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1.
Sensors (Basel) ; 23(20)2023 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-37896562

RESUMO

Biorecognition element (BRE)-based carbon nanotube (CNT) chemiresistors have tremendous potential to serve as highly sensitive, selective, and power-efficient volatile organic compound (VOC) sensors. While many research groups have studied BRE-functionalized CNTs in material science and device development, little attention has been paid to optimizing CNT density to improve chemiresistor performance. To probe the effect of CNT density on VOC detection, we present the chemiresistor-based sensing results from two peptide-based CNT devices counting more than 60 different individual measurements. We find that a lower CNT density shows a significantly higher noise level and device-to-device variation while exhibiting mildly better sensitivity. Further investigation with SEM images suggests that moderately high CNT density with a stable connection of the nanotube network is desirable to achieve the best signal-to-noise ratio. Our results show an essential design guideline for tuning the nanotube density to provide sensitive and stable chemiresistors.

2.
Sensors (Basel) ; 22(9)2022 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-35590842

RESUMO

This paper presents a microfluidic thermal flowmeter for monitoring injection pumps, which is essential to ensure proper patient treatment and reduce medication errors that can lead to severe injury or death. The standard gravimetric method for flow-rate monitoring requires a great deal of preparation and laboratory equipment and is impractical in clinics. Therefore, an alternative to the standard method suitable for remote, small-scale, and frequent infusion-pump monitoring is in great demand. Here, we propose a miniaturized thermal flowmeter consisting of a silicon substrate, a platinum heater layer on a silicon dioxide thin-membrane, and a polymer microchannel to provide accurate flow-rate measurement. The present thermal flowmeter is fabricated by the micromachining and micromolding process and exhibits sensitivity, linearity, and uncertainty of 0.722 mW/(g/h), 98.7%, and (2.36 ± 0.80)%, respectively, in the flow-rate range of 0.5-2.5 g/h when the flowmeter is operated in the constant temperature mode with the channel width of 0.5 mm. The measurement range of flow rate can be easily adjusted by changing the cross-sectional microchannel dimension. The present miniaturized thermal flowmeter shows a high potential for infusion-pump calibration in clinical settings.


Assuntos
Fluxômetros , Calibragem , Estudos Transversais , Humanos , Microfluídica , Temperatura
3.
Acc Chem Res ; 52(2): 297-306, 2019 02 19.
Artigo em Inglês | MEDLINE | ID: mdl-30688433

RESUMO

Physiological sensors in a wearable form have rapidly emerged on the market due to technological breakthroughs and have become nearly ubiquitous with the Apple Watch, FitBit, and other wearable devices. While these wearables mostly monitor simple biometric signatures, new devices that can report on the human readiness level through sensing molecular biomarkers are critical to optimizing the human factor in both commercial sectors and the Department of Defense. The military is particularly interested in real-time, wearable, minimally invasive monitoring of fatigue and human performance to improve the readiness and performance of the war fighter. However, very few devices have ventured into the realm of reporting directly on biomarkers of interest. Primarily this is because of the difficulties of sampling biological fluids in real-time and providing accurate readouts using highly selective and sensitive sensors. When additional restrictions to only use sweat, an excretory fluid, are enforced to minimize invasiveness, the demands on sensors becomes even greater due to the dilution of the biomarkers of interest, as well as variability in salinity, pH, and other physicochemical variables which directly impact the read-out of real-time biosensors. This Account will provide a synopsis not only on exemplary demonstrations and technological achievements toward implementation of real-time, wearable sweat sensors but also on defining problems that still remain toward implementation in wearable devices that can detect molecular biomarkers for real world applications. First, the authors describe the composition of minimally invasive biofluids and then identify what biomarkers are of interest as biophysical indicators. This Account then reviews demonstrated techniques for extracting biofluids from the site of generation and transport to the sensor developed by the authors. Included in this discussion is a detailed description on biosensing recognition elements and transducers developed by the authors to enable generation of selective electrochemical sensing platforms. The authors also discuss ongoing efforts to identify biorecognition elements and the chemistries necessary to enable high affinity, selective biorecognition elements. Finally, this Account presents the requirements for wearable, real-time sensors to be (1) highly stable, (2) portable, (3) reagentless, (4) continuous, and (5) responsive in real-time, before delving into specific methodologies to sense classes of biomarkers that have been explored by academia, government laboratories, and industry. Each platform has its areas of greatest utility, but also come with corresponding weaknesses: (1) ion selective electrodes are robust and have been demonstrated in wearables but are limited to detection of ions, (2) enzymatic sensors enable indirect detection of metabolites and have been demonstrated in wearables, but the compounds that can be detected are limited to a subset of small molecules and the sensors are sensitive to flow, (3) impedance-based sensors can detect a wide range of compounds but require further research and development for deployment in wearables. In conclusion, while substantial progress has been made toward wearable molecular biosensors, substantial barriers remain and need to be solved to enable deployment of minimally invasive, wearable biomarker monitoring devices that can accurately report on psychophysiological status.


