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Lithium-sulfur (Li-S) battery is one of the most promising next-generation rechargeable batteries. Lots of fundamental research has been done for the problems during cycling like capacity fading and columbic efficiency reducing owing to severe diffusion and migration of polysulfide intermediates. In the early stage, a wide variety of carbon materials are used as host materials for sulfur to enhance electrical conductivity and adsorb soluble polysulfides. Beyond carbon materials, metal based polar compounds are introduced as host materials for sulfur because of their strong catalytic activity and adsorption ability to suppress the shuttle effect. In addition, relatively high density of metal compounds is helpful for increasing volumetric energy density of Li-S batteries. This review focuses on crystalline multi-metal compounds as host materials in sulfur cathodes. The multi-metal compounds involve not only transition metal composite oxides with specific crystalline structures, binary metal chalcogenides, double or complex salts, but also the metal compounds doped or partially substituted by other metal ions. Generally, for the multi-metal compounds, microstructure and morphologies in micro-nano scale are very significant for mass transfer in electrodes; moreover, adsorption and catalytic ability for polysulfides make fast kinetics in the electrode processes.
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Due to its aggressive nature and low survival rate, esophageal cancer is one of the deadliest cancer. While the intestinal microbiome significantly influences human health and disease. This research aimed to investigate and characterize the relative abundance of intestinal bacterial composition in esophageal cancer patients. The fecal samples were collected from esophageal cancer patients (n = 15) and healthy volunteers (n = 10). The PCR-DGGE was carried out by focusing on the V3 region of the 16S rRNA gene, and qPCR was performed for Bacteroides vulgatus, Escherichia coli, Bifidobacterium, Clostridium leptum and Lactobacillus. High-throughput sequencing of the 16S rRNA gene targeting the V3+V4 region was performed on 20 randomly selected samples. PCR-DGGE and High-throughput diversity results showed a significant alteration of gut bacterial composition between the experimental and control groups, which indicates the gut microbial dysbiosis in esophageal cancer patients. At the phylum level, there was significant enrichment of Bacteroidetes, while a non-significant decrease of Firmicutes in the experimental group. At family statistics, a significantly higher level of Bacteroidaceae and Enterobacteriaceae, while a significantly lower abundance of Prevotellaceae and Veillonellaceae were observed. There was a significantly high prevalence of genera Bacteroides, Escherichia-Shigella, while a significantly lower abundance of Prevotella_9 and Dialister in the experimental group as compared to the control group. Furthermore, the species analysis also showed significantly raised level of Bacteroides vulgatus and Escherichia coli in the experimental group. These findings revealed a significant gut microbial dysbiosis in esophageal cancer patients. So, the current study can be used for the understanding of esophageal cancer treatment, disease pathway, mechanism, and probiotic development.
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Neoplasias Esofágicas , Microbioma Gastrointestinal , Bacteroides , Bacteroidetes/genética , Estudos de Casos e Controles , Disbiose/microbiologia , Escherichia coli/genética , Microbioma Gastrointestinal/genética , Humanos , RNA Ribossômico 16S/genéticaRESUMO
The objective was to develop eperisone HCl sustained-release pellets through extrusion spheronization technique and to determine the influence of different hydrophobic (polymeric based and wax-based) and hydrophilic (polymeric based) matrix former on the release of eperisone HCl (BCS class I drug) and on pellet sphericity. The pellet formulations consisted of different hydrophobic and hydrophilic matrix formers like HPMC K4M (10-20%) HPMC K15M (10%), EC (7cps) (10-20%), Carnauba wax (10-20%), Compritol ATO 888 (10-20%), Glyceryl monostearate (10%), lactose and microcrystalline cellulose. The initial burst release of the drug from matrix pellet formulations was effectively controlled by coating with 5% EC (ethylcellulose) dispersion. The dissolution profile and drug release kinetics of coated pellet formulations were determined at both acidic and basic pH medium. SEM (Scanning electron microscope) technique was used to determine the surface morphology and cross-section of F5 and F7 pellet formulation. The mechanism of drug release of coated formulation followed non-Fickian diffusion. FTIR spectroscopy was conducted and no drug and excipients interaction was observed. The results had shown that optimized coated formulation was F5 and F7 which effectively extend the drug release for 12 hours.
