An Organic Electrochemical Transistor-Based Sensor for IgG Levels Detection of Relevance in SARS-CoV-2 Infections.

Organic electrochemical transistors appear as an alternative for relatively low-cost, easy-to-operate biosensors due to their intrinsic amplification. Herein, we present the fabrication, characterization, and validation of an immuno-detection system based on commercial sensors using gold electrodes where no additional surface treatment is performed on the gate electrode. The steady-state response of these sensors has been studied by analyzing different semiconductor organic channels in order to optimize the biomolecular detection process and its the application to monitoring human IgG levels due to SARS-CoV-2 infections. Detection levels of up to tens of µgmL-1 with sensitivities up to 13.75% [µg/mL]-1, concentration ranges of medical relevance in seroprevalence studies, have been achieved.

Sclerosing angiomatoid nodular transformation (SANT) of the spleen: review of the literature / Nodular angiomatoide esclerosante transformación (SANT) de la bazo: revisión de la literatura

We present a sclerosing angiomatoid nodular transformation (SANT) case report in a 60 year-old-woman. SANT is an extremely rare benign disease of the spleen that it is radiologically similar to malignant tumors, and clinically difficult to differentiate from other splenic diseases. Splenectomy is both diagnostic and therapeutic in symptomatic cases. The analysis of the resected spleen is necessary to achieve the final diagnosis of SANT.(AU)

Design and testing of an optical instrument for skin flap monitoring.

Flap procedures are complex surgical tools widely used in reconstructive surgery. Flap ischemia is one of the most dangerous complications, both during the surgical procedure and during the patient's recovery, which can quickly lead to tissue necrosis (flap loss) with serious medical and psychological consequences. Today, bedside clinical assessment remains the gold standard for flap monitoring, but timely detection of flap ischemia is a difficult and challenging task, so auxiliary techniques are needed to support flap monitoring. Here we present a prototype of a new optical diagnostic tool, based on visible light absorption in diffuse reflectance spectroscopy, for non-invasive, continuous, real-time monitoring of flaps. The proposed approach is assessed by monitoring flap ischemic scenarios induced on pig animal models. The results obtained support that the proposed approach has great potential, not only for prompt detection of ischemia (in seconds), but also for clear differentiation between an arterial occlusion and venous occlusion.

Technological advances in fibrin for tissue engineering.

Fibrin is a promising natural polymer that is widely used for diverse applications, such as hemostatic glue, carrier for drug and cell delivery, and matrix for tissue engineering. Despite the significant advances in the use of fibrin for bioengineering and biomedical applications, some of its characteristics must be improved for suitability for general use. For example, fibrin hydrogels tend to shrink and degrade quickly after polymerization, particularly when they contain embedded cells. In addition, their poor mechanical properties and batch-to-batch variability affect their handling, long-term stability, standardization, and reliability. One of the most widely used approaches to improve their properties has been modification of the structure and composition of fibrin hydrogels. In this review, recent advances in composite fibrin scaffolds, chemically modified fibrin hydrogels, interpenetrated polymer network (IPN) hydrogels composed of fibrin and other synthetic or natural polymers are critically reviewed, focusing on their use for tissue engineering.

Sclerosing angiomatoid nodular transformation (SANT) of the spleen: review of the literature.

We present a sclerosing angiomatoid nodular transformation (SANT) case report in a 60 year-old-woman. SANT is an extremely rare benign disease of the spleen that it is radiologically similar to malignant tumors, and clinically difficult to differentiate from other splenic diseases. Splenectomy is both diagnostic and therapeutic in symptomatic cases. The analysis of the resected spleen is necessary to achieve the final diagnosis of SANT.

An Electrochemical Immunosensor for the Determination of Procalcitonin Using the Gold-Graphene Interdigitated Electrode.

