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1.
Indian J Otolaryngol Head Neck Surg ; 76(3): 2619-2625, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38883512

RESUMO

Chronic Otitis Media is characterized by distinct bacteriology compared with Acute Otitis Media, with COM being highly likely to harbor multiple bacteria of anaerobic and aerobic types of organisms (Cameron and Hussam K. El-Kashlan, xxx). In some patients, chronic infection with otorrhea will persist despite aggressive medical therapy. With the large number of cases of COM which presents to Sanjay Gandhi Memorial Hospital, and a majority being resistant to the common medications, we decided to undertake this study to have a better understanding of the bacterial epidemiology, the resistance, and what antibiotic to use in such cases. To determine the prevalence of different bacteriological agents and their antibiotic sensitivity pattern in patients of Chronic Otitis Media-Active Mucosal Disease presenting to ENT OPD at Sanjay Gandhi Memorial Hospital, Mangolpuri, Delhi. An observational cross-sectional study of 200 patients. After an initial examination, two sterile cotton swab sticks were introduced to collect pus samples from the medial part of the external auditory canal. The swabs were sent to the microbiology lab for Gram Staining, Culture, and Biochemical Tests, for identification of the different bacteriological agents and their antibiotic sensitivity patterns. Most common organism seen was Pseudomonas aeruginosa, followed by Staphylococcus aureus, Klebsiella pneumoniae, Proteus mirabilis, mixed bacterial growth, and Candida spp. If regular monitoring of bacteriological profile is done in each hospital, this will help us to choose the antibiotics in a better manner and hence prevent the appearance of newer resistant strains.

2.
Spectrochim Acta A Mol Biomol Spectrosc ; 320: 124671, 2024 Nov 05.
Artigo em Inglês | MEDLINE | ID: mdl-38906060

RESUMO

Herein, a novel ratiometric strategy for ultra-sensitive detection of o-phenylenediamine (OPD) was proposed based on combinatorial reactions of in-situ fluorogenic reaction and in-situ formation of red fluorescent dithiothreitol-copper nanoparticles (DTT-CuNPs). Here, Cu2+ is used both as an oxidant and as a precursor. Dehydroascorbic acid (DHAA) is formed via redox reaction of AA and Cu2+. Then, DHAA reacts with OPD to yield blue fluorescent quinoxaline (OXD) with emission peak at 434 nm through in-situ fluorogenic reaction. Red emitting DTT-CuNPs with emission peak at 666 nm is instantly generated due to the coordination reaction between DTT and the residual Cu2+ which is not consumed by AA. The fluorescence intensity (FI) of OXD at 434 nm is closely relied on the concentration of OPD, which can be used as a response signal for OPD detection. Meanwhile, FI of DTT-CuNPs at 666 nm has no significant change, which can be used as a reference signal for OPD detection. Thus, the ratio (F434/F666) of the Cu2+/AA/DTT sensing system is successfully employed to quantify OPD, exhibiting a wide linear range from 0.2 µM to 60 µM, with LOD of 0.09 µM.

3.
J Hazard Mater ; 472: 134522, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38714057

RESUMO

Electro-catalytic conversion of nitrate (NO3-) to ammonia (NH3) via the Nitrate Reduction to Ammonia (NORA) process represents a promising strategy for both ammonia synthesis and environmental remediation. Despite its potential, the efficiency of low-concentration NORA is often hindered by mass transfer limitations, competing byproducts (N2 and NO2-), and side reactions such as hydrogen evolution. This study introduces a novel pulsed electro-synthesis technique that alternates the potential to periodically accumulate and transform NO2- intermediates near a Cu2O@Pd electrode, enhancing the NORA process. Compared with that under potentiostatic conditions, the Cu2O@Pd electrodes exhibited a higher NORA activity under the optimized pulsed condition, where a NH3-N Faradaic efficiency (FE) of 81.2%, a yield rate of 1.08 mg h-1 cm-2 and a selectivity efficiency (SE) of 81.5%, were achieved. In-situ characterization revealed an enhancement mechanism characterized by optimized adsorption of the key *NO intermediate, followed by the hydrogenation path "*N → *NH → *NH2→ *NH3". Further investigations indicated the electro-catalytic synergies between Pd sites and Cu species, where the Pd atoms were the reaction sites for the H adsorption while the Cu species were responsible for the NO3- activation. This research offers a novel insight into a method of enhancing low-concentration NORA.

