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(1) Background: Evidence regarding Non-Alcoholic Fatty Liver Disease (NAFLD) diagnosis is limited in the context of patients with gallstone disease (GD). This study aimed to assess the predictive potential of conventional clinical and biochemical variables as combined models for diagnosing NAFLD in patients with GD. (2) Methods: A cross-sectional study including 239 patients with GD and NAFLD diagnosed by ultrasonography who underwent laparoscopic cholecystectomy and liver biopsy was conducted. Previous clinical indices were also determined. Predictive models for the presence of NAFLD stratified by biological sex were obtained through binary logistic regression and sensitivity analyses were performed. (3) Results: For women, the model included total cholesterol (TC), age and alanine aminotransferase (ALT) and showed an area under receiver operating characteristic curve (AUC) of 0.727 (p < 0.001), sensitivity of 0.831 and a specificity of 0.517. For men, the model included TC, body mass index (BMI) and aspartate aminotransferase (AST), had an AUC of 0.898 (p < 0.001), sensitivity of 0.917 and specificity of 0.818. In both sexes, the diagnostic performance of the designed equations was superior to the previous indices. (4) Conclusions: These models have the potential to offer valuable guidance to healthcare providers in clinical decision-making, enabling them to achieve optimal outcomes for each patient.
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The synthesis of partially substituted silicon hydroxyapatite (Si-HAp) nanopowders was systematically investigated via the microwave-assisted hydrothermal process. The experiments were conducted at 150 °C for 1 h using TMAS (C4H13NO5Si2) as a Si4+ precursor. To improve the Si4+ uptake in the hexagonal structure, the Si precursor was supplied above the stoichiometric molar ratio (0.2 M). The concentration of the TMAS aqueous solutions used varied between 0.3 and 1.8 M, corresponding to saturation levels of 1.5-9.0-fold. Rietveld refinement analyses indicated that Si incorporation occurred in the HAp lattice by replacing phosphate groups (PO43-) with the silicate (SiO4-) group. FT-IR and XPS analyses also confirmed the gradual uptake of SiO4- units in the HAp, as the saturation of Si4+ reached 1.8 M. TEM observations confirmed that Si-HAp agglomerates had a high crystallinity and are constituted by tiny rod-shaped particles with single-crystal habit. Furthermore, a reduction in the particle growth process took place by increasing the Si4+ excess content up to 1.8 M, and the excess of Si4+ triggered the fine rod-shaped particles self-assembly to form agglomerates. The agglomerate size that occurred with intermediate (0.99 mol%) and large (12.16 mol%) Si contents varied between 233.1 and 315.1 nm, respectively. The excess of Si in the hydrothermal medium might trigger the formation of the Si-HAp agglomerates prepared under fast kinetic reaction conditions assisted by the microwave heating. Consequently, the use of microwave heating-assisted hydrothermal conditions has delivered high processing efficiency to crystallize Si-HAp with a broad content of Si4+.
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INTRODUCTION AND OBJECTIVE: Non-Alcoholic Fatty Liver Disease (NAFLD) is a metabolic liver disease related to insulin resistance, which requires invasive methods for diagnosis. The aim of this study was to analyze whether the use of an algorithm involving both clinical indices and hepatic ultrasound measurements improves the accuracy for the non-invasive diagnosis of NAFLD. PATIENTS AND METHODS: Cross-sectional study with patients undergoing elective cholecystectomy. We collected anthropometric, metabolic, liver biopsy, and liver ultrasonography data. We calculated unpaired t-test and Pearson's coefficient, and areas under the receiver-operating characteristic curves (AUROC) for the Fatty Liver Index (FLI), Lipid Accumulation Product (LAP) indexes, right liver index diameter, and for predictive models constructed with discriminant analysis. RESULTS: One hundred patients in groups with and without NAFLD. FLI, LAP, right and caudate liver lobe diameters, and congestion index were higher in NAFLD group (pâ¯=â¯0.011, pâ¯=â¯0.011, pâ¯=â¯0.001, pâ¯=â¯0.027, pâ¯=â¯0.009). The right liver lobe diameter had the highest AUROC. Predictive models that combined sensitivity and specificity for the clinical indexes and liver ultrasound had an AUROC over 0.7. CONCLUSION: The ultrasonography measure of right liver lobe diameter by itself can reliably identify patients with NAFLD with a good sensitivity and specificity, however, this can be improved by adding the LAP mathematical index in our population.
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Algoritmos , Fígado/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/diagnóstico , Ultrassonografia/métodos , Adulto , Estudos Transversais , Feminino , Humanos , Testes de Função Hepática , Masculino , Curva ROCRESUMO
In recent years, there has been a transformation in the value chain of different industrial sectors, like the electricity networks, with the appearance of smart grids. Currently, the underlying knowledge in raw data coming from numerous devices can mark a significant competitive advantage for utilities. It is the case of the Advanced Metering Infrastructure (AMI). Such technology gets user consumption characteristics at levels of detail that were previously not possible. In this context, the terms big data and data analytics become relevant, which are tools that allow using large volumes of information and the generation of valuable knowledge from raw data that can support data-driven decisions for operating on the grid. This paper presents the results of the big data implementation and data analytics techniques in a case study with smart metering data from the city of London. Implemented big data and data analytic techniques to show how to understand user consumption patterns on a broader horizon, the relationships with seasonal variables identify behaviors related to specific events and atypical consumptions. This knowledge helps support decision making about improving demand response programs and, in general, the planning and operation of the Smart Grid.