Procalcitonin (PCT) is considered a sepsis and infection biomarker. Herein, an interdigitated electrochemical immunosensor for the determination of PCT has been developed. The interdigitated electrode was made of the laser-engraved graphene electrode decorated with gold (LEGE/Aunano). The scanning electron microscopy indicated the LEGE/Aunano has been fabricated successfully. After that, the anti-PTC antibodies were immobilized on the surface of the electrode by using 3-mercaptopropionic acid. The electrochemical performance of the fabricated immunosensor was studied using electrochemical impedance spectroscopy (EIS). The EIS method was used for the determination of PCT in the concentration range of 2.5-800 pg/mL with a limit of detection of 0.36 pg/mL. The effect of several interfering agents such as the C reactive protein (CRP), immunoglobulin G (IgG), and human serum albumin (HSA) was also studied. The fabricated immunosensor had a good selectivity to the PCT. The stability of the immunosensor was also studied for 1 month. The relative standard deviation (RSD) was obtained to be 5.2%.

Highly sensitive aptasensor for the detection of SARS-CoV-2-RBD using aptamer-gated methylene blue@mesoporous silica film/laser engraved graphene electrode.

Herein, an aptasensor was designed to detect the receptor-binding domain of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2-RBD) based on the encapsulation of the methylene blue (MB) inside the mesoporous silica film (MPSF), and an aptamer as an electrochemical probe, a porous matrix, and a bio-gatekeeper, respectively. The signal analysis of the proposed aptasensor indicated that the surface coverage of the encapsulated MB inside the MPSF (MB@MPSF) was 1.9 nmol/cm2. Aptamers were capped the MB@MPSF, avoiding the release of MB into the solution via the electrostatic attraction between the positively charged amino groups of the MPSF and negatively charged phosphate groups of the aptamers. Therefore, the electrochemical signal of the encapsulated MB in the absence of the SARS-CoV-2-RBD was high. In the presence of SARS-CoV-2-RBD, the aptamers that had a high affinity to the SARS-CoV-2-RBD molecules were removed from the electrode surface to interact with SARS-CoV-2-RBD. It gave rise to the release of the MB from the MPSF to the solution and washed away on the electrode surface. Therefore, the electrochemical signal of the aptasensor decreased. The electrochemical signal was recorded with a square wave voltammetry technical in the range of 0.5-250 ng/mL of SARS-CoV-2-RBD in a saliva sample. The limit of detection was found to be 0.36 ng/mL. Furthermore, the selectivity factor values of the proposed aptasensor to 32 ng/mL SARS-CoV-2-RBD in the presence of C-reactive protein, hemagglutinin, and neuraminidase of influenza A virus were 35.9, 11.7, and 17.37, respectively, indicating the high selectivity of the proposed aptasensor.

An electrochemical membrane-based aptasensor for detection of severe acute respiratory syndrome coronavirus-2 receptor-binding domain.

Herein, we report an electrochemical membrane-based aptasensor for the determination of the SARS-CoV-2 receptor-binding domain (SARS-CoV-2-RBD). For this purpose, the nanoporous anodic aluminium oxide membrane (NPAOM) was first fabricated electrochemically. The NPAOM was then functionalized with 3-mercaptopropyl trimethoxysilane (NPAOM-Si-SH). After that, the NPAOM-Si-SH was decorated with gold nanoparticles by using gold ion and sodium borohydride. The NPAOM-Si-S-Aunano was then attached to the surface of the working electrode of a laser-engraved graphene electrode (LEGE). Subsequently, the LEGE/NPAOM-Si-S-Aunano was fixed inside a flow cell that was made by using a three-dimensional (3D) printer, and then thiolated aptamer was transferred into the flow cell using a pump. The electrochemical behavior of the LEGE/NPAOM-Si-S-Aunano-Aptamer was studied using square wave voltammetry (SWV) in the presence of potassium ferrocyanide as a redox probe. The response of the LEGE/NPAOM-Si-S-Aunano-Aptamer to the different concentrations of the SARS-CoV-2-RBD in human saliva sample was investigated in the concentration range of 2.5-40.0 ng/mL. The limit of the detection was found to be 0.8 ng/mL. The LEGE/NPAOM-Si-S-Aunano-Aptamer showed good selectivity to 5.0 ng/mL of SARS-CoV-2-RBD in the presence of five times of the interfering agents like hemagglutinin and neuraminidase as the influenza A virus major surface glycoproteins.

Preparation and Characterization of Plasma-Derived Fibrin Hydrogels Modified by Alginate di-Aldehyde.

