| 1. |
- Jansson, Daniel T., et al.
(författare)
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Metabolism, inflammation and postoperative time are the key to early diagnosis of anastomotic leak
- 2019
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Ingår i: Journal of Surgery and Surgical Research. - : Peertechz Publications Private Limited. - 2455-2968. ; 5:2
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of the study was to find laboratory samples for early diagnosis of anastomotic leak.Summary background data: Anastomotic leakage after rectal cancer surgery is a severe complication with high mortality. Outcome is highly dependent on early diagnosis.Methods: 29 patients were investigated postoperatively after having undergone low anterior resection due to cancer recti. Patient outcomes were divided into three groups: Anastomotic leak in 7 patients, other complications in 9 patients and 13 patients who were free of complications. Patients were monitored every 6th hour with blood and intraperitoneal samples in order to identify laboratory markers for early detection of anastomotic leakage. An anastomotic leak index was created, a scoring system where points count for values higher than reference values of CRP and interleukin 6 in blood and intraperitoneal lactate, lactate/pyruvate ratio and interleukin 6 were measured at 18, 24, 42 and 48 hours postoperatively.Results: Significant differences between groups were found regarding CRP, Interleukin 6, fibrinogen and D-dimer in blood. Intraperitoneal differences were found not only in lactate and lactate/pyruvate ratio measured by microdialysis, significant differences in interleukin 6, interleukin 10 and tumour necrosis factor-α could also be demonstrated between the groups. The anastomotic leak index had a sensitivity and specificity of 86% (p=0.0007).Conclusions: The most important factor was time after operation. No laboratory parameter in itself could predict an anastomotic leak but the anastomotic leak index was a useful tool in the monitoring and assessment of clinical outcome.Mini abstract: Patients with anastomotic leak after rectal surgery were monitored with higher intraperitoneal cytokines and lactate/pyruvate ratio. The results suggest intraperitoneal microdialysis combined with blood samples of CRP and IL 6 as a feasible method for early diagnosis of anastomotic leak.
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| 2. |
- Alshamari, Muhammed, 1975-, et al.
(författare)
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Diagnostic accuracy of low-dose CT compared with abdominal radiography in non-traumatic acute abdominal pain : prospective study and systematic review
- 2016
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Ingår i: European Radiology. - New York : Springer. - 0938-7994 .- 1432-1084. ; 26:6, s. 1766-1774
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Forskningsöversikt (refereegranskat)abstract
- Objectives: Abdominal radiography is frequently used in acute abdominal non-traumatic pain despite the availability of more advanced diagnostic modalities. This study evaluates the diagnostic accuracy of low-dose CT compared with abdominal radiography, at similar radiation dose levels.Methods: Fifty-eight patients were imaged with both methods and were reviewed independently by three radiologists. The reference standard was obtained from the diagnosis in medical records. Sensitivity and specificity were calculated. A systematic review was performed after a literature search, finding a total of six relevant studies including the present.Results: Overall sensitivity with 95 % CI for CT was 75 % (66-83 %) and 46 % (37-56 %) for radiography. Specificity was 87 % (77-94 %) for both methods. In the systematic review the overall sensitivity for CT varied between 75 and 96 % with specificity from 83 to 95 % while the overall sensitivity for abdominal radiography varied between 30 and 77 % with specificity 75 to 88 %.Conclusions: Based on the current study and available evidence, low-dose CT has higher diagnostic accuracy than abdominal radiography and it should, where logistically possible, replace abdominal radiography in the workup of adult patients with acute non-traumatic abdominal pain.Key points: • Low-dose CT has a higher diagnostic accuracy than radiography. • A systematic review shows that CT has better diagnostic accuracy than radiography. • Radiography has no place in the workup of acute non-traumatic abdominal pain.
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| 3. |
- Andreassen, A. K., et al.
