Tangebisgaard5746

To provide the basis for clinical diagnosis in an emergency case, a portable smartphone device-based multi-signal sensing system for on-site determination of alkaline phosphatase (ALP) is introduced. In this system, cobalt hydroxide (CoOOH) nanoflakes can oxidize O-phenylenediamine (OPD) to produce 2,3-diaminophenazine (OxOPD), resulting in a strong fluorescence at 565 nm and an absorbance at 420 nm, respectively. The ascorbic acid 2-phosphate (AAP) can be hydrolyzed by alkaline phosphatase (ALP) to yield ascorbic acid (AA). Then, AA reduces the CoOOH nanoflakes to produce Co2+, and AA is oxidized to form dehydroascorbic acid (DHAA), thereby inhibiting the formation of OxOPD. The reaction product DHAA further combines with OPD to yield 3-(1,2-dihydroxyethyl)furo[3,4-b]quinoxalin-1(3H)-one (DFQ) accompanied by a strong fluorescence at 430 nm. Based on this, the fluorometric assay for ALP has a wide linear range from 0.8 to 190 U/L with a low detection limit of 0.16 U/L, and the colorimetric assay from 3 to 130 U/L with a detection limit of 1.94 U/L. Moreover, a portable smartphone sensing platform integrated with fluorescent and colorimetric signals was established for rapid determination of ALP without spectrometers. Recoveries of 97-104% for spiked samples and relative standard deviations (RSD) of less than 2% (n = 3) confirmed the feasibility of the developed platform in complicated samples, opening up new horizons for on-site evaluation in the biomedical field.

This study aims to evaluate the risk of postoperative mortality in octogenarians undergoing emergency laparotomy.

In compliance with STROCSS guideline for observational studies, we conducted a multicentre retrospective cohort study. All consecutive patients aged over 80 with acute abdominal pathology requiring emergency laparotomy between April 2014 and August 2019 were considered eligible for inclusion. The primary outcome measure was 30-day postoperative mortality, and the secondary outcome measures were in-hospital mortality and 1-year mortality. Statistical analyses included simple descriptive statistics, binary logistic regression analyses, and Kaplan-Meier survival statistics.

A total of 523 octogenarians were eligible for inclusion. Emergency laparotomy in octogenarians was associated with 21.8% (95% CI 18.3-25.6%) 30-day postoperative mortality, 22.6% (95% CI 19.0-26.4%) in-hospital mortality, and 40.2% (95% CI 35.9-44.5%) 1-year mortality. Binary logistic regression analysis identified ASA statarotomies in patients older than 80 years with ASA status more than 3 in the presence of peritoneal contamination carry a high risk of immediate postoperative and 1-year mortality. This should be taken into account in communications with patients and their relatives, consent process, and multidisciplinary decision-making process for operative or non-operative management of such patients.

Data about whether laparoscopic gastrectomy (LG) is applicable in serosa-positive (pT4a) gastric cancer patients remain rare. The purpose of this study is to compare the perioperative and long-term outcomes between the laparoscopic and open gastrectomy (OG) in pT4a gastric cancer patients who underwent curative resection.

A total of 1086 consecutive pT4a patients (101 patients with LG and 985 with OG) who underwent curative gastrectomy in a high-volume center between 2006 and 2016 were evaluated. Demographics, surgical, and oncologic outcomes were analyzed. Propensity score matching (PSM) analysis was performed to balance baseline confounders, and COX regression analysis was performed to identify independent prognostic factors.

After PSM adjustment, a well-balanced cohort comprising 101 patients who underwent LG and 201 who underwent OG was analyzed. Operative time (288.7 vs. 234.2min; P < 0.001) was significantly longer, while estimated blood loss (172.8 vs. 220.7ml; P < 0.001) was significantly pic.

Although laparoscopic Nissen fundoplication (LNF) is a kind of minimally invasive surgery, some transition time may still be required to allow the fundoplicated stomach to adapt to the new anatomical position. We observed transient delayed gastric emptying (DGE) post-LNF in our preliminary study. This study aimed to investigate the occurrence rate and development of transient DGE post-LNF.

Patients who underwent LNF for gastroesophageal reflux disease (GERD) at our institution were recruited consecutively. They were treated with standardized LNF and prospectively followed up for 2 months. Proper diet guidance and/or pharmacologic therapy were given during these 2 months. GERD Health-Related Quality of Life (GERD-HRQL), DGE symptoms, and DGE status were evaluated preoperatively and postoperatively.

Fifty-one patients underwent LNF and completed a 2-month follow-up. LNF succeeded in all patients. Prior to LNF, no DGE was identified. At the 1-month follow-up, LNF led to a significant reduction in the GERD-HRQL total score but a significantly increased DGE score. Endoscopically, DGE was identified in forty-seven (n = 47, 92.2%) patients. At the 2-month follow-up, the GERD-HRQL scores continued to show decreases compared to the 1 month. The DGE score returned to the baseline value. Endoscopically, no DGE was identified in any patients (n = 0, 0.0%).

Transient DGE is a very common one-month post-LNF but can recover quickly in the second month following LNF.

Transient DGE is a very common one-month post-LNF but can recover quickly in the second month following LNF.

Modern immunosuppressive regimens in paediatric kidney transplant recipients have contributed to improved long-term allograft survival, but at the expense of an increased incidence of viral infections. Here, we describe, for the first time, the incidence, risk factors and clinical outcome of CMV, EBV, BKV and JCV viraemia in a cohort of paediatric allograft recipients treated with a corticosteroid-minimisation immunosuppressive regimen (CMR).

We retrospectively analysed 98 children treated with a CMR (basiliximab induction, corticosteroids until day 4, long-term tacrolimus and mycophenolate mofetil), who received a kidney transplant in our centre between 2009 and 2019.

Over the first 4 years post-transplant, the incidences of viraemia were as follows CMV, 25.5%; EBV, 52.0%; JCV, 16.3%; BKV, 26.5%. Younger children at time of transplant were more likely to develop EBV and BKV viraemia. AS-703026 purchase EBV viraemia was also associated with a regimen involving corticosteroids, but lacking MMF. Recipient CMV serology predicted the development of EBV, BKV and CMV viraemia.