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1.
ACS Sens ; 9(6): 3066-3074, 2024 Jun 28.
Artículo en Inglés | MEDLINE | ID: mdl-38877998

RESUMEN

Point-of-care testing (POCT) devices play a crucial role as tools for disease diagnostics, and the integration of biorecognition elements with electronic components into these devices widens their functionalities and facilitates the development of complex quantitative assays. Unfortunately, biosensors that exploit large conventional IgG antibodies to capture relevant biomarkers are often limited in terms of sensitivity, selectivity, and storage stability, considerably restricting the use of POCT in real-world applications. Therefore, we used nanobodies as they are more suitable for fabricating electrochemical biosensors with near-field communication (NFC) technology. Moreover, a flow-through microfluidic device was implemented in this system for the detection of C-reactive protein (CRP), an inflammation biomarker, and a model analyte. The resulting sensors not only have high sensitivity and portability but also retain automated sequential flow properties through capillary transport without the need for an external pump. We also compared the accuracy of CRP quantitative analyses between commercial PalmSens4 and NFC-based potentiostats. Furthermore, the sensor reliability was evaluated using three biological samples (artificial serum, plasma, and whole blood without any pretreatment). This platform will streamline the development of POCT devices by combining operational simplicity, low cost, fast analysis, and portability.


Asunto(s)
Técnicas Biosensibles , Proteína C-Reactiva , Técnicas Electroquímicas , Dispositivos Laboratorio en un Chip , Anticuerpos de Dominio Único , Teléfono Inteligente , Proteína C-Reactiva/análisis , Proteína C-Reactiva/inmunología , Técnicas Electroquímicas/instrumentación , Técnicas Electroquímicas/métodos , Técnicas Biosensibles/métodos , Técnicas Biosensibles/instrumentación , Humanos , Anticuerpos de Dominio Único/química , Anticuerpos de Dominio Único/inmunología , Técnicas Analíticas Microfluídicas/instrumentación
2.
BMC Vet Res ; 20(1): 78, 2024 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-38413934

RESUMEN

BACKGROUND: Due to the increasing prevalence of equine non-infectious respiratory disease, the air contamination in equine housing (Stables A-C) and training facilities (indoor riding arenas A - C) was investigated. The aim of the study was to monitor gaseous pollutants, bioaerosols, and dust concentrations at three different sites (stables and riding halls), where different floor materials were used in the riding halls. MATERIALS AND METHODS: Air quality was monitored in housing for horses and in riding halls in terms of dust concentration, the presence of gaseous chemical pollutants, and concentrations of biological aerosol. Statistical analysis was performed using analysis of variance (ANOVA). The levels obtained were compared with acceptable limits. RESULTS: Among the gaseous pollutants identified, the highest concentration was obtained for ammonia in stables B and C (16.37 and 22.39 mg/m3, respectively). Standards for total dust were exceeded in stables B and C and in riding halls B and C. The highest numbers of bacteria and fungi were recorded in stables A and C and in riding hall B. Ulocladium sp. had the highest percentage share among the moulds identified. CONCLUSIONS: The results confirm that the wrong choice of bedding in the stable and indoor riding arenas may contribute, even in short training periods, to equine non-infectious respiratory disease (equine asthma). Bioaerosol suspended in the air together with released gaseous pollutants can exacerbate this phenomenon, which even in the case of short training periods can lead to equine asthma of varying degrees of severity. For this reason, the choice of floor material in riding halls should be treated as a priority, as the wrong decision can shorten the period during which the horse can be used for recreational purposes.