Assuntos
Biomarcadores/análise , Técnicas Biossensoriais/métodos , Monitorização Fisiológica/métodos , Suor/química , Dispositivos Eletrônicos Vestíveis , Técnicas Biossensoriais/instrumentação , Técnicas Eletroquímicas/instrumentação , Técnicas Eletroquímicas/métodos , Humanos , Monitorização Fisiológica/instrumentação
4.
Sensors (Basel) ; 20(8)2020 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-32316211

RESUMO

Real-time sensing of proteins, especially in wearable devices, remains a substantial challenge due to the need to convert a binding event into a measurable signal that is compatible with the chosen analytical instrumentation. Impedance spectroscopy enables real-time detection via either measuring electrostatic interactions or electron transfer reactions while simultaneously being amenable to miniaturization for integration into wearable form-factors. To create a more robust methodology for optimizing impedance-based sensors, additional fundamental studies exploring components influencing the design and implementation of these sensors are needed. This investigation addresses a sub-set of these issues by combining optical and electrochemical characterization to validate impedance-based sensor performance as a function of (1) biorecognition element density, (2) self-assembled monolayer chain length, (3) self-assembled monolayer charge density, (4) the electrochemical sensing mechanism and (5) the redox reporter selection. Using a pre-existing lysozyme aptamer and lysozyme analyte combination, we demonstrate a number of design criteria to advance the state-of-the-art in protein sensing. For this model system we demonstrated the following: First, denser self-assembled monolayers yielded substantially improved sensing results. Second, self-assembled monolayer composition, including both thickness and charge density, changed the observed peak position and peak current. Third, single frequency measurements, while less informative, can be optimized to replace multi-frequency measurements and in some cases (such as that with zwitterionic self-assembled monolayers) are preferred. Finally, various redox reporters traditionally not used in impedance sensing should be further explored. Collectively, these results can help limit bottlenecks associated with device development, enabling realization of next-generation impedance-based biosensing with customize sensor design for the specific application.


Assuntos
Técnicas Biossensoriais/métodos , Espectroscopia Dielétrica/métodos , Aptâmeros de Peptídeos/química , Técnicas Biossensoriais/instrumentação , Brometos/síntese química , Brometos/metabolismo , Espectroscopia Dielétrica/instrumentação , Técnicas Eletroquímicas/métodos , Eletrodos , Desenho de Equipamento , Azul de Metileno/química , Muramidase/análise , Compostos de Amônio Quaternário/química , Compostos de Amônio Quaternário/metabolismo , Compostos de Sulfidrila/química , Compostos de Sulfidrila/metabolismo
5.
Sensors (Basel) ; 19(18)2019 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-31500135

