scholarly journals Small-for-flow liver failure after extended hepatectomy: hot questions and an update

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Simone Famularo ◽  
Luca Gianotti ◽  
Oliviero Riggio
Keyword(s):  
Liver Failure ◽  
Portal Pressure ◽  
Management Strategies ◽  
Liver Parenchyma ◽  
Point Of View ◽  
Liver Size ◽  
Liver Remnant ◽  
Mortality And Morbidity ◽  
Small For Size

Small-for-size liver syndrome and posthepatectomy liver failure remain a major challenge for surgeons. Recently, updates in literature points to describe this two syndrome as two face of the same coin. These syndromes are characterized by hyperbilirubinemia, coagulopathy, hyper-GGT, high portal pressure and flow in liver remnant, occurring within the first postoperative week. It can lead to post-operative sepsis and bleeding, increasing mortality and morbidity. Despite the large experience in the field of transplantation, few studies are focused on small-for-size syndrome after major hepatectomy. For years, scientists were focused on the size of liver remnant, supposing a small liver remnant, in relation with the primary liver size, was the cause of the syndrome. The strategies used to prevent it after transplantation, have however shown a predominant role of high portal pressure and flow, leading to an alteration in functional regeneration of liver parenchyma, as the prevalent mechanism. According to these evidences, we suggest adopting another nomenclature for the two syndromes: small-for-flow-liver failure. In this article, we analyze and summarize different experiences, proposing our inward algorithm, including the role of portal flow and pressure measurements. This review seeks to be an operative instrument for surgeons and hepatologists in an effort to find a common point of view regarding small for flow liver failure and its management strategies.

Functional outcome after intracerebral haemorrhage – a review of the potential role of antiapoptotic agents

2016 ◽  
Vol 27 (3) ◽  
pp. 317-327 ◽  
Author(s):  
Abubakar Tijjani Salihu ◽  
Sangu Muthuraju ◽  
Zamzuri Idris ◽  
Abdul Rahman Izaini Ghani ◽  
Jafri Malin Abdullah
Keyword(s):  
Functional Outcome ◽  
Intracerebral Haemorrhage ◽  
Neuronal Death ◽  
Potential Role ◽  
Management Strategies ◽  
Experimental Studies ◽  
Neuronal Loss ◽  
Multimodality Treatment ◽  
Mortality And Morbidity

AbstractIntracerebral haemorrhage (ICH) is the second most common form of stroke and is associated with greater mortality and morbidity compared with ischaemic stroke. The current ICH management strategies, which mainly target primary injury mechanisms, have not been shown to improve patient’s functional outcome. Consequently, multimodality treatment approaches that will focus on both primary and secondary pathophysiology have been suggested. During the last decade, a proliferation of experimental studies has demonstrated the role of apoptosis in secondary neuronal loss at the periphery of the clot after ICH. Subsequently, the value of certain antiapoptotic agents in reducing neuronal death and improving functional outcome following ICH was evaluated in animal models. Preliminary evidence from those studies strongly supports the potential role of antiapoptotic agents in reducing neuronal death and improving functional outcome after intracerebral haemorrhage. Expectedly, the ongoing and subsequent clinical trials will substantiate these findings and provide clear information on the most potent and safe antiapoptotic agents, their appropriate dosage, and temporal window of action, thereby making them suitable for the multimodality treatment approach.

scholarly journals The role of hepatobiliary scintigraphy combined with spect/ct in predicting severity of liver failure before major hepatectomy: a single-center pilot study

2020 ◽  
Author(s):  
Matteo Serenari ◽  
Chiara Bonatti ◽  
Lucia Zanoni ◽  
Giuliano Peta ◽  
Elena Tabacchi ◽  
...  
Keyword(s):  
Liver Failure ◽  
Liver Surgery ◽  
Clinical Management ◽  
Major Hepatectomy ◽  
Photon Emission ◽  
Future Liver Remnant ◽  
Emission Computed Tomography ◽  
Hepatobiliary Scintigraphy ◽  
Liver Remnant