4.
Indian J Community Med ; 49(2): 417-423, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38665434

RESUMO

Background: Identification of mental health disorders during childhood is crucial for healthy 'adult roles' in the society, so this study aimed to estimate the magnitude of 'any mental health disorder' and to find out its correlates among children attending the pediatric out-patient department (OPD) of a medical college in West Bengal and to estimate parental stress among their parents. Materials and Methods: It was a descriptive cross-sectional study done in the pediatric OPD of Burdwan Medical College, West Bengal, during July-December, 2021. The calculated size of 288 children aged between 4 and 12 years and attending with either of their parents was selected through systematic random sampling. One of their parents (preferably mother) was interviewed using a schedule, containing a pre-validated pediatric symptom checklist and parental stress scale. Ethical clearance was obtained from the Institutional Ethics Committee. Data were analyzed using SPSS-v23. Results: The median age of the children was 7 years (5-8 y.). The majority of them were male (57.6%), lived in urban areas (59.0%), and lived in joint families (57.6%). One-fifth (20.5%) of the children were found to have any mental health disorder (AMHD). Living in an urban area (aOR = 2.5, 95% CI: 1.1-5.7), belonging to a nuclear family (aOR = 3.6, 95% CI: 1.7-8.1), and belonging to a family with social problems (aOR = 7.8, 95% CI: 2.3-27.2) were significant correlates of AMHD. Parental stress [median: 60 (55-63)] was found significantly higher (P < 0.001) among parents of children with AMHD as compared to the parents of others. Conclusion: The magnitude of AMHD was high in this study, indicating toward the necessity of implementing opportunistic screening and appropriate public health action.

5.
Cureus ; 16(2): e53387, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38435141

RESUMO

Laparoscopic pancreaticoduodenectomy (LPD) has gained popularity as an alternative to open pancreaticoduodenectomy (OPD), but comparative outcomes remain debated. The objective is to perform a systematic review and meta-analysis comparing LPD and OPD on operative time, oncologic outcomes, bleeding, morbidity, and mortality. The inclusion criteria were comparative studies on LPD vs. OPD. Outcomes were pooled using random-effects meta-analysis. A total of 27 studies were included, and LPD had a substantially longer operative duration compared to the OPD procedure, with a mean increase of 56 minutes, but blood loss was reduced by an average of 123 mL in patients who underwent LPD. Morbidity, mortality, margin status, and lymph node yields were similar between LPD and OPD. This study found comparable oncologic outcomes between LPD and OPD. LPD appears safe but requires longer operative time. High-quality randomized trials are still needed.

6.
Int Ophthalmol ; 44(1): 46, 2024 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-38336905

RESUMO

PURPOSE: To determine the toric intraocular lens (IOL) axis by using internal astigmatism axis obtained from Optical Path Difference (OPD) Scan III (Nidek Co.) in non-dilate eyes. METHODS: The eyes of patients who underwent toric IOL implantation for astigmatic correction were investigated. Patients who have ocular surface disorder, keratoconus, posterior capsule opacification were excluded. The IOL axis measured in non-dilated eyes in mesopic conditions by OPD scan III device and the IOL axis measured by using classical slit lamp biomicroscopy method in dilated eyes were detected at postoperative 1st and 6th months. Results were compared with correlation and linear regression analysis. RESULTS: Totally, 26 eyes of 18 patients were included. The difference between biomicroscopic IOL axis and OPD internal astigmatism axis was 4.96 ± 4.41 degrees at the 1st month and 3.62 ± 3.5 degrees at the 6th month. There was a significant and high correlation between biomicroscopic IOL axis and OPD internal astigmatism axis at both 1st month (r = 0.992 p < 0.001) and 6th month (r = 0.995 p < 0.001). According to regression analysis, the results of two measurement methods were significantly compatible with each other at 1st month (R Sq = 0.984 p < 0.001) and 6th month (R Sq = 0.990 p < 0.001) and there was a close to ideal linear (R Sq = 1) relationship between two methods. CONCLUSIONS: In eyes with toric IOL implantation, the IOL axis and IOL rotation according to target IOL axis can be detected easily and effectively in a short time by OPD scan internal astigmatism axis without the need to dilate the pupil.


