From Physiology to Prevention: Further remarks on a physiological imperative

Directory of Open Access Journals (Sweden)

B Jouanjean

2012-05-01

Full Text Available Physiology, is the fundamental and functional expression of life. It is the study of all the representative functions of Man in all his capacities, and in particular, his capacity to work. It is very possible to establish a link between a physiological and physiopathological state, the capacity of work and the economy, which can be understood as the articulation between the physiological capacities of Man and the production of work. If these functions are innately acquired by Man they are likewise maintained by regulatory functions throughout life. The stability of these regulatory mechanisms represent the state of good health. The management of this state, constitutes Primary Prevention where both chronic and acute physiopathology defines an alteration in these regulatory mechanisms. We deduce from this reasoning that a tripartite management adapted to the physiological situation is viable and that by choosing parameters specific to individual and collective behavior, it is possible to inject, and combine, at each level and to each demand in order to budget a healthcare system in a more balanced and equitable way. 

Ecology of Exercise in Wild Fish: Integrating Concepts of Individual Physiological Capacity, Behavior, and Fitness Through Diverse Case Studies.

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Brownscombe, Jacob W; Cooke, Steven J; Algera, Dirk A; Hanson, Kyle C; Eliason, Erika J; Burnett, Nicholas J; Danylchuk, Andy J; Hinch, Scott G; Farrell, Anthony P

2017-08-01

Wild animals maximize fitness through certain behaviors (e.g., foraging, mating, predator avoidance) that incur metabolic costs and often require high levels of locomotor activity. Consequently, the ability of animals to achieve high fitness often relies on their physiological capacity for exercise (aerobic scope) and/or their ability to acquire and utilize energy judiciously. Here, we explore how environmental factors and physiological limitations influence exercise and metabolism in fish while foraging, migrating to spawning grounds, and providing parental care. We do so with three case studies that use a number of approaches to studying exercise in wild fish using biologging and biotelemetry platforms. Bonefish (Albula vulpes) selectively use shallow water tropical marine environments to forage when temperatures are near optimal for aerobic scope and exercise capacity. Bonefish energy expenditure at upper thermal extremes is maximal while activity levels diminish, likely caused by reduced aerobic scope. Pacific salmon (Oncorhynchus spp.) reproductive migrations frequently involve passage through hydraulically challenging areas, and their ability to successfully pass these regions is constrained by their physiological capacity for exercise. Aerobic scope and swim performance are correlated with migration difficulty among sockeye salmon (O. nerka) populations; however, depletion of endogenous energy stores can also limit migration success. In another example, male smallmouth bass (Micropterus dolomieu) allocate a significant amount of energy to nest-guarding behaviors to protect their developing brood. Smallmouth bass body size, endogenous energy reserves, and physiological state influence nest-guarding behaviors and reproductive success. We suggest that in some scenarios (e.g., bonefish foraging, Pacific salmon dam passage) metabolic capacity for exercise may be the strongest determinant of biological fitness, while in others (e.g., long distance salmon migration

Dietary fibers from mushroom Sclerotia: 2. In vitro mineral binding capacity under sequential simulated physiological conditions of the human gastrointestinal tract.

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Wong, Ka-Hing; Cheung, Peter C K

2005-11-30

The in vitro mineral binding capacity of three novel dietary fibers (DFs) prepared from mushroom sclerotia, namely, Pleurotus tuber-regium, Polyporous rhinocerus, and Wolfiporia cocos, to Ca, Mg, Cu, Fe, and Zn under sequential simulated physiological conditions of the human stomach, small intestine, and colon was investigated and compared. Apart from releasing most of their endogenous Ca (ranged from 96.9 to 97.9% removal) and Mg (ranged from 95.9 to 96.7% removal), simulated physiological conditions of the stomach also attenuated the possible adverse binding effect of the three sclerotial DFs to the exogenous minerals by lowering their cation-exchange capacity (ranged from 20.8 to 32.3%) and removing a substantial amount of their potential mineral chelators including protein (ranged from 16.2 to 37.8%) and phytate (ranged from 58.5 to 64.2%). The in vitro mineral binding capacity of the three sclerotial DF under simulated physiological conditions of small intestine was found to be low, especially for Ca (ranged from 4.79 to 5.91% binding) and Mg (ranged from 3.16 to 4.18% binding), and was highly correlated (r > 0.97) with their residual protein contents. Under simulated physiological conditions of the colon with slightly acidic pH (5.80), only bound Ca was readily released (ranged from 34.2 to 72.3% releasing) from the three sclerotial DFs, and their potential enhancing effect on passive Ca absorption in the human large intestine was also discussed.

Heart Rate Variability: New Perspectives on Physiological Mechanisms, Assessment of Self-regulatory Capacity, and Health risk.

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McCraty, Rollin; Shaffer, Fred

2015-01-01

Heart rate variability, the change in the time intervals between adjacent heartbeats, is an emergent property of interdependent regulatory systems that operates on different time scales to adapt to environmental and psychological challenges. This article briefly reviews neural regulation of the heart and offers some new perspectives on mechanisms underlying the very low frequency rhythm of heart rate variability. Interpretation of heart rate variability rhythms in the context of health risk and physiological and psychological self-regulatory capacity assessment is discussed. The cardiovascular regulatory centers in the spinal cord and medulla integrate inputs from higher brain centers with afferent cardiovascular system inputs to adjust heart rate and blood pressure via sympathetic and parasympathetic efferent pathways. We also discuss the intrinsic cardiac nervous system and the heart-brain connection pathways, through which afferent information can influence activity in the subcortical, frontocortical, and motor cortex areas. In addition, the use of real-time HRV feedback to increase self-regulatory capacity is reviewed. We conclude that the heart's rhythms are characterized by both complexity and stability over longer time scales that reflect both physiological and psychological functional status of these internal self-regulatory systems.

Cardiac rehabilitation increases physical capacity but not mental health after heart valve surgery

DEFF Research Database (Denmark)

Sibilitz, Kirstine L.; Berg, Selina K.; Rasmussen, Trine B.

2016-01-01

Objective: The evidence for cardiac rehabilitation after valve surgery remains sparse. Current recommendations are therefore based on patients with ischaemic heart disease. The aim of this randomised clinical trial was to assess the effects of cardiac rehabilitation versus usual care after heart......-educational consultations (intervention) versus usual care without structured physical exercise or psycho-educational consultations (control). Primary outcome was physical capacity measured by VO2 peak and secondary outcome was self-reported mental health measured by Short Form-36. Results: 76% were men, mean age 62 years......, with aortic (62%), mitral (36%) or tricuspid/pulmonary valve surgery (2%). Cardiac rehabilitation compared with control had a beneficial effect on VO2 peak at 4 months (24.8 mL/kg/min vs 22.5 mL/kg/min, p=0.045) but did not affect Short Form-36 Mental Component Scale at 6 months (53.7 vs 55.2 points, p=0...

Mitochondrial Physiology in the Major Arbovirus Vector Aedes aegypti: Substrate Preferences and Sexual Differences Define Respiratory Capacity and Superoxide Production

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Soares, Juliana B. R. Correa; Gaviraghi, Alessandro; Oliveira, Marcus F.

2015-01-01

Adult females of Aedes aegypti are facultative blood sucking insects and vectors of Dengue and yellow fever viruses. Insect dispersal plays a central role in disease transmission and the extremely high energy demand posed by flight is accomplished by a very efficient oxidative phosphorylation process, which take place within flight muscle mitochondria. These organelles play a central role in energy metabolism, interconnecting nutrient oxidation to ATP synthesis, but also represent an important site of cellular superoxide production. Given the importance of mitochondria to cell physiology, and the potential contributions of this organelle for A. aegypti biology and vectorial capacity, here, we conducted a systematic assessment of mitochondrial physiology in flight muscle of young adult A. aegypti fed exclusively with sugar. This was carried out by determining the activities of mitochondrial enzymes, the substrate preferences to sustain respiration, the mitochondrial bioenergetic efficiency and capacity, in both mitochondria-enriched preparations and mechanically permeabilized flight muscle in both sexes. We also determined the substrates preferences to promote mitochondrial superoxide generation and the main sites where it is produced within this organelle. We observed that respiration in A. aegypti mitochondria was essentially driven by complex I and glycerol 3 phosphate dehydrogenase substrates, which promoted distinct mitochondrial bioenergetic capacities, but with preserved efficiencies. Respiration mediated by proline oxidation in female mitochondria was strikingly higher than in males. Mitochondrial superoxide production was essentially mediated through proline and glycerol 3 phosphate oxidation, which took place at sites other than complex I. Finally, differences in mitochondrial superoxide production among sexes were only observed in male oxidizing glycerol 3 phosphate, exhibiting higher rates than in female. Together, these data represent a significant step

Effects of foot reflexology on anxiety and physiological parameters in patients undergoing coronary artery bypass graft surgery: A clinical trial.

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Abbaszadeh, Yaser; Allahbakhshian, Atefeh; Seyyedrasooli, Alehe; Sarbakhsh, Parvin; Goljarian, Sakineh; Safaei, Naser

2018-05-01

This study aimed to investigate the effect of foot reflexology on anxiety and physiological parameters in patients after CABG surgery. This was a single-blind, three-arm, parallel-group, randomized controlled trial with three groups of 40 male patients undergoing CABG. Participants were placed in three groups, named intervention, placebo, and control. Physiological parameters were measured including systolic and diastolic blood pressure, mean arterial pressure, heart rate, respiratory rate, percutaneous oxygen saturation, and anxiety of participants. Results showed a statistically significant difference between intervention and control groups in terms of the level of anxiety (p foot reflexology may be used by nurses as an adjunct to standard ICU care to reduce anxiety and stabilize physiological parameters such as systolic, diastolic, mean arterial pressure, and heart rate. Copyright © 2018 Elsevier Ltd. All rights reserved.

Physiologic effects of bowel preparation

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Holte, Kathrine; Nielsen, Kristine Grubbe; Madsen, Jan Lysgård

2004-01-01

PURPOSE: Despite the universal use of bowel preparation before colonoscopy and colorectal surgery, the physiologic effects have not been described in a standardized setting. This study was designed to investigate the physiologic effects of bowel preparation. METHODS: In a prospective study, 12...

Improved cardiac function and exercise capacity following correction of pectus excavatum: a review of current literature.

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Maagaard, Marie; Heiberg, Johan

2016-09-01

Patients with pectus excavatum (PE) often describe improvements in exercise stamina following corrective surgery. Studies have investigated the surgical effect on physiological parameters; still, no consensus has yet been reached. Therefore, the aim of this literature review was to describe the cardiac outcome after surgical correction, both at rest and during exercise. In February 2016, a detailed search of the databases PubMed, Medline, and EMBASE was performed. We assessed clinical studies that described cardiac outcomes both before and after surgical correction of PE. We only included studies reporting either pre-defined echocardiographic or exercise test parameters. No exclusion criteria or statistical analyses were applied. Twenty-one full-text articles, published between 1972 and 2016, were selected, with cohort-ranges of 3-168 patients, mean age-ranges of 5-33 years, and mean follow-up-ranges from immediately to 4 years after surgery. Twelve studies described resting cardiac parameters. Four studies measured cardiac output, where one described 36% immediate increase after surgery, one reported 15% increase after Nuss-bar removal and two found no difference. Three studies demonstrated improvement in mean stroke volume ranges of 22-34% and two studies found no difference. Fifteen studies investigated exercise capacity, with 11 considering peak O 2 pr. kg, where five studies demonstrated improvements with the mean ranging from 8% to 15% after surgery, five studies demonstrated no difference, and one saw a decrease of 19% 3 months after Nuss-bar implantation. A measurable increase in exercise capacity exists following surgery, which may be caused by multiple factors. This may be owed to the relief of compressed cardiac chambers with the increased anterior-posterior thoracic dimensions, which could facilitate an improved filling of the heart. With these results, the positive physiological impact of the surgery is emphasized and the potential gain in cardiac

Sub-xyphoid pleural drain as a determinant of functional capacity and clinical results after off-pump coronary artery bypass surgery: a randomized clinical trial.

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Guizilini, Solange; Alves, Daniel F; Bolzan, Douglas W; Cancio, Andreia S A; Regenga, Marisa M; Moreira, Rita S L; Trimer, Renata; Gomes, Walter J

2014-09-01

The aim of this trial was to compare functional capacity, pulmonary shunt fraction and clinical outcomes between patients undergoing pleurotomy with a pleural drain inserted in the sub-xyphoid position and patients with a pleural drain placed in the intercostal position after off-pump coronary artery bypass surgery. Patients were randomized into two groups according to the pleural drain site: Group II (n = 33 intercostal pleural drain); and Group SI (n = 35 sub-xyphoid pleural drain). Functional capacity was assessed by the distance covered on the 6-min walking test performed preoperatively and on postoperative day (POD) 5; in addition, pulmonary function test was determined preoperatively and on POD 1 and 5. Pulmonary shunt fraction was evaluated preoperatively and on POD 1, and clinical outcomes were recorded throughout the study. Group SI had better preservation of lung volumes and capacities in POD compared with Group II (P Pulmonary shunt fraction increased in both groups postoperatively; however, Group SI showed a smaller pulmonary shunt fraction (0.26 ± 0.04 vs 0.21 ± 0.04%; P = 0.0014). Functional capacity was significantly reduced in both groups on POD 5; however, Group SI showed better preservation of functional capacity (P = 0.0001). Group SI had better postoperative clinical results, with lower incidence of atelectasis and pleural effusion (P capacity and exercise tolerance with a smaller pulmonary shunt fraction and improved clinical outcomes compared with intercostal pleural drainage after off-pump coronary artery bypass surgery. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Using Castration Surgery in Male Rats to Demonstrate the Physiological Effects of Testosterone on Seminal Vesicle Anatomy in an Undergraduate Laboratory Setting

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Belanger, Rachelle M.; Conant, Stephanie B.; Grabowski, Gregory M.

2013-01-01

Rats can be used as a model organism to teach physiological concepts in a laboratory setting. This article describes a two-part laboratory that introduces students to hypothesis testing, experimental design, the appropriate use of controls and surgical techniques. Students perform both a castration and sham-control surgery on male rats and test…

[Present situation and prospect of enhanced recovery after surgery in pancreatic surgery].

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Feng, Mengyu; Zhang, Taiping; Zhao, Yupei

2017-05-25

Enhanced recovery after surgery is a multimodal perioperative strategy according to the evidence-based medicine and multidisciplinary collaboration, aiming to improve the restoration of functional capacity after surgery by reducing surgical stress, optimal control of pain, early oral diet and early mobilization. Compared with other sub-specialty in general surgery, pancreatic surgery is characterized by complex disease, highly difficult procedure and more postoperative complications. Accordingly, pancreatic surgery shares a slow development in enhanced recovery after surgery. In this review, the feasibility, safety, application progress, prospect and controversy of enhanced recovery after surgery in pancreatic surgery are discussed.

Sinus Surgery

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... sinus computed tomography (CT) scan (without contrast), nasal physiology (rhinomanometry and nasal cytology), smell testing, and selected ... altered anatomical landmarks, or where a patient’s sinus anatomy is very unusual, making typical surgery difficult. Image ...

Robust surgery loading

NARCIS (Netherlands)

Hans, Elias W.; Wullink, Gerhard; van Houdenhoven, Mark; Kazemier, Geert

2008-01-01

We consider the robust surgery loading problem for a hospital’s operating theatre department, which concerns assigning surgeries and sufficient planned slack to operating room days. The objective is to maximize capacity utilization and minimize the risk of overtime, and thus cancelled patients. This

[Proposal for a physiologic concept of thought based on the results of stereotaxic psychosurgery].

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Nádvorník, P; Pogády, J; Bernadic, M

2003-05-01

Authors have fifty years long experience with psychostereotactic surgery. On the bases of 209 operations of different types of mentally ill patients, authors built their own physiological conception of the central nervous system function. The new conception is described using block operators of thinking at the level of hypothalamus, limbic system, and neocortex in the hierarchic order. The basic physiological hypothalamic block contains two operators: stimulus evaluation and decision to act. Both operators together form reasonable, objective substantiation of thinking, which is transformed into psychological, subjective description at higher cerebral levels. New operator is added to the block diagram at the level of the limbic system: the choice of response base on experience stored in the high capacity memory. Vast neocortical memory creates a model of the individual world and it enables a new operator to be involved: prediction of the future events. Thinking, originally based on concrete images, is using abstract terms, subjected to the principles of grammar. Physiological basis of thinking enables the convergence of subjective and objective.

Prioritizing essential surgery and safe anesthesia for the Post-2015 Development Agenda: operative capacities of 78 district hospitals in 7 low- and middle-income countries.

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LeBrun, Drake G; Chackungal, Smita; Chao, Tiffany E; Knowlton, Lisa M; Linden, Allison F; Notrica, Michelle R; Solis, Carolina V; McQueen, K A Kelly

2014-03-01

Surgery has been neglected in low- and middle-income countries for decades. It is vital that the Post-2015 Development Agenda reflect that surgery is an important part of a comprehensive global health care delivery model. We compare the operative capacities of multiple low- and middle-income countries and identify critical gaps in surgical infrastructure. The Harvard Humanitarian Initiative survey tool was used to assess the operative capacities of 78 government district hospitals in Bangladesh (n = 7), Bolivia (n = 11), Ethiopia (n = 6), Liberia (n = 11), Nicaragua (n = 10), Rwanda (n = 21), and Uganda (n = 12) from 2011 to 2012. Key outcome measures included infrastructure, equipment availability, physician and nonphysician surgical providers, operative volume, and pharmaceutical capacity. Seventy of 78 district hospitals performed operations. There was fewer than one surgeon or anesthesiologist per 100,000 catchment population in all countries except Bolivia. There were no physician anesthesiologists in any surveyed hospitals in Rwanda, Liberia, Uganda, or in the majority of hospitals in Ethiopia. Mean annual operations per hospital ranged from 374 in Nicaragua to 3,215 in Bangladesh. Emergency operations and obstetric operations constituted 57.5% and 40% of all operations performed, respectively. Availability of pulse oximetry, essential medicines, and key infrastructure (water, electricity, oxygen) varied widely between and within countries. The need for operative procedures is not being met by the limited operative capacity in numerous low- and middle-income countries. It is of paramount importance that this gap be addressed by prioritizing essential surgery and safe anesthesia in the Post-2015 Development Agenda. Copyright © 2014 Mosby, Inc. All rights reserved.

Emergency surgery

DEFF Research Database (Denmark)

Stoneham, M; Murray, D; Foss, N

2014-01-01

National reports recommended that peri-operative care should be improved for elderly patients undergoing emergency surgery. Postoperative mortality and morbidity rates remain high, and indicate that emergency ruptured aneurysm repair, laparotomy and hip fracture fixation are high-risk procedures...... undertaken on elderly patients with limited physiological reserve. National audits have reported variations in care quality, data that are increasingly being used to drive quality improvement through professional guidance. Given that the number of elderly patients presenting for emergency surgery is likely...

COMPUTERS IN SURGERY

African Journals Online (AJOL)

BODE

Key words: Computers, surgery, applications. Introduction ... With improved memory, speed and processing power in an ever more compact ... with picture and voice embedment to wit. With the ... recall the tedium of anatomy, physiology and.

The effect of foot reflexology on physiologic parameters and mechanical ventilation weaning time in patients undergoing open-heart surgery: A clinical trial study.

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Ebadi, Abbas; Kavei, Parastoo; Moradian, Seyyed Tayyeb; Saeid, Yaser

2015-08-01

The aim of this study was to investigate the efficacy of foot reflexology on physiological parameters and mechanical ventilation weaning time in patients undergoing open-heart surgery. This was a double blind three-group randomized controlled trial. Totally, 96 patients were recruited and randomly allocated to the experimental, placebo, and the control groups. Study groups respectively received foot reflexology, simple surface touching, and the routine care of the study setting. Physiological parameters (pulse rate, respiratory rate, systolic and diastolic blood pressures, mean arterial pressure, percutaneous oxygen saturation) and weaning time were measured. The study groups did not differ significantly in terms of physiological parameters (P value > 0.05). However, the length of weaning time in the experimental group was significantly shorter than the placebo and the control groups (P value foot reflexology in shortening the length of weaning time. Copyright © 2015 Elsevier Ltd. All rights reserved.

SUSPENSION MICROLARYNGOSCOPIC SURGERY AND INDIRECT MICROLARYNGOSTROBOSCOPIC SURGERY FOR BENIGN LESIONS OF THE VOCAL FOLDS

NARCIS (Netherlands)

DIKKERS, FG; SULTER, AM

1994-01-01

A prospective study was designed to compare the effects on voice capacities after either suspension microlaryngoscopic surgery or indirect microlaryngostroboscopic surgery. Patients where the clinical diagnosis 'dysphonia due to a benign lesion of the vocal fold' was made, and who could be operated

Physiological mechanisms underlying animal social behaviour.

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Seebacher, Frank; Krause, Jens

2017-08-19

Many species of animal live in groups, and the group represents the organizational level within which ecological and evolutionary processes occur. Understanding these processes, therefore, relies on knowledge of the mechanisms that permit or constrain group formation. We suggest that physiological capacities and differences in physiology between individuals modify fission-fusion dynamics. Differences between individuals in locomotor capacity and metabolism may lead to fission of groups and sorting of individuals into groups with similar physiological phenotypes. Environmental impacts such as hypoxia can influence maximum group sizes and structure in fish schools by altering access to oxygenated water. The nutritional environment determines group cohesion, and the increase in information collected by the group means that individuals should rely more on social information and form more cohesive groups in uncertain environments. Changing environmental contexts require rapid responses by individuals to maintain group coordination, which are mediated by neuroendocrine signalling systems such as nonapeptides and steroid hormones. Brain processing capacity may constrain social complexity by limiting information processing. Failure to evaluate socially relevant information correctly limits social interactions, which is seen, for example, in autism. Hence, functioning of a group relies to a large extent on the perception and appropriate processing of signals from conspecifics. Many if not all physiological systems are mechanistically linked, and therefore have synergistic effects on social behaviour. A challenge for the future lies in understanding these interactive effects, which will improve understanding of group dynamics, particularly in changing environments.This article is part of the themed issue 'Physiological determinants of social behaviour in animals'. © 2017 The Author(s).

Expectations of Sinus Surgery

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... ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... reduce the pressure in your nose. Avoid strenuous exercise for the first 2 weeks after surgery. Also ...

Laboratory reptile surgery: principles and techniques.

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Alworth, Leanne C; Hernandez, Sonia M; Divers, Stephen J

2011-01-01

Reptiles used for research and instruction may require surgical procedures, including biopsy, coelomic device implantation, ovariectomy, orchidectomy, and esophogostomy tube placement, to accomplish research goals. Providing veterinary care for unanticipated clinical problems may require surgical techniques such as amputation, bone or shell fracture repair, and coeliotomy. Although many principles of surgery are common between mammals and reptiles, important differences in anatomy and physiology exist. Veterinarians who provide care for these species should be aware of these differences. Most reptiles undergoing surgery are small and require specific instrumentation and positioning. In addition, because of the wide variety of unique physiologic and anatomic characteristics among snakes, chelonians, and lizards, different techniques may be necessary for different reptiles. This overview describes many common reptile surgery techniques and their application for research purposes or to provide medical care to research subjects.

LEUKOCYTE COPING CAPACITY AS A TOOL TO ASSESS CAPTURE- AND HANDLING-INDUCED STRESS IN SCANDINAVIAN BROWN BEARS (URSUS ARCTOS).

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Esteruelas, Núria Fandos; Huber, Nikolaus; Evans, Alina L; Zedrosser, Andreas; Cattet, Marc; Palomares, Francisco; Angel, Martine; Swenson, Jon E; Arnemo, Jon M

2016-04-01

Brown bears (Ursus arctos) are often captured and handled for research and management purposes. Although the techniques used are potentially stressful for the animals and might have detrimental and long-lasting consequences, it is difficult to assess their physiological impact. Here we report the use of the leukocyte coping capacity (LCC) technique to quantify the acute stress of capture and handling in brown bears in Scandinavia. In April and May 2012 and 2013, we collected venous blood samples and recorded a range of physiological variables to evaluate the effects of capture and the added impact of surgical implantation or removal of transmitters and sensors. We studied 24 brown bears, including 19 that had abdominal surgery. We found 1) LCC values following capture were lower in solitary bears than in bears in family groups suggesting capture caused relatively more stress in solitary bears, 2) ability to cope with handling stress was better (greater LCC values) in bears with good body condition, and 3) LCC values did not appear to be influenced by surgery. Although further evaluation of this technique is required, our preliminary results support the use of the LCC technique as a quantitative measure of stress.

The Effect of Prolapse Surgery on Vaginal Sensibility

NARCIS (Netherlands)

Lakeman, Marielle M. E.; van der Vaart, C. Huub; Laan, Ellen; Roovers, Jan-Paul W. R.

Introduction. Prolapse surgery has been shown to have major impact on sexual function. Since prolapse surgery not only influences psychological factors but might also influence physiological conditions such as vaginal innervation, there is a need for objective outcome measurements to better

The Effect of Prolapse Surgery on Vaginal Sensibility

NARCIS (Netherlands)

Lakeman, Mariëlle M. E.; van der Vaart, C. Huub; Laan, Ellen; Roovers, Jan-Paul W. R.

2011-01-01

Introduction. Prolapse surgery has been shown to have major impact on sexual function. Since prolapse surgery not only influences psychological factors but might also influence physiological conditions such as vaginal innervation, there is a need for objective outcome measurements to better

Impact of preoperative change in physical function on postoperative recovery: argument supporting prehabilitation for colorectal surgery.

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Mayo, Nancy E; Feldman, Liane; Scott, Susan; Zavorsky, Gerald; Kim, Do Jun; Charlebois, Patrick; Stein, Barry; Carli, Francesco

2011-09-01

Abdominal surgery represents a physiologic stress and is associated with a period of recovery during which functional capacity is often diminished. "Prehabilitation" is a program to increase functional capacity in anticipation of an upcoming stressor. We reported recently the results of a randomized trial comparing 2 prehabilitation programs before colorectal surgery (stationary cycling plus weight training versus a recommendation to increase walking coupled with breathing exercises); however, adherence to the programs was low. The objectives of this study were to estimate: (1) the extent to which physical function could be improved with either prehabilitation program and identify variables associated with response; and (2) the impact of change in preoperative function on postoperative recovery. This study involved a reanalysis of data arising from a randomized trial. The primary outcome measure was functional walking capacity measured by the Six-Minute Walk Test; secondary outcomes were anxiety, depression, health-related quality of life, and complications (Clavien classification). Multiple linear regression was used to estimate the extent to which key variables predicted change in functional walking capacity over the prehabilitation and follow-up periods. We included 95 people who completed the prehabilitation phase (median, 38 days; interquartile range, 22-60), and 75 who were also evaluated postoperatively (mean, 9 weeks). During prehabilitation, 33% improved their physical function, 38% stayed within 20 m of their baseline score, and 29% deteriorated. Among those who improved, mental health, vitality, self-perceived health, and peak exercise capacity also increased significantly. Women were less likely to improve; low baseline walking capacity, anxiety, and the belief that fitness aids recovery were associated with improvements during prehabilitation. In the postoperative phase, the patients who had improved during prehabilitation were also more likely to have

Nontrauma emergency surgery: optimal case mix for general surgery and acute care surgery training.

Science.gov (United States)

Cherry-Bukowiec, Jill R; Miller, Barbra S; Doherty, Gerard M; Brunsvold, Melissa E; Hemmila, Mark R; Park, Pauline K; Raghavendran, Krishnan; Sihler, Kristen C; Wahl, Wendy L; Wang, Stewart C; Napolitano, Lena M

2011-11-01

To examine the case mix and patient characteristics and outcomes of the nontrauma emergency (NTE) service in an academic Division of Acute Care Surgery. An NTE service (attending, chief resident, postgraduate year-3 and postgraduate year-2 residents, and two physician assistants) was created in July 2005 for all urgent and emergent inpatient and emergency department general surgery patient consults and admissions. An NTE database was created with prospective data collection of all NTE admissions initiated from November 1, 2007. Prospective data were collected by a dedicated trauma registrar and Acute Physiology and Chronic Health Evaluation-intensive care unit (ICU) coordinator daily. NTE case mix and ICU characteristics were reviewed for the 2-year time period January 1, 2008, through December 31, 2009. During the same time period, trauma operative cases and procedures were examined and compared with the NTE case mix. Thousand seven hundred eight patients were admitted to the NTE service during this time period (789 in 2008 and 910 in 2009). Surgical intervention was required in 70% of patients admitted to the NTE service. Exploratory laparotomy or laparoscopy was performed in 449 NTE patients, comprising 37% of all surgical procedures. In comparison, only 118 trauma patients (5.9% of admissions) required a major laparotomy or thoracotomy during the same time period. Acuity of illness of NTE patients was high, with a significant portion (13%) of NTE patients requiring ICU admission. NTE patients had higher admission Acute Physiology and Chronic Health Evaluation III scores [61.2 vs. 58.8 (2008); 58.2 vs. 55.8 (2009)], increased mortality [(9.71% vs. 4.89% (2008); 6.78% vs. 5.16% (2009)], and increased readmission rates (15.5% vs. 7.4%) compared with the total surgical ICU (SICU) admissions. In an era of declining operative caseload in trauma, the NTE service provides ample opportunity for complex general surgery decision making and operative procedures for

Risk-adjusted scoring systems in colorectal surgery.

Science.gov (United States)

Leung, Edmund; McArdle, Kirsten; Wong, Ling S

2011-01-01

Consequent to recent advances in surgical techniques and management, survival rate has increased substantially over the last 25 years, particularly in colorectal cancer patients. However, post-operative morbidity and mortality from colorectal cancer vary widely across the country. Therefore, standardised outcome measures are emphasised not only for professional accountability, but also for comparison between treatment units and regions. In a heterogeneous population, the use of crude mortality as an outcome measure for patients undergoing surgery is simply misleading. Meaningful comparisons, however, require accurate risk stratification of patients being analysed before conclusions can be reached regarding the outcomes recorded. Sub-specialised colorectal surgical units usually dedicated to more complex and high-risk operations. The need for accurate risk prediction is necessary in these units as both mortality and morbidity often are tools to justify the practice of high-risk surgery. The Acute Physiology And Chronic Health Evaluation (APACHE) is a system for classifying patients in the intensive care unit. However, APACHE score was considered too complex for general surgical use. The American Society of Anaesthesiologists (ASA) grade has been considered useful as an adjunct to informed consent and for monitoring surgical performance through time. ASA grade is simple but too subjective. The Physiological & Operative Severity Score for the enUmeration of Mortality and morbidity (POSSUM) and its variant Portsmouth POSSUM (P-POSSUM) were devised to predict outcomes in surgical patients in general, taking into account of the variables in the case-mix. POSSUM has two parts, which include assessment of physiological parameters and operative scores. There are 12 physiological parameters and 6 operative measures. The physiological parameters are taken at the time of surgery. Each physiological parameter or operative variable is sub-divided into three or four levels with

Hormonal, metabolic and physiological effects of laparoscopic surgery using a detomidine-buprenorphine combination in standing horses.

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van Dijk, P; Lankveld, D P K; Rijkenhuizen, A B M; Jonker, F H

2003-04-01

To assess the hormonal, metabolic and physiological effects of laparascopic surgery performed under a sedative analgesic combination of detomidine and buprenorphine in standing horses. Prospective study. Eight healthy adult Dutch Warmblood horses and five healthy adult ponies undergoing laparoscopy were studied. Five healthy adult horses not undergoing laparoscopy were used as a control group. The sedative effect of an initial detomidine and buprenorphine injection was maintained using a continuous infusion of detomidine alone. The heart and respiratory rate, arterial blood pH and arterial oxygen and carbon dioxide tensions were monitored, while blood samples were taken for the measurement of glucose, lactate, cortisol, insulin and nonesterified fatty acids (NEFA). The same variables were monitored in a control group of horses which were sedated, but which did not undergo surgery. At the end of the sedation period the effects of detomidine were antagonized using atipamezole. The protocol provided suitable conditions for standing laparoscopy in horses. Laparoscopy induced obvious metabolic and endocrine responses which, with the exception of NEFA values, were not significantly different from changes found in the control group. While atipamezole did not produce detectable adverse effects, it is possible that anatagonism may not be essential. The technique described reliably produces adequate sedation and analgesia for laparoscopic procedures. The level of sedation/analgesia was controlled by decreasing or increasing the infusion rate. Antagonism of the effects of detomidine may not be necessary in all cases.

POSTOPERATIVE EFFECT OF PHYSICAL THERAPY RELATED TO FUNCTIONAL CAPACITY AND RESPIRATORY MUSCLE STRENGTH IN PATIENTS SUBMITTED TO BARIATRIC SURGERY.

Science.gov (United States)

Oliveira, Josélia Jucirema Jarschel de; Freitas, Alexandre Coutinho Teixeira de; Almeida, Andréa Adriana de

Respiratory physiotherapy plays an important role preventing complications in bariatric surgery. To assess the effects of out-patient physiotherapy during post-operative period through respiratory pressures and functional capacity in individuals submitted to bariatric surgery. A prospective longitudinal and controlled study was done in adults with body mass index (BMI) equal or greater than 40 kg/m², who have been submitted to bariatric surgery. They were divided into two groups: intervention-group, who performed out-patient physiotherapy twice a week, from thirty to sixty days after surgery; and the control-group, who only followed home instructions. Both groups were evaluated before surgery and sixty days after surgery through manovacuometry, six-minute walk test and the Borg Scale of perceived exertion. Twenty participants were included the intervention-group and twenty-three in the control-group. Both groups had significant and similar weight loss after surgery. The manovacuometry presented no differences comparing pre- and post-surgery and in the comparison between the groups. The result of the six-minute walk test for the intervention-group increased by 10.1% in the post-operative period in relation to pre-. The Borg scale of perceived exertion in the intervention-group in pre-surgery decreased by 13.5% in the post-surgery compared to pre-surgery. In the control-group there was no difference comparing pre- and post-operative values, as in the comparison with the intervention-group. The low-intensity exercise program, carried out between the 30th and the 60th day after bariatric surgery provided better functional capacity; did not change respiratory muscle strength; and improved the perceived exertion rate. A fisioterapia respiratória tem papel importante na prevenção das complicações da cirurgia bariátrica. Avaliar os efeitos da fisioterapia ambulatorial no pós-operatório através das pressões respiratórias e da capacidade funcional dos indiv

Use of a physiological profile to document motor impairment in ageing and in clinical groups.

Science.gov (United States)

Lord, S R; Delbaere, K; Gandevia, S C

2016-08-15

Ageing decreases exercise performance and is frequently accompanied by reductions in cognitive performance. Deterioration in the physiological capacity to stand, locomote and exercise can manifest itself as falling over and represents a significant deterioration in sensorimotor control. In the elderly, falling leads to serious morbidity and mortality with major societal costs. Measurement of a suite of physiological capacities that are required for successful motor performance (including vision, muscle strength, proprioception and balance) has been used to produce a physiological profile assessment (PPA) which has been tracked over the age spectrum and in different diseases (e.g. multiple sclerosis, Parkinson's disease). As well as measures of specific physiological capacities, the PPA generates an overall 'score' which quantitatively measures an individual's cumulative risk of falling. The present review collates data from the PPA (and the physiological capacities it measures) as well as its use in strategies to reduce falls in the elderly and those with different diseases. We emphasise that (i) motor impairment arises via reductions in a wide range of sensorimotor abilities; (ii) the PPA approach not only gives a snapshot of the physiological capacity of an individual, but it also gives insight into the deficits among groups of individuals with particular diseases; and (iii) deficits in seemingly restricted and disparate physiological domains (e.g. vision, strength, cognition) are funnelled into impairments in tasks requiring upright balance. Motor impairments become more prevalent with ageing but careful physiological measurement and appropriate interventions offer a way to maximise health across the lifespan. © 2015 The Authors. The Journal of Physiology © 2015 The Physiological Society.

Pattern of Neonatal Surgery at a Teaching Hospital in Nigeria: A ...

African Journals Online (AJOL)

Background: Neonatal surgeries are a particularly challenging aspect of paediatric surgery following the peculiar physiologic and metabolic demands of neonates. Surgery in the neonates therefore will require specific anaesthesia, analgesia, intraoperative and postoperative monitoring. There are a wide range of surgical ...

Fast-track surgery-an update on physiological care principles to enhance recovery

DEFF Research Database (Denmark)

Kehlet, Henrik

2011-01-01

INTRODUCTION: The concept of fast-track surgery (enhanced recovery programs) has been evolved and been documented to be successful by decreasing length of stay, morbidity and convalescence across procedures. FUTURE STRATEGIES: However, there are several possibilities for further improvement of mo...... of the components of fast-track surgery, where surgical stress, fluid and pain management are key factors. There is an urgent need for better design of studies, especially in minimal invasive surgery to achieve maximal outcome effects when integrated into the fast-track methodology....

Seawater acidification affects the physiological energetics and spawning capacity of the Manila clam Ruditapes philippinarum during gonadal maturation.

Science.gov (United States)

Xu, Xian; Yang, Feng; Zhao, Liqiang; Yan, Xiwu

2016-06-01

Ocean acidification is predicted to have widespread implications for marine bivalve mollusks. While our understanding of its impact on their physiological and behavioral responses is increasing, little is known about their reproductive responses under future scenarios of anthropogenic climate change. In this study, we examined the physiological energetics of the Manila clam Ruditapes philippinarum exposed to CO 2 -induced seawater acidification during gonadal maturation. Three recirculating systems filled with 600 L of seawater were manipulated to three pH levels (8.0, 7.7, and 7.4) corresponding to control and projected pH levels for 2100 and 2300. In each system, temperature was gradually increased ca. 0.3°C per day from 10 to 20°C for 30days and maintained at 20°C for the following 40days. Irrespective of seawater pH levels, clearance rate (CR), respiration rate (RR), ammonia excretion rate (ER), and scope for growth (SFG) increased after a 30-day stepwise warming protocol. When seawater pH was reduced, CR, ratio of oxygen to nitrogen, and SFG significantly decreased concurrently, whereas ammonia ER increased. RR was virtually unaffected under acidified conditions. Neither temperature nor acidification showed a significant effect on food absorption efficiency. Our findings indicate that energy is allocated away from reproduction under reduced seawater pH, potentially resulting in an impaired or suppressed reproductive function. This interpretation is based on the fact that spawning was induced in only 56% of the clams grown at pH 7.4. Seawater acidification can therefore potentially impair the physiological energetics and spawning capacity of R. philippinarum. Copyright © 2016 Elsevier Inc. All rights reserved.

Restoration of the jawline and the neck after bariatric surgery.

Science.gov (United States)

Sclafani, Anthony P

2005-02-01

Bariatric surgery can result in massive, rapid weight loss. Patients who undergo this surgery can be left with significant facial and neck skin redundancy and may request restorative facial plastic surgery. Optimal results require a thorough understanding of the unique physiologic, metabolic, and anatomic findings in these patients. Modifications of standard rhytidectomy techniques are necessary to suit the specific features of the patient after bariatric surgery.

Physiological capacity and physical testing in male elite team handball

DEFF Research Database (Denmark)

Michalsik, Lars Bojsen; Madsen, K.; Aagaard, P.

2015-01-01

and by subsequent physical testing. RESULTS: Mean heart rate and relative workload during match-play (N.=41) were 163 ± 5 beats·min⁻¹ (group means±SD) and 70.9 ± 6.0% of VO(2-max), respectively. Relative workload was lower (P... and high demands on the anaerobic energy systems during certain periods of the match. Indications of temporary fatigue and a subsequent decline in performance were observed, since the relative workload decreased both in the first and in the second half of the match. Physiological profiles and physical test......AIM: The aim of the present study was to examine the physical demands placed on male elite team handball players in relation to playing position. METHODS: Male elite team handball field players were evaluated during match-play over a six season time span using physiological measurements...

Pattern of Nerve Blocks for Upper Limb Surgery at the University of ...

African Journals Online (AJOL)

Background: Central and peripheral neural blockade techniques are popular for lower and upper limb surgeries respectively. Lower limb surgery is amenable to central neural blockade techniques, anatomical and physiological imperatives makes peripheral neural blockade more suited for upper limb surgeries. We looked ...

Role of Fibrin Sealants in Liver Surgery

NARCIS (Netherlands)

de Boer, Marieke T.; Boonstra, Elizabeth A.; Lisman, Ton; Porte, Robert J.

2012-01-01

Background: Fibrin sealants are widely used in liver surgery. The aim of this article is to review the literature on evidence of hemostatic and biliostatic capacities of different fibrin sealants in liver surgery. Methods: In PubMed, a literature search was done with the search terms 'fibrin

Eccentric Contraction-Induced Muscle Injury: Reproducible, Quantitative, Physiological Models to Impair Skeletal Muscle's Capacity to Generate Force.

Science.gov (United States)

Call, Jarrod A; Lowe, Dawn A

2016-01-01

In order to investigate the molecular and cellular mechanisms of muscle regeneration an experimental injury model is required. Advantages of eccentric contraction-induced injury are that it is a controllable, reproducible, and physiologically relevant model to cause muscle injury, with injury being defined as a loss of force generating capacity. While eccentric contractions can be incorporated into conscious animal study designs such as downhill treadmill running, electrophysiological approaches to elicit eccentric contractions and examine muscle contractility, for example before and after the injurious eccentric contractions, allows researchers to circumvent common issues in determining muscle function in a conscious animal (e.g., unwillingness to participate). Herein, we describe in vitro and in vivo methods that are reliable, repeatable, and truly maximal because the muscle contractions are evoked in a controlled, quantifiable manner independent of subject motivation. Both methods can be used to initiate eccentric contraction-induced injury and are suitable for monitoring functional muscle regeneration hours to days to weeks post-injury.

Analytical traceability of melon (Cucumis melo var reticulatus): proximate composition, bioactive compounds, and antioxidant capacity in relation to cultivar, plant physiology state, and seasonal variability.

Science.gov (United States)

Maietti, Annalisa; Tedeschi, Paola; Stagno, Caterina; Bordiga, Matteo; Travaglia, Fabiano; Locatelli, Monica; Arlorio, Marco; Brandolini, Vincenzo

2012-06-01

Two morphologically different cultivars of Italian melons (Baggio and Giusto) were characterized considering samples harvested in different times, at the beginning (BPP) and at the end of the physiological plant production period (EPP). Proximate composition, protein, minerals, pH, phenolic content, antioxidant capacity, ascorbic acid, carotenoids, condensed tannins, and flavonoids were measured, showing a significant decrease in EPP samples (phenolics, antioxidant capacity, condensed tannins, and flavonoids); ascorbic acid decreased in Giusto cv, carotenoids in Baggio cv. Mineral content increased in either the cultivars (EPP samples). Year-to-year difference was significantly highlighted; the plant growing cycle significantly affected the chemotype. Despite these effects, the Principal Component Analysis (PCA) permitted the discrimination of Baggio from Giusto cv, and the discrimination of BPP from EPP samples as well. © 2012 Institute of Food Technologists®

Physical fitness and mitochondrial respiratory capacity in horse skeletal muscle.

Directory of Open Access Journals (Sweden)

Dominique-Marie Votion

Full Text Available BACKGROUND: Within the animal kingdom, horses are among the most powerful aerobic athletic mammals. Determination of muscle respiratory capacity and control improves our knowledge of mitochondrial physiology in horses and high aerobic performance in general. METHODOLOGY/PRINCIPAL FINDINGS: We applied high-resolution respirometry and multiple substrate-uncoupler-inhibitor titration protocols to study mitochondrial physiology in small (1.0-2.5 mg permeabilized muscle fibres sampled from triceps brachii of healthy horses. Oxidative phosphorylation (OXPHOS capacity (pmol O(2 • s(-1 • mg(-1 wet weight with combined Complex I and II (CI+II substrate supply (malate+glutamate+succinate increased from 77 ± 18 in overweight horses to 103 ± 18, 122 ± 15, and 129 ± 12 in untrained, trained and competitive horses (N = 3, 8, 16, and 5, respectively. Similar to human muscle mitochondria, equine OXPHOS capacity was limited by the phosphorylation system to 0.85 ± 0.10 (N = 32 of electron transfer capacity, independent of fitness level. In 15 trained horses, OXPHOS capacity increased from 119 ± 12 to 134 ± 37 when pyruvate was included in the CI+II substrate cocktail. Relative to this maximum OXPHOS capacity, Complex I (CI-linked OXPHOS capacities were only 50% with glutamate+malate, 64% with pyruvate+malate, and 68% with pyruvate+malate+glutamate, and ~78% with CII-linked succinate+rotenone. OXPHOS capacity with glutamate+malate increased with fitness relative to CI+II-supported ETS capacity from a flux control ratio of 0.38 to 0.40, 0.41 and 0.46 in overweight to competitive horses, whereas the CII/CI+II substrate control ratio remained constant at 0.70. Therefore, the apparent deficit of the CI- over CII-linked pathway capacity was reduced with physical fitness. CONCLUSIONS/SIGNIFICANCE: The scope of mitochondrial density-dependent OXPHOS capacity and the density-independent (qualitative increase of CI-linked respiratory capacity with increased

Enhanced recovery after elective colorectal surgery: now the standard of care.

LENUS (Irish Health Repository)

Andrews, E J

2011-09-01

Enhanced recovery programmes have been studied in randomised trials with evidence of quicker recovery of gut function, reduced morbidity, mortality and hospital stay and improved physiological and nutritional outcomes. They aim to reduce the physiological and psychological stress of surgery and consequently the uncontrolled stress response. The key elements, reduced pre-operative fasting, intravenous fluid restriction and early feeding after surgery, are in conflict with traditional management plans but are supported by strong clinical evidence. Given the strength of the current data enhanced recovery should now be the standard of care.

Applied physiology of triathlon.