RESUMO

Simultaneous measurement of skin physiological and physical properties are important for the diagnosis of skin diseases and monitoring of human performance, since it provides more comprehensive understanding on the skin conditions. Current skin analysis devices, however, require each of probes and unique protocols for the measurement of individual skin properties, resulting in inconvenience and increase of measurement uncertainty. This paper presents a pen-type skin analyzing device capable tomeasure three key skin properties at the same time: transepidermal water loss (TEWL), skin conductance, and skin hardness. It uses a single truncated hollow cone (THC) probe integrated with a humidity sensor, paired electrodes, and a load cell for the multimodal assessment of the skin properties. The present device measured TEWL with a sensitivity of 0.0068 (%/s)/(g/m2/h) and a linearity of 99.63%, conductance with a sensitivity of 1.02 µS/µS and a linearity of 99.36%, and hardness with a sensitivity of 0.98 Shore 00/Shore 00 and a linearity of 99.85%, within the appropriate ranges for the human skin. The present pen-type device has a high potential for the skin health diagnosis as well as the human performance monitoring applications.


Assuntos
Resposta Galvânica da Pele/fisiologia , Dermatopatias/diagnóstico , Fenômenos Fisiológicos da Pele , Pele/química , Dureza , Humanos , Água/química
6.
Small ; 11(41): 5520-7, 2015 Nov 04.
Artigo em Inglês | MEDLINE | ID: mdl-26313027

RESUMO

2D transition metal dichalcogenides (TMDCs) are nanomanufactured using a generalized strategy with self-assembled DNA nanotubes. DNA nanotubes of various lengths serve as lithographic etch masks for the dry etching of TMDCs. The nanostructured TMDCs are studied by atomic force microscopy, photoluminescence, and Raman spectroscopy. This parallel approach can be used to manufacture 2D TMDC nanostructures of arbitrary geometries with molecular-scale precision.


Assuntos
Calcogênios/química , DNA/química , Metais/química , Nanotubos/química , Impressão Tridimensional , DNA/ultraestrutura , Teste de Materiais , Nanotubos/ultraestrutura
7.
ACS Omega ; 9(14): 16800-16809, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38617682

RESUMO

In the past 5 years, real-time health monitoring has become ubiquitous with the development of watches and rings that can measure and report on the physiological state. As an extension, real-time biomarker sensors, such as the continuous glucose monitor, are becoming popular for both health and performance monitoring. However, few real-time sensors for biomarkers have been made commercially available; this is primarily due to problems with cost, stability, sensitivity, selectivity, and reproducibility of biosensors. Therefore, simple, robust sensors are needed to expand the number of analytes that can be detected in emerging and existing wearable platforms. To address this need, we present a simple but novel sensing material. In short, we have modified the already popular PEDOT/PSS conductive polymer by completely removing the PEDOT component and thus have fabricated a polystyrene sulfonate (PSS) sensor electrodeposited on a glassy carbon (GC) base (GC-PSS). We demonstrate that coupling the GC-PSS sensor with differential pulse voltammetry creates a sensor capable of the selective and sensitive detection of serotonin. Notably, the GC-PSS sensor has a sensitivity of 179 µA µM-1 cm-2 which is 36x that of unmodified GC and an interferent-free detection limit of 10 nM, which is below the concentrations typically found in saliva, urine, and plasma. Notably, the redox potential of serotonin interfacing with the GC-PSS sensor is at -0.188 V versus Ag/AgCl, which is significantly distanced from peaks produced by common interferants found in biofluids, including serum. Therefore, this paper reports a novel, simple sensor and polymeric interface that is compatible with emerging wearable sensor platforms.

