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Development of a warning score for early detection of colorectal anastomotic leakage:Hype or hope?

World Journal of Gastrointestinal surgery 2022年第11期14卷 1297-1309页

作者： Nuno J G Rama Óscar Lourenço Patrícia C Motta Lima maria pedro s guarino Diana Parente Ricardo Castro Ana Bento Anabela Rocha Fernando Castro-Poças João Pimentel Division of Colorectal surgical Leiria Hospital CentreLeiria 2410-021Portugal Abel salazar Biomedical Institute University of OportoOporto 4099-002Portugal Center for Innovative Care and Health Technology(ciTechCare) Polytechnic of LeiriaLeiria 2410-541Portugal Faculty of Economics CeBERUniversity of CoimbraCoimbra 3000-137Portugal Division of Clinical Pathology Leiria Hospital CentreLeiria 2410-541Portugal Division of surgical Oporto Hospital CentreOporto 4099-001Portugal Department of Gastroenterology Santo António HospitalPorto Hospital CenterOporto 4099-001Portugal Institute of Biomedical sciences Abel salazar University of OPortoOporto 4099-001Portugal Faculty of Medicine University of CoimbraCoimbra 3004-531Portugal Division of surgical Montes Claros HospitalCoimbra 3030-320Portugal

BACKGROUND Colorectal anastomotic leakage(CAL),a severe postoperative complication,is associated with high morbidity,hospital readmission,and overall healthcare *** detection of CAL remains a challenge in clinical ***,some decision models have been developed to increase the diagnostic accuracy of this *** To develop a score based on easily accessible variables to detect CAL *** Based on the least absolute shrinkage and selection operator method,a predictive classification system was developed[Early ColoRectAL Leakage(E-CRALL)score]from a prospective observational,single center cohort,carried out in a colorectal division from a non-academic *** score performance and CAL threshold from postoperative day(POD)3 to POD5 were *** on a precise analytical decision model,the standard clinical practice was compared with the E-CRALL adoption on POD3,POD4,or POD5.A cost-minimization analysis was conducted,on the assumption that all alternatives delivered similar health-related *** In this study,396 patients who underwent colorectal resection surgery with anastomosis,and 6.3%(n=25)developed *** of the patients who developed CAL(n=23;92%)were diagnosed during the first hospital admission,with a median time of diagnosis of 9.0±6.8 *** POD3 to POD5,the area under the receiver operating characteristic curve of the E-CRALL score was 0.82,0.84,and 0.95,*** POD5,if a threshold of 8.29 was chosen,87.4%of anastomotic failures were identified with E-CRALL ***,score usage could anticipate CAL diagnosis in an average of 5.2 d and 4.1 d,if used on POD3 and POD5,*** of score adoption,episode comprehensive costs were markedly greater(up to four times)in patients who developed CAL in comparison with patients who did not develop ***,the use of the E-CRALL warning score was associated with cost savings of€421442.20,with most(92.9%)of the savings from patients

关键词： Anastomotic leakage Colorectal surgery Biomarkers score Costs

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Usefulness of serum C-reactive protein and calprotectin for the early detection of colorectal anastomotic leakage:A prospective observational study

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World Journal of Gastroenterology 2022年第24期28卷 2758-2774页

作者： Nuno J G Rama Marlene C C Lages maria pedro s guarino Óscar Lourenço Patrícia C Motta Lima Diana Parente Cândida s G silva Ricardo Castro Ana Bento Anabela Rocha Fernando Castro-Pocas João Pimente Colorectal surgical Division Leiria Hospital CentreLeiria 2410-021Portugal Abel salazar Biomedical Institute(ICBAs) University of OportoOporto 4099-002Portugal Center for Innovative Care and Health Technology(ciTechCare) Polytechnic of LeiriaLeiria 2410-541Portugal Faculty of Economics CeBERUniversity of CoimbraCoimbra 3000-137Portugal Clinical Pathology Division Leiria Hospital CentreLeiria 2410-541Portugal surgical Division Oporto Hospital CentreOporto 4099-001Portugal Department of Gastroenterology Santo António HospitalPorto Hospital CenterPorto 4099-001Portugal Institute of Biomedical sciences Abel salazar University of PortoPorto 4099-001Portugal Faculty of Medicine University of CoimbraCoimbra 3004-531Portugal surgical Division Montes Claros HospitalCoimbra 3030-320Portugal