Science.gov (United States)

O'Toole, M L; Douglas, P S

1995-04-01

The triathlon is a 3-event endurance sport in which athletes compete sequentially in swimming, cycling and running. The primary determinant of success is the ability to sustain a high rate of energy expenditure for prolonged periods of time. Exercise training-induced physiological adaptations in virtually all systems of the body allow the athlete to accomplish this. Aerobic capacity (measured as maximal oxygen uptake, VO2max), economy of motion (submaximal VO2) and fractional utilisation of maximal capacity (%VO2max) reflect the integrated responses of these physiological adaptations. Numerous studies have reported relatively high mean VO2max values for various groups of triathletes that are comparable to those reported for athletes in single-event endurance sports and clearly above those reported for untrained individuals. In shorter distance triathlons and in studies using recreational (rather than elite) triathletes, VO2max is related to performance in the corresponding event of the triathlon (e.g. tethered swimming VO2max with swim time). In longer events and with more elite triathletes, VO2max correlates less well with performance. The physiological adaptations that correspond to and facilitate improved VO2max occur centrally in the cardiovascular system, centred on increased maximal cardiac output, and peripherally in the metabolic systems, centred around increased arterio-venous O2 (a-v O2) difference. While a high VO2max in individuals is clearly of importance to triathlon performance, energy output must be sustained for long periods of time, making economy of motion also very important. Studies suggests that competitive swimmers have better swimming economy than triathletes. However, since many triathletes have previously been competitive swimmers this finding is questionable. The finding suggests that triathletes from nonswimming backgrounds would benefit from improving swimming technique rather than concentrating training workouts solely on distance. In

A general native-state method for determination of proliferation capacity of human normal and tumor tissues in vitro

International Nuclear Information System (INIS)

Hoffman, R.M.; Connors, K.M.; Meerson-Monosov, A.Z.; Herrera, H.; Price, J.H.

1989-01-01

An important need in cancer research and treatment is a physiological means in vitro by which to assess the proliferation capacity of human tumors and corresponding normal tissue for comparison. The authors have recently developed a native-state, three-dimensional, gel-supported primary culture system that allows every type of human cancer to grow in vitro at more than 90% frequency, with maintenance of tissue architecture, tumor-stromal interaction, and differentiated functions. Here they demonstrate that the native-state culture system allows proliferation indices to be determined for all solid cancer types explanted directly from surgery into long-term culture. Normal tissues also proliferate readily in this system. The degree of resolution of measurement of cell proliferation by histological autoradiography within the cultured tissues is greatly enhanced with the use of epi-illumination polarization microscopy. The histological status of the cultured tissues can be assessed simultaneously with the proliferation status. Carcinomas generally have areas of high epithelial proliferation with quiescent stromal cells. Sarcomas have high proliferation of cells of mesenchymal organ. Normal tissues can also proliferate at high rates. An image analysis system has been developed to automate proliferation determination. The high-resolution physiological means described here to measure the proliferation capacity of tissues will be important in further understanding of the deregulation of cell proliferation in cancer as well as in cancer prognosis and treatment

The alcohol patient and surgery

DEFF Research Database (Denmark)

Tønnesen, H

1999-01-01

Alcohol abusers have a threefold increased risk of post-operative morbidity after surgery. The most frequent complications are infections, cardiopulmonary insufficiency, and bleeding episodes. Pathogenesis is suppressed immune capacity, subclinical cardiac dysfunction, and haemostatic imbalance...

Physiological responses in barley to applications of lanthanum

International Nuclear Information System (INIS)

Reddy, N.; Maheswaran, J.; Peverill, K.; Meehan, B.

1998-01-01

Full text: Chinese research and glasshouse investigations carried out in Victoria by the authors have shown that several plant species, when treated with Rare Earth Elements (REEs), retain greater amounts of moisture under water stressed conditions. The physiological adaptation of the plant to retain moisture in response to REE treatment however, has not been investigated. A glasshouse trial is currently in progress to study the physiological and agronomic responses of barley (cv. Schooner) grown in pots to application of lanthanum (0, 5 and 10 kg/ha), at a concentration of 0.05%, under well-watered (field capacity) and water-deficit (25 - 30% field capacity) conditions. Lanthanum was applied both directly to the soil and as a foliar spray. The physiological measurements include, photosynthetic rate, leaf water potential, osmotic potential, relative water content, stomatal conductance and water use efficiency. Measured agronomic parameters include plant height, tiller production, leaf area development, total grain weight, total biomass, root and shoot ratio and harvest index. Analysis of plant tissue for N, P, K, Ca, Mg, Zn and La to study the relationship between application of REE and nutrient uptake is also being carried out. The paper discusses physiological and agronomic changes in barley plants in response to treatment with lanthanum, under conditions of water stress

The Physiological Profile of Junior Soccer Players at SSBB Surabaya Bhakti

Science.gov (United States)

Nashirudin, M.; Kusnanik, N. W.

2018-01-01

Soccer players are required to have good physical fitness in order to achieve optimum accomplishment; physical fitness stands as the foundation of technical and tactical proficiency as well as the mental maturity during the matches. The purpose of this study was to identify the physiological profile of junior soccer players of SSB Surabaya Bhakti age 16-17. The research was conducted at 20 junior soccer players. This research was quantitative with descriptive analysis. Data were collected by testing of physiological (anaerobic power and capacity including explosive leg power, speed, agility; aerobic capacity: cardiovascular endurance). Data was analyzed using percentage. The result showed that the percentage of explosive leg power of junior soccer players were 30% (good category), speed was 85% (average category), right agility was 90% (average category), left agility was 75% (average category). On the other hand, the aerobic power and capacity of the junior soccer players in this study was 50% (average category). The conclusion of this research is that the physiological profile of junior soccer players at SSB Surabaya Bhakti age 16-17 was majority in average category.

Comparative Fecal Metagenomics Unveils Unique Functional Capacity of the Swine Gut

Science.gov (United States)

Uncovering the taxonomic composition and functional capacity within the swine gut microbial consortia is of great importance to animal physiology and health and to food and water safety due to the presence of human pathogens in pig feces. Limited information on the physiological...

Physiological Indices of Stress Prior to and Following Total Knee Arthroplasty Predict the Occurrence of Severe Post-Operative Pain.

Science.gov (United States)

Cremeans-Smith, Julie K; Greene, Kenneth; Delahanty, Douglas L

2016-05-01

The severe pain and disability associated with osteoarthritis often motivate individuals to undergo arthroplastic surgery. However, a significant number of surgical patients continue to experience pain following surgery. Prior research has implicated both the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) in the sensitization of pain receptors and chronic pain conditions. This study uses a prospective, observational, cohort design to examine whether physiological stress responses before and after surgery could predict post-operative pain severity. Participants included 110 patients undergoing total knee arthroplasty. Physiological indices of stress included the measurement of catecholamine and cortisol levels in 15-hour urine samples collected prior to and 1 month following surgery, as well as in-hospital heart rate and blood pressure (before and after surgery), which were abstracted from medical records. Patients completed the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) [Bellamy et al., J Orthop Rheumatol 1: , 95 (1988)] 2.5 weeks prior to surgery and at a 3-month follow-up. Contrary to expectations, lower stress hormone levels at baseline were related to more severe post-operative pain. Data at later time points, however, supported our hypothesis: cardiovascular tone shortly before surgery and urinary levels of epinephrine 1 month following surgery were positively related to pain severity 3 months later. Results suggest that the occurrence of post-operative pain can be predicted on the basis of stress physiology prior to and following arthroplastic surgery. © 2015 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The future of robotics in hand surgery.

Science.gov (United States)

Liverneaux, P; Nectoux, E; Taleb, C

2009-10-01

Robotics has spread over many surgical fields over the last decade: orthopaedic, cardiovascular, urologic, gynaecologic surgery and various other types of surgery. There are five different types of robots: passive, semiactive and active robots, telemanipulators and simulators. Hand surgery is at a crossroad between orthopaedic surgery, plastic surgery and microsurgery; it has to deal with fixing all sorts of tissues from bone to soft tissues. To our knowledge, there is not any paper focusing on potential clinical applications in this realm, even though robotics could be helpful for hand surgery. One must point out the numerous works on bone tissue with regard to passive robots (such as fluoroscopic navigation as an ancillary for percutaneous screwing in the scaphoid bone). Telemanipulators, especially in microsurgery, can improve surgical motion by suppressing physiological tremor thanks to movement demultiplication (experimental vascular and nervous sutures previously published). To date, the robotic technology has not yet become simple-to-use, cheap and flawless but in the future, it will probably be of great technical help, and even allow remote-controlled surgery overseas.

Functional capacity and postural pain outcomes after reduction mammaplasty.

Science.gov (United States)

Freire, Marcia; Neto, Miguel Sabino; Garcia, Elvio Bueno; Quaresma, Marina Rodrigues; Ferreira, Lydia Masako

2007-04-01

Neck, shoulder, and lower back pain and reduction of functional capacity can be caused by breast hypertrophy. Reduction mammaplasty appears to improve these aspects. After a systematic review of the literature, no scientific evidence was found to confirm this hypothesis. The authors' objective was to evaluate the impact of reduction mammaplasty on pain and functional capacity of patients with mammary hypertrophy. One hundred patients with mammary hypertrophy, between 18 and 55 years old, with no previous mammary surgery, were consecutively selected from the Plastic Surgery Outpatient Clinic of the Universidade Federal de São Paulo-Escola Paulista de Medicina and randomly allocated into two groups. Group A (n = 50) underwent mammaplasty reduction immediately, whereas group B patients (n = 50) were placed on a waiting list (control group). All patients were interviewed for clinical and demographic data and evaluated to measure pain and functional capacity. To measure shoulder, neck, and lower back pain, a visual analogue scale (0 = no pain, 10 = unbearable pain) was used. The Stanford Health Assessment Questionnaire (HAQ-20), Brazilian validated version (0 = best, 3 = worst), was applied to assess functional capacity. Pain and functional capacity were measured at baseline and 6 months after surgery. Forty-six of 50 patients, from both groups, completed the study. The mean (+/-SD) patient age in groups A and B was 31.6 +/- 11 and 32.3 +/- 10 years, respectively. The mean breast tissue weight was 1052 +/- 188 g. Functional capacity in group A was improved 6 months after reduction mammaplasty, compared with group B (control), in the following aspects: getting dressed, getting up, walking, maintaining personal hygiene, reaching, and grasping objects. The mean pain intensity dropped in the lower back, from 5.7 to 1.3; in the shoulders, from 6.1 to 1.1; and in the neck, from 5.2 to 0.9. Reduction mammaplasty improved functional capacity and relieved pain in the lower back

Anaesthetic Management of Conjoined Twins′ Separation Surgery

Directory of Open Access Journals (Sweden)

Kolli S Chalam

2009-01-01

Full Text Available Anaesthesia for conjoined twins, either for separation surgery, or for MRI or other evaluation procedures is an enormous challenge to the paediatric anaesthesiologist. This is an extra challenging surgery because we the anaesthesiologists need to care for two patients at the same time instead of just one. Anaesthesia for conjoined twins ′separation surgery mainly centered on the following concerns: 1.Conjoined Twins′ physiology like crossed circulation. distribution of blood volume and organ sharing with their anaesthetic implications. 2.Long marathon surgery with massive fluid shifts and loss of blood & blood components and their rapid replenishment. 3.Meticulous planning for organized management of long hours of anaesthetic administration in two paediatric subjects simultaneously with multi surgical specialties involvement and their unique requirements.We report the anaesthetic and intensive care management of one pair of Pygopagus separation surgery and also the review of literature and world statistics.

Anthropometric and physiological predispositions for elite soccer.

Science.gov (United States)

Reilly, T; Bangsbo, J; Franks, A

2000-09-01

This review is focused on anthropometric and physiological characteristics of soccer players with a view to establishing their roles within talent detection, identification and development programmes. Top-class soccer players have to adapt to the physical demands of the game, which are multifactorial. Players may not need to have an extraordinary capacity within any of the areas of physical performance but must possess a reasonably high level within all areas. This explains why there are marked individual differences in anthropometric and physiological characteristics among top players. Various measurements have been used to evaluate specific aspects of the physical performance of both youth and adult soccer players. The positional role of a player is related to his or her physiological capacity. Thus, midfield players and full-backs have the highest maximal oxygen intakes ( > 60 ml x kg(-1) x min(-1)) and perform best in intermittent exercise tests. On the other hand, midfield players tend to have the lowest muscle strength. Although these distinctions are evident in adult and elite youth players, their existence must be interpreted circumspectly in talent identification and development programmes. A range of relevant anthropometric and physiological factors can be considered which are subject to strong genetic influences (e.g. stature and maximal oxygen intake) or are largely environmentally determined and susceptible to training effects. Consequently, fitness profiling can generate a useful database against which talented groups may be compared. No single method allows for a representative assessment of a player's physical capabilities for soccer. We conclude that anthropometric and physiological criteria do have a role as part of a holistic monitoring of talented young players.

Image-guided surgery.

Science.gov (United States)

Wagner, A; Ploder, O; Enislidis, G; Truppe, M; Ewers, R

1996-04-01

Interventional video tomography (IVT), a new imaging modality, achieves virtual visualization of anatomic structures in three dimensions for intraoperative stereotactic navigation. Partial immersion into a virtual data space, which is orthotopically coregistered to the surgical field, enhances, by means of a see-through head-mounted display (HMD), the surgeon's visual perception and technique by providing visual access to nonvisual data of anatomy, physiology, and function. The presented cases document the potential of augmented reality environments in maxillofacial surgery.

The History of Hiatal Hernia Surgery

Science.gov (United States)

Stylopoulos, Nicholas; Rattner, David W.

2005-01-01

Objective: This review addresses the historical evolution of hiatal hernia (HH) repair and reports in a chronological fashion the major milestones in HH surgery before the laparoscopic era. Methods: The medical literature and the collections of the History of Medicine Division of the National Library of Medicine were searched. Secondary references from all sources were studied. The senior author's experience and personal communications are also reported. Results: The first report of HH was published in 1853 by Bowditch. Rokitansky in 1855 demonstrated that esophagitis was due to gastroesophageal reflux, and Hirsch in 1900 diagnosed an HH using x-rays. Eppinger diagnosed an HH in a live patient, and Friedenwald and Feldman related the symptoms to the presence of an HH. In 1926, Akerlund proposed the term hiatus hernia and classified HH into the 3 types that we use today. The first elective surgical repair was reported in 1919 by Soresi. The physiologic link between HH and gastroesophageal reflux was made at the second half of the 20th century by Allison and Barrett. In the midst of a physiologic revolution, Nissen and Belsey developed their famous operations. In 1957, Collis published his innovative operation. Thal described his technique in 1965, and in 1967, Hill published his procedure. Many modifications of these procedures were published by Pearson and Henderson, Orringer and Sloan, Rossetti, Dor, and Toupet. Donahue and Demeester significantly improved Nissen's operation, and they were the first to truly understand its physiologic mechanism. Conclusion: Hiatal hernia surgery has evolved from anatomic repair to physiological restoration. PMID:15622007

A Physiological Case Study of a Paralympic Wheelchair Tennis Player: Reflective Practise

Science.gov (United States)

Diaper, Nicholas J.; Goosey-Tolfrey, Victoria L.

2009-01-01

This study was designed to examine the physiological changes caused by long-term training in a world class female tennis player in preparation for a major championship. Additionally, we aim to describe the training interventions and determine a suitable cooling strategy that was to be used at the 2004 Paralympic Games. The athlete underwent regular physiological assessment during 2003-2004. Physiological measures involved body composition, submaximal and peak oxygen uptake and key variables associated with maximal sprinting. In addition, a suitable match-play cooling intervention and hydration strategy was also explored. Body composition improved over the course of the study. Aerobic capacity fell by 21%, yet the submaximal physiological variables such as lactate profile and pushing economy improved. The trade off of aerobic capacity was perhaps noticeably counter-balanced with the maintenance of the peak sprinting speed and improvement found in the fatigue profile across ten repeated sprints. The extensive training programme was responsible for these changes and these adaptations resulted in a more confident athlete, in peak physical condition leading into the Paralympic Games. It is difficult to appreciate the extent to which this work had an impact on tennis performance given the skill requirements of wheelchair tennis and this warrants future attention. Key points Physiological adaptations were apparent over the two-year training period. The training emphasis resulted in a reduction in aerobic capacity, yet an improvement in repetitive sprint performance was seen leading into the Major competition. An effective cooling technique was identified that could be used during wheelchair tennis performance. The athlete and coaches were complimentary to the physiological support provided, which resulted in a more confident athlete at the Paralympic Games. PMID:24149542

The pharmacokinetics of cefazolin in patients undergoing elective & semi-elective abdominal aortic aneurysm open repair surgery

Directory of Open Access Journals (Sweden)

Roberts Michael S

2011-02-01

Full Text Available Abstract Background Surgical site infections are common, so effective antibiotic concentrations at the sites of infection are required. Surgery can lead to physiological changes influencing the pharmacokinetics of antibiotics. The aim of the study is to evaluate contemporary peri-operative prophylactic dosing of cefazolin by determining plasma and subcutaneous interstitial fluid concentrations in patients undergoing elective of semi-elective abdominal aortic aneurysm (AAA open repair surgery. Methods/Design This is an observational pharmacokinetic study of patients undergoing AAA open repair surgery at the Royal Brisbane and Women's Hospital. All patients will be administered 2-g cefazolin by intravenous injection within 30-minutes of the procedure. Participants will have samples from blood and urine, collected at different intervals. Patients will also have a microdialysis catheter inserted into subcutaneous tissue to measure interstitial fluid penetration by cefazolin. Participants will be administered indocyanine green and sodium bromide as well as have cardiac output monitoring performed and tetrapolar bioimpedance to determine physiological changes occurring during surgery. Analysis of samples will be performed using validated liquid chromatography tandem mass-spectrometry. Pharmacokinetic analysis will be performed using non-linear mixed effects modeling to determine individual and population pharmacokinetic parameters and the effect of peri-operative physiological changes on cefazolin disposition. Discussion The study will describe cefazolin levels in plasma and the interstitial fluid of tissues during AAA open repair surgery. The effect of physiological changes to the patient mediated by surgery will also be determined. The results of this study will guide clinicians and pharmacists to effectively dose cefazolin in order to maximize the concentration of antibiotics in the tissues which are the most common site of surgical site infections.

Utilizing Forced Vital Capacity to Predict Low Lung Compliance and Select Intraoperative Tidal Volume During Thoracic Surgery.

Science.gov (United States)

Hoftman, Nir; Eikermann, Eric; Shin, John; Buckley, Jack; Navab, Kaveh; Abtin, Fereidoun; Grogan, Tristan; Cannesson, Maxime; Mahajan, Aman

2017-12-01

Tidal volume selection during mechanical ventilation utilizes dogmatic formulas that only consider a patient's predicted body weight (PBW). In this study, we investigate whether forced vital capacity (FVC) (1) correlates better to total lung capacity (TLC) than PBW, (2) predicts low pulmonary compliance, and (3) provides an alternative method for tidal volume selection. One hundred thirty thoracic surgery patients had their preoperative TLC calculated via 2 methods: (1) pulmonary function test (PFT; TLCPFT) and (2) computed tomography 3D reconstruction (TLCCT). We compared the correlation between TLC and PBW with the correlation between TLC and FVC to determine which was stronger. Dynamic pulmonary compliance was then calculated from intraoperative ventilator data and logistic regression models constructed to determine which clinical measure best predicted low compliance. Ratios of tidal volume/FVC plotted against peak inspiratory pressure were utilized to construct a new model for tidal volume selection. Calculated tidal volumes generated by this model were then compared with those generated by the standard lung-protective formula Vt = 7 cc/kg. The correlation between FVC and TLC (0.82 for TLCPFT and 0.76 for TLCCT) was stronger than the correlation between PBW and TLC (0.65 for TLCPFT and 0.58 for TLCCT). Patients with very low compliance had significantly smaller lung volumes (forced expiratory volume at 1 second, FVC, TLC) and lower diffusion capacity of the lungs for carbon monoxide when compared with patients with normal compliance. An FVC cutoff of 3470 cc was 100% sensitive and 51% specific for predicting low compliance. The proposed equation Vt = FVC/8 significantly reduced calculated tidal volume by a mean of 22.5% in patients with low pulmonary compliance without affecting the mean tidal volume in patients with normal compliance (mean difference 0.9%). FVC is more strongly correlated to TLC than PBW and a cutoff of about 3.5 L can be utilized to predict

An experimental approach to estimate operator’s information processing capacity for diagnosing tasks in NPPs

International Nuclear Information System (INIS)

Kim, Ji Tae; Shin, Seung Ki; Kim, Jong Hyun; Seong, Poong Hyun

2013-01-01

Highlights: • Main control room operator’s information processing capacity is determined. • The relationship between the information processing capacity and human factors is described. • The information processing capacity results from the subjective and physiological measures are nearly identical. - Abstract: The objectives of this research are: (1) to determine information processing capacity of an operator in a main control room and (2) to describe the relationship between the information processing capacity and human factors. This research centers on the relationship, as experimentally determined, between an operator’s mental workload and information flow during accident diagnosis tasks at nuclear power plants. Based on this relationship, the operator’s information processing capacity is established. In this paper, the information processing capacity is defined as the operator’s ability to manage the amount of bits in a second when diagnosing tasks or accidents. If the operator’s performance decreases rapidly as the information flow rate (bit/s) increases, it is possible to determine the operator’s information processing capacity. The cognitive information of a diagnosis task can be quantified using an information flow model and the operator’s mental workload is measured by subjective and physiological measures. NASA-TLX (Task Load indeX) is selected as the subjective method and an eye tracking system is used as the physiological measure for the workload. In addition, the information processing capacity related to human factors is investigated. Once the information processing capacity of operators is known, then it will be possible to apply it to predict the operators’ performance, design diagnosis tasks, and design human–machine interface

[PSYCHO PHYSIOLOGICAL MARKERS OF ACCELERATED AGING AMONG THOSE WORKING WITH OCCUPATIONAL HAZARDS].

Science.gov (United States)

Bashkireva, A S; Kachan, Ye Yu; Kulapina, M E

2015-01-01

We assessed the significance of psycho physiological markers of accelerated aging of the function of attention using comparative analysis of two occupational groups in order to reveal how the working process affects mental work capacity. We revealed peculiarities of systemic structure of functions which determine mental work capacity depending on the age and length of service in lorry drivers. It was proved that decrease in the mnestic functions of lorry-drivers takes place 10-15 years earlier compared to the control group. Psycho physiological indices, reflecting the functioning of attention, decreased not only with aging but also with longer driving experience. Our results show that it is necessary to conduct further studies of psycho physiological markers of age-related decrease in short-term memory depending on the activities at work in order to prevent accelerated aging and achieve professional longevity.

[Lung volume reduction surgery for severe pulmonary emphysema in Iceland].

Science.gov (United States)

Gunnarsson, Sverrir I; Johannsson, Kristinn B; Guðjónsdóttir, Marta; Jónsson, Steinn; Beck, Hans J; Magnusson, Bjorn; Gudbjartsson, Tomas

2011-12-01

Lung volume reduction surgery (LVRS) can benefit patients with severe emphysema. The aim of this study was to evaluate the outcome of LVRS performed in Iceland. A prospective study of 16 consecutive patients who underwent bilateral LVRS through median sternotomy between January 1996 and December 2008. All patients had disabling dyspnea, lung hyperinflation, and emphysema with upper lobe predominance. Preoperatively all patients underwent pulmonary rehabilitation. Spirometry, lung volumes, arterial blood gases and exercise capacity were measured before and after surgery. Mean follow-up time was 8.7 years. Mean age was 59.2 ± 5.9 years. All patients had a history of heavy smoking. There was no perioperative mortality and survival was 100%, 93%, and 63% at 1, 5, and 10 years, respectively. The forced expiratory volume in 1 second (FEV1) and the forced vital capacity (FVC) improved significantly after surgery by 35% (plung capacity, residual volume and partial pressure of CO2 also showed statistically significant improvements but exercise capacity, O2 consumption and diffusing capacity of the lung for CO did not change. Prolonged air leak (≥ 7 days) was the most common complication (n=7). Five patients required reoperation, most commonly for sternal dehiscence (n=4). In this small prospective study, FEV1 and FVC increased and lung volumes and PaCO2 improved after LVRS. Long term survival was satisfactory although complications such as reoperations for sternal dehiscence were common and hospital stay therefore often prolonged.

Disparities in access to emergency general surgery care in the United States.

Science.gov (United States)

Khubchandani, Jasmine A; Shen, Connie; Ayturk, Didem; Kiefe, Catarina I; Santry, Heena P

2018-02-01

As fewer surgeons take emergency general surgery call and hospitals decrease emergency services, a crisis in access looms in the United States. We examined national emergency general surgery capacity and county-level determinants of access to emergency general surgery care with special attention to disparities. To identify potential emergency general surgery hospitals, we queried the database of the American Hospital Association for "acute care general hospital," with "surgical services," and "emergency department," and ≥1 "operating room." Internet search and direct contact confirmed emergency general surgery services that covered the emergency room 7 days a week, 24 hours a day. Geographic and population-level emergency general surgery access was derived from Geographic Information Systems and US Census. Of the 6,356 hospitals in the 2013 American Hospital Association database, only 2,811 were emergency general surgery hospitals. Counties with greater percentages of black, Hispanic, uninsured, and low-education individuals and rural counties disproportionately lacked access to emergency general surgery care. For example, counties above the 75th percentile of African American population (10.2%) had >80% odds of not having an emergency general surgery hospital compared with counties below the 25th percentile of African American population (0.6%). Gaps in access to emergency general surgery services exist across the United States, disproportionately affecting underserved, rural communities. Policy initiatives need to increase emergency general surgery capacity nationwide. Copyright © 2017 Elsevier Inc. All rights reserved.

Outcome of patients undergoing open heart surgery at the Uganda ...

African Journals Online (AJOL)

An approach in which open heart surgeries are conducted locally by visiting teams enabling skills transfer to the local team and helps build to build capacity has been adopted at the Uganda Heart Institute (UHI). Objectives: We reviewed the progress of open heart surgery at the UHI and evaluated the postoperative ...

A qualitative study of regional anaesthesia for vitreo-retinal surgery.

Science.gov (United States)

McCloud, Christine; Harrington, Ann; King, Lindy

2014-05-01

The aim of this research was to collect experiential knowledge about regional ocular anaesthesia - an integral component of most vitreo-retinal surgery. Anaesthesia for vitreo-retinal surgery has predominantly used general anaesthesia, because of the length and complexity of the surgical procedure. However, recent advances in surgical instrumentation and techniques have reduced surgical times; this decision has led to the adoption of regional ocular anaesthesia for vitreo-retinal day surgery. Although regional ocular anaesthesia has been studied from several perspectives, knowledge about patients' experience of the procedure is limited. An interpretive qualitative research methodology underpinned by Gadamer's philosophical hermeneutics. Eighteen participants were interviewed in-depth between July 2006-December 2007 following regional ocular anaesthesia. Interview data were thematically analysed by coding and grouping concepts. Four themes were identified: 'not knowing': the time prior to the experience of a regional eye block; 'experiencing': the experience of regional ocular anaesthesia; 'enduring': the capacity participants displayed to endure regional ocular anaesthesia with the hope that their vision would be restored; and 'knowing': when further surgery was required and past experiences were recalled. The experience of regional ocular anaesthesia had the capacity to invoke anxiety in the participants in this study. Many found the experience overwhelming and painful. What became clear was the participant's capacity to stoically 'endure' regional ocular anaesthesia, indicating the value people placed on visual function. © 2013 John Wiley & Sons Ltd.

Capacity of the aquatic fern (Salvinia minima Baker) to accumulate high concentrations of nickel in its tissues, and its effect on plant physiological processes

Energy Technology Data Exchange (ETDEWEB)

Fuentes, Ignacio I.; Espadas-Gil, Francisco; Talavera-May, Carlos; Fuentes, Gabriela; Santamaría, Jorge M., E-mail: jorgesm@cicy.mx

2014-10-15

Highlights: • We document the capacity of an aquatic fern to hyper-accumulate Ni. • Effects of high Ni concentrations uptake on plant performance is documented. • High concentration of Ni in tissues damage photosynthesis. • Damage is related to carboxylation mechanisms than to electron transfer efficiency. • S. minima is a good candidate for remediation of water bodies contaminated with Ni. - Abstract: An experiment was designed to assess the capacity of Salvinia minima Baker to uptake and accumulate nickel in its tissues and to evaluate whether or not this uptake can affect its physiology. Our results suggest that S. minima plants are able to take up high amounts of nickel in its tissues, particularly in roots. In fact, our results support the idea that S. minima might be considered a hyper-accumulator of nickel, as it is able to accumulate 16.3 mg g{sup −1} (whole plant DW basis). Our results also showed a two-steps uptake pattern of nickel, with a fast uptake of nickel at the first 6 to 12 h of being expose to the metal, followed by a slow take up phase until the end of the experiment at 144 h. S. minima thus, may be considered as a fern useful in the phytoremediation of residual water bodies contaminated with this metal. Also from our results, S. minima can tolerate fair concentrations of the metal; however, at concentrations higher than 80 μM Ni (1.5 mg g{sup −1} internal nickel concentration), its physiological performance can be affected. For instance, the integrity of cell membranes was affected as the metal concentration and exposure time increased. The accumulation of high concentrations of internal nickel did also affect photosynthesis, the efficiency of PSII, and the concentration of photosynthetic pigments, although at a lower extent.

The effect of EC-IC bypass surgery on resting cerebral blood flow and cerebrovascular reserve capacity studied with stable Xe-CT and acetazolamide test

Energy Technology Data Exchange (ETDEWEB)

Yamashita, T.; Kashiwagi, S.; Nakano, S.; Takasago, T.; Abiko, S.; Shiroyama, Y.; Hayashi, M.; Ito, H. (Yamaguchi Univ. School of Medicine (Japan). Dept. of Neurosurgery)

1991-06-01

Cerebral blood flow (CBF) and cerebrovascular reserve capacity (CRC) were measured by stable xenon computerized tomography (Xe-CT) and acetazolamide test in 15 patients with cerebrovascular disease before and after extracranial-intracranial (EC-IC) bypass surgery for minor stroke, reversible ischemic neurological deficit or transient ischemic attack. All had angiographically shown occlusive lesions of the major arterial trunk. In the present series, global analysis showed that the bypass did not increase the resting rCBF, but did increase the rCRC. We divided the patients into four groups according to the preoperative resting rCBF and rCRC. All 3 patients with normal resting rCBF and reduced rCRC showed postoperative improvement of rCRC. Of 6 patients with reduced CBF and reduced CRC, three had postoperative increase in resting CBF and four had increased CRC. One of two patients with reduced CBF and normal CRC showed only an increase in CRC. We propose that reduced CRC or reduced CBF with reduced CRC are criteria for selection of candidates for bypass surgery. We conclude that Xe-CT with the Diamox test is a useful and simple method for evaluating cerebral hemodynamics. Preoperative grouping with a combination of preoperative resting rCBF and preoperative rCRC is useful for predicting the effect of EC-IC bypass surgery. (orig.).

Principles of laser surgery. Advantages and disadvantages.

Science.gov (United States)

Ballow, E B

1992-07-01

An attempt has been made in this article to present an honest and accurate state-of-art narrative of laser surgery for pedal conditions. The theory of operation, physiologic effects and procedural comparisons have been presented regarding those procedures and lasers that are available for use by podiatric surgeons and others treating the foot and leg. Although some information described within this article is anecdotal, it is elaborated with representative expert material from the scientific literature. Overall, a sound theoretic understanding of the mode of action of lasers and extensive training and experience is encouraged when engaging in this exciting discipline of surgery.

Biological properties of extracellular vesicles and their physiological functions

NARCIS (Netherlands)

Yáñez-Mó, María; Siljander, Pia R-M; Andreu, Zoraida; Zavec, Apolonija Bedina; Borràs, Francesc E; Buzas, Edit I; Buzas, Krisztina; Casal, Enriqueta; Cappello, Francesco; Carvalho, Joana; Colás, Eva; Cordeiro-da Silva, Anabela; Fais, Stefano; Falcon-Perez, Juan M; Ghobrial, Irene M; Giebel, Bernd; Gimona, Mario; Graner, Michael; Gursel, Ihsan; Gursel, Mayda; Heegaard, Niels H H; Hendrix, An; Kierulf, Peter; Kokubun, Katsutoshi; Kosanovic, Maja; Kralj-Iglic, Veronika; Krämer-Albers, Eva-Maria; Laitinen, Saara; Lässer, Cecilia; Lener, Thomas; Ligeti, Erzsébet; Linē, Aija; Lipps, Georg; Llorente, Alicia; Lötvall, Jan; Manček-Keber, Mateja; Marcilla, Antonio; Mittelbrunn, Maria; Nazarenko, Irina; Nolte-'t Hoen, Esther N M; Nyman, Tuula A; O'Driscoll, Lorraine; Olivan, Mireia; Oliveira, Carla; Pállinger, Éva; Del Portillo, Hernando A; Reventós, Jaume; Rigau, Marina; Rohde, Eva; Sammar, Marei; Sánchez-Madrid, Francisco; Santarém, N; Schallmoser, Katharina; Ostenfeld, Marie Stampe; Stoorvogel, Willem|info:eu-repo/dai/nl/074352385; Stukelj, Roman; Van der Grein, Susanne G|info:eu-repo/dai/nl/412755211; Vasconcelos, M Helena; Wauben, Marca H M|info:eu-repo/dai/nl/112675735; De Wever, Olivier

2015-01-01

In the past decade, extracellular vesicles (EVs) have been recognized as potent vehicles of intercellular communication, both in prokaryotes and eukaryotes. This is due to their capacity to transfer proteins, lipids and nucleic acids, thereby influencing various physiological and pathological

Toward the art of robotic-assisted vitreoretinal surgery

Directory of Open Access Journals (Sweden)

Amir Molaei

2017-01-01

Full Text Available New technological progress in robotics has brought many beneficial clinical applications. Currently, computer integrated robotic surgery has gained clinical acceptance for several surgical procedures. Robotically assisted eye surgery is envisaged as a promising solution to overcome the shortcomings inherent to conventional surgical procedures as in vitreoretinal surgeries. Robotics by its high precision and fine mechanical control can improve dexterity, cancel tremor, and allow highly precise remote surgical capability, delicate vitreoretinal manipulation capabilities. Combined with magnified three-dimensional imaging of the surgical site, it can enhance surgical precision. Tele-manipulation can provide the ability for tele-surgery or haptic feedback of forces generated by the manipulation of intraocular tissues. It presents new solutions for some sight-threatening conditions such as retinal vein cannulation where, due to physiological limitations of the surgeon's hand, the procedure cannot be adequately performed. In this paper, we provide an overview of the research and advances in robotically assisted vitreoretinal eye surgery. Additionally the barriers to the integration of this method in the field of ocular surgery are summarized. Finally, we discuss the possible applications of the method in the area of vitreoretinal surgery.

Physiological capacity and physical testing in male elite team handball

DEFF Research Database (Denmark)

Michalsik, Lars Bojsen; Madsen, K.; Aagaard, P.

2015-01-01

AIM: The aim of the present study was to examine the physical demands placed on male elite team handball players in relation to playing position. METHODS: Male elite team handball field players were evaluated during match-play over a six season time span using physiological measurements...... in "Jump and Reach" testing was 0.71 ± 0.08 m (range: 0.61-0.86 m). Maximal ball throwing speed was observed using the set shot with 3-step run-up (92.8 ± 5.3 km·h⁻¹, range: 75.8-108.2 km·h⁻¹). CONCLUSION: Modern male elite team handball imposes moderate-to-high demands on the aerobic energy system...

[RESEARCH PROGRESS OF PERIPHERAL NERVE SURGERY ASSISTED BY Da Vinci ROBOTIC SYSTEM].

Science.gov (United States)

Shen, Jie; Song, Diyu; Wang, Xiaoyu; Wang, Changjiang; Zhang, Shuming

2016-02-01

To summarize the research progress of peripheral nerve surgery assisted by Da Vinci robotic system. The recent domestic and international articles about peripheral nerve surgery assisted by Da Vinci robotic system were reviewed and summarized. Compared with conventional microsurgery, peripheral nerve surgery assisted by Da Vinci robotic system has distinctive advantages, such as elimination of physiological tremors and three-dimensional high-resolution vision. It is possible to perform robot assisted limb nerve surgery using either the traditional brachial plexus approach or the mini-invasive approach. The development of Da Vinci robotic system has revealed new perspectives in peripheral nerve surgery. But it has still been at the initial stage, more basic and clinical researches are still needed.

Laparoscopic surgery for morbid obesity.

Science.gov (United States)

Hallerbäck, B; Glise, H; Johansson, B; Johnson, E

1998-01-01

Morbid obesity, defined as a body mass index (BMI), i.e. weight (kg)/height (m2) over 36 for males and 38 for females, is a common condition and a threat for health, life and individual well being. Hitherto, surgery is the only effective treatment for weight reduction. Surgical methods can be malabsorptive, reducing the patients ability to absorb nutrients, or restrictive, reducing the capacity of food intake. Exclusively malabsorptive methods have been abandoned due to severe side effects. Restrictive methods, gastroplasties, reduces the compliance capacity of the stomach. Two types are performed laparoscopically, the vertical banded gastroplasty and the adjustable gastric banding. The proximal gastric by pass is also performed laparoscopically and is a combination of a restrictive proximal gastroplasty and a malabsorptive Roux-en-Y gastro-jejunal anastomosis. With laparoscopic adjustable gastric banding mean BMI was reduced from 41 kg/m2 to 33 kg/m2 (n = 43) after one year. Two years after surgery mean BMI was 30 kg/m2 (n = 16). The different operative techniques are further discussed in this paper.

Impact of multimodal preoperative preparation program on children undergoing surgery

Directory of Open Access Journals (Sweden)

Priya Reshma Aranha

2017-01-01

Full Text Available Background: The advanced era of technological development in child health care has resulted in more pediatric procedures being performed in various settings. Millions of children undergo surgery every year which is a stressful event. Many nonpharmacological strategies are being used to manage the preoperative fear and anxiety in children. The current study aims to assess the effectiveness of multimodal preoperative preparation program (MPPP on children undergoing surgery in terms of its effect on the psychophysiological parameters. Objective: The aim of this study is to assess the effectiveness of MPPP on the psychophysiological parameters of children undergoing surgery. Materials and Methods: A quasi-experimental study was conducted in a selected multi-specialty hospital. Using the purposive sampling technique, a total of 110 children aged 8–12 years were assigned to nonintervention (n = 55 and intervention (n = 55 groups, respectively. The MPPP was administered to the intervention group. The children in the nonintervention group received the routine preoperative care. Child's fear and anxiety was assessed on admission, prior to shifting the child to operation theater (OT, 24 and 48 h after surgery, whereas child's pulse, respiration, blood pressure (BP, and oxygen saturation was assessed on admission, prior to shifting the child to OT, 6, 12, 24, and 48 h after surgery and pain was assessed at 24 and 48 h after surgery. Results: The mean fear and anxiety scores of children were significantly lower in the intervention group than that of nonintervention group (P 0.05. This study also found that there is a significant association between the psychophysiological parameters of children with the selected demographic variables (P < 0.05. A positive correlation was found between the psychological and physiological parameters of children undergoing surgery. Conclusion: The MPPP is effective on psychophysiological parameters of children undergoing

Prehabilitation with Whey Protein Supplementation on Perioperative Functional Exercise Capacity in Patients Undergoing Colorectal Resection for Cancer: A Pilot Double-Blinded Randomized Placebo-Controlled Trial.

Science.gov (United States)

Gillis, Chelsia; Loiselle, Sarah-Eve; Fiore, Julio F; Awasthi, Rashami; Wykes, Linda; Liberman, A Sender; Stein, Barry; Charlebois, Patrick; Carli, Francesco

2016-05-01

A previous comprehensive prehabilitation program, providing nutrition counseling with whey protein supplementation, exercise, and psychological care, initiated 4 weeks before colorectal surgery for cancer, improved functional capacity before surgery and accelerated functional recovery. Those receiving standard of care deteriorated. The specific role of nutritional prehabilitation alone on functional recovery is unknown. This study was undertaken to estimate the impact of nutrition counseling with whey protein on preoperative functional walking capacity and recovery in patients undergoing colorectal resection for cancer. We conducted a double-blinded randomized controlled trial at a single university-affiliated tertiary center located in Montreal, Quebec, Canada. Colon cancer patients (n=48) awaiting elective surgery for nonmetastatic disease were randomized to receive either individualized nutrition counseling with whey protein supplementation to meet protein needs or individualized nutrition counseling with a nonnutritive placebo. Counseling and supplementation began 4 weeks before surgery and continued for 4 weeks after surgery. The primary outcome was change in functional walking capacity as measured with the 6-minute walk test. The distance was recorded at baseline, the day of surgery, and 4 weeks after surgery. A change of 20 m was considered clinically meaningful. The whey group experienced a mean improvement in functional walking capacity before surgery of +20.8 m, with a standard deviation of 42.6 m, and the placebo group improved by +1.2 (65.5) m (P=0.27). Four weeks after surgery, recovery rates were similar between groups (P=0.81). Clinically meaningful improvements in functional walking capacity were achieved before surgery with whey protein supplementation. These pilot results are encouraging and justify larger-scale trials to define the specific role of nutrition prehabilitation on functional recovery after surgery. Copyright © 2016 Academy of

The alcohol patient and surgery

DEFF Research Database (Denmark)

Tønnesen, H

1999-01-01

Alcohol abusers have a threefold increased risk of post-operative morbidity after surgery. The most frequent complications are infections, cardiopulmonary insufficiency, and bleeding episodes. Pathogenesis is suppressed immune capacity, subclinical cardiac dysfunction, and haemostatic imbalance....... The economic implications of alcohol abuse in surgical patients are tremendous. Interventional studies are required to reduce future increases in post-operative morbidity....

Evaluation of the cerebral vasodilatory capacity by the acetazolamide test before EC-IC bypass surgery in patients with occlusion of the internal carotid artery

DEFF Research Database (Denmark)

Vorstrup, S; Brun, B; Lassen, N A

1986-01-01

Cerebral blood flow (CBF) was measured by xenon-133 inhalation tomography in 18 patients with cerebrovascular disease before and 4 months after extracranial-intracranial bypass surgery. Only patients who showed a reduced CBF in areas that were intact on the CT scan and relevant to the clinical...... the patients with a compromised collateral circulation and hence reduced CBF due to reduced perfusion pressure, a cerebral vasodilatory stress test was performed using acetazolamide (Diamox). In normal subjects, Diamox has been shown to increase tomographic CBF without change of the flow distribution...... pathways. However, an increase in the regional vasodilatory capacity was observed postoperatively in the majority of patients....

Genetic approaches in comparative and evolutionary physiology

Science.gov (United States)

Bridgham, Jamie T.; Kelly, Scott A.; Garland, Theodore

2015-01-01

Whole animal physiological performance is highly polygenic and highly plastic, and the same is generally true for the many subordinate traits that underlie performance capacities. Quantitative genetics, therefore, provides an appropriate framework for the analysis of physiological phenotypes and can be used to infer the microevolutionary processes that have shaped patterns of trait variation within and among species. In cases where specific genes are known to contribute to variation in physiological traits, analyses of intraspecific polymorphism and interspecific divergence can reveal molecular mechanisms of functional evolution and can provide insights into the possible adaptive significance of observed sequence changes. In this review, we explain how the tools and theory of quantitative genetics, population genetics, and molecular evolution can inform our understanding of mechanism and process in physiological evolution. For example, lab-based studies of polygenic inheritance can be integrated with field-based studies of trait variation and survivorship to measure selection in the wild, thereby providing direct insights into the adaptive significance of physiological variation. Analyses of quantitative genetic variation in selection experiments can be used to probe interrelationships among traits and the genetic basis of physiological trade-offs and constraints. We review approaches for characterizing the genetic architecture of physiological traits, including linkage mapping and association mapping, and systems approaches for dissecting intermediary steps in the chain of causation between genotype and phenotype. We also discuss the promise and limitations of population genomic approaches for inferring adaptation at specific loci. We end by highlighting the role of organismal physiology in the functional synthesis of evolutionary biology. PMID:26041111

Energy reallocation during and after periods of nutritional stress in Steller sea lions: low-quality diet reduces capacity for physiological adjustments.

Science.gov (United States)

Jeanniard du Dot, Tiphaine; Rosen, David A S; Trites, Andrew W

2009-01-01

Two groups of female Steller sea lions (groups H and P) were subjected to periods of energy restriction and subsequent refeeding during winter and summer to determine changes in energy partitioning among principal physiological functions and the potential consequences to their fitness. Both sea lion groups consumed high-quality fish (herring) before and after the energy restrictions. During restrictions, group H was fed a lower quantity of herring and group P a caloric equivalent of low-quality fish (pollock). Quantitative estimates of maintenance and production energies and qualitative estimates of thermoregulation, activity, and basal metabolic rate were measured. During summer, all animals compensated for the imposed energy deficit by releasing stored energy (production energy). Group H also optimized the energy allocation to seasonal conditions by increasing activity during summer, when fish are naturally abundant (foraging effort), and by decreasing thermoregulation capacity when waters are warmer. During winter, both groups decreased the energy allocated to overall maintenance functions (basal metabolic rate, thermoregulation, and activity together) in addition to releasing stored energy, but they preserved thermoregulatory capacity. Group H also decreased activity levels in winter, when foraging in the wild is less efficient, unlike group P. Overall, sea lions fed pollock did not change energy allocation to suit environmental conditions as readily as those fed herring. This implies that a low energy-density diet may further reduce fitness of animals in the wild during periods of nutritional stress.

water stress mediated changes in growth, physiology and secondary metabolites of desi ajwain (trachyspermum ammi l.)

International Nuclear Information System (INIS)

Azhar, N.; Hussain, B.; Abbasi, K.Y.

2011-01-01

Biotic and abiotic stresses exert a considerable influence on the production of several secondary metabolites in plants; water stress is one of the most important abiotic stress factors. This study was carried out to elucidate the effect of drought stress on growth, physiology and secondary metabolite production in desi ajwain (Trachyspermum ammi L.). Plants were grown in pots and three drought levels (100%, 80% and 60%) of field capacity were created. The experiment was laid out in complete randomized design (CRD) with three replicates. Data on growth, physiological and biochemical parameters were recorded and analyzed statistically. Physiological parameters like transpiration rate and stomatal conductance decreased concentration increased. The photosynthetic rate showed significantly with increasing water stress levels, but internal CO/sub 2/ non-significant reduction from 100% field capacity to 80% field capacity but increased at 60% field capacity. Growth parameters including plant height, herb fresh and dry weights were reduced significantly with increasing stress levels, while total phenolic contents and chlorophyll contents increased under water stress conditions. These results suggest that cultivation of medicinal plants like desi ajwain under drought stress could enhance the production of secondary metabolites. (author)

Physiological responses to acute experimental hypoxia in the air ...