Fibrin hydrogels are one of the most popular scaffolds used in tissue engineering due to their excellent biological properties. Special attention should be paid to the use of human plasma-derived fibrin hydrogels as a 3D scaffold in the production of autologous skin grafts, skeletal muscle regeneration and bone tissue repair. However, mechanical weakness and rapid degradation, which causes plasma-derived fibrin matrices to shrink significantly, prompted us to improve their stability. In our study, plasma-derived fibrin was chemically bonded to oxidized alginate (alginate di-aldehyde, ADA) at 10%, 20%, 50% and 80% oxidation, by Schiff base formation, to produce natural hydrogels for tissue engineering applications. First, gelling time studies showed that the degree of ADA oxidation inhibits fibrin polymerization, which we associate with fiber increment and decreased fiber density; moreover, the storage modulus increased when increasing the final volume of CaCl2 (1% w/v) from 80 µL to 200 µL per milliliter of hydrogel. The contraction was similar in matrices with and without human primary fibroblasts (hFBs). In addition, proliferation studies with encapsulated hFBs showed an increment in cell viability in hydrogels with ADA at 10% oxidation at days 1 and 3 with 80 µL of CaCl2; by increasing this compound (CaCl2), the proliferation does not significantly increase until day 7. In the presence of 10% alginate oxidation, the proliferation results are similar to the control, in contrast to the sample with 20% oxidation whose proliferation decreases. Finally, the viability studies showed that the hFB morphology was maintained regardless of the degree of oxidation used; however, the quantity of CaCl2 influences the spread of the hFBs.

An Electrochemical Impedance Spectroscopy-Based Aptasensor for the Determination of SARS-CoV-2-RBD Using a Carbon Nanofiber-Gold Nanocomposite Modified Screen-Printed Electrode.

Worldwide, human health is affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hence, the fabrication of the biosensors to diagnose SARS-CoV-2 is critical. In this paper, we report an electrochemical impedance spectroscopy (EIS)-based aptasensor for the determination of the SARS-CoV-2 receptor-binding domain (SARS-CoV-2-RBD). For this purpose, the carbon nanofibers (CNFs) were first decorated with gold nanoparticles (AuNPs). Then, the surface of the carbon-based screen-printed electrode (CSPE) was modified with the CNF-AuNP nanocomposite (CSPE/CNF-AuNP). After that, the thiol-terminal aptamer probe was immobilized on the surface of the CSPE/CNF-AuNP. The surface coverage of the aptamer was calculated to be 52.8 pmol·cm-2. The CSPE/CNF-AuNP/Aptamer was then used for the measurement of SARS-CoV-2-RBD by using the EIS method. The obtained results indicate that the signal had a linear-logarithmic relationship in the range of 0.01-64 nM with a limit of detection of 7.0 pM. The proposed aptasensor had a good selectivity to SARS-CoV-2-RBD in the presence of human serum albumin; human immunoglobulins G, A, and M, hemagglutinin, and neuraminidase. The analytical performance of the aptasensor was studied in human saliva samples. The present study indicates a practical application of the CSPE/CNF-AuNP/Aptamer for the determination of SARS-CoV-2-RBD in human saliva samples with high sensitivity and accuracy.

Highly Sensitive RNA-Based Electrochemical Aptasensor for the Determination of C-Reactive Protein Using Carbon Nanofiber-Chitosan Modified Screen-Printed Electrode.

C-reactive protein (CRP) is one of the biomarkers related to coronavirus disease 2019 (COVID-19). Therefore, it is crucial to develop a highly sensitive, selective, and cost-effective biosensor for the determination of CRP. In this study, we designed an electrochemical aptasensor. For this purpose, the surface of a carbon screen-printed electrode was first modified with a carbon nanofiber-chitosan (CNFs-CHIT) nanocomposite. After that, the amino-terminal RNA aptamer probes were linked to the amino groups of CHIT via glutaraldehyde as the cross-linker. Finally, methylene blue (MB) as a redox probe was self-assembled on the surface of the aptasensor. The obtained results indicated that the CNFs-CHIT nanocomposite increased the surface coverage of the aptamer up to 5.9 times. The square-wave voltammetry was used for the measurement of CRP concentration in the linear range of 1.0-150.0 pM. The obtained results indicated that the signal had a logarithmic relationship with the concentration of CRP. The limit of detection (LOD) was obtained to be 0.37 pM. The dissociation constant (Kd) that demonstrates the affinity of the aptamer probe to its target was found to be 0.93 pM. The analytical performances of the proposed RNA aptasensor were better than the previously reported aptasensors for CRP. The proposed aptasensor was also applied for the determination of CRP in the human plasma samples. The obtained results indicated that there were no statistically significant differences between the responses of the proposed RNA aptasensor and an enzyme-linked immunosorbent assay kit (ELISA). The analytical performances of the proposed RNA aptasensor described in this paper are better than previously reported aptasensors for CRP determination.

