Impact of postoperative complications on clinical and economic consequences in pancreatic surgery

Filip ?e?ka,Bohumil Jon,Eva ?ermakova,Zden?k ?ubrt,Alexander Ferko 대한외과학회 2015 Annals of Surgical Treatment and Research Vol.90 No.1

Purpose: Patients who develop complications consume a disproportionately large share of available resources in surgery; therefore the attention of healthcare funders focuses on the economic impact of complications. The main objective of this work was to assess the clinical and economic impact of postoperative complications in pancreatic surgery, and furthermore to assess risk factors for increased costs. Methods: In all, 161 consecutive patients underwent pancreatic resection. The costs of the treatment were determined and analyzed. Results: The overall morbidity rate was 53.4%, and the in-hospital mortality rate was 3.7%. The median of costs for all patients without complication was 3,963 Euro, whereas the median of costs for patients with at least one complication was significantly increased at 10,670 Euro (P < 0.001). In multivariate analysis American Society of Anesthesiologists ≥ 3 (P = 0.006), multivisceral resection (P < 0.001) and any complication (P < 0.001) were independently associated with increased costs. Conclusion: Postoperative complications are associated with an increase in mortality, length of hospital stay, and hospital costs. The treatment costs increase with the severity of the postoperative complications. Those factors that are known to increase the treatment costs in pancreatic resection should be considered when planning patients for surgery.

Poster Session : PS 0316 ; Hematology : A Case of Pancytopenia

( Filipe Filipe ),( Joana Martins ),( Catarina Espirito Santo ),( Ligia Peixoto ),( Ines Vendrell ),( Helena Luna Pais ),( Alba Acabado ),( Paulo Cantiga Duarte ),( Jose Braz Nogueira ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Megaloblastosis represents a wide group of disorders sharing a common pathophysiological pathway, due to defi cient intake or absorption of Vitamin B12 and folic acid. Major causes for this condition include alcoholism, achlorhydria, pernicious anemia or gastrectomy and celiac disease. It leads to abnormal DNA replication, impaired protein synthesis and nuclear maturation. It presents with macrocytosis, hypersegmented neutrophils, and elevated Lactate dehydrogenase (LDH) levels. It is more prevalent in underdeveloped countries and older populations, having similar gender distribution. Authors present the case of a 69-year-old man, with a previous known history of essential thrombocytosis, medicated with hydroxyurea (with irregular adherence to treatment), congestive heart failure and chronic alcoholism. He was admitted at the emergency room (ER) with symptoms of confusion, slurred speech and fatigue for a week. He presented mucosal palor, fever (38. 1ºC), splenomegaly, and a left lateral maleolar ulcer with a purulent exsudate. Blood values revealed pancytopenia (macrocytic anemia Hb 4. 1 g/dL and MCV 123 fi); Leukocytes 1110x106/L; Platelet count 30. 000x106/L), acute renal failure (blood urea nitrogen 97 mg/dL; creatinine 2. 5 mg/ dL) LDH 1545 U/L. He underwent blood transfusions at the ER, without previous iron tests screening. On subsequent evaluation, authors found levels of Vitamin B12 of 172 pg/mL and folate 0. 9 nmol/L. Patient underwent a bone marrow aspiration with bone biopsy, compatible with megaloblastic anemia. An endoscopy was performed, with histological fi ndings suggestive of atrophic gastritis, with no H. pylori bacilli found. Additional tests such as anti-gastric parietal cells antibodies and anti-intrinsic factor antibodies, were negative. The patient was medicated with Vitamin B12 injections and folic acid, with good reticulocitary response. At discharge he presented, blood values of Hb 8. 7 g/dL; Leukocytes 7110x106/L; and platelet count of 862. 000x106/L. This represents a case of severe pancytopenia, enhancing the relevance of megaloblastosis as differential diagnosis for this entity.

Speaker Dependent Coefficients for Speaker Recognition

Filip Orsag 보안공학연구지원센터 2010 International Journal of Security and Its Applicat Vol.4 No.1

Impact of postoperative complications on clinical and economic consequences in pancreatic surgery

Filip Čečka,Bohumil Jon,Eva Čermáková,Zdeněk Šubrt,Alexander Ferko 대한외과학회 2016 Annals of Surgical Treatment and Research(ASRT) Vol.90 No.1

Purpose: Patients who develop complications consume a disproportionately large share of available resources in surgery; therefore the attention of healthcare funders focuses on the economic impact of complications. The main objective of this work was to assess the clinical and economic impact of postoperative complications in pancreatic surgery, and furthermore to assess risk factors for increased costs. Methods: In all, 161 consecutive patients underwent pancreatic resection. The costs of the treatment were determined and analyzed. Results: The overall morbidity rate was 53.4%, and the in-hospital mortality rate was 3.7%. The median of costs for all patients without complication was 3,963 Euro, whereas the median of costs for patients with at least one complication was significantly increased at 10,670 Euro (P < 0.001). In multivariate analysis American Society of Anesthesiologists ≥ 3 (P = 0.006), multivisceral resection (P < 0.001) and any complication (P < 0.001) were independently associated with increased costs. Conclusion: Postoperative complications are associated with an increase in mortality, length of hospital stay, and hospital costs. The treatment costs increase with the severity of the postoperative complications. Those factors that are known to increase the treatment costs in pancreatic resection should be considered when planning patients for surgery

Redox Mediators in CO₂-assisted Li-O₂ Batteries: Performance Enhancement and Mechanistic Studies

