Levesquemcnally6817
Subsequent rapid progression of the hematologic disease led to patient's death, approximately two months after the diagnosis of recurrence.
the percutaneous hepatic biopsy is a necessary procedure for the diagnosis of liver diseases which can cause complications and psychological discomfort for the patient.
to determine the safety profile of propofol in percutaneous hepatic biopsy, the complications of the technique per se and patients satisfaction once completed.
a retrospective observational study was performed via the acquisition of data of tolerance and perceived quality by the patients using a transversal survey.
ninety-seven patients were included with an average propofol dose of 170.46 mg. IDO-IN-2 supplier Of the complications resulting from the sedation, there were six slight desaturations (6.2 %) resolved with a forehead maneuver (50 %) or cessation of the propofol infusion pump (50 %) and eleven hypotension episodes (11.3 %) resolved without intervention (82.82 %) or with fluid replacement (18.18 %). Of the complications resulting from the technique, there were three cases of early-onset pain (3.1 %) and one delayed (1.03 %); all were resolved with 1 g of intravenous paracetamol. All patients were discharged with oral tolerance and without the need for analgesia 24 hours after the procedure. General satisfaction, as well as psychological discomfort, were evaluated as "very good/excellent" in 100 % of the patients.
propofol demonstrated a favorable safety profile in hepatic biopsy, aiding in the ultimate success of the procedure and tolerance for the patient. We propose the expansion of the use of sedation with propofol to this procedure.
propofol demonstrated a favorable safety profile in hepatic biopsy, aiding in the ultimate success of the procedure and tolerance for the patient. We propose the expansion of the use of sedation with propofol to this procedure.We consider very interesting the comments made by Serrano Díaz et al. on pancreatic stents inserted as prophylaxis for acute post-ERCP pancreatitis. As we recently stated in an editorial related to the prevention of this frequent complication, the aggressive way in which the pancreatic gland may respond to contact with the devices that are used for common bile duct cannulation via the papilla of Vater is almost philosophically surprising. It is our opinion that, usually, a pancreatic stent should only be inserted if the guidewire has spontaneously entered the main pancreatic duct (MPD). In ERCPs aiming at bile duct drainage, even when bile duct cannulation has been troublesome with extensive papillary manipulation, attempting cannulation of the MPD with the sole purpose of stent insertion can be more harmful than beneficial.
both percutaneous transhepatic cholangiography and drainage (PTCD) and endoscopic retrograde cholangiopancreatography (ERCP) with SEMS implantation have been used for unresectable hilar cholangiocarcinoma (HC) in the clinic for many years. However, which one is preferred is still unknown.
to study the effects of biliary drainage of self-expanding metal stents (SEMS) implantation under PTCD or ERCP to treat HC.
the clinical data of 82 patients with HC from January 2006 to January 2015 were recorded retrospectively. Patients were treated with biliary implantation of self-expanding metal stents (SEMS) under PTCD (PTCD group, 40 patients) or ERCP (ERCP group, 42 patients). Clinical data, including total bilirubin concentrations, complications and survival time were analyzed.
the remission of jaundice was similar in both groups (p > 0.05). The median survival time of the ERCP group and PTCD group were 237 d and 252 d respectively, with no significant differences (p > 0.05). The biliary infection rates under ERCP and PTCD procedure were 52.4 % and 20.0 % respectively, with a significant statistical difference (p < 0.05). For those HC patients of Bismuth III/IV, the infection rates under ERCP and PTCD procedure were 58.3 % and 14.3 %, respectively (p < 0.05).
both PTCD and ERCP with SEMS implantation were effective to prolong the survival time of HC patients. The biliary infection rates were higher in the ERCP group, especially for Bismuth III/IV HC patients.
both PTCD and ERCP with SEMS implantation were effective to prolong the survival time of HC patients. The biliary infection rates were higher in the ERCP group, especially for Bismuth III/IV HC patients.
the management of postoperative esophageal leaks is a huge therapeutic challenge. Thanks to the advances in endoscopy, treatment with esophageal stents has been proposed as a valid option.
the main objective of the study was to evaluate the effectiveness and safety of the use of fully covered esophageal metal stents in the treatment of postoperative esophageal leaks.
a retrospective observational study was performed in patients with postoperative esophageal leaks, treated with fully covered self-expandable metal stents between June 2011 and May 2018.
twenty-five patients were evaluated and 34 stents were placed. The closure of the leak was observed in 21 patients after removal of the stent, with an overall technical success rate of 84 %. The mean time with a stent placed for closure of the fistula was 55.7 ± 27.11 days/patient (mean of 39 ± 24.30 days/stent). The most frequent complication was a partial distal stent migration (7/34 stents), followed by five cases of complete migration into the stomach.
endoscopic treatment with fully covered self-expandable metal stents seems to be an effective and safe first-line treatment for postoperative esophageal leaks, according to the experience in our center.
