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1.
Anal Sci ; 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38836970

RESUMO

Coal is the primary energy source in China, widely used in energy production, industrial processes, and chemical engineering. Due to the complexity and diversity of coal quality, there is an urgent need for new technologies to achieve rapid and accurate detection and analysis of coal, aiming to improve coal resource utilization and reduce pollutant emissions. This study proposes a rapid quantitative analysis of coal using laser-induced breakdown spectroscopy combined with the random forest algorithm. Firstly, a Q-switched Nd: YAG laser at 1064 nm was employed to ablate coal samples, generating plasma, and spectral data were collected using a spectrometer. Secondly, the study explores the impact of different parameters in the preprocessing method (wavelet transform) on the predictive performance of the random forest model. It identifies elements related to coal ash content and calorific value along with their spectral information. Subsequently, to further validate the predictive performance of the model, a comparison is made with models established using support vector machine, artificial neural network, and partial least squares. Finally, under optimal parameters for spectral information preprocessing (wavelet transform with Db4 as the base function and 3 decomposition levels), a model combining wavelet transform with Random Forest is established to predict and analyze the ash content and calorific value of coal. The results demonstrate that the Wavelet Transform-Random Forest model exhibits excellent predictive performance (coal ash content: R2 = 0.9470, RMSECV = 4.8594, RMSEP = 4.8450; coal calorific value: R2 = 0.9485, RMSECV = 1.5996, RMSEP = 1.5949). Therefore, laser-induced breakdown spectroscopy combined with the random forest algorithm is an effective method for rapid and accurate detection and analysis of coal. The predicted coal composition values show high accuracy, providing insights and methods for coal composition monitoring and analysis.

2.
Int Med Case Rep J ; 17: 487-495, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38784139

RESUMO

Objective: We report a case of Carmi Syndrome in a neonate. Aim: To share our lessons in diagnosis of the case of Carmi Syndrome. Case Report: Carmi Syndrome is an extremely rare autosomal recessive genetic disorder characterized the coexistence of pyloric atresia and junctional epidermolysis bullosa, and with aplasia cutis congenita in approximately 28% patients. In this case, a full-term male neonate was born to a G4P2+1L1 multipara through cesarean section delivery in hospital in a non-consanguineous marriage with 4000mL of II°meconium-stained amniotic fluid. He was found extensive skin loss over lower legs and other parts, with scattered blisters and bilateral microtia. Plain abdominal X-ray revealed a large gastric air bubble with no gas distally. The mother had an intrauterine fetal loss previously for reasons unknown. The dermatologist diagnosed the newborn with Bart Syndrome, while the pediatric surgeon diagnosed congenital pyloric atresia(CPA). The parents refused further treatment and the neonate passed away about 30 hours after birth. Outcome: The neonate passed away about 30 hours after birth. Conclusion: Lessons from this case:①.Rule out Carmi Syndrome in patients with PA, and differentiate Bart syndrome and Carmi Syndrome in patients with abnormal skin manifestations. ②. For rare and/or severe diseases, multidisciplinary teams(MDTs) should be establish. ③. Genetic counseling and prenatal diagnosis are necessary prior to subsequent childbearings. ④.Termination of pregnancy might be contemplated if certain indicators are revealed.

3.
Opt Express ; 32(5): 7448-7462, 2024 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-38439424

RESUMO

Optofluidic systems, integrating microfluidic and micro-optical technologies, have emerged as transformative tools for various applications, from molecular detection to flow cytometry. However, existing optofluidic microlenses often rely on external forces for tunability, hindering seamless integration into systems. This work presents an approach using two-photon polymerization (TPP) to fabricate inherently tunable microlens arrays, eliminating the need for supplementary equipment. The optofluidic design incorporates a three-layered structure enabling dynamic manipulation of refractive indices within microchannels, leading to tunable focusing characteristics. It is shown that the TPP fabricated optofluidic microlenses exhibit inherent tunable focal lengths, numerical apertures, and spot sizes without reliance on external forces. This work signifies some advancements in optofluidic technology, offering precise and tunable microlenses with potential applications in adaptive imaging and variable focal length microscopy.

