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SUBMITTER: Krzhizhanovskaya V
PROVIDER: S-EPMC7304771 | biostudies-literature | 2020 May
REPOSITORIES: biostudies-literature
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Project description:E-JOURNAL LINKED ABSTRACT URL http://www.current-oncology.com/index.php/oncology/article/view/840/ Pseudocirrhosis is a rare form of liver disease that causes clinical symptoms and shows radiographic signs of cirrhosis, but that has histologic features suggesting a distinct pathologic process. In the setting of cancer, hepatic metastases and systemic chemotherapy are suspected causes of pseudocirrhosis. We present the case of a 49-year-old woman with medullary thyroid carcinoma metastatic to the liver who developed pseudocirrhosis. The patient was initially enrolled in a phase i clinical trial of 5-fluorouracil, leucovorin, and oxaliplatin (folfox) in combination with sunitinib (NCT00599924). After this patient’s liver metastases regressed measurably, she was switched to sunitinib maintenance. After 4 months of combination therapy with folfox–sunitinib and 15 months of sunitinib maintenance, she developed abdominal bloating, early satiety, and right upper quadrant pain that increased with inspiration. Computed tomography of the abdomen revealed cirrhotic morphology changes in the liver, including the appearance of a nodular surface and capsular retraction. The patient had no risk factors for cirrhosis and laboratory testing for causes of liver disease were normal or negative. Core-needle liver biopsy demonstrated sheets and nests of epithelioid and spindle cells resembling the primary tumor; septal fibrosis and regenerative nodules typical of cirrhosis were not observed. The background hepatic plate architecture was intact. Laboratory studies showed increased aminotransferases, alkaline phosphatase, and international normalized ratio, and decreased albumin. Portal hypertension, esophageal varices, portal hypertensive gastropathy, and hepatic hydrothorax developed as a result of advanced liver disease. Because of disease progression, sunitinib was discontinued, and the patient was managed with sorafenib. Pseudocirrhosis has often been attributed to chemotherapeutic agents, particularly in the context of metastatic breast cancer. The toxicity profiles of folfox and sunitinib include hepatic steatosis and other forms of hepatotoxicity, but cirrhotic-like disease has not been reported. Considering the transformation of discrete hepatic metastases into a diffuse carcinomatous infiltrate and the unrelated toxicities of folfox and sunitinib, we diagnosed this patient with carcinomatous pseudocirrhosis secondary to metastatic medullary thyroid carcinoma. We discuss the diagnosis of pseudocirrhosis in this case and review the literature regarding pseudocirrhosis in cancer.
| S-EPMC3267587 | biostudies-literature
Project description:Venous thromboembolism (VTE) and atrial fibrillation (AF) is a major burden on the health care system. The average occurrence of venous thromboembolism annually is around 108 per 100,000 person-year. DOACs have transformed treatment of coagulation disorder, and now, it is the leading treatment for stroke prevention in AF and VTE prophylaxis and treatment. For more many years, oral vitamin K antagonists (VKAs) were the drug of choice in managing VTE. VKAs treatment is safe and effective if therapeutic international normalized ratio (INR) maintained on the target. However, achieving a stable, therapeutic international normalized ratio (INR) can be difficult and challenging in the context of drug and food interactions and liver disorder, resulting in undertreatment which increases the risk of thromboembolism or overtreatment which might cause bleeding. Herein, we provide an overview of DOACs indications, use in specific comorbidities, monitoring parameters, perioperative management, and reversal agents.
| S-EPMC9638657 | biostudies-literature
Project description:ObjectiveThis study measured the effect the experience of house calls might have on third-year medical students.MethodsStudents were surveyed via an anonymous online survey at the start of their geriatrics clerkship, again at the end of their clerkship, and once more three months later. Empathy was measured using the Jefferson Scale of Empathy - Student version (JSE) and student attitudes towards the geriatrics population was measured using the UCLA Geriatrics Attitudes Scale (GAS). Data were analyzed using SPSS version 27.0.ResultsNo changes in empathy were found when comparing students who completed house calls versus those who did not. However, students who trained in office settings were noted to have higher JSE scores at the three-month follow-up survey, students who worked in hospital settings had higher JSE scores at the completion of the clerkship, and student who worked in assisted living facilities had higher GAS scores at the completion of the clerkship.ConclusionsTeaching students ways to improve empathy can be challenging. The setting in which a student trains may be an area of focus for improving empathy among trainees and should be researched further.
