Simultaneous biliary drainage and portal vein embolization before extended hepatectomy for hilar cholangiocarcinoma: preliminary experience.

BACKGROUND: Patients with resectable hilar cholangiocarcinoma often present obstructive jaundice and a small future remnant liver (FRL) ratio. A sequential approach comprising preoperative biliary drainage followed by portal vein embolization (PVE) is usually performed but leads to long preoperative management (6-12 weeks) before patients can undergo resection. To simplify and shorten this phase of liver preparation, we developed a new preoperative approach that involves percutaneous biliary drainage and PVE during the same procedure. We report the outcomes of this combined procedure. METHODS: During 1 year, four patients underwent simultaneous biliary drainage and PVE followed 1 month later by surgical resection of hilar cholangiocarcinoma. Liver volumes were assessed by CT before, and 1, and 3 months after the combined procedure. Serum liver enzymes were assessed before and 1 month after the combined procedure. RESULTS: The combined procedure was feasible in all cases, with no related complications. After the combined procedure, transaminases remained stable or decreased, whereas gamma-glutamyl-transpeptidase, alkaline phosphatase, and bilirubin decreased. During the first month, the left lobe volume increased by +27.9 % (range 19-40.9 %). The FRL ratio increased from 24.9 to 33.2 %. All patients underwent R0 liver resection with a favorable postoperative outcome. The remnant liver volume increased by +132 % (range 78-245 %) between 1 and 3 months. CONCLUSIONS: Simultaneous percutaneous biliary drainage and PVE is feasible. This all-in-one preoperative approach greatly decreases waiting time until surgical resection. These encouraging results warrant further investigation to confirm the safety and to evaluate the reduction in the dropout rate for liver resection in this tumor with poor prognosis.

Sistema de gestió de subhastes per a un portal Immobiliari

Desenvolupament de un sistema de gestió de subhastes per aun portal immobiliari i s¿engloba dintre de l¿àrea de Java Enterprise Edition.

Pressure ulcer prevention

This leaflet provides information on pressure ulcers, how they develop and the steps patients and carers can take to prevent them.

Anàlisi i disseny d'un portal Web per a un club d'escacs

Aquest treball de final de carrera vol fer una anàlisi de les necessitats de publicació de continguts i serveis a Internet d'un club d'escacs. Pel que fa a la implementació, l'objectiu es desenvolupar un portal web base, amb una tecnologia que permeti que el client pugui implementar la totalitat de les funcionalitats previstes en un futur.

Anàlisi i Estudi del Portal www.paeria.es

Aquest treball té com objectiu realitzar una aproximació als projectes web des del punt de vista de la InteraccióHumana amb els Ordinadors, el Disseny Centrat en l¿Usuari i la Usabilitat, tenint en compte i aplicant en cada cas, la seva metodologia pròpia.

Biomphalaria tenagophila: dynamics of populations of resistant and susceptible strains to Schistosoma mansoni, with or without pressure of the parasite

Resistant (Taim, RS) and susceptible albino (Joinville, SC) Biomphalaria tenagophila populations were kept together, at different proportions, throughout a 18-month-period. Some of the snail groups were submitted to Schistosoma mansoni infection. The targets of this study were (a) to analyze the populational dynamics among resistant and susceptible individuals to S. mansoni; (b) to study the resistance phenotype in descendants of cross-breeding; (c) to observe whether the parasite could exert any kind of selection in those snail populations. Throughout the experiment it could be observed that the susceptible B. tenagophila strain (Joinville) underwent a selective pressure of the parasite that was negative, since the individuals showed a high mortality rate. Although B. tenagophila (Taim) population presented a higher mortality rate without pressure of the parasite, this event was compensated by a reproductive capacity. B. tenagophila Taim was more fecund than B. tenagophila Joinville and was able to transmit the resistance character to their descendants. F1 generation obtained by cross-breeding between resistant and susceptible lineages was completely resistant to S. mansoni infection, irrespective of the Taim proportion. Moreover, less than 5% of F2 progeny were susceptible to S. mansoni infection.