Abstract Hepatobiliary scintigraphy (HBS) has been demonstrated to predict post-hepatectomy liver failure (PHLF). However, existing cutoff values for future liver remnant function (FLR-F) were previously set according to the “50–50 criteria” PHLF definition. Methods of calculation and fields of application in liver surgery have changed in the meantime. The aim of this study was to demonstrate the role of HBS combined with single photon emission computed tomography (SPECT/CT) in predicting severity of PHLF, according to the International Study Group of Liver Surgery (ISGLS). All patients submitted to major hepatectomy with preoperative HBS-SPECT/CT between November 2016 and December 2019, were analyzed. Patients were resected according to hepatic volumetry. Receiver operating characteristic (ROC) curve analysis was performed to identify cutoffs of FLR function for predicting PHLF according to ISGLS definition and grading. Of the 38 patients enrolled, 26 were submitted to one-stage hepatectomy (living liver donors = 4) and 12 to two-stage procedures (portal vein embolization = 4, ALPPS = 8). Overall, 18 patients developed PHLF according to ISGLS criteria: 12 of grade A (no change in the patient’s clinical management) and 6 of grade B (change in clinical management). ROC analysis established increasingly higher cutoffs of FLR-F for predicting PHLF according to the “50–50 criteria”, ISGLS grade B and ISGLS grade A/B, respectively. HBS with SPECT/CT may help to assess severity of PHLF following major hepatectomy. Prospective multicenter trials are needed to confirm the effective role of HBS-SPECT/CT in liver surgery.

scholarly journals The Role of Time Management in Achieving Creativity: A Field Study at Al - Aqsa University in the Gaza Strip - Palestine: دور إدارة الوقت في تحقيق الإبداع: دراسة ميدانية في جامعة الأقصى في قطاع غزة - فلسطين

2016 ◽  
Vol 2 (1) ◽  
Author(s):  
Ezz El Din Mahmoud Abdel Shair
Keyword(s):  
Time Management ◽  
Gaza Strip ◽  
Descriptive Analysis ◽  
Management Strategies ◽  
Point Of View ◽  
Faculty Members ◽  
The Gaza Strip ◽  
Time Planning

The study aimed to identify the role of time management in achieving innovation at Al-Aqsa University in the Gaza Strip - Palestine through three time management strategies (targeting the aims, priorities, time planning and decision making) at Al-Aqsa University in the Gaza Strip - Palestine. And the relationship between the strategies of time management and innovation at Al-Aqsa University in the Gaza Strip - Palestine from the point of view of faculty members. The descriptive analysis approach was used. The research community consisted of heads of departments and academics at the faculties, units and centers at Al-Aqsa University. The data collection tool for the study was a questionnaire distributed to a random sample of 265 faculty members. The study reached several results, the most important of which is that time management has a role in achieving creativity at Al-Aqsa University in the Gaza Strip - Palestine, and that the availability of time management dimensions have a role in achieving creativity at Al-Aqsa University. The study showed that there is keenness among the sample members at Al-Aqsa University to plan early on their day-to-day work, low level of attention to long term goals and weak pursuit of these goals such acts, as well as there is less attention by the sample to predict the problems of work before they occur, and that faculty members at Al-Aqsa University have the ability to put forward ideas and solutions to address the problems fast.  

scholarly journals Stay Home: Role of Physical Exercise Training in Elderly Individuals’ Ability to Face the COVID-19 Infection

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Walid Kamal Abdelbasset
Keyword(s):  
Older Adults ◽  
Immune System ◽  
Exercise Training ◽  
Physical Exercise ◽  
Point Of View ◽  
Home Exercise ◽  
Mortality And Morbidity ◽  
Elderly Individuals ◽  
Physical Exercise Training

Recently, the novel coronavirus epidemic occurred in China and spread worldwide to become a global pandemic. COVID-19 is a fatal viral infection causing death, particularly in aged individuals, due to impaired immunity. To date, no intervention is available to prevent COVID-19 and its manifestations. Physical exercise training generally has health benefits, and it assists in the prevention of several chronic diseases. Therefore, this review is aimed at exploring the role of physical exercise training in the face of COVID-19 in older adults and elderly individuals. From this point of view, this review suggests that physical exercise training plays a key role in promoting immune system regulation, delaying immunity dysfunction, reducing circulatory inflammation markers, and preventing sarcopenia and thus could prevent the risk of acquiring COVID-19 infection and reduce the complications of recommended self-isolation in older adults and elderly individuals. Additionally, immunity biomarkers were optimistically demonstrated in older adults following physical exercise training, thereby reducing mortality and morbidity rates. Finally, in accordance with recommendations to stay home and perform self-isolation to prevent the spread of COVID-19, all populations are strongly recommended to practice regular home exercise training at home to promote immune system functioning.

scholarly journals Thrombolytic Therapy in Pulmonary Thromboembolism

2021 ◽  
Author(s):  
Navdeep Singh Sidhu ◽  
Sumandeep Kaur
Keyword(s):  
High Risk ◽  
Thrombolytic Therapy ◽  
Pulmonary Thromboembolism ◽  
Management Strategies ◽  
Intermediate Risk ◽  
Mortality And Morbidity ◽  
Potential Clinical Benefit ◽  
Acute Pulmonary Thromboembolism ◽  
Risk Categorization