8.
Biosensors (Basel) ; 13(6)2023 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-37366999

RESUMO

The current COVID-19 pandemic has highlighted the power, speed, and simplicity of point-of-care (POC) diagnostics. POC diagnostics are available for a wide range of targets, including both drugs of abuse as well as performance-enhancing drugs. For pharmacological monitoring, minimally invasive fluids such as urine and saliva are commonly sampled. However, false positives or negatives caused by interfering agents excreted in these matrices may confound results. For example, false positives have, in most cases, prevented the use of POC diagnostics for pharmacological agent detection; the consequence is that centralized labs are instead tasked to perform these screenings, resulting in significant delays between sampling and testing. Thus, a rapid, simple, and inexpensive methodology for sample purification is required for the POC to reach a field-deployable tool for the pharmacological human health and performance assessments. Buffer exchange is a simple, rapid approach to remove interfering agents, but has traditionally been difficult to perform on small pharmacological molecules. Therefore, in this communication, we use salbutamol, a performance-enhancing drug, as a case example to demonstrate the efficacy of ion-exchange chromatography as a technique to perform buffer exchange for charged pharmacological agents. This manuscript demonstrates the efficacy of this technique leveraging a commercial spin column to remove interfering agents found in simulant urines, such as proteins, creatinine, and urea, while retaining salbutamol. The utility and efficacy of the method was then confirmed in actual saliva samples. The eluent was then collected and run on the lateral flow assays (LFAs), improving the reported limit of detection by over 5× (new lower limit of detection of 10 ppb compared to reported 60 ppb by the manufacturer) while simultaneously removing noise due to background interfering agents.


Assuntos
COVID-19 , Sistemas Automatizados de Assistência Junto ao Leito , Humanos , COVID-19/diagnóstico , Pandemias , Testes Imediatos , Cromatografia Líquida de Alta Pressão
9.
ACS Sens ; 8(2): 610-618, 2023 02 24.
Artigo em Inglês | MEDLINE | ID: mdl-36657059

RESUMO

Inhaled medications are commonplace for administering bronchodilators, anticholinergics, and corticosteroids. While they have a defined legitimate use, they are also used in sporting events as performance-enhancing drugs. These performance enhancers can be acquired via both legal (i.e., at a pharmacy through over-the-counter medications or through a prescription) and illicit (i.e., black market and foreign pharmacies) means, thus making monitoring procurement impossible. While urine tests can detect these pharmacological agents hours after they have been inhaled, there is a significant lag time before they are observed in urine. Direct detection of these inhaled agents is complicated and requires a multiplexed approach due to the sheer number of inhaled pharmacological agents. Therefore, detection of propellants, which carry the drug into the lungs, provides a simpler path forward toward detection of broad pharmacological agents. In this paper, we demonstrate the first use of terahertz spectroscopy (THz) to detect inhaled medications in human subjects. Notably, we were able to detect and quantitate the propellant, HFA-134a, in breath up to 30 min after using an asthma inhaler, enabling the use of a point-of-care device to monitor exhaled breath for the presence of propellants. We also demonstrate via simulations that the same approach can be leveraged to detect and identify next-generation propellants, specifically HFA-152a. As a result, we provide evidence that a single point-of-care THz sensor can detect when individuals have used pressure-mediated dose inhalers (pMDIs) without further modification of the hardware.


Assuntos
Asma , Espectroscopia Terahertz , Humanos , Propelentes de Aerossol/uso terapêutico , Asma/tratamento farmacológico , Nebulizadores e Vaporizadores , Broncodilatadores/química , Broncodilatadores/uso terapêutico
10.
BJU Int ; 109(6): 910-5, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21883858

