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Surgical Site Infections in Colorectal Cancer Surgeries: A Systematic Review and Meta-Analysis of the Impact of Surgical Approach and Associated Risk Factors 结直肠癌手术中的手术部位感染:手术方法和相关风险因素影响的系统回顾和荟萃分析
Pub Date : 2024-07-05 DOI: 10.3390/life14070850
Valentin Calu, Catalin Piriianu, Adrian Miron, V. T. Grigorean
Background: Surgical site infections (SSIs) represent a noteworthy contributor to both morbidity and mortality in the context of patients who undergo colorectal surgery. Several risk factors have been identified; however, their relative significance remains uncertain. Methods: We conducted a meta-analysis of observational studies from their inception up until 2023 that investigated risk factors for SSIs in colorectal surgery. A random-effects model was used to pool the data and calculate the odds ratio (OR) and 95% confidence interval (CI) for each risk factor. Results: Our analysis included 26 studies with a total of 61,426 patients. The pooled results showed that male sex (OR = 1.45), body mass index (BMI) ≥ 25 kg/m2 (OR = 1.09), American Society of Anesthesiologists (ASA) score ≥ 3 (OR = 1.69), were all independent risk factors for SSIs in colorectal surgery. Conversely, laparoscopic surgery (OR = 0.70) was found to be a protective factor. Conclusions: The meta-analysis conducted revealed various risk factors, both modifiable and non-modifiable, associated with surgical site infections (SSIs) in colorectal surgery. These findings emphasize the significance of targeted interventions, including optimizing glycemic control, minimizing blood loss, and using laparoscopic techniques whenever feasible in order to decrease the occurrence of surgical site infections in this particular group of patients.
背景:手术部位感染(SSI)是导致结直肠手术患者发病率和死亡率的一个值得注意的因素。目前已确定了几种风险因素,但其相对重要性仍不确定。方法:我们对结肠直肠手术 SSI 风险因素的观察性研究进行了荟萃分析,这些研究从开始到 2023 年一直在进行。采用随机效应模型汇总数据,并计算出每个风险因素的几率比(OR)和 95% 置信区间(CI)。结果:我们的分析包括 26 项研究,共涉及 61426 名患者。汇总结果显示,男性(OR = 1.45)、体重指数(BMI)≥ 25 kg/m2(OR = 1.09)、美国麻醉医师协会(ASA)评分≥ 3(OR = 1.69)都是结直肠手术中发生 SSI 的独立风险因素。相反,腹腔镜手术(OR = 0.70)则是一个保护因素。结论:荟萃分析揭示了与结直肠手术中手术部位感染(SSI)相关的各种风险因素,包括可改变的和不可改变的因素。这些发现强调了有针对性的干预措施的重要性,包括优化血糖控制、尽量减少失血量以及在可行的情况下使用腹腔镜技术,以减少这类特殊患者手术部位感染的发生。
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引用次数: 0
Light-Assisted Formation of Nucleosides and Nucleotides from Formamide in the Presence of Cerium Phosphate 在磷酸铈存在下光辅助甲酰胺形成核苷和核苷酸
Pub Date : 2024-07-05 DOI: 10.3390/life14070846
Shoval Gilboa, Larisa Panz, Nitai Arbell, Yaron Paz
The abiotic formation of nucleotides from small, simple molecules is of large interest in the context of elucidating the origin of life scenario. In what follows, it is shown that nucleosides and nucleotides can be formed from formamide in a one-pot reaction utilizing the mineral cerium phosphate (CePO4) as a photocatalyst, a catalyst and a reactant that supplies the necessary phosphate groups. While the most abundant RNA/DNA building blocks were thymidine and thymidine monophosphate, considerable yields of other building blocks such as cytidine, cytidine monophosphate, and adenosine cyclic monophosphate were found. Comparing the yield of nucleosides and nucleotides under light conditions to that in the dark suggests that in the presence of cerium phosphate, light promotes the formation of nucleobases, whereas the formation of nucleotides from nucleosides take place even in the absence of light. The scenario described herein is considerably simpler than other scenarios involving several steps and several reactants. Therefore, by virtue of the principle of Occam’s razor, it should be of large interest for the community.
