of 20 animals received systemic glycine supplementation for 7 days, while another similar control group did not. Clinical mucositis severity and neutrophil infiltrate (on histology) were assessed by blinded examiners. Free radical production was measured as malondialdehyde (MDA) levels. Results: As compared to control animals, glycine-treated animals demonstrated a highly significant reduction in clinical severity of oral mucositis, neutrophil infiltrate, and MDA levels (p < 0.001 for all). Conclusions: Glycine supplementation reduces the severity of chemotherapy-induced oral mucositis in an animal model. This effect is at least partly mediated through inhibition of the inflammatory response and reduced production of damaging free radicals.
文摘Background:The increasing proportion of the aged population and their fragility are reflected in an increase in geriatric deaths from various causes and modes of death.This study sought to examine several factors related to suspicious deaths in the geriatric age group at Zeinhom Morgue in Egypt.Subjects and Methods:Ninety-four elderly individuals aged older than 65 years who were referred to the Zeinhom Morgue in 2018 were enrolled.The demographic data,circumstances of death,cause of death,autopsy findings,and chemical,and toxicological analyses were analyzed.Results:Deaths(n=94)were classified as accidental,suicide,homicide,and unknown.The majority of fatalities(61.7%)were aged 65-70,and all unnatural deaths occurred in metropolitan settings.Homicides accounted for the majority of unnatural fatalities(30.9%),with the motivation being robbery and fighting,and were more common among males.Suicides were limited to males;they occurred primarily in the victim’s house,and a history of psychiatric illnesses was usually revealed.Conclusion:A forensic autopsy is necessary for elderly fatalities without clear diagnoses or unusual circumstances.Male sex,hypertension,unemployment,social isolation,and violent environment are major risk factors among elder suspicious deaths.Cardiovascular failure was the major cause of mortality,with blunt trauma being the most common injury.
文摘China and India are two long-standing Asian cMlizations, each with a rich history lasting thousands of years. Since ancient times, the two peoples have been connected by land and sea, particularly through the Silk Road and this connection has allowed for friendly cultural and economic exchanges. The Chinese navy and the Indian navy are also not strangers to one another. As early as 1958, the Indian cruiser INS Mysore had paid a friendly visit to Shanghai for military exchanges at a time when most Western countries had policies of boycotting and containing China. This friendly gesture from the Indian Navy was very encour- aging for the newly born People＇s Republic of China.