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Preparações de Ação Retardada/farmacocinética , Relaxantes Musculares Centrais/farmacocinética , Propiofenonas/farmacocinética , Celulose/análogos & derivados , Química Farmacêutica , Preparações de Ação Retardada/química , Desenvolvimento de Medicamentos , Liberação Controlada de Fármacos , Excipientes/química , Ácidos Graxos , Glicerídeos , Lactose/análogos & derivados , Metilcelulose/análogos & derivados , Microscopia Eletrônica de Varredura , Relaxantes Musculares Centrais/administração & dosagem , Relaxantes Musculares Centrais/química , Polímeros , Propiofenonas/administração & dosagem , Propiofenonas/química , Espectroscopia de Infravermelho com Transformada de Fourier , CerasRESUMO
Increasing agricultural productivity via modern breeding strategies is of prime interest to attain global food security. An array of biotic and abiotic stressors affect productivity as well as the quality of crop plants, and it is a primary need to develop crops with improved adaptability, high productivity, and resilience against these biotic/abiotic stressors. Conventional approaches to genetic engineering involve tedious procedures. State-of-the-art OMICS approaches reinforced with next-generation sequencing and the latest developments in genome editing tools have paved the way for targeted mutagenesis, opening new horizons for precise genome engineering. Various genome editing tools such as transcription activator-like effector nucleases (TALENs), zinc-finger nucleases (ZFNs), and meganucleases (MNs) have enabled plant scientists to manipulate desired genes in crop plants. However, these approaches are expensive and laborious involving complex procedures for successful editing. Conversely, CRISPR/Cas9 is an entrancing, easy-to-design, cost-effective, and versatile tool for precise and efficient plant genome editing. In recent years, the CRISPR/Cas9 system has emerged as a powerful tool for targeted mutagenesis, including single base substitution, multiplex gene editing, gene knockouts, and regulation of gene transcription in plants. Thus, CRISPR/Cas9-based genome editing has demonstrated great potential for crop improvement but regulation of genome-edited crops is still in its infancy. Here, we extensively reviewed the availability of CRISPR/Cas9 genome editing tools for plant biotechnologists to target desired genes and its vast applications in crop breeding research.
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Sistemas CRISPR-Cas , Edição de Genes/métodos , Genoma de Planta , Plantas/genética , Produtos Agrícolas/genética , Melhoramento Vegetal , Plantas Geneticamente Modificadas/genéticaRESUMO
OBJECTIVE: To find the causative mutation by linkage analysisof Charcot-Marie-Tooth disease while focussing on AMACR gene. METHODS: The case-control study was conducted from November 2016 to March 2017 in Kongju National University Korea.A family of 15 members with composite symptoms of peripheral neuropathy were enrolled. In addition, 50 healthy controls, which had no clinical features and family history of neuromuscular disorders, were also recruited. The family was selected for sequencing analysis by using capillary sequencing. It was sequenced for all the causative genes for CMT disease i.e. PMP22, MPZ, MFN2, GDAP1, NEFL, CX32, MYH14, LMNA, TRPV4, LITAF. Various regions of chromosome were suspected based on the logarithm of the odds score. RESULTS: Of the 15-member family, 7(47%) were affected and 8(53%)were unaffected. Those unaffected also acted as the controls. A missense mutation was found in exon 1 of the AMACR gene at p.Gly175Asp position. The mutation was also found in some of the unaffected members as well as in the control samples. CONCLUSIONS: As the mutation was found in the healthy samples as well, it can be said that the current mutation AMACR can be involved in some other forms of peripheral neuropathy which can be with other phenotypes.