从简单的小分子中非生物地形成核苷酸,对于阐明生命起源情景具有重大意义。下文将说明,利用矿物磷酸铈(CePO4)作为光催化剂、催化剂和提供必要磷酸基团的反应物,核苷和核苷酸可在一次反应中由甲酰胺形成。虽然最丰富的 RNA/DNA 构建模块是胸苷和胸苷单磷酸,但其他构建模块如胞苷、胞苷单磷酸和环单磷酸腺苷的产量也相当可观。比较光照条件下和黑暗条件下核苷酸和核苷酸的产量表明,在磷酸铈存在的情况下,光照会促进核碱基的形成,而核苷酸形成核苷酸的过程即使在没有光照的情况下也会发生。与其他涉及多个步骤和多个反应物的情况相比,本文描述的情况要简单得多。因此,根据奥卡姆剃刀原理,它应该引起社会的广泛关注。
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引用次数: 0
The Efficacy of Early Rehabilitation Combined with Virtual Reality Training in Patients with First-Time Acute Stroke: A Randomized Controlled Trial 早期康复结合虚拟现实训练对首次急性卒中患者的疗效:随机对照试验
Pub Date : 2024-07-05 DOI: 10.3390/life14070847
Ta-Chung Chao, Chia-Huei Lin, Meei-Shyuan Lee, Cheng-Chiang Chang, Chia-Ying Lai, Chien-Yao Huang, Wen-Yuan Chang, S. Chiang
Early rehabilitation has beneficial impacts on functional outcomes for patients with acute stroke. However, whether the addition of virtual reality (VR) training could further improve these patients’ muscle strength, functional recovery, and psychological health is unknown. A randomized controlled trial was conducted on 33 patients with first-time acute ischemic stroke. The patients were randomly assigned using a 1:1 randomization ratio to either the experimental group (EG) or the comparison group (CG). Both groups received early rehabilitation, and the EG received extra VR training during their stay in the hospital. Muscle strength, functional status, and psychological health were assessed before the intervention and at discharge. Generalized estimating equations were used to examine the intervention effects via the interaction of time and group. After adjusting for potential covariates, the EG showed a more significant decrease in depression at discharge than the CG (ß = 3.77, p = 0.011). There were no differences in muscle strength and functional recovery between groups after intervention. Adding VR training into early rehabilitation facilitates substantial positive effects on psychological health, specifically depression, but not muscle strength and functional recovery, compared to receiving early rehabilitation alone in patients with first-time acute stroke during their hospitalized period.
早期康复对急性中风患者的功能恢复有好处。然而,增加虚拟现实(VR)训练是否能进一步改善这些患者的肌肉力量、功能恢复和心理健康还不得而知。我们对 33 名首次急性缺血性中风患者进行了随机对照试验。这些患者按照 1:1 的随机比例被随机分配到实验组(EG)或对比组(CG)。两组患者都接受了早期康复治疗,EG 组患者在住院期间接受了额外的 VR 训练。干预前和出院时对肌肉力量、功能状态和心理健康进行了评估。使用广义估计方程通过时间和组别的交互作用来检验干预效果。在对潜在的协变量进行调整后,出院时 EG 比 CG 的抑郁下降更为显著(ß = 3.77,p = 0.011)。干预后,各组在肌肉力量和功能恢复方面没有差异。与住院期间只接受早期康复训练相比,在早期康复中加入 VR 训练对首次急性脑卒中患者的心理健康(尤其是抑郁)有很大的积极影响,但对肌力和功能恢复的影响不大。
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引用次数: 0
Effect of Crushed Flaxseed Consumption on Cardiovascular Risk Indicators in Menopausal Women 食用碎亚麻籽对绝经妇女心血管风险指标的影响
Pub Date : 2024-07-05 DOI: 10.3390/life14070849
Petra Lenártová, M. Gažarová, J. Kopčeková, J. Mrázová
Flaxseed is known for its numerous health benefits and is often used in the prevention and treatment of civilizational diseases. This study aimed to evaluate the impact of consuming crushed flaxseed on cardiovascular risk in 51 menopausal women. The intervention lasted for 8 weeks, during which participants received a daily dose of 40 g of crushed flaxseed from two varieties with differing lignan contents. Participants were divided into three subgroups based on the variety of flaxseed consumed: (1) high-lignan group (HL), (2) low-lignan group (LL), and (3) control group (no flaxseed consumption). Biochemical blood parameters were measured using a BiOLis 24i Premium automatic analyzer. Body composition was assessed using an InBody 720 device. In the lipid profile, we observed a significant increase in total cholesterol (T-C) and high-density lipoprotein cholesterol (HDL-C) levels, along with a significant decrease in low-density lipoprotein cholesterol (LDL-C) levels in both the HL and LL groups. Triglyceride (TG) levels exhibited no significant change, whereas high-sensitivity C-reactive protein (hs-CRP) levels were significantly reduced in both the HL (p < 0.01) and LL (p < 0.01) groups. Visceral fat area (VFA) and percent body fat (PBF) showed a slight decreasing trend in the HL group, whereas in the LL group, VFA showed a slight increase. Body mass index (BMI) remained stable across all groups. These findings suggest that for the modulation of cardiovascular disease (CVD) risk factors, the daily dosage, duration of consumption, form of intake, and the specific variety of flaxseed (based on lignan content) are crucial factors.