Portal web per la gestió d'incidències informàtiques

Memòria del projecte final de carrera sobre la creació d'un portal web per gestionar i enregistrar les incidències informàtiques sobre els clients d'una empresa consultora.

Inmuebles : portal de anuncios inmobiliarios en Java EE

Definición, análisis, diseño e implementación de un portal basado en la arquitectura Java EE que sintetiza los conocimientos adquiridos en la carrera de Ingeniería Técnica de Sistemas cursada en la UOC.

Desarrollo de un portal web con el CMS DotNetNuke

Memoria, presentación en vídeo y producto desarrollado del trabajo/proyecto fin de Carrera de la titulación de Ingeniería en Informática, consistente en la realización de un portal web para una pyme ficticia de nombre VendetArte dedicada a la representación de artesanos. El portal web ha sido desarrollado con el gestor de contenidos (CMS) DotNetNuke que trabaja bajo plataforma .NET

TFC J2EE : Anàlisi, disseny i implementació d'un portal fent servir l'arquitectura J2EE

Els objectius generals d'aquest projecte són bàsicament crear un portal amb l'arquitectura struts de j2ee que permeti una comunicació dinàmica dins el món del submarinisme.

Issues in blood pressure control and the potential role of single-pill combination therapies.

Hypertension (HTN) is a major risk factor for cardiovascular mortality, yet only a small proportion of hypertensive individuals receive appropriate therapy and achieve target blood pressure (BP) values. Factors influencing the success of antihypertensive therapy include physicians' acceptance of guideline BP targets, the efficacy and tolerability of the drug regimen, and patient compliance and persistence with therapy. It is now well recognised that most hypertensive patients require at least two antihypertensive agents to achieve their target BP. However, complicated treatment regimens are a major contributory factor to poor patient compliance. The use of combination therapy for HTN offers a number of advantages over the use of monotherapy, including improved efficacy, as drug combinations with a synergistic mechanism of action can be used. This additive effect means that lower doses of the individual components can be used, which may translate into a decreased likelihood of adverse events. The use of single-pill combination therapy, in which two or more agents are combined in a single dosage form, offers all the benefits of free combination therapy (improved efficacy and tolerability over monotherapy) together with the added benefit of improved patient compliance because of the simplified treatment regimen. The use of single-pill combination therapy may also be associated with cost savings compared with the use of free combinations for reasons of cheaper drug costs, fewer physician visits and fewer hospitalisations for uncontrolled HTN and cardiovascular events. Thus, the use of single-pill combination therapy for HTN should help improve BP goal attainment through improved patient compliance, leading to reduced costs for cardiovascular-related care.

Portal de Licitación Industrial

Un portal comunitari configurat de tal manera que asseguri el flux, la privadesa i confidencialitat de la informació. Les eines del portal no són res de nou: Fòrum públic i privat, gestió de fitxers, flux d'informació, calendari d'esdeveniments i configuracions de grups (i.g. Proveïdors de confiança); la novetat està en l'enfocament.

Desarrollo de librería Django para desarrollo de RIAs e implementación de zona privada de portal web sminn.com

El presente proyecto consiste en dos partes bien diferencias: terminar la funcionalidad prevista para el portal web sminn.com en forma de su sección privada para profesionales y experimentar la evolución de dicho portal a una aplicación web compleja tipo "single page RIA" implementando una librería a liberar que ayude al desarrollo de dicho tipo de aplicaciones. De esta forma la primera parte aportará conocimiento de diseño y desarrollo para diferentes aspectos de un portal web estándar sobre Django y la segunda parte aportará un recurso que evolucionará junto a la comunidad de software libre. Dentro del experimento de uso de la librería para una siguiente versión del portal web sminn.com se proponela realización de pruebas de interfaz adaptable.