Objectives: This study aims to assess the feasibility and short-term and intermediate-term technical success rate of the concept of systematic selective hepatic vein (HV) reconstruction for parenchyma-sparing hepatectomies (PSHs) in patients with colorectal liver metastases (CRLM) in accordance with stage 2a of the IDEAL framework.
Design: The prospective case series of patients deemed eligible and operated on according to the concept.
Setting: All patients were treated by a single surgical team in three hospitals in Ukraine from June 2022 to November 2023.
Participants: The study included nine cases of resectable CRLM with at least one lesion located in the hepatocaval confluence with HV(s) invasion, for whom reconstruction of the HV(s) allowed for additional parenchyma preservation, being an alternative to major or extended hepatectomy.
Interventions: Liver resections with different types of HVs reconstruction (primary closure, patching, end-to-end anastomosis with or without grafting) were performed after a thorough evaluation of the future liver remnant volume, volume of potentially additionally preserved parenchyma and possibility of future repeat hepatectomies.
Main Outcome Measures: Postoperative morbidity, short-term and long-term patency of the reconstructed vessels, and the volume of additionally preserved parenchyma were the focus.
Results: Segmental resection was performed in four cases, two with graft interposition. Patch reconstruction was performed for three HVs and two inferior vena cava resections. Two cases required primary closure. No mortality was observed, while the major morbidity rate was 33%. The short-term and long-term patency of the reconstructed HVs was 88.9% and 66.7%, respectively. HV reconstructions allowed the preservation of additional parenchyma (mean 495.4 mL, 95% CI 350.2 to 640.7). A decision-making algorithm to be used within the described approach is proposed.
Conclusions: Selective HV reconstruction is a feasible approach for PSH for CRLM. Further studies are needed to compare this approach to convenient major hepatectomies.
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http://dx.doi.org/10.1136/bmjsit-2024-000302 | DOI Listing |
Expert Opin Drug Saf
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Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Introduction: The risk of HCC is twice as high in diabetic patients compared to non-diabetic ones, suggesting that diabetes advances carcinogenesis in the liver through a variety of mechanisms. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have been shown to improve liver outcomes, emerging as promising agents to treat hepatocellular carcinoma (HCC) in patients with type 2 diabetes mellitus (T2DM).
Methods: We searched PubMed and Scopus databases for articles presenting an association between SGLT2is and HCC to explore the putative mechanisms of action underlying the anti-proliferative activity of SGLT2is.
J Med Internet Res
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Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Background: Mobile health (mHealth) interventions have gained popularity in augmenting psychiatric care for adults with psychosis. Interest has grown in leveraging mHealth to empower individuals living with severe mental illness and extend continuity of care beyond the hospital to the community. However, reported outcomes have been mixed, likely attributed in part to the intervention and adopted outcomes, which affected between-study comparisons.
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December 2024
Huazhong University of Science and Technology, School of Chemistry and Chemical Engineering, Luoyu load, 430074, Wuhan, CHINA.
Electrochemical carbon dioxide reduction reaction (CO2RR) to highly value-added C2+ fuels or chemicals is a promising pathway to address environment issues and energy crisis. In the periodic table, Cu as only the candidate can convert CO2 to C2+ products such as C2H4 and C2H5OH due to the suitable absorption energy to reaction intermediate. Application of Cu is limited for its low activity and poor selectivity.
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December 2024
Pandit Deendayal Energy University, Chemistry, Gandhinagar, Gujarat-382077, India, Gandhinagar, INDIA.
The accurate discrimination among various volatile organic compounds, especially ethanol and acetone possess a serious concern for metal oxide based chemiresistive sensors. The work presents a systematic approach to address the issue by utilizing superior sensing potentiality of Zn0.5Ni0.
View Article and Find Full Text PDFChemistry
December 2024
University of Münster Department of Chemistry and Pharmacy: Westfalische Wilhelms-Universitat Munster Fachbereich 12 Chemie und Pharmazie, Institut für Anorganische und Analytische Chemie, Corrensstr. 28/30, 48149, Münster, GERMANY.
Two artificial imidazole-derived nucleobases, HQIm (3H-imidazo[4,5-f]quinolin-5-ol) and CaIm (imidazole-4-carboxylate), were introduced into short DNA duplexes to systematically investigate their thermal stability upon metal ion coordination. Metal-mediated base pairs are formed with the 3d metal ions CoII, NiII and ZnII, as well as with the lanthanoid ions EuIII and SmIII, which induce a thermal stabilization of up to 8 °C upon binding. The latter are the first lanthanoid-mediated base pairs involving only four donor atoms that result in a significant duplex stabilization.
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