Assuntos
Astigmatismo , Lentes Intraoculares , Facoemulsificação , Humanos , Implante de Lente Intraocular/métodos , Acuidade Visual , Facoemulsificação/métodos , Astigmatismo/cirurgia , Refração Ocular
7.
Molecules ; 29(4)2024 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-38398545

RESUMO

The development of various enzyme-linked immunosorbent assays (ELISAs) coupled with surface-enhanced Raman scattering (SERS) detection is a growing area in analytical chemistry due to their potentially high sensitivity. A SERS-based ELISA with horseradish peroxidase (HRP) as an enzymatic label, an o-phenylenediamine (oPD) substrate, and a 2,3-diaminophenazine (DAP) enzymatic product was one of the first examples of such a system. However, the full capabilities of this long-known approach have yet to be revealed. The current study addresses a previously unrecognized problem of SERS detection stage performance. Using silver nanoparticles and model mixtures of oPD and DAP, the effects of the pH, the concentration of the aggregating agent, and the particle surface chloride stabilizer were extensively evaluated. At the optimal mildly acidic pH of 3, a 0.93 to 1 M citrate buffer, and AgNPs stabilized with 20 mM chloride, a two orders of magnitude advantage in the limits of detection (LODs) for SERS compared to colorimetry was demonstrated for both DAP and HRP. The resulting LOD for HRP of 0.067 pmol/L (1.3 amol per assay) underscores that the developed approach is a highly sensitive technique. We suppose that this improved detection system could become a useful tool for the development of SERS-based ELISA protocols.


Assuntos
Nanopartículas Metálicas , Fenazinas , Fenilenodiaminas , Análise Espectral Raman , Peroxidase do Rábano Silvestre , Análise Espectral Raman/métodos , Cloretos , Prata
8.
Z Kinder Jugendpsychiatr Psychother ; 52(4): 201-211, 2024 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-38323523

RESUMO

The Operationalized Psychodynamic Diagnostic of Children and Adolescents (OPD-KJ-2) in Everyday Clinical Practice with the Plämobox: Applicability and Interrater Reliability Abstract: Objective: The OPD-CA2 manual for assessing psychodynamic aspects in children and adolescents is well established in clinical practice. However, publications regarding its reliability and validity are limited to (1) adolescents, (2) the structure of the first version of the manual and not to the comprehensive revision of the OPD-CA2, (3) the axes "structure" and (partly) "conflict" but not the axis "relationship," and (4) missing applicability in everyday clinical practice. Methodology: The present study comprised 42 children aged 6-12 years (age level 2 of the OPD-CA2), with and without mental illness, and assessed them using two randomly assigned raters. We assessed them using a low-structured diagnostic symbol game with miniature figurines and objects based on videotapes. We also tested the interrater reliability of the OPD-CA2 axes. Results: The overall assessment of structure and the assessment of the four subdimensions succeeded with good to very good agreement. We could also determine the presence of relevant conflict dynamics with very high agreement, while not recognizing specific conflicts in the clinical sample. Our assessment of the items of the relationship axis shows a low level of agreement. Conclusions: Overall, we can confirm the reliability of the OPD-CA2 for everyday clinical assessment in the younger age groups. Finally, we discuss which factors contribute to the heterogeneous picture.


Assuntos
Transtornos Mentais , Variações Dependentes do Observador , Psicometria , Humanos , Criança , Masculino , Feminino , Reprodutibilidade dos Testes , Psicometria/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Transtornos Mentais/psicologia , Adolescente , Manuais como Assunto , Determinação da Personalidade/estatística & dados numéricos , Conflito Psicológico , Terapia Psicanalítica
9.
J Cancer Policy ; 39: 100469, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38278353

RESUMO

BACKGROUND: Cancer imposes a substantial economic burden due to treatment costs, supportive care, and loss of productivity. Besides all the affecting factors, major concerns lead to significant financial burdens of cancer treatment, bringing unwanted huge unbearable direct and indirect treatment costs. The aim was to explore the nature of additional mobility/travel required for accessing health care for cancer patients and also to assess financial burden due to additional mobility/travel costs for cancer treatment. METHODS: This study employed unit-level cross-sectional data from the 75th round (2017-18) of India's National Sample Survey (NSS). The primary analysis commenced with descriptive and bivariate analyses to explore mean health spending and out-of-pocket expenses. Subsequently, multivariable logistic regression models were utilized to estimate the associations between catastrophic health expenditure, distress financing, and the treatment location. RESULTS: The findings highlight distinct healthcare utilization patterns: inpatient treatments predominantly occur within the same district (50.4 %), followed by a different district (38.8 %), and a smaller share in other states (10.8 %). Outpatients largely receive treatment in the same district (65.5 %), followed by a different district (26.8 %), and around 8 % percent in other states. Urban areas show higher inpatient visits within the same district (41.8 %) and different districts (33.5 %). Outpatients, particularly those seeking treatment in other states, experience higher total expenditures, notably with higher out-of-pocket expenses. Distress financing is more common among inpatients (20.6 %) and combined inpatient/outpatient cases (23.9 %), while outpatients exhibit a lower rate (6.8 %). CONCLUSION: The findings collectively suggest the importance of developing local healthcare infrastructures to reduce the additional mobility of cancer patients. The policy should focus to train and deploy oncologists in non-urban areas can help bridge the gap in cancer care proficiency and reduce the need for patients to travel long distances for treatment.


