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Single-operator cholangioscopy for biliary complications in liver transplant recipients

World Journal of Gastroenterology 2017年第22期23卷 4064-4071页

作者： Anna Hüsing-Kabar Hauke Sebastian Heinzow Hartmut Hans-Jürgen Schmidt carina Stenger Hans Ulrich Gerth Michele Pohlen Gerold Tholking Christian Wilms Iyad Kabar Department of Transplant Medicine University Hospital Muenster Department of Medicine D Division of General Internal MedicineNephrology and RheumatologyUniversity Hospital Muenster Department of Medicine A Hematology and OncologyUniversity Hospital Muenster

To evaluate cholangioscopy in addition to endoscopic retrograde cholangiopancreatography (ERCP) for management of biliary complications after liver transplantation (LT).METHODSTwenty-six LT recipients with duct-to-duct biliary reconstruction who underwent ERCP for suspected biliary complications between April and December 2016 at the university hospital of Muenster were consecutively enrolled in this observational study. After evaluating bile ducts using fluoroscopy, cholangioscopy using a modern digital single-operator cholangioscopy system (SpyGlass DS™) was performed during the same procedure with patients under conscious sedation. All patients received peri-interventional antibiotic prophylaxis and bile was collected during the intervention for microbial analysis and for antibiotic susceptibility ***-three biliary complications were found in a total of 22 patients, whereas four patients showed normal bile ducts. Anastomotic strictures were evident in 14 (53.8%) patients, non-anastomotic strictures in seven (26.9%), biliary cast in three (11.5%), and stones in six (23.1%). A benefit of cholangioscopy was seen in 12 (46.2%) patients. In four of them, cholangioscopy was crucial for selective guidewire placement prior to planned intervention. In six patients, biliary cast and/or stones failed to be diagnosed by ERCP and were only detectable through cholangioscopy. In one case, a bile duct ulcer due to fungal infection was diagnosed by cholangioscopy. In another case, signs of bile duct inflammation caused by acute cholangitis were evident. One patient developed post-interventional cholangitis. No further procedure-related complications occurred. Thirty-seven isolates were found in bile. Sixteen of these were gram-positive (43.2%), 12 (32.4%) were gram-negative bacteria, and Candida species accounted for 24.3% of all isolated microorganisms. Interestingly, only 48.6% of specimens were sensitive to prophylactic ***-operator c

关键词： Cholangioscopy Endoscopic retrograde cholangiopancreatography Liver transplantation Biliary complications Biliary strictures

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Glucose-6-phosphate-dehydrogenase deficiency and its correlation with other risk factors in jaundiced newborns in Southern Brazil

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Asian Pacific Journal of Tropical Biomedicine 2011年第2期1卷 110-113页

作者： Clarissa Gutirrez Carvalho Simone Martins Castro Ana Paula Santin carina Zaleski felipe Gutirrez Carvalho Roberto Giugliani Genetics Service Hospital de Clinicas de Porto AlegrePGP in PediatricsUFRGS Pharmacy School UFRGS Medical School UFRGS

Objective:To evaluate the correlation between glucose-6-phosphate-dehydrogenase(G6PD) deficiency and neonatal ***:Prospective,observational case-control study was conducted on 490 newborns admitted to Hospital de Clinicas de Porto Alegre for phototherapy, who all experienced 35 or more weeks of gestation,from March to December *** screening of G6PD activity was performed,followed by ***:There was prevalence of 4.6% and a boy-girl ratio of 3:1 in jaundiced *** jaundiced neonate with ABO incompatibility presented G6PD deficiency,and no Mediterranean mutation was found.A higher proportion of deficiency was observed in *** was no association with UGT1A1 variants. Conclusions:G6PD deficiency is not related to severe hyperbilirubinemia and considering the high miscegenation in this area of Brazil,other gene interactions should be investigated.