( Filipe Marques Mota ),변혜령,김동하 한국공업화학회 2020 한국공업화학회 연구논문 초록집 Vol.2020 No.-

While replacing O₂ with air reflects a critical step towards the practical application of Li-air batteries, the present CO₂ alters the O₂ chemistry. In the tetraglyme-electrolyte, minor CO₂ reflected a swift shift towards the formation of Li₂CO₃, requiring impracticable recharge potentials (4.5 V). In our recent study, we revealed that a Br₃ ^-/Br₂ redox mediator could successfully suppress the overcharge potential. Hindered overcharges (~0.5 V) driven by electrochemically-generated Br₂ were found to be a function of the LiBr concentration and the insulating Li₂CO₃ structure. Coupled electrochemical and spectroscopic analyses shed light on the involved redox shuttling steps and unveiled the prominent presence of soluble Br₂···Br₃ ^- loosely-bound anionic complexes at progressive states-of-charge.

Thermolectric ZnO:Al,Ga thin films

Filipe CORREIA,Luis REBOUTA,Maria BENELMEKKI,Carlos TAVARES 한국진공학회 2016 한국진공학회 학술발표회초록집 Vol.2016 No.8

Assessing the effect of CO₂ in Li-O₂/CO₂ Batteries with Tetraglyme Electrolyte

( Filipe Marques Mota ),변혜령,김동하 한국공업화학회 2019 한국공업화학회 연구논문 초록집 Vol.2019 No.1

Reflecting the languished research state of Li-O₂, alternative devices operating under CO₂ or O₂/CO₂ with analogously high theoretical energy density have gained recent attraction. Here, we assess the effect of CO₂ within a 5 to 100% range in Li-O₂/CO₂. In the LiTFSI/tetraglyme electrolyte, the reaction mechanism is swiftly shifted toward the formation of Li₂CO₃ even at 5% CO₂. Conspicuous product and intermediate species identification and quantification are presented. Tuning the CO₂ content is shown to offer superior cyclability, deterred byproduct formation with enhanced electrolyte stability, and extended discharge capacity (1.5-fold), correlated with an induced stabilization of metastable CO₄^-/C₂O₆^2- intermediates in tetraglyme. These findings highlight the promise of a shift in the underlying mechanism of Li-air cells upon CO₂ incorporation on conventional O₂-based devices.

Automated identification of the modal parameters of a cable-stayed bridge: Influence of the wind conditions

Filipe Magalhães,Álvaro Cunha 국제구조공학회 2016 Smart Structures and Systems, An International Jou Vol.17 No.3

This paper was written in the context of a benchmark study promoted by The Hong Kong Polytechnic University using data samples collected in an instrumented cable-stayed bridge. The main goal of the benchmark test was to study the identification of the bridge modes of vibration under different wind conditions. In this contribution, the tools developed at ViBest/FEUP for automated data processing of setups collected by dynamic monitoring systems are presented and applied to the data made available in the context of the benchmark study. The applied tools are based on parametric output only modal identification methods combined with clustering algorithms. The obtained results demonstrate that the proposed algorithms succeeded to automatically identify the modes with relevant contribution for the bridge response under different wind conditions.

Localization of transient events in dispersive medium by attack time and filter bank analysis

Filip FRANEK(플필립),JunGu KANG(강준구),SungUk CHOI(최성욱),JongHo LEE(이종호) 한국소음진동공학회 2015 한국소음진동공학회 학술대회논문집 Vol.2015 No.4

Localization of vibration events in structural systems is a challenge due to character of propagating waves in dispersive medium, in which bending waves propagate with a frequency dependent speed of sound. This property of solid materials is adverse for time of arrival methods used in non-dispersive medium. The proposed ideas tackle the problem of various propagation speed of each frequency component. The first method using attack time and magnitude information detects the change of envelope that is position dependent and becomes flatter and longer further from the origin of vibration. This envelope shape can be extracted by signal manipulation that obtains positive and smoothed magnitude envelope of the original signal or it can accumulate the signal from which the slope information can be obtained, and signals can be ranked. Second method utilize standard techniques for time estimation as triggering, and cross-correlation, but it separates the signals into multiple frequency bands beforehand as was suggested by White. The results give more detailed information about closeness of sound sources since there is not only a simple integer order to indicate the closeness of sensors from the vibration origin, whereas a histogram of each method is obtained by feeding the methods through the filter banks.

Mapping mechanistic pathways driven by the effect of a Br₃^-/Br₂ redox promoter in CO₂-assisted Li-O₂ Batteries

( Filipe Marques Mota ),변혜령,김동하 한국공업화학회 2019 한국공업화학회 연구논문 초록집 Vol.2019 No.1

Rechargeable Li-air cells operating under CO₂ or O₂/CO₂ offer alternative mechanistic pathways with analogously high theoretical energy density. The Li-O₂/CO₂ cell in tetraglyme electrolyte suffers from recharge potentials at ~4.5 V required for the decomposition of the main discharge product, Li₂CO₃. In this work we assess the promise of incorporating a Br₃^-/Br₂ redox promoter. Hindered overcharges (~0.5 V) driven by electrochemically-generated Br₂ are revealed to be a function of the LiBr concentration and the insulating Li₂CO₃ structure. Coupled electrochemical and spectroscopic analyses at progressive states-of-charge are proposed as a seminal methodology to dissect the underlying complexity of involved redox shuttling steps and evaluate the appropriateness of redox mediators beyond an overcharge decrease.