Records |
Author  |
Das, B.C.; Khan, A.S.; Elahi, N.E.; Uddin, M.S.; Debnath, B.C.; Khan, Z.R. |
Title |
Morbidity and Mortality after Pancreatoduodenectomy: A Five Year Experience in Bangabandhu Sheikh Mujib Medical University |
Type |
Journal Article |
Year |
2017 |
Publication |
Mymensingh Medical Journal : MMJ |
Abbreviated Journal |
Mymensingh Med J |
Volume |
26 |
Issue |
1 |
Pages |
145-153 |
Keywords |
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Abstract |
Mortality and morbidity was assessed after adoption of a systematic care for patient with pancreatoduodenectomy starting from patient selection and preparation, operative technique, and postoperative care. In this prospective study seventy patients who underwent pancreatoduodenectomy for periampullary carcinoma with curative intent between January 2010 and December 2014 were carefully analyzed prospectively. Patients were selected those who had ampullary carcinoma, lower bile duct carcinoma and small size carcinoma head of pancreas without local invasion and distant metastasis, and the patient who did not have any major disabling comorbid diseases. All patients were assessed uniformly before surgery and deficiency were corrected up to normal level before operation. Pancreatoduodenectomy and standard lymphadenectomy was performed meticulously with minimum blood loss. The pancreatojejunal reconstruction was performed using duct-to-mucosa method mostly. A nasojejunal feeding tube was placed in most patients for starting postoperative early oral feeding. Broad spectrum antibiotics and the epidural analgesia were mostly prescribed for good control infection and pain. Proper nutrition was maintained in calculative way through central venous line and nasojejunal feeding tube in the early postoperative period. General care, early mobilization and chest physiotherapy were given routinely in each patient. Seventy-seven percent (n=54) patients did not have any postoperative complications and they were discharged from hospital within 12-14 postoperative days. The morbidity occurred in 16 patients (23%) and most common complication was wound infection (18%, n=9). The rest complications were pancreatojejunal anastomotic leakage – 2, hepaticojejunal anastomosis leakage – 1, melaena – 1, intra-abdominal abscess – 1, intra-abdominal hemorrhage – 1, and renal dysfunction – 1. The mortality rate was 5.7% (n=4), causes of death were massive myocardial infarction; 1, failure of reversal from anesthesia; 1, massive intraabdominal bleeding; 1 and CV catheter related severe sepsis; 1. Review of recent published literature revealed that mortality and morbidity our series is better than low volume center and almost similar with high volume center of pancreatoduodenectomy surgery. Our systematic management policy of careful patient selection, planned approach in the form of proper work up, meticulous conduction of the procedure, appropriate postoperative care provides an acceptable morbidity and mortality after pancreatoduodenectomy. |
Address |
Dr Bidhan C Das, Associate Professor, Division of Hepatobiliary-Pancreatic Surgery, Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail: dbidhan@yahoo.com |
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English |
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ISSN |
1022-4742 |
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Notes |
PMID:28260769 |
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no |
Call Number |
ref @ user @ |
Serial |
99757 |
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Author  |
de Morais Sato, P.; Unsain, R.F.; Gittelsohn, J.; Sanches Tavares da Silva, J.G.; Goncalves Perez, I.C.; Baeza Scagliusi, F. |
Title |
Strategies used by overweight and obese low-income mothers to feed their families in urban Brazil |
Type |
Journal Article |
Year |
2017 |
Publication |
Appetite |
Abbreviated Journal |
Appetite |
Volume |
111 |
Issue |
|
Pages |
63-70 |
Keywords |
Brazil; Food insecurity; Low-income; Obesity; Overweight; Women |
Abstract |
OBJECTIVE: To describe and compare strategies adopted by overweight and obese low-income mothers living in different vulnerable contexts to deal with food constraints and feed their families. DESIGN: Qualitative in-depth interviews. Data were analyzed with exploratory content analysis and the number of segments per theme was used to compare neighborhoods. SETTING: Three low-income neighborhoods in Santos, Brazil. PARTICIPANTS: A purposive sample of 21 overweight or obese mothers. RESULTS: We identified three main types of strategies, namely, food acquisition, cooking, and eating. Food acquisition included social support and food-sourcing strategies. Social support strategies ranged from macro (governmental programs) to micro (family) levels. Food-sourcing strategies involved price research and use of credit to buy foods. Cooking approaches included optimizing food (e.g., adding water to beans), avoiding