亚麻籽因其对健康的诸多益处而闻名,常用于预防和治疗文明病。这项研究旨在评估食用亚麻籽对 51 名更年期女性心血管风险的影响。干预为期 8 周,参与者每天摄入 40 克碎亚麻籽,亚麻籽来自两个木酚素含量不同的品种。根据食用的亚麻籽品种,参与者被分为三个亚组:(1)高木素组(HL);(2)低木素组(LL);(3)对照组(不食用亚麻籽)。使用 BiOLis 24i Premium 自动分析仪测量血液生化指标。使用 InBody 720 设备评估身体成分。在血脂谱中,我们观察到 HL 组和 LL 组的总胆固醇(T-C)和高密度脂蛋白胆固醇(HDL-C)水平显著增加,而低密度脂蛋白胆固醇(LDL-C)水平显著下降。甘油三酯(TG)水平无明显变化,而高敏 C 反应蛋白(hs-CRP)水平在 HL 组(p < 0.01)和 LL 组(p < 0.01)均显著降低。内脏脂肪面积(VFA)和体脂百分比(PBF)在 HL 组呈轻微下降趋势,而在 LL 组,内脏脂肪面积呈轻微上升趋势。各组的体重指数(BMI)保持稳定。这些研究结果表明,要调节心血管疾病(CVD)风险因素,每天的摄入量、摄入时间、摄入形式以及亚麻籽的具体品种(基于木质素含量)都是至关重要的因素。
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引用次数: 0
Cell Cycle Kinetics and Sister Chromatid Exchange in Mosaic Turner Syndrome 马赛克特纳综合征的细胞周期动力学和姐妹染色单体交换
Pub Date : 2024-07-05 DOI: 10.3390/life14070848
M. B. Goulart, Eduardo Vieira Neto, Daniela R. Ney Garcia, Marília Martins Guimarães, Isaías Soares de Paiva, Karina de Ferran, Nathalia Correia Krause dos Santos, Luciana Santos Barbosa, Amanda F. de Figueiredo, M. Ribeiro, Márcia Gonçalves Ribeiro
Turner syndrome (TS) is caused by a complete or partial absence of an X or Y chromosome, including chromosomal mosaicism, affecting 1 in 2500 female live births. Sister chromatid exchange (SCE) is used as a sensitive indicator of spontaneous chromosome instability. Cells from mosaic patients constitute useful material for SCE evaluations as they grow under the influence of the same genetic background and endogenous and exogenous factors. We evaluated the proliferation dynamics and SCE frequencies of 45,X and 46,XN cells of 17 mosaic TS patients. In two participants, the 45,X cells exhibited a proliferative disadvantage in relation to 46,XN cells after 72 h of cultivation. The analysis of the mean proliferation index (PI) showed a trend for a significant difference between the 45,X and 46,X+der(X)/der(Y) cell lineages; however, there were no intra-individual differences. On the other hand, mean SCE frequencies showed that 46,X+der(X) had the highest mean value and 46,XX the lowest, with 45,X occupying an intermediate position among the lineages found in at least three participants; moreover, there were intra-individual differences in five patients. Although 46,X+der(X)/der(Y) cell lineages, found in more than 70% of participants, were the most unstable, they had a slightly higher mean PI than the 45,X cell lineages in younger (≤17 years) mosaic TS participants. This suggests that cells with a karyotype distinct from 45,X may increase with time in mosaic TS children and adolescents.
