Factors predicting mortality after tips for refractory ascites: a single center experience

Introduction: Transjugular intrahepatic porto-systemic shunt (TIPS) is an accepted indication for treating refractory ascites. Different models have been proposed for the prediction of survival after TIPS; aim of present study was to evaluate the factors associated with mortality after TIPS for refractory ascites. Methods: Seventy-three consecutive patients undergoing a TIPS for refractory ascites in our centre between 2003 and 2008, were prospectively recorded in a database ad were the subject of the study. Mean follow-up was 17±2 months. Forty patients were awaiting liver transplantation (LT) and 12 (16.4%) underwent LT during follow-up. Results: Mean MELD at the moment of TIPS was 15.7±5.3. Overall mortality was 23.3% (n=17) with a mean survival after TIPS of 17±14 months. MELD score (B=0.161, p=0.042), AST (B= 0.020, p=0.090) and pre-TIPS HVPG (B=0.016, p=0.093) were independent predictors of overall mortality. On multivariate analysis MELD (B=0.419, p=0.018) and pre-TIPS HVPG (B=0.223, p=0.060) independently predicted 1 year survival. Patients were stratified into categories of death risk, using ROC curves for the variables MELD and HVPG. Patients with MELD<10 had a low probability of death after TIPS (n=6, 16% mortality); patients with HVPG <16 mmHg (n=6) had no mortality. Maximum risk of death was found in patients with MELD score 19 (n=16, 31% mortality) and in those with HVPG 25 mmHg (n=27, 26% mortality). Conclusions: TIPS increases overall survival in patients with refractory ascites. Liver function (assessed by MELD), necroinflammation (AST) and portal hypertension (HVPG) are independent predictors of survival; patients with MELD>19 and HVPG>25 mmHg are at highest risk of death after TIPS

Ion implantation of organic thin films and electronic devices

Organic semiconductors have great promise in the field of electronics due to their low cost in term of fabrication on large areas and their versatility to new devices, for these reasons they are becoming a great chance in the actual technologic scenery. Some of the most important open issues related to these materials are the effects of surfaces and interfaces between semiconductor and metals, the changes caused by different deposition methods and temperature, the difficulty related to the charge transport modeling and finally a fast aging with time, bias, air and light, that can change the properties very easily. In order to find out some important features of organic semiconductors I fabricated Organic Field Effect Transistors (OFETs), using them as characterization tools. The focus of my research is to investigate the effects of ion implantation on organic semiconductors and on OFETs. Ion implantation is a technique widely used on inorganic semiconductors to modify their electrical properties through the controlled introduction of foreign atomic species in the semiconductor matrix. I pointed my attention on three major novel and interesting effects, that I observed for the first time following ion implantation of OFETs: 1) modification of the electrical conductivity; 2) introduction of stable charged species, electrically active with organic thin films; 3) stabilization of transport parameters (mobility and threshold voltage). I examined 3 different semiconductors: Pentacene, a small molecule constituted by 5 aromatic rings, Pentacene-TIPS, a more complex by-product of the first one, and finally an organic material called Pedot PSS, that belongs to the branch of the conductive polymers. My research started with the analysis of ion implantation of Pentacene films and Pentacene OFETs. Then, I studied totally inkjet printed OFETs made of Pentacene-TIPS or PEDOT-PSS, and the research will continue with the ion implantation on these promising organic devices.

Transport Properties and Novel Sensing Applications of Organic Semiconducting Crystals

The present thesis is focused on the study of Organic Semiconducting Single Crystals (OSSCs) and crystalline thin films. In particular solution-grown OSSC, e.g. 4-hdroxycyanobenzene (4HCB) have been characterized in view of their applications as novel sensors of X-rays, gamma-rays, alpha particles radiations and chemical sensors. In the field of ionizing radiation detection, organic semiconductors have been proposed so far mainly as indirect detectors, i.e. as scintillators or as photodiodes. I first study the performance of 4HCB single crystals as direct X-ray detector i.e. the direct photon conversion into an electrical signal, assessing that they can operate at room temperature and in atmosphere, showing a stable and linear response with increasing dose rate. A dedicated study of the collecting electrodes geometry, crystal thickness and interaction volume allowed us to maximize the charge collection efficiency and sensitivity, thus assessing how OSSCs perform at low operating voltages and offer a great potential in the development of novel ionizing radiation sensors. To better understand the processes generating the observed X-ray signal, a comparative study is presented on OSSCs based on several small-molecules: 1,5-dinitronaphthalene (DNN), 1,8-naphthaleneimide (NTI), Rubrene and TIPS-pentacene. In addition, the proof of principle of gamma-rays and alpha particles has been assessed for 4HCB single crystals. I have also carried out an investigation of the electrical response of OSSCs exposed to vapour of volatile molecules, polar and non-polar. The last chapter deals with rubrene, the highest performing molecular crystals for electronic applications. We present an investigation on high quality, millimeter-sized, crystalline thin films (10 – 100 nm thick) realized by exploiting organic molecular beam epitaxy on water-soluble substrates. Space-Charge-Limited Current (SCLC) and photocurrent spectroscopy measurements have been carried out. A thin film transistor was fabricated onto a Cytop® dielectric layer. The FET mobility exceeding 2 cm2/Vs, definitely assess the quality of RUB films.