RESUMO

OBJECTIVE: To compare the perioperative parameters of paediatric patients who underwent nephrectomy via laparo-endoscopic single site (LESS) surgery (also known as single incision laparoscopic surgery or SILS) with those who underwent nephrectomy via conventional laparoscopy (LAP), robotic-assisted laparoscopy (RALN), and open surgery (OPEN). PATIENTS AND METHODS: The medical records of 69 paediatric patients at a single institution who underwent nephrectomies for non-functioning kidneys in 72 renal units (39 OPEN, 11 LAP, 11 RALN and 11 LESS) were reviewed for patient demographics and perioperative clinical parameters. RESULTS: The minimally invasive modalities in children, including LESS nephrectomy, were associated with shorter lengths of hospital stay (P < 0.001) and decreased postoperative pain medication usage (P < 0.001) than with open surgery. Similar surgical times were noted with LESS and the other minimally invasive modalities (LAP and RALN) (P= 0.056). However, the minimally invasive modalities (LESS, LAP and RALN) were associated with slightly longer surgical times when compared with open surgery (P < 0.001), which may, in part, be secondary to learning curve factors. No differences were noted among the minimally invasive modalities for postoperative pain medication usage (P= 0.354) and length of hospital stay (P= 0.86). CONCLUSIONS: The minimally invasive modalities for nephrectomy in children, including LESS nephrectomy, are associated with shorter lengths of hospital stay and decreased postoperative pain medication use when compared with open surgery. LESS nephrectomy in children is associated with similar surgical times, lengths of hospital stay and postoperative pain medication use as the other minimally invasive modalities (LAP and RALN). Slightly longer surgical times are noted with the minimally invasive modalities, including LESS nephrectomy, when compared with open surgery, which may, in part, be secondary to learning curve factors.


Assuntos
Nefropatias/cirurgia , Laparoscopia/métodos , Nefrectomia/métodos , Robótica , Adolescente , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Tempo de Internação/estatística & dados numéricos , Masculino , Nefrectomia/efeitos adversos , Dor Pós-Operatória/etiologia , Estudos Retrospectivos , Fatores de Tempo , Resultado do Tratamento
11.
Biosens Bioelectron ; 211: 114374, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35605548

RESUMO

There is an increased demand for real-time monitoring of biological and biochemical processes. While most sensor research focuses on physiological conditions, less has been done towards developing real-time biosensors that can operate in and survive exposure to extreme environments and harsh chemicals such as fuel. One interesting application is monitoring microbial load in fuel tanks to prevent both fuel spoilage and biocorrosion. We developed a comprehensive method to enable the first reagentless, real-time, microbial sensor platform that is also fuel resistant. We first identified an extracellular protein epitope conserved in fuel-degrading fungi then used this epitope to develop a suitable biorecognition element (BRE) through biopanning of a 7-mer phage displayed peptide library. After demonstrating the BRE's affinity to fungi using molecular and fluorescence assays, we incorporated the BRE into a reagentless, real-time electrochemical sensing platform based on a self-assembled monolayer of peptide BREs and redox reporters. Finally, we incorporated this real-time electrochemical sensing platform into a microfluidic device. We demonstrated detection of Yarrowia lipolytica as low as 1 × 104 CFU/mL in a bath cell, and demonstrate a microfluidic cell that functions even after exposure to jet fuel. In summary, this work describes development of a fuel-resistant biosensor for monitoring microbial growth in extreme environments.


Assuntos
Técnicas Biossensoriais , Técnicas Biossensoriais/métodos , Epitopos , Dispositivos Lab-On-A-Chip , Microfluídica , Biblioteca de Peptídeos
12.
Adv Sci (Weinh) ; 9(7): e2104426, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-35023321

RESUMO

Human health and performance monitoring (HHPM) is imperative to provide information necessary for protecting, sustaining, evaluating, and improving personnel in various occupational sectors, such as industry, academy, sports, recreation, and military. While various commercially wearable sensors are on the market with their capability of "quantitative assessments" on human health, physical, and psychological states, their sensing is mostly based on physical traits, and thus lacks precision in HHPM. Minimally or noninvasive biomarkers detectable from the human body, such as body fluid (e.g., sweat, tear, urine, and interstitial fluid), exhaled breath, and skin surface, can provide abundant additional information to the HHPM. Detecting these biomarkers with novel or existing sensor technologies is emerging as critical human monitoring research. This review provides a broad perspective on the state of the art biosensor technologies for HHPM, including the list of biomarkers and their physiochemical/physical characteristics, fundamental sensing principles, and high-performance sensing transducers. Further, this paper expands to the additional scope on the key technical challenges in applying the current HHPM system to the real field.