An ultrasensitive molecularly imprinted polymer-based electrochemical sensor for the determination of SARS-CoV-2-RBD by using macroporous gold screen-printed electrode.

Herein, a novel molecularly imprinted polymer (MIP) based electrochemical sensor for the determination of the receptor-binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2-RBD) has been developed. For this purpose, first, a macroporous gold screen-printed electrode (MP-Au-SPE) has been fabricated. The MIP was then synthesized on the surface of the MP-Au-SPE through the electro-polymerization of ortho-phenylenediamine in the presence of SARS-CoV-2-RBD molecules as matrix polymer, and template molecules, respectively. During the fabrication process, the SARS-CoV-2-RBD molecules were embedded in the polymer matrix. Subsequently, the template molecules were removed from the electrode by using alkaline ethanol. The template molecules removal was studied using cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS), scanning electron microscope (SEM), energy-dispersive X-ray spectroscopy (EDX), and attenuated total reflectance spectroscopy (ATR). The fabricated MIP film acted as an artificial recognition element for the measurement of SARS-CoV-2-RBD. The EIS technique was used for the measurement of the SARS-CoV-2-RBD in the saliva solution. The electron transfer resistance (Ret) of the MIP-based sensor in a ferri/ferrocyanide solution increased as the SARS-CoV-2-RBD concentration increased due to the occupation of the imprinted cavities by the SARS-CoV-2-RBD. The MIP-based sensor exhibited a good response to the SARS-CoV-2-RBD in the concentration range between 2.0 and 40.0 pg mL-1 with a limit of detection of 0.7 pg mL-1. The obtained results showed that the fabricated MIP sensor has high selectivity sensitivity, and stability.

Clinical assessment of W-band spectroscopy for non-invasive detection and monitoring of sustained hyperglycemia.

HbA1c is the gold standard test for monitoring medium/long term glycemia conditions in diabetes care, which is a critical factor in reducing the risk of chronic diabetes complications. Current technologies for measuring HbA1c concentration are invasive and adequate assays are still limited to laboratory-based methods that are not widely available worldwide. The development of a non-invasive diagnostic tool for HbA1c concentration can lead to the decrease of the rate of undiagnosed cases and facilitate early detection in diabetes care. We present a preliminary validation diagnostic study of W-band spectroscopy for detection and monitoring of sustained hyperglycemia, using the HbA1c concentration as reference. A group of 20 patients with type 1 diabetes mellitus and 10 healthy subjects were non-invasively assessed at three different visits over a period of 7 months by a millimeter-wave spectrometer (transmission mode) operating across the full W-band. The relationship between the W-band spectral profile and the HbA1c concentration is studied using longitudinal and non-longitudinal functional data analysis methods. A potential blind discrimination between patients with or without diabetes is obtained, and more importantly, an excellent relation (R-squared = 0.97) between the non-invasive assessment and the HbA1c measure is achieved. Such results support that W-band spectroscopy has great potential for developing a non-invasive diagnostic tool for in-vivo HbA1c concentration monitoring in humans.

A photo-electrochemical aptasensor for the determination of severe acute respiratory syndrome coronavirus 2 receptor-binding domain by using graphitic carbon nitride-cadmium sulfide quantum dots nanocomposite.