BACKGROUND Colorectal anastomotic leakage(CAL)is one of the most dreaded complications after colorectal surgery,with an incidence that can be as high as 27%.This event is associated with increased morbidity and mortality;therefore,its early diagnosis is crucial to reduce clinical consequences and *** biomarkers have been suggested as laboratory tools for the diagnosis of *** To assess the usefulness of plasma C-reactive protein(CRP)and calprotectin(CLP)as early predictors of *** A prospective monocentric observational study was conducted including patients who underwent colorectal resection with anastomosis,from March 2017 to August *** were divided into three groups:G1–no complications;G2–complications not related to CAL;and G3–*** biomarkers were measured and analyzed in the first 5 postoperative days(PODs),namely white blood cell(WBC)count,eosinophil cell count(ECC),CRP,CLP,and procalcitonin(PCT).Clinical criteria,such as abdominal pain and clinical condition,were also *** correlation between biomarkers and CAL was *** operating characteristic(ROC)curve analysis was used to compare the accuracy of these biomarkers as predictors of CAL,and the area under the ROC curve(AUROC),specificity,sensitivity,positive predictive value,and negative predictive value(NPV)during this period were *** In total,25 of 396 patients developed CAL(6.3%),and the mean time for this diagnosis was 9.0±6.8 *** operative characteristics,such as surgical approach,blood loss,intraoperative complications,and duration of the procedure,were notably related to the development of *** length of hospital stay was markedly higher in the group that developed CAL compared with the group with complications other than CAL and the group with no complications(median of 21 d vs 13 d and 7 d respectively;Pst predictive performance was on POD4 and POD5,with the largest AUROC of 0.84 on ***

关键词： Anastomotic leakage Colorectal surgery Biomarkers C-reactive protein Calprotectin

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Liquid crystal immunosensors for the selective detection of Escherichia coli with a fast analysis tool

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Photonics Research 2024年第7期12卷 1564-1573页

作者： sANDRO C.OLIVEIRA maria s.sOAREs BÁRBARA V.GONÇALVEs ANDREIA C.M.RODRIGUEs AMADEU M.V.M.sOAREs RITA G.sOBRAL NUNO F.sANTOs JAN NEDOMA pedro L.ALMEIDA CARLOs MARQUEs CICECO-Aveiro Institute of Materials Physics DepartmentUniversity of Aveiro3810-193 AveiroPortugal i3N Physics DepartmentUniversity of Aveiro3810-193 AveiroPortugal Associate Laboratory i4HB-Institute for Health and Bioeconomy School of Sciences and TechnologyNOVA University of Lisbon1099-085 LisbonPortugal CEsAM-Centre for Environmental and Marine studies and Department of Biology University of Aveiro3810-193 AveiroPortugal Department of Telecommunications VSB-Technical University of OstravaOstrava 70800Czech Republic i3N-CENIMAT School of Sciences and TechnologyNOVA University of Lisbon1099-085 LisbonPortugal UnIRE ISELPolytechnic Institute of Lisbon1549-020 LisbonPortugal Department of Physics VSB-Technical University of OstravaOstrava 70800Czech Republic