Assuntos
Técnicas Biossensoriais , Dispositivos Eletrônicos Vestíveis , Biomarcadores , Humanos , Monitorização Fisiológica , Suor
13.
ACS Sens ; 7(12): 3730-3740, 2022 12 23.
Artigo em Inglês | MEDLINE | ID: mdl-36512716

RESUMO

Quantitative analytical gas sampling is of great importance in a range of environmental, safety, and scientific applications. In this article, we present the design, operation, and performance of a recently developed tabletop terahertz (THz) spectroscopic molecular sensor capable of rapid (minutes) and sensitive detection of polar gaseous analytes with near "absolute" specificity. A novel double-coil absorption cell design and an array of room-temperature sorbent-based preconcentration modules facilitate quantitative THz detection of light polar volatile compounds, which often challenge the capabilities of established gas sensing techniques. Acetone, ethanol, methanol, acetaldehyde, formaldehyde, and isoprene are detected at low parts-per-billion to high parts-per-trillion levels. This work evaluates performance-limiting factors for THz spectroscopy-based chemical identification: (1) spectral signal to noise and (2) preconcentrator efficiency.


Assuntos
Gases , Espectroscopia Terahertz , Espectroscopia Terahertz/métodos , Acetaldeído , Etanol , Acetona
14.
Adv Mater Interfaces ; 9(18): 2102209, 2022 Jun 22.
Artigo em Inglês | MEDLINE | ID: mdl-35538926

RESUMO

Multiplex electronic antigen sensors for detection of SARS-Cov-2 spike glycoproteins and hemagglutinin from influenza A are fabricated using scalable processes for straightforward transition to economical mass-production. The sensors utilize the sensitivity and surface chemistry of a 2D MoS2 transducer for attachment of antibody fragments in a conformation favorable for antigen binding with no need for additional linker molecules. To make the devices, ultra-thin layers (3 nm) of amorphous MoS2 are sputtered over pre-patterned metal electrical contacts on a glass chip at room temperature. The amorphous MoS2 is then laser annealed to create an array of semiconducting 2H-MoS2 transducer regions between metal contacts. The semiconducting crystalline MoS2 region is functionalized with monoclonal antibody fragments complementary to either SARS-CoV-2 S1 spike protein or influenza A hemagglutinin. Quartz crystal microbalance experiments indicate strong binding and maintenance of antigen avidity for antibody fragments bound to MoS2. Electrical resistance measurements of sensors exposed to antigen concentrations ranging from 2-20 000 pg mL-1 reveal selective responses. Sensor architecture is adjusted to produce an array of sensors on a single chip suited for detection of analyte concentrations spanning six orders of magnitude from pg mL-1 to µg mL-1.

15.
J Urol ; 186(4 Suppl): 1734-9, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21855900

RESUMO

PURPOSE: The prevalence of obesity and urolithiasis in children has increased with time. We evaluated the relationship between body mass and urolithiasis in children. MATERIALS AND METHODS: We performed a matched case-control study in a network of 30 primary care pediatric practices. Cases included subjects with ICD-9 codes for urolithiasis and controls were matched on age, duration of observation before the index date and clinical practice. Age and sex specific body mass index z scores at the time of the stone episode were calculated. Continuous body mass index z scores and clinical weight categories were evaluated with covariates, including race, ethnicity, gender and payer status. The OR and 95% CI were calculated using multivariate conditional logistic regression. RESULTS: We identified 110 cases and 396 matched controls, of whom 1.9% and 4.3% were overweight, and 3.7% and 4.5% were obese, respectively. On multivariate conditional logistic regression analysis the continuous body mass index z score (OR 0.84, 95% CI 0.63-1.12, p = 0.18), overweight status (OR 0.13, 95% CI 0.01-1.18) and obese status (OR 0.18, 95% CI 0.02-1.40) were not associated with urolithiasis. However, black race (OR 0.35, 95% CI 0.15-0.85) and Medicaid payer status (OR 0.47, 95% CI 0.24-0.93) were associated with a significant decrease in the odds of urolithiasis. CONCLUSIONS: High body mass was not associated with urolithiasis in our primary care pediatric practice network. However, black race and Medicaid payer status were associated with decreased odds of urolithiasis.