Assuntos
Estresse Financeiro , Neoplasias , Humanos , Estudos Transversais , Financiamento Pessoal , Custos de Cuidados de Saúde , Gastos em Saúde , Neoplasias/terapia
10.
Photodiagnosis Photodyn Ther ; 45: 103911, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38043761

RESUMO

BACKGROUND: Comparison of OPD-Scan III and Pentacam measurements of relevant parameters guiding the selection of multifocal intraocular lenses in cataract patients. METHODS: A retrospective study included 120 patients (120 eyes) with cataract. Their chord kappa, chord alpha, corneal spherical aberration, and pupil size were measured by OPD-Scan Ⅲ and Pentacam. Pairwise t-tests, Pearson tests, and Bland-Altman analyses were used, respectively, to assess the difference, correlation, and agreement between the devices. RESULTS: There was no significant difference in photopic chord kappa and corneal spherical aberration between the two instruments (P = 0.054, P = 0.065). Chord alpha and pupil size varied significantly between the two instruments (P < 0.001). OPD-Scan III results revealed a significant association between photopic chord kappa and mesopic chord kappa (r = 0.823, P < 0.001). There was a significant positive correlation between photopic and mesopic chord kappa measured by OPD-Scan Ⅲ and chord kappa measured by Pentacam (r = 0.840, r  = 0.757, P < 0.001). The chord alpha evaluated by the two tools had a moderate correlation (r = 0.442, P < 0.001) between them. Bland-Altman analysis showed that there was excellent agreement between the two instruments in measuring chord kappa and corneal spherical aberration, while the chord alpha and pupil size were not consistent. CONCLUSIONS: The chord kappa and corneal spherical aberration measured by OPD-Scan III and Pentacam were consistent in the preoperative decision making of multifocal intraocular lens implantation in cataract patients, both of which have clinical guiding significance. In addition, OPD-Scan III provides more comprehensive day and night chord kappa and pupil diameters, which improves clinical advice for patients with complicated ocular diseases and high demands for nocturnal vision.


Assuntos
Catarata , Fotoquimioterapia , Humanos , Acuidade Visual , Estudos Retrospectivos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes , Biometria
11.
Mikrochim Acta ; 191(1): 24, 2023 12 13.
Artigo em Inglês | MEDLINE | ID: mdl-38091091

RESUMO

A novel determination method for protein biomarkers based on on-chip flow rate measurement was developed using a microchip with organic photodiodes (OPDs). This quantitative method is based on the flow rate measurement of an ink solution pushed out by oxygen gas generated through catalase reaction. The amount of oxygen gas generated in the sample reservoir is dependent on the concentration of the analyte; therefore, the flow rate of the ink solution is also dependent on the concentration of the analyte. The concentration of the analyte can thus be estimated by measurement of the ink solution flow rate. The ink solution flow rate was estimated by measuring the migration time of the ink solution between two points using two OPDs placed below the microchannel. The principle of this method was demonstrated by the measurement of catalase using the microchip. In addition, the developed method was applied to the determination of C-reactive protein (CRP), a biomarker of inflammation, based on a catalase-linked immunosorbent assay (C-LISA). The limit of detection for CRP was 0.20 µg/mL. The method was also applied to the determination of CRP in human serum, and the quantitative values obtained by this method were in excellent agreement with those obtained by the conventional enzyme-linked immunosorbent assay (ELISA) method. The developed method does not require a photodetector with high sensitivity and is thus capable of downsizing; therefore, this will be useful for on-site analyses such as point-of-care testing and field measurements.