The consumption of contaminated food may cause serious illnesses,and traditional methods to detect Escherichia coli are still associated with long waiting times and high costs given the necessity to transport samples to specialized *** is a need to develop new technologies that allow cheap,fast,and direct monitoring at the site of ***,in this work,we developed optical immunosensors for the selective detection of ***,based on liquid crystal technology,whose molecules can align in different manners depending on the boundary conditions (such as substrates) as well as the environment that they *** glass substrate was functionalized with *** antibody using cysteamine as an intermediate,and a vertical alignment was imposed on the liquid crystal molecules by using DMOAP during *** presence of bacteria disrupts the alignment of the liquid crystal molecules,changing the intensity of light emerging between cross polarizers,measured using a polarized optical microscope and a *** was possible to detect *** in suspensions in the concentration range from 2.8 cells/mL to 2.8×10^(9) cells∕*** was also evaluated,and the sensors were used to analyze contaminated water samples.A prototype was developed to allow faster,in-situ,and easier analysis avoiding bulky instruments.

关键词： crystal alignment analysis

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Transcranial Direct Current stimulation: Effects on Motor and Non-Motor symptoms of Parkinson’s Disease

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Journal of Behavioral and Brain science 2024年第5期14卷 135-160页

作者： Fayda Protásio Carlos Alberto Bezerra Tomaz Joaquim Brasil-Neto pedro Brandão Nasser Allam maria Clotilde Henriques Tavares Laboratory of Neuroscience and Behavior Department of Physiological Sciences Institute of Biology University of Braslia Braslia Brazil Master Program in Environment University CEUMA So Lus MA and Faculty of Medicine Euro-American University Center-UNIEURO Braslia Brazil Faculty of Medicine Euro-American University Center-UNIEURO Braslia Brazil NA Neurologistas Associados Braslia Brazil

Introduction: In the last thirty years, brain neuromodulation techniques have been used as an alternative to pharmacological treatment of neurological disorders. Parkinson’s disease (PD) is a neurodegenerative disorder leading to bradykinesia, rest tremor, postural changes, and non-motor symptoms such as depression, anxiety, sleep disorders, pain, and cognitive decline that compromises executive functions (EFs), responsible for the orderly execution of behaviors and tasks of daily life and intentional and directed actions. To this date, a few studies with transcranial direct current stimulation (tDCs) have shown beneficial effects in PD patients concerning specific motor and non-motor symptoms, targeting the motor cortex and/or prefrontal regions. Objective: The main objective of this study was to evaluate the effects of left prefrontal tDCs across a broad spectrum of motor and non-motor symptoms of PD using established validated scales. Method: single-blind randomized clinical trial with 18 volunteers with PD, aged between 45 and 80 years (66.1 ± 9.65), who met inclusion and exclusion criteria. Participants were submitted to assessments of motor and non-motor functions employing psychometric scales and tests to evaluate EFs and were randomly divided into two groups: control (sham stimulation) and experimental (active stimulation). All participants were involved in three separate tDCs sessions. The anode was positioned over the left dorsolateral prefrontal cortex and the cathode over the right supraorbital region, with a direct current intensity of 2 mA, lasting 20 minutes. At the end of the three sessions, all participants were reassessed. Results: significant effects of tDCs on non-motor functions were observed for cognition (verbal fluency of actions, clock copy test, appointment by visual confrontation, and verbal memory with immediate free recall) and subjective assessment of sleep quality (overall restlessness and discomfort in the arms and legs at night, leg

关键词： Parkinson’s Disease Neuromodulation Transcranial Direct Current stimulation—tDCs Movement Disorders Mood sleep Cognition

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Hydro-wind Optimal Operation for Joint Bidding in Day-ahead Market: storage Efficiency and Impact of Wind Forecasting Uncertainty

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Journal of Modern Power systems and Clean Energy 2020年第1期8卷 142-149页

作者： António Cerejo sílvio J.P.s.mariano pedro M.s.Carvalho maria R.A.Calado Technical-scientific Unity of Electrical and Industrial Engineering Polytechnic Institute of Castelo BrancoAvenida do Empresário6000-767 Castelo BrancoPortugal Department of Electromechanical Engineering University of Beira Interior and Instituto de TelecomunicacoesCalcada Fonte do Lameiro6201-001 CovilhaPortugal Department of Electrical and Computer Engineering Instituto Superior Técnicoand INESC-IDUniversity of LisbonAv.Rovisco Pais1049-001 LisbonPortuga