4.
Opt Lett ; 48(21): 5603-5606, 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37910713

RESUMO

Optofluidic chips are frequently utilized in applications such as biological observation, chemical detection, dynamic displays, imaging, holography, and sensing. Yet, developing continuously zoomable technology has been challenging in the production of optical devices. Using a spatial light modulator to shape a femtosecond laser to achieve multibeam parallel pulse punching, we propose an easy-to-fabricate, stable, and reliable tuning technique in this Letter. We then propose the addition of a liquid medium with a continuously variable refractive index to achieve controllable zooming without changing the position and morphology of the microlens. By pumping various concentrations of the liquid medium into the optofluidic chip, continuous tunability of the device was experimentally verified.

5.
Opt Express ; 30(22): 39996-40008, 2022 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-36298940

RESUMO

Multifunctional electrodes possess superior properties such as high photoelectric properties and high stability. Laser manufacturing process is one of the widely used method for electrode fabrication. However, the current multifunctional electrode laser manufacturing process suffers from low fabrication speed. Here, we report a high-efficiency laser digital patterning process to fabricate copper-based flexible transparent conducting electrodes. By using a spatially modulated, one single laser spot is modulated into an array of spots with equal intensity, and the fabrication speed can be improved by more than 20 times over the traditional single pulse processing. In addition, copper mesh electrodes with a high photoelectric property have been fabricated. A transparent touch screen panel and multifunctional windows are fabricated with transparent electrodes to demonstrate their use in vehicle defogging, portable heating, and wearable devices.

6.
Opt Lett ; 47(11): 2638-2641, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35648893

RESUMO

An anisotropic plasmonic surface of nanoellipsoid arrays is successfully fabricated on an Au film using slit-shaping-based femtosecond laser nanoprinting. The size and orientation of the nanoellipsoid can be exquisitely and flexibly controlled by adjusting the width and direction of the slit and the laser pulse energy. By dark-field optical micro-spectroscopy, anisotropic plasmonic color rendering as well as resonant light scattering from the lateral and vertical modes are experimentally and theoretically investigated in the visible spectral range. In addition, prospective use in the fields of steganographic encryption and multidimensional optical multiplexing is also proposed.

7.
Nanomaterials (Basel) ; 12(7)2022 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-35407162

RESUMO

Based on nonequilibrium molecular dynamics (NEMD) and nonequilibrium Green's function simulations, the interfacial thermal conductance (ITC) of graphene/h-BN in-plane heterostructures with near-interface defects (monovacancy defects, 585 and f5f7 double-vacancy defects) is studied. Compared to pristine graphene/h-BN, all near-interface defects reduce the ITC of graphene/h-BN. However, differences in defective structures and the wrinkles induced by the defects cause significant discrepancies in heat transfer for defective graphene/h-BN. The stronger phonon scattering and phonon localization caused by the wider cross-section in defects and the larger wrinkles result in the double-vacancy defects having stronger energy hindrance effects than the monovacancy defects. In addition, the approximate cross-sections and wrinkles induced by the 585 and f5f7 double-vacancy defects provide approximate heat hindrance capability. The phonon transmission and vibrational density of states (VDOS) further confirm the above results. The double-vacancy defects in the near-interface region have lower low-frequency phonon transmission and VDOS values than the monovacancy defects, while the 585 and f5f7 double-vacancy defects have similar low-frequency phonon transmission and VDOS values at the near-interface region. This study provides physical insight into the thermal transport mechanisms in graphene/h-BN in-plane heterostructures with near-interface defects and provides design guidelines for related devices.

8.
Micromachines (Basel) ; 12(6)2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34071820

RESUMO

Femtosecond laser-induced crystallization and ablation of Ge2Sb2Te5 (GST) phase change film is investigated by reflectivity pump-probing technology. Below the ablation threshold, the face-centered cubic structure (FCC) state in the central area can be formed, and cylindrical rims are formed in the peripheral dewetting zone due to the solidification of transported matter. The time of surface temperature dropping to the crystallization point needs about 30 ps for 5.86 mJ/cm2 and 82 ps for 7.04 mJ/cm2, respectively. At higher laser fluence, crystallization GST island structures appear in the central ablation region due to the extremely short heating time (100 ps). Furthermore, crystallization rate is faster than the ablation rate of the GST film, which is caused by different reflectivity.