Indian Academy of Sciences (India)

When C. batrachus was exposed for different periods at experimental hypoxia level (0.98±0.1 mg/L, DO), hemoglobin and hematocrit concentrations were increased, along with decrease in mean cellular hemoglobin concentration, which reflected a physiological adaptation to enhance oxygen transport capacity. Significant ...

30 Years of Robotic Surgery.

Science.gov (United States)

Leal Ghezzi, Tiago; Campos Corleta, Oly

2016-10-01

The idea of reproducing himself with the use of a mechanical robot structure has been in man's imagination in the last 3000 years. However, the use of robots in medicine has only 30 years of history. The application of robots in surgery originates from the need of modern man to achieve two goals: the telepresence and the performance of repetitive and accurate tasks. The first "robot surgeon" used on a human patient was the PUMA 200 in 1985. In the 1990s, scientists developed the concept of "master-slave" robot, which consisted of a robot with remote manipulators controlled by a surgeon at a surgical workstation. Despite the lack of force and tactile feedback, technical advantages of robotic surgery, such as 3D vision, stable and magnified image, EndoWrist instruments, physiologic tremor filtering, and motion scaling, have been considered fundamental to overcome many of the limitations of the laparoscopic surgery. Since the approval of the da Vinci(®) robot by international agencies, American, European, and Asian surgeons have proved its factibility and safety for the performance of many different robot-assisted surgeries. Comparative studies of robotic and laparoscopic surgical procedures in general surgery have shown similar results with regard to perioperative, oncological, and functional outcomes. However, higher costs and lack of haptic feedback represent the major limitations of current robotic technology to become the standard technique of minimally invasive surgery worldwide. Therefore, the future of robotic surgery involves cost reduction, development of new platforms and technologies, creation and validation of curriculum and virtual simulators, and conduction of randomized clinical trials to determine the best applications of robotics.

Critical differences between elective and emergency surgery: identifying domains for quality improvement in emergency general surgery.

Science.gov (United States)

Columbus, Alexandra B; Morris, Megan A; Lilley, Elizabeth J; Harlow, Alyssa F; Haider, Adil H; Salim, Ali; Havens, Joaquim M

2018-04-01

The objective of our study was to characterize providers' impressions of factors contributing to disproportionate rates of morbidity and mortality in emergency general surgery to identify targets for care quality improvement. Emergency general surgery is characterized by a high-cost burden and disproportionate morbidity and mortality. Factors contributing to these observed disparities are not comprehensively understood and targets for quality improvement have not been formally developed. Using a grounded theory approach, emergency general surgery providers were recruited through purposive-criterion-based sampling to participate in semi-structured interviews and focus groups. Participants were asked to identify contributors to emergency general surgery outcomes, to define effective care for EGS patients, and to describe operating room team structure. Interviews were performed to thematic saturation. Transcripts were iteratively coded and analyzed within and across cases to identify emergent themes. Member checking was performed to establish credibility of the findings. A total of 40 participants from 5 academic hospitals participated in either individual interviews (n = 25 [9 anesthesia, 12 surgery, 4 nursing]) or focus groups (n = 2 [15 nursing]). Emergency general surgery was characterized by an exceptionally high level of variability, which can be subcategorized as patient-variability (acute physiology and comorbidities) and system-variability (operating room resources and workforce). Multidisciplinary communication is identified as a modifier to variability in emergency general surgery; however, nursing is often left out of early communication exchanges. Critical variability in emergency general surgery may impact outcomes. Patient-variability and system-variability, with focus on multidisciplinary communication, represent potential domains for quality improvement in this field. Copyright © 2017 Elsevier Inc. All rights reserved.

Does bariatric surgery improve adipose tissue function?

Science.gov (United States)

Frikke-Schmidt, H.; O’Rourke, R. W.; Lumeng, C. N.; Sandoval, D. A.; Seeley, R. J.

2017-01-01

Summary Bariatric surgery is currently the most effective treatment for obesity. Not only do these types of surgeries produce significant weight loss but also they improve insulin sensitivity and whole body metabolic function. The aim of this review is to explore how altered physiology of adipose tissue may contribute to the potent metabolic effects of some of these procedures. This includes specific effects on various fat depots, the function of individual adipocytes and the interaction between adipose tissue and other key metabolic tissues. Besides a dramatic loss of fat mass, bariatric surgery shifts the distribution of fat from visceral to the subcutaneous compartment favoring metabolic improvement. The sensitivity towards lipolysis controlled by insulin and catecholamines is improved, adipokine secretion is altered and local adipose inflammation as well as systemic inflammatory markers decreases. Some of these changes have been shown to be weight loss independent, and novel hypothesis for these effects includes include changes in bile acid metabolism, gut microbiota and central regulation of metabolism. In conclusion bariatric surgery is capable of improving aspects of adipose tissue function and do so in some cases in ways that are not entirely explained by the potent effect of surgery. PMID:27272117

Success stories and emerging themes in conservation physiology.

Science.gov (United States)

Madliger, Christine L; Cooke, Steven J; Crespi, Erica J; Funk, Jennifer L; Hultine, Kevin R; Hunt, Kathleen E; Rohr, Jason R; Sinclair, Brent J; Suski, Cory D; Willis, Craig K R; Love, Oliver P

2016-01-01

The potential benefits of physiology for conservation are well established and include greater specificity of management techniques, determination of cause-effect relationships, increased sensitivity of health and disturbance monitoring and greater capacity for predicting future change. While descriptions of the specific avenues in which conservation and physiology can be integrated are readily available and important to the continuing expansion of the discipline of 'conservation physiology', to date there has been no assessment of how the field has specifically contributed to conservation success. However, the goal of conservation physiology is to foster conservation solutions and it is therefore important to assess whether physiological approaches contribute to downstream conservation outcomes and management decisions. Here, we present eight areas of conservation concern, ranging from chemical contamination to invasive species to ecotourism, where physiological approaches have led to beneficial changes in human behaviour, management or policy. We also discuss the shared characteristics of these successes, identifying emerging themes in the discipline. Specifically, we conclude that conservation physiology: (i) goes beyond documenting change to provide solutions; (ii) offers a diversity of physiological metrics beyond glucocorticoids (stress hormones); (iii) includes approaches that are transferable among species, locations and times; (iv) simultaneously allows for human use and benefits to wildlife; and (v) is characterized by successes that can be difficult to find in the primary literature. Overall, we submit that the field of conservation physiology has a strong foundation of achievements characterized by a diversity of conservation issues, taxa, physiological traits, ecosystem types and spatial scales. We hope that these concrete successes will encourage the continued evolution and use of physiological tools within conservation-based research and management

Cost and effectiveness of lung lobectomy by video-assisted thoracic surgery for lung cancer.

Science.gov (United States)

Mafé, Juan J; Planelles, Beatriz; Asensio, Santos; Cerezal, Jorge; Inda, María-Del-Mar; Lacueva, Javier; Esteban, Maria-Dolores; Hernández, Luis; Martín, Concepción; Baschwitz, Benno; Peiró, Ana M

2017-08-01

Video-assisted thoracic surgery (VATS) emerged as a minimally invasive surgery for diseases in the field of thoracic surgery. We herein reviewed our experience on thoracoscopic lobectomy for early lung cancer and evaluated Health System use. A cost-effectiveness study was performed comparing VATS vs. open thoracic surgery (OPEN) for lung cancer patients. Demographic data, tumor localization, dynamic pulmonary function tests [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), diffusion capacity (DLCO) and maximal oxygen uptake (VO2max)], surgical approach, postoperative details, and complications were recorded and analyzed. One hundred seventeen patients underwent lung resection by VATS (n=42, 36%; age: 63±9 years old, 57% males) or OPEN (n=75, 64%; age: 61±11 years old, 73% males). Pulmonary function tests decreased just after surgery with a parallel increasing tendency during first 12 months. VATS group tended to recover FEV1 and FVC quicker with significantly less clinical and post-surgical complications (31% vs. 53%, P=0.015). Costs including surgery and associated hospital stay, complications and costs in the 12 months after surgery were significantly lower for VATS (P<0.05). The VATS approach surgery allowed earlier recovery at a lower cost than OPEN with a better cost-effectiveness profile.

Activation capacity of the alternative and classic complement pathways in patients operated on for colorectal cancer

DEFF Research Database (Denmark)

Zimmermann-Nielsen, Erik; Iversen, Lene H; Svehag, Sven-Erik

2002-01-01

surgery. The samples were analyzed with an enzyme-linked immunosorbent assay that measured C3 activation capacity by the alternative and classic complement pathways. Cancer patients were compared according to Dukes stage, type of surgery performed, transfusion of blood, development of infection, venous....... Significant differences in C3 activation capacities were observed between cancer patients that were related to Dukes stage and in patients with and without buffy coat-depleted red cells suspended in saline, adenine, glucose, and mannitol transfusion, infectious events, and deep venous thromboembolism...

Benefits of Bariatric Surgery and Perioperative Surgical Safety

Directory of Open Access Journals (Sweden)

Ji Chung Tham

2015-11-01

Full Text Available Obesity is a worldwide problem with numerous associated health problems. The number of patients eligible for surgery outnumber surgical capacity and so patients need to be prioritised based on their obesity- related health burden and comorbidities. Weight loss as a result of bariatric surgery is significant and maintained in the long term. In addition to weight loss, patient health improves in terms of metabolic, macrovascular, and microvascular disease. As a result, quality of life is better, along with psychosocial wellbeing. Bariatric surgery is associated with a relatively low number of complications and appears to result in a reduction in mortality risk due to the resolution of comorbidities. Hence, surgery can now be routinely considered as an adjunct to medical therapy in the management of obesity.

['Anatomia actuosa et apta'. The mechanist 'proto'-physiology of B.S. Albinus].

Science.gov (United States)

van der Korst, J K

1993-01-01

Already during his tenure as professor of anatomy and surgery (1721-1746) and before he became a professor of physiology and medicine at the University of Leiden, Bernard Siegfried Albinus held private lecture courses on physiology. In these lectures he pleaded for a separation of physiology from theoretical medicine, which was still its customary place in the medical curriculum of the first half of the eighteenth century. According to Albinus, physiology was a science in its own right and should be solely based on the careful observation of forms and structures of the human body. From the 'fabrica', the function ('aptitudo') could be derived by careful reasoning. As shown by a set of lecture notes, which recently came to light, Albinus adhered, initially, to a strictly mechanistic explanatory model, which was almost completely based on the physiological concepts of Herman Boerhaave. However, in contrast to the latter, he even rejected the involvement of chemical processes in digestion. Although his lectures were highly acclaimed as demonstrations of minute anatomy, Albinus met with little or no direct response in regard to his concept of physiology.

Effects of types of media and NPK fertilizer on the rooting capacity of chrysanthemum cuttings

NARCIS (Netherlands)

Budiarto, K.; Sulyo, Y.; Dwi, E.; Maaswinkel, R.H.M.

2006-01-01

Physiological status of chrysanthemum cuttings during rooting process highly influences plant growth and flower production. Amongst other aspects, rooting capacity of the cuttings is the most important. Rooting capacity is influenced by environmental conditions such as growing medium and nutrition.

A conceptual framework for the emerging discipline of conservation physiology

Science.gov (United States)

Coristine, Laura E.; Robillard, Cassandra M.; Kerr, Jeremy T.; O'Connor, Constance M.; Lapointe, Dominique; Cooke, Steven J.

2014-01-01

Current rates of biodiversity decline are unprecedented and largely attributed to anthropogenic influences. Given the scope and magnitude of conservation issues, policy and management interventions must maximize efficiency and efficacy. The relatively new field of conservation physiology reveals the physiological mechanisms associated with population declines, animal–environment relationships and population or species tolerance thresholds, particularly where these relate to anthropogenic factors that necessitate conservation action. We propose a framework that demonstrates an integrative approach between physiology, conservation and policy, where each can inform the design, conduct and implementation of the other. Each junction of the conservation physiology process has the capacity to foster dialogue that contributes to effective implementation, monitoring, assessment and evaluation. This approach enables effective evaluation and implementation of evidence-based conservation policy and management decisions through a process of ongoing refinement, but may require that scientists (from the disciplines of both physiology and conservation) and policy-makers bridge interdisciplinary knowledge gaps. Here, we outline a conceptual framework that can guide and lead developments in conservation physiology, as well as promote innovative research that fosters conservation-motivated policy. PMID:27293654

The usefulness of myocardial SPECT for the preoperative cardiac risk evaluation in noncardiac surgery

International Nuclear Information System (INIS)

Lim, Seok Tae; Lee, Dong Soo; Kang, Won Jon; Chung, June Key; Lee, Myung Chul

1999-01-01

We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. 118 patients ( M: F=66: 52, 62.7±10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest Tl-201/ stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heat failure and unstable angina) were surveyed through perioperative periods (14.6±5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery

Success stories and emerging themes in conservation physiology

Science.gov (United States)

Madliger, Christine L.; Cooke, Steven J.; Crespi, Erica J.; Funk, Jennifer L.; Hultine, Kevin R.; Hunt, Kathleen E.; Rohr, Jason R.; Sinclair, Brent J.; Suski, Cory D.; Willis, Craig K. R.; Love, Oliver P.

2016-01-01

The potential benefits of physiology for conservation are well established and include greater specificity of management techniques, determination of cause–effect relationships, increased sensitivity of health and disturbance monitoring and greater capacity for predicting future change. While descriptions of the specific avenues in which conservation and physiology can be integrated are readily available and important to the continuing expansion of the discipline of ‘conservation physiology’, to date there has been no assessment of how the field has specifically contributed to conservation success. However, the goal of conservation physiology is to foster conservation solutions and it is therefore important to assess whether physiological approaches contribute to downstream conservation outcomes and management decisions. Here, we present eight areas of conservation concern, ranging from chemical contamination to invasive species to ecotourism, where physiological approaches have led to beneficial changes in human behaviour, management or policy. We also discuss the shared characteristics of these successes, identifying emerging themes in the discipline. Specifically, we conclude that conservation physiology: (i) goes beyond documenting change to provide solutions; (ii) offers a diversity of physiological metrics beyond glucocorticoids (stress hormones); (iii) includes approaches that are transferable among species, locations and times; (iv) simultaneously allows for human use and benefits to wildlife; and (v) is characterized by successes that can be difficult to find in the primary literature. Overall, we submit that the field of conservation physiology has a strong foundation of achievements characterized by a diversity of conservation issues, taxa, physiological traits, ecosystem types and spatial scales. We hope that these concrete successes will encourage the continued evolution and use of physiological tools within conservation-based research and

Functioning of obese individuals in pre- and postoperative periods of bariatric surgery.

Science.gov (United States)

Vargas, C B; Picolli, F; Dani, C; Padoin, A V; Mottin, C C

2013-10-01

Obesity is a pathologic condition that causes functional incapacity, with reduction of quality of life and life expectancy and an increase in mortality. Bariatric surgery is indicated to alleviate associated comorbidities and increase physical capacity. The objective of this work was to evaluate the functional capacity of patients with morbid obesity before and after (3 months) bariatric surgery. This was a cross-sectional study involving 67 patients, where 61 were women and six men, with a mean age of 38 ± 10 years and mean BMI of 50.45 ± 8.5 kg/m2. All patients were assessed before surgery and 3 months afterwards. The following assessments were performed: 6-min walk test (6MWT), functional independence measure (FIM), and test for risk of falling and transfer capacity, called the timed up-and-go test. The study demonstrated a reduction in parameters evaluated in 6MWT with a statistically significant difference at two times (rest and final) when evaluated before and after bariatric surgery (p < 0.001). In relation to the FIM and timed up-and-go test, the patients showed a statistically significant improvement (p < 0.001) for both when comparing the tasks evaluated at the pre- and postoperative moments. Obesity has an impact on the functioning and quality of life of patients. We observed an improvement in all instruments used for assessment before and after bariatric surgery, where a linear component was demonstrated in relation to diminution of body mass index and functioning.

One-Stop Clinic Utilization in Plastic Surgery: Our Local Experience and the Results of a UK-Wide National Survey

Science.gov (United States)

Gorman, Mark; Coelho, James; Gujral, Sameer; McKay, Alastair

2015-01-01

Introduction. “See and treat” one-stop clinics (OSCs) are an advocated NHS initiative to modernise care, reducing cancer treatment waiting times. Little studied in plastic surgery, the existing evidence suggests that though they improve care, they are rarely implemented. We present our experience setting up a plastic surgery OSC for minor skin surgery and survey their use across the UK. Methods. The OSC was evaluated by 18-week wait target compliance, measures of departmental capacity, and patient satisfaction. Data was obtained from 32 of the 47 UK plastic surgery departments to investigate the prevalence of OSCs for minor skin cancer surgery. Results. The OSC improved 18-week waiting times, from a noncompliant mean of 80% to a compliant 95% average. Department capacity increased 15%. 95% of patients were highly satisfied with and preferred the OSC to a conventional service. Only 25% of UK plastic surgery units run OSCs, offering varying reasons for not doing so, 42% having not considered their use. Conclusions. OSCs are underutilised within UK plastic surgery, where a significant proportion of units have not even considered their benefit. This is despite associated improvements in waiting times, department capacity, and levels of high patient satisfaction. We offer our considerations and local experience instituting an OSC service. PMID:26236502

Status of sex reassignment surgery for gender identity disorder in Japan.

Science.gov (United States)

Masumori, Naoya

2012-05-01

An incongruence between one's physiological sex and the gender identity that is one's basic sense of self as a man or a woman is known as gender identity disorder. In general, the conditions of physiological men having female gender identity and physiological women having male gender identity are called male-to-female and female-to-male gender identity disorder, respectively. Although the precise pathogenesis of gender identity disorder remains unclear, the prevalence of gender identity disorder is quite high, with the rates calculated for male-to-female to be 1:25,000 and female-to-male to be 1:12,000 in Hokkaido, Japan. The diagnosis and treatment of gender identity disorder in Japan are based on the Diagnostic and Therapeutic Guidelines for Patients with Gender Identity Disorder, 4th edition. Although gender identity disorder was previously thought to be a psychiatric condition, it is extremely difficult to assign gender identity to physiological sex by psychiatric and psychological treatments. To adapt the figure of the body to the native gender identity, physical treatments such as administration of cross-sex steroids and sex reassignment surgery are considered. However, there are very few institutions that routinely carry out sex reassignment surgery in Japan, even though it is mandatory for changing sex on the census register at the present time. Sex reassignment surgery for male-to-female and female-to-male patients includes orchiectomy, penectomy, clitoroplasty, vaginoplasty and vulvoplasty, and hysterectomy, ovariectomy, metoidioplasty and phalloplasty, respectively. To provide accurate information about physical treatment for patients with gender identity disorder, even urologists who are not actively involved in the diagnosis and treatment of gender identity disorder should understand the fundamental aspects and contemporary problems of gender identity disorder. © 2012 The Japanese Urological Association.

A PHYSIOLOGICAL CASE STUDY OF A PARALYMPIC WHEELCHAIR TENNIS PLAYER: REFLECTIVE PRACTISE

Directory of Open Access Journals (Sweden)

Nicholas J. Diaper

2009-06-01

Full Text Available This study was designed to examine the physiological changes caused by long-term training in a world class female tennis player in preparation for a major championship. Additionally, we aim to describe the training interventions and determine a suitable cooling strategy that was to be used at the 2004 Paralympic Games. The athlete underwent regular physiological assessment during 2003-2004. Physiological measures involved body composition, submaximal and peak oxygen uptake and key variables associated with maximal sprinting. In addition, a suitable match-play cooling intervention and hydration strategy was also explored. Body composition improved over the course of the study. Aerobic capacity fell by 21%, yet the submaximal physiological variables such as lactate profile and pushing economy improved. The trade off of aerobic capacity was perhaps noticeably counter-balanced with the maintenance of the peak sprinting speed and improvement found in the fatigue profile across ten repeated sprints. The extensive training programme was responsible for these changes and these adaptations resulted in a more confident athlete, in peak physical condition leading into the Paralympic Games. It is difficult to appreciate the extent to which this work had an impact on tennis performance given the skill requirements of wheelchair tennis and this warrants future attention

Professor Samuel David Gross (1805-1884) and His Innovations in Surgery and Medicine.

Science.gov (United States)

Laios, Konstantinos

2018-06-01

Professor Samuel David Gross (1805-1884) is considered as one of the founders of American surgery. He was a skillful surgeon who could excellently perform a lithotomy, an amputation, and a cataract surgery. He introduced many new surgical techniques and designed new surgical and medical instruments. He expertise was not limited to surgery alone; he also published studies concerning internal medicine, pathology, experimental physiology, and pharmacology. His most important treatise was his 2-volume work, A System of Surgery, Pathological, Diagnostic, Therapeutic and Operative (1861), which was a standard reference book in surgery in the United States during the second half of 19th century. Gross received many honors during his life. He was active in the operating room until his death.

Evolutionary History Underlies Plant Physiological Responses to Global Change Since the Last Glacial Maximum

Science.gov (United States)

Becklin, K. M.; Medeiros, J. S.; Sale, K. R.; Ward, J. K.

2014-12-01

Assessing family and species-level variation in physiological responses to global change across geologic time is critical for understanding factors that underlie changes in species distributions and community composition. Ancient plant specimens preserved within packrat middens are invaluable in this context since they allow for comparisons between co-occurring plant lineages. Here we used modern and ancient plant specimens preserved within packrat middens from the Snake Range, NV to investigate the physiological responses of a mixed montane conifer community to global change since the last glacial maximum. We used a conceptual model to infer relative changes in stomatal conductance and maximum photosynthetic capacity from measures of leaf carbon isotopes, stomatal characteristics, and leaf nitrogen content. Our results indicate that most of the sampled taxa decreased stomatal conductance and/or photosynthetic capacity from glacial to modern times. However, plant families differed in the timing and magnitude of these physiological responses. Additionally, leaf-level responses were more similar within plant families than within co-occurring species assemblages. This suggests that adaptation at the level of leaf physiology may not be the main determinant of shifts in community composition, and that plant evolutionary history may drive physiological adaptation to global change over recent geologic time.

Cardiovascular anatomy and physiology in the female.

Science.gov (United States)

Wingate, S

1997-12-01

Important differences in male and female cardiovascular anatomy and physiology may account for many of the gender differences seen in various cardiac disease states. Predominant influences on female disease manifestations include (1) women's smaller body size, hence smaller hearts and smaller coronary vessels and (2) women's fluctuating levels of estrogen throughout their lifespan. Understanding these critical anatomic and physiologic differences allows the clinician to better predict and plan care for women. For example, knowing that women generally have a smaller body surface area than men allows one to better understand why men have higher creatine kinase (CK) values than do women--an important distinction when interpreting these values in the acute care setting. The fact that women's hearts and coronary vessels are generally smaller than men's also helps one understand why women have a higher in-hospital mortality than men post-coronary artery bypass graft surgery (see article by Allen in this issue for more detailed information on revascularization). These are only a few examples of the many opportunities that acute care nurses have to integrate their knowledge of anatomy and physiology into proactive planning for their female cardiac patients.

Bariatric surgery and long-term nutritional issues

Science.gov (United States)

Lupoli, Roberta; Lembo, Erminia; Saldalamacchia, Gennaro; Avola, Claudia Kesia; Angrisani, Luigi; Capaldo, Brunella

2017-01-01

Bariatric surgery is recognized as a highly effective therapy for obesity since it accomplishes sustained weight loss, reduction of obesity-related comorbidities and mortality, and improvement of quality of life. Overall, bariatric surgery is associated with a 42% reduction of the cardiovascular risk and 30% reduction of all-cause mortality. This review focuses on some nutritional consequences that can occur in bariatric patients that could potentially hinder the clinical benefits of this therapeutic option. All bariatric procedures, to variable degrees, alter the anatomy and physiology of the gastrointestinal tract; this alteration makes these patients more susceptible to developing nutritional complications, namely, deficiencies of macro- and micro-nutrients, which could lead to disabling diseases such as anemia, osteoporosis, protein malnutrition. Of note is the evidence that most obese patients present a number of nutritional deficits already prior to surgery, the most important being vitamin D and iron deficiencies. This finding prompts the need for a complete nutritional assessment and, eventually, an adequate correction of pre-existing deficits before surgery. Another critical issue that follows bariatric surgery is post-operative weight regain, which is commonly associated with the relapse of obesity-related co-morbidities. Nu-tritional complications associated with bariatric surgery can be prevented by life-long nutritional monitoring with the administration of multi-vitamins and mineral supplements according to the patient’s needs. PMID:29204255

MUSCULAR OXIDATIVE CAPACITY IN OVARIECTOMIZED RATS DISCUSSION ON THE ENDURANCE PERFORMANCE OF FEMALE ATHLETES WITH SPORTS-RELATED-AMENORRHEA

Directory of Open Access Journals (Sweden)

Natsuo Yasui

2004-11-01

Full Text Available The purpose of this study was to evaluate the effects of ovariectomy on intramuscular energy metabolism in adult rats. Based on the results, we discussed the skeletal muscle metabolism in female athlete with sports related amenorrhea. Twenty-five adult (20-week-old Sprague-Dawley female rats were used. Fifteen rats underwent ovariectomy (OVX group, and the other ten rats were sham-operated (Sham group. One and four weeks after surgery, muscular oxidative capacity was measured using 31P-MR spectra of the gastrocnemius-plantaris-soleus (GPS muscles group at rest and during electric stimulation. Wet weight and maximum tension of the whole GPS muscles group were also measured. From the MRS measurements, the muscle oxidative capacity in the OVX group was significantly lower than that in the Sham group (p < 0.05 at both one and four weeks after surgery. The muscle's wet weight one week after surgery in the OVX group was the same as the Sham group, while four weeks after surgery it was significantly greater than that in the Sham group (p < 0.05. There were no significant differences in maximum tension among the groups. In conclusion, in adult rats the oxidative capacity decreased due to ovariectomy despite the increase in muscle weight. It is suggested that the muscular endurance capacity in female adult athletes with sports related amenorrhea may deteriorate.

Systemic physiology and neuroapoptotic profiles in young and adult rats exposed to surgery

DEFF Research Database (Denmark)

Ibrahim, Rami Mossad; Krammer, Caspar Weel; Hansen, Tom Giedsing

2015-01-01

to one of four anaesthetics regimens: (i) sevoflurane/dexmedetomidine, (ii) sevoflurane/fentanyl; (iii) propofol/dexmedetomidine, and (iv) propofol/fentanyl. Animals underwent a dorsal skin flap procedure while physiologic, metabolic and biochemical parameters were closely monitored. Neuroapoptotic...

Self-reported physical activity and lung function two months after cardiac surgery--a prospective cohort study.

Science.gov (United States)

Jonsson, Marcus; Urell, Charlotte; Emtner, Margareta; Westerdahl, Elisabeth

2014-03-28

Physical activity has well-established positive health-related effects. Sedentary behaviour has been associated with postoperative complications and mortality after cardiac surgery. Patients undergoing cardiac surgery often suffer from impaired lung function postoperatively. The association between physical activity and lung function in cardiac surgery patients has not previously been reported. Patients undergoing cardiac surgery were followed up two months postoperatively. Physical activity was assessed on a four-category scale (sedentary, moderate activity, moderate regular exercise, and regular activity and exercise), modified from the Swedish National Institute of Public Health's national survey. Formal lung function testing was performed preoperatively and two months postoperatively. The sample included 283 patients (82% male). Two months after surgery, the level of physical activity had increased (p < 0.001) in the whole sample. Patients who remained active or increased their level of physical activity had significantly better recovery of lung function than patients who remained sedentary or had decreased their level of activity postoperatively in terms of vital capacity (94 ± 11% of preoperative value vs. 91 ± 9%; p = 0.03), inspiratory capacity (94 ± 14% vs. 88 ± 19%; p = 0.008), and total lung capacity (96 ± 11% vs. 90 ± 11%; p = 0.01). An increased level of physical activity, compared to preoperative level, was reported as early as two months after surgery. Our data shows that there could be a significant association between physical activity and recovery of lung function after cardiac surgery. The relationship between objectively measured physical activity and postoperative pulmonary recovery needs to be further examined to verify these results.

Physical work capacity in older adults: implications for the aging worker.

Science.gov (United States)

Kenny, Glen P; Yardley, Jane E; Martineau, Lucie; Jay, Ollie

2008-08-01

In many developed countries, the workforce is rapidly aging. Occupational demands however, have not decreased despite the fact that workers see a decline in physical work capacity with age. The purpose of this review is to examine the physiological adaptations to aging, the impact of aging on performance and the benefits of physical fitness in improving functional work capacity in aging individuals. An extensive search of the scientific literature was performed, acquiring published articles which examined the physiological changes associated with age-related decrements in the physical work capacity of healthy aging adults. The databases accessed included AARP Ageline, AccessScience, Annual Reviews, CISTI, Cochrane Library, Clinical Evidence, Digital Dissertations (Proquest), Embase, HealthSTAR, Medline, PubMed, Scopus, and PASCAL and included relevant information sites obtained on the world wide web. While a great deal of variation exists, an average decline of 20% in physical work capacity has been reported between the ages of 40 and 60 years, due to decreases in aerobic and musculoskeletal capacity. These declines can contribute to decreased work capacity, and consequential increases in work-related injuries and illness. However, differences in habitual physical activity will greatly influence the variability seen in individual physical work capacity and its components. Well-organized, management-supported, work-site health interventions encouraging physical activity during work hours could potentially decrease the incidence of age-related injury and illness. Age-associated functional declines and the accompanying risk of work-related injury can be prevented or at least delayed by the practice of regular physical activity. Older workers could optimally pursue their careers until retirement if they continuously maintain their physical training.

Frailty assessment in vascular surgery and its utility in preoperative decision making.

Science.gov (United States)

Kraiss, Larry W; Beckstrom, Julie L; Brooke, Benjamin S

2015-06-01

The average patient requiring vascular surgery has become older, as life expectancy within the US population has increased. Many older patients have some degree of frailty and reside near the limit of their physiological reserve with restricted ability to respond to stressors such as surgery. Frailty assessment is an important part of the preoperative decision-making process, in order to determine whether patients are fit enough to survive the vascular surgery procedure and live long enough to benefit from the intervention. In this review, we will discuss different measures of frailty assessment and how they can be used by vascular surgery providers to improve preoperative decision making and the quality of patient care. Copyright © 2015 Elsevier Inc. All rights reserved.

Optimizing transfusion in vascular surgery: is bloodless surgery an option?

Science.gov (United States)

Shander, Aryeh

2008-01-01

The prospect of surgery without blood loss is an emerging reality. Use of a blood conservation strategy is gaining increasing recognition as a sound and practical approach, especially for the majority of large blood loss surgeries. However, critical situations still occur in which transfusions are necessary or unavoidable for the short-term survival of the patient. The decision-making processes for determining when to transfuse, which blood products to give, and how much are presented here with an evaluation of the risks of transfusion and a discussion on blood conservation strategies. Modalities that may be used in such strategies include restricted phlebotomy, the implementation of restrictive transfusion triggers, acute normovolemic hemodilution, intraoperative and postoperative blood salvage, and refined operative techniques to achieve meticulous hemostasis. In addition, the proper use of erythropoiesis-stimulating agents well before surgery can reduce the number of units transfused. The risks and costs of allogeneic blood transfusions underscore the need for and value of blood conservation techniques. Increasingly, hospitals are adopting blood conservation strategies as part of their routine practice. Blood conservation is a rapidly evolving field in which active research is expanding our understanding of the molecular, physiologic, and clinical aspects of hematopoiesis, circulatory response, coagulation enigmas, artificial oxygen carriers, and the impact of anemia on organ function. Ongoing research offers the possibility of replacement or elimination of allogeneic blood transfusions in a variety of clinical settings.

Aerobic capacity mediates susceptibility for the transition from steatosis to steatohepatitis.

Science.gov (United States)

Morris, E Matthew; McCoin, Colin S; Allen, Julie A; Gastecki, Michelle L; Koch, Lauren G; Britton, Steven L; Fletcher, Justin A; Fu, Xiarong; Ding, Wen-Xing; Burgess, Shawn C; Rector, R Scott; Thyfault, John P

2017-07-15

) activation compared to HCR rats. Further, LCR rats had greater WD-induced decreases in complete FAO and mitochondrial respiratory capacity. Intrinsic aerobic capacity had no impact on WD-induced hepatic steatosis; however, rats bred for low aerobic capacity developed greater hepatic inflammation, which was associated with reduced hepatic mitochondrial FAO and respiratory capacity and increased accumulation of cholesterol esters. These results confirm epidemiological reports that aerobic capacity impacts progression of liver disease and suggest that these effects are mediated through alterations in hepatic mitochondrial function. © 2017 The Authors. The Journal of Physiology © 2017 The Physiological Society.

Manual hyperinflation partly prevents reductions of functional residual capacity in cardiac surgical patients--a randomized controlled trial

NARCIS (Netherlands)

Paulus, Frederique; Veelo, Denise P.; de Nijs, Selma B.; Beenen, Ludo F. M.; Bresser, Paul; de Mol, Bas A. J. M.; Binnekade, Jan M.; Schultz, Marcus J.

2011-01-01

Cardiac surgery is associated with post-operative reductions of functional residual capacity (FRC). Manual hyperinflation (MH) aims to prevent airway plugging, and as such could prevent the reduction of FRC after surgery. The main purpose of this study was to determine the effect of MH on

[Lung volume reduction surgery for emphysema and bullous pulmonary emphysema].

Science.gov (United States)

Le Pimpec-Barthes, F; Das Neves-Pereira, J-C; Cazes, A; Arame, A; Grima, R; Hubsch, J-P; Zukerman, C; Hernigou, A; Badia, A; Bagan, P; Delclaux, C; Dusser, D; Riquet, M

2012-04-01

The improvement of respiratory symptoms for emphysematous patients by surgery is a concept that has evolved over time. Initially used for giant bullae, this surgery was then applied to patients with diffuse microbullous emphysema. The physiological and pathological concepts underlying these surgical procedures are the same in both cases: improve respiratory performance by reducing the high intrapleural pressure. The functional benefit of lung volume reduction surgery (LVRS) in the severe diffuse emphysema has been validated by the National Emphysema Treatment Trial (NETT) and the later studies which allowed to identify prognostic factors. The quality of the clinical, morphological and functional data made it possible to develop recommendations now widely used in current practice. Surgery for giant bullae occurring on little or moderately emphysematous lung is often a simpler approach but also requires specialised support to optimize its results. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

A Physiological Signature of the Cost of Reproduction Associated with Parental Care.

Science.gov (United States)

Fowler, Melinda A; Williams, Tony D

2017-12-01

Costs of reproduction are an integral and long-standing component of life-history theory, but we still know relatively little about the specific physiological mechanisms underlying these trade-offs. We experimentally manipulated workload during parental care in female European starlings (Sturnus vulgaris) using attachment of radios and/or wing clipping and assessed measures of workload, current breeding productivity, future fecundity, and survival (local return rate) in relation to treatment. Females with wing clipping and radio attachment paid a clear cost of reproduction compared with all other treatment groups: they had lower future fecundity and lower return rates despite having lower current breeding productivity. We then measured 13 physiological traits, including measures of aerobic/metabolic capacity, oxidative stress and muscle damage, intermediary metabolism and energy supply, and immune function. Our results show that the cost of reproduction in females with wing clipping and radio attachment was associated with lower oxygen-carrying capacity (lower hematocrit and hemoglobin levels), lower energy reserves (plasma nonesterified fatty acid and triglyceride levels), decreased immune function (lower haptoglobin levels), and elevated levels of oxidative stress (higher levels of dROMs [reactive oxygen metabolites] and lower levels of the endogenous antioxidant uric acid). Our study provides evidence that costs of reproduction involve a widespread decline in physiological function across multiple physiological systems consistent with long-standing ideas of cumulative "wear and tear" and allostatic load.

The Influence of Various Types of Water Gymnastics Upon the Exercise Capacity

OpenAIRE

BADAU, Dana; BADAU, Adela

2015-01-01

Between the components of the physiological capacity and the practice degree of the physical exercise is a direct interrelation, which is influenced by a number of factors, out of which deployment environment with its features has a leading role. Determining the relationship between the effort capacity by heart rate changes during recovery after exercise, determining the body aerobic resistance level, as a result of the entertaining and recreational activities, specifically, pe...

Virtual Reality for Pain Management in Cardiac Surgery

Science.gov (United States)

Mosso-Vázquez, José Luis; Gao, Kenneth; Wiederhold, Brenda K.

2014-01-01

Abstract Surgical anxiety creates psychological and physiological stress, causes complications in surgical procedures, and prolongs recovery. Relaxation of patients in postoperative intensive care units can moderate patient vital signs and reduce discomfort. This experiment explores the use of virtual reality (VR) cybertherapy to reduce postoperative distress in patients that have recently undergone cardiac surgery. Sixty-seven patients were monitored at IMSS La Raza National Medical Center within 24 hours of cardiac surgery. Patients navigated through a 30 minute VR simulation designed for pain management. Results were analyzed through comparison of pre- and postoperative vital signs and Likert scale survey data. A connection was found in several physiological factors with subjective responses from the Likert scale survey. Heavy positive correlation existed between breathing rate and Likert ratings, and a moderate correlation was found between mean arterial pressure and Likert ratings and heart rate and Likert ratings, all of which indicated lower pain and stress within patients. Further study of these factors resulted in the categorization of patients based upon their vital signs and subjective response, providing a context for the effectiveness of the therapy to specific groups of patients. PMID:24892200

Cell response to surgery.

LENUS (Irish Health Repository)

Ni Choileain, Niamh

2012-02-03

OBJECTIVES: To describe the profound alterations in host immunity that are produced by major surgery as demonstrated by experimental and clinical studies, and to evaluate the benefits of therapeutic strategies aimed at attenuating perioperative immune dysfunction. DATA SOURCES: A review of the English-language literature was conducted, incorporating searches of the MEDLINE, EMBASE, and Cochrane collaboration databases to identify laboratory and clinical studies investigating the cellular response to surgery. STUDY SELECTION: Original articles and case reports describing immune dysfunction secondary to surgical trauma were included. DATA EXTRACTION: The results were compiled to show outcomes of different studies and were compared. DATA SYNTHESIS: Current evidence indicates that the early systemic inflammatory response syndrome observed after major surgery that is characterized by proinflammatory cytokine release, microcirculatory disturbance, and cell-mediated immune dysfunction is followed by a compensatory anti-inflammatory response syndrome, which predisposes the patient to opportunistic infection, multiple organ dysfunction syndrome, and death. Because there are currently no effective treatment options for multiple organ dysfunction syndrome, measures to prevent its onset should be initiated at an early stage. Accumulating experimental evidence suggests that targeted therapeutic strategies involving immunomodulatory agents such as interferon gamma, granulocyte colony-stimulating factor, the prostaglandin E(2) antagonist, indomethacin, and pentoxifylline may be used for the treatment of systemic inflammatory response syndrome to prevent the onset of multiple organ dysfunction syndrome. CONCLUSIONS: Surgical trauma produces profound immunological dysfunction. Therapeutic strategies directed at restoring immune homeostasis should aim to redress the physiological proinflammatory-anti-inflammatory cell imbalance associated with major surgery.

The association of muscle strength, aerobic capacity and swim time performance in young, competitive swimmers

DEFF Research Database (Denmark)

Henriksen, Peter; Knudsen, Hans Kromann; Juul-Kristensen, Birgit

2016-01-01

The association of muscle strength, aerobic capacity and swim time performance in young, competitive swimmers Introduction Swim time performance is affected by physiological factors such as muscle strength and power of the upper and lower extremities as well as aerobic capacity (Smith et al., 2002......). The association between these factors and swim time performance may plausibly identify some of the determinants for performance enhancement in swimming (Smith et al., 2002). In order to detail the individual training programme, reference values are needed. The aims of this study were firstly to determine...... the association between muscle strength and power, aerobic capacity and 100 m freestyle time (FT) in young, competitive swimmers, and secondly to determine reference values for these physiological factors. Methods In total, 119 competitive swimmers aged 11-15 years were assessed with Grip Strength (GS), Vertical...

Macular thickness after glaucoma filtration surgery.

Science.gov (United States)

Sesar, Antonio; Cavar, Ivan; Sesar, Anita Pusić; Geber, Mia Zorić; Sesar, Irena; Laus, Katia Novak; Vatavuk, Zoran; Mandić, Zdravko

2013-09-01

The aim of present study was to analyze early postoperative changes in the macular area using optical coherence tomography (OCT) after uncomplicated glaucoma filtration surgery. This prospective study included 32 patients (34 eyes) with open-angle glaucoma, which underwent trabeculectomy with or without use of mitomycin C. Exclusion criteria were macular edema, uveitis, age-related macular degeneration, blurred optical media, secondary glaucoma and angle-closure glaucoma. All standard clinical examinations were made before surgery, at the 2nd day, 1 week and 1 month after surgery. Tomography of the macula was performed during every examination using Cirrus HD OCT for the analysis of central subfield thickness. Results show that thickening of the macula was slightly higher 1 week and 1 month after operation in comparison with baseline end 2nd day postoperativelly. There was no significant difference in the change of macular thickness in patients who have used topical prostaglandins compared with those who have used other topical medications. Also, there was no difference in macular changes between patients treated with or without mitomycin C. In conclusion, we found a slight subclinical increase in macular thickness after uncomplicated trabeculectomy, for which we considered that was the result in reduction of intraocular pressure after glaucoma surgery. Macular thickening after glaucoma filtering surgery could be a physiological reaction to the stress of the retina caused by a sudden reduction of intraocular pressure and it is the consequence of altered relationship between capillary pressure and interstitial fluid pressure.

Myocardial injury after surgery is a risk factor for weaning failure from mechanical ventilation in critical patients undergoing major abdominal surgery.

Directory of Open Access Journals (Sweden)

Shu Li

Full Text Available Myocardial injury after noncardiac surgery (MINS is a newly proposed concept that is common among adults undergoing noncardiac surgery and associated with substantial mortality. We analyzed whether MINS was a risk factor for weaning failure in critical patients who underwent major abdominal surgery.This retrospective study was conducted in the Department of Critical Care Medicine of Peking University People's Hospital. The subjects were all critically ill patients who underwent major abdominal surgery between January 2011 and December 2013. Clinical and laboratory parameters during the perioperative period were investigated. Backward stepwise regression analysis was performed to evaluate MINS relative to the rate of weaning failure. Age, hypertension, chronic renal disease, left ventricular ejection fraction before surgery, Acute Physiologic and Chronic Health Evaluation II score, pleural effusion, pneumonia, acute kidney injury, duration of mechanical ventilation before weaning and the level of albumin after surgery were treated as independent variables.This study included 381 patients, of whom 274 were successfully weaned. MINS was observed in 42.0% of the patients. The MINS incidence was significantly higher in patients who failed to be weaned compared to patients who were successfully weaned (56.1% versus 36.5%; P<0.001. Independent predictive factors of weaning failure were MINS, age, lower left ventricular ejection fraction before surgery and lower serum albumin level after surgery. The MINS odds ratio was 4.098 (95% confidence interval, 1.07 to 15.6; P = 0.04. The patients who were successfully weaned had shorter hospital stay lengths and a higher survival rate than those who failed to be weaned.MINS is a risk factor for weaning failure from mechanical ventilation in critical patients who have undergone major abdominal surgery, independent of age, lower left ventricular ejection fraction before surgery and lower serum albumin levels after

Age-Related Patterns of Physical and Physiological Characteristics in Adolescent Wrestlers

Directory of Open Access Journals (Sweden)

Erkan Demirkan

2015-03-01

Full Text Available The aim of the study was to examine the physical and physiological differences as dependent on age of young wrestlers. One hundred and twenty-six 15 – 17 year old wrestlers volunteered as subjects in the present study. The physical and physiological profiles included body weight, height, body mass index, flexibility, anaerobic power, aerobic endurance, strength, speed, and body composition. The statistically significant (p<0.05 results are as follows: Age group 17 (AG 17 had significantly higher leg and arm anaerobic power and capacity (leg power: 952±216 Watt (W; arm power: 684±194 W and leg capacity: 489±101 W; arm capacity: 354±88 respectively as compared to the AG15 with (leg power: 718±279 Watt (W; arm power: 458±149 W and leg capacity: 376±132 W; arm capacity: 247±86 W respectively. AG17 wrestlers were significantly faster than AG 15 (4.29±.25 second - 4.53±.30 second respectively. AG 15 wrestlers had significantly lower right and left hand grip strength (right: 36.4±10.7 kg, left: 34.9±10 kg than AG 16 (right: 43.9±8.4kg, left: 42.5±7.8 kg and AG17 wrestlers (right: 46.6±8.7kg, left: 46.4±8.3 kg. In conclusion The results of this study suggest that height, body weight, fat free mass, arms – legs anaerobic power and capacity, speeds and hand grip strengths were increased both in one age range and in two ages range together with age progression, but it was clearly seen statistical differences in two ages range.

Antioxidant capacity and physical exercise

Directory of Open Access Journals (Sweden)

A Marciniak

2009-09-01

Full Text Available The aim of this article is a presentation of current knowledge regarding the changes of plasma antioxidant capacity observed in response to physical exercise. Human body created the enzymatic and non-enzymatic systems, which play a protective role in the harmful impact of free radicals. Those two systems constitute what is known as the plasma total antioxidant capacity. The amount of reactive oxygen species (ROS and reactive nitrogen species (NOS in combination with oxidation processes increases in some tissues during physiological response to physical exercise. These changes are observed after single bout of exercise as well as after regular training. The response of human body to physical exercise can be analysed using various models of exercise test. Application of repeated type of exhaustion allows for characterizing the ability of human body to adjust to the increased energy loss and increased oxygen consumption. This article presents the characteristics of components of plasma antioxidant capacity, the mechanisms of free radicals production and their role in human body. It discusses also the currently used methods of detecting changes in total antioxidant capacity and its individual elements in response to single bout of exercise and regular training. It presents the review of literature about research performed in groups of both regularly training and low exercise activity individuals as well as in group of healthy subjects and patients with circulation diseases.

Remodeling pathway control of mitochondrial respiratory capacity by temperature in mouse heart: electron flow through the Q-junction in permeabilized fibers.

