ABSTRACT
Tumor recurrence and metastasis after liver transplantation (LT) remains one of the most important factors that affect the outcome of LT for hepatocellular carcinoma (HCC). The diagnosis and treatment strategies in the era of precision medicine, including utilizing multi-omics, high-throughput gene sequencing analysis, big data and artificial intelligence to select the biomarkers which can accurately predict the prognosis after LT, evaluating the immune status comprehensively, inducing immune tolerance, providing effective prevention for patients at a high risk of recurrence with sensitive antitumor drugs and attaching importance to individualized treatment for recurrence and metastasis, may further improve the outcome of LT. Combined with experience and review of relevant research articles, the authors elaborate perioperative diagnosis and treatment strategies of LT for HCC, aiming to promote the application of precision medicine in the field of LT.
ABSTRACT
Objective: To explore the therapeutic and recurrence-preventing effects of Qi-Replenishing and Blood-Activating Formula in rats with acetic acid-induced gastric ulcer. Methods: A total of 138 SD rats were selected to make rat models with gastric ulcer induced by acetic acid (24 rats with sham operation served as sham operation group), and were randomly divided into model group (n = 30), western medicine group (n = 30), traditional Chinese medicine (TCM) group (n = 24) and combination group (combined western medicine and TCM group, n = 30). Western medicine group was gavaged with omeprazole in the morning and with iso-volumetric distilled water in the afternoon; TCM group and TCM sham operation group were gavaged with iso-volumetric distilled water in the morning and with Qi-Replenishing and Blood-Activating Formula in the afternoon; combination group was gavaged with omeprazole in the morning and with Qi-Replenishing and Blood-Activating Formula in the afternoon; sham operation group and model group were gavaged with iso-volumetric distilled water both in the morning and afternoon. Ulcer indexes and degree of mucosal degree in rats at different time points after gavage were observed. Twenty-eight days after gavage, interleukin (IL)-1β was given to induce ulcer recurrence so as to observe the recurrent severity and rate of ulcer in each group. Results: Compared with model group and western medicine group, treatment in combination group could prominently reduce the ulcer index of rats with peptic ulcer, and increase the healing rate and inhibition rate of peptic ulcer. After IL-1β-induced ulcer recurrence, combination group was significantly superior to model group and western medicine group in ulcer recurrent rate [50% (3/6) vs. 100% (6/6)] and severity. Conclusions: Basic acid-suppression therapy combined with Qi-Replenishing and Blood-Activating Formula can effectually improve the ulcer healing quality and reduce ulcer recurrence.
ABSTRACT
OBJECTIVE@#To explore the therapeutic and recurrence-preventing effects of Qi-Replenishing and Blood-Activating Formula in rats with acetic acid-induced gastric ulcer.@*METHODS@#A total of 138 SD rats were selected to make rat models with gastric ulcer induced by acetic acid (24 rats with sham operation served as sham operation group), and were randomly divided into model group (n = 30), western medicine group (n = 30), traditional Chinese medicine (TCM) group (n = 24) and combination group (combined western medicine and TCM group, n = 30). Western medicine group was gavaged with omeprazole in the morning and with iso-volumetric distilled water in the afternoon; TCM group and TCM sham operation group were gavaged with iso-volumetric distilled water in the morning and with Qi-Replenishing and Blood-Activating Formula in the afternoon; combination group was gavaged with omeprazole in the morning and with Qi-Replenishing and Blood-Activating Formula in the afternoon; sham operation group and model group were gavaged with iso-volumetric distilled water both in the morning and afternoon. Ulcer indexes and degree of mucosal degree in rats at different time points after gavage were observed. Twenty-eight days after gavage, interleukin (IL)-1β was given to induce ulcer recurrence so as to observe the recurrent severity and rate of ulcer in each group.@*RESULTS@#Compared with model group and western medicine group, treatment in combination group could prominently reduce the ulcer index of rats with peptic ulcer, and increase the healing rate and inhibition rate of peptic ulcer. After IL-1β-induced ulcer recurrence, combination group was significantly superior to model group and western medicine group in ulcer recurrent rate [50% (3/6) vs. 100% (6/6)] and severity.@*CONCLUSIONS@#Basic acid-suppression therapy combined with Qi-Replenishing and Blood-Activating Formula can effectually improve the ulcer healing quality and reduce ulcer recurrence.
ABSTRACT
Patients with relapsing eye diseases can be treated using Kampo medicine to prevent recurrence. In our 30-year experience, only 27 patients have been treated with a Kampo formula aimed at preventing recurrence. Their conditions have included hordeolum, multiple chalazion, subconjunctival hemorrhage, filamentary keratitis, corneal herpes, Posner-Schlossman syndrome, central serous chorioretinopathy and vitreous hemorrhage. Of our patients with these conditions, the number with a successful Kampo treatment outcome for more than 3 years has been 12, when following the principles of Kampo medicine, i.e., “treatment according to a Kampo pattern of identification.”It is considered difficult to prevent recurrence in patients with relapsing eye disease, but our results indicate the effectiveness of Kampo medicine for such patients and, therefore, we believe Kampo medicine should be used continuously for these conditions in the future.In addition, there are no standard guidelines regarding a treatment time required to confirm success in preventing a recurrence in patients with relapsing disease, but we assume that it should to be more than 3 or 4 years.