Assuntos
Proteína C-Reativa , Oxigênio , Humanos , Proteína C-Reativa/análise , Catalase , Tinta , Biomarcadores
12.
Biosensors (Basel) ; 13(11)2023 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-37998151

RESUMO

The promising field of organic electronics has ushered in a new era of biosensing technology, thus offering a promising frontier for applications in both medical diagnostics and environmental monitoring. This review paper provides a comprehensive overview of organic electronics' remarkable progress and potential in biosensing applications. It explores the multifaceted aspects of organic materials and devices, thereby highlighting their unique advantages, such as flexibility, biocompatibility, and low-cost fabrication. The paper delves into the diverse range of biosensors enabled by organic electronics, including electrochemical, optical, piezoelectric, and thermal sensors, thus showcasing their versatility in detecting biomolecules, pathogens, and environmental pollutants. Furthermore, integrating organic biosensors into wearable devices and the Internet of Things (IoT) ecosystem is discussed, wherein they offer real-time, remote, and personalized monitoring solutions. The review also addresses the current challenges and future prospects of organic biosensing, thus emphasizing the potential for breakthroughs in personalized medicine, environmental sustainability, and the advancement of human health and well-being.


Assuntos
Técnicas Biossensoriais , Dispositivos Eletrônicos Vestíveis , Humanos , Eletrônica , Tecnologia
13.
Front Psychol ; 14: 1248992, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37780157

RESUMO

Background: The assessment of personality functioning is at the core of current dimensional models of personality disorders. A variety of measures from different clinical and research traditions aim to assess basic psychological capacities regarding the self and others. While some instruments have shown reliability and validity in clinical or other selected samples, much less is known about their performance in the general population. Methods: In three samples representative of the German adult population with a total of 7,256 participants, levels of personality functioning were measured with the short 12-item version of the Operationalized Psychodynamic Diagnosis - Structure Questionnaire (OPD-SQS). We addressed questions of factor structure, reliability, validity, factorial invariance, and provide norm values. Results: Confirmatory factor analysis indicated a satisfactory to good model fit. OPD-SQS models were mostly unaffected by variables such as gender, age, or measurement time. As expected, personality functioning was associated with general psychopathology as well as indices of occupational functioning. Conclusion: The OPD-SQS is a viable measure to assess personality functioning in the general population.

14.
Int Ophthalmol ; 43(12): 4911-4919, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37828345

RESUMO

PURPOSE: To investigate the relationship between lens morphology and aberrations in patients with myopia. METHODS: This cross-sectional study included 155 patients with myopia in their right eyes. Spherical power and cylindrical power were achieved by cycloplegic autorefraction. The eyes were divided into three groups for analysis based on their spherical equivalent (SE) values. The 4 mm and 6 mm ocular and internal aberrations were measured using the OPD-scan III. Lens parameters were measured using CASIA2, including lens thickness (LT), radius of anterior/posterior lens surface curvature (RAL/RPL), lens decentration (DEC), and lens tilt (TILT). The differences of lenticular parameters and aberration parameters among the three groups analyzed with ANOVA or Kruskal Wallis test. Pearson correlation or Spearman correlation analysis was performed to evaluate the relationships between the lens parameters and aberrations. A p value < 0.05 indicated statistical significance. RESULTS: The difference in LT, RAL, DEC and TITL among the three groups was statistically significant (p < 0.05). And there were differences among differences in internal high-order aberrations, spherical aberration, and coma aberration(p < 0.05).Spherical power was positively correlated with LT and TITL (p < 0.05) and negatively correlated with DEC, RAL, and RPL (p < 0.05). Cylindrical power was positively correlated with LT (p < 0.05) and negatively correlated DEC (p < 0.05); The lenticular parameters (LT, RAL, DEC, and TILT) were mainly correlated with the ocular and internal spherical aberration. LT and DEC were correlated with ocular and internal higher-order aberrations and coma aberration. CONCLUSION: DEC and LT were the main factors affecting aberrations in patients with myopia.