Asunto(s)
Asma , Enfermedades de los Caballos , Caballos , Animales , Polvo/análisis , Bacterias , Hongos , Asma/veterinaria , Aerosoles y Gotitas Respiratorias , Enfermedades de los Caballos/inducido químicamente , Enfermedades de los Caballos/epidemiología
3.
Anal Chem ; 95(38): 14475-14483, 2023 09 26.
Artículo en Inglés | MEDLINE | ID: mdl-37695838

RESUMEN

We investigate the interactions between C-reactive protein (CRP) and new CRP-binding peptide materials using experimental (biological and physicochemical) methods with the support of theoretical simulations (computational modeling analysis). Three specific CRP-binding peptides (P2, P3, and P9) derived from an M13 bacteriophage have been identified using phage-display technology. The binding efficiency of the peptides exposed on phages toward the CRP protein was demonstrated via biological methods. Fibers of the selected phages/peptides interact differently due to different compositions of amino acid sequences on the exposed peptides, which was confirmed by transmission electron microscopy. Numerical and experimental studies consistently showed that the P3 peptide is the best CRP binder. A combination of theoretical and experimental methods demonstrates that identifying the best binder can be performed simply, cheaply, and fast. Such an approach has not been reported previously for peptide screening and demonstrates a new trend in science where calculations can replace or support laborious experimental techniques. Finally, the best CRP binder─the P3 peptide─was used for CRP recognition on silicate-modified indium tin oxide-coated glass electrodes. The obtained electrodes exhibit a wide range of operation (1.0-100 µg mL-1) with a detection limit (LOD = 3σ/S) of 0.34 µg mL-1. Moreover, the dissociation constant Kd of 4.2 ± 0.144 µg mL-1 (35 ± 1.2 nM) was evaluated from the change in the current. The selectivity of the obtained electrode was demonstrated in the presence of three interfering proteins. These results prove that the presented P3 peptide is a potential candidate as a receptor for CRP, which can replace specific antibodies.


Asunto(s)
Proteína C-Reactiva , Péptidos , Secuencia de Aminoácidos , Anticuerpos , Bacteriófago M13
4.
J Clin Med ; 12(15)2023 Aug 02.
Artículo en Inglés | MEDLINE | ID: mdl-37568488

RESUMEN

Appendix neuroendocrine neoplasm (ANEN) treatment is based on tumor size and proliferation markers. Recently, the role of the follicle-stimulating hormone receptor (FSHR) from the clinical perspective has also been increasingly discussed. The FSHR is expressed in the endothelial cells of both intratumoral and peritumoral blood vessels, where it contributes to neoangiogenesis and blood vessel remodeling. FSHR expression is associated with a range of tumor types, such as gastrointestinal tumors, and it is not detected in healthy tissues located more than 10 mm from the tumor site or in tumor lymphatics. In this study, we evaluated the expression of FSHR and CD31 in the blood vessels of ANENs in females and males with confirmed histopathology. We conducted a quantitative analysis of the immunohistochemical reactions and found a higher number of microvessels in the mucosa and submucosa of neuroendocrine tumors in the appendix. A higher level of FSHR expression was observed in women. Future research should consider whether an elevated number of blood vessels along with a strong pattern of FSHR expression may influence future treatment strategies.

5.
ACS Omega ; 8(29): 26253-26262, 2023 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-37521637

RESUMEN

Phage-derived affinity peptides have become widespread thanks to their easy selection via phage display. Interactions between a target protein and its specific peptide are similar to those between antibodies and antigens. The strength of these non-covalent complexes may be described by the dissociation constant (Kd). In this paper, protein-specific peptides are exposed on the pIII protein present in the M13 bacteriophage virion with up to five copies. Therefore, one phage particle can bind from one to five ligands. Here, we discuss the dependences between phage-displayed peptides and their ligands in solution using a model system based on troponin T (TnT) binding phages. Moreover, a method of calculating Kd values from ELISA experiments was developed and is presented. The determined Kd values are in the picomolar range.