Assuntos
Índice de Massa Corporal , Obesidade/epidemiologia , Urolitíase/epidemiologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Masculino , Obesidade/complicações , Prevalência , Estudos Retrospectivos , Fatores de Risco , Estados Unidos/epidemiologia , Urolitíase/etiologia
16.
J Urol ; 186(4 Suppl): 1663-7, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21862079

RESUMO

PURPOSE: Robotic assisted laparoscopic pyeloplasty is an emerging, minimally invasive alternative to open pyeloplasty in children for ureteropelvic junction obstruction. The procedure is associated with smaller incisions and shorter hospital stays. To our knowledge previous outcome analyses have not included human capital calculations, especially regarding loss of parental workdays. We compared perioperative factors in patients who underwent robotic assisted laparoscopic and open pyeloplasty at a single institution, especially in regard to human capital changes, in an institutional cost analysis. MATERIALS AND METHODS: A total of 44 patients 2 years old or older from a single institution underwent robotic assisted (37) or open (7) pyeloplasty from 2008 to 2010. We retrospectively reviewed the charts to collect demographic and perioperative data. The human capital approach was used to calculate parental productivity losses. RESULTS: Patients who underwent robotic assisted laparoscopic pyeloplasty had a significantly shorter average hospital length of stay (1.6 vs 2.8 days, p <0.05). This correlated with an average savings of lost parental wages of $90.01 and hospitalization expenses of $612.80 per patient when excluding amortized robot costs. However, cost savings were not achieved by varying length of stay when amortized costs were included. CONCLUSIONS: Robotic assisted laparoscopic pyeloplasty in children is associated with human capital gains, eg decreased lost parental wages, and lower hospitalization expenses. Future comparative outcome analyses in children should include financial factors such as human capital loss, which can be especially important for families with young children.


Assuntos
Efeitos Psicossociais da Doença , Rim/cirurgia , Laparoscopia/métodos , Robótica , Ureter/cirurgia , Obstrução Ureteral/cirurgia , Procedimentos Cirúrgicos Urológicos/métodos , Adolescente , Criança , Pré-Escolar , Custos e Análise de Custo , Feminino , Seguimentos , Humanos , Laparoscopia/economia , Tempo de Internação/economia , Masculino , Pais , Procedimentos de Cirurgia Plástica/economia , Procedimentos de Cirurgia Plástica/métodos , Estudos Retrospectivos , Fatores Socioeconômicos , Estados Unidos , Obstrução Ureteral/economia , Procedimentos Cirúrgicos Urológicos/economia , Adulto Jovem
17.
Methodist Debakey Cardiovasc J ; 17(3): 13-17, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35855294

RESUMO

We present the case of a healthy 29-year-old male with no significant medical history who presented with electrocardiogram findings consistent with pericarditis and elevated troponin levels, commonly seen in myocarditis, after receiving his second Pfizer-BioNTec vaccination for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). The patient had significant clinical improvement shortly after receiving aspirin and colchicine and was discharged home with these medications. His laboratory findings returned to baseline less than 2 weeks after his illness. While this case highlights the importance of diagnosis, intervention selection, and treatment of myopericarditis amid ongoing global vaccination campaigns, it should be emphasized that the benefits of vaccination considerably outweigh the risks.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Miocardite , Adulto , COVID-19/prevenção & controle , Vacinas contra COVID-19/efeitos adversos , Humanos , Masculino , Miocardite/diagnóstico , Miocardite/tratamento farmacológico , Miocardite/etiologia , SARS-CoV-2 , Vacinação
18.
ACS Sens ; 5(1): 13-18, 2020 01 24.
Artigo em Inglês | MEDLINE | ID: mdl-31833351

RESUMO

Environmental hazards typically are encountered in the gaseous phase; however, selective sensing modalities for identifying and quantitating compounds of interest in an inexpensive, pseudo-real-time format are severely lacking. Here, we present a novel proof-of-concept that combines an Air2Liquid sampler in conjunction with an oil-in-water microfluidic assay for detection of organophosphates. We believe this proof-of-concept will enable development of a new platform technology for semivolatile detection that we have demonstrated to detect 50 pmoles (2 ppb) of neurotoxic organophosphates.