特纳综合征(TS)是由于完全或部分缺失 X 或 Y 染色体(包括染色体嵌合)引起的,每 2500 名活产儿中就有 1 名女性患有该病。姐妹染色单体交换(SCE)是自发染色体不稳定的敏感指标。来自马赛克患者的细胞是评估 SCE 的有用材料,因为它们在相同的遗传背景和内外源因素的影响下生长。我们评估了17名马赛克TS患者的45,X和46,XN细胞的增殖动态和SCE频率。在两名参与者中,培养 72 小时后,45,X 细胞与 46,XN 细胞相比表现出增殖劣势。对平均增殖指数(PI)的分析表明,45,X细胞系和46,X+der(X)/der(Y)细胞系之间存在显著差异的趋势;但个体内部没有差异。另一方面,平均 SCE 频率显示,46,X+der(X) 的平均值最高,46,XX 的平均值最低,45,X 在至少三名参与者的细胞系中处于中间位置;此外,在五名患者中存在个体内差异。虽然在超过70%的参与者中发现的46,X+der(X)/der(Y)细胞系最不稳定,但在较年轻(≤17岁)的镶嵌型TS参与者中,它们的平均PI略高于45,X细胞系。这表明,在镶嵌型TS儿童和青少年中,核型与45,X不同的细胞可能会随着时间的推移而增加。
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引用次数: 0
Hepatic Veno-Occlusive Disease and Colorectal Cancer: Expect the Unexpected 肝静脉闭塞症与结直肠癌:期待意外
Pub Date : 2024-07-04 DOI: 10.3390/life14070845
Doina Georgescu, D. Lighezan, A. Lascu, Roxana Buzaș, A. Faur, Ioana Ionita, C. Rosca, Ioana Suceava, Despina Calamar-Popovici, M. Ionita, O. Ancusa
Sinusoidal obstruction syndrome/veno-occlusive disease (SOS/VOD) is a rare liver vascular condition, potentially life-threatening, with clinical signs of portal hypertension, frequently reported in relation to bone marrow transplantation and possibly in non-transplantation-related chemotherapy. We report the case of a 65-year-old female patient who insidiously developed fatigue, mild tenderness of the right upper abdominal quadrant, hepato-splenomegaly and slight weight gain consecutive to ascites development, as well as persistent elevation of transaminases and mild thrombocytopenia. To note, she had a previous history of colorectal cancer (CRC) with liver metastases and several courses of chemotherapy. Abdominal duplex and elastography measurements made the diagnosis of cirrhosis improbable. A lot of lab work-ups were performed in order to rule out several diseases and conditions. Further, transjugular access was used to perform the measurement of the hepatic venous pressure gradient and liver biopsy that confirmed SOS/VOD. In late 2023, she was diagnosed with endometrial adenocarcinoma, requiring chemotherapy again. At present, the liver condition is stationary, but the prognosis is, however, uncertain. In conclusion, we presented the atypical case of a female patient who developed portal hypertension syndrome associated with the late onset of SOS/VOD, after 5-fluorouracil and oxaliplatin chemotherapy for CRC and liver metastases, subsequently diagnosed with endometrial adenocarcinoma, which posed many diagnostic and therapeutic challenges. Given the potentially bad outcome, an early diagnosis of SOS/VOD in patients receiving drugs of risk is important not only to stratify further risk, but also to initiate an appropriate therapy in order to improve the prognosis.