wastefulness, and substitutions (e.g., using water instead of milk when making cakes). Eating themes ranged from lack of quantity to lack of quality. Strategies to deal with the lack of food were affected by family dynamics, such as prioritizing provision of fruits to children. Food choices (e.g., low consumption of fruits and high consumption of fatty meats) derived from strategies may help promote overweight and obesity. Furthermore, for participants, financial constraints were perceived as barriers to following nutritionists' recommendations and weight loss. CONCLUSIONS: This study highlights the barriers that low-income women face in adopting a healthy diet and sheds light on the importance of the symbolic value of food, even in the context of food insecurity. Finally, it suggests that environmental aspects could increase the accessibility to fruits and vegetables. These findings could be used to inform the planning and implementation of interventions. |
Address |
Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715 – Sao Paulo/SP – CEP 01255-000, Sao Paulo/SP, Brazil |
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0195-6663 |
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Notes |
PMID:28034737 |
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no |
Call Number |
ref @ user @ |
Serial |
97449 |
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Author  |
de Morais Sato, P.; Unsain, R.F.; Gittelsohn, J.; Sanches Tavares da Silva, J.G.; Goncalves Perez, I.C.; Baeza Scagliusi, F. |
Title |
Strategies used by overweight and obese low-income mothers to feed their families in urban Brazil |
Type |
Journal Article |
Year |
2017 |
Publication |
Appetite |
Abbreviated Journal |
Appetite |
Volume |
111 |
Issue |
|
Pages |
63-70 |
Keywords |
Brazil; Food insecurity; Low-income; Obesity; Overweight; Women |
Abstract |
OBJECTIVE: To describe and compare strategies adopted by overweight and obese low-income mothers living in different vulnerable contexts to deal with food constraints and feed their families. DESIGN: Qualitative in-depth interviews. Data were analyzed with exploratory content analysis and the number of segments per theme was used to compare neighborhoods. SETTING: Three low-income neighborhoods in Santos, Brazil. PARTICIPANTS: A purposive sample of 21 overweight or obese mothers. RESULTS: We identified three main types of strategies, namely, food acquisition, cooking, and eating. Food acquisition included social support and food-sourcing strategies. Social support strategies ranged from macro (governmental programs) to micro (family) levels. Food-sourcing strategies involved price research and use of credit to buy foods. Cooking approaches included optimizing food (e.g., adding water to beans), avoiding wastefulness, and substitutions (e.g., using water instead of milk when making cakes). Eating themes ranged from lack of quantity to lack of quality. Strategies to deal with the lack of food were affected by family dynamics, such as prioritizing provision of fruits to children. Food choices (e.g., low consumption of fruits and high consumption of fatty meats) derived from strategies may help promote overweight and obesity. Furthermore, for participants, financial constraints were perceived as barriers to following nutritionists' recommendations and weight loss. CONCLUSIONS: This study highlights the barriers that low-income women face in adopting a healthy diet and sheds light on the importance of the symbolic value of food, even in the context of food insecurity. Finally, it suggests that environmental aspects could increase the accessibility to fruits and vegetables. These findings could be used to inform the planning and implementation of interventions. |
Address |
Department of Nutrition, School of Public Health, University of Sao Paulo, Av. Dr. Arnaldo, 715 – Sao Paulo/SP – CEP 01255-000, Sao Paulo/SP, Brazil |
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0195-6663 |
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Notes |
PMID:28034737 |
Approved |
no |
Call Number |
ref @ user @ |
Serial |
98033 |
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Author  |
de Sousa, J.F.; Torrieri, R.; Serafim, R.B.; Di Cristofaro, L.F.M.; Escanfella, F.D.; Ribeiro, R.; Zanette, D.L.; Paco-Larson, M.L.; da Silva, W.A.J.; Tirapelli, D.P. da C.; Neder, L.; Carlotti, C.G.J.; Valente, V. |
Title |
Expression signatures of DNA repair genes correlate with survival prognosis of astrocytoma patients |
Type |
Journal Article |
Year |
2017 |
Publication |
Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine |
Abbreviated Journal |
Tumour Biol |
Volume |
39 |
Issue |
4 |
Pages |
1010428317694552 |
Keywords |
Apoptosis; Astrocytoma/genetics/metabolism/*mortality; Brain Neoplasms/genetics/metabolism/*mortality; Cell Cycle; Cell Line, Tumor; *DNA Repair; DNA Repair Enzymes/genetics/metabolism; Exodeoxyribonucleases/genetics/metabolism; Gene Expression; Humans; Kaplan-Meier Estimate; N-Glycosyl Hydrolases/genetics/metabolism; Prognosis; DNA repair; astrocytoma; genomic instability; glioblastoma; tumor progression |