Science.gov (United States)

Lemieux, Hélène; Blier, Pierre U; Gnaiger, Erich

2017-06-06

Fuel substrate supply and oxidative phosphorylation are key determinants of muscle performance. Numerous studies of mammalian mitochondria are carried out (i) with substrate supply that limits electron flow, and (ii) far below physiological temperature. To analyze potentially implicated biases, we studied mitochondrial respiratory control in permeabilized mouse myocardial fibers using high-resolution respirometry. The capacity of oxidative phosphorylation at 37 °C was nearly two-fold higher when fueled by physiological substrate combinations reconstituting tricarboxylic acid cycle function, compared with electron flow measured separately through NADH to Complex I or succinate to Complex II. The relative contribution of the NADH pathway to physiological respiratory capacity increased with a decrease in temperature from 37 to 25 °C. The apparent excess capacity of cytochrome c oxidase above physiological pathway capacity increased sharply under hypothermia due to limitation by NADH-linked dehydrogenases. This mechanism of mitochondrial respiratory control in the hypothermic mammalian heart is comparable to the pattern in ectotherm species, pointing towards NADH-linked mt-matrix dehydrogenases and the phosphorylation system rather than electron transfer complexes as the primary drivers of thermal sensitivity at low temperature. Delineating the link between stress and remodeling of oxidative phosphorylation is important for understanding metabolic perturbations in disease evolution and cardiac protection.

Affordability of cataract surgery using the Big Mac prices

Directory of Open Access Journals (Sweden)

Van C. Lansingh

2015-01-01

Conclusion: The price of cataract surgery does not consider the patient's capacity to pay, based on a simple tool such as the BMcI. This suggests affordability issues, particularly when patients work for minimum wages and/or do not have access to free health care.

Effect of gamma irradiation on lifespan and offspring physiology of male drosophila melanogaster

International Nuclear Information System (INIS)

Hou Jiangyu; Gu Wei; Jiang Fangping; Han Hetong

2010-01-01

This study aimed to investigate the effects of γ-rays irradiation on adult longevity and physiological changes in F 1 generation.Male Drosophila melanogaster at 1 ∼ 2 days old were irradiated by γ-rays with doses of 5, 10, 15 and 30 Gy. In all experimental groups, mean lifespan, maximum lifespan and 90% of lethaldeath irradiated flies were reduced(at P 1 generation of irradiated group, body weight increased, but the capacity of physiological stress declined. (authors)

Physiological and Biomechanical Mechanisms of Distance Specific Human Running Performance.

Science.gov (United States)

Thompson, M A

2017-08-01

Running events range from 60-m sprints to ultra-marathons covering 100 miles or more, which presents an interesting diversity in terms of the parameters for successful performance. Here, we review the physiological and biomechanical variations underlying elite human running performance in sprint to ultramarathon distances. Maximal running speeds observed in sprint disciplines are achieved by high vertical ground reaction forces applied over short contact times. To create this high force output, sprint events rely heavily on anaerobic metabolism, as well as a high number and large cross-sectional area of type II fibers in the leg muscles. Middle distance running performance is characterized by intermediates of biomechanical and physiological parameters, with the possibility of unique combinations of each leading to high-level performance. The relatively fast velocities in mid-distance events require a high mechanical power output, though ground reaction forces are less than in sprinting. Elite mid-distance runners exhibit local muscle adaptations that, along with a large anaerobic capacity, provide the ability to generate a high power output. Aerobic capacity starts to become an important aspect of performance in middle distance events, especially as distance increases. In distance running events, V˙O2max is an important determinant of performance, but is relatively homogeneous in elite runners. V˙O2 and velocity at lactate threshold have been shown to be superior predictors of elite distance running performance. Ultramarathons are relatively new running events, as such, less is known about physiological and biomechanical parameters that underlie ultra-marathon performance. However, it is clear that performance in these events is related to aerobic capacity, fuel utilization, and fatigue resistance. Published by Oxford University Press on behalf of the Society for Integrative and Comparative Biology 2017. This work is written by US Government employees and is in

Stomatal structure and physiology do not explain differences in water use among montane eucalypts.

Science.gov (United States)

Gharun, Mana; Turnbull, Tarryn L; Pfautsch, Sebastian; Adams, Mark A

2015-04-01

Understanding the regulation of water use at the whole-tree scale is critical to advancing the utility of physiological ecology, for example in its role in predictive hydrology of forested catchments. For three eucalypt species that dominate high-elevation catchments in south-eastern Australia, we examined if whole-tree water use could be related to three widely discussed regulators of water use: stomatal anatomy, sensitivity of stomata [i.e. stomatal conductance (g(s))] to environmental influences, and sapwood area. While daily tree water use varied sixfold among species, sap velocity and sapwood area varied in parallel. Combined, stomatal structure and physiology could not explain differences in species-specific water use. Species which exhibited the fastest (Eucalyptus delegatensis) and slowest (Eucalyptus pauciflora) rates of water use both exhibited greater capacity for physiological control of g(s) [indicated by sensitivity to vapour pressure deficit (VPD)] and a reduced capacity to limit g(s) anatomically [indicated by greater potential g(s) (g(max))]. Conversely, g(s) was insensitive to VPD and g(max) was lowest for Eucalyptus radiata, the species showing intermediate rates of water use. Improved knowledge of stomatal anatomy will help us to understand the capacity of species to regulate leaf-level water loss, but seems likely to remain of limited use for explaining rates of whole-tree water use in montane eucalypts at the catchment scale.

[Dr. Valdimir Jakovljević--his contribution to the art of surgery].

Science.gov (United States)

Ilić, M

1992-01-01

In this article we present biographical data of Dr Vladimir Jakovljević, a surgeon (1893-1960), and his contribution to the technical approach to cephalic duodenopancreatectomy: the first pancreatico-jejunostomy, and first reported in world's literature triple different anastomosis of the jejunum with part of the stomach (after a 2/3 resection of the organ), choledochus and a part of the head of the pancreas, done by Vladimir Jakovljević in 1934, and published in "Medicinski pregled" (Medical Review) in 1935. A basic surgical teaching of Dr Jakovljević school of surgery is an aspiration toward the "physiological surgery", a technical viability for performing the most difficult operation on the biliary tract, a strong surgical imagination and full information about contemporary knowledge on surgery.

Multilevel orthopedic surgery for crouch gait in cerebral palsy: An evaluation using functional mobility and energy cost

Directory of Open Access Journals (Sweden)

Dhiren Ganjwala

2011-01-01

Full Text Available Background: The evidence for the effectiveness of orthopaedic surgery to correct crouch gait in cerebral diplegic is insufficient. The crouch gait is defined as walking with knee flexion and ankle dorsiflexion through out the stance phase. Severe crouch gait in patients with spastic diplegia causes excessive loading of the patellofemoral joint and may result in anterior knee pain, gait deterioration, and progressive loss of function. We retrospectively evaluated the effect of surgery on the mobility and energy consumption at one year or more with the help of validated scales and scores. Materials and Methods: 18 consecutive patients with mean age of 14.6 years with cerebral diplegia with crouched gait were operated for multilevel orthopaedic surgery. Decisions for surgery were made with the observations on gait analysis and physical examination. The surgical intervention consisted of lengthening of short muscle-tendon units, shortening of long muscles and correction of osseous deformities. The paired samples t test was used to compare values of physical examination findings, walking speed and physiological cost index. Two paired sample Wilcoxon signed rank test was used to compare functional walking scales. Results: After surgery, improvements in functional mobility, walking speed and physiological cost index were found. No patient was able to walk 500 meters before surgery while all were able to walk after surgery. The improvements that were noted at one year were maintained at two years. Conclusions: Multilevel orthopedic surgery for older children and adolescents with crouch gait is effective for improving function and independence.

Effects of a surgical ward care protocol following open colon surgery as part of an enhanced recovery after surgery programme.

Science.gov (United States)

Kim, BoYeoul; Park, SungHee; Park, KyuJoo; Ryoo, SeungBum

2017-11-01

To investigate the effects of a standardised care protocol as part of an enhanced recovery after surgery programme on the management of patients who underwent open colon surgery at the University Hospital, South Korea. Patients who undergo open colon surgery often have concerns about their care as they prepare for hospitalisation. By shortening hospital stay lengths, enhanced recovery after surgery programmes could reduce the number of opportunities for patient education and communication with nurses. Therefore, our surgical team developed an enhanced recovery after surgery programme, applied using a care protocol for patients with colorectal cancer, that spans the entire recovery process. A retrospective, comparative study was conducted using a care protocol as part of an enhanced recovery after surgery programme. Comparisons were made before and after the implementation of an enhanced recovery after surgery programme with a care protocol. Records of 219 patients who underwent open colon surgery were retrospectively audited. The records were grouped according to the care protocol used (enhanced recovery after surgery programme with a care protocol or traditional care programme). The outcomes, including postoperative bowel function recovery, postoperative pain control, recovery time and postoperative complications, were compared between two categories. Patients who were managed using the programme with a care protocol had shorter hospital stays, fewer complications, such as postoperative ileus wound infections, and emergency room visits than those who were managed using the traditional care programme. The findings can be used to facilitate the implementation of an enhanced recovery after surgery programme with a care protocol following open colon surgery. We present a care protocol that enables effective management using consistent and standardised education providing bedside care for patients who undergo open colon surgery. This care protocol empowers long

A parallel robot to assist vitreoretinal surgery

Energy Technology Data Exchange (ETDEWEB)

Nakano, Taiga; Sugita, Naohiko; Mitsuishi, Mamoru [University of Tokyo, School of Engineering, Tokyo (Japan); Ueta, Takashi; Tamaki, Yasuhiro [University of Tokyo, Graduate School of Medicine, Tokyo (Japan)

2009-11-15

This paper describes the development and evaluation of a parallel prototype robot for vitreoretinal surgery where physiological hand tremor limits performance. The manipulator was specifically designed to meet requirements such as size, precision, and sterilization; this has six-degree-of-freedom parallel architecture and provides positioning accuracy with micrometer resolution within the eye. The manipulator is controlled by an operator with a ''master manipulator'' consisting of multiple joints. Results of the in vitro experiments revealed that when compared to the manual procedure, a higher stability and accuracy of tool positioning could be achieved using the prototype robot. This microsurgical system that we have developed has superior operability as compared to traditional manual procedure and has sufficient potential to be used clinically for vitreoretinal surgery. (orig.)

Light propagation through the eye: numerical considerations and applications to presbylasik surgery analysis

OpenAIRE

Espinosa Tomás, Julián; Pérez Rodríguez, Jorge; Mas Candela, David; Illueca Contri, Carlos; Sala Pomares, Esperanza; Ortiz Márquez, Dolores; Alió y Sanz, Jorge L.

2006-01-01

Trabajo presentado en el 3rd European Meeting in Physiological Optics, London, September 7-9, 2006. Transmittance evaluation of cornea. Transmittance evaluation of crystalline lens. Wave propagation (angular spectrum) up to the plane of interest. Applications to presbylasik surgery analysis.

Physiological adaptations to interval training and the role of exercise intensity.

Science.gov (United States)

MacInnis, Martin J; Gibala, Martin J

2017-05-01

Interval exercise typically involves repeated bouts of relatively intense exercise interspersed by short periods of recovery. A common classification scheme subdivides this method into high-intensity interval training (HIIT; 'near maximal' efforts) and sprint interval training (SIT; 'supramaximal' efforts). Both forms of interval training induce the classic physiological adaptations characteristic of moderate-intensity continuous training (MICT) such as increased aerobic capacity (V̇O2 max ) and mitochondrial content. This brief review considers the role of exercise intensity in mediating physiological adaptations to training, with a focus on the capacity for aerobic energy metabolism. With respect to skeletal muscle adaptations, cellular stress and the resultant metabolic signals for mitochondrial biogenesis depend largely on exercise intensity, with limited work suggesting that increases in mitochondrial content are superior after HIIT compared to MICT, at least when matched-work comparisons are made within the same individual. It is well established that SIT increases mitochondrial content to a similar extent to MICT despite a reduced exercise volume. At the whole-body level, V̇O2 max is generally increased more by HIIT than MICT for a given training volume, whereas SIT and MICT similarly improve V̇O2 max despite differences in training volume. There is less evidence available regarding the role of exercise intensity in mediating changes in skeletal muscle capillary density, maximum stroke volume and cardiac output, and blood volume. Furthermore, the interactions between intensity and duration and frequency have not been thoroughly explored. While interval training is clearly a potent stimulus for physiological remodelling in humans, the integrative response to this type of exercise warrants further attention, especially in comparison to traditional endurance training. © 2016 The Authors. The Journal of Physiology © 2016 The Physiological Society.

Southern Ocean phytoplankton physiology in a changing climate.

Science.gov (United States)

Petrou, Katherina; Kranz, Sven A; Trimborn, Scarlett; Hassler, Christel S; Ameijeiras, Sonia Blanco; Sackett, Olivia; Ralph, Peter J; Davidson, Andrew T

2016-09-20

The Southern Ocean (SO) is a major sink for anthropogenic atmospheric carbon dioxide (CO 2 ), potentially harbouring even greater potential for additional sequestration of CO 2 through enhanced phytoplankton productivity. In the SO, primary productivity is primarily driven by bottom up processes (physical and chemical conditions) which are spatially and temporally heterogeneous. Due to a paucity of trace metals (such as iron) and high variability in light, much of the SO is characterised by an ecological paradox of high macronutrient concentrations yet uncharacteristically low chlorophyll concentrations. It is expected that with increased anthropogenic CO 2 emissions and the coincident warming, the major physical and chemical process that govern the SO will alter, influencing the biological capacity and functioning of the ecosystem. This review focuses on the SO primary producers and the bottom up processes that underpin their health and productivity. It looks at the major physico-chemical drivers of change in the SO, and based on current physiological knowledge, explores how these changes will likely manifest in phytoplankton, specifically, what are the physiological changes and floristic shifts that are likely to ensue and how this may translate into changes in the carbon sink capacity, net primary productivity and functionality of the SO. Copyright © 2016 Elsevier GmbH. All rights reserved.

Lung-protective ventilation in abdominal surgery.

Science.gov (United States)

Futier, Emmanuel; Jaber, Samir

2014-08-01

To provide the most recent and relevant clinical evidence regarding the use of prophylactic lung-protective mechanical ventilation in abdominal surgery. Evidence is accumulating, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary complications in patients undergoing abdominal surgery. Nonprotective ventilator settings, especially high tidal volume (>10-12 ml/kg), very low level of positive end-expiratory pressure (PEEP, ventilator-associated lung injury in patients with healthy lungs. Stimulated by the previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung-protective mechanical ventilation. Recent data provide compelling evidence that prophylactic lung-protective mechanical ventilation using lower tidal volume (6-8 ml/kg of predicted body weight), moderate PEEP (6-8 cm H2O), and recruitment maneuvers is associated with improved functional or physiological and clinical postoperative outcome in patients undergoing abdominal surgery. The use of prophylactic lung-protective ventilation can help in improving the postoperative outcome.

Space Physiology within an Exercise Physiology Curriculum

Science.gov (United States)

Carter, Jason R.; West, John B.

2013-01-01

Compare and contrast strategies remain common pedagogical practices within physiological education. With the support of an American Physiological Society Teaching Career Enhancement Award, we have developed a junior- or senior-level undergraduate curriculum for exercise physiology that compares and contrasts the physiological adaptations of…

Rowing, the ultimate challenge to the human body - implications for physiological variables

DEFF Research Database (Denmark)

Volianitis, S.; Secher, Niels H.

2009-01-01

Clinical diagnoses depend on a variety of physiological variables but the full range of these variables is seldom known. With the load placed on the human body during competitive rowing, the physiological range for several variables is illustrated. The extreme work produced during rowing...... is explained by the seated position and the associated ability to increase venous return and, thus, cardiac output. This review highlights experimental work on Olympic rowing that presents a unique challenge to the human capacities, including cerebral metabolism, to unprecedented limits, and provides a unique...

The physiology of mountain biking.

Science.gov (United States)

Impellizzeri, Franco M; Marcora, Samuele M

2007-01-01

Mountain biking is a popular outdoor recreational activity and an Olympic sport. Cross-country circuit races have a winning time of approximately equal 120 minutes and are performed at an average heart rate close to 90% of the maximum, corresponding to 84% of maximum oxygen uptake (VO2max). More than 80% of race time is spent above the lactate threshold. This very high exercise intensity is related to the fast starting phase of the race; the several climbs, forcing off-road cyclists to expend most of their effort going against gravity; greater rolling resistance; and the isometric contractions of arm and leg muscles necessary for bike handling and stabilisation. Because of the high power output (up to 500W) required during steep climbing and at the start of the race, anaerobic energy metabolism is also likely to be a factor of off-road cycling and deserves further investigation. Mountain bikers' physiological characteristics indicate that aerobic power (VO2max >70 mL/kg/min) and the ability to sustain high work rates for prolonged periods of time are prerequisites for competing at a high level in off-road cycling events. The anthropometric characteristics of mountain bikers are similar to climbers and all-terrain road cyclists. Various parameters of aerobic fitness are correlated to cross-country performance, suggesting that these tests are valid for the physiological assessment of competitive mountain bikers, especially when normalised to body mass. Factors other than aerobic power and capacity might influence off-road cycling performance and require further investigation. These include off-road cycling economy, anaerobic power and capacity, technical ability and pre-exercise nutritional strategies.

Use of satiety peptides in assessing the satiating capacity of foods

NARCIS (Netherlands)

Mars, M.; Stafleu, A.; Graaf, de C.

2012-01-01

Foods differ in their satiating capacity. Satiety peptides may help to provide evidence for biological mechanisms behind these differences. The aim of this paper was to discuss the physiological relevance of three individual appetite peptides, i.e. CCK, GLP-1 and PYY, in assessing the satiating

Digested Ara h 1 Loses Sensitizing Capacity When Separated into Fractions

DEFF Research Database (Denmark)

Bøgh, Katrine Lindholm; Barkholt, Vibeke; Rigby, Neil M.

2012-01-01

The major peanut allergen Ara h 1 is an easily digestible protein under physiological conditions. The present study revealed that pepsin digestion products of Ara h 1 retained the sensitizing potential in a Brown Norway rat model, while this sensitizing capacity was lost by separating the digest...

Elite futsal refereeing: Activity profile and physiological demands

DEFF Research Database (Denmark)

Rebelo, António N.; Ascensão, António A.; Magalhães, José F.

2011-01-01

Rebelo, AN, Ascensão, AA, Magalhães, JF, Bischoff, R, Bendiksen, M, and Krustrup, P. Elite futsal refereeing: activity profile and physiological demands. J Strength Cond Res 24(X): 000-000, 2010-The purpose of this study was to determine the physiological demands and to establish the relationship...... between activity profile and endurance capacity of futsal referees. Eighteen elite futsal referees (33.0 ± 5.1 years, 173 ± 5 cm, and 73.2 ± 8.4 kg) were studied. Video filming (n = 18) and heart rate (HR) recordings were performed throughout games. Blood lactate (n = 14) was determined at rest and after....... Considering the data obtained in the present study, the use of match-specific intermittent fitness tests to evaluate futsal referees seems to be required....

Dysfunctional Natural Killer Cells in the Aftermath of Cancer Surgery.

Science.gov (United States)

Angka, Leonard; Khan, Sarwat T; Kilgour, Marisa K; Xu, Rebecca; Kennedy, Michael A; Auer, Rebecca C

2017-08-17

The physiological changes that occur immediately following cancer surgeries initiate a chain of events that ultimately result in a short pro-, followed by a prolonged anti-, inflammatory period. Natural Killer (NK) cells are severely affected during this period in the recovering cancer patient. NK cells play a crucial role in anti-tumour immunity because of their innate ability to differentiate between malignant versus normal cells. Therefore, an opportunity arises in the aftermath of cancer surgery for residual cancer cells, including distant metastases, to gain a foothold in the absence of NK cell surveillance. Here, we describe the post-operative environment and how the release of sympathetic stress-related factors (e.g., cortisol, prostaglandins, catecholamines), anti-inflammatory cytokines (e.g., IL-6, TGF-β), and myeloid derived suppressor cells, mediate NK cell dysfunction. A snapshot of current and recently completed clinical trials specifically addressing NK cell dysfunction post-surgery is also discussed. In collecting and summarizing results from these different aspects of the surgical stress response, a comprehensive view of the NK cell suppressive effects of surgery is presented. Peri-operative therapies to mitigate NK cell suppression in the post-operative period could improve curative outcomes following cancer surgery.

Vitamin D and intestinal calcium transport after bariatric surgery.

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Schafer, Anne L

2017-10-01

Bariatric surgery is a highly effective treatment for obesity, but it may have detrimental effects on the skeleton. Skeletal effects are multifactorial but mediated in part by nutrient malabsorption. While there is increasing interest in non-nutritional mechanisms such as changes in fat-derived and gut-derived hormones, nutritional factors are modifiable and thus represent potential opportunities to prevent and treat skeletal complications. This review begins with a discussion of normal intestinal calcium transport, including recent advances in our understanding of its regulation by vitamin D, and areas of continued uncertainty. Human and animal studies of vitamin D and intestinal calcium transport after bariatric surgery are then summarized. In humans, even with optimized 25-hydroxyvitamin D levels and recommended calcium intake, fractional calcium absorption decreased dramatically after Roux-en-Y gastric bypass (RYGB). In rats, intestinal calcium absorption was lower after RYGB than after sham surgery, despite elevated 1,25-dihyroxyvitamin D levels and intestinal gene expression evidence of vitamin D responsiveness. Such studies have the potential to shed new light on the physiology of vitamin D and intestinal calcium transport. Moreover, understanding the effects of bariatric surgery on these processes may improve the clinical care of bariatric surgery patients. Published by Elsevier Ltd.

Student Responses to a Hands-On Kinesthetic Lecture Activity for Learning about the Oxygen Carrying Capacity of Blood

Science.gov (United States)

Breckler, Jennifer; Yu, Justin R.

2011-01-01

This article describes a new hands-on, or "kinesthetic," activity for use in a physiology lecture hall to help students comprehend an important concept in cardiopulmonary physiology known as oxygen carrying capacity. One impetus for designing this activity was to address the needs of students who have a preference for kinesthetic…

Effect of dexamethasone on perioperative renal function impairment during cardiac surgery with cardiopulmonary bypass

NARCIS (Netherlands)

Loef, BG; Henning, RH; Epema, AH; Rietman, GW; van Oeveren, W; Navis, GJ; Ebels, T

2004-01-01

Background. In cardiac surgery with cardiopulmonary bypass (CPB), corticosteroids are administered to attenuate the physiological changes caused by the systemic inflammatory response. The effects of corticosteroids on CPB-associated renal damage have not been documented. The purpose of this study

Computational Modeling in Liver Surgery

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Bruno Christ

2017-11-01

Full Text Available The need for extended liver resection is increasing due to the growing incidence of liver tumors in aging societies. Individualized surgical planning is the key for identifying the optimal resection strategy and to minimize the risk of postoperative liver failure and tumor recurrence. Current computational tools provide virtual planning of liver resection by taking into account the spatial relationship between the tumor and the hepatic vascular trees, as well as the size of the future liver remnant. However, size and function of the liver are not necessarily equivalent. Hence, determining the future liver volume might misestimate the future liver function, especially in cases of hepatic comorbidities such as hepatic steatosis. A systems medicine approach could be applied, including biological, medical, and surgical aspects, by integrating all available anatomical and functional information of the individual patient. Such an approach holds promise for better prediction of postoperative liver function and hence improved risk assessment. This review provides an overview of mathematical models related to the liver and its function and explores their potential relevance for computational liver surgery. We first summarize key facts of hepatic anatomy, physiology, and pathology relevant for hepatic surgery, followed by a description of the computational tools currently used in liver surgical planning. Then we present selected state-of-the-art computational liver models potentially useful to support liver surgery. Finally, we discuss the main challenges that will need to be addressed when developing advanced computational planning tools in the context of liver surgery.

Self-esteem and functional capacity outcomes following reduction mammaplasty.

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Sabino Neto, Miguel; Demattê, Maria Fernanda; Freire, Marcia; Garcia, Elvio Bueno; Quaresma, Marina; Ferreira, Lydia M

2008-01-01

Both physical health and psychosocial outcomes are important issues in the evaluation of medical treatment. Women with breast hypertrophy may suffer from low self-esteem and reduced functional capacity because of the size of their breasts. The aim of this study was to evaluate the impact of reduction mammaplasty on self-esteem and functional capacity in patients with breast hypertrophy. One hundred patients with breast hypertrophy who ranged in age from 18 to 55 years and who had undergone no previous mammary surgery were selected from the Plastic Surgery Outpatient Clinic of the Federal University of São Paulo (UNIFESP-EPM). They were randomly allocated into two groups (A and B) of 50 patients each. Patients from group A were submitted for reduction mammaplasty while those from group B were placed on the waiting list and used as a control group. At the beginning of the study, all patients were interviewed to collect clinical and demographic data and to have their self-esteem and functional capacity measured. Two Brazilian-validated versions of quality of life measurement instruments were chosen: the Rosenberg Self-Esteem Scale and Rolland-Morris (to assess functional capacity). A visual analog scale (VAS) was used to evaluate pain intensity. Six months after the beginning of the study, these instruments were again administered to both groups. Forty-six out of 50 patients from each group (A and B) completed the study. The mean age of group A was 31.6 years (SD, 11 yrs), and that of group B was 32.3 years (SD, 10 yrs). The mean weight of removed breast tissue from group A patients was 1052 g (SD, 188 g). A decrease on the score of Rosenberg Self-Esteem Scale of patients from group A indicated an improvement of self-esteem (P self-esteem and functional capacity and relieved pain in the lower back region in patients with breast hypertrophy.

Correlations between tests of aging in Hiroshima subjects: an attempt to define physiologic age

Energy Technology Data Exchange (ETDEWEB)

Hollingsworth, J W; Hashizume, Asaji; Jablon, Seymour

1964-12-01

Nine physiologic functions which change with age were measured in 437 subjects during their regular visits to the Atomic Bomb Casualty Commission clinic in Hiroshima, Japan. This pilot study was undertaken to determine the feasibility of collecting such data in a population sample physiologic age score. Tests conducted consisted of: skin elasticity, systolic blood pressure, vital capacity, hand grip strength, light extinction time, vibrometer, visual activity, audiometry, and serum cholesterol. The study demonstrated that adequate sample data could be obtained, and that statistical treatment could construct a physiologic age for individual subjects. However, the tests were of limited value below age 40, and the validation of the concept of physiologic age requires eventual correlation with mortality. Since the ABCC program includes a highly accurate mortality survey, it is hoped that data on physiologic aging can be collected and eventually related to mortality. 11 references, 3 figures, 6 tables.

Effect of intermediate care on mortality following emergency abdominal surgery. The InCare trial

DEFF Research Database (Denmark)

Vester-Andersen, Morten; Waldau, Tina; Wetterslev, Jørn

2013-01-01

ABSTRACT: BACKGROUND: Emergency abdominal surgery carries a 15% to 20% short-term mortality rate. Postoperative medical complications are strongly associated with increased mortality. Recent research suggests that timely recognition and effective management of complications may reduce mortality....... The aim of the present trial is to evaluate the effect of postoperative intermediate care following emergency major abdominal surgery in high-risk patients.Methods and design: The InCare trial is a randomised, parallel-group, non-blinded clinical trial with 1:1 allocation. Patients undergoing emergency...... laparotomy or laparoscopic surgery with a perioperative Acute Physiology and Chronic Health Evaluation II score of 10 or above, who are ready to be transferred to the surgical ward within 24 h of surgery are allocated to either intermediate care for 48 h, or surgical ward care. The primary outcome measure...

Sex differences in the physiology of eating

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Asarian, Lori

2013-01-01

Hypothalamic-pituitary-gonadal (HPG) axis function fundamentally affects the physiology of eating. We review sex differences in the physiological and pathophysiological controls of amounts eaten in rats, mice, monkeys, and humans. These controls result from interactions among genetic effects, organizational effects of reproductive hormones (i.e., permanent early developmental effects), and activational effects of these hormones (i.e., effects dependent on hormone levels). Male-female sex differences in the physiology of eating involve both organizational and activational effects of androgens and estrogens. An activational effect of estrogens decreases eating 1) during the periovulatory period of the ovarian cycle in rats, mice, monkeys, and women and 2) tonically between puberty and reproductive senescence or ovariectomy in rats and monkeys, sometimes in mice, and possibly in women. Estrogens acting on estrogen receptor-α (ERα) in the caudal medial nucleus of the solitary tract appear to mediate these effects in rats. Androgens, prolactin, and other reproductive hormones also affect eating in rats. Sex differences in eating are mediated by alterations in orosensory capacity and hedonics, gastric mechanoreception, ghrelin, CCK, glucagon-like peptide-1 (GLP-1), glucagon, insulin, amylin, apolipoprotein A-IV, fatty-acid oxidation, and leptin. The control of eating by central neurochemical signaling via serotonin, MSH, neuropeptide Y, Agouti-related peptide (AgRP), melanin-concentrating hormone, and dopamine is modulated by HPG function. Finally, sex differences in the physiology of eating may contribute to human obesity, anorexia nervosa, and binge eating. The variety and physiological importance of what has been learned so far warrant intensifying basic, translational, and clinical research on sex differences in eating. PMID:23904103

Image-guided robotic surgery.

Science.gov (United States)

Marescaux, Jacques; Solerc, Luc

2004-06-01

Medical image processing leads to an improvement in patient care by guiding the surgical gesture. Three-dimensional models of patients that are generated from computed tomographic scans or magnetic resonance imaging allow improved surgical planning and surgical simulation that offers the opportunity for a surgeon to train the surgical gesture before performing it for real. These two preoperative steps can be used intra-operatively because of the development of augmented reality, which consists of superimposing the preoperative three-dimensional model of the patient onto the real intraoperative view. Augmented reality provides the surgeon with a view of the patient in transparency and can also guide the surgeon, thanks to the real-time tracking of surgical tools during the procedure. When adapted to robotic surgery, this tool tracking enables visual serving with the ability to automatically position and control surgical robotic arms in three dimensions. It is also now possible to filter physiologic movements such as breathing or the heart beat. In the future, by combining augmented reality and robotics, these image-guided robotic systems will enable automation of the surgical procedure, which will be the next revolution in surgery.

Cancer-related fatigue in breast cancer patients after surgery: a multicomponent model using partial least squares-path modeling.

Science.gov (United States)

Bortolon, Catherine; Krikorian, Alicia; Carayol, Marion; Brouillet, Denis; Romieu, Gilles; Ninot, Gregory

2014-04-01

The aim of this study is to examine factors contributing to cancer-related fatigue (CRF) in breast cancer patients who have undergone surgery. Sixty women (mean age: 50.0) completed self-rated questionnaires assessing components of CRF, muscular and cognitive functions. Also, physiological and subjective data were gathered. Data were analyzed using partial least squares variance-based structural equation modeling in order to examine factors contributing to CRF after breast surgery. The tested model was robust in terms of its measurement quality (reliability and validity). According to the structural model results, emotional distress (β = 0.59; p accounting for 61% of the explained variance. Also, emotional distress (β = 0.41; p accounted for 41% of the explained variance. However, the relationship between low physical function and CRF was weak and nonsignificant (β = 0.01; p > 0.05). Emotional distress, altered vigilance capacity, and pain are associated with CRF in postsurgical breast cancer. In addition, emotional distress and pain are related to diminished physical function, which, in turn, has no significant impact on CRF. The current model should be examined in subsequent phases of the treatment (chemotherapy and/or radiotherapy) when side effects are more pronounced and may lead to increased intensity of CRF and low physical function. Copyright © 2013 John Wiley & Sons, Ltd.

PHYSIOLOGICAL AND AGROECOLOGICAL ASPECTS OF CADMIUM INTERACTIONS WITH BARLEY PLANTS: AN OVERVIEW

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A VASSILEV

2003-07-01

Full Text Available This work is a review of author’s previous publications, unpublished results as well as available literature on barley responses to Cd contamination. The physiological backgrounds of the acute Cd toxicity in barley plants are briefly described. Some data characterizing the chronic Cd toxicity in barley have been also provided in relation to its possible use for seed production and Cd phytoextraction on Cd-contaminated agricultural soils. Information about the main physiological factors limiting growth of Cd-exposed barley plants and grain yield, seedling quality as well as Cd phytoextraction capacity of barley grown in Cd-contaminated soils is presented.

The operating room case-mix problem under uncertainty and nurses capacity constraints.

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Yahia, Zakaria; Eltawil, Amr B; Harraz, Nermine A

2016-12-01

Surgery is one of the key functions in hospitals; it generates significant revenue and admissions to hospitals. In this paper we address the decision of choosing a case-mix for a surgery department. The objective of this study is to generate an optimal case-mix plan of surgery patients with uncertain surgery operations, which includes uncertainty in surgery durations, length of stay, surgery demand and the availability of nurses. In order to obtain an optimal case-mix plan, a stochastic optimization model is proposed and the sample average approximation method is applied. The proposed model is used to determine the number of surgery cases to be weekly served, the amount of operating rooms' time dedicated to each specialty and the number of ward beds dedicated to each specialty. The optimal case-mix selection criterion is based upon a weighted score taking into account both the waiting list and the historical demand of each patient category. The score aims to maximizing the service level of the operating rooms by increasing the total number of surgery cases that could be served. A computational experiment is presented to demonstrate the performance of the proposed method. The results show that the stochastic model solution outperforms the expected value problem solution. Additional analysis is conducted to study the effect of varying the number of ORs and nurses capacity on the overall ORs' performance.

Cardiac surgery in the parturient.

Science.gov (United States)

Chandrasekhar, Shobana; Cook, Christopher R; Collard, Charles D

2009-03-01

Heart disease is the primary cause of nonobstetric mortality in pregnancy, occurring in 1%-3% of pregnancies and accounting for 10%-15% of maternal deaths. Congenital heart disease has become more prevalent in women of childbearing age, representing an increasing percentage (up to 75%) of heart disease in pregnancy. Untreated maternal heart disease also places the fetus at risk. Independent predictors of neonatal complications include a maternal New York Heart Association heart failure classification >2, anticoagulation use during pregnancy, smoking, multiple gestation, and left heart obstruction. Because cardiac surgical morbidity and mortality in the parturient is higher than nonpregnant patients, most parturients with cardiac disease are first managed medically, with cardiac surgery being reserved when medical management fails. Risk factors for maternal mortality during cardiac surgery include the use of vasoactive drugs, age, type of surgery, reoperation, and maternal functional class. Risk factors for fetal mortality include maternal age >35 yr, functional class, reoperation, emergency surgery, type of myocardial protection, and anoxic time. Nonetheless, acceptable maternal and fetal perioperative mortality rates may be achieved through such measures as early preoperative detection of maternal cardiovascular decompensation, use of fetal monitoring, delivery of a viable fetus before the operation and scheduling surgery on an elective basis during the second trimester. Additionally, fetal morbidity may be reduced during cardiopulmonary bypass by optimizing maternal oxygen-carrying capacity and uterine blood flow. Current maternal bypass recommendations include: 1) maintaining the pump flow rate >2.5 L x min(-1) x m(-2) and perfusion pressure >70 mm Hg; 2) maintaining the hematocrit > 28%; 3) using normothermic perfusion when feasible; 4) using pulsatile flow; and 5) using alpha-stat pH management.

Surgery as a Double-Edged Sword: A Clinically Feasible Approach to Overcome the Metastasis-Promoting Effects of Surgery by Blunting Stress and Prostaglandin Responses

International Nuclear Information System (INIS)

Benish, Marganit; Ben-Eliyahu, Shamgar

2010-01-01

Surgery remains an essential therapeutic approach for most solid malignancies, including breast cancer. However, surgery also constitutes a risk factor for promotion of pre-existing micrometastases and the initiation of new metastases through several mechanisms, including the release of prostaglandins and stress hormones (e.g., catecholamines and glucocorticoids). However, the perioperative period also presents an opportunity for cell mediated immunity (CMI) and other mechanisms to eradicate or control minimal residual disease, provided that the deleterious effects of surgery are minimized. Here, we discuss the key role of endogenous stress hormones and prostaglandins in promoting the metastatic process through their direct impact on malignant cells, and through their deleterious impact on anti-cancer CMI. We further discuss the effects of anesthetic techniques, the extent of surgery, pain alleviation, and timing within the menstrual cycle with respect to their impact on tumor recurrence and physiological stress responses. Last, we suggest an attractive perioperative drug regimen, based on a combination of a cyclooxygenase (COX)-2 inhibitor and a β-adrenergic blocker, which we found effective in attenuating immune suppression and the metastasis-promoting effects of surgery in several tumor models. This regimen is clinically applicable, and could potentially promote disease free survival in patients operated for breast and other types of cancer

Surgery as a Double-Edged Sword: A Clinically Feasible Approach to Overcome the Metastasis-Promoting Effects of Surgery by Blunting Stress and Prostaglandin Responses

Energy Technology Data Exchange (ETDEWEB)

Benish, Marganit; Ben-Eliyahu, Shamgar, E-mail: shamgar@post.tau.ac.il [Neuroimmunology Research Unit, Department of Psychology, Tel Aviv University, Tel Aviv 69978 (Israel)

2010-11-24

Surgery remains an essential therapeutic approach for most solid malignancies, including breast cancer. However, surgery also constitutes a risk factor for promotion of pre-existing micrometastases and the initiation of new metastases through several mechanisms, including the release of prostaglandins and stress hormones (e.g., catecholamines and glucocorticoids). However, the perioperative period also presents an opportunity for cell mediated immunity (CMI) and other mechanisms to eradicate or control minimal residual disease, provided that the deleterious effects of surgery are minimized. Here, we discuss the key role of endogenous stress hormones and prostaglandins in promoting the metastatic process through their direct impact on malignant cells, and through their deleterious impact on anti-cancer CMI. We further discuss the effects of anesthetic techniques, the extent of surgery, pain alleviation, and timing within the menstrual cycle with respect to their impact on tumor recurrence and physiological stress responses. Last, we suggest an attractive perioperative drug regimen, based on a combination of a cyclooxygenase (COX)-2 inhibitor and a β-adrenergic blocker, which we found effective in attenuating immune suppression and the metastasis-promoting effects of surgery in several tumor models. This regimen is clinically applicable, and could potentially promote disease free survival in patients operated for breast and other types of cancer.

Recovery time after intra-abdominal transmitter placement for telemetric (neuro)physiological measurement in freely moving common marmosets (Callitrix jacchus).

NARCIS (Netherlands)

Bakker, Jaco; Arndt, Saskia; Klomp, Rianne; Rijnbeek, Milene, W.M.; Philippens, Ingrid, H.C.H.M.; Langermans, Jan, A.

2014-01-01

Background Telemetry is very important for monitoring physiological functions in awake and freely moving laboratory animals. Although implantable transmitters reduce stress resulting from daily handling and restraint, the procedure requires invasive surgery, which affects behaviour and wellbeing of

Biological properties of extracellular vesicles and their physiological functions

Directory of Open Access Journals (Sweden)

María Yáñez-Mó

2015-05-01

Full Text Available In the past decade, extracellular vesicles (EVs have been recognized as potent vehicles of intercellular communication, both in prokaryotes and eukaryotes. This is due to their capacity to transfer proteins, lipids and nucleic acids, thereby influencing various physiological and pathological functions of both recipient and parent cells. While intensive investigation has targeted the role of EVs in different pathological processes, for example, in cancer and autoimmune diseases, the EV-mediated maintenance of homeostasis and the regulation of physiological functions have remained less explored. Here, we provide a comprehensive overview of the current understanding of the physiological roles of EVs, which has been written by crowd-sourcing, drawing on the unique EV expertise of academia-based scientists, clinicians and industry based in 27 European countries, the United States and Australia. This review is intended to be of relevance to both researchers already working on EV biology and to newcomers who will encounter this universal cell biological system. Therefore, here we address the molecular contents and functions of EVs in various tissues and body fluids from cell systems to organs. We also review the physiological mechanisms of EVs in bacteria, lower eukaryotes and plants to highlight the functional uniformity of this emerging communication system.

Biological properties of extracellular vesicles and their physiological functions

Science.gov (United States)

Yáñez-Mó, María; Siljander, Pia R.-M.; Andreu, Zoraida; Zavec, Apolonija Bedina; Borràs, Francesc E.; Buzas, Edit I.; Buzas, Krisztina; Casal, Enriqueta; Cappello, Francesco; Carvalho, Joana; Colás, Eva; Silva, Anabela Cordeiro-da; Fais, Stefano; Falcon-Perez, Juan M.; Ghobrial, Irene M.; Giebel, Bernd; Gimona, Mario; Graner, Michael; Gursel, Ihsan; Gursel, Mayda; Heegaard, Niels H. H.; Hendrix, An; Kierulf, Peter; Kokubun, Katsutoshi; Kosanovic, Maja; Kralj-Iglic, Veronika; Krämer-Albers, Eva-Maria; Laitinen, Saara; Lässer, Cecilia; Lener, Thomas; Ligeti, Erzsébet; Linē, Aija; Lipps, Georg; Llorente, Alicia; Lötvall, Jan; Manček-Keber, Mateja; Marcilla, Antonio; Mittelbrunn, Maria; Nazarenko, Irina; Hoen, Esther N.M. Nolte-‘t; Nyman, Tuula A.; O'Driscoll, Lorraine; Olivan, Mireia; Oliveira, Carla; Pállinger, Éva; del Portillo, Hernando A.; Reventós, Jaume; Rigau, Marina; Rohde, Eva; Sammar, Marei; Sánchez-Madrid, Francisco; Santarém, N.; Schallmoser, Katharina; Ostenfeld, Marie Stampe; Stoorvogel, Willem; Stukelj, Roman; Van der Grein, Susanne G.; Vasconcelos, M. Helena; Wauben, Marca H. M.; De Wever, Olivier

2015-01-01

In the past decade, extracellular vesicles (EVs) have been recognized as potent vehicles of intercellular communication, both in prokaryotes and eukaryotes. This is due to their capacity to transfer proteins, lipids and nucleic acids, thereby influencing various physiological and pathological functions of both recipient and parent cells. While intensive investigation has targeted the role of EVs in different pathological processes, for example, in cancer and autoimmune diseases, the EV-mediated maintenance of homeostasis and the regulation of physiological functions have remained less explored. Here, we provide a comprehensive overview of the current understanding of the physiological roles of EVs, which has been written by crowd-sourcing, drawing on the unique EV expertise of academia-based scientists, clinicians and industry based in 27 European countries, the United States and Australia. This review is intended to be of relevance to both researchers already working on EV biology and to newcomers who will encounter this universal cell biological system. Therefore, here we address the molecular contents and functions of EVs in various tissues and body fluids from cell systems to organs. We also review the physiological mechanisms of EVs in bacteria, lower eukaryotes and plants to highlight the functional uniformity of this emerging communication system. PMID:25979354

Urban plant physiology: adaptation-mitigation strategies under permanent stress.

Science.gov (United States)

Calfapietra, Carlo; Peñuelas, Josep; Niinemets, Ülo

2015-02-01

Urban environments that are stressful for plant function and growth will become increasingly widespread in future. In this opinion article, we define the concept of 'urban plant physiology', which focuses on plant responses and long term adaptations to urban conditions and on the capacity of urban vegetation to mitigate environmental hazards in urbanized settings such as air and soil pollution. Use of appropriate control treatments would allow for studies in urban environments to be comparable to expensive manipulative experiments. In this opinion article, we propose to couple two approaches, based either on environmental gradients or manipulated gradients, to develop the concept of urban plant physiology for assessing how single or multiple environmental factors affect the key environmental services provided by urban forests. Copyright © 2014 Elsevier Ltd. All rights reserved.

Physiology of Sedentary Behavior and Its Relationship to Health Outcomes

Science.gov (United States)

Thyfault, John P; Du, Mengmeng; Kraus, William E; Levine, James A; Booth, Frank W

2014-01-01

Purpose This paper reports on the findings and recommendations of the “Physiology of Sedentary Behavior and its Relationship to Health Outcomes” group, a part of a larger workshop entitled Sedentary Behavior: Identifying Research Priorities sponsored by the National Heart, and Lung and Blood Institute and the National Institute on Aging, which aimed to establish sedentary behavior research priorities. Methods The discussion within our workshop lead to the formation of critical physiological research objectives related to sedentary behaviors, that if appropriately researched would greatly impact our overall understanding of human health and longevity. Results and Conclusions Primary questions are related to physiological “health outcomes” including the influence of physical activity vs. sedentary behavior on function of a number of critical physiological systems (aerobic capacity, skeletal muscle metabolism and function, telomeres/genetic stability, and cognitive function). The group also derived important recommendations related to the “central and peripheral mechanisms” that govern sedentary behavior and how energy balance has a role in mediating these processes. General recommendations for future sedentary physiology research efforts include that studies of sedentary behavior, including that of sitting time only, should focus on the physiological impact of a “lack of human movement” in contradistinction to the effects of physical movement and that new models or strategies for studying sedentary behavior induced adaptations and links to disease development are needed to elucidate underlying mechanism(s). PMID:25222820

Investigation on maternal physiological and psychological factors of cheilopalatognathus.

Science.gov (United States)

Ma, J; Zhao, W; Ma, R M; Li, X J; Wen, Z H; Liu, X F; Hu, W D; Zhang, C B

2013-01-01

Case-control study on mothers of cheilopalatognathus children was conducted, to investigate the maternal physiological and psychological factors for occurrence of cheilopalatognathus. One hundred ten mothers of cheilopalatognathus children who were scheduled for one-stage surgery were selected as a research group, and 110 mothers of normal children served as a normal control group at the same time. Trait Anxiety Inventory (T-AI), Life Events Scale (LES), Trait Coping Style Questionnaire (TCSQ), Type C Behavior Scale (CBS), adult Eysenck Personality Questionnaire (EPQ), and homemade general questionnaire survey were employed for the investigation. Compared with the control group, the scores for negative event tension value, anxiety, and depressive factors were higher in the study group (p introvert and extrovert personalities. The study results suggest that pregnant women's physiological and psychological factors can cause changes in cheilopalatognathus incidence, which is expected to be guidance for healthcare during pregnancy, to prevent the occurrence of cheilopalatognathus.

Principles of exercise physiology: responses to acute exercise and long-term adaptations to training.

