Minimally invasive surgical treatment of algic syndrome of advanced pancreatic cancer and chronic relapsing pancreatitis

Catedra 2 Chirurgie, LCȘ „Chirurgie Reconstructivă a Tractului Digestiv”, USMF “Nicolae Testemițanu”, SCR Chișinău, Republica Moldova, Al XII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” din Republica Moldova cu participare internațională 23-25 septembrie 2015Introducere: Sindromul algic refractar la tratamentul antalgic în cancerul pancreatic nerezecabil (CPN), pancreatita cronică (PC) severă, statusul biologic precar al pacientului în cazurile în care o intervenție cu viză patogenică este contraindicată impun intervenții chirurgicale limitate la paliația durerii. Scop: Evaluarea splanhnicectomiei toracoscopice (SPLT) în tratamentul sindromului de durere în PC recidivantă și CPN. Material și metode: Studiul include 18 (23,08%) pacienți cu PC, 36 (46,15%) pacienți cu PC recidivantă și 21 (26,92%) pacienți cu CPN, 3 (3,85%) pacienți cu cancer cu localizare nepancreatică nerezecabil, desfăsurat în perioada anilor 2008-2014 în Clinica 1 din cadrul Catedrei 2 Chirurgie. Lotul de pacienți cu PC a inclus 47 (87,04%) bărbați și 7 (12,86%) femei, vârsta medie – 52,2 ani (limitele: 28-72 ani). Lotul de pacienți cu CPN – 19 (90,91%) bărbați, 2 (9,09%) femei, vârsta medie – 58 ani (limitele: 45-78 ani). Rezultate: S-au practicat 62 (79,49%) SPLT pe stînga, 12 (15,38%) SPLT pe dreapta. Patru (5,13%) pacienți au necesitat și SPLT dreaptă la 8 săptămâni după SPLT stângă datorită răspunsului terapeutic minimal. Efectul analgetic pe termen scurt (<3 luni) este denotat de eficacitate în 54 (100%) cazuri de PC recidivantă și 20 (83,3%) cazuri de CPN. Între 3-6 luni eficacitatea analgeziei s-a menținut la 36 (66,6%) cazuri de PC recidivantă (continuând ulterior după 6 luni) și 16 (67%) cazuri de CPN. Mortalitatea perioperatorie a fost 0. Spitalizarea medie postoperatorie a fost de 3,3 zile (2-5 zile). Concluzii: SPLT este o procedură paliativă, fezabilă, sigură, ce prezintă avantajele abordului minim invaziv în special în lipsa de complicații, și implicit costuri mai mici în controlul durerii din CPN și PC refractară la tratamentul antalgic conservator. Protezarea endoscopică și SPLT reprezintă soluții miniinvazive cu implicații asupra ratei de supraviețuire în cazurile de CPN complicat cu icter mecanic.Introduction: Refractory algic syndrome to analgesic treatment in unresectable pancreatic cancer (CPN), severe chronic pancreatitis (CP), the precarious biological status of the patient in cases where surgery is contraindicated, require procedures that are limited to pain palliation. Purpose: The rating of thoracoscopic splanchnicectomy (SPLT) in the treatment of pain syndrome in relapsing CP and CPN. Material and methods: The study includes 18 (23.08%) patients with CP, 36 (46.15%) patients with relapsing CP and 21 (26.92%) patients with CPN 3 (3.85%) patients with unresectable cancer, held during the years 2008-2014 in the Clinic N 1. The patients with CP included 47 (87.04%) men and seven (12.86%) women, the average age – 52.2 years (28-72 years). The patients with CPN – 19 (90.91%) men and two (9.09%) women, average age – 58 years (within 45-78 years). Results: There were performed 62 (79.49%) left SPLT, 12 (15.38%) right SPLT. Four (5.13%) patients also required SPLT on the right on 8 weeks after SPLT on the left due to the minimal therapeutic response. The analgesic effect on short-term (<3 months) had an efficacy in 54 (100%) relapsing CP cases and 20 (83.3%) cases of CPN. Between 3-6 months, the analgesic efficacy was maintained at 36 (66.6%) cases of relapsing CP (continuing after 6 months) and 16 (67.0%) of CPN. The perioperative mortality was 0. Mean postoperative hospital stay was 3.3 days (2-5 days). Conclusion: SPLT is a feasible and safe palliative procedure that presents the advantages of the minimally invasive approach, especially in the absence of complications, lower costs in CPN and CP pain control during the conservative analgesic treatment. The endoscopic prosthetic and SPLT presents some minimally invasive solutions that can increase the survival rate in CPN cases

Excess-entropy scaling in supercooled binary mixtures

Supercooled liquids near the glass transition show remarkable non-Arrhenius transport phenomena, whose origin is yet to be clarified. Here, the authors use GPU molecular dynamics simulations for various binary mixtures in the supercooled regime to show the validity of a quasiuniversal excess-entropy scaling relation for viscosity and diffusion

Clinical Applications of Artificial Intelligence—An Updated Overview

Artificial intelligence has the potential to revolutionize modern society in all its aspects. Encouraged by the variety and vast amount of data that can be gathered from patients (e.g., medical images, text, and electronic health records), researchers have recently increased their interest in developing AI solutions for clinical care. Moreover, a diverse repertoire of methods can be chosen towards creating performant models for use in medical applications, ranging from disease prediction, diagnosis, and prognosis to opting for the most appropriate treatment for an individual patient. In this respect, the present paper aims to review the advancements reported at the convergence of AI and clinical care. Thus, this work presents AI clinical applications in a comprehensive manner, discussing the recent literature studies classified according to medical specialties. In addition, the challenges and limitations hindering AI integration in the clinical setting are further pointed out

Spatio‐Temporal Pattern of Tuberculosis Distribution in Romania and Particulate Matter Pollution Associated With Risk of Infection

Abstract The study proposes a dynamic spatio‐temporal profile of the distribution of tuberculosis incidence and air pollution in Romania, where this infectious disease induces more than 8,000 new cases annually. The descriptive analysis for the years 2012–2021 assumes an identification of the structuring patterns of mycobacterium tuberculosis risk in the Romanian population, according to gender and age, exploiting spatial modeling techniques of time series data. Through spatial autocorrelation, the degree of similarity between the analyzed territorial systems was highlighted and the relationships that are built between the analysis units in spatial proximity were investigated. By modeling the geographical distribution of tuberculosis, the spatial correlation with particulate matter (PM2.5) pollution was revealed. The identification of clusters of infected persons is an indispensable step in the construction of efficient tuberculosis management systems. The results highlight the link between the distribution of tuberculosis, air pollution and socio‐economic development, which requires a detailed analysis of the epidemiological data obtained in the national tuberculosis surveillance and control program from the perspective of geographical distribution