6.
BMC Vet Res ; 19(1): 3, 2023 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-36609375

RESUMEN

BACKGROUND: The study assessed the effect of smectites (bentonite and zeolite) used as natural sorbents in the diet of pigs on feed digestibility, health parameters, the severity of anatomo-histological changes in organs, and the accumulation of volatile pollutants in organs. MATERIAL AND METHODS: The study was conducted using fattening pigs (crossbreds from multiple breeds) assigned to three groups - a control (C) and two experimental groups (A and B), with 240 pigs in each group (3 replicates × 80). The animals in group C received a standard complete diet, while groups A and B received diets with 1.5% composed smectite sorbents. The feed and faeces were analysed for content of dry matter, crude ash, crude protein, ether extract, and crude fibre. The content of P was determined using a Helios Alpha UV-VIS spectrophotometer. Whole blood was analysed for haematological parameters and serum for biochemical parameters. Tissue samples were collected for analysis of volatile substances and histological analysis. After slaughter, samples of the lungs, liver, kidneys and jejunum were collected for morphological evaluation, and samples of the perirenal fat, liver, kidneys, lungs and brain for headspace gas chromatography (GC) to determine the levels of volatile toxic substances. RESULTS: A statistical increase in the digestibility of crude fibre and an increase in that of P were observed in both experimental groups (A and B) in comparison to the control. The whole blood and serum of the pigs from the control group had statistically significantly higher levels of creatinine, urea, and Mg and a higher WBC count compared to both experimental groups (A and B). CONCLUSIONS: The feed additives were not shown to have a negative effect on the health parameters analysed or on accumulation of pollutants in selected tissues. No significant effect on the digestibility of most nutrients was observed; only an increase in the digestibility of crude fibre and a decrease in P digestibility were noted in the experimental groups.


Asunto(s)
Dieta , Digestión , Porcinos , Animales , Dieta/veterinaria , Nutrientes , Heces , Yeyuno , Alimentación Animal/análisis , Fenómenos Fisiológicos Nutricionales de los Animales
7.
Biosensors (Basel) ; 11(12)2021 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-34940253

RESUMEN

C-reactive protein (CRP) is an inflammation biomarker that should be quantified accurately during infections and healing processes. Nanobodies are good candidates to replace conventional antibodies in immunodiagnostics due to their inexpensive production, simple engineering, and the possibility to obtain higher binder density on capture surfaces. Starting from the same pre-immune library, we compared the selection output resulting from two independent panning strategies, one exclusively exploiting the phage display and another in which a first round of phage display was followed by a second round of yeast display. There was a partial output convergence between the two methods, since two clones were identified using both panning protocols but the first provided several further different sequences, whereas the second favored the recovery of many copies of few clones. The isolated anti-CRP nanobodies had affinity in the low nanomolar range and were suitable for ELISA and immunoprecipitation. One of them was fused to SpyTag and exploited in combination with SpyCatcher as the immunocapture element to quantify CRP using electrochemical impedance spectroscopy. The sensitivity of the biosensor was calculated as low as 0.21 µg/mL.


Asunto(s)
Bacteriófagos , Proteína C-Reactiva/análisis , Camélidos del Nuevo Mundo , Anticuerpos de Dominio Único , Animales , Ensayo de Inmunoadsorción Enzimática , Saccharomyces cerevisiae/genética
8.
Onco Targets Ther ; 14: 2497-2503, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33883904

RESUMEN

INTRODUCTION: Incidences of chronic myeloid leukaemia (CML) after treatment of Hodgkin lymphoma (HL) are well described. Here, we report a case of secondary HL in a patient with CML treated with dasatinib as a third-line treatment. PATIENT INFORMATION: A 64-year-old male was diagnosed with CML and initially treated with imatinib and then with nilotinib due to resistance. Finally, the patient experienced cardiovascular complications, and dasatinib was introduced. After 19 months of treatment, the patient experienced enlargement of lymph nodes that formed packs on the neck. INTERVENTIONS: Based on histopathological examination of the lymph nodes, a diagnosis of classical Hodgkin lymphoma - mixed cellularity was established. The patient was successfully treated with 4 cycles of AVD (adriamycin, vinblastine, dacarbazine) chemotherapy. OUTCOMES: Complete metabolic remission of Hodgkin lymphoma is currently sustained, and the molecular response to dasatinib at a reduced dose of 50 mg daily corresponds with a deep molecular response. CONCLUSION: In this report, we demonstrate the efficacy and safety of the combination of dasatinib and AVD regimens in coexisting CML and HL. This case report emphasizes the importance of insightful evaluation and differential diagnosis in cases of lymphadenopathy during CML treatment.