Assuntos
Técnicas Biossensoriais/métodos , Gases/química , Organofosfatos/metabolismo
19.
J Urol ; 180(6): 2616-9; discussion 2619, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18950810

RESUMO

PURPOSE: Therapeutic options currently available for urinary stones include shock wave lithotripsy, percutaneous nephrolithotomy and ureteroscopic treatment. While these treatment options have become the standard of care in the adult population, the same has not necessarily been applied to the pediatric population, despite an increasing prevalence of stone disease in children. We report our flexible ureteroscopic experience with urinary stones in children. MATERIALS AND METHODS: A total of 170 ureteroscopic treatments were performed. Demographic information was collected. Stone burden was measured in millimeters. Operative access, operative times, intraoperative complications, stone-free status and postoperative complications were evaluated. RESULTS: A total of 167 children (89 boys and 78 girls) underwent 170 ureteroscopic procedures for urinary calculi. Mean patient age was 62.4 months at the time of the procedure (range 3 to 218). Mean followup was 19.7 months (range 6 to 39). Mean stone burden was 6.12 mm (range 3 to 24), with an average of 1.3 stones per patient. Retrograde access could not be obtained in 95 of the children (57%). No ureters were actively dilated. Flexible ureteroscopy was performed in all cases regardless of stone location. Stone clearance was 100% for stone burdens 10 mm or less and 97% for burdens greater than 10 mm after 1 ureteroscopy. CONCLUSIONS: Pediatric ureteroscopy is a safe and efficacious modality in the treatment of all upper urinary tract calculi, including lower pole calculi.


Assuntos
Cálculos Renais/terapia , Litotripsia/métodos , Cálculos Ureterais/terapia , Ureteroscopia , Adolescente , Criança , Pré-Escolar , Feminino , Hospitais Pediátricos , Humanos , Lactente , Masculino , Philadelphia , Estudos Prospectivos
20.
ACS Omega ; 3(6): 6230-6236, 2018 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-31458805

RESUMO

Breathing-air quality within commercial airline cabins has come under increased scrutiny because of the identification of volatile organic compounds (VOCs) from the engine bleed air used to provide oxygen to cabins. Ideally, a sensor would be placed within the bleed air pipe itself, enabling detection before it permeated through and contaminated the entire cabin. Current gas-phase sensors suffer from issues with selectivity, do not have the appropriate form factor, or are too complex for commercial deployment. Here, we chose isopropyl alcohol (IPA), a main component of de-icer spray used in the aerospace community, as a target analyte: IPA exposure has been hypothesized to be a key component of aerotoxic syndrome in pre, during, and postflight. IPAs proposed mechanism of action is that of an anesthetic and central nervous system depressant. In this work, we describe IPA sensor development by showing (1) the integration of a polymer as an IPA capture matrix, (2) the adoption of a redox chemical additives as an IPA oxidizer, and (3) the application of carbon nanotubes as an electronic sensing conduit. We demonstrate the ability to not only detect IPA at 100-10 000 ppm in unfiltered, laboratory air but also discriminate among IPA, isoprene, and acetone, especially in comparison to a typical photoionization detector. Overall, we show an electronic device that operates at room temperature and responds preferentially to IPA, where the increase in the resistance corresponds directly to the concentration of IPA. Ultimately, this study opens up the pathway to selective electronic sensors that can enable real-time monitoring in a variety of environments for the force health prevention and protection, and the potential through future work to enable low parts-per-million and possibly high parts-per-billion selective detection of gas-phase VOCs of interest.

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