Assuntos
Cristalino , Miopia , Humanos , Estudos Transversais , Coma , Miopia/diagnóstico , Refração Ocular
15.
Z Psychosom Med Psychother ; 69(3): 261-277, 2023 Oct.
Artigo em Alemão | MEDLINE | ID: mdl-37815587

RESUMO

Objectives: Personality organization or functioning describes biographically acquired characteristics for the regulation of psychological processes. Limitations correlate with symptom load. This study examines whether significant improvement in personality functioning can be achieved in the framework of a multimodal psychodynamic treatment and its influence on the psychological symptoms. Methods: In this naturalistic study design (N = 318) personality organization was measured with the OPD-SQS and the symptoms were obtained using PHQ-9, GAD-7, SCL-9 and mini- Spin. Changes in the functioning levels were calculated using a t-test. The associations between the functional and symptom improvements were calculated using hierarchical regressionmodels. ANOVAs for dependent samples were used to calculate the association of the personality organization changes on symptom reduction Results: Treatment resulted in significant improvement in personality structure.The greater the changes, the lower the symptom burden at the end of treatment. Patients with lower personality structure benefited equally well from treatment. Conclusions: Personality functioning improves with multimodal psychodynamic therapy and is accompanied by reduction of psychological symptoms. Structural changes proceed equally in high and low structured patients.


Assuntos
Transtornos da Personalidade , Psicoterapia Psicodinâmica , Humanos , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/terapia , Personalidade
16.
Data Brief ; 49: 109441, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37577744

RESUMO

In this article, supplementary data analyses regarding the association between different types of child maltreatment (CM) and diabetes as well as mediation analyses examining the role of personality functioning are provided (original research article: 'Associations of different types of child maltreatment and diabetes in adulthood - the mediating effect of personality functioning: findings from a population-based representative German sample') (Zara et al., 2023). Analyses are based on a representative sample of the German population (N = 5,041). Data was acquired through a representative survey conducted by the independent research institute USUMA Berlin. CM, personality functioning, a diabetes diagnosis as well as symptoms of depression and anxiety were assessed using self-report questionnaires (CTQ, OPD-SQS, PHQ-4). Correlation analyses for all used variables were conducted. Independent t-tests were performed to examine whether symptoms of depression and anxiety are elevated in patients with diabetes and CM (compared to no CM). Regarding the odd ratios (ORs) calculated to examine the association between types of CM and diabetes as well as mediation analyses investigating the role of personality functioning in these associations, sensitivity analyses with persons ≥ 30 years are provided. The additional analyses are intended to add to the body of research showing that patients with diabetes experience symptoms of depression and anxiety more frequently compared to the general population (Kampling and Kruse, 2020; Chireh et al., 2019; Smith et al., 2018), examine the association between different types of CM and diabetes, and explore the role of personality functioning in the association between CM and diabetes.

17.
J Laparoendosc Adv Surg Tech A ; 33(10): 949-956, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37582273

RESUMO

Background: With the development of surgical instruments and the growth of professional expertise over the past decades, laparoscopic pancreatoduodenectomy (LPD) is widely applied in different centers. However, there are still some controversies about the safety of this procedure. Meanwhile, perioperative outcomes are affected by hospital size, surgeon experience, and the learning curve. The purpose of this study is to compare the short-term outcomes of LPD with open pancreatoduodenectomy (OPD) at different stages of the learning curve. Methods: We retrospectively analyzed the clinical data of 911 patients who had received pancreatoduodenectomy (PD) at a single institution. Among them, 208 patients underwent OPD, and 703 cases received LPD successfully. We divided those patients into three phases based on the key point of the learning curve for LPD and compared the perioperative outcomes with OPD at each stage. Result: Morbidity and mortality rates associated with LPD were significantly higher in the initial stage than in the OPD group, whereas the number of harvested lymph nodes and R0 resection rate for pancreatic cancer were comparable to the OPD group. As surgical experience increased, postoperative complications, operating time, and intraoperative blood loss all are greatly decreased. At the mature stage of the learning curve, the rate of postoperative complications in LPD was lower than in the OPD group. Meanwhile, the length of hospital stay was significantly shortened compared to the OPD group. Conclusion: After a long period of training and learning, LPD can be performed safely. And LPD can produce comparable oncological results, with faster postoperative recovery and lower incidence of postoperative complications, after the surgeons successfully surmounted the learning curve.