(författare)
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Everolimus Initiation With Early Calcineurin Inhibitor Withdrawal in De Novo Heart Transplant Recipients: Three-Year Results From the Randomized SCHEDULE Study
- 2016
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Ingår i: American Journal of Transplantation. - : WILEY-BLACKWELL. - 1600-6135 .- 1600-6143. ; 16:4, s. 1238-1247
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Tidskriftsartikel (refereegranskat)abstract
- In a randomized, open-label trial, de novo heart transplant recipients were randomized to everolimus (3-6ng/mL) with reduced-exposure calcineurin inhibitor (CNI; cyclosporine) to weeks 7-11 after transplant, followed by increased everolimus exposure (target 6-10ng/mL) with cyclosporine withdrawal or standard-exposure cyclosporine. All patients received mycophenolate mofetil and corticosteroids. A total of 110 of 115 patients completed the 12-month study, and 102 attended a follow-up visit at month 36. Mean measured GFR (mGFR) at month 36 was 77.4mL/min (standard deviation [SD] 20.2mL/min) versus 59.2mL/min (SD 17.4mL/min) in the everolimus and CNI groups, respectively, a difference of 18.3mL/min (95% CI 11.1-25.6mL/min; p < 0.001) in the intention to treat population. Multivariate analysis showed treatment to be an independent determinant of mGFR at month 36. Coronary intravascular ultrasound at 36 months revealed significantly reduced progression of allograft vasculopathy in the everolimus group compared with the CNI group. Biopsy-proven acute rejection grade 2R occurred in 10.2% and 5.9% of everolimus- and CNI-treated patients, respectively, during months 12-36. Serious adverse events occurred in 37.3% and 19.6% of everolimus- and CNI-treated patients, respectively (p=0.078). These results suggest that early CNI withdrawal after heart transplantation supported by everolimus, mycophenolic acid and steroids with lymphocyte-depleting induction is safe at intermediate follow-up. This regimen, used selectively, may offer adequate immunosuppressive potency with a sustained renal advantage. A follow-up study of the SCHEDULE trial, which randomized de novo heart transplant recipients to everolimus with cyclosporine discontinuation or to standard-exposure cyclosporine, shows that measured glomerular filtration rate remains significantly higher in the everolimus group at three years posttransplant, with significantly reduced progression of allograft vasculopathy compared to cyclosporine therapy.
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| 4. |
- Carson, Fabian, et al.
(författare)
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Effect of the functionalisation route on a Zr-MOF with an Ir-NHC complex for catalysis
- 2015
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Ingår i: Chemical Communications. - : Royal Society of Chemistry (RSC). - 1359-7345 .- 1364-548X. ; 51:54, s. 10864-10867
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Tidskriftsartikel (refereegranskat)abstract
- A new iridium N-heterocyclic carbene (NHC) metallolinker has been synthesised and introduced into a metal-organic framework (MOF), for the first time, via two different routes: direct synthesis and postsynthetic exchange (PSE). The two materials were compared in terms of the Ir loading and distribution using X-ray energy dispersive spectroscopy (EDS), the local Ir structure using X-ray absorption spectroscopy (XAS) and the catalytic activity. The materials showed good activity and recyclability as catalysts for the isomerisation of an allylic alcohol.
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| 5. |
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| 6. |
- Gebauer, Denis, et al.
(författare)
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Indications that Amorphous Calcium Carbonates Occur in Pathological Mineralisation-A Urinary Stone from a Guinea Pig
- 2018
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Ingår i: Minerals. - : MDPI AG. - 2075-163X. ; 8:3
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Tidskriftsartikel (refereegranskat)abstract
- Calcium carbonate is an abundant biomineral that is of great importance in industrial or geological contexts. In recent years, many studies of the precipitation of CaCO3 have shown that amorphous precursors and intermediates are widespread in the biomineralization processes and can also be exploited in bio-inspired materials chemistry. In this work, the thorough investigation of a urinary stone of a guinea pig suggests that amorphous calcium carbonate (ACC) can play a role in pathological mineralization. Importantly, certain analytical techniques that are often applied in the corresponding analyses are sensitive only to crystalline CaCO3 and can misleadingly exclude the relevance of calcium carbonate during the formation of urinary stones. Our analyses suggest that ACC is the major constituent of the particular stone studied, which possibly precipitated on struvite nuclei. Minor amounts of urea, other stable inorganics, and minor organic inclusions are observed as well.