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Doença de Charcot-Marie-Tooth/genética , DNA/genética , Mutação , Racemases e Epimerases/genética , Doença de Charcot-Marie-Tooth/metabolismo , Análise Mutacional de DNA , Feminino , Seguimentos , Humanos , Masculino , Linhagem , Fenótipo , Reação em Cadeia da Polimerase , Racemases e Epimerases/metabolismo , Estudos RetrospectivosRESUMO
BACKGROUND: Recently published data indicate increasing incidence of colorectal adenocarcinoma (CRC) in young-onset (<50 years) patients. AIMS: This study examines racial disparities in presentation and survival times among non-Hispanic Blacks (NHB) and Hispanics compared with non-Hispanic Whites (NHW). METHODS: A retrospective single-center cohort study was conducted from 2004 through 2014 using 96 patient medical charts with a diagnosis of young-onset CRC. Age, gender, primary site, and histological stage at the time of diagnosis were assessed for survival probabilities by racial group over a minimum follow-up period of 5 years. RESULTS: Among subjects with CRC diagnosis before 50 years of age, the majority of subjects were between 40 and 50 years, with CRC presentation occurring among this age group for 51 (79.7%) of NHW, 18 (81.8%) of NHB, and 5 (50.0%) of Hispanics. The majority of all patients presented with advanced stages of CRC (31.3% with stage III and 27.1% with stage IV). NHB exhibited statistically significantly worse survival compared to NHW (adjusted hazard ratio for death = 2.09; 95% confidence interval 1.14-3.84; P = 0.02). A possible trend of worse survival was identified for Hispanics compared to NHW, but this group was low in numbers and results were not statistically significant. CONCLUSION: Disparities between racial groups among young-onset CRC cases were identified in overall survival and reflect growing concern in rising incidence and differentiated care management.
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Adenocarcinoma/diagnóstico , Adenocarcinoma/mortalidade , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/mortalidade , Disparidades nos Níveis de Saúde , Grupos Raciais/estatística & dados numéricos , Adolescente , Adulto , Idade de Início , População Negra/estatística & dados numéricos , Estudos de Coortes , Feminino , Seguimentos , Hispânico ou Latino/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida/tendências , População Branca/estatística & dados numéricos , Adulto JovemRESUMO
Studies reporting the effects of oxytocin on the health of lactating animals are lacking and still no such data is available on Nili Ravi buffalo, the most prominent Asian buffalo breed. The present study was conducted to investigate the effect of oxytocin on physiological and metabolic parameters of lactating Nili Ravi buffaloes. Healthy lactating buffaloes (n = 40) of recent calving were selected from a commercial dairy farm situated in the peri-urban area of district Faisalabad, Pakistan. These buffaloes were randomly allocated to two equal groups viz experimental and control, comprising 20 animals each. Twice-a-day (morning and evening) milking practice was followed. The experimental and control buffaloes were administered subcutaneously with 3 mL of oxytocin (10 IU/mL) and normal saline respectively, prior to each milking. Serum biochemical profile including glucose, total cholesterol (tChol), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), total proteins (TP), C-reactive protein (CRP), liver enzymes aspartate transaminase (AST), alanine transaminase (ALT), and metabolic hormones triiodothyronine (T3) and thyroxine (T4) were studied. Results revealed significantly higher (P ≤ 0.01) levels of glucose, total cholesterol, LDL-C, triglycerides, total proteins, and C-reactive protein in experimental (oxytocin-injected) lactating buffaloes compared to control group. Liver enzymes AST and ALT as well as serum T4 concentration was significantly higher (P ≤ 0.01) in oxytocin-injected lactating buffaloes as compared to control animals. It was concluded that oxytocin had the key role in increasing the metabolic parameters and hormones, resulting in the optimization of production. But, at the same time, it may pose a threat to the animal health.
