Non-arbitrary minimum threshold of yearly performed pancreatoduodenectomies: National multicentric study.

BACKGROUND: Annual hospital volume of pancreatoduodenectomies could influence postoperative outcomes. The aim of this study is to establish with a non-arbitrary method the minimum threshold of yearly performed pancreatoduodenectomies in order to improve several postoperative quality outcomes. METHOD: Prospective follow-up of patients submitted to pancreatoduodenectomy in participating hospitals during 1 year. The influence of hospital volume on quality outcomes was analyzed by univariable and multivariable models. The minimum threshold of yearly performed pancreatoduodenectomies to improve outcomes was established by Akaike's information criteria. RESULTS: Data from 877 patients operated in 74 hospitals were analyzed. Of 12 quality outcomes, 9 were influenced by hospital pancreatoduodenectomy volume on multivariable analysis. To decrease the risk of complications and the risk of retrieving an insufficient number of lymph nodes at least 31 pancreatoduodenectomies per year should be performed. To decrease the risk of prolonged length of stay, postoperative death, and affected surgical margins, at least 37, 6, and 14 pancreatoduodenectomies per year should be performed, respectively. CONCLUSION: Several postoperative quality outcomes are influenced by the number of yearly performed pancreatoduodenectomies and could be improved by establishing a minimum threshold of procedures. Number of procedures needed to improve quality outcomes has been established by a non-arbitrary method.

AlxIn1-xN on Si (100) Solar Cells (x = 0-0.56) Deposited by RF Sputtering.

We investigate the photovoltaic performance of solar cells based on n-AlxIn1-xN (x = 0-0.56) on p-Si (100) hetero-junctions deposited by radio frequency sputtering. The AlxIn1-xN layers own an optical bandgap absorption edge tuneable from 1.73 eV to 2.56 eV within the Al content range. This increase of Al content results in more resistive layers (≈10-4-1 Ω·cm) while the residual carrier concentration drops from ~1021 to ~1019 cm-3. As a result, the top n-contact resistance varies from ≈10-1 to 1 MΩ for InN to Al0.56In0.44N-based devices, respectively. Best results are obtained for devices with 28% Al that exhibit a broad external quantum efficiency covering the full solar spectrum with a maximum of 80% at 750 nm, an open-circuit voltage of 0.39 V, a short-circuit current density of 17.1 mA/cm2 and a conversion efficiency of 2.12% under air mass 1.5 global (AM1.5G) illumination (1 sun), rendering them promising for novel low-cost III-nitride on Si photovoltaic devices. For Al contents above 28%, the electrical performance of the structures lessens due to the high top-contact resistivity.

Vesícula biliar accesoria con drenaje en el conducto pancreático principal: hallazgos por imagen, manejo quirúrgico y clasificación / Accessory gallbladder joining the pancreatic duct: Diagnostic imaging, surgical management and classification

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Estudio multicéntrico nacional sobre pancreatectomías totales / Multicentric study on total pancreatectomies

Introducción: La pancreatectomía total (PT) es una intervención infrecuente, con unas indicaciones no claramente definidas y unos resultados postoperatorios no estandarizados. Presentamos un estudio multicéntrico nacional sobre PT y una comparación con la literatura existente. Métodos: Estudio prospectivo observacional realizado mediante el registro nacional de pacientes operados de duodenopancreatectomía cefálica y PT realizadas por cualquier indicación durante el periodo comprendido entre el 1 enero y el 31 diciembre del 2015. Resultados: Se incluyó a 1.016 pacientes, pertenecientes a 73 centros; de ellos, 112 correspondían a PT. El porcentaje de PT/número total de casos es del 11%. La edad media fue 63,5 años y eran varones un 57,2%. El diagnóstico radiológico de sospecha más frecuente fue cáncer de páncreas (58/112 casos). La técnica de la PT más habitual fue «arteria mesentérica primero» (43/112 casos). Se efectuaron resecciones venosas en 23 pacientes (20,5%). El porcentaje de complicaciones postoperatorias a 90 días fue 50%, pero las complicaciones mayores (> IIIA) solo el 20,7%. La mortalidad global a 90 días fue del 8% (9 pacientes). La estancia media fue 20,7 días. Los 3 diagnósticos histológicos definitivos más frecuentes fueron: adenocarcinoma de páncreas, neoplasia mucinosa papilar intraductal y pancreatitis crónica. La tasa de R0 fue del 67,8%. Conclusiones: Este estudio demuestra que los resultados de morbimortalidad de la PT en España son similares o superiores a los publicados previamente. Es necesario un estudio más específico sobre PT centrado en complicaciones específicas, como la insuficiencia endocrina