9.
Bioelectrochemistry ; 136: 107629, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32818758

RESUMEN

Recently, bacteriophage particles have started to be applied as a new biomaterial for developing sensing platforms. They can be used as both a recognition element or/and as building blocks, template/scaffold. In this paper, we studied a bacteriophage selected through phage-display technology. The chosen bacteriophage acted as a building block for creating a carbon nanofiber-based electrode and as a new receptor/binding element that recognizes C-reactive protein (CRP) - one of the markers of inflammatory processes in the human body. The binding efficiency of the selected phage towards CRP is two orders of magnitude higher than in the wild type. We demonstrate that the phage-based sensor is selective against other proteins. Finally, we show that layer-by-layer methods are suitable for deposition of negatively charged phages (wild or CRP-binding) with positively charged carbon nanofibers for electrode surface modification. A three-layered electrode was successfully used for molecular recognition of CRP, and the molecular interactions were studied using electrochemical, biological, and optical methods, including microscopic and spectroscopic analyses.


Asunto(s)
Bacteriófagos/metabolismo , Proteína C-Reactiva/metabolismo , Electrodos , Nanofibras/química , Bacteriófagos/ultraestructura , Técnicas Biosensibles/métodos , Técnicas Electroquímicas/métodos , Microscopía Electrónica de Transmisión , Unión Proteica
11.
Biosens Bioelectron ; 154: 112050, 2020 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-32056957

RESUMEN

In this work we discuss a new label-free biosensing device based on indium tin oxide (ITO) overlaid section of a multimode optical fiber fused silica core. The sensor has been used to optical measurements also simultaneously interrogated electrochemically (EC). Due to optimized thickness and optical properties of ITO film, a lossy-mode resonance (LMR) could be observed in the optical domain, where electrical properties of the film allowed for application of the sensor as a working electrode in an EC setup. It has been confirmed that the LMR response depends on optical properties of the external medium, as well as potential applied to the electrode during cyclic voltammetry. After the ITO surface functionalization with amine groups and covalently attached biotin, the device has been applied for label-free biosensing of avidin in both the domains simultaneously. On the example of biotin-avidin detection system it was demonstrated that when avidin concentration increases a decrease in current and increase in LMR wavelength shift were recorded in EC and optical domain, respectively. Both optical and EC responses follow the protein interaction process, and thus can be used as cross-verification of the readouts. Moreover, an extended information has been achieved comparing to solely EC interrogation, i.e., the grafting process of biotin and avidin was directly monitored optically displaying individual steps of an incubation procedure.


Asunto(s)
Avidina/aislamiento & purificación , Técnicas Biosensibles , Biotina/aislamiento & purificación , Técnicas Electroquímicas , Avidina/química , Biotina/química , Electrodos , Óptica y Fotónica , Compuestos de Estaño/química
12.
ACS Appl Bio Mater ; 3(1): 512-521, 2020 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-35019394

RESUMEN

Bacteriophage material (M13, wild-type) deposited as a film onto a poly(ethylene terephthalate) (PET) substrate (6 µm thick with a 20 µm diameter laser-drilled microhole) has been investigated for ion conductivity and ionic current rectification effects for potential applications in membranes. The M13 aggregate membrane forms under acidic conditions (in aqueous 10 mM acids) and behaves like a microporous anion conductor with micropores defined by the packing of cylindrical virus particles. Asymmetric deposition on the PET film substrate in conjunction with semipermeability leads to anionic diode behavior. Typical rectification ratio values are around 10 (determined at ±1 V) in aqueous 10 mM acids. Cationic guest species (aqueous Cu2+, Co2+, Ag+) consistently lead to a rectification minimum at 0.5 mM guest concentration. In contrast, anionic guest species (indigo carmine) lead to a similar rectification minimum already at 5 µM concentration. The behavior is proposed to be associated with cation exclusion effects on transport.

