Surface Modification, Characterization and Biofunctionality of Pegylated Titanate Films Obtained by the Sol-Gel Method

Pegylated titanates have been prepared as biomedical supports in the form of thin films. The independent preparation of a polyethylene glycol (PEG) and a ¿tetraisopropyl-orthotitanate (TIPT) precursorwas followed by mixing at different molar ratios and spin casting onto Si (100) substrates to form the films. Activation of the hybrid structure was induced by annealing at temperatures right below the PEG melting point. Structural and compositional changes during these steps were followed by Fourier transformed infrared (FTIR) spectroscopy, XPS) and water contact angle (CA) measurements. Biofunctionality of the pegylated titanates as antifouling ophthalmic films was tested on the one hand by determination of optical constants using genetic algorithms. On the other hand, indication of surface biocompatibility was provided by seeding mesenchymal stemcells. The results show that PEG-rich surfaces are less biocompatible than mild inorganic surfaces as derived from the inhibition of cytoskeleton polarization.JRC.I.4-Nanotechnology and Molecular Imagin

Wide area transepithelial sampling with computer assisted analysis (WATS3D) to detect high grade dysplasia and cancer in Barrett's esophagus: a multi-center, randomized study.

Background and aims Current surveillance for Barrett's esophagus (BE), consisting of 4-quadrant random forceps biopsy (FB), has an inherent risk of sampling error. Wide-Area Transepithelial Sampling (WATS) may increase detection of high-grade dysplasia (HGD) and adenocarcinoma (EAC). In this multicenter, randomized trial, we aimed to evaluate WATS as a substitute for FB. Methods Patients with known BE and a recent history of dysplasia, without visible lesions, at 17 hospitals were randomized to receive either WATS followed by FB or vice-versa. All WATs samples were examined, with computer assistance, by at least two experienced pathologists at the CDx Laboratory. Similarly, all FBs were examined by two expert pathologists. The primary endpoint was concordance/disconcordance for detection of HGD/EAC between both techniques. Results 172 patients were included. Of these, 21 had HGD/EAC detected with both modalities, 18 other had HGD/EAC detected by WATS, but missed with FB and 12 were detected by FB but missed by WATS. The detection rate of HGD/EAC did not differ between WATS and FB (p=0.36). Utilizing WATS as an adjunct to FB significantly increased detection of HGD/EAC vs FB alone (absolute increase 10% [95%-CI: 6-16%]). Mean procedural times in minutes for FB alone, WATS alone, and the combination were 6.6 (95% CI:5.9-7.1), 4.9 (95% CI:4.1-5.4), and 11.2 (95%-CI:10.5-14.0) respectively. Conclusions Although the combination of WATS and FB increases dysplasia detection in a population of BE patients enriched for dysplasia, we did not find a statistically significant difference between WATS and FB for detection of HGD/EAC as single modality

Second-generation colon capsule endoscopy compared with colonoscopy

Background: Colon capsule endoscopy (CCE) represents a noninvasive technology that allows visualization of the colon without requiring sedation and air insufflation. A second-generation colon capsule endoscopy system (PillCam Colon 2) (CCE-2) was developed to increase sensitivity for colorectal polyp detection compared with the first-generation system. Objective: To assess the feasibility, accuracy, and safety of CCE-2 in a head-to-head comparison with colonoscopy. Design and Setting: Prospective, multicenter trial including 8 European sites. Patients: This study involved 117 patients (mean age 60 years). Data from 109 patients were analyzed. Intervention: CCE-2 was prospectively compared with conventional colonoscopy as the criterion standard for the detection of colorectal polyps that are ≥6 mm or masses in a cohort of patients at average or increased risk of colorectal neoplasia. Colonoscopy was independently performed within 10 hours after capsule ingestion or on the next day. Main Outcome Measurements: CCE-2 sensitivity and specificity for detecting patients with polyps ≥6 mm and ≥10 mm were assessed. Capsule-positive but colonoscopy-negative cases were counted as false positive. Capsule excretion rate, level of bowel preparation, and rate of adverse events also were assessed. Results: Per-patient CCE-2 sensitivity for polyps ≥6 mm and ≥10 mm was 84% and 88%, with specificities of 64% and 95%, respectively. All 3 invasive carcinomas were detected by CCE-2. The capsule excretion rate was 88% within 10 hours. Overall colon cleanliness for CCE-2 was adequate in 81% of patients. Limitations: Not unblinding the CCE-2 results at colonoscopy; heterogenous patient population; nonconsecutive patients. Conclusion: In this European, multicenter study, CCE-2 appeared to have a high sensitivity for the detection of clinically relevant polypoid lesions, and it might be considered an adequate tool for colorectal imaging. © 2011 American Society for Gastrointestinal Endoscopy.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

First three months of anticoagulation for venous thromboembolism in non-cancer patients: LMWH VS. VKAs. Findings from the RIETE registry

Background: The use of low-molecular-weight heparin (LMWH) for long-term therapy of venous thromboembolism (VTE) in patients without cancer has not been consistently evaluated. Methods: We used the data in the RIETE registry to compare the 3-month outcomes (VTE recurrences, major bleeding or death) in non-cancer patients with VTE, according to long-term therapy with LMWH or vitamin K antagonists (VKAs). Results: As of March 2018, 14,582 non-cancer patients with VTE had received initial therapy with LMWH and then switched to VKAs, while 9151 were prescribed LMWH for initial and long-term therapy. Overall, 11,494 had initially presented with pulmonary embolism (PE) and 12,239 with isolated deep vein thrombosis (DVT). Among 11,494 patients initially presenting with PE, 84 had VTE recurrences, 204 major bleeding and 406 died. Among 12,239 patients with isolated DVT, 133 developed VTE recurrences, 137 bled and 289 died. On propensity score analysis, PE patients on long-term LMWH therapy were at increased risk for PE recurrences (OR: 3.30; 95%CI: 1.67–6.48), major bleeding (OR: 1.68; 95%CI: 1.21–2.32) or death (OR: 3.16; 95%CI: 2.43–4.09) compared with those receiving VKAs. In patients with DVT, those on long-term LMWH also were at increased risk for PE recurrences (OR: 2.31; 95%CI: 1.13–4.73), major bleeding (OR 2.28; 95%CI: 1.51–3.44) or death (OR: 2.32; 95%CI: 1.54–3.51). Conclusions: In the RIETE non-cancer patients with VTE, long-term therapy with VKAs was associated with a lower risk for recurrences, major bleeding or death