Science.gov (United States)

Rivera-Brown, Anita M; Frontera, Walter R

2012-11-01

Physical activity and fitness are associated with a lower prevalence of chronic diseases, such as heart disease, cancer, high blood pressure, and diabetes. This review discusses the body's response to an acute bout of exercise and long-term physiological adaptations to exercise training with an emphasis on endurance exercise. An overview is provided of skeletal muscle actions, muscle fiber types, and the major metabolic pathways involved in energy production. The importance of adequate fluid intake during exercise sessions to prevent impairments induced by dehydration on endurance exercise, muscular power, and strength is discussed. Physiological adaptations that result from regular exercise training such as increases in cardiorespiratory capacity and strength are mentioned. The review emphasizes the cardiovascular and metabolic adaptations that lead to improvements in maximal oxygen capacity. Copyright © 2012 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Global surgery in a postconflict setting - 5-year results of implementation in the Russian North Caucasus

Directory of Open Access Journals (Sweden)

Fatima I. Lunze

2015-10-01

Full Text Available Background: Collaborations for global surgery face many challenges to achieve fair and safe patient care and to build sustainable capacity. The 2004 terrorist attack on a school in Beslan in North Ossetia in the Russian North Caucasus left many victims with complex otologic barotrauma. In response, we implemented a global surgery partnership between the Vladikavkaz Children's Hospital, international surgical teams, the North Ossetian Health Ministry, and civil society organizations. This study's aim was to describe the implementation and 5-year results of capacity building for complex surgery in a postconflict, mid-income setting. Design: We conducted an observational study at the Children's Hospital in Vladikavkaz in the autonomous Republic of North Ossetia-Alania, part of the Russian Federation. We assessed the outcomes of 15 initial patients who received otologic surgeries for complex barotrauma resulting from the Beslan terrorism attack and for other indications, and report the incidence of intra- and postoperative complications. Results: Patients were treated for trauma related to terrorism (53% and for indications not related to violence (47%. None of the patients developed peri- or postoperative complications. Three patients (two victims of terrorism who underwent repair of tympanic perforations presented with re-perforations. Four junior and senior surgeons were trained on-site and in Germany to perform and teach similar procedures autonomously. Conclusions: In mid-income, postconflict settings, complex surgery can be safely implemented and achieve patient outcomes comparable to global standards. Capacity building can build on existing resources, such as operation room management, nursing, and anesthesia services. In postconflict environments, substantial surgical burden is not directly attributable to conflict-related injury and disease, but to health systems weakened by conflicts. Extending training and safe surgical care to include

Evidence of depression-associated circadian rhythm disruption and regret in prostate cancer patients after surgery.

Science.gov (United States)

Christie, Joanne; Sharpley, Christopher F; Bitsika, Vicki; Christie, David

2017-12-01

The purpose of this study is to investigate the association between prostate cancer (PCa) patients' regret that their surgery harmed them, and their scores on the two key symptoms of major depressive disorder (depressed mood, anhedonia) and a symptom of melancholic depression (disruption to circadian rhythm). Forty PCa patients who had received surgery for their PCa completed a postal survey including background information, regret about surgery that 'did them a lot of harm' and three items drawn from the Zung Self-Rating Depression Scale measuring depressed mood, anhedonia and circadian rhythm disruption. There were significant correlations between all three symptoms of depression (depressed mood, anhedonia, disruption to circadian rhythm) and between patients' regret that surgery did them a lot of harm and their circadian rhythm disruption, but not between depressed mood or anhedonia and regret about surgery doing harm. These findings suggest that PCa patients' post-surgery regrets about major harm may lead to a significant disruption in a central physiological function and raise the need to consider this side effect of surgery when planning supportive services for these men.

A Study of the Effectiveness of Sensory Integration Therapy on Neuro-Physiological Development

Science.gov (United States)

Reynolds, Christopher; Reynolds, Kathleen Sheena

2010-01-01

Background: Sensory integration theory proposes that because there is plasticity within the central nervous system (the brain is moldable) and because the brain consists of systems that are hierarchically organised, it is possible to stimulate and improve neuro-physiological processing and integration and thereby increase learning capacity.…

Working Memory Capacity and Surgical Performance While Exposed to Mild Hypoxic Hypoxemia.

Science.gov (United States)

Parker, Paul J; Manley, Andrew J; Shand, Ross; O'Hara, John P; Mellor, Adrian

2017-10-01

Medical Emergency Response Team (MERT) helicopters fly at altitudes of 3000 m in Afghanistan (9843 ft). Civilian hospitals and disaster-relief surgical teams may have to operate at such altitudes or even higher. Mild hypoxia has been seen to affect the performance of novel tasks at flight levels as low as 5000 ft. Aeromedical teams frequently work in unpressurized environments; it is important to understand the implications of this mild hypoxia and investigate whether supplementary oxygen systems are required for some or all of the team members. Ten UK orthopedic surgeons were recruited and in a double blind randomized experimental protocol, were acutely exposed for 45 min to normobaric hypoxia [fraction of inspired oxygen (FIo2) ∼14.1%, equivalent to 3000 m (10,000 ft)] or normobaric normoxia (sea-level). Basic physiological parameters were recorded. Subjects completed validated tests of verbal working memory capacity (VWMC) and also applied an orthopedic external fixator (Hoffmann® 3, Stryker, UK) to a plastic tibia under test conditions. Significant hypoxia was induced with the reduction of FIo2 to ∼14.1% (Spo2 87% vs. 98%). No effect of hypoxia on VWMC was observed. The pin-divergence score (a measure of frame asymmetry) was significantly greater in hypoxic conditions (4.6 mm) compared to sea level (3.0 mm); there was no significant difference in the penetrance depth (16.9 vs. 17.2 mm). One hypoxic frame would have failed early. We believe that surgery at an altitude of 3000 m, when unacclimated individuals are acutely exposed to atmospheric hypoxia for 45 min, can likely take place without supplemental oxygen use but further work is required.Parker PJ, Manley AJ, Shand R, O'Hara JP, Mellor A. Working memory capacity and surgical performance while exposed to mild hypoxic hypoxemia. Aerosp Med Hum Perform. 2017; 88(10):918-923.

The Benefits of Exercise Training on Aerobic Capacity in Patients with Heart Failure and Preserved Ejection Fraction.

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do Prado, Danilo Marcelo Leite; Rocco, Enéas Antônio

2017-01-01

Heart failure with preserved ejection fraction (HFpEF) is defined as an inability of the ventricles to optimally accept blood from atria with blunted end- diastolic volume response by limiting the stroke volume and cardiac output. The HEpEF prevalence is higher in elderly and women and may be associated to hypertension, diabetes mellitus and atrial fibrillation. Severe exercise intolerance, manifested by dyspnea and fatigue during physical effort is the important chronic symptom in HFpEF patients, in which is the major determinant of their reduced quality of life. In this sense, several studies demonstrated reduced aerobic capacity in terms of lower peak oxygen consumption (peak VO 2 ) in patients with HFpEF. In addition, the lower aerobic capacity observed in HFpEF may be due to impaired both convective and diffusive O 2 transport (i.e. reduced cardiac output and arteriovenous oxygen difference, respectively).Exercise training program can help restore physiological function in order to increase aerobic capacity and improve the quality of life in HFpEF patients. Therefore, the primary purpose of this chapter was to clarify the physiological mechanisms associated with reduced aerobic capacity in HFpEF patients. Secondly, special focus was devoted to show how aerobic exercise training can improve aerobic capacity and quality of life in HFpEF patients.

Chronic microelectrode investigations of normal human brain physiology using a hybrid depth electrode.

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Howard, M A; Volkov, I O; Noh, M D; Granner, M A; Mirsky, R; Garell, P C

1997-01-01

Neurosurgeons have unique access to in vivo human brain tissue, and in the course of clinical treatment important scientific advances have been made that further our understanding of normal brain physiology. In the modern era, microelectrode recordings have been used to systematically investigate the cellular properties of lateral temporal cerebral cortex. The current report describes a hybrid depth electrode (HDE) recording technique that was developed to enable neurosurgeons to simultaneously investigate normal cellular physiology during chronic intracranial EEG recordings. The HDE combines microelectrode and EEG recordings sites on a single shaft. Multiple microelectrode recordings are obtained from MRI defined brain sites and single-unit activity is discriminated from these data. To date, over 60 HDEs have been placed in 20 epilepsy surgery patients. Unique physiologic data have been gathered from neurons in numerous brain regions, including amygdala, hippocampus, frontal lobe, insula and Heschl's gyrus. Functional activation studies were carried out without risking patient safety or comfort.

Use of the International Space Station as an Exercise Physiology Lab

Science.gov (United States)

Ploutz-Snyder, Lori

2013-01-01

The International Space Station (ISS) is now in its prime utilization phase with great opportunity to use the ISS as a lab. With respect to exercise physiology there is considerable research opportunity. Crew members exercise for up to 2 hours per day using a cycle ergometer, treadmill, and advanced resistive exercise device (ARED). There are several ongoing exercise research studies by NASA, ESA and CSA. These include studies related to evaluation of new exercise prescriptions (SPRINT), evaluation of aerobic capacity (VO2max), biomechanics (Treadmill Kinematics), energy expenditure during spaceflight (Energy), evaluation of cartilage (Cartilage), and evaluation of cardiovascular health (Vascular). Examples of how ISS is used for exercise physiology research will be presented.

Relation between the Disability of the Arm, Shoulder and Hand Score and Muscle Strength in Post-Cardiac Surgery Patients.

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Izawa, Kazuhiro P; Kasahara, Yusuke; Hiraki, Koji; Hirano, Yasuyuki; Watanabe, Satoshi

2017-11-27

Background: The Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire is a valid and reliable patient-reported outcome measure. DASH can be assessed by self-reported upper extremity disability and symptoms. We aimed to examine the relationship between the physiological outcome of muscle strength and the DASH score after cardiac surgery. Methods: This cross-sectional study assessed 50 consecutive cardiac patients that were undergoing cardiac surgery. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Results were analyzed using Spearman correlation coefficients. Results: The final analysis comprised 43 patients (men: 32, women: 11; age: 62.1 ± 9.1 years; body mass index: 22.1 ± 4.7 kg/m²; left ventricular ejection fraction: 53.5 ± 13.7%). Respective handgrip strength, knee extensor muscle strength, and DASH score were 27.4 ± 8.3 kgf, 1.6 ± 0.4 Nm/kg, and 13.3 ± 12.3, respectively. The DASH score correlated negatively with handgrip strength ( r = -0.38, p = 0.01) and with knee extensor muscle strength ( r = -0.32, p = 0.04). Conclusion: Physiological outcomes of both handgrip strength and knee extensor muscle strength correlated negatively with the DASH score. The DASH score appears to be a valuable tool with which to assess cardiac patients with poor physiological outcomes, particularly handgrip strength as a measure of upper extremity function, which is probably easier to follow over time than lower extremity function after patients complete cardiac rehabilitation.

Relation between the Disability of the Arm, Shoulder and Hand Score and Muscle Strength in Post-Cardiac Surgery Patients

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Kazuhiro P. Izawa

2017-11-01

Full Text Available Background: The Disabilities of the Arm, Shoulder, and Hand (DASH questionnaire is a valid and reliable patient-reported outcome measure. DASH can be assessed by self-reported upper extremity disability and symptoms. We aimed to examine the relationship between the physiological outcome of muscle strength and the DASH score after cardiac surgery. Methods: This cross-sectional study assessed 50 consecutive cardiac patients that were undergoing cardiac surgery. Physiological outcomes of handgrip strength and knee extensor muscle strength and the DASH score were measured at one month after cardiac surgery and were assessed. Results were analyzed using Spearman correlation coefficients. Results: The final analysis comprised 43 patients (men: 32, women: 11; age: 62.1 ± 9.1 years; body mass index: 22.1 ± 4.7 kg/m2; left ventricular ejection fraction: 53.5 ± 13.7%. Respective handgrip strength, knee extensor muscle strength, and DASH score were 27.4 ± 8.3 kgf, 1.6 ± 0.4 Nm/kg, and 13.3 ± 12.3, respectively. The DASH score correlated negatively with handgrip strength (r = −0.38, p = 0.01 and with knee extensor muscle strength (r = −0.32, p = 0.04. Conclusion: Physiological outcomes of both handgrip strength and knee extensor muscle strength correlated negatively with the DASH score. The DASH score appears to be a valuable tool with which to assess cardiac patients with poor physiological outcomes, particularly handgrip strength as a measure of upper extremity function, which is probably easier to follow over time than lower extremity function after patients complete cardiac rehabilitation.

Effect of comprehensive cardiac rehabilitation after heart valve surgery (CopenHeartVR)

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Sibilitz, Kirstine Laerum; Berg, Selina Kikkenborg; Hansen, Tina Birgitte

2013-01-01

replacement or repair, remains the treatment of choice. However, post surgery, the transition to daily living may become a physical, mental and social challenge. We hypothesise that a comprehensive cardiac rehabilitation programme can improve physical capacity and self-assessed mental health and reduce...

The emergence of Applied Physiology within the discipline of Physiology.

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Tipton, Charles M

2016-08-01

Despite the availability and utilization of the physiology textbooks authored by Albrecht von Haller during the 18th century that heralded the modern age of physiology, not all physicians or physiologists were satisfied with its presentation, contents, or application to medicine. Initial reasons were fundamental disagreements between the "mechanists," represented by Boerhaave, Robinson, and von Haller, and the "vitalists," represented by the faculty and graduates of the Montpellier School of Medicine in France, notably, Bordeu and Barthez. Subsequently, objections originated from Europe, United Kingdom, and the United States in publications that focused not only on the teaching of physiology to medical and secondary students, but on the specific applications of the content of physiology to medicine, health, hygiene, pathology, and chronic diseases. At the turn of the 20th century, texts began to appear with applied physiology in their titles and in 1926, physician Samson Wright published a textbook entitled Applied Physiology that was intended for both medical students and the medical profession. Eleven years later, physicians Best and Taylor published The Physiological Basis of Medical Practice: A University of Toronto Texbook in Applied Physiology Although both sets of authors defined the connection between applied physiology and physiology, they failed to define the areas of physiology that were included within applied physiology. This was accomplished by the American Physiological Society (APS) Publications Committee in 1948 with the publication of the Journal of Appplied Physiology, that stated the word "applied" would broadly denote human physiology whereas the terms stress and environment would broadly include work, exercise, plus industrial, climatic and social factors. NIH established a study section (SS) devoted to applied physiology in 1964 which remained active until 2001 when it became amalgamated into other SSs. Before the end of the 20th century when

Beta-blocker withdrawal among patients presenting for surgery from home

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Schonberger, Robert B.; Lukens, Carrie L.; Turkoglu, O. Dicle; Feinleib, Jessica L.; Haspel, Kenneth L.; Burg, Matthew M.

2012-01-01

Structured Abstract Objective This study sought to measure the incidence of perioperative beta-blocker non-compliance by patients who were prescribed chronic beta blocker therapy and presented for surgery from home. The effect of patient non-compliance on day of surgery presenting heart rate was also examined. Design Prospective observational study with outcome data obtained from review of the medical record. Setting The preoperative clinic and operating rooms of a Veterans Administration hospital. Participants Patients on chronic beta blocker therapy who presented from home for surgery. Interventions None. Measurements and Main Results Demographic and comorbidity data as well as data on self-reported compliance to beta-blocker therapy, initial day of surgery vital signs, and recent ambulatory vital signs were collected. Ten out of fifty subjects (20%; 95% CI = 9-31%) reported not taking their day of surgery beta-blocker. These self-reported non-adherers demonstrated a higher presenting heart rate on the day of surgery vs. adherent subjects (median of 78 beats per minute vs. 65 beats per minute, p=0.02 by Wilcoxon Rank-Sum Test). The difference-in-difference between baseline primary care and day of surgery heart rate was also statistically significant between compliant and non-compliant subjects (-7 beats per minute vs. +12.5 beats per minute, p<0.00001). Conclusions Patient self-report and physiologic data documented failure to take beta-blockers and possible beta-blocker withdrawal in 20% of patients who presented for surgery from home. If these findings are confirmed in larger studies, improved patient understanding of and compliance with medication instructions during preoperative visits should be a focus of future quality improvement initiatives. PMID:22418043

Physiologic assessment of coronary artery fistula

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Gupta, N.C.; Beauvais, J. (Creighton Univ., Omaha, NE (USA))

1991-01-01

Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery.

Physiologic assessment of coronary artery fistula

International Nuclear Information System (INIS)

Gupta, N.C.; Beauvais, J.

1991-01-01

Coronary artery fistula is an uncommon clinical entity. The most common coronary artery fistula is from the right coronary artery to the right side of the heart, and it is less frequent to the pulmonary artery. The effect of a coronary artery fistula may be physiologically significant because of the steal phenomenon resulting in coronary ischemia. Based on published reports, it is recommended that patients with congenital coronary artery fistulas be considered candidates for elective surgical correction to prevent complications including development of congestive heart failure, angina, subacute bacterial endocarditis, myocardial infarction, and coronary aneurysm formation with rupture or embolization. A patient is presented in whom treadmill-exercise thallium imaging was effective in determining the degree of coronary steal from a coronary artery fistula, leading to successful corrective surgery

Piezoelectric surgery in implant dentistry: clinical applications

Directory of Open Access Journals (Sweden)

Lydia Masako Ferreira

2009-01-01

Full Text Available Pizosurgery has therapeutic characteristics in osteotomies, such as extremely precise, selective and millimetric cuts and a clear operating field. Piezoelectricity uses ultrasonic frequencies, which cause the points specially designed for osteotomy to vibrate. The points of the instrument oscillate, allowing effective osteotomy with minimal or no injury to the adjacent soft tissues, membranes and nerve tissues. This article presents the various applications of piezoelectricity in oral implant surgery such as: removal of autogenous bone; bone window during elevation of the sinus membrane and removal of fractured implants. The cavitational effect caused by the vibration of the point and the spray of physiological solution, provided a field free of bleeding and easy to visualize. The study showed that the piezoelectric surgery is a new surgical procedurethat presents advantages for bone cutting in many situations in implant dentistry, with great advantages in comparison with conventional instrumentation. Operating time is longer when compared with that of conventional cutters.

Analysis of 230 cases of emergent surgery for obstructing colon cancer--lessons learned.

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Aslar, Ahmet Kessaf; Ozdemir, Süleyman; Mahmoudi, Hatim; Kuzu, Mehmet Ayhan

2011-01-01

We aimed to identify prognostic factors affecting clinical outcomes in emergent primary resection. A retrospective analysis of prospectively acquired data of 230 consecutive emergent patients between August 1994 and January 2005 were evaluated in this study. Sixty-nine patients applied with right colon obstruction and 161 patients with left. Resection and primary anastomosis was carried out in 128 patients and resection and stoma in 102 patients. The patients were divided into two cohorts: patients who developed poor outcome within 30 days after surgery and those who did not. Major morbidity or mortality were reported in 60 (26.1%) patients. Analysis revealed that the most important prognostic factors for poor outcome were American Anesthesiology Association (ASA) grade ≥3, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥11, age >60 years, presence of peritonitis, and surgery during on-call hours. Age >60 years and on-call surgery were determinant factors in right-sided obstructions, whereas ASA grade ≥3, APACHE II score ≥11, and presence of peritonitis were determinant factors in left-sided obstructions. All these factors but the timing of the operation emphasize the pivotal role of the patient's physiological condition on admission. Accurate preoperative evaluation might predict the clinical outcome and help in establishing the most appropriate treatment.

The association of muscle strength, aerobic capacity and swim time performance in young, competitive swimmers

DEFF Research Database (Denmark)

Henriksen, Peter; Kromann Knudsen, Hans; Juul-Kristensen, Birgit

Swim time performance is affected by physiological factors such as muscle strength and power of the upper and lower extremities as well as aerobic capacity (Smith et al., 2002). The association between these factors and swim time performance may plausibly identify some of the determinants...... for performance enhancement in swimming (Smith et al., 2002). In order to detail the individual training programme, reference values are needed. The aims of this study were firstly to determine the association between muscle strength and power, aerobic capacity and 100 m freestyle time (FT) in young, competitive...... swimmers, and secondly to determine reference values for these physiological factors. Methods In total, 119 competitive swimmers aged 11-15 years were assessed with Grip Strength (GS), Vertical Jump (VJ) and an intermittent running test to estimate maximal oxygen uptake, the Andersen Test (AT). Swim time...

A prospective observational study comparing a physiological scoring system with time-based discharge criteria in pediatric ambulatory surgical patients.

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Armstrong, James; Forrest, Helen; Crawford, Mark W

2015-10-01

Discharge criteria based on physiological scoring systems can be used in the postanesthesia care unit (PACU) to fast-track patients after ambulatory surgery; however, studies comparing physiological scoring systems with traditional time-based discharge criteria are lacking. The purpose of this study was to compare PACU discharge readiness times using physiological vs time-based discharge criteria in pediatric ambulatory surgical patients. We recorded physiological observations from consecutive American Society of Anesthesiologists physical status I-III patients aged 1-18 yr who were admitted to the PACU after undergoing ambulatory surgery in a tertiary academic pediatric hospital. The physiological score was a combination of the Aldrete and Chung systems. Scores were recorded every 15 min starting upon arrival in the PACU. Patients were considered fit for discharge once they attained a score ≥12 (maximum score, 14), provided no score was zero, with the time to achieve a score ≥12 defining the criteria-based discharge (CBD) time. Patients were discharged from the PACU when both the CBD and the existing time-based discharge (TBD) criteria were met. The CBD and TBD data were compared using Kaplan-Meier and log-rank analysis. Observations from 506 children are presented. Median (interquartile range [IQR]) age was 5.5 [2.8-9.9] yr. Median [IQR] CBD and TBD PACU discharge readiness times were 30 [15-45] min and 60 [45-60] min, respectively. Analysis of Kaplan-Meier curves indicated a significant difference in discharge times using the different criteria (hazard ratio, 5.43; 95% confidence interval, 4.51 to 6.53; P < 0.001). All patients were discharged home without incident. This prospective study suggests that discharge decisions based on physiological criteria have the potential for significantly speeding the transit of children through the PACU, thereby enhancing PACU efficiency and resource utilization.

Humidification during laparoscopic surgery: overview of the clinical benefits of using humidified gas during laparoscopic surgery.

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Binda, Maria Mercedes

2015-11-01

The peritoneum is the serous membrane that covers the abdominal cavity and most of the intra-abdominal organs. It is a very delicate layer highly susceptible to damage and it is not designed to cope with variable conditions such as the dry and cold carbon dioxide (CO2) during laparoscopic surgery. The aim of this review was to evaluate the effects caused by insufflating dry and cold gas into the abdominal cavity after laparoscopic surgery. A literature search using the Pubmed was carried out. Articles identified focused on the key issues of laparoscopy, peritoneum, morphology, pneumoperitoneum, humidity, body temperature, pain, recovery time, post-operative adhesions and lens fogging. Insufflating dry and cold CO2 into the abdomen causes peritoneal damage, post-operative pain, hypothermia and post-operative adhesions. Using humidified and warm gas prevents pain after surgery. With regard to hypothermia due to desiccation, it can be fully prevented using humidified and warm gas. Results relating to the patient recovery are still controversial. The use of humidified and warm insufflation gas offers a significant clinical benefit to the patient, creating a more physiologic peritoneal environment and reducing the post-operative pain and hypothermia. In animal models, although humidified and warm gas reduces post-operative adhesions, humidified gas at 32 °C reduced them even more. It is clear that humidified gas should be used during laparoscopic surgery; however, a question remains unanswered: to achieve even greater clinical benefit to the patient, at what temperature should the humidified gas be when insufflated into the abdomen? More clinical trials should be performed to resolve this query.

Who is at increased risk for acute kidney injury following noncardiac surgery?

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Murray, Patrick

2009-01-01

Abelha and colleagues evaluated the incidence and determinants of postoperative acute kidney injury (AKI) after major noncardiac surgery in patients with previously normal renal function. In this retrospective study of 1,166 patients with no previous renal insufficiency, who were admitted to a postsurgical intensive care unit (ICU) over a 2-year period, the incidence of AKI was 7.5%. Multivariate analysis identified American Society of Anesthesiologists physical status, Revised Cardiac Risk Index, high-risk surgery and congestive heart disease as preoperative AKI risk factors. AKI was an independent risk factor for hospital mortality (odds ratio = 3.12, 95% confidence interval = 1.41 to 6.93; P = 0.005), and was associated with higher severity of illness scores (Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation II), longer ICU length of stay, higher ICU mortality, increased hospital mortality and higher mortality at 6-month follow up. Although the study design excluded 121 patients with significant preoperative renal insufficiency by design, the relatively crude serum creatinine cut-offs used certainly permitted inclusion of numerous patients with preoperative renal impairment. Accordingly, the study design failed to quantify the impact of preoperative renal impairment on risk and outcomes of perioperative AKI in noncardiac surgery, and this should be a goal of such studies in the future. Nonetheless, the study is an important addition to the literature in an under-studied population of patients at high risk for AKI.

Physiological and physical characteristics of elite dragon boat paddlers.

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Ho, Sarah R; Smith, Richard M; Chapman, Philip G; Sinclair, Peter J; Funato, Kazuo

2013-01-01

The objectives of this study were to profile the physiological and physical characteristics of elite dragon boat paddlers, to identify characteristics that predict race performance and to quantify the metabolic energy contributions to simulated 200-m and 500-m dragon boat racing. Eleven, national level, male, Japanese dragon boat paddlers completed a battery of tests on a paddling ergometer including an incremental maximal aerobic capacity test, a 2-minute maximal accumulated oxygen deficit (MAOD) test, and simulated 200-m and 500-m races. A physiological and physical profile of subjects was compiled. Results showed that 200-m race performance correlated with flexed arm girth and excess postexercise oxygen consumption (EPOC) measured in the 30 minutes after the MAOD test, whereas 500-m race performance correlated with body fat percentage, relaxed and flexed arm girth, MAOD, EPOC, and peak power during the MAOD test. Stepwise multiple regression revealed that flexed arm girth was the most powerful predictor of 200-m and 500-m race performance, followed by EPOC with the combination of these 2 factors able to explain 74% and 68% of the variance in 200-m and 500-m race performance, respectively. Aerobic energy contributions for 200-m (50 seconds) and 500-m (1 minute 50 seconds) races were (mean (95% confidence intervals)) 52.1% (range, 47.4-56.8%) and 67.5% (range, 60.1-77.8%), respectively. In conclusion, coaches should develop training programs targeted at developing upper-body musculature and increasing anaerobic capacity because these factors are the strongest predictors of 200-m and 500-m race performance. Given the substantial aerobic energy contributions even for a 200-m race event, coaches should aim to increase the maximal aerobic capacity of the paddler in preparation for both 200-m and 500-m events.

Effect of darbepoetin alfa on physical function in patients undergoing surgery for colorectal cancer

DEFF Research Database (Denmark)

Nørager, C B; Jensen, M B; Madsen, M R

2007-01-01

OBJECTIVE: To study whether perioperative treatment with darbepoetin alfa (DA) improves physical performance following colorectal cancer surgery. METHODS: Patients admitted for planned colorectal cancer surgery were randomized to receive either weekly placebo or DA 300 or 150 microg depending...... on the hemoglobin (Hb) concentration. Patients were assessed 10 days before, as well as 7 and 30 days after surgery for work capacity, postural sway, muscle strength, fatigue and quality of life (QoL). The primary outcome measure were the changes in patients' physical performance from preoperative to postoperative...... differences between the 2 groups on days 7 or 30 for fatigue, postural sway and QoL. DA treatment significantly (p

Homer W. Smith's contribution to renal physiology.

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Giebisch, Gerhard

2004-01-01

Homer Smith was, for three decades, from the 1930s until his death in 1962, one of the leaders in the field of renal physiology. His contributions were many: he played a major role in introducing and popularizing renal clearance methods, introduced non-invasive methods for the measurement of glomerular filtration rate, of renal blood flow and tubular transport capacity, and provided novel insights into the mechanisms of excretion of water and electrolytes. Homer Smith's contributions went far beyond his personal investigations. He was a superb writer of several inspiring textbooks of renal physiology that exerted great and lasting influence on the development of renal physiology. Smith's intellectual insights and ability for critical analysis of data allowed him to create broad concepts that defined the functional properties of glomeruli, tubules and the renal circulation. A distinguishing feature of Homer Smith's career was his close contact and collaboration, over many years, with several clinicians of his alma mater, New York University. For initiating these pathophysiological investigations, he is justly credited to have advanced, in a major way, our understanding of altered renal function in disease. Smith's lasting scientific impact is also reflected by a whole school of investigators that trained with him and who applied his methods, analyses and concepts to the study of renal function all over the world. So great was his influence and preeminence that Robert Pitts, in his excellent tribute to Homer Smith in the Memoirs of the National Academy of Science states that his death brought an end to what might be aptly called the Smithian Era of renal physiology.

Antifibrinolytics in cardiac surgery

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Achal Dhir

2013-01-01

Full Text Available Cardiac surgery exerts a significant strain on the blood bank services and is a model example in which a multi-modal blood-conservation strategy is recommended. Significant bleeding during cardiac surgery, enough to cause re-exploration and/or blood transfusion, increases morbidity and mortality. Hyper-fibrinolysis is one of the important contributors to increased bleeding. This knowledge has led to the use of anti-fibrinolytic agents especially in procedures performed under cardiopulmonary bypass. Nothing has been more controversial in recent times than the aprotinin controversy. Since the withdrawal of aprotinin from the world market, the choice of antifibrinolytic agents has been limited to lysine analogues either tranexamic acid (TA or epsilon amino caproic acid (EACA. While proponents of aprotinin still argue against its non-availability. Health Canada has approved its use, albeit under very strict regulations. Antifibrinolytic agents are not without side effects and act like double-edged swords, the stronger the anti-fibrinolytic activity, the more serious the side effects. Aprotinin is the strongest in reducing blood loss, blood transfusion, and possibly, return to the operating room after cardiac surgery. EACA is the least effective, while TA is somewhere in between. Additionally, aprotinin has been implicated in increased mortality and maximum side effects. TA has been shown to increase seizure activity, whereas, EACA seems to have the least side effects. Apparently, these agents do not differentiate between pathological and physiological fibrinolysis and prevent all forms of fibrinolysis leading to possible thrombotic side effects. It would seem prudent to select the right agent knowing its risk-benefit profile for a given patient, under the given circumstances.

Increased Capacity for Work and Productivity After Breast Reduction.

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Cabral, Isaias Vieira; Garcia, Edgard da Silva; Sobrinho, Rebecca Neponucena; Pinto, Natália Lana Larcher; Juliano, Yara; Veiga-Filho, Joel; Ferreira, Lydia Masako; Veiga, Daniela Francescato

2017-01-01

Breast hypertrophy is a prevalent condition among women worldwide, which can affect different aspects of their quality of life. The physical and emotional impact of breast hypertrophy may harm daily activities, including work. To assess the impact of reduction mammaplasty on the ability to work and productivity of women with breast hypertrophy. A total of 60 patients with breast hypertrophy, already scheduled for breast reduction, aged 18 to 60 years and who had formal or autonomous employment were prospectively enrolled. The Brazilian versions of two validated tools, Work Productivity and Activity Impairment - General Health (WPAI-GH) and Work Limitations Questionnaire (WLQ) were self-administered at the preoperative evaluation and six months following surgery. The median age was 33 years, median body mass index was 24 kg/m 2 , and the median total weight of resected breast tissue was 617.5 g. According to the Brazilian classification of occupation, most patients (53%) had technical, scientific, artistic and similar occupations. There was a significant improvement in work capacity and productivity six months after the reduction mammaplasty, denoted by a decrease in presenteeism, absenteeism, and WLQ Productivity Loss Score (Wilcoxon analysis of variance: P work capacity and productivity of Brazilian women with breast hypertrophy. LEVEL OF EVIDENCE 4. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

[Nutritional implications of bariatric surgery on the gastrointestinal tract].

Science.gov (United States)

Rubio, M A; Moreno, C

2007-05-01

Anatomical change in the anatomy of the gastrointestinal tract after bariatric surgery leads to modification of dietary patterns that have to be adapted to new physiological conditions, either related with the volume of intakes or the characteristics of the macro- and micronutrients to be administered. Restrictive diet after bariatric surgery (basically gastric bypass and restrictive procedures) is done at several steps. The first phase after surgery consists in the administration of clear liquids for 2-3 days, followed by completely low-fat and high-protein content (> 50-60 g/day) liquid diet for 2-4 weeks, normally by means of formula-diets. Soft or grinded diet including very soft protein-rich foods, such as egg, low-calories cheese, and lean meats such as chicken, cow, pork, or fish (red meats are not so well tolerated) is recommended 2-4 weeks after hospital discharge. Normal diet may be started within 8 weeks from surgery or even later. It is important to incorporate hyperproteic foods with each meal, such egg whites, lean meats, cheese or milk. All these indications should be done under the supervision of an expert nutrition professional to always advise the patients and adapting the diet to some special situations (nausea/vomiting, constipation, diarrhea, dumping syndrome, dehydration, food intolerances, overfeeding, etc.). The most frequent vitamin and mineral deficiencies in the different types of surgeries are reviewed, with a special focus on iron, vitamin B12, calcium, and vitamin D metabolism. It should not be forgotten that the aim of obesity surgery is making the patient loose weight and thus post-surgery diet is designed to achieve that goal although without forgetting the essential role that nutritional education has on the learning of new dietary habits contributing to maintain that weight loss over time.

Cardiac Rehabilitation After Heart Valve Surgery

DEFF Research Database (Denmark)

Pollmann, Agathe Gerwina Elena; Frederiksen, Marianne; Prescott, Eva

2017-01-01

PURPOSE: Evidence of the effect of cardiac rehabilitation (CR) after heart valve surgery is scarce, but nevertheless CR is recommended for this group of patients. Therefore, this study assessed the effect of CR on exercise capacity, cardiovascular risk factors, and long-term mortality and morbidity...... ((Equation is included in full-text article.)O2peak) or 6-minute walk test (6MWT). A composite endpoint of all-cause mortality and hospital admission due to myocardial infarction, stroke, heart failure, endocarditis, revascularization, or reoperation was used to assess the hazard ratio between CR attenders...

Nasal Physiology

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Biochar amendment of fluvio-glacial temperate sandy subsoil: Effects on maize water uptake, growth and physiology

DEFF Research Database (Denmark)

Ahmed, Fauziatu; Arthur, Emmanuel; Plauborg, Finn

2018-01-01

Coarse sandy soils have poor water retention capacity, which may constrain crop growth during drought. We investigated the effect of biochar amendment to subsoil on crop physiological processes and maize yield, comparing irrigated and drought conditions. A two-year greenhouse experiment was condu......Coarse sandy soils have poor water retention capacity, which may constrain crop growth during drought. We investigated the effect of biochar amendment to subsoil on crop physiological processes and maize yield, comparing irrigated and drought conditions. A two-year greenhouse experiment...... was conducted with one-time application of straw biochar at concentrations of 0%, 1%, 2% and 3% (B0, B1, B2 and B3). Maize was planted twice in the same large pots one week and again 12 months after biochar application. Plants were fully irrigated until flowering; thereafter, half of them were subjected...... to drought. Our results indicate B2 and B3 increased soil water content at field capacity. Leaf water potential, stomatal conductance, photosynthesis and transpiration were maintained in B2 and B3 during the drying cycle in year one and in all biochar levels in year two. In the first year, B3 induced...

Building a Sustainable Global Surgical Program in an Academic Department of Surgery.

Science.gov (United States)

Zhang, Linda P; Silverberg, Daniel; Divino, Celia M; Marin, Michael

Global surgery and volunteerism in surgery has gained significant interest in recent years for general surgery residents across the country. However, there are few well-established long-term surgical programs affiliated with academic institutions. The present report discusses the implementation process and challenges facing an academic institution in building a long-term sustainable global surgery program. As one of the pioneer programs in global surgery for residents, the Icahn School of Medicine at Mount Sinai global surgery rotation has been successfully running for the last 10 years in a small public hospital in the Dominican Republic. The present report details many key components of implementing a sustainable global surgery program and the evolution of this program over time. Since 2005, 80 general surgery residents have rotated through Juan Pablo Pina Hospital in the Dominican Republic. They have performed a total of 1239 major operations and 740 minor operations. They have also participated in 328 emergency cases. More importantly, this rotation helped shape residents' sense of social responsibility and ownership in their surgical training. Residents have also contributed to the training of local residents in laparoscopic skills and through cultural exchange. As interest in global surgery grows among general surgery residents, it is essential that supporting academic institutions create sustainable and capacity-building rotations for their residents. These programs must address many of the barriers that can hinder maintenance of a sustainable global surgery experience for residents. After 10 years of sending our residents to the Dominican Republic, we have found that it is possible and valuable to incorporate a formal global surgery rotation into a general surgery residency. Copyright © 2016. Published by Elsevier Inc.

An assessment of anti-schistosomal treatment on physical work capacity.

Science.gov (United States)

Awad El Karim, M A; Collins, K J; Sukkar, M Y; Omer, A H; Amin, M A; Doré, C

1981-04-01

Acting as their own controls, village subjects from the Gezira are of the Sudan with relatively high levels of schistosomiasis infection were first tested in an exercise laboratory in Khartoum and the tests were then repeated after a period of about 1 yr during which time the subjects were treated with hycanthone and periodically monitored to ensure that they had remained free of the disease. In the meantime they were also given anti-malarial prophylaxis. Laboratory tests showed a significant improvement in physiological work capacity of up to 20% after treatment compared with untreated controls. An overall improvement in pulmonary function, particularly forced vital capacity, was observed as well as a significant increase in mean haemoglobin concentration by 1.1 g/100 ml of blood in the treated group. Apart from these improvements in physical working capacity, the treated subjects subjectively felt better after the exercise tests, as expressed by the disappearance of fatiguability.

The effect of surgery on lung volume and conventional monitoring parameters in ventilated newborn infants.

Science.gov (United States)

Proquitté, H; Freiberger, O; Yilmaz, S; Bamberg, C; Degenhardt, P; Roehr, C C; Wauer, R R; Schmalisch, G

2010-05-01

In newborn infants, thoraco-abdominal surgery is a serious intervention with respect to gas exchange and lung mechanics. This prospective clinical study compared surgery-induced changes in functional residual capacity (FRC) and ventilation inhomogeneity (VI) indices with changes in conventional monitoring parameters. Of 29 ventilated newborns (mean weight 2,770+/-864 g at surgery), 13, nine and seven underwent thoracic, abdominal or congenital diaphragmatic hernia (CDH) surgery, respectively. The multiple breath washout (MBWO) technique using heptafluoropropane as tracer gas (Babylog 8000; Dräger, Lübeck, Germany) was performed ventilatory monitoring parameters. FRC decreased in non-CDH infants, while FRC increased and VI indices decreased in CDH infants. Despite improvements, the differences in FRC and VI between CDH and non-CDH infants indicated persistent impaired lung function in CHD infants. MBWO can be advantageously used to measure the effect of surgery on the lung. While FRC and VI indices changed following surgery, conventional monitoring parameters did not.

Effects of vaginal prolapse surgery and ageing on vaginal vascularization

OpenAIRE

Weber, M.A.

2016-01-01

Ageing affects pelvic floor anatomy and function, resulting in several disorders like pelvic organ prolapse (POP), lower urinary tract symptoms and vaginal atrophy (VA). In this thesis we searched for methods to link the function of pelvic organs to physiological changes. The effects of POP and vaginal prolapse surgery on vaginal vascularization and the influence of ageing and topical oestrogens on pelvic floor disorders were examined. The lack of knowledge regarding the effects of ageing on ...

Orthognathic Surgery Has a Significant Effect on Perceived Personality Traits and Emotional Expressions.

Science.gov (United States)

Mazzaferro, Daniel M; Wes, Ari M; Naran, Sanjay; Pearl, Rebecca; Bartlett, Scott P; Taylor, Jesse A

2017-11-01

The effects of orthognathic surgery go beyond objective cephalometric correction of facial and dental disproportion and malocclusion, respectively. The authors hypothesized that there is tangible improvement following surgery that alters publicly perceived personality traits and emotions. The authors used Amazon.com's Mechanical Turk (MTurk), a crowdsourcing tool, to determine how preoperative and postoperative images of orthognathic surgery patients were perceived on six personality traits and six emotional expressions based on posteroanterior and lateral photographs. Blinded respondents provided demographic information and were randomly assigned to one of two sets of 20 photographs (10 subjects before and after surgery). Data on 20 orthognathic surgery patients were collected from 476 individuals. The majority of participants were female (52.6 percent), 18 to 39 years old (67.9 percent), Caucasian (76.6 percent), had some college or technical training or graduated college (72.7 percent), and had an annual income between $20,000 and $99,999 (74.6 percent). A paired t test analysis found that subjects were perceived significantly more favorably after orthognathic surgery in 12 countenance categories: more dominant, trustworthy, friendly, intelligent, attractive, and happy; and also less threatening, angry, surprised, sad, afraid, and disgusted (p surgery than those earning less (p orthognathic surgery, with both perceived personality traits and emotions deemed more favorable. Additional work is needed to better understand the physiologic underpinnings of such findings. Crowdsourcing technology offers a unique opportunity for surgeons to gather data regarding laypeople's perceptions of surgical outcomes in areas such as orthognathic surgery.

Physiology for engineers applying engineering methods to physiological systems

CERN Document Server

Chappell, Michael

2016-01-01

This book provides an introduction to qualitative and quantitative aspects of human physiology. It looks at biological and physiological processes and phenomena, including a selection of mathematical models, showing how physiological problems can be mathematically formulated and studied. It also illustrates how a wide range of engineering and physics topics, including electronics, fluid dynamics, solid mechanics and control theory can be used to describe and understand physiological processes and systems. Throughout the text there are introductions to measuring and quantifying physiological processes using both signal and imaging technologies. Physiology for Engineers describes the basic structure and models of cellular systems, the structure and function of the cardiovascular system, the electrical and mechanical activity of the heart and provides an overview of the structure and function of the respiratory and nervous systems. It also includes an introduction to the basic concepts and applications of reacti...

Training surgical residents for a career in academic global surgery: a novel training model.

Science.gov (United States)

Swain, JaBaris D; Matousek, Alexi C; Scott, John W; Cooper, Zara; Smink, Douglas S; Bolman, Ralph Morton; Finlayson, Samuel R G; Zinner, Michael J; Riviello, Robert

2015-01-01

Academic global surgery is a nascent field focused on improving surgical care in resource-poor settings through a broad-based scholarship agenda. Although there is increasing momentum to expand training opportunities in low-resource settings among academic surgical programs, most focus solely on establishing short-term elective rotations rather than fostering research or career development. Given the complex nature of surgical care delivery and programmatic capacity building in the resource-poor settings, many challenges remain before global surgery is accepted as an academic discipline and an established career path. Brigham and Women's Hospital has established a specialized global surgery track within the general surgery residency program to develop academic leaders in this growing area of need and opportunity. Here we describe our experience with the design and development of the program followed by practical applications and lessons learned from our early experiences. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

[Evaluation of exercise capacity in pulmonary arterial hypertension].

Science.gov (United States)

Demir, Rengin; Küçükoğlu, Mehmet Serdar

2010-12-01

Pulmonary arterial hypertension (PAH) is a life-threatening disease characterized by increased pulmonary vascular resistance that leads to right ventricular failure. The most common clinical features of PAH are dyspnea and exercise intolerance. Measurement of exercise capacity is of considerable importance for the assessment of disease severity as well as routine monitoring of disease. Maximal, symptom-limited, cardiopulmonary exercise test (CPET) is the gold standard for the evaluation of exercise capacity, whereby functions of several systems involved in exercise can be assessed, including cardiovascular, respiratory, and metabolic systems. However, in order to derive the most useful diagnostic information on physiologic limitations to exercise, CPET requires maximal effort of the patient, which can be difficult and risky for some severely ill patients. Moreover, it requires specific exercise equipment and measurement systems, and experienced and trained personnel. Thus, routine clinical use of CPET to assess exercise capacity in patients with PAH may not always be feasible. A practical and simple alternative to CPET to determine exercise capacity is the 6-minute walk test (6MWT). It is simple to perform, safe, and reproducible. In contrast to CPET, the 6MWT reflects a submaximal level of exertion that is more consistent with the effort required for daily physical activities. This review focuses on the role of CPET and 6MWT in patients with PAH.

Sub-specialization in plastic surgery in Sub-saharan Africa: capacities, gaps and opportunities

Science.gov (United States)

Ibrahim, Abdulrasheed

2014-01-01

The skill set of a plastic surgeon, which addresses a broad range of soft tissue conditions that are prevalent in sub-Saharan Africa, remains relevant in the unmet need for surgical care. Recently, there has being a major paradigm shift from discipline-based to disease-based care, resulting in an emerging component of patient-centered care; adequate access to subspecialty care in plastic and reconstructive surgery. Given the need for an evolution in sub-specialization, this article focuses on the benefits and future role of differentiation of plastic surgeons into sub-specialty training pathways in sub-Saharan Africa. PMID:25584125

Seasonal bone growth and physiology in endotherms shed light on dinosaur physiology.

Science.gov (United States)

Köhler, Meike; Marín-Moratalla, Nekane; Jordana, Xavier; Aanes, Ronny

2012-07-19

Cyclical growth leaves marks in bone tissue that are in the forefront of discussions about physiologies of extinct vertebrates. Ectotherms show pronounced annual cycles of growth arrest that correlate with a decrease in body temperature and metabolic rate; endotherms are assumed to grow continuously until they attain maturity because of their constant high body temperature and sustained metabolic rate. This apparent dichotomy has driven the argument that zonal bone denotes ectotherm-like physiologies, thus fuelling the controversy on dinosaur thermophysiology and the evolution of endothermy in birds and mammal-like reptiles. Here we show, from a comprehensive global study of wild ruminants from tropical to polar environments, that cyclical growth is a universal trait of homoeothermic endotherms. Growth is arrested during the unfavourable season concurrently with decreases in body temperature, metabolic rate and bone-growth-mediating plasma insulin-like growth factor-1 levels, forming part of a plesiomorphic thermometabolic strategy for energy conservation. Conversely, bouts of intense tissue growth coincide with peak metabolic rates and correlated hormonal changes at the beginning of the favourable season, indicating an increased efficiency in acquiring and using seasonal resources. Our study supplies the strongest evidence so far that homeothermic endotherms arrest growth seasonally, which precludes the use of lines of arrested growth as an argument in support of ectothermy. However, high growth rates are a distinctive trait of mammals, suggesting the capacity for endogenous heat generation. The ruminant annual cycle provides an extant model on which to base inferences regarding the thermophysiology of dinosaurs and other extinct taxa.

Bariatric and Metabolic Surgery in Adolescents: a Path to Decrease Adult Cardiovascular Mortality.