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PURPOSE: To describe a case of choroidal malignant melanoma in a child without ocular melanocytosis. METHODS: A 6-year-old girl presented with misalignment of the right eye of a few weeks' duration. Visual acuity was counting fingers in the right eye and 20/20 in the left eye. Ophthalmoscopy of the right eye revealed a well defined choroidal mass in the macular region measuring 10 mm in diameter with overlying subretinal fluid. Ultrasonography revealed that the mass was 10.1 mm thick with choroidal excavation. On the basis of clinical and ultrasonographic findings, the diagnosis was choroidal melanoma without ocular melanocytosis. The eye was enucleated. RESULTS: Histopathologic examination revealed malignant melanoma of the choroid. There was not extrascleral extension. CONCLUSION: Choroidal malignant melanoma can occur in young patients, even in the absence of melanocytosis.
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PURPOSE: To report an unusual large turbid detachment of the retinal pigment epithelium (RPE) overlying a hidden choroidal nevus. METHODS: Case report. RESULTS: A 51-year-old woman was referred with an asymptomatic yellow subretinal mass in the left eye presumed to represent a choroidal metastasis or melanoma. Visual acuity was 20/20 in both eyes. Ophthalmoscopy of the left eye revealed a well defined, abruptly elevated, dome-shaped amelanotic lesion temporal to the macular area measuring 4 mm in basal dimension and 2.2 mm in thickness. There was no evidence of drusen, inflammation, or hemorrhage. Fluorescein angiography and optical coherence tomography suggested RPE detachment from unknown cause. After 6 years follow-up, the RPE detachment resolved, exposing an underlying chronic choroidal nevus as the etiology. CONCLUSIONS: Choroidal nevus can produce an overlying RPE detachment that completely obscures the underlying lesion.
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BACKGROUND: Cystic neoplasms of the pancreas represent between 5% and 10% of all pancreatic tumors. Due to their malignant potential, surgery is indicated. Because of the uncommon nature of this pathology, the aim of this study was to present a series of six patients who were operated on for a cystic tumor and to analyze the morphological characteristics, surgical experience and follow-up. METHODS: This was a retrospective study. Clinical files were studied, as well as surgical and pathological registries from patients diagnosed with cystic neoplasms of the pancreas. Five females and one male were included with a mean age of 54 +/- 15 years. The main symptom was abdominal pain. RESULTS: Clinical course and CT scan results were the criteria for suspecting the diagnosis. In 4/6 patients, the tumor was located within the body and tail of the pancreas. The most frequent intervention was distal pancreatectomy. There was no mediate operative mortality in a 30-day period. Histopathological diagnoses were three serum cystadenomas, two mucinous cystadenomas and one cystadenocarcinoma. After a 4-year follow-up, no tumor recurrences have been reported in the surviving patients. CONCLUSIONS: The natural history of cystic neoplasms of the pancreas is generally benign, but complications may occur by direct invasion of neighboring structures. Clinical course, tomography, pancreatography and punction are fundamental for its treatment.
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Cistadenocarcinoma/diagnóstico , Cistadenoma Mucinoso/diagnóstico , Cistadenoma/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Dor Abdominal/etiologia , Adulto , Idoso , Colangiopancreatografia Retrógrada Endoscópica , Cistadenocarcinoma/patologia , Cistadenocarcinoma/cirurgia , Cistadenoma/patologia , Cistadenoma/cirurgia , Cistadenoma Mucinoso/patologia , Cistadenoma Mucinoso/cirurgia , Diagnóstico Diferencial , Duodenoscopia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Pancreatectomia , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Pseudocisto Pancreático/diagnóstico , Indução de Remissão , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: Cystic neoplasms of the pancreas represent between 5% and 10% of all pancreatic tumors. Due to their malignant potential, surgery is indicated. Because of the uncommon nature of this pathology, the aim of this study was to present a series of six patients who were operated on for a cystic tumor and to analyze the morphological characteristics, surgical experience and follow-up. METHODS: This was a retrospective study. Clinical files were studied, as well as surgical and pathological registries from patients diagnosed with cystic neoplasms of the pancreas. Five females and one male were included with a mean age of 54 +/- 15 years. The main symptom was abdominal pain. RESULTS: Clinical course and CT scan results were the criteria for suspecting the diagnosis. In 4/6 patients, the tumor was located within the body and tail of the pancreas. The most frequent intervention was distal pancreatectomy. There was no mediate operative mortality in a 30-day period. Histopathological diagnoses were three serum cystadenomas, two mucinous cystadenomas and one cystadenocarcinoma. After a 4-year follow-up, no tumor recurrences have been reported in the surviving patients. CONCLUSIONS: The natural history of cystic neoplasms of the pancreas is generally benign, but complications may occur by direct invasion of neighboring structures. Clinical course, tomography, pancreatography and punction are fundamental for its treatment.