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Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Búfalos/fisiologia , Lactação/sangue , Lactação/efeitos dos fármacos , Ocitocina/sangue , Animais , Búfalos/sangue , Proteína C-Reativa/metabolismo , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Hormônios/sangue , Fígado/efeitos dos fármacos , Fígado/enzimologia , Leite , Paquistão , Triglicerídeos/sangueRESUMO
Use of technology in education has increased worldwide. Teaching methodologies are shifting from traditional classroom lectures to e-learning and computer-based learning. Pakistani students are also now fathoming necessity of acquiring tools for strengthening their knowledge and skills. The objective of present study was to analyze the shifting trends (perception and attitudes) of Pakistani Pharmacy students towards learning tools. A survey based study conducted on 296 students from various years of Pharmacy, studying in a state owned university, Karachi, Pakistan. This study was initially piloted and Cronbach's-alpha was computed for evaluation of internal consistency of questionnaire (for perception; 0.660, for attitude; 0.777 respectively). Data was computed by SPSS, version 16 (Crosstab) and Chisquare (P=0.05). Most of the students strongly agreed (53%; χ² =495;P<0.05) that introducing technology will improve learning; books are reliable reading source (53%; χ² =437.23; P<0.05) or book-reading is essential (50%; χ² =360.36; P<0.05) while others disagreed that they only study from class lectures (31%; χ² =17.22; P<0.05); not take classes (41%; χ² =48.21; P<0.05); have used software (44%; χ² =46.54; P<0.05). Majority of the students agreed on incorporating technology to improve learning. Other factors such as unavailability and expenditure of books influenced their ability to learn. This study might assist policy makers in developing policies that could improve learning.
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Atitude do Pessoal de Saúde , Atitude Frente aos Computadores , Instrução por Computador/métodos , Educação em Farmácia/métodos , Percepção , Estudantes de Farmácia/psicologia , Ensino/métodos , Acesso à Informação , Adolescente , Distribuição de Qui-Quadrado , Currículo , Feminino , Humanos , Masculino , Paquistão , Inquéritos e Questionários , Adulto JovemRESUMO
Brown spot caused by Bipolaris oryzae is a major damaging fungal disease of rice which can decrease the yield and value of produce due to grain discoloration. The objectives of the current study were to investigate and understand the biochemical indices of brown spot disease resistance in rice. A total of 108 genotypes (mutant and hybrid) along with Super Basmati and parent RICF-160 were evaluated against brown spot disease. The genotypes exhibiting resistant and susceptible responses to brown spot disease according to the IRRI standard disease rating scale were screened and selected. To study the biochemical response mechanism, forty five selected genotypes along with Super Basmati and RICF-160 were analyzed using the biochemical markers. The physiological and biochemical analysis provided valuable insights and confirmed the resistance of rice hybrids and mutants against brown spot disease. Positive correlations were observed among stress bio-markers and disease response. Rice genotypes i.e. Mu-AS-8, Mu-AS-19, Mu-AS-20 and Mu-AS-35 exhibited moderate resistant response while Hy-AS-92, Hy-AS-98, Hy-AS-99, Hy-AS-101, Hy-AS-102 and Hy-AS-107 showed resistant response to brown spot disease. Brown spot resistant rice genotypes had lesser values of malondialdehyde and total oxidant status and higher antioxidant activities i.e. superoxide dismutase, peroxidase, total phenolic content and lycopene. The selected resistant rice genotypes had resistance capacity against Bipolaris oryzae stress. In conclusion, identified resistant mutants i.e. Mu-AS-8, Mu-AS-19, Mu-AS-20 and Mu-AS-35 and hybrids i.e. Hy-AS-92, Hy-AS-98, Hy-AS-99, Hy-AS-101, Hy-AS-102 and Hy-AS-107 could be used in rice breeding program to achieve sustainable rice production by coping the emerging challenge of brown spot disease under variable climate conditions.
