Unclassified autoimmune pancreatitis mimicking pancreatic cancer

A 24-year-old black male presented with a 1-week obstructive jaundice and intermittent abdominal pain, with no significant weight loss and an unsuspicious abdominal exam. Blood chemistry showed a cholestatic pattern but a complete immunological and tumoral panel (anti-smooth muscle antibody, anti-mitochondrial antibody, anti-nuclear antibody, anti-neutrophil cytoplasmic antibody, anti-Smith, anti-double-stranded-DNA antibody (anti-dsDNA), complement C3/C4, carcinoembryonic antigen, CA 19-9 and IgG4) were all within normal limits. Abdominal ultrasound revealed dilatation of the intra and extra-hepatic bile ducts. CT scan showed an abnormal dilatation of the distal bile duct but no focal enlargement of the head of the pancreas. Endoscopic ultrasound suggested an inflammatory process but the magnetic resonance cholangio-pancreatography favored a neoplastic obstruction of the distal common bile duct. Fine-needle aspiration cytology was insufficient for definitive diagnosis and the patient underwent major surgery. Follow-up with mild exocrine pancreatic insufficiency treated with enzyme replacement.info:eu-repo/semantics/publishedVersio

Alimentação parentérica: monografia: nutrição parentérica: indicações, modalidades e suas complicações

Trabalho realizado no contexto do estágio de Cuidados Intensivos do Internato Médico Complementar, sob orientação de Isabel SerraA nutrição parentérica pode ser definida como o aporte, por via endovenosa, de nutrientes. Pode ser considerada parcial se fornece apenas uma parte dos nutrientes ou total se o aporte contém as quantidades adequadas de todos os nutrientes essenciais. A necessidade da sua utilização depende de 2 factores: a gravidade da agressão e o grau de desnutrição

Plasmonic polyaniline/gold nanorods hybrid composites for selective NIR photodetection: Synthesis and characterization

Abstract In this study, we present the development of polyaniline/gold nanorod nanocomposites and the effect of the nanorods' aspect ratio and concentration on the overall electrical conductivity of nanocomposite systems. The electrical characterization showed that at the same atomic gold concentration, the conductivity of the nanocomposites increased by about 14% after increasing the gold nanorods' aspect ratio from 2.9 to 3.8. Furthermore, the conductivity of the nanocomposites increases linearly with the concentration of atomic gold, keeping the nanorods' aspect ratio stable, due to increasing the metallic content. The interaction between polyaniline and gold nanorods was investigated by FTIR, micro Raman, and XPS spectroscopic techniques, indicating the delocalization of the charges across the polymer chains induced by the incorporation of the nanorods. The interaction most likely occurs through the imine nitrogen of the polymer's backbone. The homogenous distribution of the gold nanorods in the polyaniline matrix was verified by TEM. Furthermore, the selective photosensitivity of the developed nanocomposites to NIR light was examined, and an increase in their current density was detected when the nanocomposites were irradiated at the wavelength that coincides with the longitudinal plasmonic resonance absorption of the incorporated nanorods. We foresee applications of the developed nanocomposites in numerous optoelectronic sectors

Photochemical synthesis: Effect of UV irradiation on gold nanorods morphology

Abstract Gold nanorods (AuNRs) were synthesized by photochemical method, through irradiation of a reaction solution, containing gold precursor, surfactant and a mild reducing agent to speed up the process. The effects of the irradiation parameters on the morphology of the formed AuNRs were investigated by UV–Vis absorption spectra and transmission electron microscopy. Specifically, the control of the UV irradiance (irradiation power per unit area) and irradiation time allowed the preparation of AuNRs with a wide range of sizes. Increase of the irradiation power leads to the formation of smaller AuNRs, with concomitant decrease of length and diameter. Since both axes show a simultaneous size decrease, the produced AuNRs have increased aspect ratio. Overall we show that application of high UV irradiance for short times favors the synthesis of small AuNRs with increased anisotropy. We propose that the rise of the irradiation power primarily accelerates the reduction of the gold precursor, promoting in such way the formation of smaller seeds. Short irradiation times guard against dissolution effects on the formed nanorods

Transmesocolic hernia with sigmoid colon strangulation without surgical history: a series of two case reports.

The incidence of internal hernias is rare (0.2-0.9%). The prevalence of intestinal obstruction for an internal hernia is low (0.5-5%), however if strangulation is present the overall mortality is higher than 50%. There are multiple places where an internal hernia may be localized, with transmesenteric: transmesocolic (8%) and transomental (1-4%) as the rarest. We report a series of two cases (men with 40 years-old and women with 92 years old) of volvulus of colon sigmoid in a strangulated transverse and descendent transmesocolic hernia, with one case associated also to a transomental hernia. Both patients were submitted to a Hartmann procedure and on follow-up remained free of complains. In conclusion, transmesenteric internal hernia should be included as diagnosis hypothesis for intestinal occlusion and if the diagnosis is made, the patient should be submitted to emergency surgery due to high rates of complications, high morbidity and mortality.info:eu-repo/semantics/publishedVersio

Effect of precursor solution dark incubation on gold nanorods morphology

Abstract Gold nanorods were synthesized in an aqueous solution of hexadecyltrimethylammonium bromide via a combination of chemical reduction and UV photoirradiation. Gold ligand complexes, present in the stock solution, are initially reduced, by ascorbic acid as mild reducing agent. The gold ions nucleation and colloid growth proceeds then by subsequent UV irradiation of the so-obtained precursor solution. We present a systematic study of the effect of incubation of the precursor solution on the dispersion state and aspect ratio of the produced nanorods. Incubation of the precursor solution allows the synthesis of higher aspect ratio nanorods with narrower size distribution compared to those obtained without incubation. We propose a mechanism for the gold nanorods formation including two stages, a nucleation and a diffusive growth. This allows us to explain the synthesis improvement as a consequence of the increase in the size of the gold ligand complexes aggregates, leading to a decrease of the nanorods growth rate

Adult intussusception: a single-center 10-year experience

Background Adult intussusception (AI) is a rare condition, usually with a lead point, and for which surgery is the treatment of choice. Given the risks and possible complications of untreated AI, an accurate preoperative diagnosis is of the utmost importance. Although AI remains difficult to diagnose, computerized tomography (CT) is presently considered the best diagnostic tool. Methods Sixteen patients of 20 years and older with intraoperative diagnosis of intussusception, who underwent surgery between January 2000 and December 2009, were reviewed retrospectively. Patients were assessed concerning clinical presentation, imagiological findings, surgical treatment, and postoperative histological evaluation. Results Most patients (93.8 %) were admitted via emergency room (ER) due to abdominal pain. Fourteen (87.5 %) AI cases showed an underlying organic cause, e.g., masses or tumors. The most frequent comorbidities were Peutz–Jeghers syndrome (PJS; 18.8 %) and HIV (12.5 %). Eight (50.0 %) intussusceptions were ileocolic and six (37.5 %) were in the small bowel. Total 43.8 % of lesions were malignant. Preoperative diagnosis of intussusception was possible in 50.0 % of cases by ultrasonography (US) and in 81.8 % by CT. US showed no predictive value concerning intussusception location. Total 27.3 % of CTs correctly identified the location, but only 9 % accurately identified the lead point. Conclusions We propose that all AI cases should be treated with surgical resection without attempting reduction, even when no lead point is detected by imaging studies, and this approach should be based on the oncological criteria. CT can be regarded as the most accurate diagnostic tool for intussusception, although its predictive value concerning location and lead point is still far from ideal