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| 7. |
- Granlund, Moa Z., et al.
(författare)
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Evaluation of Co, La, and Mn promoted Rh catalysts for autothermal reforming of commercial diesel : Aging and characterization
- 2015
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Ingår i: Applied Catalysis B. - : Elsevier BV. - 0926-3373 .- 1873-3883. ; 172, s. 145-153
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Tidskriftsartikel (refereegranskat)abstract
- In this study, three bimetallic catalysts are evaluated for autothermal reforming (AIR) of fuels (1 wt.% Rh and 6 wt.% X (X= Co, La or Mn) supported on high-surface area CeO2-ZrO2). The catalysts are aged for approximately 35 h and carefully characterized both as fresh and aged materials. The objective is to illuminate the changes in material properties after time on stream as well as the differences among the materials. The changes in material properties are evaluated by H-2-TPR, BET surface area analysis, TEM, SEM, and STEM. The material's tendency to coke is investigated by TPO analysis. The three materials exhibit promising initial activity. However, the Co-promoted sample decreases sharply in activity after 25 h of operation. Meanwhile, the other two materials display a more stable activity throughout the evaluated time. The deactivation of the Co-promoted material could be linked to the high amount of coke deposited during operation. Based on the results from the activity evaluation and characterization, the material promoted with lanthanum displays the most promising results. The addition of lanthanum resulted in a catalyst that was both stable and had high activity, even though a low rhodium loading is used. The material also shows superior thermal resistance compared to the other two materials. In addition, the tendency to coke is significantly lower compered to the other materials, which is especially beneficial when dealing with AIR of complex fuels.
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| 8. |
- Grins, Jekabs, et al.
(författare)
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A structural study of Ruddlesden-Popper phases Sr3-xYx(Fe1.25Ni0.75)O7-delta with x <= 0.75 by neutron powder diffraction and EXAFS/XANES spectroscopy
- 2018
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Ingår i: Journal of Materials Chemistry A. - : Royal Society of Chemistry (RSC). - 2050-7488 .- 2050-7496. ; 6:13, s. 5313-5323
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Tidskriftsartikel (refereegranskat)abstract
- The structures of Ruddlesden-Popper n = 2 member phases Sr3-xYxFe1.25Ni0.75O7-delta with 0 <= x <= 0.75 have been investigated using neutron powder diffraction and K-edge Fe and Ni EXAFS/XANES spectroscopy in order to gain information about the evolution of the oxygen vacancy distribution and Fe/Ni oxidation state with x. Both samples prepared at 1300 degrees C under a flow of N-2(g), with delta = 1.41-1.00, and samples subsequently annealed in air at 900 degrees C, with delta = 0.44-0.59, were characterized. The as-prepared x = 0.75 phase has delta = 1, the O1 atom site is vacant, and the Fe3+/Ni2+ ions have a square pyramidal coordination. With decreasing x the O3 occupancy decreases nearly linearly to 81% for x = 0, while the O1 occupancy increases from 0 for x = 0.4 to 33% for x = 0. The air-annealed x = 0.75 sample has a delta value of 0.59 and the Fe3+/Fe4+/Ni2+/Ni3+ ions have both square pyramidal and octahedral coordination. With decreasing x, the delta value decreases to 0.45 for x = 0, implying an increase in the oxidation states of Fe/Ni ions. EXAFS/XANES data show that for the as-prepared samples the coordination changes are predominantly for Ni2+ ions and that the air-annealed samples contain both Fe3+/Fe4+ and Ni2+/Ni3+ ions.