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Bipolaris , Etilenos , Oryza , Oryza/genética , Oryza/microbiologia , Resistência à Doença/genética , Melhoramento VegetalRESUMO
BACKGROUND: Esophageal carcinoma presents as 2 types, esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC) with the frequency of both changing in the United States (US). AIM: To investigate EAC/ESCC incidence time trends among the 3 main US racial groups and investigate trends in US EAC survival by ethnicity. METHODS: Twenty-five years (1992-2016) of data from SEER 13 program was analyzed to compare incidence trends in EAC and ESCC between non-Hispanic whites (nHW), non-Hispanic Blacks (nHB) and Hispanics (Hisp) using SEERStat®. In addition, SEER 18 data, from 1975-2015, on EAC in the US was analyzed to evaluate racial disparities in incidence and survival using SEERStat® and Ederer II method. RESULTS: In the 3 major US ethnic groups, age-adjusted incidence of ESCC has declined while EAC has continued to rise from 1992-2016. Of note, in Hisp, the EAC incidence rate increased while ESCC decreased from 1992 to 2016, resulting in EAC as the predominant esophageal cancer subtype in this group since 2011, joining nHW. Furthermore, although ESCC remains the predominant tumor in nHB, the difference between ESCC and EAC has narrowed dramatically over 25 years. EAC survival probabilities were worse in all minority groups compared to nHw. CONCLUSION: Hisp have joined nHW as US ethnic groups more likely to have EAC than ESCC. Of note, EAC incidence in nHB is increasing at the highest rate nationally. Despite lower EAC incidence in all minority groups compared to nHW, these populations have decreased survival compared to nHW.
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Lithium-sulfur batteries with high theoretical energy density have emerged as one of the most promising next-generation rechargeable batteries, while their discharge capacity and cycle stability are challenges mainly due to the shuttle effect of polysulfide intermediates. Employing an effective catalyst for the conversion of polysulfides in cathode reactions can promote the reaction kinetics to restrain the shuttle of polysulfides. Here, for the first time, La2MoO6 (LMO) as a catalyst is introduced into sulfur cathodes. To investigate the effect of La2MoO6, we prepare two different structures of La2MoO6/carbon nanofiber composites. One is carbon nanofiber-supported crystalline La2MoO6 nanoparticles (LMO@CNFs) and the other is amorphous La2MoO6 nanoparticles embedded in carbon nanofibers (LMO-in-CNFs). For sulfur electrodes with â¼73 wt % sulfur loading, LMO@CNFs/S and LMO-in-CNFs/S deliver initial gravimetric capacities of 1493.4 and 1246.7 mA h g-1, respectively, at a 0.1C rate, obviously higher than that of the control sample CNFs/S. Moreover, LMO@CNFs/S shows much better rate performance than LMO-in-CNFs/S, indicating strongly that La2MoO6 is a highly effective catalyst to promote kinetic conversion of polysulfides.
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Yellow (YR) and leaf (LR) rusts caused by Puccinia striiformis f. sp. tritici (Pst) and Puccinia triticina, respectively, are of utmost importance to wheat producers because of their qualitative and quantitative effect on yield. The search for new loci resistant to both rusts is an ongoing challenge faced by plant breeders and pathologists. Our investigation was conducted on a subset of 168 pre-breeding lines (PBLs) to identify the resistant germplasm against the prevalent local races of LR and YR under field conditions followed by its genetic mapping. Our analysis revealed a range of phenotypic responses towards both rusts. We identified 28 wheat lines with immune response and 85 resistant wheat genotypes against LR, whereas there were only eight immune and 52 resistant genotypes against YR. A GWAS (genome-wide association study) identified 190 marker-trait associations (MTAs), where 120 were specific to LR and 70 were specific to YR. These MTAs were confined to 86 quantitative trait loci (QTLs), where 50 QTLs carried MTAs associated with only LR, 29 QTLs carried MTAs associated with YR, and seven QTLs carried MTAs associated with both LR and YR. Possible candidate genes at the site of these QTLs are discussed. Overall, 70 PBLs carried all seven LR/YR QTLs. Furthermore, there were five PBLs with less than five scores for both LR and YR carrying positive alleles of all seven YR/LR QTLs, which are fit to be included in a breeding program for rust resistance induction.