13.
Biosens Bioelectron ; 133: 8-15, 2019 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-30903939

RESUMEN

In this work we discussed a label-free biosensing application of long-period gratings (LPGs) optimized in refractive index (RI) sensitivity by deposition of thin tantalum oxide (TaOx) overlays. Comparing to other thin film and materials already applied for maximizing the RI sensitivity, TaOx offers good chemical and mechanical stability during its surface functionalization and other biosensing experiments. It was shown theoretically and experimentally that when RI of the overlay is as high as 2 in IR spectral range, for obtaining LPGs ultrasensitive to RI, the overlay's thickness must be determined with subnanometer precision. In this experiment the TaOx overlays were deposited using Atomic Layer Deposition method that allowed for achieving overlays with exceptionally well-defined thickness and optical properties. The TaOx nano-coated LPGs show RI sensitivity determined for a single resonance exceeding 11,500 nm/RIU in RI range nD= 1.335-1.345 RIU, as expected for label-free biosensing applications. Capability for detection of various in size biological targets, i.e., proteins (avidin) and bacteria (Escherichia coli), with TaOx-coated LPGs was verified using biotin and bacteriophage adhesin as recognition elements, respectively. It has been shown that functionalization process, as well as type of recognition elements and target analyte must be taken into consideration when the LPG sensitivity is optimized. In this work optimized approach made possible detection of small in size biological targets such as proteins with sensitivity reaching 10.21 nm/log(ng/ml).


Asunto(s)
Avidina/aislamiento & purificación , Técnicas Biosensibles , Escherichia coli/aislamiento & purificación , Tecnología de Fibra Óptica , Nanopartículas , Óxidos/química , Refractometría , Tantalio/química
14.
Gastrointest Endosc ; 89(6): 1141-1149, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-30659831

RESUMEN

BACKGROUND AND AIMS: The diagnosis of gastric premalignant conditions (GPCs) relies on endoscopy with mucosal sampling. We hypothesized that the endoscopist biopsy rate (EBR) might constitute a quality indicator for EGD, and we have analyzed its association with GPC detection and the rate of missed gastric cancers (GCs). METHODS: We analyzed EGD databases from 2 high-volume outpatient units. EBR values, defined as the proportion of EGDs with ≥1 biopsy to all examinations were calculated for each endoscopist in Unit A (derivation cohort) and divided by the quartile values into 4 groups. Detection of GPC was calculated for each group and compared using multivariate clustered logistic regression models. Unit B database was used for validation. All patients were followed in the Cancer Registry for missed GCs diagnosed between 1 month and 3 years after EGDs with negative results. RESULTS: Sixteen endoscopists in Unit A performed 17,490 EGDs of which 15,340 (87.7%) were analyzed. EBR quartile values were 22.4% to 36.7% (low EBR), 36.8% to 43.7% (moderate), 43.8% to 51.6% (high), and 51.7% and 65.8% (very-high); median value 43.8%. The odds ratios for the moderate, high, and very-high EBR groups of detecting GPC were 1.6 (95% confidence interval [CI], 1.3-1.9), 2.0 (95% CI, 1.7-2.4), and 2.5 (95% CI, 2.1-2.9), respectively, compared with the low EBR group (P < .001). This association was confirmed with the same thresholds in the validation cohort. Endoscopists with higher EBR (≥43.8%) had a lower risk of missed cancer compared with those in the lower EBR group (odds ratio, 0.44; 95% CI, 0.20-1.00; P = .049). CONCLUSIONS: The EBR parameter is highly variable among endoscopists and is associated with efficacy in GPC detection and the rate of missed GCs.