Science.gov (United States)

Beamish, Andrew James; Olbers, Torsten

2015-09-01

Obesity is a major health problem across all age groups and has escalated to pandemic proportions. The proportion of children with overweight or obesity has risen rapidly over recent decades, and it is recognized that most obese children become obese adults. Furthermore, BMI is the strongest CV risk factor to track from childhood into adulthood. As well as BMI, multiple CV risk factors begin in childhood and strong associations between these factors and BMI are evident. Clear evidence exists for the CV benefits of reversing obesity in adults, much of which examines the effects of bariatric surgery. The capacity of bariatric surgery to reliably achieve safe and lasting improvement in BMI is unparalleled, and the emerging evidence base in adolescent bariatric surgery has so far concurred. In the absence of effective alternatives, it appears that the increase in use of bariatric surgery in adolescents will continue.

Glucoregulation after canine islet transplantation : Contribution of insulin secretory capacity, insulin action, and the entero-insular axis

NARCIS (Netherlands)

vanderBurg, MPM; van Suylichem, PTR; Guicherit, OR; Frolich, M; Lemkes, HHPJ; Gooszen, HG

1997-01-01

The physiological glucoregulatory mechanisms after islet transplantation have been incompletely investigated, We studied the insulin secretory capacity (ISC) by intravenous arginine stimulation during 35-mM glucose clamps, insulin action during hyperinsulinemic euglycemic clamps, and mixed-meal

THE N.I. PIROGOV'S CONTRIBUTION TO THE SURGERY OF MUSCULOSKELETAL SYSTEM (ON THE OCCASION OF THE 200-th ANNIVERSARY OF THE BIRTH

Directory of Open Access Journals (Sweden)

R. M. Tikhilov

2010-01-01

Full Text Available Based on the analysis of the scientific heritage the authors presented the contribution of the great Russian surgeon N.I. Pirogov in the development of surgery of the locomotor system. Discussed in detail next lines of activity of N.I. Pirogov being of interest of trauma and orthopedic surgeons, in particular the: anatomical and physiological approach to studying the issues of surgery of extremities, development of scientific and organizational bases in the domestic military-field surgery, the Pirogov's ideas in the field of reconstructive surgery of the extremities, as well as its contribution to the reforming of surgical education in Russia and improvement of the domestic surgical instruments.

Hospital-based versus hybrid cardiac rehabilitation program in coronary bypass surgery patients in western Iran: effects on exercise capacity, risk factors, psychological factors, and quality of life.

Science.gov (United States)

Najafi, Farid; Nalini, Mahdi

2015-01-01

The efficacy of alternative delivery models for a cardiac rehabilitation program (CRP) in low- and middle-income countries is not well documented. This study compared the traditional hospital-based CRP with a hybrid CRP in western Iran. This observational study was conducted with postcoronary surgery patients in Imam-Ali Hospital in Kermanshah, Iran. Both program models included 2 phases: (1) a common preliminary phase (2-4 weeks) involving exercise training and a plan to control cardiac risk factors; and (2) a complementary phase (8 weeks) consisting of group educational classes and exercise training conducted 3 times a week in the hospital or once a week accompanied by phone calls in the hybrid program. Changes in exercise capacity, blood pressure, lipids, resting heart rate, body mass index, waist circumference, smoking, depression, anxiety, and quality of life as well as differences in attendance at hospital sessions were investigated. From a total of 887 patients, 780 (87.9%) completed the programs. There was no association between course completion and type of CRP. Mean age of patients completing the programs was 55.6 ± 8.7 years and 23.8% were female. The hospital-based (n = 585) and hybrid (n = 195) programs resulted in a significant increase in exercise capacity (P countries where there are no appropriate health facilities in remote areas.

Estimation of Aerobic Capacity and Determination of Its Associated Factors among Male Workers of Industrial Sector of Shiraz City, 2010

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A. Rajaei Fard

2011-12-01

Full Text Available Background and aims   In order to physiologically fit the job to the worker’s capability, maximum aerobic capacity (VO2-max is used. This study was conducted to estimate VO2-max and determine its associated factors among workers of industrial sector of Shiraz city.   Methods  In this cross-sectional study, 500 healthy male workers employed in Shiraz city industries participated voluntarily. Subjects’ aerobic capacity was assessed by ergocycle test according to Astrand protocol for 6 minutes. A questionnaire consisted of two parts covering demographic, anthropometric and physiological characteristics was used as data collecting tool.   Results    Mean and standard deviation of age of workers was 32.01 and 7.66 years, respectively. Worker’s aerobic capacity was estimated to be 2.69±0.263 1.min-1 . The results showed that there was association between VO2-max and age, weight and BMI while no association was found between VO2-max and height. Also, statistical analysis revealed association between VO2-max and smoking and exercise per week (P<0.05. Nature of work , shift working, job satisfaction and fatigue had no association with aerobic capacity. Based on the results, regression equations were developed for estimation of aerobic capacity.  Conclusion  Aerobic capacity had association with age, weight, BMI, exercise and smoking.  

Rice Physiology

Science.gov (United States)

P.A. Counce; Davidi R. Gealy; Shi-Jean Susana Sung

2002-01-01

Physiology occurs tn physical space through chemical reactions constrained by anatomy and morphology, yet guided by genetics. Physiology has been called the logic of life. Genes encode structural and fimcdonal proteins. These proteins are subsequently processed to produce enzymes that direct and govern the biomechanical processes involved in the physiology of the...

Thalamic physiology of intentional essential tremor is more like cerebellar tremor than postural essential tremor

OpenAIRE

Zakaria, R; Lenz, FA; Hua, S; Avin, BH; Liu, CC; Mari, Z

2013-01-01

The neuronal physiological correlates of clinical heterogeneity in human essential tremor are unknown. We now test the hypothesis that thalamic neuronal and EMG activities during intention essential tremor are similar to those of the intention tremor which is characteristic of cerebellar lesions. Thalamic neuronal firing was studied in a cerebellar relay nucleus (ventral intermediate, Vim) and in a pallidal relay nucleus (ventral oral posterior, Vop) during stereotactic surgery for the treatm...

Criteria for Determining the Adaptive Capacity of Students of Higher Medical Institutions

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M V Yoltukhivskyi

2018-01-01

Full Text Available The article focuses on the importance of the adaptive capacity of students of higher medical institutions in the process of their professional training. The criteria for evaluating the adaptive capacity of students depending on their age were determined. The main mechanisms of forming the adaptive capacity at the organism level were found to be: 1 biochemical mechanisms which manifest themselves in the intracellular processes, e.g. the change in enzyme activity or their number; 2 physiological mechanisms, e.g. increased sweating as the body temperature rises; 3 morphofunctional mechanisms, i.e. the features of body structure and functions which are associated with lifestyle; 4 behavioural mechanisms – e.g. the creation of comfortable living conditions, etc.; 5 ontogenetic mechanisms, i.e. the acceleration of individual development or its slowdown contributing to the survival when conditions change.

Pulmonary Dead Space Fraction and Extubation Success in Children After Cardiac Surgery.

Science.gov (United States)

Devor, Renee L; Kang, Paul; Wellnitz, Chasity; Nigro, John J; Velez, Daniel A; Willis, Brigham C

2018-04-01

1) Determine the correlation between pulmonary dead space fraction and extubation success in postoperative pediatric cardiac patients; and 2) document the natural history of pulmonary dead space fractions, dynamic compliance, and airway resistance during the first 72 hours postoperatively in postoperative pediatric cardiac patients. A retrospective chart review. Cardiac ICU in a quaternary care free-standing children's hospital. Twenty-nine with balanced single ventricle physiology, 61 with two ventricle physiology. None. We collected data for all pediatric patients undergoing congenital cardiac surgery over a 14-month period during the first 72 hours postoperatively as well as prior to extubation. Overall, patients with successful extubations had lower preextubation dead space fractions and shorter lengths of stay. Single ventricle patients had higher initial postoperative and preextubation dead space fractions. Two-ventricle physiology patients had higher extubation failure rates if the preextubation dead space fraction was greater than 0.5, whereas single ventricle patients had similar extubation failure rates whether preextubation dead space fractions were less than or equal to 0.5 or greater than 0.5. Additionally, increasing initial dead space fraction values predicted prolonged mechanical ventilation times. Airway resistance and dynamic compliance were similar between those with successful extubations and those who failed. Initial postoperative dead space fraction correlates with the length of mechanical ventilation in two ventricle patients but not in single ventricle patients. Lower preextubation dead space fractions are a strong predictor of successful extubation in two ventricle patients after cardiac surgery, but may not be as useful in single ventricle patients.

Physiological parameters

International Nuclear Information System (INIS)

Natera, E.S.

1998-01-01

The physiological characteristics of man depend on the intake, metabolism and excretion of stable elements from food, water, and air. The physiological behavior of natural radionuclides and radionuclides from nuclear weapons testing and from the utilization of nuclear energy is believed to follow the pattern of stable elements. Hence information on the normal physiological processes occurring in the human body plays an important role in the assessment of the radiation dose received by man. Two important physiological parameters needed for internal dose determination are the pulmonary function and the water balance. In the Coordinated Research Programme on the characterization of Asian population, five participants submitted data on these physiological characteristics - China, India, Japan, Philippines and Viet Nam. During the CRP, data on other pertinent characteristics such as physical and dietary were simultaneously being collected. Hence, the information on the physiological characteristics alone, coming from the five participants were not complete and are probably not sufficient to establish standard values for the Reference Asian Man. Nonetheless, the data collected is a valuable contribution to this research programme

Exercise Testing Reveals Everyday Physical Challenges of Bariatric Surgery Candidates.

Science.gov (United States)

Creel, David B; Schuh, Leslie M; Newton, Robert L; Stote, Joseph J; Cacucci, Brenda M

2017-12-01

Few studies have quantified cardiorespiratory fitness among individuals seeking bariatric surgery. Treadmill testing allows researchers to determine exercise capacity through metabolic equivalents. These findings can assist clinicians in understanding patients' capabilities to carry out various activities of daily living. The purpose of this study was to determine exercise tolerance and the variables associated with fitness, among individuals seeking bariatric surgery. Bariatric surgery candidates completed submaximal treadmill testing and provided ratings of perceived exertion. Each participant also completed questionnaires related to history of exercise, mood, and perceived barriers/benefits of exercise. Over half of participants reported that exercise was "hard to very hard" before reaching 70% of heart rate reserve, and one-third of participants reported that exercise was "moderately hard" at less than 3 metabolic equivalents (light activity). Body mass index and age accounted for the majority of the variance in exercise tolerance, but athletic history, employment status, and perceived health benefits also contributed. Perceived benefit scores were higher than barrier scores. Categories commonly used to describe moderate-intensity exercise (3-6 metabolic equivalents) do not coincide with perceptions of intensity among many bariatric surgery candidates, especially those with a body mass index of 50 or more.

The influence of aesthetic surgery on the profile of emotion.

Science.gov (United States)

Rubesa, Gordana; Tic-Bacić, Tamara; Svesko-Visentin, Helena; Bacić, Giordano

2011-09-01

In the clinical practise it has been observed that the person changes physically, too, after aesthetic surgery. The aim of this work was to examine, by objective psychological measurements, what changes occur, and what personality features change. Forty six subjects that had an aesthetic surgery were examined; they were tested before, and eighteen month after the surgery by the Profile Index of Emotion (PIE). Before the re-testing the subjects were analyzed by "The Life Events Scale" to exclude the possibility of the influence of new life events on the results of the re-test. The control group of 29 volunteers was tested by the same psychological instruments. The control group never verbalized the wish for an aesthetic surgery; they were never in psychiatric treatment, and the corresponded to the experimental group in the age, sex and education level. Analysis of the data obtained from PIE test before and after the operation shows a statistical significant increase of the adaptability segments and an improvement of capacity for taking and giving. Emotional conflict does not disappear, but a new balance is established, satisfaction is higher, and the identity is more integrated.

The influence of different space-related physiological variations on exercise capacity determined by oxygen uptake kinetics

Science.gov (United States)

Stegemann, J.

Oxygen uptake kinetics, following defined variations of work load changes allow to estimate the contribution of aerob and anaerob energy supply which is the base for determining work capacity. Under the aspect of long duration missions with application of adequate dosed countermeasures, a reliable estimate of the astronaut's work capacity is important to adjust the necessary inflight training. Since the kinetics of oxygen uptake originate in the working muscle group itself, while measurements are performed at the mouth, various influences within the oxygen transport system might disturb the determinations. There are not only detraining effects but also well-known other influences, such as blood- and fluid shifts induced by weightlessness. They might have an impact on the circulatory system. Some of these factors have been simulated by immersion, blood donation, and changing of the body position.

Basic results and prospects for development of physiology of work of miners of Donbass coal mines

Energy Technology Data Exchange (ETDEWEB)

Grebnyak, V.P. (Institut Gigieny Truda i Profzabolevanii, Donetsk (USSR))

1988-11-01

In the Donbass, tunnelers and stopers work under unfavorable factors of the underground environment: heavy physical work in limited space, increased possibility of accidents and personal risk, a warming microclimate, noise and dust. In view of this, role of physiology of work consists in guaranteeing normalization of work load, in development of rational regiments of work and rest, and a basis of psychophysical criteria of professional choice, development of physiologically based methods of rehabilitation, preparation of miners for factors of underground medium. Physiologic normalization of work of miners can be achieved by establishing norms of work and rest. With mechanization of mining, level of tension of work has increased, requiring longer rest periods after work. Increased temperatures of deep mines necessitate corresponding increase in rest periods, reducing exhaustion of workers and physiologically increasing productivity of work 12-15%. Investigations in physiology of work of miners have established norms of loads, national regimens of work and rest, ways to prevent disease and reduce physiologic tension of organism to prevent functional breakdowns and illnesses. For the future, further study of mechanisms causing strain and exhaustion affecting work capacity of miners is recommended. 14 refs.

Effects of Deficient Irrigation on Some of the Morpho-physiological Characteristics of Four Fig Cultivars

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Gh. Davarynejad

2016-07-01

Full Text Available Introduction: The amount of water available to plants includes one of the most important factors that affect the growth of plants. The objective of the present study was to investigate and compare the tolerance of different fig types (Ficus carica L. to different low irrigation treatments. Materials and Methods: A factorial trial based on a completely randomized design with 3 replications was carried out in Ferdowsi University of Mashhad. The treatments of this experiment were four levels of irrigation including; supplying enough water to pots (100% field capacity, mild stress (75% field capacity, average stress (50% field capacity and severe stress (25% field capacity on Green, Black, Shah Fig and Matthew cultivars. Some of morphological and physiological traits like stem growth, leaf umber, leaf area, root length, root area, fresh and dry weight of shoot and root, root to shoot ratio, relative water content, electrolyte leakage, total chlorophyll and proline were measured. Results and Discussion: According to the results, significant differences were observed between different irrigation treatments for all measured parameters. The highest level of stem growth, leaf umber and leaf area were detected in control treatment (100% field capacity, while the lowest contents were observed in severe stress (25% field capacity. The results showed that the fresh and dry weight of shoot and root decreased with increasing drought stress, so that the lowest amounts were observed in severe stress treatment (25% field capacity. The levels of relative water content was significantly affected by different irrigation treatments, since treated plants with severe stress treatment (25% field capacity had the lowest relative water values, while the highest levels was observed in control treatment (100% field capacity. The highest and lowest of total chlorophyll content was observed in control treatments (100% field capacity and severe stress (25% field capacity

Late Onset of CSF Rhinorrhea in a Postoperative Transsphenoidal Surgery Patient Following Robotic-Assisted Abdominal Hysterectomy

OpenAIRE

Dowdy, Justin T.; Moody, Marcus W.; Cifarelli, Christopher P.

2014-01-01

Cerebrospinal fluid (CSF) leak is the most commonly encountered perioperative complication in transsphenoidal surgery for pituitary lesions. Direct closure with a combination of autologous fat, local bone, and/or synthetic grafts remains the standard of care for leaks encountered at the time of surgery as well as postoperatively. The development of the vascularized nasoseptal flap as a closure technique has increased the surgeon’s capacity to correct even larger openings in the dura of the se...

EFFECTS OF AROMATHERAPY MASSAGE ON THE SLEEP QUALITY AND PHYSIOLOGICAL PARAMETERS OF PATIENTS IN A SURGICAL INTENSIVE CARE UNIT.

Science.gov (United States)

Özlü, Zeynep Karaman; Bilican, Pınar

2017-01-01

Surgical pain is experienced by inpatients with clinical, disease-related concerns, unknown encounters after surgery, quality of sleep, restrictions in position after surgery is known to be serious. The study was conducted to determine the effect of aromatherapy massage on quality of sleep and physiological parameters in surgical intensive care patients. This is an experimental study. The sample of this study consisted of 60 patients who were divided into two groups as experimental group and control group including 30 patients in each one. The participants were postoperative patients, absent complications, who were unconscious and extubated. A data collection form on personal characteristics of the patients, a registration form on their physical parameters and the Richards-Campbell Sleep Scale (RCSQ) were used to collect the data of the study. The Richards-Campbell Sleep Scale indicated that while the experimental group had a mean score of 53.80 ± 13.20, the control group had a mean score of 29.08 ± 9.71 and there was a statistically significant difference between mean scores of the groups. In a comparison of physiologic parameters, only diastolic blood pressure measuring between parameters in favor of an assembly as a statistically significant difference was detected. Results of the study showed that aromatherapy massage enhanced the sleep quality of patients in a surgical intensive care unit and resulted in some positive changes in their physiological parameters.

Genetic Influences on Physiological and Subjective Responses to an Aerobic Exercise Session among Sedentary Adults

International Nuclear Information System (INIS)

Karoly, H. C.; Stevens, C.; Harlaar, N.; Hutchison, K. E.; Bryan, A. D.; Magnan, R. E.

2012-01-01

To determine whether genetic variants suggested by the literature to be associated with physiology and fitness phenotypes predicted differential physiological and subjective responses to a bout of aerobic exercise among inactive but otherwise healthy adults. Method. Participants completed a 30-minute submaximal aerobic exercise session. Measures of physiological and subjective responding were taken before, during, and after exercise. 14 single nucleotide polymorphisms (SNPs) that have been previously associated with various exercise phenotypes were tested for associations with physiological and subjective response to exercise phenotypes. Results. We found that two SNPs in the FTO gene (rs8044769 and rs3751812) were related to positive affect change during exercise. Two SNPs in the CREB1 gene (rs2253206 and 2360969) were related to change in temperature during exercise and with maximal oxygen capacity (VO 2 max). The SLIT2 SNP rs1379659 and the FAM5C SNP rs1935881 were associated with norepinephrine change during exercise. Finally, the OPRM1 SNP rs1799971 was related to changes in norepinephrine, lactate, and rate of perceived exertion (RPE) during exercise. Conclusion. Genetic factors influence both physiological and subjective responses to exercise. A better understanding of genetic factors underlying physiological and subjective responses to aerobic exercise has implications for development and potential tailoring of exercise interventions.

Prognostic Factors for Satisfaction After Decompression Surgery for Lumbar Spinal Stenosis

DEFF Research Database (Denmark)

Paulsen, Rune Tendal; Bouknaitir, Jamal Bech; Fruensgaard, Søren

2018-01-01

: To present clinical outcome data and identify prognostic factors related to patient satisfaction 1 yr after posterior decompression surgery for lumbar spinal stenosis. METHOD: This multicenter register study included 2562 patients. Patients were treated with various types of posterior decompression. Patients...... with previous spine surgery or concomitant fusion were excluded. Patient satisfaction was analyzed for associations with age, sex, body mass index, smoking status, duration of pain, number of decompressed vertebral levels, comorbidities, and patient-reported outcome measures, which were used to quantify....... CONCLUSION: This study found smoking, long duration of leg pain, and cancerous and neurological disease to be associated with patient dissatisfaction, whereas good walking capacity at baseline was positively associated with satisfaction after 1 yr....

CORRELATION BETWEEN CERVICAL SAGITTAL ALIGNMENT AND FUNCTIONAL CAPACITY IN CERVICAL SPONDYLOSIS

Directory of Open Access Journals (Sweden)

Marcel Machado da Motta

Full Text Available ABSTRACT Objective: To correlate the radiographic parameters of sagittal cervical alignment with quality of life and functional capacity in patients with cervical spondylosis under conservative treatment. Methods: This is an observational and prospective study in patients with cervical spondylosis under conservative treatment and without indication for surgery. The 52 patients included were divided into three groups: axial pain, radiculopathy, and cervical myelopathy. The radiographic parameters considered were cervical lordosis (CL, cervical sagittal vertical axis (CSVA, T1 slope (TS and the discrepancy between TS and CL (TS-CL. Quality of life and functional capacity were evaluated by the Neck Disability Index (NDI questionnaire. Pain was assessed by the Visual Analogue Scale (VAS. The correlation between the radiographic parameters and the clinical scores was evaluated by the Pearson correlations coefficient. Results: There was no difference in cervical radiographic parameters between the three groups. In the total of the sample, the mean value of the CSVA was 17.8o (±8.3o, CL, 22.4° (± 8.8°; TS, 29.3° (±6.6°, and TS-CL, 7.0° (±7.4°. Significant inverse correlation (r= -0.3, p=0.039 was observed between NDI and CL, but there was no significant correlation between CL and VAS. CSVA (p=0.541, TS (p=0.287 and TS-CL (p=0.287 had no significantly correlated with NDI or VAS. Conclusion: Considering patients with cervical spondylosis not candidates for surgery, the only sagittal parameter that correlated with functional capacity was LC. In these patients, the correlation between cervical alignment and quality of life needs to be better characterized.

Corrective Jaw Surgery

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Management of cerebrospinal fluid leak during endoscopic pituitary surgery.

Science.gov (United States)

Berker, Mustafa; Aghayev, Kamran; Yücel, Taşkın; Hazer, Derya Burcu; Onerci, Metin

2013-08-01

Dural opening and closures are major steps in endoscopic pituitary surgery. Restoring the normal anatomy at the end of the procedure creates a natural barrier between the intrasellar compartment and the sinonasal cavity. In this study, we present a relatively simple dural opening and closure technique for endoscopic pituitary surgery. This technique provides a better alternative to the use of a more complex nasoseptal flap or the multilevel closure with artificial materials as it restores the normal anatomy after the tumor removal and provides a better physiological barrier between the sinonasal cavity and the intrasellar compartment. Incision is performed in circular or horseshoe fashion leaving a small peduncle, and then the dura is reflected. Of the 733 endoscopic transsphenoidal procedures in 667 patients conducted between January 2006 and May 2012, we used this described technique in 50 cases (7.4%). In these 50 cases with dural flap, there was no postoperative CSF leakage. Intraoperative CSF leakage was observed in 135 (20.2%) of the 667 patients. In 15 (11.1%) of these 135 patients we used the dural flap technique accompanied with fat and/or fascia lata support. There was no postoperative leakage in these patients. In the remaining 120 (89.9%) patients who had intraoperative CSF leakage, we used fat and/or fascia lata for the reconstruction of the sella floor. But we observed postoperative CSF leakage in 12 (10%) of the 120 patients without the dural flap which were reoperated. The dural flap technique we employ has several advantages. First of all, it allows optimal physiological reconstruction after the surgery. Secondly, the bridge between the flap and the main dura helps maintain the vascular supply, which in turn can radically shorten the healing time. Thirdly, this technique is obviously a better alternative to the time consuming and expensive multilevel closures with tissue sealants and artificial grafts. Copyright © 2012 Elsevier Ireland Ltd. All

Effectiveness of inquiry-based learning in an undergraduate exercise physiology course.

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Nybo, Lars; May, Michael

2015-06-01

The present study was conducted to investigate the effects of changing a laboratory physiology course for undergraduate students from a traditional step-by-step guided structure to an inquiry-based approach. With this aim in mind, quantitative and qualitative evaluations of learning outcomes (individual subject-specific tests and group interviews) were performed for a laboratory course in cardiorespiratory exercise physiology that was conducted in one year with a traditional step-by-step guided manual (traditional course) and the next year completed with an inquiry-based structure (I-based course). The I-based course was a guided inquiry course where students had to design the experimental protocol and conduct their own study on the basis of certain predefined criteria (i.e., they should evaluate respiratory responses to submaximal and maximal exercise and provide indirect and direct measures of aerobic exercise capacity). The results indicated that the overall time spent on the experimental course as well as self-evaluated learning outcomes were similar across groups. However, students in the I-based course used more time in preparation (102 ± 5 min) than students in the traditional course (42 ± 3 min, P traditional course. Furthermore, students in the I-based course achieved a higher (P traditional course (31 ± 4%). Although students were unfamiliar with cardiorespiratory exercise physiology and the experimental methods before the course, it appears that an inquiry-based approach rather than one that provides students with step-by-step instructions may benefit learning outcomes in a laboratory physiology course. Copyright © 2015 The American Physiological Society.

Obesity-related cardiorenal disease: the benefits of bariatric surgery.

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Fenske, Wiebke; Athanasiou, Thanos; Harling, Leanne; Drechsler, Christiane; Darzi, Ara; Ashrafian, Hutan

2013-09-01

The inexorable increase in the prevalence of obesity is a global health concern, which will result in a concomitant escalation in health-care costs. Obesity-related metabolic syndrome affects approximately 25% of adults and is associated with cardiovascular and renal disease. The heart and kidneys are physiologically interdependent, and the pathological effects of obesity can lead to cardiorenal syndrome and, ultimately, kidney and heart failure. Weight loss can prevent or ameliorate obesity-related cardiorenal syndrome, but long-term maintenance of a healthy weight has been difficult to achieve through lifestyle changes or pharmacotherapy. Bariatric surgery offers both sustained weight loss and favourable metabolic changes, including dramatic improvements in glycaemic control and symptoms of type 2 diabetes mellitus. Procedures such as Roux-en-Y gastric bypass offer immediate multisystemic benefits, including bile flow alteration, reduced gastric size, anatomical gut rearrangement and altered flow of nutrients, vagal manipulation and enteric hormone modulation. In patients with cardiorenal syndrome, bariatric surgery also offers renoprotection and cardioprotection, and attenuates both kidney and heart failure by improving organ perfusion and reversing metabolic dysfunction. However, further research is required to understand how bariatric surgery acts on the cardiorenal axis, and its pioneering role in novel treatments and interventions for cardiorenal disease.

Effects of hand massage on anxiety in patients undergoing ophthalmology surgery using local anesthesia

Directory of Open Access Journals (Sweden)

Jafar Rafiei Kiasari

2012-08-01

Full Text Available Introduction: Anxiety is a common disorder in patients before surgery. Inappropriately managed anxiety can cause psychological and physiological reactions and will affect the process of surgery and recovery. Therefore, this study examined the effects of hand mas-sage on anxiety in patients undergoing ophthalmology surgery using local anesthesia. Methods: In this interventional study, 52 patients who were supposed to undergo oph-thalmology surgery using local anesthesia were studied. Patients were randomly as-signed to two groups of intervention, who received hand massage before surgery (n = 27 and control (n = 25. Massaging lasted for 5 minutes (2.5 minutes on each hand before surgery. Stroking and scrubbing methods were performed by 2 trained research-ers. Anxiety level, blood pressure, heart rate, and respiratory rate were measured before and after the intervention in both groups. Anxiety was evaluated using Spielberger State-Trait Anxiety Inventory. Data was analyzed by chi-square, independent samples t-test, and paired t-test. Results: There were no significant differences in mean anxiety, systolic blood pressure, diastolic blood pressure, heart rate, and respiratory rate between the two groups before the intervention (p > 0.05. However, there was a significant differenc in the mean stress level between the two groups after the intervention (p 0.05. Conclusion: Our findings suggested that 5 minutes of hand massage before ophthalmology surgery (under local anesthesia could reduce anxiety. Therefore, this method can be used to increase patient comfort and reduce anxiety before surgical interventions.

Mapping Cardiac Physiology and Parenting Processes in Maltreating Mother–Child Dyads

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Skowron, Elizabeth A.; Loke, Eric; Gatzke-Kopp, Lisa M.; Cipriano-Essel, Elizabeth A.; Woehrle, Petra L.; Van Epps, John J.; Gowda, Anjali; Ammerman, Robert T.

2013-01-01

Child maltreatment (CM) lies on an extreme end of the continuum of parenting-at-risk, and while CM has been linked with a variety of behavioral indicators of dysregulation in children, less is known about how physiological markers of regulatory capacity contribute to this association. The present study examined patterns of mother and child physiological regulation and their relations with observed differences in parenting processes during a structured interaction. Abusing, neglecting, and non-CM mothers and their 3- to 5-year-old children completed a resting baseline and moderately challenging joint task. The structural analysis of social behavior was used to code mother–child interactions while simultaneous measures of respiratory sinus arrhythmia were obtained. Results indicated that physically abusive mothers were more likely to react to children’s positive bids for autonomy with strict and hostile control, than either neglecting or non-CM mothers. CM exposure and quality of maternal responding to children’s autonomous bids were uniquely associated with lower parasympathetic tone in children. Results provide evidence of neurodevelopmental associations between early CM exposure, the immediate interactive context of parenting, and children’s autonomic physiology. PMID:21842991

Pancreatic and Intestinal Function Post Roux-en-Y Gastric Bypass Surgery for Obesity

DEFF Research Database (Denmark)

O'Keefe, Stephen J D; Rakitt, Tina; Ou, Junhai

2017-01-01

OBJECTIVES: Despite the fact that the most effective treatment for morbid obesity today is gastric bypass surgery, some patients develop life-threatening nutritional complications associated with their weight loss. METHODS: Here we examine the influence of the altered anatomy and digestive...... physiology on pancreatic secretion and fat absorption. Thirteen post Roux-en-Y gastric bypass (RYGB) patients who had lost >100 lbs in the first year following surgery and who gave variable histories of gastrointestinal (GI) dysfunction, were selected for study. Food-stimulated pancreatic enzyme secretion...... balance study when a normal diet was given containing ~100 g fat/d. RESULTS: Result showed that all patients had some fat malabsorption, but eight had coefficients of fat absorption associated with significantly lower feed-stimulated secretion rates of trypsin...

[Multidisciplinary team building in enhanced recovery after surgery].

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Jia, W D

2018-01-01

There has been 10 years to explore the road in line with China's actual enhanced recovery after surgery(ERAS) since Academician Li Jieshou introduced the view of ERAS into China. ERAS has been widely carried out in the field of surgery, and gradually formed with Chinese characteristics of ERAS clinical pathway.The clinical implementation of ERAS relies on the effective integration of a series of perioperative methods, and any single technique or method can't completely reduce the perioperative physiological and psychological traumatic stress of the patient, so as to achieve the patient's rapid rehabilitation patient-centered multidisciplinary team(MDT)collaboration is an inevitable trend in ERAS development. On the basis of drawing lessons from foreign experience, the establishment of ERAS-MDT model in line with China's national conditions is a new subject that needs to be studied at present. The construction of ERAS-MDT might promote the development of new ERAS services, new technologies, and ultimately promote the improvement of surgical treatment, and bring the greatest clinical benefit to the society and patients.

Evaluation of space capacities of the respiratory muscles during hypokinesia

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Baranov, V. M.; Aleksandrova, N. P.; Tikhonov, M. A.

2005-08-01

Nowdays, the phenomenon of physical performance degradation after a long period of motor restraint or microgravity is universally interpreted as a result of deconditioning of the cardiovascular system and anti- gravity skeletal muscles.Yet, deconditioning affects not only the skeletal but also respiratory muscles exhaustion of which by relative hypoventilation brings about hypercapnia, hypoxia and pulmonary acidosis conducive to the sensations of painful breathlessness impacting the capacity for physical work. It should be emphasized that these developments are little known in spite of their theoretical and practical significance; therefore, our purpose was to study the functional state and spare capacity of the respiratory muscles in laboratory animals (Wistar rats) following 3-wk tail-suspension.The experiment strengthened the hypothesis according to which simulation of the physiological effects of motor restraint and microgravity leads to fatigue and deconditioning of the respiratory muscles.

Badminton Specific Testing and Development of Physical On-Court Exercise Capacity in Elite Youth Badminton Players

DEFF Research Database (Denmark)

Madsen, Christian Ole Møller

This thesis describes the development of two badminton-specific tests to evaluate players' maximum movement speed and the endurance capacity using game-like movement patterns and intermittent game-like conditions. The badminton speed test (B-SPEED) is used to assess maximal movements during...... in adult players only. This thesis aims to enhance the existing research within the field by also evaluating badminton-specific speed and endurance in elite youth players in both a cross-sectional and longitudinal manner, and with reference to the physiological capacities of world top-50 single players....

Physiological performance and thermal tolerance of major Red Sea macrophytes

KAUST Repository

Weinzierl, Michael S.

2017-12-01

As anthropogenically-forced ocean temperatures continue to rise, the physiological response of marine macrophytes becomes exceedingly relevant. The Red Sea is a semi-isolated sea- the warmest in the world (SST up to 34°C) - already exhibiting signs of rapid warming rates exceeding those of other tropical oceans. This will have profound effects on the physiology of marine organisms, specifically marine macrophytes, which have direct influence on the dynamic carbonate system of the Red Sea. The aim of this paper is to define the physiological capability and thermal optima and limits of six ecologically important Red Sea macrophytes- ranging from seagrasses to calcifying and non-calcifying algae- and to describe the effects of increasing thermal stress on the performance and limits of each macrophyte in terms of activation energy. Of the species considered, Halophila stipulacae, Halimeda optunia, Halimeda monile and Padina pavonica thrive in thermal extremes and may be more successful in future Red Sea warming scenarios. Specifically, Halimeda opuntia increased productivity and calcification rates up to 38°C, making it the most thermally resilient macrophyte. Halophila stipulacae is the most productive seagrass, and hence has the greatest positive effect on Omega saturation state and offers chemical buffer capacity to future ocean acidification.

Using virtual reality to control preoperative anxiety in ambulatory surgery patients: A pilot study in maxillofacial and plastic surgery.

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Ganry, L; Hersant, B; Sidahmed-Mezi, M; Dhonneur, G; Meningaud, J P

2018-01-06

Preoperative anxiety may lead to medical and surgical complications, behavioral problems and emotional distress. The most common means of prevention are based on using medication and, more recently, hypnosis. The aim of our study was to determine whether a virtual reality (VR) program presenting natural scenes could be part of a new therapy to reduce patients' preoperative anxiety. Our prospective pilot study consisted of a single-blind trial in skin cancer surgery at the Henri-Mondor teaching hospital in France. In the outpatient surgery department, 20 patients with a score of >11 on the Amsterdam preoperative anxiety and information scale (APAIS) were virtually immersed into a natural universe for 5minutes. Their stress levels were assessed before and after this experience by making use of a visual analog scale (VAS), by measuring salivary cortisol levels, and by determining physiological stress based on heart coherence scores. The VAS score was significantly reduced after the simulation (P<0.009) as was the level of salivary cortisol (P<0.04). Heart coherence scores remained unchanged (P=0.056). VR allows patients to be immersed in a relaxing, peaceful environment. It represents a non-invasive way to reduce preoperative stress levels with no side effects and no need for additional medical or paramedical staff. Our results indicate that VR may provide an effective complementary technique to manage stress in surgery patients. Randomized trials are necessary to determine precise methods and benefits. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

[History of cranial surgery, cerebral tumor surgery and epilepsy surgery in Mexico].

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Chico-Ponce de León, F

2009-08-01

The first report of intra-cerebral tumor surgery was provided by Bennett & Goodle, in London, 1884. Worldwide this kind of surgery was performed in France by Chipault, in Italy by Durante, in the United States by Keen and in Deutchland by Krause & Oppenheim. Lavista in Mexico City operated on intra-cerebral tumor in 1891, and the report was printed in 1892. In the same publication, Lavista exhibited the first cases of epilepsy surgery. Since now, it is the first report of this kind of surgery in the Spanish-speaking world.

Quantitative Circulatory Physiology: an integrative mathematical model of human physiology for medical education.

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Abram, Sean R; Hodnett, Benjamin L; Summers, Richard L; Coleman, Thomas G; Hester, Robert L

2007-06-01

We have developed Quantitative Circulatory Physiology (QCP), a mathematical model of integrative human physiology containing over 4,000 variables of biological interactions. This model provides a teaching environment that mimics clinical problems encountered in the practice of medicine. The model structure is based on documented physiological responses within peer-reviewed literature and serves as a dynamic compendium of physiological knowledge. The model is solved using a desktop, Windows-based program, allowing students to calculate time-dependent solutions and interactively alter over 750 parameters that modify physiological function. The model can be used to understand proposed mechanisms of physiological function and the interactions among physiological variables that may not be otherwise intuitively evident. In addition to open-ended or unstructured simulations, we have developed 30 physiological simulations, including heart failure, anemia, diabetes, and hemorrhage. Additional stimulations include 29 patients in which students are challenged to diagnose the pathophysiology based on their understanding of integrative physiology. In summary, QCP allows students to examine, integrate, and understand a host of physiological factors without causing harm to patients. This model is available as a free download for Windows computers at http://physiology.umc.edu/themodelingworkshop.

Adolescent bariatric surgery program characteristics: the Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study experience.

Science.gov (United States)

Michalsky, Marc P; Inge, Thomas H; Teich, Steven; Eneli, Ihuoma; Miller, Rosemary; Brandt, Mary L; Helmrath, Michael; Harmon, Carroll M; Zeller, Meg H; Jenkins, Todd M; Courcoulas, Anita; Buncher, Ralph C

2014-02-01

The number of adolescents undergoing weight loss surgery (WLS) has increased in response to the increasing prevalence of severe childhood obesity. Adolescents undergoing WLS require unique support, which may differ from adult programs. The aim of this study was to describe institutional and programmatic characteristics of centers participating in Teen Longitudinal Assessment of Bariatric Surgery (Teen-LABS), a prospective study investigating safety and efficacy of adolescent WLS. Data were obtained from the Teen-LABS database, and site survey completed by Teen-LABS investigators. The survey queried (1) institutional characteristics, (2) multidisciplinary team composition, (3) clinical program characteristics, and (4) clinical research infrastructure. All centers had extensive multidisciplinary involvement in the assessment, pre-operative education, and post-operative management of adolescents undergoing WLS. Eligibility criteria and pre-operative clinical and diagnostic evaluations were similar between programs. All programs have well-developed clinical research infrastructure, use adolescent-specific educational resources, and maintain specialty equipment, including high weight capacity diagnostic imaging equipment. The composition of clinical team and institutional resources is consistent with current clinical practice guidelines. These characteristics, coupled with dedicated research staff, have facilitated enrollment of 242 participants into Teen-LABS. © 2013 Published by Elsevier Inc.

Scheduling elective surgeries: the tradeoff among bed capacity, waiting patients and operating room utilization using goal programming.

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Li, Xiangyong; Rafaliya, N; Baki, M Fazle; Chaouch, Ben A

2017-03-01

Scheduling of surgeries in the operating rooms under limited competing resources such as surgical and nursing staff, anesthesiologist, medical equipment, and recovery beds in surgical wards is a complicated process. A well-designed schedule should be concerned with the welfare of the entire system by allocating the available resources in an efficient and effective manner. In this paper, we develop an integer linear programming model in a manner useful for multiple goals for optimally scheduling elective surgeries based on the availability of surgeons and operating rooms over a time horizon. In particular, the model is concerned with the minimization of the following important goals: (1) the anticipated number of patients waiting for service; (2) the underutilization of operating room time; (3) the maximum expected number of patients in the recovery unit; and (4) the expected range (the difference between maximum and minimum expected number) of patients in the recovery unit. We develop two goal programming (GP) models: lexicographic GP model and weighted GP model. The lexicographic GP model schedules operating rooms when various preemptive priority levels are given to these four goals. A numerical study is conducted to illustrate the optimal master-surgery schedule obtained from the models. The numerical results demonstrate that when the available number of surgeons and operating rooms is known without error over the planning horizon, the proposed models can produce good schedules and priority levels and preference weights of four goals affect the resulting schedules. The results quantify the tradeoffs that must take place as the preemptive-weights of the four goals are changed.

Bariatric surgery insurance requirements independently predict surgery dropout.

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Love, Kaitlin M; Mehaffey, J Hunter; Safavian, Dana; Schirmer, Bruce; Malin, Steven K; Hallowell, Peter T; Kirby, Jennifer L

2017-05-01

Many insurance companies have considerable prebariatric surgery requirements despite a lack of evidence for improved clinical outcomes. The hypothesis of this study is that insurance-specific requirements will be associated with a decreased progression to surgery and increased delay in time to surgery. Retrospective data collection was performed for patients undergoing bariatric surgery evaluation from 2010-2015. Patients who underwent surgery (SGY; n = 827; mean body mass index [BMI] 49.1) were compared with those who did not (no-SGY; n = 648; mean BMI: 49.4). Univariate and multivariate analysis were performed to identify specific co-morbidity and insurance specific predictors of surgical dropout and time to surgery. A total of 1475 patients using 12 major insurance payors were included. Univariate analysis found insurance requirements associated with surgical drop out included longer median diet duration (no-SGY = 6 mo; SGY = 3 mo; Psurgery dropout. Additionally, surgical patients had an average interval between initial visit and surgery of 5.8±4.6 months with significant weight gain (2.1 kg, Psurgery insurance requirements were associated with lack of patient progression to surgery in this study. In addition, delays in surgery were associated with preoperative weight gain. Although prospective and multicenter studies are needed, these findings have major policy implications suggesting insurance requirements may need to be reconsidered to improve medical care. Copyright © 2017 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Exercise Capacity and Mortality in Patients with Ischemic Left Ventricular Dysfunction Randomized to Coronary Artery Bypass Surgery or Medical Therapy: An Analysis From the Surgical Treatment for Ischemic Heart Failure (STICH) Trial

Science.gov (United States)

Stewart, Ralph; Szalewska, Dominika; She, Lilin; Lee, Kerry L.; Drazner, Mark H.; Lubiszewska, Barbara; Kosevic, Dragana; Ruengsakulrach, Permyos; Nicolau, José C.; Coutu, Benoit; Choudhary, Shiv K.; Mark, Daniel B.; Cleland, John G.F.; Piña, Ileana L.; Velazquez, Eric J.; Rynkiewicz, Andrzej; White, Harvey

2014-01-01

Objective To assess the prognostic significance of exercise capacity in patients with ischemic left ventricular (LV) dysfunction eligible for coronary artery bypass surgery (CABG). Background Poor exercise capacity is associated with mortality, but it is not known how this influences the benefits and risks of CABG compared to medical therapy. Methods In an exploratory analysis physical activity was assessed by questionnaire and 6-minute walk test in 1,212 patients before randomization to CABG (n=610) or medical management (n=602) in the STICH trial. Mortality (n=462) was compared by treatment allocation during 56 (IQR 48 to 68) months follow-up for subjects able (n=682) and unable (n=530) to walk 300m in 6 minutes and with less (Physical Ability Score >55, n= 749) and more (PAS ≤55, n=433) limitation by dyspnea or fatigue. Results Compared to medical therapy mortality was lower for patients randomized to CABG who walked ≥300m (HR 0.77, 95% CI 0.59 to 0.99, p=0.038) and those with a PAS >55 (HR 0.79, 95% CI 0.62 to 1.01, p=0.061). Patients unable to walk 300m or with a PAS ≤55 had higher mortality during the first 60 days with CABG (HR 3.24, 95% CI 1.64 to 6.83, p=0.002) and no significant benefit from CABG during total follow-up (HR 0.95, 95% CI 0.75 to 1.19, p=0.626, interaction p=0.167). Conclusion These observations suggest that patients with ischemic LV dysfunction and poor exercise capacity have increased early risk, and similar 5 year mortality with CABG compared to medical therapy, while those with better exercise capacity have improved survival with CABG. PMID:25023813

Intra-operative neurophysiological mapping and monitoring during brain tumour surgery in children: an update.

Science.gov (United States)

Coppola, Angela; Tramontano, Vincenzo; Basaldella, Federica; Arcaro, Chiara; Squintani, Giovanna; Sala, Francesco

2016-10-01

Over the past decade, the reluctance to operate in eloquent brain areas has been reconsidered in the light of the advent of new peri-operative functional neuroimaging techniques and new evidence from neuro-oncology. To maximise tumour resection while minimising morbidity should be the goal of brain surgery in children as much as it is in adults, and preservation of brain functions is critical in the light of the increased survival and the expectations in terms of quality of life. Intra-operative neurophysiology is the gold standard to localise and preserve brain functions during surgery and is increasingly used in paediatric neurosurgery. Yet, the developing nervous system has peculiar characteristics in terms of anatomical and physiological maturation, and some technical aspects need to be tailored for its use in children, especially in infants. This paper will review the most recent advances in the field of intra-operative neurophysiology (ION) techniques during brain surgery, focussing on those aspects that are relevant to the paediatric neurosurgery practice.

Long term stability of nanowire nanoelectronics in physiological environments.

Science.gov (United States)

Zhou, Wei; Dai, Xiaochuan; Fu, Tian-Ming; Xie, Chong; Liu, Jia; Lieber, Charles M

2014-03-12

Nanowire nanoelectronic devices have been exploited as highly sensitive subcellular resolution detectors for recording extracellular and intracellular signals from cells, as well as from natural and engineered/cyborg tissues, and in this capacity open many opportunities for fundamental biological research and biomedical applications. Here we demonstrate the capability to take full advantage of the attractive capabilities of nanowire nanoelectronic devices for long term physiological studies by passivating the nanowire elements with ultrathin metal oxide shells. Studies of Si and Si/aluminum oxide (Al2O3) core/shell nanowires in physiological solutions at 37 °C demonstrate long-term stability extending for at least 100 days in samples coated with 10 nm thick Al2O3 shells. In addition, investigations of nanowires configured as field-effect transistors (FETs) demonstrate that the Si/Al2O3 core/shell nanowire FETs exhibit good device performance for at least 4 months in physiological model solutions at 37 °C. The generality of this approach was also tested with in studies of Ge/Si and InAs nanowires, where Ge/Si/Al2O3 and InAs/Al2O3 core/shell materials exhibited stability for at least 100 days in physiological model solutions at 37 °C. In addition, investigations of hafnium oxide-Al2O3 nanolaminated shells indicate the potential to extend nanowire stability well beyond 1 year time scale in vivo. These studies demonstrate that straightforward core/shell nanowire nanoelectronic devices can exhibit the long term stability needed for a range of chronic in vivo studies in animals as well as powerful biomedical implants that could improve monitoring and treatment of disease.

Evolved changes in the intracellular distribution and physiology of muscle mitochondria in high-altitude native deer mice.

