BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment...BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment.Yellow fever(YF)is an infectious disease that primarily affects the liver and has a high mortality rate.However,LT can be a viable option for treating rare cases with extensive liver involvement.However,the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.AIM To present necessary adjustments to established scoring systems for ALF secondary to YF.METHODS This was an observational,retrospective,single-center study.Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil.During hospitalization,general supportive therapeutic measures were implemented,and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure.LT is considered a viable measure for patients with signs of end-stage liver failure.RESULTS Eight of 14(57%)patients developed severe neurological alterations within the first 96 hours after hospital admission.Four patients underwent emergency LT,and despite a moderate viral infection of the graft after transplantation,the 5-year survival rate was 50%.Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF,they are insufficient for predicting the risk of mortality in this context,primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.CONCLUSION To ensure good applicability in cases of YF-induced ALF,the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.展开更多
通过英汉语黄颜色义项的演变,证实:语言具有模糊性、任意性,并且语言的模糊性功能使得使用者可以根据需要将某一词项(如黄色)增加某一义项或减少某一义项,或者使某一义项边缘化、或消亡,或使某一义项中心化或突出。传统汉语经过几千年,...通过英汉语黄颜色义项的演变,证实:语言具有模糊性、任意性,并且语言的模糊性功能使得使用者可以根据需要将某一词项(如黄色)增加某一义项或减少某一义项,或者使某一义项边缘化、或消亡,或使某一义项中心化或突出。传统汉语经过几千年,黄色与皇权紧密相关,是"尊贵"与"辉煌"的象征,而随着帝制的废止、皇权消亡,黄色"尊贵"与"辉煌"的义项随之边缘化,甚至消亡。继而代之以"色情"、"下流""、丑陋"等贬义。在英语世界"yellow"是对黄色人种族类的蔑称。我们有义务让"he is yellow"语句在全世界范围内含有褒义、荣耀的义项,且让这褒义、荣耀的义项突显。我们的政府、文人、媒体、乃至学校等可以发挥决定性的作用。展开更多
基金Supported by The INCT-CNPq Program,No.465425/2014-3.
文摘BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment.Yellow fever(YF)is an infectious disease that primarily affects the liver and has a high mortality rate.However,LT can be a viable option for treating rare cases with extensive liver involvement.However,the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.AIM To present necessary adjustments to established scoring systems for ALF secondary to YF.METHODS This was an observational,retrospective,single-center study.Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil.During hospitalization,general supportive therapeutic measures were implemented,and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure.LT is considered a viable measure for patients with signs of end-stage liver failure.RESULTS Eight of 14(57%)patients developed severe neurological alterations within the first 96 hours after hospital admission.Four patients underwent emergency LT,and despite a moderate viral infection of the graft after transplantation,the 5-year survival rate was 50%.Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF,they are insufficient for predicting the risk of mortality in this context,primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.CONCLUSION To ensure good applicability in cases of YF-induced ALF,the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.
文摘通过英汉语黄颜色义项的演变,证实:语言具有模糊性、任意性,并且语言的模糊性功能使得使用者可以根据需要将某一词项(如黄色)增加某一义项或减少某一义项,或者使某一义项边缘化、或消亡,或使某一义项中心化或突出。传统汉语经过几千年,黄色与皇权紧密相关,是"尊贵"与"辉煌"的象征,而随着帝制的废止、皇权消亡,黄色"尊贵"与"辉煌"的义项随之边缘化,甚至消亡。继而代之以"色情"、"下流""、丑陋"等贬义。在英语世界"yellow"是对黄色人种族类的蔑称。我们有义务让"he is yellow"语句在全世界范围内含有褒义、荣耀的义项,且让这褒义、荣耀的义项突显。我们的政府、文人、媒体、乃至学校等可以发挥决定性的作用。
