Electroactive -poly(vinylidene fluoride) membranes were obtained by isothermal crystallization from the solution. Different morphologies and microstructures were obtained by crystallizing at different temperatures. The mechanism and kinetics of solvent evaporation from the polymeric solution were investigated using isothermal thermogravimetric analysis. The kinetic parameters and the activation energy were also 2 calculated. The solvent evaporation is ruled by two steps, related with a metastableunstable -metastable transition in the solution phase diagram. Scanning electron microscopy revealed the porous structure and the variations of the morphology with the variation of the isothermal evaporation temperature. Finally, the infrared spectroscopy measurements confirm that the polymer crystallizes in the electroactive -phase of PVDF.
Background and Aim
The RHEMITT score (Renal disease; Heart failure; Endoscopic findings; Major bleeding; Incomplete SBCE; Tobacco; Treatment by enteroscopy) was the first score to accurately predict the individual risk of small bowel rebleeding after capsule endoscopy (SBCE). The aim of the study is on the prospective validation of the RHEMITT score.
Methods
Cohort of consecutive patients with mid‐gastrointestinal bleeding (MGIB) submitted to SBCE and followed prospectively, during at least 12 months, since 2017 until 2020. Rebleeding was defined as an overt bleeding event (melena or hematochezia) or a hemoglobin decrease of at least 2 g/dL. The RHEMITT score was calculated for each patient and the rebleeding rates compared. The performance of the score was tested by calculating the area under curve of the receiver operator characteristic curve. A rebleeding‐free survival was assessed, corresponding to the period between the date of SBCE and the date of the first post‐SBCE rebleeding event.
Results
We included 162 patients, 102 (62.9%) were female, with a mean age of 64 years old. The sensitivities and specificities of the score grades for predicting rebleeding were as following: for low‐risk patients, 0% (0–10%) and 28.8% (21.1–36.5%); for intermediate‐risk patients, 23.3% (8.2–38.4%) and 72% (64.3–79.7%); for high‐risk patients, 76.7% (61.6–91.8%) and 99.2% (97.7–100%), corresponding to an area under curve of the receiver operator characteristic of 0.988 (P < 0.001). Kaplan–Meyer plots were statistically different according to the attributed risk (log‐rank P value <0.001; Breslow–Wilcoxon P value <0.001).
Conclusion
The RHEMITT score performed with excellent discriminative power in predicting rebleeding risk, and we herewith propose a surveillance of MGIB patients guided by the RHEMITT score.
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