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Mahalingam, Sajeni; McClelland, Grant B; Scott, Graham R

2017-07-15

Mitochondrial function changes over time at high altitudes, but the potential benefits of these changes for hypoxia resistance remains unclear. We used high-altitude-adapted populations of deer mice, which exhibit enhanced aerobic performance in hypoxia, to examine whether changes in mitochondrial physiology or intracellular distribution in the muscle contribute to hypoxia resistance. Permeabilized muscle fibres from the gastrocnemius muscle had higher respiratory capacities in high-altitude mice than in low-altitude mice. Highlanders also had higher mitochondrial volume densities, due entirely to an enriched abundance of subsarcolemmal mitochondria, such that more mitochondria were situated near the cell membrane and adjacent to capillaries. There were several effects of hypoxia acclimation on mitochondrial function, some of which were population specific, but they differed from the evolved changes in high-altitude natives, which probably provide a better indication of adaptive traits that improve performance and hypoxia resistance at high altitudes. High-altitude natives that have evolved to live in hypoxic environments provide a compelling system to understand how animals can overcome impairments in oxygen availability. We examined whether these include changes in mitochondrial physiology or intracellular distribution that contribute to hypoxia resistance in high-altitude deer mice (Peromyscus maniculatus). Mice from populations native to high and low altitudes were born and raised in captivity, and as adults were acclimated to normoxia or hypobaric hypoxia (equivalent to 4300 m elevation). We found that highlanders had higher respiratory capacities in the gastrocnemius (but not soleus) muscle than lowlanders (assessed using permeabilized fibres with single or multiple inputs to the electron transport system), due in large part to higher mitochondrial volume densities in the gastrocnemius. The latter was attributed to an increased abundance of subsarcolemmal

Dietary composition regulates Drosophila mobility and cardiac physiology

Science.gov (United States)

Bazzell, Brian; Ginzberg, Sara; Healy, Lindsey; Wessells, R. J.

2013-01-01

SUMMARY The impact of dietary composition on exercise capacity is a subject of intense study in both humans and model organisms. Interactions between diet and genetics are a crucial component of optimized dietary design. However, the genetic factors governing exercise response are still not well understood. The recent development of invertebrate models for endurance exercise is likely to facilitate study designs examining the conserved interactions between diet, exercise and genetics. As a first step, we used the Drosophila model to describe the effects of varying dietary composition on several physiological indices, including fatigue tolerance and climbing speed, cardiac performance, lipid storage and autophagy. We found that flies of two divergent genetic backgrounds optimize endurance and cardiac performance on relatively balanced low calorie diets. When flies are provided with unbalanced diets, diets higher in sugar than in yeast facilitate greater endurance at the expense of cardiac performance. Importantly, we found that dietary composition has a profound effect on various physiological indices, whereas total caloric intake per se has very little predictive value for performance. We also found that the effects of diet on endurance are completely reversible within 48 h if flies are switched to a different diet. PMID:23155082

Robotic surgery for rectal cancer: current immediate clinical and oncological outcomes.

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Araujo, Sergio Eduardo Alonso; Seid, Victor Edmond; Klajner, Sidney

2014-10-21

Laparoscopic rectal surgery continues to be a challenging operation associated to a steep learning curve. Robotic surgical systems have dramatically changed minimally invasive surgery. Three-dimensional, magnified and stable view, articulated instruments, and reduction of physiologic tremors leading to superior dexterity and ergonomics. Therefore, robotic platforms could potentially address limitations of laparoscopic rectal surgery. It was aimed at reviewing current literature on short-term clinical and oncological (pathological) outcomes after robotic rectal cancer surgery in comparison with laparoscopic surgery. A systematic review was performed for the period 2002 to 2014. A total of 1776 patients with rectal cancer underwent minimally invasive robotic treatment in 32 studies. After robotic and laparoscopic approach to oncologic rectal surgery, respectively, mean operating time varied from 192-385 min, and from 158-297 min; mean estimated blood loss was between 33 and 283 mL, and between 127 and 300 mL; mean length of stay varied from 4-10 d; and from 6-15 d. Conversion after robotic rectal surgery varied from 0% to 9.4%, and from 0 to 22% after laparoscopy. There was no difference between robotic (0%-41.3%) and laparoscopic (5.5%-29.3%) surgery regarding morbidity and anastomotic complications (respectively, 0%-13.5%, and 0%-11.1%). Regarding immediate oncologic outcomes, respectively among robotic and laparoscopic cases, positive circumferential margins varied from 0% to 7.5%, and from 0% to 8.8%; the mean number of retrieved lymph nodes was between 10 and 20, and between 11 and 21; and the mean distal resection margin was from 0.8 to 4.7 cm, and from 1.9 to 4.5 cm. Robotic rectal cancer surgery is being undertaken by experienced surgeons. However, the quality of the assembled evidence does not support definite conclusions about most studies variables. Robotic rectal cancer surgery is associated to increased costs and operating time. It also seems to be

Does gastric bypass surgery change body weight set point?

Science.gov (United States)

Hao, Z; Mumphrey, M B; Morrison, C D; Münzberg, H; Ye, J; Berthoud, H R

2016-12-01

The relatively stable body weight during adulthood is attributed to a homeostatic regulatory mechanism residing in the brain which uses feedback from the body to control energy intake and expenditure. This mechanism guarantees that if perturbed up or down by design, body weight will return to pre-perturbation levels, defined as the defended level or set point. The fact that weight re-gain is common after dieting suggests that obese subjects defend a higher level of body weight. Thus, the set point for body weight is flexible and likely determined by the complex interaction of genetic, epigenetic and environmental factors. Unlike dieting, bariatric surgery does a much better job in producing sustained suppression of food intake and body weight, and an intensive search for the underlying mechanisms has started. Although one explanation for this lasting effect of particularly Roux-en-Y gastric bypass surgery (RYGB) is simple physical restriction due to the invasive surgery, a more exciting explanation is that the surgery physiologically reprograms the body weight defense mechanism. In this non-systematic review, we present behavioral evidence from our own and other studies that defended body weight is lowered after RYGB and sleeve gastrectomy. After these surgeries, rodents return to their preferred lower body weight if over- or underfed for a period of time, and the ability to drastically increase food intake during the anabolic phase strongly argues against the physical restriction hypothesis. However, the underlying mechanisms remain obscure. Although the mechanism involves central leptin and melanocortin signaling pathways, other peripheral signals such as gut hormones and their neural effector pathways likely contribute. Future research using both targeted and non-targeted 'omics' techniques in both humans and rodents as well as modern, genetically targeted, neuronal manipulation techniques in rodents will be necessary.

Anesthesia for Ambulatory Pediatric Surgery in Sub-Saharan Africa: A Pilot Study in Burkina Faso.

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Kabré, Yvette B; Traoré, Idriss S S; Kaboré, Flavien A R; Ki, Bertille; Traoré, Alain I; Ouédraogo, Isso; Bandré, Emile; Wandaogo, Albert; Ouédraogo, Nazinigouba

2017-02-01

Long surgical wait times and limited hospital capacity are common obstacles to surgical care in many countries in Sub-Saharan Africa (SSA). Introducing ambulatory surgery might contribute to a solution to these problems. The purpose of this study was to evaluate the safety and feasibility of introducing ambulatory surgery into a pediatric hospital in SSA. This is a cross-sectional descriptive study that took place over 6 months. It includes all patients assigned to undergo ambulatory surgery in the Pediatric University Hospital in Ouagadougou, Burkina Faso. Eligibility criteria for the ambulatory surgery program included >1 year of age, American Society of Anesthesiologists (ASA) 1 status, surgery with a low risk of bleeding, lasting anesthesia with halothane. Sixty-five percent also received regional or local anesthesia consisting of caudal block in 79.23% or nerve block in 20.77%. The average duration of surgery was 33 ± 17.47 minutes. No intraoperative complications were noted. All the patients received acetaminophen and a nonsteroidal anti-inflammatory drug in the recovery room. Twelve (11.7%) patients had complications in recovery, principally nausea and vomiting. Eight (7.8%) patients were admitted to the hospital. No serious complications were associated with ambulatory surgery. Its introduction could possibly be a solution to improving pediatric surgical access in low-income countries.

Corrective Jaw Surgery

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Full Text Available ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ... out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment of jaws ...

Endothelin receptor antagonism in single ventricle physiology with fontan palliation: A systematic review and meta-analysis

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Gwendolyn Derk

2015-04-01

Conclusions: Bosentan was found to be a safe and well tolerated endothelin receptor antagonist in Fontan patients over 3–6 months of therapy. Bosentan use was associated with improved functional capacity. Future studies with larger sample size and longer duration are warranted to examine the long-term safety and efficacy of endothelin blockade in Fontan physiology.

Pathophysiology and clinical implications of peroperative fluid management in elective surgery

DEFF Research Database (Denmark)

Holte, Kathrine

2010-01-01

amounts of fluid caused adverse physiologic effects in healthy volunteers indicates that addition of the surgical trauma per se increases fluid requirements. Volume kinetic analysis applied 4 hours postoperatively was not able to detect the presence of either overhydration or hypovolemia regardless...... mobilization. In major (colonic) surgery with a standardized multimodal rehabilitation regimen, over-all functional recovery was not affected with a "liberal" ( approximately 5 liters) vs. "restrictive" 1.5 liter crystalloid-based regimen, however based on three anastomotic leakages in the "restrictive" group...

[Actinobacteria and their odor-producing capacities in a surface water in Shanghai].

Science.gov (United States)

Chen, Jiao; Bai, Xiao-hui; Lu, Ning; Wang, Xian-yun; Zhang, Yong-hui; Wu, Pan-cheng; Guo, Xin-chi

2014-10-01

The odor in raw water is one of the main sources of odor in drinking water. The occurrence of actinobacteria and their odor producing capacities in a reservoir in.Shanghai were investigated. Gauze's medium and membrane filtration were used for actinobacteria isolation. Through combined methods of 16S rRNA sequencing, colony and hyphae morphology, carbon source utilization, physiological and biochemical characteristics, 40 strains of actinobacteria were identified from the reservoir. Results showed that there were 38 Streptomyces, an Aeromicrobium and a Pseudonocardia. Liquid culture medium and the real reservoir water were used to test the odor producing capacity of these 40 strains of actinobacteria, and headspace solid phase microextraction (HS-SPME) and high resolution gas chromatography mass spectroscopy (GC/MS) were used to analyze the odor compounds 2-methylisoborneol (2-MIB) and geosmin (GSM) in the fermentation liquor. The test results showed that, the odor-producing capacities of these actinobacteria in different fermentation media showed different variation trends, even within the genera Streptomyces. The odor-producing capacity of actinobacteria in the liquid culture medium could not represent their states in the reservoir water or their actual odor contribution to the aquatic environment.

Neuroprotective Anesthesia Regimen and Intensive Management for Pediatric Cardiac Surgery with Cardiopulmonary Bypass: a Review and Initial Experience

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Jyrson Guilherme Klamt

Full Text Available Abstract This article describes our proposal for routine anesthesia, intraoperative medical management, cerebral and physiological monitoring during pediatric cardiac surgery with cardiopulmonary bypass that intend to provide appropriate anesthesia (analgesia, hypnosis, neuroprotection, adequate cerebral and systemic oxygen supply, and preventing against drugs neurotoxicity. A concise retrospective data is presented.

Preserving privacy of online digital physiological signals using blind and reversible steganography.

Science.gov (United States)

Shiu, Hung-Jr; Lin, Bor-Sing; Huang, Chien-Hung; Chiang, Pei-Ying; Lei, Chin-Laung

2017-11-01

Physiological signals such as electrocardiograms (ECG) and electromyograms (EMG) are widely used to diagnose diseases. Presently, the Internet offers numerous cloud storage services which enable digital physiological signals to be uploaded for convenient access and use. Numerous online databases of medical signals have been built. The data in them must be processed in a manner that preserves patients' confidentiality. A reversible error-correcting-coding strategy will be adopted to transform digital physiological signals into a new bit-stream that uses a matrix in which is embedded the Hamming code to pass secret messages or private information. The shared keys are the matrix and the version of the Hamming code. An online open database, the MIT-BIH arrhythmia database, was used to test the proposed algorithms. The time-complexity, capacity and robustness are evaluated. Comparisons of several evaluations subject to related work are also proposed. This work proposes a reversible, low-payload steganographic scheme for preserving the privacy of physiological signals. An (n,  m)-hamming code is used to insert (n - m) secret bits into n bits of a cover signal. The number of embedded bits per modification is higher than in comparable methods, and the computational power is efficient and the scheme is secure. Unlike other Hamming-code based schemes, the proposed scheme is both reversible and blind. Copyright © 2017 Elsevier B.V. All rights reserved.

Long-term effects of bariatric surgery on meal disposal and β-cell function in diabetic and nondiabetic patients

DEFF Research Database (Denmark)

Camastra, Stefania; Muscelli, Elza; Gastaldelli, Amalia

2013-01-01

Gastric bypass surgery leads to marked improvements in glucose tolerance and insulin sensitivity in obese type 2 diabetes (T2D); the impact on glucose fluxes in response to a physiological stimulus, such as a mixed meal test (MTT), has not been determined. We administered an MTT to 12 obese T2D...... nonsurgical obese and lean controls). Endogenous glucose production, however, was less suppressed during the MMT as the combined result of a relative hyperglucagonemia and the rapid fall in plasma glucose and insulin levels. We conclude that in T2D, bypass surgery changes the postprandial response...

Bariatric surgery and implications for stoma care.

Science.gov (United States)

Swash, Carolyn

In the UK, 62% of the population are now described as being either overweight or obese. People with weight-management issues are more likely to suffer from cardiovascular disease and diabetes, as well as having an increased risk of cancer, including bowel cancer. Following the initial National Institute for Health and Care Excellence guidance in 2006, revised in 2014, health professionals have a more proactive role in identifying people with weight-management issues and supporting them to achieve a weight that helps reduce their health risks. This includes referrals to bariatric surgeons for consideration for surgery if appropriate. One particular surgical procedure, the Roux-en-Y, is not reversible and alters the capacity of the stomach and function of the small bowel in order to achieve weight loss. Using a case study, this article will highlight the role of the stoma nurse in managing a patient, who previously had a Roux-en-Y procedure for weight loss and subsequently needed formation of a loop ileostomy after surgery for bowel cancer.

Compulsive eating and gastric bypass surgery: what does hunger have to do with it?

Science.gov (United States)

Saunders, R

2001-12-01

Binge eating and other patterns of disordered eating in obese patients need further investigation. In a previous study by this author, one-third of patients presenting for bariatric surgery met strict criteria for Binge Eating Disorder. It is important to clarify the role of such eating behaviors on outcome of surgery to determine whether treatments targeted specifically at these behaviors and associated psychological issues can improve surgical outcome. The aim of this paper is to raise awareness of the range of disordered eating patterns in bariatric patients, describe an approach used, and discuss issues reported by patients after surgery. Patients completed questionnaires before surgery (QWEP, BES, BDI) and were seen for a pre-surgery mental health evaluation. High risk patients were identified and invited to attend a post-surgery group (CBT approach) as a preventive measure to help them deal with eating patterns as well as emotional adjustment. Disordered eating patterns can persist after surgery. While surgery may decrease actual physical hunger and reduce physical capacity for food, it is still possible to eat compulsively, although the patterns may change somewhat due to the surgical procedure. Since long-term weight maintenance depends on post-operative changes in eating behaviors, it is important to identify patients at risk for a range of disordered eating patterns so that a comprehensive treatment plan that targets the eating disturbances and associated psychological components can be implemented.

OSAS Surgery and Postoperative Discomfort: Phase I Surgery versus Phase II Surgery

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Giulio Gasparini

2015-01-01

Full Text Available Introduction. This study aims to investigate the reasons that discourage the patients affected by OSAS to undergo orthognathic surgery and compares the postoperative discomfort of phase I (soft tissue surgery and phase II (orthognathic surgery procedures for treatment of OSAS. Material and Methods. A pool of 46 patients affected by OSAS was divided into two groups: “surgery patients” who accepted surgical treatments of their condition and “no surgery patients” who refused surgical procedures. The “surgery patients” group was further subdivided into two arms: patients who accepted phase I procedures (IP and those who accepted phase II (IIP. To better understand the motivations behind the refusal of II phase procedures, we asked the patients belonging to both the IP group and “no surgery” group to indicate the main reason that influenced their decision to avoid II phase procedures. We also monitored and compared five parameters of postoperative discomfort: pain, painkiller assumption, length of hospitalization, foreign body sensation, and diet assumption following IP and IIP procedures. Results. The main reason to avoid IIP procedures was the concern of a more severe postoperative discomfort. Comparison of the postoperative discomfort following IP versus IIP procedures showed that the former scored worse in 4 out of 5 parameters analyzed. Conclusion. IIP procedures produce less postoperative discomfort. IIP procedures, namely, orthognathic surgery, should be the first choice intervention in patients affected by OSAS and dentoskeletal malformation.

Along paths converging to Bengt Saltin’s early contributions in exercise physiology

Science.gov (United States)

Schantz, P

2015-01-01

A fascinating chain of events led in 1941 to the formation of the Department of Physiology at the Royal Gymnastic Central Institute (GCI) in Stockholm, Sweden. Erik Hohwü Christensen, from the scientifically advanced Lindhard School in Copenhagen became its first professor. A central research question for him concerned determining the limiting factors for maximal physical performance in man. This was the academic setting where the sports interested medical student Bengt Saltin was introduced to exercise physiology. In the summer of 1959, he became involved in a study on intermittent vs continuous running. A doctoral project, with Per-Olof Åstrand as his tutor, resulted in 1964 as the thesis “Aerobic work capacity and circulation at exercise in man. With special reference to the effect of prolonged exercise and/or heat exposure”. In the decade that followed, Saltin continued along that path. However, he also added a vital research line involving pioneering studies on skeletal muscles in the exercising man, a series of novel studies on the physiological demands in various sports, and studies of the effects of physical training within the general population. PMID:26589112

Tennis elbow surgery

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Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is often an outpatient surgery. This means you will not stay in the hospital overnight. You will be given ...

Mohs micrographic surgery

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Skin cancer - Mohs surgery; Basal cell skin cancer - Mohs surgery; Squamous cell skin cancer - Mohs surgery ... Mohs surgery usually takes place in the doctor's office. The surgery is started early in the morning and is ...

Exercise capacity in the Bidirectional Glenn physiology: Coupling cardiac index, ventricular function and oxygen extraction ratio.

Science.gov (United States)

Vallecilla, Carolina; Khiabani, Reza H; Trusty, Phillip; Sandoval, Néstor; Fogel, Mark; Briceño, Juan Carlos; Yoganathan, Ajit P

2015-07-16

In Bi-directional Glenn (BDG) physiology, the superior systemic circulation and pulmonary circulation are in series. Consequently, only blood from the superior vena cava is oxygenated in the lungs. Oxygenated blood then travels to the ventricle where it is mixed with blood returning from the lower body. Therefore, incremental changes in oxygen extraction ratio (OER) could compromise exercise tolerance. In this study, the effect of exercise on the hemodynamic and ventricular performance of BDG physiology was investigated using clinical patient data as inputs for a lumped parameter model coupled with oxygenation equations. Changes in cardiac index, Qp/Qs, systemic pressure, oxygen extraction ratio and ventricular/vascular coupling ratio were calculated for three different exercise levels. The patient cohort (n=29) was sub-grouped by age and pulmonary vascular resistance (PVR) at rest. It was observed that the changes in exercise tolerance are significant in both comparisons, but most significant when sub-grouped by PVR at rest. Results showed that patients over 2 years old with high PVR are above or close to the upper tolerable limit of OER (0.32) at baseline. Patients with high PVR at rest had very poor exercise tolerance while patients with low PVR at rest could tolerate low exercise conditions. In general, ventricular function of SV patients is too poor to increase CI and fulfill exercise requirements. The presented mathematical model provides a framework to estimate the hemodynamic performance of BDG patients at different exercise levels according to patient specific data. Published by Elsevier Ltd.

[Nosocomial infections after cardiac surgery in infants and children with congenital heart disease].

Science.gov (United States)

Barriga, José; Cerda, Jaime; Abarca, Katia; Ferrés, Marcela; Fajuri, Paula; Riquelme, María; Carrillo, Diego; Clavería, Cristián

2014-02-01

Nosocomial infections generate high morbidity and mortality in children undergoing cardiac surgery. To determine risk factors for nosocomial infections in children after congenital heart surgery. A retrospective case-control study, in patients younger than 15 years undergoing surgery for congenital heart disease from January 2007 to December 2011 admitted to the Pediatric Critical Patient Unit (UPC-P) in a university hospital. For cases, the information was analyzed from the first episode of infection. 39 patients who develop infections and 39 controls who did not develop infection were enrolled. The median age of cases was 2 months. We identified a number of factors associated with the occurrence of infections, highlighting in univariate analysis: age, weight, univentricular heart physiology, complexity of the surgical procedure according to RACHS-1 and cardiopulmonary bypass (CPB) time ≥ 200 minutes. Multivariate analysis identified CPB time ≥ 200 minutes as the major risk factor, with an OR of 11.57 (CI: 1.04 to 128.5). CPB time ≥ 200 minutes was the mayor risk factor associated with the development of nosocomial infections.

[Thymus surgery in a general surgery department].

Science.gov (United States)

Mega, Raquel; Coelho, Fátima; Pimentel, Teresa; Ribero, Rui; Matos, Novo de; Araújo, António

2005-01-01

Evaluation of thymectomy cases between 1990-2003, in a General Surgery Department. Evaluation of the therapeutic efficacy in Miastenia Gravis patients. Retrospective study based on evaluation of data from Serviço de Cirurgia, Neurologia and Consult de Neurology processes, between 1990-2003, of 15 patients submitted to total thymectomy. 15 patients, aged 17 to 72, 11 female and 4 male. Miastenia Gravis was the main indication for surgery, for uncontrollable symptoms or suspicion of thymoma. In patients with myasthenia, surgery was accomplish after compensation of symptoms. There weren't post-surgery complications. Pathology were divided in thymic hyperplasia and thymoma. Miastenia patients have there symptoms diminished or stable with reduction or cessation of medical therapy. Miastenia was the most frequent indication for thymectomy. Surgery was good results, with low morbimortality, as long as the protocols are respected.

Lung volume reduction surgery for diffuse emphysema.

Science.gov (United States)

van Agteren, Joseph Em; Carson, Kristin V; Tiong, Leong Ung; Smith, Brian J

2016-10-14

of bias across many studies, lack of blinding and low participant numbers for some outcomes. Eight of the studies compared LVRS versus standard medical care, one compared two closure techniques (stapling vs laser ablation), one looked at the effect of buttressing the staple line on the effectiveness of LVRS and one compared traditional 'resectional' LVRS with a non-resectional surgical approach. Participants completed a mandatory course of pulmonary rehabilitation/physical training before the procedure commenced. Short-term mortality was higher for LVRS (odds ratio (OR) 6.16, 95% confidence interval (CI) 3.22 to 11.79; 1489 participants; five studies; moderate-quality evidence) than for control, but long-term mortality favoured LVRS (OR 0.76, 95% CI 0.61 to 0.95; 1280 participants; two studies; moderate-quality evidence). Participants identified post hoc as being at high risk of death from surgery were those with particularly impaired lung function, poor diffusing capacity and/or homogenous emphysema. Participants with upper lobe-predominant emphysema and low baseline exercise capacity showed the most favourable outcomes related to mortality, as investigators reported no significant differences in early mortality between participants treated with LVRS and those in the control group (OR 0.87, 95% CI 0.23 to 3.29; 290 participants; one study), as well as significantly lower mortality at the end of follow-up for LVRS compared with control (OR 0.45, 95% CI 0.26 to 0.78; 290 participants; one study). Trials in this review furthermore provided evidence of low to moderate quality showing that improvements in lung function parameters other than forced expiratory volume in one second (FEV 1 ), quality of life and exercise capacity were more likely with LVRS than with usual follow-up. Adverse events were more common with LVRS than with control, specifically the occurrence of (persistent) air leaks, pulmonary morbidity (e.g. pneumonia) and cardiovascular morbidity. Although

Corrective Jaw Surgery

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Full Text Available ... and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more ... find out more. Corrective Jaw Surgery Corrective Jaw Surgery Orthognathic surgery is performed to correct the misalignment ...

Along paths converging to Bengt Saltin's early contributions in exercise physiology.

Science.gov (United States)

Schantz, P

2015-12-01

A fascinating chain of events led in 1941 to the formation of the Department of Physiology at the Royal Gymnastic Central Institute (GCI) in Stockholm, Sweden. Erik Hohwü Christensen, from the scientifically advanced Lindhard School in Copenhagen became its first professor. A central research question for him concerned determining the limiting factors for maximal physical performance in man. This was the academic setting where the sports interested medical student Bengt Saltin was introduced to exercise physiology. In the summer of 1959, he became involved in a study on intermittent vs continuous running. A doctoral project, with Per-Olof Åstrand as his tutor, resulted in 1964 as the thesis "Aerobic work capacity and circulation at exercise in man. With special reference to the effect of prolonged exercise and/or heat exposure". In the decade that followed, Saltin continued along that path. However, he also added a vital research line involving pioneering studies on skeletal muscles in the exercising man, a series of novel studies on the physiological demands in various sports, and studies of the effects of physical training within the general population. © 2015 The Authors. Scandinavian Journal of Medicine & Science in Sports published by John Wiley & Sons Ltd.

Exercise and Training at Altitudes: Physiological Effects and Protocols

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Olga Cecilia Vargas Pinilla

2014-01-01

Full Text Available An increase in altitude leads to a proportional fall in the barometric pressure, and a decrease in atmospheric oxygen pressure, producing hypobaric hypoxia that affects, in different degrees, all body organs, systems and functions. The chronically reduced partial pressure of oxygen causes that individuals adapt and adjust to physiological stress. These adaptations are modulated by many factors, including the degree of hypoxia related to altitude, time of exposure, exercise intensity and individual conditions. It has been established that exposure to high altitude is an environmental stressor that elicits a response that contributes to many adjustments and adaptations that influence exercise capacity and endurance performance. These adaptations include in crease in hemoglobin concentration, ventilation, capillary density and tissue myoglobin concentration. However, a negative effect in strength and power is related to a decrease in muscle fiber size and body mass due to the decrease in the training intensity. Many researches aim at establishing how training or living at high altitudes affects performance in athletes. Training methods, such as living in high altitudes training low, and training high-living in low altitudes have been used to research the changes in the physical condition in athletes and how the physiological adaptations to hypoxia can enhanceperformance at sea level. This review analyzes the literature related to altitude training focused on how physiological adaptations to hypoxic environments influence performance, and which protocols are most frequently used to train in high altitudes.

Extended upper abdominal resections as part of debulking surgery at the time of tertiary cytoreduction for relapsed ovarian cancer; case report and literature review

OpenAIRE

Nicolae Bacalbașa; Irina Balescu

2017-01-01

Ovarian cancer remains one of the most aggressive gynecologic malignancies with high capacity to recur even in cases submitted to surgery with curative intent. However, even in these cases the best therapeutic option in order to achieve a good control of the disease remains radical surgery. We present the case of a 65-year-old patient diagnosed submitted to surgery for stage IIIC ovarian cancer five years before. At two years follow up she was diagnosed with an isolated recurrence at the leve...

Lower growth temperature increases alternative pathway capacity and alternative oxidase protein in tobacco.

Science.gov (United States)

Vanlerberghe, G C; McIntosh, L

1992-09-01

Suspension cells of NT1 tobacco (Nicotiana tabacum L. cv bright yellow) have been used to study the effect of growth temperature on the CN-resistant, salicylhydroxamic acid-sensitive alternative pathway of respiration. Mitochondria isolated from cells maintained at 30 degrees C had a low capacity to oxidize succinate via the alternative pathway, whereas mitochondria isolated from cells 24 h after transfer to 18 degrees C displayed, on average, a 5-fold increase in this capacity (from 7 to 32 nanoatoms oxygen per milligram protein per minute). This represented an increase in alternative pathway capacity from 18 to 45% of the total capacity of electron transport. This increased capacity was lost upon transfer of cells back to 30 degrees C. A monoclonal antibody to the terminal oxidase of the alternative pathway (the alternative oxidase) from Sauromatum guttatum (T.E. Elthon, R.L. Nickels, L. McIntosh [1989] Plant Physiology 89: 1311-1317) recognized a 35-kilodalton mitochondrial protein in tobacco. There was an excellent correlation between the capacity of the alternative path in isolated tobacco mitochondria and the levels of this 35-kilodalton alternative oxidase protein. Cycloheximide could inhibit both the increased level of the 35-kilodalton alternative oxidase protein and the increased alternative pathway capacity normally seen upon transfer to 18 degrees C. We conclude that transfer of tobacco cells to the lower temperature increases the capacity of the alternative pathway due, at least in part, to de novo synthesis of the 35-kilodalton alternative oxidase protein.

Validation of a Novel Virtual Reality Simulator for Robotic Surgery

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Henk W. R. Schreuder

2014-01-01

Full Text Available Objective. With the increase in robotic-assisted laparoscopic surgery there is a concomitant rising demand for training methods. The objective was to establish face and construct validity of a novel virtual reality simulator (dV-Trainer, Mimic Technologies, Seattle, WA for the use in training of robot-assisted surgery. Methods. A comparative cohort study was performed. Participants (n=42 were divided into three groups according to their robotic experience. To determine construct validity, participants performed three different exercises twice. Performance parameters were measured. To determine face validity, participants filled in a questionnaire after completion of the exercises. Results. Experts outperformed novices in most of the measured parameters. The most discriminative parameters were “time to complete” and “economy of motion” (P<0.001. The training capacity of the simulator was rated 4.6 ± 0.5 SD on a 5-point Likert scale. The realism of the simulator in general, visual graphics, movements of instruments, interaction with objects, and the depth perception were all rated as being realistic. The simulator is considered to be a very useful training tool for residents and medical specialist starting with robotic surgery. Conclusions. Face and construct validity for the dV-Trainer could be established. The virtual reality simulator is a useful tool for training robotic surgery.

Systematic review of the surgery-first approach in orthognathic surgery

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Chiung Shing Huang

2014-08-01

Full Text Available The surgery-first approach in orthognathic surgery has recently created a broader interest in completely eliminating time-consuming preoperative orthodontic treatment. Available evidence on the surgery-first approach should be appraised to support its use in orthognathic surgery. A MEDLINE search using the keywords "surgery first" and "orthognathic surgery" was conducted to select studies using the surgery-first approach. We also manually searched the reference list of the selected keywords to include articles not selected by the MEDLINE search. The search identified 18 articles related to the surgery-first approach. There was no randomized controlled clinical trial. Four papers were excluded as the content was only personal opinion or basic scientific research. Three studies were retrospective cohort studies in nature. The other 11 studies were case reports. For skeletal Class III surgical correction, the final long-term outcomes for maxillofacial and dental relationship were not significantly different between the surgery-first approach and the orthodontics-first approach in transverse (e.g., intercanine or intermolar width dimension, vertical (e.g., anterior open bite, lower anterior facial height dimension, and sagittal (e.g., anterior-posterior position of pogonion and lower incisors dimension. Total treatment duration was substantially shorter in cases of surgery-first approach use. In conclusion, most published studies related to the surgery-first approach were mainly on orthognathic correction of skeletal Class III malocclusion. Both the surgery-first approach and orthodontics-first approach had similar long-term outcomes in dentofacial relationship. However, the surgery-first approach had shorter treatment time.

Doppler radar physiological sensing

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Lubecke, Victor M; Droitcour, Amy D; Park, Byung-Kwon; Singh, Aditya

2016-01-01

Presents a comprehensive description of the theory and practical implementation of Doppler radar-based physiological monitoring. This book includes an overview of current physiological monitoring techniques and explains the fundamental technology used in remote non-contact monitoring methods. Basic radio wave propagation and radar principles are introduced along with the fundamentals of physiological motion and measurement. Specific design and implementation considerations for physiological monitoring radar systems are then discussed in detail. The authors address current research and commercial development of Doppler radar based physiological monitoring for healthcare and other applications.

The effects of a pilates-aerobic program on maximum exercise capacity of adult women

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Milena Mikalački

Full Text Available ABSTRACT Introduction: Physical exercise such as the Pilates method offers clinical benefits on the aging process. Likewise, physiologic parameters may be improved through aerobic exercise. Methods: In order to compare the differences of a Pilates-Aerobic intervention program on physiologic parameters such as the maximum heart rate (HRmax, relative maximal oxygen consumption (relative VO2max and absolute (absolute VOmax, maximum heart rate during maximal oxygen consumption (VO2max-HRmax, maximum minute volume (VE and forced vital capacity (FVC, a total of 64 adult women (active group = 48.1 ± 6.7 years; control group = 47.2 ± 7.4 years participated in the study. The physiological parameters, the maximal speed and total duration of test were measured by maximum exercise capacity testing through Bruce protocol. The HRmax was calculated by a cardio-ergometric software. Pulmonary function tests, maximal speed and total time during the physical test were performed in a treadmill (Medisoft, model 870c. Likewise, the spirometry analyzed the impact on oxygen uptake parameters, including FVC and VE. Results: The VO2max (relative and absolute, VE (all, P<0.001, VO2max-HRmax (P<0.05 and maximal speed of treadmill test (P<0.001 showed significant difference in the active group after a physical exercise interventional program. Conclusion: The present study indicates that the Pilates exercises through a continuous training program might significantly improve the cardiovascular system. Hence, mixing strength and aerobic exercises into a training program is considered the optimal mechanism for healthy aging.

Giant right coronary artery aneurysm with unusual physiology: Role of intraoperative transesophageal echocardiography

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David M Orozco

2012-01-01

Full Text Available A 65-year-old woman presented with a history of dyspnea and atypical chest pain. She was diagnosed with a non-ST-segment elevation myocardial infarction due to a giant right coronary artery aneurysm. After a failed percutaneous embolization, she was scheduled for right coronary artery aneurysm resection, posterior descending artery revascularization and mitral valve repair. During the induction of anesthesia and institution of mechanical ventilation, the patient suffered cardiovascular collapse. The transesophageal echocardiographic examination revealed tamponade physiology owing to compression of the cardiac chambers by the unruptured aneurysm, which resolved with the sternotomy. The surgery was carried out uneventfully.

Turbinate surgery

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Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery; Nasal obstruction - turbinate surgery ... There are several types of turbinate surgery: Turbinectomy: All or ... This can be done in several different ways, but sometimes a ...

[Specialty specific reference values in linen use in public health and social service as a basis for determining laundry capacities].

Science.gov (United States)

Rietdorf, M; Häse, I

1990-01-01

The use of linen in health and social care should primarily be seen from a hygienic angle. Disproportions between the use of linen in the various fields of health care and the available laundry capacities have a negative hygienic and economic effect. Laundry capacities should, therefore, be calculated on the basis of specialty-specific guidevalues. The authors propose indicators suitable to this aim and present the results of a comprehensive analysis for the inpatient departments of internal medicine, surgery, urology, ophthalmology and otorhinolaryngology.

Variable Operative Experience in Hand Surgery for Plastic Surgery Residents.

Science.gov (United States)

Silvestre, Jason; Lin, Ines C; Levin, Lawrence Scott; Chang, Benjamin

Efforts to standardize hand surgery training during plastic surgery residency remain challenging. We analyze the variability of operative hand experience at U.S. plastic surgery residency programs. Operative case logs of chief residents in accredited U.S. plastic surgery residency programs were analyzed (2011-2015). Trends in fold differences of hand surgery case volume between the 10th and 90th percentiles of residents were assessed graphically. Percentile data were used to calculate the number of residents achieving case minimums in hand surgery for 2015. Case logs from 818 plastic surgery residents were analyzed of which a minority were from integrated (35.7%) versus independent/combined (64.3%) residents. Trend analysis of fold differences in case volume demonstrated decreasing variability among procedure categories over time. By 2015, fold differences for hand reconstruction, tendon cases, nerve cases, arthroplasty/arthrodesis, amputation, arterial repair, Dupuytren release, and neoplasm cases were below 10-fold. Congenital deformity cases among independent/combined residents was the sole category that exceeded 10-fold by 2015. Percentile data suggested that approximately 10% of independent/combined residents did not meet case minimums for arterial repair and congenital deformity in 2015. Variable operative experience during plastic surgery residency may limit adequate exposure to hand surgery for certain residents. Future studies should establish empiric case minimums for plastic surgery residents to ensure hand surgery competency upon graduation. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Medical evaluation of the pregnant patient requiring nonobstetric surgery

International Nuclear Information System (INIS)

Barron, W.M.

1985-01-01

This article provides a summary of currently available information from a broad range of disciplines aimed at guiding the physician caring for the pregnant patient who requires nonobstetric surgery. An understanding of the anatomic and physiologic alterations that occur during pregnancy will allow such procedures to be accomplished with morbidity and mortality approaching those of nonpregnant surgical patients. The presence of the fetus does impose some restraint; however, this should rarely impair appropriate diagnosis and treatment of maternal disease. This obtains from the broad range of diagnostic and therapeutic alternatives available, and from the fact that what is beneficial for maternal health is generally best for the fetus. 64 references

Bariatric Surgery

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... often. Each type of surgery has advantages and disadvantages. Bariatric Surgery Benefits Bariatric surgery can improve many ... Grants & Grant History Research Resources Research at NIDDK Technology Advancement & Transfer Meetings & Workshops Health Information Diabetes Digestive ...

Anomalous baroreflex functionality inherent in floxed and Cre-Lox mice: an overlooked physiological phenotype.

Science.gov (United States)

Tsai, Ching-Yi; Poon, Yan-Yuen; Chen, Chang-Han; Chan, Samuel H H

2017-10-01

The last two decades have seen the emergence of Cre-Lox recombination as one of the most powerful and versatile technologies for cell-specific genetic engineering of mammalian cells. Understandably, the primary concerns in the practice of Cre-Lox recombination are whether the predicted genome has been correctly modified and the targeted phenotypes expressed. Rarely are the physiological conditions of the animals routinely examined because the general assumption is that they are normal. Based on corroborative results from radiotelemetric recording, power spectral analysis, and magnetic resonance imaging/diffusion tensor imaging in brain-derived neurotrophic factor-floxed mice, the present study revealed that this assumption requires amendment. We found that despite comparable blood pressure and heart rate with C57BL/6 or Cre mice under the conscious state, floxed and Cre-Lox mice exhibited diminished baroreflex-mediated sympathetic vasomotor tone and cardiac vagal baroreflex. We further found that the capacity and plasticity of baroreflex of these two strains of mice under isoflurane anesthesia were retarded, as reflected by reduced connectivity between the nucleus tractus solitarii and rostral ventrolateral medulla or nucleus ambiguus. The identification of anomalous baroreflex functionality inherent in floxed and Cre-Lox mice points to the importance of incorporating physiological phenotypes into studies that engage gene manipulations such as Cre-Lox recombination. NEW & NOTEWORTHY We established that anomalous baroreflex functionality is inherent in floxed and Cre-Lox mice. These two mouse strains exhibited diminished baroreflex-mediated sympathetic vasomotor tone and cardiac vagal baroreflex under the conscious state, retarded capacity and plasticity of baroreflex under isoflurane anesthesia, and reduced connectivity between key nuclei in the baroreflex neural circuits. Copyright © 2017 the American Physiological Society.

Chronic exposure to soil salinity in terrestrial species: Does plasticity and underlying physiology differ among specialized ground-dwelling spiders?

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Renault, D; Puzin, C; Foucreau, N; Bouchereau, A; Pétillon, J

2016-07-01

In salt marshes, the alternation of low and high tides entails rapid shifts of submersion and aerial exposure for terrestrial communities. In these intertidal environments, terrestrial species have to deal with an osmotic loss in body water content and an increase in sodium chloride concentration when salt load increases. In salt marshes, spiders represent an abundant arthropod group, whose physiological ecology in response to variations of soil salinity must be further investigated. In this study, we compared the effect of salinity on the survival and physiology of three species of Lycosidae; two salt marsh species (Arctosa fulvolineata and Pardosa purbeckensis) and one forest species (P. saltans). Spiders were individually exposed at three salinity conditions (0‰, 35‰ and 70‰) and survival, changes in body water content, hemolymph ions (Na(+), Ca(2+), Mg(2+), K(+); ICP-MS technique) and metabolites (mainly amino acids, polyols, sugars; LC and GC techniques) were assessed. The survival of the forest species P. saltans was very quickly hampered at moderate and high salinities. In this spider, variations of hemolymph ions and metabolites revealed a quick loss of physiological homeostasis and a rapid salt-induced dehydration of the specimens. Conversely, high survival durations were measured in the two salt-marsh spiders, and more particularly in A. fulvolineata. In both P. purbeckensis and A. fulvolineata, the proportion of Na(+), Ca(2+), Mg(2+), K(+) remained constant at the three experimental conditions. Accumulation of hemolymph Na(+) and amino acids (mainly glutamine and proline) demonstrated stronger osmoregulatory capacities in these salt-marsh resident spiders. To conclude, even if phylogenetically close (belonging to the same, monophyletic, family), we found different physiological capacities to cope with salt load among the three tested spider species. Nevertheless, physiological responses to salinity were highly consistent with the realized

Lung surgery

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... are thoracotomy and video-assisted thoracoscopic surgery (VATS). Robotic surgery may also be used. Lung surgery using ... Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

An experimental approach to estimation of human information processing capacity for diagnosis tasks in NPPs

Energy Technology Data Exchange (ETDEWEB)

Kim, Ji Tae

2006-02-15

root of cause of the faults or accidents. In this research, using both an information flow model and Conant's model, the cognitive information of a diagnosis task can be quantified. Information flow models of eight accident diagnosis tasks are analyzed and quantified. Eight accident cases considered in this research are: Reactor Coolant Pump (RCP) trip, Pressurizer (PZR) spray failure, Main Steam Isolation Valve (MSIV) failure, PZR spray and heater failure, Feedwater Line Break (FLB), Loss Of Coolant Accident (LOCA), Steam Generator Tube Rupture (SGTR), and Steam Line Break (SLB). As mentioned above, to determine the information processing capacity, the workload and an information flow model are used. To measure the operator's workload, subjective and physiological (objective) measures are considered. Subjective methods are used in the various fields including aviation, automobile, and the nuclear industry. In this research NASA-TLX (Task Load ineX) is selected as the subjective method. NASA-TLX is multi-dimensional rating technique and provides an overall workload score based on the weighted average of ratings on six subscales. An eye tracking system is used as a physiological (objective) measure for the workload in this research. The duration of eye closures and the rate of eye blinks decease when the mental demand of a task increases. As visual input is disabled during eye closure, reduced blink rates help to maintain continuous visual input when high levels of visual attention are required. Thorough the experiments, two groups were divided according to a subject's gaze for area of interests. The two groups were a skilled group and a less skilled group, and the information processing capacity of each group was found respectively. Both information processing capacity results from the subjective method (NASA-TLX) and physiological measure (the eye tracking system) were nearly identical. In addition, the information processing capacity related to human

An experimental approach to estimation of human information processing capacity for diagnosis tasks in NPPs

International Nuclear Information System (INIS)

Kim, Ji Tae

2006-02-01

research, using both an information flow model and Conant's model, the cognitive information of a diagnosis task can be quantified. Information flow models of eight accident diagnosis tasks are analyzed and quantified. Eight accident cases considered in this research are: Reactor Coolant Pump (RCP) trip, Pressurizer (PZR) spray failure, Main Steam Isolation Valve (MSIV) failure, PZR spray and heater failure, Feedwater Line Break (FLB), Loss Of Coolant Accident (LOCA), Steam Generator Tube Rupture (SGTR), and Steam Line Break (SLB). As mentioned above, to determine the information processing capacity, the workload and an information flow model are used. To measure the operator's workload, subjective and physiological (objective) measures are considered. Subjective methods are used in the various fields including aviation, automobile, and the nuclear industry. In this research NASA-TLX (Task Load ineX) is selected as the subjective method. NASA-TLX is multi-dimensional rating technique and provides an overall workload score based on the weighted average of ratings on six subscales. An eye tracking system is used as a physiological (objective) measure for the workload in this research. The duration of eye closures and the rate of eye blinks decease when the mental demand of a task increases. As visual input is disabled during eye closure, reduced blink rates help to maintain continuous visual input when high levels of visual attention are required. Thorough the experiments, two groups were divided according to a subject's gaze for area of interests. The two groups were a skilled group and a less skilled group, and the information processing capacity of each group was found respectively. Both information processing capacity results from the subjective method (NASA-TLX) and physiological measure (the eye tracking system) were nearly identical. In addition, the information processing capacity related to human factors was investigated

One lung ventilation strategies for infants and children undergoing video assisted thoracoscopic surgery

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Teddy Suratos Fabila

2013-01-01

Full Text Available The advantages of video assisted thoracoscopic surgery (VATS in children have led to its increased usage over the years. VATS, however, requires an efficient technique for one lung ventilation. Today, there is an increasing interest in developing the technique for lung isolation to meet the anatomic and physiologic variations in infants and children. This article aims to provide an updated and comprehensive review on one-lung ventilation strategies for infants and children undergoing VATS. Search of terms such as ′One lung ventilation for infants and children′, ′Video assisted thoracoscopic surgery for infants and children′, and ′Physiologic changes during one lung ventilation for infants and children′ were used. The search mechanics and engines for this review included the following: Kandang Kerbau Hospital (KKH eLibrary, PubMed, Ovid Medline, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. During the search the author focused on significant current and pilot randomized control trials, case reports, review articles, and editorials. Critical decision making on what device to use based on the age, weight, and pathology of the patient; and how to use it for lung isolation are discussed in this article. Furthermore, additional information regarding the advantages, limitations, techniques of insertion and maintenance of each device for one lung ventilation in infants and children were the highlights in this article.

Repetitive endoscopic sinus surgery failure: a role for radical surgery?

NARCIS (Netherlands)

Videler, Ward J. M.; Wreesmann, Volkert B.; van der Meulen, Freerk W.; Knegt, Paul P.; Fokkens, Wytske J.

2006-01-01

OBJECTIVES: Endoscopic sinus surgery (ESS) is considered to be the golden standard for surgery in patients with chronic rhinosinusitis and nasal polyposis. However, there is still a small group of patients unresponsive despite repetitive surgery. Radical surgery aimed at reduction of the

Evaluation of kidney repair capacity using 99mTc-DMSA in ischemia/reperfusion injury models.