Wind power production is *** imbalance between committed and delivered energy in pool markets leads to the increase of system costs,which must be incurred by defaulting producers,thereby decreasing their *** avoid this situation,wind producers can submit their bids together with hydro *** the mismatches between the predicted and supplied wind power can be used by hydro producers,turbining or pumping such differences when *** study formulates the problem of hydro-wind production optimization in operation contexts of pool *** problem is solved for a simple three-reservoir cascade case to discuss optimization *** results show a depreciation in optimal revenues from hydro power when wind forecasting is *** depreciation is caused by an asymmetry in optimal revenues from positive and negative wind power *** problem of neutralizing the effect of forecasting uncertainty is subsequently formulated and solved for the three-reservoir *** results are discussed to conclude the impacts of uncertainty on joint bidding in pool market contexts.

关键词： Optimization hydro power wind power uncertainty joint bidding pool market

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Estimating Risk-aware Flexibility Areas for Electric Vehicle Charging Pools via AC stochastic Optimal Power Flow

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Journal of Modern Power systems and Clean Energy 2023年第4期11卷 1247-1256页

作者： Juan s.Giraldo Nataly Bañol Arias pedro P.Vergara maria Vlasiou Gerwin Hoogsteen Johann L.Hurink Energy Transition studies Group Netherlands Organisation for Applied Scientific Research(TNO)Amsterdam1043 NTThe Netherlands Department of Electrical Engineering Mathematics and Computer ScienceUniversity of TwenteEnschede7522 NBThe Netherlands Intelligent Electrical Power Grids Group Electrical EngineeringMathematics and Computer ScienceDelft University of TechnologyDelft2628 CDThe Netherlands

This paper introduces an AC stochastic optimal power flow(sOPF)for the flexibility management of electric vehicle(EV)charging pools in distribution networks under *** AC sOPF considers discrete utility functions from charging pools as a compensation mechanism for eventual energy not served to their charging *** application of the AC sOPF is described where a distribution system operator(DsO)requires flexibility to each charging pool in a day-ahead time frame,minimizing the cost for flexibility while guaranteeing technical *** areas are defined for each charging pool and calculated as a function of a risk parameter involving the uncertainty of the *** show that all players can benefit from this approach,i.e.,the DsO obtains a riskaware solution,while charging pools/tasks perceive a reduction in the total energy payment due to flexibility services.

关键词： Electric vehicle flexibility management stochastic optimal power flow(sOPF) risk awareness compensation mechanism

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Dehydrated patient without clinically evident cause:A case report

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World Journal of Clinical Cases 2020年第20期8卷 4838-4843页

作者： Federica Palladino maria Cristina Fedele marianna Casertano Laura Liguori Tiziana Esposito stefano guarino Emanuele Miraglia del Giudice Pierluigi Marzuillo Department of Woman Child and of General and Specialized SurgeryUniversitàdegli Studi della Campania“Luigi Vanvitelli”Naples 80138Italy

BACKGROUND Patients affected by cystic fibrosis can present with metabolic alkalosis such as Bartter's *** this case report we want to underline this differential diagnosis and we aimed focusing on the suspect of cystic fibrosis,also in case of a negative newborn *** sUMMARY In a hot August–with a mean environmental temperature of 36℃–an 8-mo-old female patient presented with severe dehydration complicated by hypokalemic metabolic alkalosis,in absence of fever,diarrhea and *** diagnosis between cystic fibrosis and tubulopathies causing metabolic alkalosis(Bartter's syndrome)was *** started intravenous rehydration with subsequent improvement of clinical conditions and serum electrolytes *** diagnosed a mild form of cystic fibrosis(heterozygous mutations:G126 D and F508 del in the cystic fibrosis transmembrane conductance regulator gene).The trigger factor of this condition had been heat *** When facing a patient with hypokalemic metabolic alkalosis,cystic fibrosis presenting with Pseudo-Bartter's syndrome should be considered in the differential diagnosis,even if the newborn screening was negative.