窦性梗阻综合征/静脉闭塞症(SOS/VOD)是一种罕见的肝脏血管疾病,可能危及生命,临床表现为门静脉高压,经常报道与骨髓移植有关,也可能与非移植相关的化疗有关。我们报告了一例 65 岁女性患者的病例,她隐匿性出现乏力、右上腹轻度压痛、肝脾肿大、体重轻微增加,随后出现腹水,转氨酶持续升高,血小板轻度减少。值得注意的是,她以前曾患结肠直肠癌(CRC)并有肝转移,接受过几个疗程的化疗。腹部双反射和弹性成像测量结果显示,肝硬化的诊断可能性不大。为了排除多种疾病和病症,医生进行了大量的实验室检查。此外,经颈静脉入路测量肝静脉压力梯度和肝活检证实了 SOS/VOD。2023 年底,她被诊断为子宫内膜腺癌,需要再次接受化疗。目前,肝脏状况稳定,但预后不确定。总之,我们介绍了一例非典型病例:一名女性患者在接受 5-氟尿嘧啶和奥沙利铂化疗治疗 CRC 和肝转移灶后,出现了门静脉高压综合征,并伴有晚发的 SOS/VOD,随后被确诊为子宫内膜腺癌,这给诊断和治疗带来了诸多挑战。考虑到潜在的不良后果,在接受风险药物治疗的患者中早期诊断 SOS/VOD 不仅对进一步的风险分层很重要,而且对启动适当的治疗以改善预后也很重要。
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引用次数: 0
Myocardial, Valvular and Vascular Abnormalities in Repaired Tetralogy of Fallot 法洛氏四联症修复后的心肌、瓣膜和血管异常
Pub Date : 2024-07-03 DOI: 10.3390/life14070843
Attila Nemes
Tetralogy of Fallot is the most common heart defect associated with cyanosis characterized by the co-occurrence of pulmonary stenosis, right ventricular hypertrophy, and ventricular septal defect with over-riding of the aorta. The present review purposed to summarize myocardial, valvular and vascular abnormalities, which were described in a series of patients following repair of tetralogy of Fallot. It was also aimed to describe potential differences in these parameter using different surgical strategies.
法洛氏四联症是与紫绀相关的最常见的心脏缺陷,其特点是同时存在肺动脉狭窄、右心室肥大和室间隔缺损以及主动脉覆顶。本综述旨在总结法洛氏四联症修复术后一系列患者的心肌、瓣膜和血管异常情况。本综述还旨在描述采用不同手术策略时这些参数的潜在差异。
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引用次数: 0
Exploring Varied Treatment Strategies for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) 探索代谢功能障碍相关性脂肪性肝病(MASLD)的各种治疗策略
Pub Date : 2024-07-03 DOI: 10.3390/life14070844
Amani Elshaer, D. Chascsa, Blanca C Lizaola-Mayo
Metabolic dysfunction-associated steatotic liver disease (MASLD) represents a liver disorder characterized by steatosis with underlying metabolic risk factors. The prevalence of MASLD continues to rise, leading to increased patient risk of various complications. Recent research has been focused on new therapeutic strategies to reduce the incidence of MASLD and provide effective treatment plans to prevent further irreversible liver damage. The treatment approach is multifactorial, with a primary focus on weight loss and management of underlying comorbidities through lifestyle modifications, pharmacotherapy, or surgical options. Ongoing research is exploring new pharmacological therapies that could enhance the treatment of MASLD.
代谢功能障碍相关性脂肪性肝病(MASLD)是一种以脂肪变性为特征并伴有潜在代谢风险因素的肝脏疾病。代谢性脂肪肝的发病率持续上升,导致患者出现各种并发症的风险增加。近期的研究主要集中在新的治疗策略上,以降低 MASLD 的发病率,并提供有效的治疗方案,防止进一步出现不可逆的肝损伤。治疗方法是多因素的,主要侧重于通过改变生活方式、药物治疗或手术选择来减轻体重和控制潜在的并发症。目前正在进行的研究正在探索新的药物疗法,以加强对 MASLD 的治疗。
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引用次数: 0
Emerging Transcatheter Therapies for Valvular Heart Disease: Focus on Mitral and Tricuspid Valve Procedures 治疗瓣膜性心脏病的新兴经导管疗法:聚焦二尖瓣和三尖瓣手术
Pub Date : 2024-07-02 DOI: 10.3390/life14070842
N. Ktenopoulos, O. Katsaros, A. Apostolos, M. Drakopoulou, Grigoris Tsigkas, Constantinos Tsioufis, P. Davlouros, Konstantinos Toutouzas, A. Karanasos
The emergence of percutaneous treatment options provides novel therapeutic alternatives for older and feeble patients who are at high risk for any surgical procedure. The purpose of our review was to offer an up-to-date analysis of the rapidly expanding field of percutaneous technologies for mitral, tricuspid, and pulmonary procedures. Edge-to-edge repair is an established treatment for secondary mitral regurgitation (MR), while transcatheter mitral valve replacement is a potential and expanding option for managing both secondary and primary MR. However, additional advancements are necessary to enhance the safety and feasibility of this procedure. Transcatheter tricuspid intervention is an emerging option that was conceived after the success of transcatheter procedures in aortic and mitral valves, and it is currently still in the early stages of advancement. This can be attributed, at least in part, to the previously overlooked effect of tricuspid regurgitation on patient outcomes. The development of edge-to-edge repair represents the forefront of innovations in transcatheter procedures. There is a scarcity of data about tricuspid annuloplasty and replacement, and further study is necessary. Transcatheter mitral, tricuspid, and pulmonary procedures show prospects for the future, while their role in clinical practice has not been definitively established.