关键词： Glucosephosphate dehydrogenase Jaundice Hyperbilirubinemia Neonatal Hemoglobin

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Building Envelope Rehabilitation Costs： Determination and Variability

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Journal of Civil Engineering and Architecture 2012年第3期6卷 300-307页

作者： carina Isabel Pereira de Sousa Joao Carlos Goncalves Lanzinha Civil Engineering and Architecture Department Faculty of Engineering University of Beira Interior Covilh6 Portugal

In recent decades, there has been a great deal of investment in Portugal in the construction of new buildings to the detriment of the rehabilitation of existing ones. As a result, the historic centres of towns and cities are deteriorating, while their suburbs are spreading. One of the main problems affecting the rehabilitation of residential buildings is that it is extremely difficult to accurately estimate the costs involved. Although there are established methods （and technical documents available） to aid the costing of new buildings, there is a lack of official information about the costs of rehabilitation work, particularly as regards the external envelope of buildings. This article demonstrates how to determine rehabilitation costs （with particular emphasis on the envelope of residential buildings） by gathering information from specialized companies, assessing price variability and consulting databases of rehabilitation costs from other countries. It also presents some examples of costing for particular rehabilitation jobs.

关键词： Rehabilitation building envelope costs.

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Life before Myocardial Infarction<br/>—A Qualitative Study of Middle-Aged Women

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Health 2014年第20期6卷 2765-2774页

作者： carina Wennerholm Michaela Jern Marja-Liisa Honkasalo Tomas faresjö Department of Medicine and Health Sciences Community Medicine/General Practice Link&ouml ping University Link&ouml ping Sweden Center for the Study of Culture and Health University of Turku Turku Finland

The health burden of myocardial infarction is rising for middle-aged women and they are underrepresented in research of cardiovascular diseases. The aim of this qualitative study was to explore how life had been for middle-aged women before they suffered a myocardial infarction (MI). Through a health care register, we identified all women (n = 46) under 65 years of age in a defined region in southeast Sweden who had suffered an MI the past 2 years and a strategic selection of n = 16 women from these was made. These selected women were interviewed and their narratives were interpreted by qualitative content analysis. The qualitative interviews generated five general themes: “Serious life events”, “Negative affectivity”, “Loneliness”, “Being a good girl” and “Lack of control”. The interviews revealed that many of these women had been exposed to extreme and repeated traumatic life events in their lives. Many had a cynical attitude towards others, felt lonely and experienced a lack of social support. Many of these women endeavored to “be a good girl”, which was a special psychosocial phenomenon found. This study uncovered that these women before they suffered an MI were affected by a variety of psychosocial factors. The study stresses the importance of psychosocial risk factors in the assessment of middle-aged women’s risk profile for MI. A general conclusion for clinical practice is that in the assessment of the individual risk for myocardial infarction for middle-aged women, potential psychosocial factors might also be considered.

关键词： Myocardial Infarction Women Risk factors Psychosocial factors Qualitative Research

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Assessing neuraxial microstructural changes in a transgenic mouse model of early stage Amyotrophic Lateral Sclerosis by ultra-high field MRI and diffusion tensor metrics

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Animal Models and Experimental Medicine 2020年第2期3卷 117-129页

作者： Rodolfo G.Gatto carina Weissmann Manish Amin Ariel finkielsztein Ronen Sumagin Thomas H.Mareci Osvaldo D.Uchitel Richard L.Magin Department of Bioengineering University of Illinois at ChicagoChicagoILUSA Instituto de fisiología Biologia Molecular y Neurociencias-IfIBYNE-CONICET University of Buenos AiresBuenos AiresArgentina Department of Biochemistry National High Magnetic Field LaboratoryUniversity of FloridaGainesvilleFLUSA Department of Pathology School of MedicineNorthwestern UniversityChicagoILUSA

Objective: Cell structural changes are one of the main features observed during the development of amyotrophic lateral sclerosis(ALS). In this work, we propose the use of diffusion tensor imaging(DTI) metrics to assess specific ultrastructural changes in the central nervous system during the early neurodegenerative stages of ***: Ultra-high field MRI and DTI data at 17.6 T were obtained from fixed, excised mouse brains, and spinal cords from ALS(G93 A-SOD1) ***: Changes in fractional anisotropy(fA) and linear, planar, and spherical anisotropy ratios(C_L, C_P, and C_S, respectively) of the diffusion eigenvalues were measured in white matter(WM) and gray matter(GM) areas associated with early axonal degenerative processes(in both the brain and the spinal cord). Specifically, in WM structures(corpus callosum, corticospinal tract, and spinal cord funiculi) as the disease progressed, fA, C_L, and C_P values decreased, whereas C_S values increased. In GM structures(prefrontal cortex, hippocampus, and central spinal cord) fA and C_P decreased, whereas the C_L and C_S values were unchanged or slightly smaller. Histological studies of a fluorescent mice model(YfP, G93 A-SOD1 mouse) corroborated the early alterations in neuronal morphology and axonal connectivity measured by ***: Changes in diffusion tensor shape were observed in this animal model at the early, nonsymptomatic stages of ALS. further studies of C_L, C_P, and C_S as imaging biomarkers should be undertaken to refine this neuroimaging tool for future clinical use in the detection of the early stages of ALS.