Herein, a photoelectrochemical aptasensor for the quantitive measurement of the severe acute respiratory syndrome coronavirus-2 receptor-binding domain (Sars-Cov-2 RBD) has been reported for the first time. For this purpose, first, graphitic carbon nitride and (gC3N4) and cadmium sulfide (CdS) quantum dots were fabricated and characterized. After that, gC3N4 and CdS were mixed well. The fabricated nanomaterials were characterized by scanning transmission electron microscopy. Then, the CdS QDs-gC3N4 nanocomposite was added to the solution containing chitosan as an amine-rich polymer to generate a Chitosan/CdS-gC3N4 nanocomposite. Subsequently, the surface of the ITO electrode was modified with Chitosan/CdS-gC3N4. After that, the amine-terminal aptamer probes were immobilized on the surface of the Chitosan/CdS QDs-gC3N4/ITO electrode by using glutaraldehyde as an amine-amine crosslinker. The electrochemical performances of the electrodes were studied using cyclic voltammetry (CV), electrochemical Impedance Spectroscopy (EIS), and photo-electrochemistry (PEC). The surface coverage of the immobilized aptamer probe was founded to be 26.2 pmol.cm-2. The obtained results demonstrated that the proposed photo-electrochemical aptasensor can be used for the measurement of Sars-Cov-2 RBD within 0.5-32.0 nM. The limit of detection (LOD) was obtained to be 0.12 nM (at 3σ/slope). The affinity of the Aptamer/Chitosan/CdS QDs-gC3N4/ITO was also founded to be 3.4 nM by using Langmuir-typical adsorption systems. The proposed photo-electrochemical aptasensor was applied for the measurement of the spiked Sars-Cov-2 RBD in human saliva samples at two concentrations. The effect of the interfering biomaterials such as human immunoglobulin G human immunoglobulin A, human immunoglobulin M, and human serum albumin was also studied.

External Prospective Validation of the Modified CriSTAL Score for 30- and 90-day Mortality in Geriatric Urgent Surgical Patients.

OBJECTIVE: This study aimed to determine the predictive accuracy of the modified clinical prognostic tool Criteria for Screening and Triaging to Appropriate aLternative care (CriSTAL) to predict 30-day and 90-day mortality in older patients undergoing urgent abdominal surgery. BACKGROUND: Anticipating the mid-term mortality of older patients undergoing urgent surgery is complex and flawed with uncertainty. METHODS: A prospective study of consecutive ≥ 65 years old presenting at the emergency department who subsequently underwent urgent abdominal surgery. The modified CriSTAL score was calculated in the sample using the FRAIL scale instead of the Clinical Frailty Scale. Discrimination (area under the receiver-operating characteristic (AUROC)) and model calibration were used to test the predictive accuracy of the modified CriSTAL score for death within 30-day mortality as the primary outcome. RESULTS: A total of 500 patients (median age 78 years) were enrolled. The observed 30-day and 90-day mortality rate were 11.6% and 13.6%. The modified CriSTAL tool AUROC curve to predict 30-day and 90-day mortality was 0.78 and 0.77. The model was well calibrated according to the Hosmer-Lemeshow test (p: 0.302) and the calibration plots to predict 30-day and 90-day mortality. CONCLUSIONS: The modified CriSTAL tool (with FRAIL scale as frailty instrument) had good discriminant power and was well calibrated to predict 30-day and 90-day mortality in elderly patients undergoing urgent abdominal surgery. The modified CriSTAL tool is an easy preoperative tool that could assist in the prognosis of postoperative outcomes and decision-making discussions with patients before for urgent abdominal surgery.

Design of a Multipurpose Photonic Chip Architecture for THz Dual-Comb Spectrometers.