Acute pulmonary thromboembolism (PE) is a common disorder with significant mortality and morbidity. Timely recognition and prompt therapy of this disorder is essential to prevent adverse consequences. Thrombolytic therapy has an important role in the management of high-risk pulmonary embolism patients, where it can be lifesaving. However, the potential clinical benefit of thrombolytic therapy needs to balanced against the risk of major bleeding associated with the use of these agents. Hence patient selection is of paramount importance in determining the success of this therapy. Management strategies in PE are centered around the concept of risk stratification of the cases. In this chapter we briefly discuss the risk categorization of PE cases, followed by a more elaborative discussion of the role of thrombolytic therapy in the management of patients with high risk or intermediate risk PE.

Elucidation of block boundaries as the dissolution channels in hydrated cement

1978 ◽  
Vol 36 (1) ◽  
pp. 484-485
Author(s):  
N.V. Belov ◽  
U.I. Papiashwili ◽  
B.E. Yudovich
Keyword(s):  
Liquid Phase ◽  
Grain Boundaries ◽  
Benzoyl Peroxide ◽  
Phase Contrast ◽  
Active Role ◽  
Point Of View ◽  
Hardened Cement ◽  
Hydrated Cement ◽  
Hardened Cement Paste

It has been almost universally adopted that dissolution of solids proceeds with development of uniform, continuous frontiers of reaction.However this point of view is doubtful / 1 /. E.g. we have proved the active role of the block (grain) boundaries in the main phases of cement, these boundaries being the areas of hydrate phases' nucleation / 2 /. It has brought to the supposition that the dissolution frontier of cement particles in water is discrete. It seems also probable that the dissolution proceeds through the channels, which serve both for the liquid phase movement and for the drainage of the incongruant solution products. These channels can be appeared along the block boundaries.In order to demonsrate it, we have offered the method of phase-contrast impregnation of the hardened cement paste with the solution of methyl metacrylahe and benzoyl peroxide. The viscosity of this solution is equal to that of water.

The Contemporary Role of Resection and Ablation in Colorectal Cancer Liver Metastases

2020 ◽  
Vol 04 (03) ◽  
pp. 291-302
Author(s):  
Mariam F. Eskander ◽  
Christopher T. Aquina ◽  
Aslam Ejaz ◽  
Timothy M. Pawlik
Keyword(s):  
Colorectal Cancer ◽  
Portal Vein ◽  
Surgical Oncology ◽  
Portal Vein Ligation ◽  
Safe Alternative ◽  
Colorectal Cancer Liver Metastases ◽  
Liver Remnant ◽  
New Era ◽  
Ablation Therapy

AbstractAdvances in the field of surgical oncology have turned metastatic colorectal cancer of the liver from a lethal disease to a chronic disease and have ushered in a new era of multimodal therapy for this challenging illness. A better understanding of tumor behavior and more effective systemic therapy have led to the increased use of neoadjuvant therapy. Surgical resection remains the gold standard for treatment but without the size, distribution, and margin restrictions of the past. Lesions are considered resectable if they can safely be removed with tumor-free margins and a sufficient liver remnant. Minimally invasive liver resections are a safe alternative to open surgery and may offer some advantages. Techniques such as portal vein embolization, association of liver partition with portal vein ligation for staged hepatectomy, and radioembolization can be used to grow the liver remnant and allow for resection. If resection is not possible, nonresectional ablation therapy, including radiofrequency and microwave ablation, can be performed alone or in conjunction with resection. This article presents the most up-to-date literature on resection and ablation, with a discussion of current controversies and future directions.

Whatever Happened to the Cambridge Capital Theory Controversies? (With comments by L. Pasinetti, F. Fisher, J. Felipe and J. McCombie, R. Greenfield and reply by the authors)

2009 ◽  
pp. 4-27
Author(s):  
A. Cohen ◽  
G. Harcourt
Keyword(s):  
Economic Theory ◽  
Economic Thought ◽  
Point Of View ◽  
Chronological Order ◽  
Capital Theory

The article written by the well-known theorists and historians of economic thought contains a detailed overview of the Cambridge capital controversy, which had raged from the mid-1950-s through the mid-1970-s. The authors track the origins of the controversy and cover arguments of both sides in chronological order. From their point of view, the discussion hasnt been resolved, and its main underlying aspects were ideological beliefs and fundamental methodological controversies on the nature of equilibrium and on the role of time in economic theory. The article is published with comments written by other leading theoreticians.

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