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Many synthetic routes manufacture zirconium nanoparticles in metal oxide, nitride, and other combination forms. Coupled with other variables such as concentration, pH, and form of precursor used, the various synthetic methods support synthesizing the zirconium metal oxide nanoparticles with changed features. Various synthetic methods were studied, such as sol-gel, hydrothermal, laser ablation, and precipitation. All have different synthetic routes, different precursors and solvents were sued, and the product was characterized by SEM, TEM, photo luminance spectroscopy, UV-absorption spectroscopy, and powder X-ray diffraction. X-ray diffraction determined the crystal structure by identifying the crystal shape, arrangement of atoms, and spacing between them. SEM and TEM studied the particle size and morphology of nanoparticles. UV-visible absorption spectroscopy and PL spectroscopy were used for the determination of optical properties of nanoparticles. Zirconium oxide nanoparticles have many applications in the medical field. The review study primarily focuses on the efficient combination of zirconium dioxide with other additive materials and functionalization techniques used to improve the material's properties, assisting the use of the material in hip arthroplasty and bone tissue applications. The development of sophisticated near-infrared (NIR) absorbing small molecules for useful phototheranostic applications was discussed in this paper.
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Nanopartículas Metálicas , Nanopartículas , Nanopartículas Metálicas/química , Nanopartículas/uso terapêutico , Óxidos , Pós , Solventes , Difração de Raios X , Zircônio/química , Zircônio/uso terapêuticoRESUMO
Neurofibromatosis-1 (NF-1) is an autosomal dominant condition characterized by cutaneous pigmentation and tumour formation along nerves in the brain, skin, and other organs. Gastrointestinal stromal tumours (GIST) are rare mesenchymal tumours involving the gastrointestinal tract (GI) associated with NF-1. We present a case of life-threatening GI bleeding from GIST in a patient with NF-1. In NF-1 patients presenting with GI bleeding, GISTs should be part of the differential. Clinicians must have a low threshold for urgent abdominal imaging if endoscopy does not detect the source of GI bleeding.
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Congenital sucrase isomaltase deficiency (CSID) is an autosomal recessive disorder which leads to chronic intestinal malabsorption of nutrients from ingested starch and sucrose. Symptoms usually present after consumption of fruits, juices, grains, and starches, leading to failure to thrive and malnutrition. Diagnosis is suspected on detailed patient history and confirmed by a disaccharidase assay using small intestinal biopsies or sucrose hydrogen breath test. Treatment of CSID consists of limiting sucrose in diet and replacement therapy with sacrosidase. Due to its nonspecific symptoms, CSID may be undiagnosed in many patients for several years. We present a case of a 50-year-old woman with persistent symptoms of bloating in spite of extensive evaluation and treatment.
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OBJECTIVES: The objective of the study was to compare the two antidepressant drugs citalopram and escitalopram on the basis of efficacy in depressed patients of Hepatitis C patients receiving interferons. METHODS: In this double blind randomized trial, the hepatitis C patients visited National institute of liver and Gastro intestinal diseases (NILGID), Dow University Hospital, were screened for depression before starting treatment with interferons. The Institutional review board approval was obtained and its letter reference no.is: IRB-682/DUHS/Approval/2016/169. Patients with previous history of depression were excluded from the study. The patients who started with Interferon therapy were assessed for depression on baseline and then on each visit. Those who developed depression were randomly assigned to receive either citalopram or escitalopram. Treatment groups were assessed with depression scale each time they visit the clinic. Two antidepressants were compared for their efficacy at an interval of 4 weeks, 8weeks and then 12 weeks. RESULTS: In the current study 80 patients were randomized to receive either citalopram or escitalopram. The study outcome was better in patients treated with escitalopram. The mean change in depression score from baseline to the end of the study was greater in escitalopram group i.e. 10.41 as compared to citalopram group i.e. 14.17. The difference in depression score was also calculated as 4.28 and.3.76 (p < 0.001) for both the drugs at week 8 and week 12 respectively, which was statistically significant. Difference in depression score were also calculated for gender 0.576 (p = 0.497) and age 0.950 (p = 0.265), which were found to be non-significant, statistically. CONCLUSION: The results demonstrated superiority of escitalopram over citalopram, the drug is twice as potent as the racemic mixture. Additionally the drug is well tolerated and exhibited better effects. Escitalopram proved to be a safer alternative to citalopram.