关键词： Metabolic alkalosis Dehydration Cystic fibrosis Pseudo-Bartter syndrome Heat exposure Children Case report

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Clinical and pathological characterization of epstein-barr virus-associated gastric carcinomas in portugal

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World Journal of Gastroenterology 2017年第40期23卷 7292-7302页

作者： Joana Ribeiro Andreia Oliveira mariana Malta Claudia Oliveira Fernanda silva Ana Galaghar Luís pedro Afonso maria Cassiano Neves Rui Medeiros pedro Pimentel-Nunes Hugo sousa Molecular Oncology and Viral Pathology Group Portuguese Oncology Institute of Porto Faculty of Medicine of Porto University Department of Pathology Portuguese Oncology Institute of Porto Medical Oncology Department Portuguese Oncology Institute of Porto Instituto CUF de Oncologia Virology service Portuguese Oncology Institute of Porto Research Department-Portuguese League Against Cancer(Liga Portuguesa Contra o Cancro-Núcleo Regional do Norte) Gastroenterology service Portuguese Oncology Institute of Porto CINTEsIs-Center for Health Technology and services Research(Centro de Investigacao Médica Faculdade de Medicina da Universidade do Porto)

AIM To determine the prevalence of epstein-barr virus(eb V)-associated gastric carcinomas in the North Region of Portugal and to study its clinicopathological characteristics. METHODs We have performed a retrospective study including a total of 179 consecutive patients with gastric cancer(GC) submitted to gastrectomy during 2011 at the Portuguese Oncology Institute of Porto. Clinical and pathological data was collected from individual clinical records and inserted on a database with unique codification. Tumour tissues were collected from the institutional tumour bank. eb V was detected by in situ hybridization for the detection of eb V-encoded small RNAs(ebe Rs) and eb V latent proteins(LMP1 and LMP2 A) were detected by *** The analysis showed that eb V-associated gastric carcinomas(eb Va GC) represents 8.4%(15/179) of all GC cases, with a significant differential distribution among histological types(P s, 100%(1/1) of adenosquamous carcinoma, 8.7%(8/92) of tubular adenocarcinomas, 8.0%(2/25) of mixed carcinomas and 2%(1/51) in poorly cohesive carcinomas. The analysis revealed a higher predominance of eb Va GC in the upper third and middle(cardia, fundus and body) of the stomach(P = 0.041), a significant lower number of regional lymph nodes invasion(P = 0.025) and a tendency for better prognosis(P = 0.222). eb V latent protein expression revealed that all eb Va GC cases were LMP1-negative, nevertheless 6 cases(40%) expressed LPM2 A, which reveals that these cases show a distinct eb V-Latency profile(latency II-like).CONCLUsION eb Va GC represents 8.4% of all GC in the North Region of Portugal. The eb V-infected patients have specific clinic-pathological features that should be further explored to develop new strategies of management and treatment.

关键词： Gastric cancer Epstein-barr virus Prevalencel Epstein-barr virus-associated gastric carcinomas

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Recurrent ischemic strokes in a young celiac woman with MTHFR gene mutation

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World Journal of Gastroenterology 2012年第26期18卷 3472-3476页

作者： Elisa Fabbri Lisa Rustignoli Antonio Muscari Giovanni M Puddu maria guarino Rita Rinaldi Elena Minguzzi Giacomo Caio Marco Zoli Umberto Volta stroke Unit Department of Internal MedicineAging and Nephrological DiseasesUniversity of Bologna40138 BolognaItaly Neurology Unit Department of Internal MedicineAging and Nephrological DiseasesS.Orsola-Malpighi Hospital40138 BolognaItaly Department of Digestive Diseases and Internal Medicine S.Orsola-Malpighi Hospital40138 BolognaItaly