Abstract |
Astrocytomas are the most common primary brain tumors. They are very resistant to therapies and usually progress rapidly to high-grade lesions. Here, we investigated the potential role of DNA repair genes in astrocytoma progression and resistance. To this aim, we performed a polymerase chain reaction array-based analysis focused on DNA repair genes and searched for correlations between expression patters and survival prognoses. We found 19 genes significantly altered. Combining these genes in all possible arrangements, we found 421 expression signatures strongly associated with poor survival. Importantly, five genes (DDB2, EXO1, NEIL3, BRCA2, and BRIP1) were independently correlated with worse prognoses, revealing single-gene signatures. Moreover, silencing of EXO1, which is remarkably overexpressed, promoted faster restoration of double-strand breaks, while NEIL3 knockdown, also highly overexpressed, caused an increment in DNA damage and cell death after irradiation of glioblastoma cells. These results disclose the importance of DNA repair pathways for the maintenance of genomic stability of high-grade astrocytomas and suggest that EXO1 and NEIL3 overexpression confers more efficiency for double-strand break repair and resistance to reactive oxygen species, respectively. Thereby, we highlight these two genes as potentially related with tumor aggressiveness and promising candidates as novel therapeutic targets. |
Address |
7 Center for Integrative Systems Biology (CISBi), NAP/USP, Ribeirao Preto, Brazil |
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1010-4283 |
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Notes |
PMID:28378638 |
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no |
Call Number |
ref @ user @ |
Serial |
96598 |
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Author  |
Del Brutto, O.H.; Mera, R.M.; Zambrano, M.; Del Brutto, V.J. |
Title |
Severe edentulism is a major risk factor influencing stroke incidence in rural Ecuador (The Atahualpa Project) |
Type |
Journal Article |
Year |
2017 |
Publication |
International Journal of Stroke : Official Journal of the International Stroke Society |
Abbreviated Journal |
Int J Stroke |
Volume |
12 |
Issue |
2 |
Pages |
201-204 |
Keywords |
Adult; Comorbidity; Ecuador/epidemiology; Female; Follow-Up Studies; Humans; Hypertension/complications/epidemiology; Incidence; Male; Middle Aged; Mouth, Edentulous/complications/*epidemiology; Prospective Studies; Risk Factors; Rural Population; Severity of Illness Index; Stroke/complications/*epidemiology; Ecuador; Stroke incidence; cohort study; edentulism; stroke risk factors |
Abstract |
Background There is no information on stroke incidence in rural areas of Latin America, where living conditions and cardiovascular risk factors are different from urban centers. Aim Using a population-based prospective cohort study design, we aimed to assess risk factors influencing stroke incidence in community-dwelling adults living in rural Ecuador. Methods First-ever strokes occurring from 1 June 2012 to 31 May 2016, in Atahualpa residents aged >/=40 years, were identified from yearly door-to-door surveys and other overlapping sources. Poisson regression models adjusted for demographics, cardiovascular risk factors, edentulism and the length of observation time per subject were used to estimate stroke incidence rate ratio as well as factors influencing such incidence. Results Of 807 stroke-free individuals prospectively enrolled in the Atahualpa Project, follow-up was achieved in 718 (89%), contributing 2,499 years of follow-up (average 3.48 +/- 0.95 years). Overall stroke incidence rate was 2.97 per 100 person-years of follow-up (95% CI: 1.73-4.2), which increased to 4.77 (95% CI: 1.61-14.1) when only persons aged >/=57 years were considered. Poisson regression models, adjusted for relevant confounders, showed that high blood pressure (IRR: 5.24; 95% CI: 2.55-7.93) and severe edentulism (IRR: 5.06; 95% CI: 2.28-7.85) were the factors independently increasing stroke incidence. Conclusions Stroke incidence in this rural setting is comparable to that reported from the developed world. Besides age and high blood pressure, severe edentulism is a major factor independently predicting incident strokes. Public awareness of the consequences of poor dental care might reduce stroke incidence in rural settings. |
Address |
4 Department of Neurology, University of Chicago, Chicago, IL, USA |
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ISSN |
1747-4930 |
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Notes |
PMID:27777377 |
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no |
Call Number |
ref @ user @ |
Serial |
97187 |
Permanent link to this record |