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BACKGROUND: The measurement of liver volume (LV) is considered to be an effective prognosticator for postoperative liver failure in patients undergoing hepatectomy. It is unclear whether LV can be used to predict mortality in cirrhotic patients. METHODS: We enrolled 584 consecutive cirrhotic patients who underwent computerized topography (CT) of the abdomen for hepatocellular carcinoma surveillance and 50 age, gender, race, and BMI-matched controls without liver disease. Total LV (TLV), functional LV (FLV), and segmental liver volume (in cm3) were measured from CT imaging. Cirrhotic subjects were followed until death, liver transplantation, or study closure date of July 31, 2016. The survival data were assessed with log-rank statistics and independent predictors of survival were performed using Cox hazards model. RESULTS: Cirrhotic subjects had significantly lower TLV, FLV, and segmental (all except for segments 1, 6, 7) volume when compared to controls. Subjects presenting with hepatic encephalopathy had significantly lower TLV and FLV than those without HE (p = 0.002). During the median follow-up of 1145 days, 112 (19%) subjects were transplanted and 131 (23%) died. TLV and FLV for those who survived were significantly higher than those who were transplanted or dead (TLV:1740 vs. 1529 vs. 1486, FLV 1691 vs. 1487 vs. 1444, p < 0.0001). In the Cox regression model, age, MELD score, TLV, or FLV were independent predictors of mortality. CONCLUSION: Baseline liver volume is an independent predictor of mortality in subjects with cirrhosis. Therefore, it may be useful to provide these data while performing routine surveillance CT scan as an important added value. Further studies are needed to validate these findings and to better understand their clinical utility.
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Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/mortalidade , Tomografia Computadorizada por Raios X , Carcinoma Hepatocelular/diagnóstico por imagem , Estudos de Casos e Controles , Progressão da Doença , Feminino , Hepatectomia , Humanos , Cirrose Hepática/cirurgia , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
Elevated carbohydrate antigen 19-9 (CA19-9) beyond 1000 U/L occurs in nonneoplastic conditions which is causing questioning of the use of CA19-9 as a marker for screening. We report a case where a 51-year-old male with Mirrizi Syndrome (MS) presented with markedly increased CA19-9 level (4,618 U/mL). MS is a rare complication characterized by compression of the common bile or hepatic duct caused by an impacted gallstone in the cystic duct or neck of the gallbladder. Biliary epithelial cells secrete CA19-9: it is hypothesized that increased proliferation of such cells caused by inflammation leads to increased secretion. CA19-9 should not be used as a diagnostic tool, but rather for surveillance.
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Calciphylaxis can be a severe life-threatening dermatologic disease that is a known complication associated with end-stage renal disease. However, multiple non-uremic etiologies that are not yet well studied can cause calciphylaxis. We report a rare care of a 40-year-old female with history of alcoholic cirrhosis without any evidence of renal dysfunction who presents with calciphylaxis.
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Median arcuate ligament syndrome is a rare disorder that is clinically characterized by the triad of postprandial abdominal pain, weight loss, and often an abdominal bruit due to compression of the celiac artery by the median arcuate ligament. Given the nonspecific symptoms, this is a rare and difficult diagnosis to obtain. We present a patient with nonspecific abdominal pain in whom etiology was ultimately determined to be median arcuate ligament syndrome.