Purpose
Predicting postoperative complications and mortality is important to plan the surgical strategy. Different scores have been proposed before to predict them but none of them have been yet ...implemented into the routine clinical practice because their difficulties and low accuracy with new surgical strategies and enhanced recovery. The main aim of this study is to identify risk factors for postoperative morbidity and mortality after colonic resection (CR) without protective stomas, in order to develop a comprehensive, up-to-date, simple, reliable, and applicable model for the preoperative assessment of patients with colon cancer.
Methods
Multivariable analysis was performed to identify risk factors for 60-day morbidity and mortality. Coefficients derived from the regression model were used in the nomograms to predict morbidity and mortality.
Results
Three thousand one hundred ninety-three patients from 52 hospitals were included into the analysis. Sixty-day postoperative complications rate was 28.3% and the mortality rate was 3%. In multivariable analysis the independent risk factors for postoperative complications were age, male gender, liver and pulmonary diseases, obesity, preoperative albumin, anticoagulant treatment, open surgery, intraoperative complications, and urgent surgery. Independent risk factors for mortality were age, preoperative albumin anticoagulant treatment, and intraoperative complications.
Conclusions
Risk factors for morbidity and mortality after CR for cancer were identified and two easy predictive tools were developed. Both of them could provide important information for preoperative consultation and surgical planning in the time of enhance recovery.
Immunocytochemistry against neuropeptides contained within primary afferent neurons was used to study the morphology and distribution of intraepidermal free nerve endings in cat facial skin. ...Calcitonin gene-related peptide (CGRP) and substance P (SP) immunoreactivity was found in similar intraepidermal nerve endings of cat glabrous and hairy skin epithelia. The greatest density of immunoreactive intraepidermal nerve endings was located in the nose epidermis. Small limited areas with immunoreactive intraepidermal nerve endings were also found in facial hairy skin.
The indirect immunofluorescence technique to detect endogenous C-flanking peptide of neuropeptide Y (NPY), C-PON, in combination with NADPH-diaphorase (NADPH-d) histochemistry, were applied to the ...same sections to establish whether C-PON containing cell bodies in the rat striatum can be labelled by their content of NADPH-diaphorase activity. NADPH-diaphorase activity proved to be a reliable marker for these positive C-PON neurons. Our results suggest that, in the rat striatum, C-PON, SOM and NPY co-exist in the same cells.
Metal complexes bearing carbene ligands LnM=CR1R2 are relevant intermediates in catalytic transformations. The stability of isolated carbene complexes decreases for the case of monosubstituted ...carbenes (R1 = H). We have discovered that the copper complex TpMsCu(C(H)NEt2) (1) readily transfers the aminocarbene :C(H)NEt2 to other complexes of metals, such as rhodium, iridium, palladium, platinum, copper, or gold, leading to complexes bearing the M–C(H)NEt2 moiety. Experimental data allow us to propose that this monosubstituted aminocarbene (MAC) ligand displays a nucleophilicity similar to that of NHC (N-Heterocyclic Carbene) ligands bearing bulky substituents but it has a considerably lower volume. These features allow unprecedented reactivity patterns, such as the generation of the first stable monosubstituted carbene adduct of Rh2(OAc)4, a well-known catalyst for carbene transfer reactions. Density functional theory (DFT) studies carried out on the transfer of the MAC ligand from TpMsCu(C(H)NEt2) to trans-PdCl2(NCMe)(PPh3) led us to ascertain that the transmetalation process involves several intermediates in which the TpMs ligand shifts between the κ2 and κ3 coordination modes.
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•An isolable carbene copper complex readily transfers a monosubstituted carbene ligand (MAC)•Several G9–G11 metal complexes bearing this MAC ligand have been isolated•Nucleophilicity of MAC is similar to bulky NHC ligands despite its much-reduced volume
Carbenes are a class of ligands with exceptional importance in transition-metal chemistry, not only from a structural perspective but also for their key role in catalytic transformations. N-heterocyclic carbenes and diaminocarbenes are ubiquitous in metal-catalyzed reactions that form new C–C or C–X bonds. Here, we introduce a simple system based on an isolable copper compound bearing a monosubstituted aminocarbene ligand (MAC) that transfers such that moiety to other metal centers at room temperature within minutes, leading to the formation of the corresponding metal-MAC derivatives. This ligand displays exceptional properties because it is highly nucleophilic like other very bulky carbenes but with a quite reduced size, opening new ways to tailor carbene-metal catalysts.
A general protocol for the transmetalation of the monosubstituted carbene ligand (MAC) is reported, with MAC being similar in nucleophilicity to bulky NHC ligands but with a significant difference in volume.
One of the most aggressive microorganisms in infective endocarditis (IE) is Staphylococcus aureus. We analyse the resistance of S. aureus to antibiotics and its impact on the clinical course of IE in ...a recent 15-year period.
Retrospective study of patients with IE in a university hospital from 2005 to 2019. Bivariate and multivariate analysis of severity at admission, comorbidities, minimum inhibitory concentrations (MIC) and mortality.
Of the 293 IE cases, 66 (22.5%) were due to S. aureus, and 21 (7.2%) were methicillin-resistant S. aureus (MRSA). The prevalence of strains with a MIC to vancomycin ≥ 1mg/L increased from 4.8% to 63.6% (p <0.001) and the cases of MRSA from 38 to 27.3% (p = 0.045). Older age (p= 0.02), comorbidity (p <0.01) and nosohusial origin (p = 0.01), were factors associated with MRSA. But the antimicrobial resistance and severity on admission were not associated with exitus; predictive factors were the right-sided IE (OR = 0.08; 95% CI: 0.01-0.51), comorbidities (OR per Charlson index point = 1.30; 95% CI: 1.01-1.69) and creatinine on admission (OR per mg / dL = 1.56; 95% CI = 1.01- 2.35; p = 0.04).
We have experienced an increase in IE cases with MIC to vancomycin ≥ 1mg/L, without significant variation in infections due to MRSA. Antimicrobial resistance was not associated with mortality, but comorbidity and left involvement were predictive factors.
Light and electron microscopic immunocytochemistry was used to study certain cell groups in the posteromedial thalamus which contain galanin-immunoreactive (GAL-IR) fibers. The nuclei ...subparafascicularis pars parvicellularis (SPFpc) and parafascicularis (PF) contain a dense network of GAL-IR fibers which form basketlike structures around unstained cells. The periventricular area also contains numerous GAL-IR fibers and these also occasionally form basketlike structures. The GAL-IR terminal fields continue caudally in the mesodiencephalic junction and merge with other GAL-IR fibers in the dorsal aspects of the substantia nigra and around the dorsolateral tip of the medial lemniscus. Ultrastructural analysis of the GAL-IR basketlike structures revealed that GAL-IR terminals make numerous synapses with the cell bodies and proximal dendrites of SPFpc neurones. These results suggest that the activity of cells in the SPFpc and PF nuclei may be strongly influenced by galanin-containing nerve fibers probably originating in the spinal cord.
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