endoscopic treatment with fully covered self-expandable metal stents seems to be an effective and safe first-line treatment for postoperative esophageal leaks, according to the experience in our center.Up-flow biological activated carbon (BAC) filters have been empirically employed in drinking water treatment plants (DWTPs) to address the challenges of its down-flow counterparts (e.g., high head loss and insufficient use of BAC beds), yet their performances and mechanisms toward ammonia removal are not fully evaluated. This study characterized the occurrence, distribution, and diversities of nitrifiers in up-flow and down-flow BAC filters by investigating 18 full-scale drinking water treatment trains in different geographic locations. Quantitative polymerase chain reaction analysis of gene markers of target microorganisms demonstrated higher numbers of total bacteria, ammonia-oxidizing bacteria (AOB), and Nitrospira in the up-flow filters relative to the down-flow filters (P less then 0.05), implying enhanced biological activities and nitrification potential within up-flow filters. The dominance of ammonia-oxidizing archaea (AOA) over AOB (i.e., 1.3-4.0 log10 gene copies higher) in 17 BAC filters illustrated the critical role of AOA in drinking water nitrification. Stratification of biomass was mainly found in the down-flow filters rather than the up-flow filters, suggesting better mixing of filter media across up-flow filter beds. Analysis of similarity results revealed that the AOA and Nitrospira community compositions were mainly affected by water sources and locations (P less then 0.05) but not flow configurations. These results provide insight into nitrification mechanisms in BAC filters with different flow configurations in real-world DWTPs.DBU-promoted cascade selective nucleophilic addition/C-C bond cleavage/hetero-Diels-Alder reactions accompanied by aromatization of substituted 2-amino-4H-chromen-4-ones with substituted β-nitrostyrenes or with the combined substituted β-nitrostyrenes and aromatic aldehydes were developed for the synthesis of 2,4-diaryl-substituted 5H-chromeno[2,3-b]pyridin-5-ones. This procedure provides a highly efficient and facile route to functionalized 5H-chromeno[2,3-b]pyridines from readily available substrates under mild reaction conditions.Colloidal quantum wells, or nanoplatelets, exhibit large, circularly polarized optical Stark effects under sub-band-gap femtosecond illumination. The optical Stark effect is measured for CdSe colloidal quantum wells of several thicknesses and separately as a measure of pump photon energy, pump fluence, and temperature. These measurements show that optical Stark effects in colloidal quantum wells shift the absorption features up to 5 meV, at the intensities up to 2.9 GW·cm-2 and large detuning (>400 meV) of the pump photon energy from the band edge absorption. Optical Stark shifts are underpinned by large transition dipoles of the colloidal quantum wells (μ = 15-23 D), which are larger than those of any reported colloidal quantum dots or epitaxial quantum wells. The rapid ( less then 500 fs), narrow band blue shift of the excitonic features under circular excitation indicates the viability of these materials beyond light emission such as spintronics or all-optical switching.The ability to predict material properties without the need for resource-consuming experimental efforts can immensely accelerate material and drug discovery. Although ab initio methods can be reliable and accurate in making such predictions, they are computationally too expensive on a large scale. The recent advancements in artificial intelligence and machine learning as well as the availability of large quantum mechanics derived datasets enable us to train models on these datasets as a benchmark and to make fast predictions on much larger datasets. The success of these machine learning models highly depends on the machine-readable fingerprints of the molecules that capture their chemical properties as well as topological information. In this work, we propose a common deep learning-based framework to combine different types of molecular fingerprints to enhance prediction accuracy. A graph neural network (GNN), many-body tensor representation (MBTR), and a set of simple molecular descriptors (MD) were used to predict the total energies, highest occupied molecular orbital (HOMO) energies, and lowest unoccupied molecular orbital (LUMO) energies of a dataset containing ∼62k large organic molecules with complex aromatic rings and remarkably diverse functional groups. The results demonstrate that a combination of best performing molecular fingerprints can produce better results than the individual ones. The simple and flexible deep learning framework developed in this work can be easily adapted to incorporate other types of molecular fingerprints.Compounds bearing organophosphorus motifs and 2-oxazolidinone have found numerous applications in pharmaceutical chemistry, homogeneous catalysis, and organic materials. Here, we describe an efficient and selective protocol for straightforward access to a series of 5-((diarylphosphoryl)methyl)oxazolidin-2-ones via the copper-catalyzed difunctionalization of the C≡C bond of propargylic amines with CO2 and phosphine oxide. Notably, copper catalysis is a sustainable and benign catalytic mode. This reaction proceeds under mild reaction conditions, which is operationally simple and scalable with a broad scope, exclusive selectivity, and good functional group compatibility. Mechanistic studies suggest a one-pot tandem cyclization/radical addition sequence, along with the phosphorylation/cyclization scheme.