Introduction: Total pancreatectomy (TP) is an uncommon operation, with indications that have not been clearly defined and non-standardized postoperative results. We present a national multicentric study on TP and a comparison with the existing literature Methods: A prospective observational study using data from the national registry of patients after pancreaticoduodenectomy and TP performed for any indication during the study period: January 1 to December 31, 2015 Results: 1016 patients were included from 73 hospitals, 112 of whom had undergone TP. The percentage of TP from the total number of cases was 11%. The mean age was 63.5 years, and 57.2% were males. The most frequently suspected radiological diagnosis was pancreatic cancer (58/112 cases). The most common TP technique was "mesentery artery first" (43/112 cases). Venous resections were performed in 23 patients (20.5%). The percentage of postoperative complications within 90 days was 50%, but major complications (>IIIA) were only 20.7%. The overall 90-day mortality was 8% (9 patients). The average stay was 20.7 days. The 3 most frequent definitive histological diagnoses were: adenocarcinoma of the pancreas, intraductal papillary mucinous neoplasm and chronic pancreatitis. The R0 rate was 67.8%. Conclusions: This study shows that the morbidity and mortality results of TP in Spain are similar or superior to previous publications. More precise TP studies are necessary, focused on specific complications such as endocrine insufficiency

Multicentric study on total pancreatectomies. / Estudio multicéntrico nacional sobre pancreatectomías totales.

INTRODUCTION: Total pancreatectomy (TP) is an uncommon operation, with indications that have not been clearly defined and non-standardized postoperative results. We present a national multicentric study on TP and a comparison with the existing literature METHODS: A prospective observational study using data from the national registry of patients after pancreaticoduodenectomy and TP performed for any indication during the study period: January 1 to December 31, 2015 RESULTS: 1016 patients were included from 73 hospitals, 112 of whom had undergone TP. The percentage of TP from the total number of cases was 11%. The mean age was 63.5 years, and 57.2% were males. The most frequently suspected radiological diagnosis was pancreatic cancer (58/112 cases). The most common TP technique was "mesentery artery first" (43/112 cases). Venous resections were performed in 23 patients (20.5%). The percentage of postoperative complications within 90 days was 50%, but major complications (>IIIA) were only 20.7%. The overall 90-day mortality was 8% (9 patients). The average stay was 20.7 days. The 3most frequent definitive histological diagnoses were: adenocarcinoma of the pancreas, intraductal papillary mucinous neoplasm and chronic pancreatitis. The R0 rate was 67.8%. CONCLUSIONS: This study shows that the morbidity and mortality results of TP in Spain are similar or superior to previous publications. More precise TP studies are necessary, focused on specific complications such as endocrine insufficiency.

Electrical Characterization of Amorphous Silicon MIS-Based Structures for HIT Solar Cell Applications.

A complete electrical characterization of hydrogenated amorphous silicon layers (a-Si:H) deposited on crystalline silicon (c-Si) substrates by electron cyclotron resonance chemical vapor deposition (ECR-CVD) was carried out. These structures are of interest for photovoltaic applications. Different growth temperatures between 30 and 200 °C were used. A rapid thermal annealing in forming gas atmosphere at 200 °C during 10 min was applied after the metallization process. The evolution of interfacial state density with the deposition temperature indicates a better interface passivation at higher growth temperatures. However, in these cases, an important contribution of slow states is detected as well. Thus, using intermediate growth temperatures (100-150 °C) might be the best choice.