In this work, we present a multipurpose photonic integrated circuit capable of generating multiheterodyne complex Dual-Combs (DC) THz signals. Our work focuses on translating the functionality of an electro-optic tunable DC system into a photonic chip employing standard building blocks to ensure the scalability and cost efficiency of the integrated device. The architecture we analyze for integration is based on three stages: a seed comb, a mode selection stage and a DC stage. This final DC stage includes a frequency shifter, a key element to improve the final detection of the THz signals and obtain real-time operation. This investigation covers three key aspects: (1) a solution for comb line selection on GHz spaced combs using OIL or OPLL on photonic chips is studied and evaluated, (2) a simple and versatile scheme to produce a frequency shift using the double sideband suppressed carrier modulation technique and an asymmetric Mach Zehnder Interferometer to filter one of the sidebands is proposed, and (3) a multipurpose architecture that can offer a versatile effective device, moving from application-specific PICs to general-purpose PICs. Using the building blocks (BBs) available from an InP-based foundry, we obtained simulations that offer a high-quality Dual-Comb frequency shifted signal with a side mode suppression ratio around 21 dB, and 41 dB after photodetection with an intermediate frequency of 1 MHz. We tested our system to generate a Dual-Comb with 10 kHz of frequency spacing and an OOK modulation with 5 Gbps which can be down-converted to the THz range by a square law detector. It is also important to note that the presented architecture is multipurpose and can also be applied to THz communications. This design is a step to enable a commercial THz photonic chip for multiple applications such as THz spectroscopy, THz multispectral imaging and THz telecommunications and offers the possibility of being fabricated in a multi-project wafer.

Real-Time Impedance Monitoring of Epithelial Cultures with Inkjet-Printed Interdigitated-Electrode Sensors.

From electronic devices to large-area electronics, from individual cells to skin substitutes, printing techniques are providing compelling applications in wide-ranging fields. Research has thus fueled the vision of a hybrid, printing platform to fabricate sensors/electronics and living engineered tissues simultaneously. Following this interest, we have fabricated interdigitated-electrode sensors (IDEs) by inkjet printing to monitor epithelial cell cultures. We have fabricated IDEs using flexible substrates with silver nanoparticles as a conductive element and SU-8 as the passivation layer. Our sensors are cytocompatible, have a topography that simulates microgrooves of 300 µm width and ~4 µm depth, and can be reused for cellular studies without detrimental in the electrical performance. To test the inkjet-printed sensors and demonstrate their potential use for monitoring laboratory-growth skin tissues, we have developed a real-time system and monitored label-free proliferation, migration, and detachment of keratinocytes by impedance spectroscopy. We have found that variations in the impedance correlate linearly to cell densities initially seeded and that the main component influencing the total impedance is the isolated effect of the cell membranes. Results obtained show that impedance can track cellular migration over the surface of the sensors, exhibiting a linear relationship with the standard method of image processing. Our results provide a useful approach for non-destructive in-situ monitoring of processes related to both in vitro epidermal models and wound healing with low-cost ink-jetted sensors. This type of flexible sensor as well as the impedance method are promising for the envisioned hybrid technology of 3D-bioprinted smart skin substitutes with built-in electronics.

Estudio prospectivo de los factores asociados al delirium en el postoperatorio de la cirugía abdominal urgente / Prospective Study of Factors Associated With Postoperative Delirium After Urgent Abdominal Surgery

INTRODUCCIÓN: El delirium es una complicación frecuente en pacientes ancianos intervenidos de cirugía abdominal urgente. MÉTODOS: Estudio prospectivo que incluye pacientes consecutivos ≥ 65 años intervenidos de cirugía abdominal urgente entre 2017 y 2019. Se registró: edad, sexo, ASA, estado fisiológico, deterioro cognitivo, fragilidad (escala de Frail), dependencia funcional (escala de Barthel), calidad de vida (Euroqol-5D-EVA), estado nutricional (MNA-SF), diagnóstico preoperatorio, tipo de cirugía (clasificación BUPA), vía de abordaje y diagnóstico de delirium postoperatorio (Confusion Assessment Method). Se realizó un análisis univariante y multivariante para analizar la relación de estas variables con el delirium. RESULTADOS: El estudio incluye 446 pacientes con una mediana de edad de 78 años; el 63,6% eran ASA ≥ III y el 8% presentaban un deterioro cognitivo previo. El 13,2% eran frágiles y el 5,4% de los pacientes tenían un grado de dependencia grave o total. Un 13,6% desarrollaron delirium en el postoperatorio. En el análisis univariante todas las variables son estadísticamente significativas salvo el sexo, el tipo de cirugía (BUPA) y la duración. En el análisis multivariante los factores asociados fueron: la edad (p < 0,001; OR: 1,08 [IC 95%: 1,038-1,139]), el ASA (p = 0,026; OR: 3,15 [IC 95%: 1,149-8,668]), la alteración fisiológica (p < 0,001; OR: 5,8 [IC 95%: 2,176 15,457]), el diagnóstico (p = 0,006) y el deterioro cognitivo (p < 0,001; OR: 5,8 [IC 95%: 2,391-14,069]). CONCLUSIÓN: Los factores asociados al delirium son la edad, el ASA, la alteración fisiológica a su llegada a urgencias, el diagnóstico preoperatorio y el deterioro cognitivo previo