9.
World J Urol ; 39(9): 3207-3215, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33515055

RESUMO

PURPOSE: To synthesize the evidence from randomized controlled trials of prostatic urethral lift (PUL) and convective water vapor thermal energy therapy (WAVE) for minimally invasive treatment of men with benign prostatic hyperplasia. METHODS: A systematic search of databases was performed to identify trials comparing WAVE or PUL to either an active or sham surgery control in subjects with symptomatic benign prostatic obstruction. A controlled indirect treatment comparison based on the approach of Bucher was performed for outcomes including International Prostate Symptom Score and maximum urinary flow rate (Qmax). The durability of treatment response was assessed by life-table analysis of freedom from retreatment through 4 years. RESULTS: Two multicenter sham-controlled trials (Rezum II Study, NCT01912339: LIFT Study, NCT01294150) were identified. The trials employed a common sham procedure and were similar with respect to their designs and subjects' baseline characteristics. Comparisons on the treatment effect in excess of sham response found non-significant differences between WAVE and PUL for symptom score [mean difference (MD): - 1.7 points; 95% confidence interval (CI): - 4.8, 1.4] but Qmax improvements favored WAVE [MD: 3.4 ml/sec; CI: 1.2, 5.6]. The proportion free of retreatment through 4 years was 89.1% for WAVE versus 75.4% for PUL [log-rank P = 0.004]. CONCLUSIONS: PUL and WAVE provide similar subjective improvements but flow-rate improvement and durability of response seem greater for WAVE. The confirmation of these findings in a randomized trial is warranted.


Assuntos
Hiperplasia Prostática/terapia , Vapor , Uretra/cirurgia , Humanos , Masculino , Modalidades de Fisioterapia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos
10.
Opt Lett ; 45(4): 901-904, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-32058500

RESUMO

We report a facile top-flat square nanosecond (ns) laser direct writing ablation technique in a thin silver film substrate to fabricate the silver square-shaped cell structure of flexible transparent electrodes. Square silver cell structures feature smooth surface morphology, excellent edge definition, mechanical stability, strong adhesion to the substrate, and favorable resistance and transparency. In particular, this strategy enables fabrication of a high square-shaped cell areal density (ablated square cell to the total area) Ag mesh, substantially improving transparency ($ {\gt} {85}\% $>85%) without considerably sacrificing conductivity ($ {\lt} {5}\;\Omega \;{{\rm sq}^{ - 1}}$<5Ωsq-1 unit of resistance). Consequently, the proposed metallic square-shaped structure shows compatibility with a polyethylene naphthalate flexible substrate for silver-based wearable electronic devices without any protective layer over the electrodes.

11.
Opt Express ; 27(7): 10087-10097, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-31045155

RESUMO

Laser-induced periodic surface structures (LIPSS) are a universal phenomenon that can allow tailoring nanoelectronics and nanophotonics devices. However, there is an issue about the formation mechanism of LIPSS, and the current research mainly focuses on the formation process of the individual structures, such as the low spatial frequency LIPSS (LSFL), sub-wavelength structures, and laser-induced periodic annular surface structures (LIPASS). A whole process formation picture of the series of these periodic structures is still missing. In this study, a pump-probing setup is applied to ensure the real-time and in situ monitoring of surface modification under different pulse numbers. LSFL firstly appears on the surface after two laser shots, and then, laser-induced orthogonal periodic structures (LIOPS) become the dominant morphology after five laser shots, which result from the local field enhancement of the surface ripples. As the laser shots increase, the LSFL split leads to the formation of nanopillars, and the formation of the nanopillars under the surface LSFL (after ten laser shots) is due to the transition between the LSFL and HSFL with an orientation parallel to the laser polarization. A dip surrounded by annular periodic fringes after 50 laser shots is observed, which is due to the interference of the incident laser field and the reflected laser field on the crater surface. Finally, a direct writing technique for fabrication of nano-gratings is also reported.