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| 9. |
- Grins, J., et al.
(författare)
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A structural study of Ruddlesden-Popper phases Sr3-xYx(Fe125Ni075)O7-δ with x ≤ 0.75 by neutron powder diffraction and EXAFS/XANES spectroscopy
- 2018
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Ingår i: Journal of Materials Chemistry A. - : Royal Society of Chemistry (RSC). - 2050-7488 .- 2050-7496. ; 6:13, s. 5313-5323
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Tidskriftsartikel (refereegranskat)abstract
- The structures of Ruddlesden-Popper n = 2 member phases Sr 3-x Y x Fe 1 25Ni0.75O 7-δ with 0 ≤ x ≤ 0.75 have been investigated using neutron powder diffraction and K-edge Fe and Ni EXAFS/XANES spectroscopy in order to gain information about the evolution of the oxygen vacancy distribution and Fe/Ni oxidation state with x. Both samples prepared at 1300°C under a flow of N 2 (g), with δ = 1.41-1.00, and samples subsequently annealed in air at 900°C, with δ = 0.44-0.59, were characterized. The as-prepared x = 0.75 phase has δ = 1, the O1 atom site is vacant, and the Fe 3+ /Ni 2+ ions have a square pyramidal coordination. With decreasing x the O3 occupancy decreases nearly linearly to 81% for x = 0, while the O1 occupancy increases from 0 for x = 0.4 to 33% for x = 0. The air-annealed x = 0.75 sample has a δ value of 0.59 and the Fe 3+ /Fe 4+ /Ni 2+ /Ni 3+ ions have both square pyramidal and octahedral coordination. With decreasing x, the δ value decreases to 0.45 for x = 0, implying an increase in the oxidation states of Fe/Ni ions. EXAFS/XANES data show that for the as-prepared samples the coordination changes are predominantly for Ni 2+ ions and that the air-annealed samples contain both Fe 3+ /Fe 4+ and Ni 2+ /Ni 3+ ions.
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| 10. |
- Gullestad, Lars, et al.
(författare)
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Long-term outcomes of thoracic transplant recipients following conversion to everolimus with reduced calcineurin inhibitor in a multicenter, open-label, randomized trial
- 2016
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Ingår i: Transplant International. - : Wiley-Blackwell Publishing Inc.. - 0934-0874 .- 1432-2277. ; 29:7, s. 819-829
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Tidskriftsartikel (refereegranskat)abstract
- The NOCTET study randomized 282 patients ≥1 year after heart or lung transplantation to continue conventional calcineurin inhibitor (CNI) therapy or to start everolimus with reduced-exposure CNI. Last follow-up, at ≥5 years postrandomization (mean: 5.6 years) was attended by 72/140 everolimus patients (51.4%) and 91/142 controls (64.1%). Mean measured GFR remained stable in the everolimus group from randomization (51.3 ml/min) to last visit (51.4 ml/min) but decreased in controls (from 50.5 ml/min to 45.3 ml/min) and was significantly higher with everolimus at last follow-up (P = 0.004). The least squares mean (SE) change from randomization was -1.5 (1.7)ml/min with everolimus versus -7.2 (1.7)ml/min for controls (difference: 5.7 [95% CI 1.7; 9.6]ml/min; P = 0.006). The difference was accounted for by heart transplant patients (difference: 6.9 [95% 2.3; 11.5]ml/min; P = 0.004). Lung transplant patients showed no between-group difference at last follow-up. Rates of rejection, death, and major cardiac events were similar between groups, as was graft function. Pneumonia was more frequent with everolimus (18.3% vs. 6.4%). In conclusion, introducing everolimus in maintenance heart transplant patients, with reduced CNI, achieves a significant improvement in renal function which is maintained for at least 5 years, but an early renal benefit in lung transplant patients was lost. Long-term immunosuppressive efficacy was maintained.
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