INTRODUCTION: Delirium is a frequent complication in elderly patients after urgent abdominal surgery. METHODS: Prospective study of consecutive patients aged ≥ 65 years who had undergone urgent abdominal surgery from 2017-2019. The following variables were recorded: age, sex, ASA, physiological state, cognitive impairment, frailty (FRAIL Scale), functional dependence (Barthel Scale), quality of life (Euroqol-5D-VAS), nutritional status (MNA-SF), preoperative diagnosis, type of surgery (BUPA Classification), approach and diagnosis of postoperative delirium (Confusion Assessment Method). Univariate and multivariate analyses were performed to analyze the correlation of these variables with delirium. RESULTS: The study includes 446 patients with a median age of 78 years, 63.6% were ASA ≥ III and 8% had prior cognitive impairment. 13.2% were frail and 5.4% of the patients had a severe or total degree of dependence. 13.6% developed delirium in the postoperative period. In the univariate analysis, all the variables were statistically significant except for sex, type of surgery (BUPA) and duration. In the multivariate analysis the associated factors were: age (P < .001; OR: 1,08; 95% CI: 1,038-1,139), ASA (P = .026; OR: 3.15; 95% CI: 1.149-8.668), physiological state (P < .001; OR: 5.8; 95% CI: 2.176-15.457), diagnosis (P = .006) and cognitive impairment (P < .001; OR: 5.8; 95% CI: 2.391-14.069). CONCLUSION: The factors associated with delirium are age, ASA, physiological state in the emergency room, preoperative diagnosis and prior cognitive impairment

Hyperspectral terahertz imaging with electro-optic dual combs and a FET-based detector.

In this paper, a terahertz hyperspectral imaging architecture based on an electro-optic terahertz dual-comb source is presented and demonstrated. In contrast to single frequency sources, this multi-heterodyne system allows for the characterization of the whole spectral response of the sample in parallel for all the frequency points along the spectral range of the system. This hence provides rapid, highly consistent results and minimizes measurement artifacts. The terahertz illumination signal can be tailored (in spectral coverage and resolution) with high flexibility to meet the requirements of any particular application or experimental scenario while maximizing the signal-to-noise ratio of the measurement. Besides this, the system provides absolute frequency accuracy and a very high coherence that allows for direct signal detection without inter-comb synchronization mechanisms, adaptive acquisition, or post-processing. Using a field-effect transistor-based terahertz resonant 300 GHz detector and the raster-scanning method we demonstrate the two-dimensional hyperspectral imaging of samples of different kinds to illustrate the remarkable capabilities of this innovative architecture. A proof-of-concept demonstration has been performed in which tree leaves and a complex plastic fragment have been analyzed in the 300 GHz range with a frequency resolution of 10 GHz.

Prospective validation of the Urgent Surgery Elderly Mortality risk score (USEM).

INTRODUCTION: We aimed to test the predictive ability and to compare the predictive ability of the USEM to SRS, SORT and ASA in a prospective sample. PATIENTS AND METHODS: A Prospective cohort of >65-year-old patients undergoing urgent abdominal surgery in a Hospital. Models calibration and discrimination were evaluated using the receiver operating characteristics curves and the Hosmer-Lemeshow test. RESULTS: A total of 500 patients with a median age of 78 years were included. The AUROC in the validation cohort was 0.824. The USEM overestimated mortality (Test Hosmer-Lemeshow p < 0.001), after recalibration the USEM provided an accurate prediction of postoperative mortality. CONCLUSIONS: After the recalibration, the USEM had good discriminant power to estimate the risk of mortality in elderly patients after urgent abdominal surgery.