12.
Materials (Basel) ; 12(1)2018 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-30587777

RESUMO

Femtosecond laser pulse of 800 nm wavelength and 150 fs temporal width ablation of As2S3 chalcogenide glasses is investigated by pump-probing technology. At lower laser fluence (8.26 mJ/cm²), the surface temperature dropping to the melting point is fast (about 43 ps), which results in a clean hole on the surface. As the laser fluence increases, it takes a longer time for lattice temperature to cool to the melting point at high fluence (about 200 ps for 18.58 mJ/cm², about 400 ps for 30.98 mJ/cm²). The longer time of the surface heating temperature induces the melting pool in the center, and accelerates material diffusing and gathering surrounding the crater, resulting in the peripheral rim structure and droplet-like structure around the rim. In addition, the fabricated long periodic As2S3 glasses diffraction gratings can preserve with high diffraction efficiency by laser direct writing technology.

13.
J Phys Condens Matter ; 30(46): 465701, 2018 Nov 21.
Artigo em Inglês | MEDLINE | ID: mdl-30265248

RESUMO

A theoretical model is proposed to analyze the inter-valley electron transferring between direct Γ and indirect L valleys, which sheds light on the electron conduction dynamics in (0 0 1) tensile strained Ge. Inter-valley scattering is included to calculate average scattering time between Γ and L valleys based on a time-dependent Hamiltonian describing the electron-phonon interaction. Numerical results indicate that enhanced indirect-to-direct inter-valley scattering and reduced direct-to-indirect inter-valley scattering are reliable by introducing tensile strain in Ge material. The population ratio of electrons in Γ and L valleys in strained Ge will increase one to two orders of magnitude compared to the model without the inter-valley scattering. The results offer fundamental understanding of phonon engineering for further improvement of performance in strained germanium light sources.

14.
Nanoscale ; 10(17): 8133-8138, 2018 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-29671438

RESUMO

Optically electric- and magnetic resonance-induced dielectric nanostructures have garnered significant attention due to applications as tunable electronic and optoelectronic device. In this letter, we describe an ultrafast and large-area method to construct symmetrical and single-crystal Si island structures directly on Si substrates by a pulse laser dewetting method. The tunable surface electric field intensity distribution could convert the stochastic dewetting process into a deterministic process (classical dipole mode and Mie resonance dipole mode) on predefined Si pit arrays via laser dewetting. Under this condition, these pre-patterned Si substrate structures not only induced high spatial ordering of islands, but also improved their size uniformity. By adjusting the laser fluence, the diameter of the single-crystal Si islands could be selected in the range 41.7-147.1 nm.

15.
ACS Nano ; 12(3): 2231-2241, 2018 03 27.
Artigo em Inglês | MEDLINE | ID: mdl-29481049

RESUMO

Manipulating and tuning nanoparticles by means of optical field interactions is of key interest for nanoscience and applications in electronics and photonics. We report scalable, direct, and optically modulated writing of nanoparticle patterns (size, number, and location) of high precision using a pulsed nanosecond laser. The complex nanoparticle arrangement is modulated by the laser pulse energy and polarization with the particle size ranging from 60 to 330 nm. Furthermore, we report fast cooling-rate induced phase switching of crystalline Si nanoparticles to the amorphous state. Such phase switching has usually been observed in compound phase change materials like GeSbTe. The ensuing modification of atomic structure leads to dielectric constant switching. Based on these effects, a multiscale laser-assisted method of fabricating Mie resonator arrays is proposed. The number of Mie resonators, as well as the resonance peaks and dielectric constants of selected resonators, can be programmed. The programmable light-matter interaction serves as a mechanism to fabricate optical metasurfaces, structural color, and multidimensional optical storage devices.

16.
Sci Rep ; 7(1): 8644, 2017 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-28819172

RESUMO

The structural evolution and phase-change kinetics of NiO-doped ZnSb films are investigated. NiO-doped ZnSb films exhibit a single-step crystallization process, which is different from that of undoped ZnSb. NiO-doped ZnSb can directly crystallize into a stable ZnSb phase at temperatures greater than 320 °C with suppression of a metastable ZnSb phase. These characteristics enlarge the amorphous/crystalline resistance ratio by approximately five orders of magnitude. Moreover, NiO doping of ZnSb films increases crystallization temperature from 260 to 275 °C, improves data retention temperature from 201.7 to 217.3 °C and increases crystalline activation energy from 5.64 to 6.34 eV. The improvement of the thermal parameters in the nanocomposite can be attributed to stable ZnSb grain growth refinement owing to the dispersion of NiO particles in the sample matrix. This provides additional nucleation sites and produces more ZnSb/NiO interfaces, which can initiate the nucleation and accelerate crystallization. The kinetic exponent n decreases from 1.12 to 0.44, which confirms the ultrafast one-dimensional growth and heterogeneous phase transition of the NiO-doped ZnSb films. The improved thermal stability, larger resistance ratio and direct transition to a stable phase with ultrafast one-dimensional crystal growth indicate the good potential of these materials in phase-change memory applications.