Asunto(s)
Biopsia/estadística & datos numéricos , Gastritis Atrófica/patología , Gastroscopía/normas , Lesiones Precancerosas/patología , Indicadores de Calidad de la Atención de Salud , Neoplasias Gástricas/patología , Adenoma/diagnóstico , Adenoma/patología , Adolescente , Adulto , Anciano , Atención Ambulatoria , Esófago de Barrett/diagnóstico , Esófago de Barrett/patología , Estudios de Cohortes , Neoplasias Duodenales/diagnóstico , Neoplasias Duodenales/patología , Femenino , Gastritis Atrófica/diagnóstico , Humanos , Almacenamiento y Recuperación de la Información , Modelos Logísticos , Masculino , Metaplasia , Persona de Mediana Edad , Análisis Multivariante , Polonia , Lesiones Precancerosas/diagnóstico , Estudios Retrospectivos , Lesiones Intraepiteliales Escamosas/diagnóstico , Lesiones Intraepiteliales Escamosas/patología , Estómago/patología , Neoplasias Gástricas/diagnóstico , Adulto Joven
15.
Bioconjug Chem ; 27(12): 2900-2910, 2016 Dec 21.
Artículo en Inglés | MEDLINE | ID: mdl-27748604

RESUMEN

With the advent of nanotechnology, carbon nanomaterials such as carbon nanofibers (CNF) have aroused substantial interest in various research fields, including energy storage and sensing. Further improvement of their properties might be achieved via the application of viral particles such as bacteriophages. In this report, we present a filamentous M13 bacteriophage with a point mutation in gene VII (pVII-mutant-M13) that selectively binds to the carbon nanofibers to form 3D structures. The phage-display technique was utilized for the selection of the pVII-mutant-M13 phage from the phage display peptide library. The properties of this phage make it a prospective candidate for a scaffold material for CNFs. The results for binding of CNF by mutant phage were compared with those for maternal bacteriophage (pVII-M13). The efficiency of binding between pVII-mutant-M13 and CNF is about 2 orders of magnitude higher compared to that of the pVII-M13. Binding affinity between pVII-mutant-M13 and CNF was also characterized using atomic force microscopy, scanning electron microscopy, and transmission electron microscopy, which confirmed the specificity of the interaction of the phage pVII-mutant-M13 and the CNF; the binding occurs via the phage's ending, where the mutated pVII protein is located. No similar behavior has been observed for other carbon nanomaterials such as graphite, reduced graphene oxide, single-walled carbon nanotubes, and multiwalled carbon nanotubes. Infrared spectra confirmed differences in the interaction with CNF between the pVII-mutant-M13 and the pVII-M13. Basing on conducted research, we hypothesize that the interactions are noncovalent in nature, with π-π interactions playing the dominant role. Herein, the new bioconjugate material is introduced.


Asunto(s)
Bacteriófago M13/química , Bacteriófago M13/metabolismo , Nanofibras/química , Bacteriófago M13/genética , Grafito/química , Microscopía de Fuerza Atómica , Microscopía Electrónica de Rastreo , Microscopía Electrónica de Transmisión , Espectroscopía de Fotoelectrones , Mutación Puntual , Espectrofotometría Infrarroja
16.
Eur J Gastroenterol Hepatol ; 26(6): 607-15, 2014 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-24743502