Celiac disease(CD) is frequently associated with neurological disorders,but very few reports concern the association with ischemic stroke.A 26-year-old woman affected by CD with secondary amenorrhea,carrier of a homozygous 5,10-methylenetetrahydrofolate reductase mutation with hyperhomocysteinemia,was affected by two occipital ischemic strokes within a period of 5 *** the time of the second stroke,while she was being treated with folic acid,acetylsalicylic acid and a gluten-free diet,she had left hemianopsia,left hemiparesthesias,and gait *** magnetic resonance imaging showed a subacute right occipital ischemic lesion,which was extended to the dorsal region of the right thalamus and the ipsilateral thalamocapsular *** and deamidated gliadin peptide antibodies were no longer present,while antinuclear antibodies,antineuronal antibodies and immune circulating complexes were only slightly *** the patient was taking folic acid,her homocysteine levels were almost normal and apparently not sufficient alone to explain the clinical event.A conventional cerebral angiography showed no signs of ***,rare causes of occipital stroke in young patients,such as Fabry's disease and mitochondrial myopathy,encephalomyopathy,lactic acidosis and stroke-like symptoms,were also excluded by appropriate ***,the most probable cause for the recurrent strokes in this young woman remained CD,although the mechanisms involved are still *** two main hypotheses concern malabsorption(with consequent deficiency of vitamins known to exert neurotrophic and neuroprotective effects) and immunemediated *** should be kept in mind in the differential diagnosis of ischemic stroke in young patients.

关键词： Celiac disease Female Methylenetetrahy-drofolate reductase stroke Vasculitis Young

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Biotinylated polyurethane-urea nanoparticles for targeted theranostics in human hepatocellular carcinoma

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Nano Research 2015年第5期8卷 1729-1745页

作者： Genoveva MorraI-Ruiz pedro Melgar-Lesmes Andrea Lopez-Vicente Conxita solans maria Jose Garcia-Celma Department of Pharmacy and Pharmaceutical Technology Faculty of Pharmacy University of Barcelona Av Joan XXIII s/n 08028 Barcelona Spain Institute of Advanced Chemistry of Catalonia (IQAC) CS/C Jordi Girona 18-26 08034 Barcelona Spain Networking Research Center on Bioengineering Biomaterials and Nanomedicine CIBER-BBN Spain

Over the past years, significant efforts have been devoted to explore novel drug delivery and detection strategies for simultaneous therapy and diagnostics. The development of biotinylated polyurethane-urea nanoparticles as theranostic nanocarriers for targeted drug and plasmid delivery, for fluorescence detection of human hepatocellular carcinoma cells, is described herein. These targeted nanoparticles are specifically designed to incorporate biotin into the polymeric matrix, since many tumor types overexpress receptors for biotin as a mechanism to boost uncontrolled cell growth. The obtained nanoparticles were spherical, exhibited an average diameter ranging 110-145 nm, and showed no cytotoxicity in healthy endothelial cells. Biotinylated nanoparticles are selectively incorporated into the perinuclear and nuclear area of the human hepatocellular carcinoma cell line, HepG2, in division, but not into growing, healthy, human endothelial cells. Indeed, the simultaneous incorporation of the anticancer drugs, phenoxodiol or sunitinib, together with plasmid DNA encoding green fluorescent protein, into these nanoparticles allows a targeted pharmacological antitumor effect and furthermore, selective transfection of a reporter gene, to detect these cancer cells. The combined targeted therapy and detection strategy described here could be exploited for liver cancer therapy and diagnostics, with a moderate safety profile, and may also be a potential tool for other types of cancer.

关键词： cancer therapy DNA nanoparticles polyurethane theranostics

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