经皮治疗方法的出现为年老体弱、手术风险高的患者提供了新的治疗选择。我们的综述旨在对迅速扩展的二尖瓣、三尖瓣和肺手术经皮技术领域进行最新分析。边缘对边缘修补术是治疗继发性二尖瓣反流(MR)的成熟疗法,而经导管二尖瓣置换术则是治疗继发性和原发性二尖瓣反流的潜在且不断扩展的选择。然而,要提高这种手术的安全性和可行性,还需要更多的进步。经导管三尖瓣介入治疗是在经导管主动脉瓣和二尖瓣手术取得成功后出现的一种新选择,目前仍处于早期发展阶段。这至少可以部分归因于以前被忽视的三尖瓣反流对患者预后的影响。边缘到边缘修复术的发展代表了经导管手术创新的最前沿。有关三尖瓣瓣环成形术和置换术的数据还很少,有必要进行进一步研究。经导管二尖瓣、三尖瓣和肺动脉瓣手术展现了未来的前景,但它们在临床实践中的作用尚未明确确立。
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引用次数: 0
The Morphology of the Femur Influences the Fracture Risk during Stumbling and Falls on the Hip—A Computational Biomechanical Study 股骨形态影响髋部踉跄跌倒时的骨折风险--计算生物力学研究
Pub Date : 2024-07-02 DOI: 10.3390/life14070841
Jan-Oliver Sass, M. Saemann, M. Kebbach, Ehsan Soodmand, Andreas Wree, Rainer Bader, D. Kluess
Proximal femur fracture risk depends on subject-specific factors such as bone mineral density and morphological parameters. Here, we aim to analyze the dependency of the femoral strength on sixteen morphological parameters. Therefore, finite-element analyses of 20 human femurs during stumbling and lateral falls on the hip were conducted. Pearson correlation coefficients were calculated and morphological parameters with significant correlations were examined in principal component analysis and linear regression analysis. The dependency of the fracture strength on morphological parameters was more pronounced during lateral falls on the hip compared to stumbling. Significant correlations were observed between the neck shaft angle (r = −0.474), neck diameter (r = 0.507), the true distance between the femoral head center and femoral shaft axis (r = 0.459), and its projected distance on the frontal plane (r = 0.511), greater trochanter height (r = 0.497), and distance between the femoral head center and a plane parallel to the frontal plane containing the projection of the femoral head center to the femoral neck axis (r = 0.669). Principal component analysis was strongly weighted by parameters defining the lever arm during a lateral fall as well as the loaded cross-section in the femoral neck.
股骨近端骨折风险取决于受试者的特定因素,如骨矿物质密度和形态参数。在此,我们旨在分析股骨强度与 16 个形态参数的关系。因此,我们对髋部在踉跄和侧向跌倒时的 20 个人体股骨进行了有限元分析。计算了皮尔逊相关系数,并通过主成分分析和线性回归分析对具有显著相关性的形态参数进行了研究。与跌跌撞撞相比,髋部横向跌落时骨折强度对形态参数的依赖性更为明显。在股骨颈轴角(r = -0.474)、股骨颈直径(r = 0.507)、股骨头中心与股骨轴轴之间的真实距离(r = 0.459)及其在正面的投影距离(r = 0.511)、大转子高度(r = 0.497)、股骨头中心与包含股骨头中心至股骨颈轴投影的额面平行平面之间的距离(r = 0.669)。在主成分分析中,横向摔倒时的杠杆臂参数和股骨颈受力截面参数的权重很高。
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引用次数: 0
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Life
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