RESUMEN

OBJECTIVE: Endoscopic submucosal dissection (ESD) has a high curative resection rate for gastrointestinal mucosal lesions, but is not used widely in Europe because of a high complication rate and a long learning curve. This study analyzed the ESD learning curve at a single European treatment center. MATERIALS AND METHODS: ESD and hybrid-ESD (hESD) procedures were used to treat large colonic lesions that could not be resected in one piece by other endoscopic methods. Procedure duration and speed, and en-bloc, complete (R0) resection, and complication rates were analyzed. RESULTS: Fifty-three patients underwent ESD (37 pure ESD, 16 hESD), most with rectal lesions (n=34, 64.2%). The mean lesion diameter was 3.7 ± 1.1 cm2 (range 2.0-7.0 cm), the median procedure duration was 70.0 min [interquartile range (IQR) 31.0-113.0 min], and the median treatment speed was 0.086 cm2/min (IQR 0.055-0.152). En-bloc and R0 resection rates were 86.5% (32/37) and 81.1% (30/37), respectively. Procedure speed increased significantly after about 25 cases (P=0.0313). The median hESD procedure treatment speed was 0.159 cm/min (n=16, IQR 0.094-0.193), which was better than with classical ESD (P=0.04). The hESD en-bloc and R0 resection rates were comparable to those of classical ESD (P>0.05). The only complication was bleeding, 5.7% (3/53); no perforation occurred. Recurrence was detected during follow-up (median 30.0 months, IQR 12-48) in one patient (1.7%). CONCLUSION: ESD is useful and safe for resection of large colorectal polyps, and procedure speed increased considerably after 25 procedures. hESD was faster than ESD, with a high therapeutic resection rate.


Asunto(s)
Colonoscopía/métodos , Neoplasias Colorrectales/cirugía , Adenocarcinoma/patología , Adenocarcinoma/cirugía , Adenoma/patología , Adenoma/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Colonoscopía/efectos adversos , Colonoscopía/educación , Neoplasias Colorrectales/patología , Disección/efectos adversos , Disección/educación , Disección/métodos , Educación Médica Continua/métodos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Tempo Operativo , Resultado del Tratamiento
17.
World J Gastroenterol ; 19(12): 1953-61, 2013 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-23569341

RESUMEN

AIM: To investigate the indications, resection rate, and safety of endoscopic submucosal dissection (ESD) for neoplastic lesions in the gastrointestinal tract at a European referral center. METHODS: We carried out a retrospective analysis of the ESD procedures performed in our center for mucosal neoplastic and submucosal lesions of the gastrointestinal tract. The duration of the procedure, en bloc and complete (R0) resection rates, and complication rates were evaluated. Variables were reported as mean ± SD or simple proportions. Univariate analysis and comparisons of procedure times and resection rates were performed using Mann-Whitney U tests, or χ(2) tests for dichotomous variables. RESULTS: Between 2007 and 2011, ESD was performed in a total of 103 patients (46.7% male, mean age 64.0 ± 12.7 years). The indications for the procedure were epithelial tumor (n = 54), submucosal tumor (n = 42), or other (n = 7). The total en bloc resection rate was 90.3% (93/103) and R0 resection rate 80.6% (83/103). The median speed of the procedure was 15.0 min/cm(2). The complete resection rate was lower for submucosal tumors arising from the muscle layer (68%, 15/22, P < 0.05). Resection speed was quicker for submucosal tumors localized in the submucosal layer than for lesions arising from the muscularis propria layer (8.1 min/cm(2) vs 17.9 min/cm(2), P < 0.05). The R0 resection rate and speed were better in the last 24 mo (90.1%, 49/54 and 15.3 min/cm(2)) compared to the first 3 years of treatment (73.5%, 36/49, P < 0.05 and 22.0 min/cm(2), P < 0.05). Complications occurred in 14.6% (n = 15) of patients, including perforation in 5.8% (n = 6), pneumoperitoneum in 3.9% (n = 4), delayed bleeding in 1.9% (n = 2), and other in 2.9% (n = 3). Only one patient with delayed perforation required surgical treatment. During the mean follow-up of 26 ± 15.3 mo, among patients with R0 resection, recurrence occurred in one patient (1.2%). CONCLUSION: ESD is an effective and safe method for resection of neoplastic lesions with low recurrence. Speed and the R0 resection rate increased after 50 procedures.