ABSTRACT
La infección del tracto urinario (ITU), con sus múltiples presentaciones clínicas, está entre las enfermedades infecciosas más frecuentes, tanto en pacientes ambulatorios como hospitalizados. El uso del examen de orina completa y de urocultivo debe ser racional. La bacteriuria asintomática no debe ser buscada ni tratada, en parte porque esto favorece el desarrollo de bacterias resistentes a antibióticos. Distintos cuadros clínicos requieren de distintas duraciones de terapia antibiótica, y tanto el exceso de días de tratamiento como su falta deben evitarse. Se requiere investigación en la búsqueda de estrategias más efectivas para prevenir las ITU recurrentes y en el desarrollo de nuevos antibióticos orales para las ITU resistentes.
Urinary tract infection, with its multiple clinical presentations, is one of the most common infectious diseases in both ambulatory and hospitalized patients. The urinalysis and urine culture should be used when appropriate. Asymptomatic bacteriuria should not be screened or treated, in part because of a concern for the selection of antibiotic resistant bacteria. The appropriate duration of treatment of urinary tract infection should be completed. Research is needed in newstrategies for prevention of recurrent urinary tract infections and development of new oral antibiotics for drug resistant bacteria.
Subject(s)
Humans , Urinary Tract Infections/diagnosis , Urinary Tract Infections/therapy , Cystitis/diagnosis , Cystitis/therapy , Urinary Tract Infections/etiology , Urinary Tract Infections/urine , Pyelonephritis/diagnosis , Pyelonephritis/therapy , Risk Factors , Secondary PreventionABSTRACT
Objetivos: descrever um caso de recorrência da Síndrome Alcoólica Fetal em duas gerações de uma família brasileira. Descrição do caso: uma paciente de 24 anos, filha de mãe alcoólatra, foi adotada ainda no período neonatal e teve diagnóstico confirmado de Síndrome Alcoólica Fetal. A paciente começou a consumir bebidas alcoólicas durante a adolescência, mantendo o etilismo durante a primeira e segunda gestação, com ambos os conceptos apresentando Síndrome Alcoólica Fetal ao nascimento. Na terceira gestação, não houve ingestão de bebidas alcoólicas, nascendo uma menina não acometida pela síndrome. Todos os indivíduos acometidos preenchem os critérios diagnósticos: exposição pré-natal ao álcool, dismorfismo crânio-facial, deficiência de crescimento (baixa estatura) e acometimento do sistema nervoso central.Conclusões: apesar da recorrência de Síndrome Alcoólica Fetal ser relativamente frequente entre irmãos e estar bem documentada na literatura, a recorrência familial em indivíduos de duas gerações (como mãe-filhos) é rara. Sendo uma síndrome evitável, há necessidade de intervenção multiprofissional e interdisciplinar na prevenção da mesma, atuando não apenas nos grupos de risco, como mulheres alcoólatras, mas também em mulheres jovens, etilistas sociais e com vida sexual ativa, conscientizando-as sobre os possíveis efeitos da exposição ao álcool na gestação.
Aims: To report a case of recurrence of fetal alcohol syndrome in two generations of a brazilian family. Case description: A 24-year old female, daughter of an alcohol addicted woman, was adopted during neonatal period, and had fetal alcohol syndrome diagnosis confirmed. She started alcohol consumption during her adolescence and had alcohol exposure during her first and second pregnancies, with both newborns showing signs of fetal alcohol syndrome at birth. In her third pregnancy, there was no alcohol exposure and she gave birth to a non-affected daughter. All affected patients fulfill the diagnosis criteria: alcohol pre-natal exposure, cranio-facial dysmorphism, growth retardation (short stature) and central nervous system involvement.Conclusions: Although the recurrence in fetal alcohol syndrome is quite common among siblings and has been well documented in literature, the recurrence in relatives from different generations, such as mother-child occurrence, is rare. Given that this is a preventable syndrome, it is important to implement an interdisciplinary approach, not only for groups with risk factors, but educating women in general about the deleterious effects of alcohol ingestion during pregnancy.
ABSTRACT
Nos casos de hiperparatireoidismo secundário onde não é possível o tratamento clínico, é indicada a paratireoidectomia. No Serviço de Cirurgia de Cabeça e Pescoço do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, o tipo de cirurgia utilizada é a paratireoidectomia total com auto-implante de paratireóide em membro superior. Nesses casos, ao contrário da paratireoidectomia total, pode haver recidiva do hiperparatireoidismo no sítio do implante, com sintomas sistêmicos e com necessidade de intervenção para retirada do tecido hiperplásico. Já na paratireoidectomia total, há hipoparatireoidismo definitivo e risco de doença óssea adinâmica. O presente estudo tem como escopo avaliar os pacientes submetidos a paratireoidectomia com implante e esclarecer se há fatores clínicos e de imunohistoquímica que possam indicar antes da cirurgia algum risco de recidiva no implante.
When clinical treatment of secondary hyperparathyroidism fails, parathyroidectomy is mandatory. Total parathyroidectomy and immediate parathyroid autotransplantation in the forearm is the treatment of choice at Head and Neck Surgery of Hospital das Clínicas of University of São Paulo Medical School. In this cases, recurrent hyperparathyroidism may be caused by hyperplastic graft tissue. Without autotransplantation, adinamic bone disease may occur. The present study seek to evaluate patients submitted to total parathyroidectomy and autotransplantation and try to clarify clinical or immunohistochemical.