17.
Opt Express ; 21(8): 9923-30, 2013 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-23609698

RESUMO

We describe the fabrication of nanostructures on SiGe film by KrF excimer laser with nanosecond pulse width, and find a more direct and clear relationship between the laser irradiation conditions and the nanoscale structures. Perfect annular nanostructures around scattering points on the SiGe film are firstly obtained after the irradiation of a KrF excimer pulse laser beam (100 mJ/cm(2)) at different incident angles. The different shapes of annular structures are related to different energy distributions due to the optical interference between the scattered light and the incident beam. As laser energy increases, a threshold of pulse energy (230 mJ/cm(2)) is found, above which a droplet-like morphology completely replacing the surface annular structures. And the disorder morphology is mainly caused by the thermal effect of the incident beam.


Assuntos
Germânio/química , Germânio/efeitos da radiação , Lasers , Nanopartículas/química , Nanopartículas/efeitos da radiação , Nanopartículas/ultraestrutura , Silício/química , Silício/efeitos da radiação , Teste de Materiais , Propriedades de Superfície/efeitos da radiação
18.
Circ Arrhythm Electrophysiol ; 2(5): 474-80, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19843914

RESUMO

BACKGROUND: It is unknown if brief episodes of device-detected atrial fibrillation (AF) increase thromboembolic event (TE) risk. METHODS AND RESULTS: TRENDS was a prospective, observational study enrolling patients with > or = 1 stroke risk factor (heart failure, hypertension, age > or = 65 years, diabetes, or prior TE) receiving pacemakers or defibrillators that monitor atrial tachycardia (AT)/AF burden (defined as the longest total AT/AF duration on any given day during the prior 30-day period). This time-varying exposure was updated daily during follow-up and related to TE risk. Annualized TE rates were determined according to AT/AF burden subsets: zero, low (<5.5 hours [median duration of subsets with nonzero burden]), and high (> or = 5.5 hours). A multivariate Cox model provided hazard ratios including terms for stroke risk factors and time-varying AT/AF burden and antithrombotic therapy. Patients (n=2486) had at least 30 days of device data for analysis. During a mean follow-up of 1.4 years, annualized TE risk (including transient ischemic attacks) was 1.1% for zero, 1.1% for low, and 2.4% for high burden subsets of 30-day windows. Compared with zero burden, adjusted hazard ratios (95% CIs) in the low and high burden subsets were 0.98 (0.34 to 2.82, P=0.97) and 2.20 (0.96 to 5.05, P=0.06), respectively. CONCLUSIONS: The TE rate was low compared with patients with traditional AF with similar risk profiles. The data suggest that TE risk is a quantitative function of AT/AF burden. AT/AF burden > or = 5.5 hours on any of 30 prior days appeared to double TE risk. Additional studies are needed to more precisely investigate the relationship between stroke risk and AT/AF burden.


Assuntos
Fibrilação Atrial/complicações , Acidente Vascular Cerebral/etiologia , Idoso , Análise de Variância , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/terapia , Distribuição de Qui-Quadrado , Desfibriladores Implantáveis , Feminino , Humanos , Embolia Intracraniana/epidemiologia , Embolia Intracraniana/etiologia , Ataque Isquêmico Transitório/epidemiologia , Ataque Isquêmico Transitório/etiologia , Masculino , Prognóstico , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Terapia Trombolítica
19.
Am J Health Syst Pharm ; 65(10): 947-52, 2008 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-18463344