| S-EPMC10192808 | biostudies-literature
Project description:BackgroundA total proctocolectomy followed by ileal pouch-anal anastomosis is a potentially curative surgery for ulcerative colitis or familial adenomatous polyposis. About 5-35% of patients with ulcerative colitis and 0-11% of patients with familial adenomatous polyposis develop subsequent inflammation of the ileal pouch termed pouchitis.AimTo provide a comprehensive analysis of the research studying the possible pathogenesis of pouchitis. The goals were to identify promising areas of investigation, to help focus clinicians, researchers and patients on how to better understand and then potentially manage ileal pouchitis, and to provide avenues for future research investigations.MethodsThis review examined manuscripts from 1981 to 2015 that discussed and/or proposed hypotheses with supportive evidence for the potential underlying pathogenic mechanism for pouchitis.ResultsThe pathogenesis of pouchitis is not definitively understood, but various hypotheses have been proposed, including (i) recurrence of ulcerative colitis, (ii) dysbiosis of the ileal pouch microbiota, (iii) deprivation of nutritional short-chain fatty acids, (iv) mucosal ischaemia and oxygen-free radical injury, (v) host genetic susceptibility and (vi) immune dysregulation. However, none of these alone are able to fully explain pouchitis pathogenesis.ConclusionsPouchitis, similar to inflammatory bowel disease, is a complex disorder that is not caused by any one single factor. More likely, pouchitis occurs through a combination of both dysregulated host inflammatory mechanisms and interaction with luminal microbiota.
| S-EPMC5785099 | biostudies-literature
Project description:BackgroundThe hip resurfacing concept was developed for young and active patients, especially for femoral bone stock preservation. However, concerns about metal-on-metal bearings with adverse reactions to metal debris have led to a drop off in hip-resurfacing procedures.Questions/purposesThe goal of this review is to evaluate our current knowledge of survivorship of second-generation hip resurfacing devices and elaborate international perspectives for product improvement.MethodsA comprehensive literature search provided information on national joint arthroplasty registers worldwide with a minimum of 3000 reported hip resurfacings. It culminated in the analysis of six registers.ResultsLong-term data showed that available hip resurfacing device survivorship ranged from 95 to 99.7% with 10 years of follow-up, in selected patient populations. The criteria for success were well known, male gender, good bone quality, head component size greater than 48 mm, and cup inclination less than 45°. On the other hand, the recent recall of some hip-resurfacing devices has resulted in huge medico-legal problems and has discredited all implants. It has brought about the recent evolution of hip resurfacing. Femoral fixation is now available for cemented and cementless surfaces. Bearings are still always metal-on-metal, but new types have come on board. Newer designs suggest that ceramic-on-ceramic, cross-linked polyethylene, and oxinium may be applied in this configuration.ConclusionsIn 2015, the evolution of hip resurfacing is ongoing in terms of implant design, alternative bearings, and implant fixation with hopes of improving survivorship.
| S-EPMC5264568 | biostudies-literature
Project description:Alcohol-related hepatitis (ARH) is a unique type of alcohol-associated liver disease characterized by acute liver inflammation caused by significant alcohol use. It ranges in severity from mild to severe and carries significant morbidity and mortality. The refinement of scoring systems has enhanced prognostication and guidance of clinical decision-making in the treatment of this complex disease. Although treatment focuses on supportive care, steroids have shown benefit in select circumstances. There has been a recent interest in this disease process, as coronavirus disease 2019 pandemic led to substantial rise in cases. Although much is known regarding the pathogenesis, prognosis remains grim due to limited treatment options. This article summarizes the epidemiology, genetics, pathogenesis, diagnosis and treatment of ARH.
| S-EPMC10198060 | biostudies-literature
Project description:Thanks to its unique features at the nanoscale, nanofluidics, the study and application of fluid flow in nanochannels/nanopores with at least one characteristic size smaller than 100 nm, has enabled the occurrence of many interesting transport phenomena and has shown great potential in both bio- and energy-related fields. The unprecedented growth of this research field is apparently attributed to the rapid development of micro/nanofabrication techniques. In this review, we summarize recent activities and achievements of nanofabrication for nanofluidic devices, especially those reported in the past four years. Three major nanofabrication strategies, including nanolithography, microelectromechanical system based techniques, and methods using various nanomaterials, are introduced with specific fabrication approaches. Other unconventional fabrication attempts which utilize special polymer properties, various microfabrication failure mechanisms, and macro/microscale machining techniques are also presented. Based on these fabrication techniques, an inclusive guideline for materials and processes selection in the preparation of nanofluidic devices is provided. Finally, technical challenges along with possible opportunities in the present nanofabrication for nanofluidic study are discussed.
| S-EPMC3612116 | biostudies-other
Project description: Not available
| S-EPMC8203399 | biostudies-literature
Project description:There is broad agreement that current food systems are not on a sustainable trajectory that will enable us to reach the Sustainable Development Goals by 2030, particularly in the face of anthropogenic climate change. Guided by a consideration of some food system reconfigurations in the past, we outline an agenda of work around four action areas: rerouting old systems into new trajectories; reducing risks; minimising the environmental footprint of food systems; and realigning the enablers of change needed to make new food systems function. Here we highlight food systems levers that, along with activities within these four action areas, may shift food systems towards more sustainable, inclusive, healthy and climate-resilient futures. These actions, summarised here, are presented in extended form in a report of an international initiative involving hundreds of stakeholders for reconfiguring food systems. Highlights • Food systems need to shift towards more sustainable, inclusive, healthy and climate-resilient futures.• Food systems reconfiguration needs to happen in the next ten years in order to achieve the Paris agreement and SDG agenda.• Food systems reconfiguration include rerouting trajectories, reducing risks and emissions, realigning enablers of change.• Actions for food systems reconfiguration need to be tailored to the diversity of farmer types.
| S-EPMC7523551 | biostudies-literature