RESUMEN
BACKGROUND: Infections still represent the main factors influencing morbidity and mortality following liver transplantation. This study aimed to evaluate the incidence and risk factors for infection and survival after liver transplantation. METHODS: We retrospectively examined medical records in 210 liver recipients who underwent liver transplantation between April 2015 and October 2017 in our hospital. Clinical manifestations and results of pathogen detection test were used to define infection. We analyzed the prevalence, risk factors and prognosis of patients with infection. RESULTS: The median follow-up was 214 days; the incidence of infection after liver transplantation was 46.7% (nâ¯=â¯98) which included pneumonia (43.4%), biliary tract infection (21.9%), peritonitis (21.4%) and bloodstream infection (7.6%). Among the pathogens in pneumonia, the most frequently isolated was Acinetobacter baumanii (23.5%) and Klebsiella pneumoniae (21.2%). Model for end-stage liver disease (MELD) score (ORâ¯=â¯1.083, 95% CI: 1.045-1.123; P < 0.001), biliary complication (ORâ¯=â¯4.725, 95% CI: 1.119-19.947; Pâ¯=â¯0.035) and duration of drainage tube (ORâ¯=â¯1.040, 95% CI: 1.007-1.074; P = 0.017) were independent risk factors for posttransplant infection. All-cause mortality was 11.0% (n = 23). The prognostic factors for postoperative infection in liver recipients were prior-transplant infection, especially pneumonia within 2 weeks before transplantation. Kaplan-Meier curves of survival showed that recipients within 2 weeks prior infection had a significantly lower cumulative survival rate compared with those without infection (65.2% vs. 90.0%; hazard ratio: 4.480; P < 0.001). CONCLUSIONS: Infection, especially pneumonia within 2 weeks before transplantation, complication with impaired renal function and MELD score after 7 days of transplantation was an independent prognostic factor for postoperative infection in liver transplant recipients.
Asunto(s)
Enfermedad Hepática en Estado Terminal/cirugía , Infecciones/etiología , Trasplante de Hígado/efectos adversos , Adolescente , Adulto , Anciano , Niño , Preescolar , China , Enfermedad Hepática en Estado Terminal/complicaciones , Femenino , Humanos , Incidencia , Lactante , Infecciones/microbiología , Infecciones/virología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Adulto JovenRESUMEN
Cosmetic industry grows fast in recent years. To reveal the image of dermal structure, it is necessary to apply three-dimensional medical imaging technology. To reduce the invasiveness of laser source on tissues, tissue recognition imaging is proposed to retrieve the intrinsic optical property, namely, the reflection spectrum of every scanned point for imaging. The reflection spectra of main kinds of skin tissue, such as melanin, collagen and hemoglobin, were established as reference database. Broad-band rays were then employed to derive the reflection spectrum of each scanned sample element; the tissue type of the scanned point was identified by cross-correlation of the derived spectrum and the database. In imaging program, all scanned points were filled in with their corresponding tissue color, e.g., black for melanin, white for collagen, or red for hemoglobin, and finally the colored skin tomography resulted. Tissue recognition imaging has merits of easy configuration, low cost, color imaging, high resolution and real non-invasiveness. Substituting LED modules for its spectrometer, tissue recognition imaging is promising to be miniaturized as personal and portable skincare devices, which have great potential in future cosmetic market.
Asunto(s)
Piel/química , Tomografía Computarizada por Rayos X , Colágeno/análisis , Hemoglobinas/análisis , Humanos , Imagenología Tridimensional , Melaninas/análisisRESUMEN
The cosmetic industry has witnessed significant growth in recent years. Conventional hand-held skin cameras allow for 2D inspection of the skin surface. This paper proposes a new model for full-color 3D imaging of the skin tissue using fiber-based optical coherence tomography (OCT). Compared to laser or LD sources, RGB LED was found more suitable and thus chosen in the low-coherence interferometry due to its wider bandwidth. A floating objective lens was used to confocalize the R, G and B imaging planes and to derive a full-color image of the capillary system in the skin tissue. The skin imaging system can be miniaturized to form a new hand-held model using an RGB integrated source, a micro-interferometer module and a high-speed beam steering device. Non-invasive, full-color and hand-held skin imaging contributes to advances in the fields of skin science, dermatology and cosmetology.