RESUMO

PURPOSE: Characteristics of the amiodarone-warfarin interaction during long-term follow-up were studied. METHODS: Medical records from patients seen in the anticoagulation clinic at the Hennepin County Medical Center between April 1998 and March 2003 were retrospectively reviewed. Patients were included if they were older than 18 years, used the anticoagulation clinic as their primary clinic for anticoagulation therapy, and were receiving combined amiodarone and warfarin therapy for at least one month. The primary study endpoint was the occurrence of International Normalized Ratios (INRs) of >5 at any time during combined warfarin-amiodarone therapy. The secondary endpoint was the frequency of warfarin dosage changes. RESULTS: A total of 70 patients met study inclusion criteria. Of these 70, 7 had amiodarone started before warfarin initiation. Of the 2434 INR values analyzed, 43% (n = 1043) were in the target therapeutic range, 34% (n = 820) were below target range, and 23% (n = 571) were above target range. A total of 102 INR values (4%) were above 5. The relative risk of having an INR of >5 for patients on concurrent warfarin and amiodarone versus those on warfarin alone was 1.366 (p = 0.005). INRs of >5 were most common during the first 12 weeks of combined therapy, with no subsequent large peaks evident. CONCLUSION: Among patients treated in an anticoagulation clinic, INR values of >5 were most common during the first 12 weeks of combined therapy with amiodarone and warfarin and necessitated reduction in warfarin dosage. No other notable changes in INR or amiodarone or warfarin dosage occurred throughout the remainder of the 80-week study period.


Assuntos
Amiodarona/farmacologia , Antiarrítmicos/farmacologia , Anticoagulantes/farmacologia , Varfarina/farmacologia , Adulto , Idoso , Amiodarona/administração & dosagem , Antiarrítmicos/administração & dosagem , Anticoagulantes/administração & dosagem , Arritmias Cardíacas/sangue , Arritmias Cardíacas/tratamento farmacológico , Relação Dose-Resposta a Droga , Interações Medicamentosas , Quimioterapia Combinada , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Varfarina/administração & dosagem
20.
Gastrointest Endosc ; 59(1): 8-14, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14722540

RESUMO

BACKGROUND: Increasingly, pancreatic stents are being placed to prevent post-ERCP pancreatitis. However, guidewire and stent placement may fail if the duct is small or tortuous, potentially exacerbating the risk. This study assessed the impact of unsuccessful pancreatic stent placement on complications and the efficacy of a modified technique for stent insertion when pancreatic ductal anatomy makes stent insertion technically difficult. METHODS: Technical variables and 30-day complications of consecutive therapeutic ERCPs, including attempted major papilla pancreatic stent insertion were prospectively studied. Success rates for pancreatic stent placement were compared for a 1-year period during which conventional deep guidewire insertion was used and another 1-year period in which a modified technique was used as needed in patients with ductal anatomy that made stent placement technically difficult. In the modified technique, a short (2-3 cm) small diameter (3F-5F) stent was placed over a 0.018-in nitinol-tipped guidewire, passed as little as 1 to 2 cm beyond the pancreatic sphincter. RESULTS: In 225 high-risk therapeutic ERCPs, pancreatitis occurred after the procedure in two of 3 (66.7%) patients in whom pancreatic stent insertion failed vs. 32 of 222 (14.4%) patients with successful insertion (p=0.06). Severe pancreatitis occurred only after unsuccessful stent insertion. Significant multivariate risk factors for post-ERCP pancreatitis were unsuccessful pancreatic stent insertion (odds ratio 16.1: 95% CI[1.3, 200]), sphincter of Oddi dysfunction (odds ratio 3.2: 95% CI[1.4, 7.5]), and prior post-ERCP pancreatitis (odds ratio 3.2: 95% CI[1.4, 7.1]). The following were not risk factors: performance of pancreatic, biliary, or needle-knife pre-cut sphincterotomy; number of pancreatic contrast injections; and difficult cannulation. Stent placement was unsuccessful in 3 (3.2%) of 93 attempts during the 1-year period in which a conventional technique was used vs. none of 132 attempts in a subsequent year in which the modified technique was used. CONCLUSIONS: Failed attempts at pancreatic stent placement are associated with an extremely high risk of post-ERCP pancreatitis. Success can be consistently achieved by use of a modified technique.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica/efeitos adversos , Pancreatite/prevenção & controle , Stents , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ductos Pancreáticos , Pancreatite/etiologia , Implantação de Prótese/métodos , Esfíncter da Ampola Hepatopancreática/fisiopatologia , Falha de Tratamento
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