关键词： amyotrophic lateral sclerosis animal models diffusion tensor imaging G93A-SOD1 mice ultra-high field MRI

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Pilot study on the Non-Invasive Detectability of femoral Neck fractures with frequency Response functions

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World Journal of Mechanics 2014年第7期4卷 210-216页

作者： Wolfgang Witteveen carina Wagner Patrick Jachs Stefan froschauer Harald Schoffl Upper Austrian University of applied Sciences WelsAustria BioMed-zet Life Science GmbH LinzAustria

A suspicion of a femoral neck fracture is a frequently recurring situation, especially in nursing homes. for the clarification of such a suspicion normally imaging techniques are used. Such equipment is expensive and therefore is located in hospitals. In addition to the costs, a transport causes stress for the patient. This pilot study is devoted to the question whether the detection of a femoral neck fracture with vibration measurements is possible in principal. In such a case, the clarification could be done on-site by an ordinary person using much cheaper equipment. This would reduce the stress for the patient and save money. for this purpose vibration measurements on a dead body with intact, with partially fractured and with complete cut femoral neck have been performed. Two different methods for the vibration initiation have been investigated, the so called impact testing and the shaker testing. The frequency response function has been determined for all combinations on both sides of the body. It turned out that there is a clear difference in the frequency response functions of the fractured bone with respect to the intact bone when shaker testing is used. This indicates that the method could have the potential to be a cost-saving alternative to imaging techniques. However, in a next step a statistically reliable clinical survey on living persons needs to be done.

关键词： Biomechanics Vibrations frequency Response function fRf femoral Neck fracture

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Times Series Applied to Study Vitamin D Seasonality in argentina

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Applied Mathematics 2021年第7期12卷 546-555页

作者： José Bavio carina fernández Patricia fernández Beatriz Marrón Depto. de Matemática Universidad Nacional del Sur Bahía Blanca Buenos Aires Argentina IACA Laboratiorios Bahía Blanca Buenos Aires Argentina

In this study, we analyze how vitamin D (VD) serum levels flow with latitude and throughout seasons of the year within a population sample over three years, taking into account that VD is mainly photosynthesized in the skin from sun exposure. Vitamin D levels have been measured in 80,763 patients during 2013, 2014, and 2015. To accomplish the objectives, we first perform some inference tests like two-way Analysis of Variance (ANOVA) followed by post-hoc tests. Secondly, we develop time series techniques including cross correlation calculations. Least than 10% of the sample had healthy VD levels, which should be a fact of public health major concern. The effect of the interaction between the two factors, zones and seasons, was proved by ANOVA. The mean values which are significantly different were determined by post hoc test. furthermore, we find that mean serum VD levels, measured as 25-hydroxy-VD, follow a seasonal lag pattern of 9 weeks, a delay for minimum and maximum values after the respective equinoxes and daily sunlight duration. Reliable estimates of the population are provided in the present study, since one of the strengths is its huge sample size. We have quantitatively characterized the seasonality of serum vitamin D levels in the argentine and the seasonal lag pattern has been determined for the study region.

关键词： Vitamin D Status Population Study Time Series Correlation Interaction Effects

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Stability of Brazilian Seasonally Dry forests under Climate Change: Inferences for Long-Term Conservation

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American Journal of Plant Sciences 2013年第4期4卷 792-805页

作者： Rosane G. Collevatti Matheus Souza Lima-Ribeiro José Alexandre f. Diniz-filho Guilherme Oliveira Ricardo Dobrovolski Levi carina Terribile Departamento de Ecologia Instituto de Ciências Biológicas Universidade Federal de Goiás Goiania Brazil Laboratório de Genética & Biodiversidade Instituto de Ciências Biológicas Universidade Federal de Goiás Goiania Brazil Laboratório de Macroecologia Universidade Federal de Goiás Jataí Brazil