Asunto(s)
Adenocarcinoma/cirugía , Disección/estadística & datos numéricos , Endoscopía Gastrointestinal/estadística & datos numéricos , Neoplasias Gastrointestinales/cirugía , Leiomioma/cirugía , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
18.
Gastrointest Endosc ; 75(2): 276-86, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22032850

RESUMEN

BACKGROUND: Endoscopic submucosal dissection (ESD) is a well-accepted method for removing superficial mucosal tumors; however, there is limited data on the use of this method for removing subepithelial tumors. OBJECTIVE: To investigate the efficacy, safety, and outcome of ESD for gastric subepithelial tumors and determine factors related to treatment success. DESIGN: Retrospective analysis of a prospectively maintained database. SETTING: Single tertiary academic center. PATIENTS AND INTERVENTIONS: From April 2007 to November 2010, 37 patients with gastric subepithelial tumors were treated with ESD. MAIN OUTCOME MEASUREMENTS: Macroscopically and microscopically complete en block resection rate (R0), complication rate, and endosonographic features predictive of R0 resection. RESULTS: The median tumor diameter was 25.0 mm, (range 10-60 mm, IQR 17-37). The overall rate of R0 resections was 81.1% (30/37, 95%CI: 61.8-90.2%), including 100% (15/15, 95%CI: 78.2-100.0%) of tumors from the submucosa and 68.2% (15/22, 95%CI: 45.1-86.1%) of tumors from the muscularis propria. Seventeen patients had a final diagnosis of gastrointestinal stromal tumor. The severe complication (perforation) rate was 5.4% (2/37, 95%CI: 0.0-9.5%). One patient required surgery; the other was treated conservatively. No recurrence was observed in patients with R0 resections at a median follow up of 21.0 months (IQR 11-35). Successful R0 resections were predicted by the observation of no, or only narrow, tumor connections with the underlying muscle layer during EUS (OR=35.0, 95%CI: 3.7-334.4, p=0.001). LIMITATIONS: Single-center, retrospective analysis, short follow-up. CONCLUSIONS: ESD is an effective and relatively safe method for removing gastric subepithelial tumors. Endoscopic ultrasonography findings can predict complete tumor resections.


Asunto(s)
Disección/métodos , Mucosa Gástrica/cirugía , Tumores del Estroma Gastrointestinal/diagnóstico por imagen , Tumores del Estroma Gastrointestinal/cirugía , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Disección/efectos adversos , Endosonografía , Femenino , Tumores del Estroma Gastrointestinal/patología , Gastroscopía , Humanos , Masculino , Persona de Mediana Edad , Neumoperitoneo/etiología , Estudios Retrospectivos , Neoplasias Gástricas/patología
19.
PLoS One ; 5(5): e10825, 2010 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-20520831

RESUMEN

BACKGROUND: The ability to travel mentally through time sets humans apart from many other species, yet little is known about this core cognitive capacity. In particular, what shapes the passage of the mind's journey through time? Guided by the viewpoint that higher cognitive activity can have a sensory-motor grounding, we explored the possibility that mental time travel is influenced by apparent movement through space. METHODOLOGY/PRINCIPAL FINDINGS: Participants performed a mundane vigilance task, during which they were expected to daydream, while viewing a display that elicited an illusion of self-motion (i.e., vection). Afterwards, the contents of their mind wandering experiences were probed. The results revealed that the direction of apparent motion influenced the temporal focus of mental time travel. While backward vection prompted thinking about the past, forward vection triggered a preponderance of future-oriented thoughts. CONCLUSIONS/SIGNIFICANCE: Consistent with recent evidence that traveling mentally through time entails associated movements in space, the current results demonstrate the converse relationship-apparent movement through space influenced the temporal locus of mental activity. Together, these findings corroborate the viewpoint that mental time travel may be grounded in the embodiment of spatiotemporal information in a bidirectional manner.


Asunto(s)
Imaginación , Percepción de Movimiento , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estimulación Luminosa , Factores de Tiempo , Adulto Joven
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