18.
Cureus ; 15(6): e40109, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37425494

RESUMO

The most frequent reason for cutaneous metastases is breast cancer in females. Breast cancer patients can present with cutaneous manifestations of breast disease at the time of their initial diagnosis; however, cutaneous metastases more often present well after the initial diagnosis and treatment of the breast disease. We described three cases of carcinoma of breast metastasis to the skin of the breast and the chest wall, each with a unique dermatological presentation. A 52-year-old woman presented with a cutaneous erythematous papule for the past month. She underwent a modified radical mastectomy one year before. On presentation, she was diagnosed to have erythematous papule near the operative scar and surrounding chest wall and referred to the dermatology outdoor department, where a skin biopsy was done, which confirmed erysipeloides carcinoma. The second case includes a 38-year-old premenopausal lady who was diagnosed with carcinoma of the right breast with a locally advanced stage. She was treated with neoadjuvant chemotherapy (NACT) followed by modified radical mastectomy and subsequently presented with biopsy-proven multiple skin nodules on the chest wall at the same side. She was discussed in a multidisciplinary tumor board and planned for palliative chemotherapy followed by hormonal therapy. In the third case, a 42-year-old perimenopausal woman diagnosed with locally advanced left breast carcinoma presented in the surgical oncology outdoor patient department (OPD) with multiple skin erythema over the left breast. Biopsy was done from the skin erythema site showing metastasis to the skin. She was discussed in a multidisciplinary tumor board and planned for systemic chemotherapy followed by assessment for surgery. Skin erythema and erythematous papules are rare manifestations of cutaneous metastasis in patients with carcinoma of the breast; typically, patients present with a chest wall nodule. Careful examination and early detection of these uncommon skin lesions can lower morbidity and slow the progression of diseases in these patients.

19.
Front Med (Lausanne) ; 10: 1194006, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37521343

RESUMO

Objective: To evaluate the effect of long-term rotation on astigmatism following Evolution-toric intraocular collamer lens (EVO-TICL) implantation. Methods: Forty eyes of 22 patients were enrolled in this prospective study. Visual acuity, refractive parameters, and axial position of the EVO-TICL by OPD-Scan III aberrometer were measured preoperatively, 1 month and 3 years postoperatively. Results: Last visit, the safety index was 1.32 ± 0.15 and the efficacy index was 1.01 ± 0.23. The best-fitting curve of the attempted versus achieved correction was y = 0.9751x + 0.001. The mean spherical equivalent (SE) decreased from -8.94 ± 2.72D preoperatively to 0.06 ± 0.24D and - 0.36 ± 0.46D 1 month and 3 years postoperatively, respectively. The mean target and surgical induced astigmatism were 1.55 ± 0.61D and 1.67 ± 0.94D 3 years postoperatively. The average expected axis of the TICL was-1.15 ± 9.07 (-21-19°). One month and 3 years postoperatively, the average actual axis was -0.70 ± 9.86 (-20-20°) and - 0.35 ± 11.72 (-25-30°), respectively. The absolute rotation of the TICL was 3.70 ± 4.42 (0-22°) and 6.00 ± 6.70 (0-32°) 1 month and 3 years postoperatively, respectively (p < 0.001). The expected astigmatism was -0.10 ± 0.12D, and the mean actual astigmatism was -0.21 ± 0.30D and - 0.44 ± 0.45D 1 month and 3 years postoperatively, respectively. The mean absolute rotation without postoperative astigmatism was 3.73 ± 2.69 (0-9°) and 1.67 ± 1.66 (0-5°) for low (<2D) and high (≥2D) astigmatic TICL, respectively (p < 0.05). Conclusion: EVO-TICL implantation is safe and effective, with good predictability and stability. OPD-Scan is a fast device to detect the axial position of the TICL without mydriasis, and the axial position is relatively stable in the long term postoperatively. A slight rotation of low-astigmatic TICL may not cause postoperative astigmatism, whereas rotation of the high-astigmatic TICL may cause it.

20.
Biomimetics (Basel) ; 8(3)2023 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-37504170

RESUMO

This paper presents a comprehensive investigation of the various parameters involved in the fabrication of a molecularly imprinted polymer (MIP) sensor for the detection of cortisol. Parameters such as monomer concentration, electropolymerization cycles, pH, monomer-template ratio, template removal technique, and rebinding time were optimized to establish a more consistent and effective method for the fabrication of MIP sensors. Under the optimized conditions, the MIP sensor demonstrated a proportional decrease in differential pulse voltammetry peak currents with increasing cortisol concentration in the range of 0.1 to 100 nM. The sensor exhibited excellent sensitivity, with a limit of detection of 0.036 nM. Selectivity experiments using a non-imprinted polymer sensor confirmed the specific binding affinity of the MIP sensor for cortisol, distinguishing it from other steroid hormones. This study provides crucial insights into the development of a reliable and sensitive strategy for cortisol detection using O-PD-based MIPs. These findings laid the foundation for further advancements in MIP research.

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