We identified climatically stable areas of seasonally dry forests (SDfs) from Central Brazil through time and assessed the effectiveness of the current reserves network in representing these climatically stable areas, as well as areas of high suitability in the present or in the future only. We used an ensemble approach based on several methods for ecological niche modelling (ENMs) to obtain potential distributions 16 SDf’ species for past (last glacial maximum), present, and future (end of XXI century) climate scenarios. We then computed how many current Brazilian reserves matched both stable areas (suitable areas for all time periods), present and future geographical ranges alone for each species, in a multi-level gap analysis. We found range shifts due to climate changes for SDf’ species. Although the future geographical range and stable areas for all analyzed species matched at least with one reserve, many protected areas will lose importance in protecting suitable areas for species in the future. Moreover, the current Brazilian reserves cover only a small amount of their climatically stable areas. However, some reserves will be suitable for many SDf’ species (90%) at the same time, but climatically stable for only half of them. Our findings show that vegetation community from SDfs may persist in Brazilian territories until the end of XXI century, and challenges about long-term conservation of the SDfs may be partially reached with already existing Brazilian reserve network, however the reserves should be connected to permit habitat tracking.

关键词： Cerrado Biome Ecological Niche Modelling Global Climate Change Quaternary Climate Change Gap Analysis

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Temporal Variations of the Chemical Composition of Three Seaweeds in Two Tropical Coastal Environments

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Open Journal of Marine Science 2014年第2期4卷 118-139页

作者： Andyara Nascimento carina Coelho-Gomes Elisabete Barbarino Sergio Oliveira Lourenco Department of Marine Biology Fluminense Federal UniversityNiteroiBrazil Maria Thereza College NiteroiBrazil Post-Graduate Programme in Chemistry Fluminense Federal UniversityNiteroiBrazil

The seaweeds Chaetomorpha antennina, Gymnogongrus griffithsiae and Ulva fasciata were studied regarding tissue concentrations of total nitrogen, total phosphorus, total protein, hydrosoluble protein, total carbohydrate, chlorophyll a and total carotenoid throughout a 39-month survey in two coastal environments of Rio de Janeiro State, Brazil. One of the sites (Itapuca Stone) has high concentrations of dissolved nutrients and an intense long-term process of cultural eutrophication;the second site (Bananal Inlet) is thought to have lower concentrations of dissolved nutrients and no relevant anthropic impact. Seaweeds experienced changes in the concentrations of the substances in the thalli;however they did not show any cyclic seasonal pattern, except for pigments, with lower values in summer in both sites. The differences found for each species in each sampling at the sites were small (e.g. U. fasciata, more total nitrogen at Itapuca Stone) or absent (e.g. C. antennina, no significant differences for hydrosoluble protein in the sites). Differences in the concentrations of dissolved nutrients in the sites did not generate contrasting chemical profiles in the seaweeds. There is no evidence of nitrogen- or phosphorus-limitation in any season. It is presumable that the concentrations of dissolved nutrients at the nutrient-poorer site are sufficient to generate high concentrations of the substances in the thalli of the species tested, similar to the concentrations measured in the eutrophic site. Experimental data are needed to elucidate the factors that promote the success of the species tested under contrasting nutrient availability and environmental disturbance.

关键词： Chemical Composition Coastal Environments Dissolved Nutrients Seaweeds Temporal Variations

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Static Digits Recognition Using Rotational Signatures and Hu Moments with a Multilayer Perceptron

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Engineering（科研） 2014年第11期6卷 692-698页

作者： francisco Solís Margarita Hernández Amelia Pérez carina Toxqui Autonomous University of Mexico State Toluca Mexico Polytechnic University of Tulancingo Tulancingo Mexico

This paper presents two systems for recognizing static signs (digits) from American Sign Language (ASL). These systems avoid the use color marks, or gloves, using instead, low-pass and high-pass filters in space and frequency domains, and color space transformations. first system used rotational signatures based on a correlation operator;minimum distance was used for the classification task. Second system computed the seven Hu invariants from binary images;these descriptors fed to a Multi-Layer Perceptron (MLP) in order to recognize the 9 different classes. first system achieves 100% of recognition rate with leaving-one-out validation and second experiment performs 96.7% of recognition rate with Hu moments and 100% using 36 normalized moments and k-fold cross validation.

关键词： Sign Language Recognition Rotational Signatures Hu Moments Multi-Layer Perceptron

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