Science.gov (United States)

Kwak, Wonjung; Jang, Hee-Seong; Belay, Takele; Kim, Jinu; Ha, Yeong Su; Lee, Sang Woo; Ahn, Byeong-Cheol; Lee, Jaetae; Park, Kwon Moo; Yoo, Jeongsoo

2011-03-04

Quantitative (99m)Tc-DMSA renal uptake was studied in different renal ischemia/reperfusion (I/R) mice models for the assessment of renal repair capacity. Mice models of nephrectomy, uni- and bi-lateral I/R together with sham-operated mice were established. At 1h, 1d, 4d, 1, 2 and 3 wk after I/R, (99m)Tc-DMSA (27.7 ± 1.3 MBq) was injected via tail vein and after 3h post-injection, the mice were scanned for 30 min with pinhole equipped gamma camera. Higher uptake of (99m)Tc-DMSA was measured in normal kidneys of uni-lateral I/R model and nephrectomized kidney I/R model at 3 wk post-surgery. Comparing the restoration capacities of the affected kidneys of nephrectomy, uni- and bi-lateral I/R models, higher repair capacity was observed in the nephrectomized model followed by bi-lateral then uni-lateral models. The normal kidney may retard the restoration of damaged kidney in uni-lateral I/R model. Moreover, 3 wk after Uni-I/R, the size of injured kidney was significantly smaller than non-ischemic contralateral and sham operated kidneys, while nephrectomy I/R kidneys were significantly enlarged compared to all others at 3 wk post-surgery. Very strong correlation between (99m)Tc-DMSA uptake and weight of dissected kidneys in I/R models was observed. Consistent with (99m)Tc-DMSA uptake results, all histological results indicate that kidney recovery after injury is correlated with the amount of intact tubules and kidney sizes. In summary, our study showed good potentials of (99m)Tc-DMSA scan as a promising non-invasive method for evaluation of kidney restoration after I/R injuries. Interestingly, mice with Bi-I/R injury showed faster repair capacity than those with uni-I/R. Copyright © 2011 Elsevier Inc. All rights reserved.

Plastic Surgery

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... Staying Safe Videos for Educators Search English Español Plastic Surgery KidsHealth / For Teens / Plastic Surgery What's in ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...

An Insect Herbivore Microbiome with High Plant Biomass-Degrading Capacity

Energy Technology Data Exchange (ETDEWEB)

Suen, Garret; Barry, Kerrie; Goodwin, Lynne; Scott, Jarrod; Aylward, Frank; Adams, Sandra; Pinto-Tomas, Adrian; Foster, Clifton; Pauly, Markus; Weimer, Paul; Bouffard, Pascal; Li, Lewyn; Osterberger, Jolene; Harkins, Timothy; Slater, Steven; Donohue, Timothy; Currie, Cameron; Tringe, Susannah G.

2010-09-23

Herbivores can gain indirect access to recalcitrant carbon present in plant cell walls through symbiotic associations with lignocellulolytic microbes. A paradigmatic example is the leaf-cutter ant (Tribe: Attini), which uses fresh leaves to cultivate a fungus for food in specialized gardens. Using a combination of sugar composition analyses, metagenomics, and whole-genome sequencing, we reveal that the fungus garden microbiome of leaf-cutter ants is composed of a diverse community of bacteria with high plant biomass-degrading capacity. Comparison of this microbiome?s predicted carbohydrate-degrading enzyme profile with other metagenomes shows closest similarity to the bovine rumen, indicating evolutionary convergence of plant biomass degrading potential between two important herbivorous animals. Genomic and physiological characterization of two dominant bacteria in the fungus garden microbiome provides evidence of their capacity to degrade cellulose. Given the recent interest in cellulosic biofuels, understanding how large-scale and rapid plant biomass degradation occurs in a highly evolved insect herbivore is of particular relevance for bioenergy.

An insect herbivore microbiome with high plant biomass-degrading capacity.

Directory of Open Access Journals (Sweden)

Garret Suen

2010-09-01

Full Text Available Herbivores can gain indirect access to recalcitrant carbon present in plant cell walls through symbiotic associations with lignocellulolytic microbes. A paradigmatic example is the leaf-cutter ant (Tribe: Attini, which uses fresh leaves to cultivate a fungus for food in specialized gardens. Using a combination of sugar composition analyses, metagenomics, and whole-genome sequencing, we reveal that the fungus garden microbiome of leaf-cutter ants is composed of a diverse community of bacteria with high plant biomass-degrading capacity. Comparison of this microbiome's predicted carbohydrate-degrading enzyme profile with other metagenomes shows closest similarity to the bovine rumen, indicating evolutionary convergence of plant biomass degrading potential between two important herbivorous animals. Genomic and physiological characterization of two dominant bacteria in the fungus garden microbiome provides evidence of their capacity to degrade cellulose. Given the recent interest in cellulosic biofuels, understanding how large-scale and rapid plant biomass degradation occurs in a highly evolved insect herbivore is of particular relevance for bioenergy.

TMJ surgery following orthognathic surgery: A case series

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C. Politis

2018-06-01

Full Text Available Orthognathic surgery may affect or cause temporomandibular joint (TMJ complaints. This study evaluated the need for TMJ surgery after orthognathic surgery.A retrospective cohort study was carried out on 630 consecutive patients undergoing at least a Le Fort I or bilateral sagittal split osteotomy (BSSO. The mean follow-up time was 2,3 years. Clinical, surgical and radiographic findings were collected.Ten of the 630 patients (1.6% had additional arthroscopic TMJ-surgery in one (9 or in both (1 joints because of internal derangement, resistant to conventional therapy. Only 4/10 patients had successful outcomes following arthroscopic surgery. One patient with unsuccessful outcome required multiple additional open TMJ-surgeries, all remaining ineffective to relieve pain and restricted mouth opening. If arthroscopy failed to relieve symptoms (5/10 patients, further conservative management was opted. Arthroscopy seemed effective mainly in patients without pre-existing TMJ complaints.A further five of the 630 patients (0.8% required more treatment because of bilateral postoperative condylar resorption, but none of them required TMJ-surgery.In contrast to patients with bilateral condylar resorption where the skeletal relapse remained the issue of concern, patients with internal derangement/osteoarthrosis exhibited major occlusal changes in one patient only (1/10, leaving the TMJ complaints as the main concern. Keywords: Sagittal split osteotomy, Le Fort I osteotomy, Orthognathic surgery, Condylar remodelling, Condylar resorption, Osteoarthrosis, Internal derangement, Relapse, Arthroscopy

Body Dysmorphic Disorder: Contraindication or Ethical Justification for Female Genital Cosmetic Surgery in Adolescents.

Science.gov (United States)

Spriggs, Merle; Gillam, Lynn

2016-11-01

Is Female Genital Cosmetic Surgery for an adolescent with Body Dysmorphic Disorder ever ethically justified? Cosmetic genital surgery (specifically labioplasty) for adolescent girls is one of the most ethically controversial forms of cosmetic surgery and Body Dysmorphic Disorder is typically seen as a contraindication for cosmetic surgery. Two key ethical concerns are (1) that Body Dysmorphic Disorder undermines whatever capacity for autonomy the adolescent has; and (2) even if there is valid parental consent, the presence of Body Dysmorphic Disorder means that cosmetic surgery will fail in its aims. In this article, we challenge, in an evidence-based way, the standard view that Body Dysmorphic Disorder is a contraindication for genital cosmetic surgery in adolescents. Our argument gathers together and unifies a substantial amount of disparate research in the context of an ethical argument. We focus on empirical questions about benefit and harm, because these are ethically significant. Answers to these questions affect the answer to the ethical question. We question the claim that there would be no benefit from surgery in this situation, and we consider possible harms that might be done if treatment is refused. For an adolescent with Body Dysmorphic Disorder, the most important thing may be to avoid harm. We find ourselves arguing for the ethical justifiability of cosmetic labioplasty for an adolescent with Body Dysmorphic Disorder, even though we recognize that it is a counter intuitive position. We explain how we reached our conclusion. © 2016 John Wiley & Sons Ltd.

Random mtDNA mutations modulate proliferation capacity in mouse embryonic fibroblasts

International Nuclear Information System (INIS)

Kukat, Alexandra; Edgar, Daniel; Bratic, Ivana; Maiti, Priyanka; Trifunovic, Aleksandra

2011-01-01

Highlights: → Increased mtDNA mutations in MEFs lead to high level of spontaneous immortalization. → This process is independent of endogenous ROS production. → Aerobic glycolysis significantly contributes to spontaneous immortalization of MEFs. -- Abstract: An increase in mtDNA mutation load leads to a loss of critical cells in different tissues thereby contributing to the physiological process of organismal ageing. Additionally, the accumulation of senescent cells that display changes in metabolic function might act in an active way to further disrupt the normal tissue function. We believe that this could be the important link missing in our understanding of the molecular mechanisms of premature ageing in the mtDNA mutator mice. We tested proliferation capacity of mtDNA mutator cells in vitro. When cultured in physiological levels of oxygen (3%) their proliferation capacity is somewhat lower than wild-type cells. Surprisingly, in conditions of increased oxidative stress (20% O 2 ) mtDNA mutator mouse embryonic fibroblasts exhibit continuous proliferation due to spontaneous immortalization, whereas the same conditions promote senescence in wild-type cells. We believe that an increase in aerobic glycolysis observed in mtDNA mutator mice is a major mechanism behind this process. We propose that glycolysis promotes proliferation and allows a fast turnover of metabolites, but also leads to energy crisis due to lower ATP production rate. This could lead to compromised replication and/or repair and therefore, in rare cases, might lead to mutations in tumor suppressor genes and spontaneous immortalization.

Using an Educational Multimedia Application to Prepare Children for Outpatient Surgeries.

Science.gov (United States)

Fernandes, Sara; Arriaga, Patrícia; Esteves, Francisco

2015-01-01

Surgery is a highly stressful event for children and caregivers. Extensive effort has been made to improve preoperative care in order to alleviate worry about the surgical procedure itself. This study tested the impact of an educational multimedia intervention on the cognitive, emotional, and physiological responses of children undergoing surgery, as well as on parental state anxiety. Children (n = 90) were assigned to three different groups: an educational multimedia intervention (experimental group), an entertainment video game intervention (comparison group), and a control group (no intervention). Children who received the educational multimedia intervention reported lower level of worries about hospitalization, medical procedures, illness, and negative consequences than those in the control and in the comparison groups. Parental state anxiety was also lower in the both the educational and the entertainment video game interventions compared to the control group. These findings suggest that providing information to children regarding medical procedures and hospital rules and routines is important to reduce their preoperative worries, and also relevant for parental anxiety.

Apolipoprotein E e4 allele does not increase the risk of early postoperative delirium after major surgery.

Science.gov (United States)

Abelha, Fernando José; Fernandes, Vera; Botelho, Miguela; Santos, Patricia; Santos, Alice; Machado, J C; Barros, Henrique

2012-02-01

BACKGROUND: A relationship between patients with a genetic predisposition to and those who develop postoperative delirium has not been yet determined. The aim of this study was to determine whether there is an association between apolipoprotein E epsilon 4 allele (APOE4) and delirium after major surgery. METHODS: Of 230 intensive care patients admitted to the post anesthesia care unit (PACU) over a period of 3 months, 173 were enrolled in the study. Patients' demographics and intra- and postoperative data were collected. Patients were followed for the development of delirium using the Intensive Care Delirium Screening Checklist, and DNA was obtained at PACU admission to determine apolipoprotein E genotype. RESULTS: Fifteen percent of patients developed delirium after surgery. Twenty-four patients had one copy of APOE4. The presence of APOE4 was not associated with an increased risk of early postoperative delirium (4% vs. 17%; P = 0.088). The presence of APOE4 was not associated with differences in any studied variables. Multivariate analysis identified age [odds ratio (OR) 9.3, 95% confidence interval (CI) 2.0-43.0, P = 0.004 for age ≥65 years), congestive heart disease (OR 6.2, 95% CI 2.0-19.3, P = 0.002), and emergency surgery (OR 59.7, 95% CI 6.7-530.5, P < 0.001) as independent predictors for development of delirium. The Simplified Acute Physiology Score II (SAPS II) and The Acute Physiology and Chronic Health Evaluation II (APACHE II) were significantly higher in patients with delirium (P < 0.001 and 0.008, respectively). Hospital mortality rates of these patients was higher and they had a longer median PACU stay. CONCLUSIONS: Apolipoprotein e4 carrier status was not associated with an increased risk for early postoperative delirium. Age, congestive heart failure, and emergency surgery were independent risk factors for the development of delirium after major surgery.

The Effect of Inhalation Aromatherapy on Physiological and Psychological Parameters of Patient’s Candidate for Coronary Artery Bypass Graft: Pilot Study

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N. Rajai

2016-08-01

Full Text Available Introduction: Anxiety and stress are common problems before coronary artery bypass graft surgery has a destructive effect on the patient's condition. One of the medications therapies that are effective in reducing anxiety level is Aromatherapy. The aim of this study is to assess the effect of inhalation aromatherapy on physiological and psychological parameters of patients who are candidate for coronary artery bypass graft. Method: In this pilot study, 30 patients candidate of coronary artery bypass graft were selected by convenient sampling method. For intervention on the morning of the surgery, patients inhaled Lavender essential oil from a distance of 5 cm of the nose, for 20 minutes. Physiological and psychological parameters of patients the day before surgery and then 5 and 30 minutes after intervention was estimated by Form vital signs and DASS questionnaire. Data were analyzed in three phases using Descriptive Statistics and repeated measures ANOVA by SPSS.17. Results: 20% of patients were female, 80% male with an average age of 65/36±8/05. The results show a significant difference between the three time phases in variable of the pulse (P = 0/041, respiration (P = 0/040 and stress (P=0.046. Discussion: Aromatherapy can be an effective way to reduce stress levels and pulse in patients candidate for coronary artery bypass graft. Since this results study obtained from a pilot study, to Generalize the results, clinical trials with larger sample size is recommended.

Pulmonary function and health-related quality of life 1-year follow up after cardiac surgery.

Science.gov (United States)

Westerdahl, Elisabeth; Jonsson, Marcus; Emtner, Margareta

2016-07-08

Pulmonary function is severely reduced in the early period after cardiac surgery, and impairments have been described up to 4-6 months after surgery. Evaluation of pulmonary function in a longer perspective is lacking. In this prospective study pulmonary function and health-related quality of life were investigated 1 year after cardiac surgery. Pulmonary function measurements, health-related quality of life (SF-36), dyspnoea, subjective breathing and coughing ability and pain were evaluated before and 1 year after surgery in 150 patients undergoing coronary artery bypass grafting, valve surgery or combined surgery. One year after surgery the forced vital capacity and forced expiratory volume in 1 s were significantly decreased (by 4-5 %) compared to preoperative values (p < 0.05). Saturation of peripheral oxygen was unchanged 1 year postoperatively compared to baseline. A significantly improved health-related quality of life was found 1 year after surgery, with improvements in all eight aspects of SF-36 (p < 0.001). Sternotomy-related pain was low 1 year postoperatively at rest (median 0 [min-max; 0-7]), while taking a deep breath (0 [0-4]) and while coughing (0 [0-8]). A more pronounced decrease in pulmonary function was associated with dyspnoea limitations and impaired subjective breathing and coughing ability. One year after cardiac surgery static and dynamic lung function measurements were slightly decreased, while health-related quality of life was improved in comparison to preoperative values. Measured levels of pain were low and saturation of peripheral oxygen was same as preoperatively.

Heart bypass surgery

Science.gov (United States)

Off-pump coronary artery bypass; OPCAB; Beating heart surgery; Bypass surgery - heart; CABG; Coronary artery bypass graft; Coronary artery bypass surgery; Coronary bypass surgery; Coronary artery disease - CABG; CAD - CABG; Angina - ...

Physiological Basis for the Tolerance of Yeast Zygosaccharomyces bisporus to Salt Stress

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Akshya Sharma

2017-10-01

Full Text Available Zygosaccharomyces bisporus is a moderately halotolerant yeast isolated from highly sugary and salty foods. We performed various evident biochemical and in vivo experiments as first of its kind to sketch out the possible overlay of salt tolerance mechanism in this model organism. The growth and survival curve analysis revealed that 1.0 M NaCl concentration (sublethal enacts growth inhibitory effects with prompting immediate delay in cell division cycle; however, yeast cells adopted modified stress physiologically with further stretched stress spans which was accompanied by an upsurge in the level of cellular metabolites such as trehalose (reserve carbohydrate and chiefly glycerol (polyols as major compatible osmolytes, suggesting their role in defense mechanism against osmotic stress. To further elucidate the relation of osmotic stress cell physiology to salinity, thiobarbituric acid reactive substances, protein carbonyl, and reduced glutathione content were measured in salt-stressed cells demonstrating positive correlation of reactive oxygen species generation in Z. bisporus with an elevated concentration of lipid and protein oxidation, thereby damaging cell membrane and eventually causing cell death. We assessed NaCl exposure sourcing increased intracellular reactive oxygen species concentration, by an electron transfer-based colorimetric cupric-reducing antioxidant capacity assay justifying that cellular total antioxidant capacity which uses all the combined antioxidant activities present within vitamins, proteins, lipids, and glutathione reverses these deleterious stress effects. Henceforth, performance of Z. bisporus MTCC 4801 mounted because of stress regime seems to be multifactorial.

Pain and cardiorespiratory responses of children during physiotherapy after heart surgery.

Science.gov (United States)

Araujo, Adriana Sanches Garcia; Klamt, Jyrson Guilherme; Vicente, Walter Villela de Andrade; Garcia, Luis Vicente

2014-01-01

The aim of the present study was to determine the occurrence of pain and changes in blood pressure, heart rate, respiratory rate, and arterial oxygen saturation associated with physiotherapy in children undergoing cardiac surgery. Eighteen extubated children were assessed for the presence of pain using the face, legs, activity, cry, consolability scale, and blood pressure, heart rate, respiratory rate and arterial oxygen saturation were simultaneously recorded. The physiological parameters were measured at the following time periods: immediately before physiotherapy, five and 10 minutes after the beginning of physiotherapy, and five minutes after its end. Pain was assessed immediately before physiotherapy, ten minutes after the beginning of physiotherapy and five minutes after its end. Pain and physiological changes were assessed by the Friedman test and the correlation between the physiological parameters and the pain scores was assessed by the Spearman test. Pain increased during physiotherapy and decreased significantly after it compared to pre-physiotherapy scores. Systolic blood pressure and heart rate increased significantly after 10 minutes of the beginning of physiotherapy. Arterial oxygen saturation tended to decrease during physiotherapy and to increase after it, although without significance. The correlation between pain scores and the physiological variables was significant only for systolic blood pressure and heart rate ten minutes after the beginning of physiotherapy. Manipulation after the beginning of physiotherapy seems to be accompanied by significant pain and by important associated cardiovascular changes. Apparent analgesia and improved respiratory function were observed after respiratory physiotherapy.

Metal composition of fine particulate air pollution and acute changes in cardiorespiratory physiology

International Nuclear Information System (INIS)

Cakmak, Sabit; Dales, Robert; Kauri, Lisa Marie; Mahmud, Mamun; Van Ryswyk, Keith; Vanos, Jennifer; Liu, Ling; Kumarathasan, Premkumari; Thomson, Errol; Vincent, Renaud; Weichenthal, Scott

2014-01-01

Background: Studying the physiologic effects of components of fine particulate mass (PM 2.5 ) could contribute to a better understanding of the nature of toxicity of air pollution. Objectives: We examined the relation between acute changes in cardiovascular and respiratory function, and PM 2.5 -associated-metals. Methods: Using generalized linear mixed models, daily changes in ambient PM 2.5 -associated metals were compared to daily changes in physiologic measures in 59 healthy subjects who spent 5-days near a steel plant and 5-days on a college campus. Results: Interquartile increases in calcium, cadmium, lead, strontium, tin, vanadium and zinc were associated with statistically significant increases in heart rate of 1–3 beats per minute, increases of 1–3 mmHg in blood pressure and/or lung function decreases of up to 4% for total lung capacity. Conclusion: Metals contained in PM 2.5 were found to be associated with acute changes in cardiovascular and respiratory physiology. - Highlights: • We measured daily lung function, heart rate and blood pressure in 61 subjects. • Study sites were adjacent to a steel plant and on a college campus. • PM 2.5 -associated metal concentrations were measured daily at each site. • On days of higher metal concentrations, physiologic variables slightly deteriorated. • Some metal components may contribute to the toxicity of PM 2.5 . - Several PM 2.5 metals were associated with acute changes in cardiovascular or respiratory physiology. Given the evidence of source specificity, our study provides novel information

Plant-pathogen interactions: leaf physiology alterations in poplars infected with rust (Melampsora medusae).

Science.gov (United States)

Gortari, Fermín; Guiamet, Juan José; Graciano, Corina

2018-01-23

Rust produced by Melampsora sp. is considered one of the most relevant diseases in poplar plantations. Growth reduction in poplar plantations takes place because rust, like other pathogens, alters leaf physiology. There is not a complete evaluation of several of the physiological traits that can be affected by rust at leaf level. Therefore, the aim of this work was to evaluate, in an integrative way and in the same pathosystem, which physiological processes are affected when Populus deltoides Bartr. ex Marsh. leaves are infected by rust (Melampsora medusae Thümen). Leaves of two clones with different susceptibility to rust were analyzed. Field and pot experiments were performed, and several physiological traits were measured in healthy and infected leaves. We conclude that rust affects leaf mesophyll integrity, and so water movement in the leaf in liquid phase is affected. As a consequence, gas exchange is reduced, affecting both carbon fixation and transpiration. However, there is an increase in respiration rate, probably due to plant and fungal respiration. The increase in respiration rate is important in the reduction of net photosynthetic rate, but also some damage in the photosynthetic apparatus limits leaf capacity to fix carbon. The decrease in chlorophyll content would start later and seems not to explain the reduction in net photosynthetic rate. Both clones, although they have different susceptibility to rust, are affected in the same physiological mechanisms. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effect of oxygen levels on the physiology of dendritic cells: implications for adoptive cell therapy.

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Futalan, Diahnn; Huang, Chien-Tze; Schmidt-Wolf, Ingo G H; Larsson, Marie; Messmer, Davorka

2011-01-01

Dendritic cell (DC)-based adoptive tumor immunotherapy approaches have shown promising results, but the incidence of tumor regression is low and there is an evident call for identifying culture conditions that produce DCs with a more potent Th1 potential. Routinely, DCs are differentiated in CO(2) incubators under atmospheric oxygen conditions (21% O(2)), which differ from physiological oxygen levels of only 3-5% in tissue, where most DCs reside. We investigated whether differentiation and maturation of DCs under physiological oxygen levels could produce more potent T-cell stimulatory DCs for use in adoptive immunotherapy. We found that immature DCs differentiated under physiological oxygen levels showed a small but significant reduction in their endocytic capacity. The different oxygen levels did not influence their stimuli-induced upregulation of cluster of differentiation 54 (CD54), CD40, CD83, CD86, C-C chemokine receptor type 7 (CCR7), C-X-C chemokine receptor type 4 (CXCR4) and human leukocyte antigen (HLA)-DR or the secretion of interleukin (IL)-6, tumor necrosis factor (TNF)-α and IL-10 in response to lipopolysaccharide (LPS) or a cytokine cocktail. However, DCs differentiated under physiological oxygen level secreted higher levels of IL-12(p70) after exposure to LPS or CD40 ligand. Immature DCs differentiated at physiological oxygen levels caused increased T-cell proliferation, but no differences were observed for mature DCs with regard to T-cell activation. In conclusion, we show that although DCs generated under atmospheric or physiological oxygen conditions are mostly similar in function and phenotype, DCs differentiated under physiological oxygen secrete larger amounts of IL-12(p70). This result could have implications for the use of ex vivo-generated DCs for clinical studies, since DCs differentiated at physiological oxygen could induce increased Th1 responses in vivo.

A Gut Feeling to Cure Diabetes: Potential Mechanisms of Diabetes Remission after Bariatric Surgery

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Young Min Cho

2014-12-01

Full Text Available A cure for type 2 diabetes was once a mere dream but has now become a tangible and achievable goal with the unforeseen success of bariatric surgery in the treatment of both obesity and type 2 diabetes. Popular bariatric procedures such as Roux-en-Y gastric bypass and sleeve gastrectomy exhibit high rates of diabetes remission or marked improvement in glycemic control. However, the mechanism of diabetes remission following these procedures is still elusive and appears to be very complex and encompasses multiple anatomical and physiological changes. In this article, calorie restriction, improved β-cell function, improved insulin sensitivity, and alterations in gut physiology, bile acid metabolism, and gut microbiota are reviewed as potential mechanisms of diabetes remission after Roux-en-Y gastric bypass and sleeve gastrectomy.

Artificial light pollution: Shifting spectral wavelengths to mitigate physiological and health consequences in a nocturnal marsupial mammal.

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Dimovski, Alicia M; Robert, Kylie A

2018-05-02

The focus of sustainable lighting tends to be on reduced CO 2 emissions and cost savings, but not on the wider environmental effects. Ironically, the introduction of energy-efficient lighting, such as light emitting diodes (LEDs), may be having a great impact on the health of wildlife. These white LEDs are generated with a high content of short-wavelength 'blue' light. While light of any kind can suppress melatonin and the physiological processes it regulates, these short wavelengths are potent suppressors of melatonin. Here, we manipulated the spectral composition of LED lights and tested their capacity to mitigate the physiological and health consequences associated with their use. We experimentally investigated the impact of white LEDs (peak wavelength 448 nm; mean irradiance 2.87 W/m 2 ), long-wavelength shifted amber LEDs (peak wavelength 605 nm; mean irradiance 2.00 W/m 2 ), and no lighting (irradiance from sky glow light treatments. White LED exposed wallabies had significantly suppressed nocturnal melatonin compared to no light and amber LED exposed wallabies, while there was no difference in lipid peroxidation. Antioxidant capacity declined from baseline to week 10 under all treatments. These results provide further evidence that short-wavelength light at night is a potent suppressor of nocturnal melatonin. Importantly, we also illustrate that shifting the spectral output to longer wavelengths could mitigate these negative physiological impacts. © 2018 Wiley Periodicals, Inc.

AMPK controls exercise endurance, mitochondrial oxidative capacity, and skeletal muscle integrity

DEFF Research Database (Denmark)

Lantier, Louise; Fentz, Joachim; Mounier, Rémi

2014-01-01

AMP-activated protein kinase (AMPK) is a sensor of cellular energy status that plays a central role in skeletal muscle metabolism. We used skeletal muscle-specific AMPKα1α2 double-knockout (mdKO) mice to provide direct genetic evidence of the physiological importance of AMPK in regulating muscle...... diminished maximal ADP-stimulated mitochondrial respiration, showing an impairment at complex I. This effect was not accompanied by changes in mitochondrial number, indicating that AMPK regulates muscle metabolic adaptation through the regulation of muscle mitochondrial oxidative capacity and mitochondrial...

Facial Cosmetic Surgery

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... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

Thyroid Surgery

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... Hypothyroidism in Children and Adolescents Pediatric Differentiated Thyroid Cancer Thyroid Nodules in Children and Adolescents Thyroid Surgery Resources Thyroid Surgery Brochure PDF Thyroid Surgery FAQs PDF En Español Cirugia De La Tiroides El folleto de Cirugia De La Tiroides Search Thyroid ...

Preparing for Surgery

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... Events Advocacy For Patients About ACOG Preparing for Surgery Home For Patients Search FAQs Preparing for Surgery ... Surgery FAQ080, August 2011 PDF Format Preparing for Surgery Gynecologic Problems What is the difference between outpatient ...

Preventing or reducing smoking-related complications in otologic and neurotologic surgery.

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Golub, Justin S; Samy, Ravi N

2015-10-01

To discuss effects of smoking on otologic surgery in an era of electronic (e-) cigarettes and proposals for legalization of marijuana. Physiologic mechanisms and clinical outcomes are presented. Tobacco smoke can cause a variety of tissue effects that may adversely impact otologic surgery outcomes. Results in tympanoplasty using temporalis fascia are inferior in smokers compared with nonsmokers. More recent data show that in cartilage tympanoplasty, graft incorporation rates in smokers may approach those of nonsmokers. However, these results may not be as durable long-term in smokers. Evidence from nonotologic studies suggests that smoking cessation and nicotine replacement therapy may reduce perioperative morbidity. No data are available on electronic cigarettes and otologic outcomes; however, based on the pathophysiologic mechanisms of tobacco smoking, electronic cigarettes are likely a safer alternative. Marijuana smoke also needs to be considered as more states consider legalization. Cigarette smoking negatively influences otologic surgery results, mostly because of tobacco combustion byproducts. Counseling and, if needed, pharmacologic measures to reduce smoking are recommended. E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking. Our review contributes to the discussion of how the trends of e-cigarette use and marijuana legalization will unfold in the future to affect our patients' outcomes.

Lymphocytes Mitochondrial Physiology as Biomarker of Energy Metabolism during Fasted and Fed Conditions

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Erika Cortez

2012-01-01

Full Text Available Mitochondria are central coordinators of energy metabolism, and changes of their physiology have long been associated with metabolic disorders. Thus, observations of energy dynamics in different cell types are of utmost importance. Therefore, tools with quick and easy handling are needed for consistent evaluations of such interventions. In this paper, our main hypothesis is that during different nutritional situations lymphocytes mitochondrial physiology could be associated with the metabolism of other cell types, such as cardiomyocytes, and consequently be used as metabolic biomarker. Blood lymphocytes and heart muscle fibers were obtained from both fed and 24 h-fasted mice, and mitochondrial analysis was assessed by high-resolution respirometry and western blotting. Carbohydrate-linked oxidation and fatty acid oxidation were significantly higher after fasting. Carnitine palmitoil transferase 1 and uncouple protein 2 contents were increased in the fasted group, while the glucose transporters 1 and 4 and the ratio phosphorylated AMP-activated protein kinase/AMPK did not change between groups. In summary, under a nutritional status modification, mitochondria demonstrated earlier adaptive capacity than other metabolic sensors such as glucose transporters and AMPK, suggesting the accuracy of mitochondria physiology of lymphocytes as biomarker for metabolic changes.

Impact of bile salt adaptation of Lactobacillus delbrueckii subsp. lactis 200 on its interaction capacity with the gut.

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Burns, Patricia; Reinheimer, Jorge; Vinderola, Gabriel

2011-10-01

In a previous work, bile-salt-resistant derivatives were obtained from non-intestinal lactobacilli. The aim of this work was to investigate the impact of bile adaptation of Lactobacillus delbrueckii subsp. lactis 200 on morphology, surface properties, in vivo interaction capacity with the gut and ability to activate the gut immune response. Electron microscopy studies, growth kinetics in the presence of bovine and porcine bile, the capacity to deconjugate bile acids, hydrophobicity, autoaggregation and co-aggregation capacities were studied for the parental strain and its bile-resistant derivative in vitro. Additionally, survival in intestinal fluid, the interaction with the gut and the immunomodulating capacities were studied in mice. Bile salt adaptation conferred upon the adapted strain a higher capacity to withstand physiological concentrations of bile salts and greater survival capacity in intestinal fluid. However, bile salt exposure reduced cell hydrophobicity, autoaggregation and adhesion capacities, resulting in reduced persistence in the intestinal lumen and delayed capacity to activate the gut immune response. Insight into the effects of bile salts upon the interaction and immunomodulating capacity of lactobacilli with the gut is provided, relating in vitro and in vivo results. Copyright © 2011 Institut Pasteur. Published by Elsevier Masson SAS. All rights reserved.

Association between laboratory capacities and world-cup performance in Nordic combined.

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Rasdal, Vegard; Fudel, Ronny; Kocbach, Jan; Moen, Frode; Ettema, Gertjan; Sandbakk, Øyvind

2017-01-01

Nordic combined (NC) is an Olympic winter-sport performed as a ski jumping (SJ) event followed by a cross-country (XC) pursuit race employing the skating style. To elucidate the associations between sport-specific laboratory capacities and SJ, XC skiing, and overall NC performance in a world-cup NC event. Twelve international world-cup NC athletes from 8 nations performed laboratory testing one day prior to participating in a world-cup NC event. Squat jumps and SJ imitations (IMIT) were performed on a three-dimensional force plate, whereas XC skiing-specific physiological characteristics were obtained from roller ski skating tests on a treadmill and an all-out double poling (DP) test. Finally, body composition was measured. Laboratory capacities were correlated against performance in SJ, 10-km XC skiing, and overall NC in the world-cup event. Multiple regression analysis was used to determine the best suited laboratory variables for predicting performance. Vertical IMIT velocity together with body-mass provided the best prediction for SJ performance (r2 = 0.70, pjump capacity while minimizing body-mass within the BMI limit set by FIS should be considered in the seasonal training of NC athletes.

Corrective Jaw Surgery

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... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ...

The effect of pH, buffer capacity and ionic strength on quetiapine fumarate release from matrix tablets prepared using two different polymeric blends.

Science.gov (United States)

Hamed, Rania; AlJanabi, Reem; Sunoqrot, Suhair; Abbas, Aiman

2017-08-01

The objective of this study was to investigate the effect of the different physiological parameters of the gastrointestinal (GI) fluid (pH, buffer capacity, and ionic strength) on the in vitro release of the weakly basic BCS class II drug quetiapine fumarate (QF) from two once-a-day matrix tablet formulations (F1 and F2) developed as potential generic equivalents to Seroquel ® XR. F1 tablets were prepared using blends of high and low viscosity grades of hydroxypropyl methylcellulose (HPMC K4M and K100LV, respectively), while F2 tablets were prepared from HPMC K4M and PEGylated glyceryl behenate (Compritol ® HD5 ATO). The two formulations attained release profiles of QF over 24 h similar to that of Seroquel ® XR using the dissolution medium published by the Food and Drug Administration (FDA). A series of solubility and in vitro dissolution studies was then carried out using media that simulate the gastric and intestinal fluids and cover the physiological pH, buffer capacity and ionic strength range of the GIT. Solubility studies revealed that QF exhibits a typical weak base pH-dependent solubility profile and that the solubility of QF increases with increasing the buffer capacity and ionic strength of the media. The release profiles of QF from F1, F2 and Seroquel ® XR tablets were found to be influenced by the pH, buffer capacity and ionic strength of the dissolution media to varying degrees. Results highlight the importance of studying the physiological variables along the GIT in designing controlled release formulations for more predictive in vitro-in vivo correlations.

Corrective Jaw Surgery

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Full Text Available ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ... to find out more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures ...

The Role of Exercise in Cardiac Aging: From Physiology to Molecular Mechanisms.

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Roh, Jason; Rhee, James; Chaudhari, Vinita; Rosenzweig, Anthony

2016-01-22

Aging induces structural and functional changes in the heart that are associated with increased risk of cardiovascular disease and impaired functional capacity in the elderly. Exercise is a diagnostic and therapeutic tool, with the potential to provide insights into clinical diagnosis and prognosis, as well as the molecular mechanisms by which aging influences cardiac physiology and function. In this review, we first provide an overview of how aging impacts the cardiac response to exercise, and the implications this has for functional capacity in older adults. We then review the underlying molecular mechanisms by which cardiac aging contributes to exercise intolerance, and conversely how exercise training can potentially modulate aging phenotypes in the heart. Finally, we highlight the potential use of these exercise models to complement models of disease in efforts to uncover new therapeutic targets to prevent or treat heart disease in the aging population. © 2016 American Heart Association, Inc.

Do physiological measures predict selected CrossFit® benchmark performance?

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Butcher SJ

2015-07-01

Full Text Available Scotty J Butcher,1,2 Tyler J Neyedly,3 Karla J Horvey,1 Chad R Benko2,41Physical Therapy, University of Saskatchewan, 2BOSS Strength Institute, 3Physiology, University of Saskatchewan, 4Synergy Strength and Conditioning, Saskatoon, SK, CanadaPurpose: CrossFit® is a new but extremely popular method of exercise training and competition that involves constantly varied functional movements performed at high intensity. Despite the popularity of this training method, the physiological determinants of CrossFit performance have not yet been reported. The purpose of this study was to determine whether physiological and/or muscle strength measures could predict performance on three common CrossFit "Workouts of the Day" (WODs.Materials and methods: Fourteen CrossFit Open or Regional athletes completed, on separate days, the WODs "Grace" (30 clean and jerks for time, "Fran" (three rounds of thrusters and pull-ups for 21, 15, and nine repetitions, and "Cindy" (20 minutes of rounds of five pull-ups, ten push-ups, and 15 bodyweight squats, as well as the "CrossFit Total" (1 repetition max [1RM] back squat, overhead press, and deadlift, maximal oxygen consumption (VO2max, and Wingate anaerobic power/capacity testing.Results: Performance of Grace and Fran was related to whole-body strength (CrossFit Total (r=-0.88 and -0.65, respectively and anaerobic threshold (r=-0.61 and -0.53, respectively; however, whole-body strength was the only variable to survive the prediction regression for both of these WODs (R2=0.77 and 0.42, respectively. There were no significant associations or predictors for Cindy.Conclusion: CrossFit benchmark WOD performance cannot be predicted by VO2max, Wingate power/capacity, or either respiratory compensation or anaerobic thresholds. Of the data measured, only whole-body strength can partially explain performance on Grace and Fran, although anaerobic threshold also exhibited association with performance. Along with their typical training

The Effects of Heat Adaptation on Physiology, Perception and Exercise Performance in the Heat: A Meta-Analysis.

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Tyler, Christopher J; Reeve, Tom; Hodges, Gary J; Cheung, Stephen S

2016-11-01

Exercise performance and capacity are impaired in hot, compared to temperate, conditions. Heat adaptation (HA) is one intervention commonly adopted to reduce this impairment because it may induce beneficial exercise performance and physiological and perceptual adaptations. A number of investigations have been conducted on HA but, due to large methodological differences, the effectiveness of different HA regimens remain unclear. (1) To quantify the effect of different HA regimens on exercise performance and the physiological and perceptual responses to subsequent heat exposure. (2) To offer practical HA recommendations and suggestions for future HA research based upon a systematic and quantitative synthesis of the literature. PubMed was searched for original research articles published up to, and including, 16 February 2016 using appropriate first- and second-order search terms. English-language, peer-reviewed, full-text original articles using human participants were reviewed using the four-stage process identified in the PRISMA statement. Data for the following variables were obtained from the manuscripts by at least two of the authors: participant sex, maximal oxygen consumption and age; HA duration, frequency, modality, temperature and humidity; exercise performance and capacity; core and skin temperature; heart rate, stroke volume, cardiac output, skin blood flow, sweat onset temperature, body mass loss, sweat rate, perception of thirst, volitional fluid consumption, plasma volume changes; sweat concentrations of sodium, chloride and potassium; aldosterone, arginine vasopressin, heat shock proteins (Hsp), ratings of perceived exertion (RPE) and thermal sensation. Data were divided into three groups based upon the frequency of the HA regimen. Performance and capacity data were also divided into groups based upon the type of HA used. Hedges' g effect sizes and 95 % confidence intervals were calculated. Correlations were run where appropriate. Ninety-six articles

Personalized physiological medicine.

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Ince, Can

2017-12-28

This paper introduces the concept of personalized physiological medicine that is specifically directed at the needs of the critically ill patient. This differs from the conventional view of personalized medicine, characterized by biomarkers and gene profiling, instead focusing on time-variant changes in the pathophysiology and regulation of various organ systems and their cellular and subcellular constituents. I propose that personalized physiological medicine is composed of four pillars relevant to the critically ill patient. Pillar 1 is defined by the frailty and fitness of the patient and their physiological reserve to cope with the stress of critical illness and therapy. Pillar 2 involves monitoring of the key physiological variables of the different organ systems and their response to disease and therapy. Pillar 3 concerns the evaluation of the success of resuscitation by assessment of the hemodynamic coherence between the systemic and microcirculation and parenchyma of the organ systems. Finally, pillar 4 is defined by the integration of the physiological and clinical data into a time-learning adaptive model of the patient to provide feedback about the function of organ systems and to guide and assess the response to disease and therapy. I discuss each pillar and describe the challenges to research and development that will allow the realization of personalized physiological medicine to be practiced at the bedside for critically ill patients.

Corrective Jaw Surgery

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Full Text Available ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ... Extractions and Other Oral Surgeries Extractions and Other Oral Surgeries Oral and maxillofacial surgeons surgically treat the soft ...

Plant Physiology in Greenhouses

NARCIS (Netherlands)

Heuvelink, E.; Kierkels, T.

2015-01-01

Since 2004 Ep Heuvelink and Tijs Kierkels have been writing a continuing series of plant physiology articles for the Dutch horticultural journal Onder Glas and the international edition In Greenhouses. The book Plant Physiology in Greenhouses consists of 50 of their plant physiology articles. The

Lower Growth Temperature Increases Alternative Pathway Capacity and Alternative Oxidase Protein in Tobacco 1

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Vanlerberghe, Greg C.; McIntosh, Lee

1992-01-01

Suspension cells of NT1 tobacco (Nicotiana tabacum L. cv bright yellow) have been used to study the effect of growth temperature on the CN-resistant, salicylhydroxamic acid-sensitive alternative pathway of respiration. Mitochondria isolated from cells maintained at 30°C had a low capacity to oxidize succinate via the alternative pathway, whereas mitochondria isolated from cells 24 h after transfer to 18°C displayed, on average, a 5-fold increase in this capacity (from 7 to 32 nanoatoms oxygen per milligram protein per minute). This represented an increase in alternative pathway capacity from 18 to 45% of the total capacity of electron transport. This increased capacity was lost upon transfer of cells back to 30°C. A monoclonal antibody to the terminal oxidase of the alternative pathway (the alternative oxidase) from Sauromatum guttatum (T.E. Elthon, R.L. Nickels, L. McIntosh [1989] Plant Physiology 89: 1311-1317) recognized a 35-kilodalton mitochondrial protein in tobacco. There was an excellent correlation between the capacity of the alternative path in isolated tobacco mitochondria and the levels of this 35-kilodalton alternative oxidase protein. Cycloheximide could inhibit both the increased level of the 35-kilodalton alternative oxidase protein and the increased alternative pathway capacity normally seen upon transfer to 18°C. We conclude that transfer of tobacco cells to the lower temperature increases the capacity of the alternative pathway due, at least in part, to de novo synthesis of the 35-kilodalton alternative oxidase protein. Images Figure 3 Figure 4 PMID:16652932

Corrective Jaw Surgery

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Full Text Available ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require ...

Case series: Dexmedetomidine and ketamine for anesthesia in patients with uncorrected congenital cyanotic heart disease presenting for non-cardiac surgery

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Rakhee Goyal

2013-01-01

Full Text Available The number of patients with uncorrected congenital cyanotic heart disease is less but at times some may present for non-cardiac surgery with a high anesthetic risk. Some of these may even be adults with compromised cardiopulmonary physiology posing greater challenges to the anesthesiologist. The authors have used a combination of dexmedetomidine and ketamine for anesthesia for non cardiac surgery in five patients with cyanotic heart disease and right to left shunt (3-Eisenmenger′s syndrome, 2-Tetralogy of Fallot. The sympathoinhibitory effects of dexmedetomidine were balanced with the cardiostimulatory effects of ketamine, thereby maintaining good cardiovascular stability. The analgesia was good and there was no postoperative agitation.This drug combination was effective and safe for patients with cyanotic heart disease for non cardiac surgeries.

Genetic response in masseter muscle after orthognathic surgery in comparison with healthy controls - A Microarray study.

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Marewski, Maya; Petto, Carola; Schneider, Matthias; Harzer, Winfried

2017-04-01

One third of adult patients with orthognathic surgery of a prognathic or retrognathic mandible show relapse. The sagittal split osteotomy of the mandible leads to a displacement of both parts up to 10 mm without any changes of muscle attachment. Changed mandible length needs adaptation of muscle capacity because of changed force to moment ratio. The aim of this Microarray study was to analyze the general genetic response of masseter muscle in patients with retrognathism or prognathism of the mandible six months after surgery in comparison with healthy untreated controls. We found in tissue samples from masseter muscle a reduction of different entities between patients and controls but less in retrognathic than in prognathic patients (274/429). The different entities to controls in prognathia were reduced from 1862 to 1749 but increased in retrognathia from 1070 to 1563. We have to consider that the total amount of different entities to the controls is higher in patients with prognathic mandible (7364) because of their strong genetic controlled development compared with that in patients with retrognathic mandible (4126), which is more environmentally influenced. It can be concluded that function follows form after surgical change with high inheritance. In retrognathic patients the adaptation could be delayed or the capacity of regeneration potential is not sufficient. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Perioperative factors associated with pressure ulcer development after major surgery

Science.gov (United States)

2018-01-01

Background Postoperative pressure ulcers are important indicators of perioperative care quality, and are serious and expensive complications during critical care. This study aimed to identify perioperative risk factors for postoperative pressure ulcers. Methods This retrospective case-control study evaluated 2,498 patients who underwent major surgery. Forty-three patients developed postoperative pressure ulcers and were matched to 86 control patients based on age, sex, surgery, and comorbidities. Results The pressure ulcer group had lower baseline hemoglobin and albumin levels, compared to the control group. The pressure ulcer group also had higher values for lactate levels, blood loss, and number of packed red blood cell (pRBC) units. Univariate analysis revealed that pressure ulcer development was associated with preoperative hemoglobin levels, albumin levels, lactate levels, intraoperative blood loss, number of pRBC units, Acute Physiologic and Chronic Health Evaluation II score, Braden scale score, postoperative ventilator care, and patient restraint. In the multiple logistic regression analysis, only preoperative low albumin levels (odds ratio [OR]: 0.21, 95% CI: 0.05–0.82; P pressure ulcer development. A receiver operating characteristic curve was used to assess the predictive power of the logistic regression model, and the area under the curve was 0.88 (95% CI: 0.79–0.97; P pressure ulcer development after surgery. PMID:29441175

Thoracic damage control surgery.

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Gonçalves, Roberto; Saad, Roberto

2016-01-01

The damage control surgery came up with the philosophy of applying essential maneuvers to control bleeding and abdominal contamination in trauma patients who are within the limits of their physiological reserves. This concept was extended to thoracic injuries, where relatively simple maneuvers can shorten operative time of in extremis patients. This article aims to revise the various damage control techniques in thoracic organs that must be known to the surgeon engaged in emergency care. RESUMO A cirurgia de controle de danos surgiu com a filosofia de se aplicar manobras essenciais para controle de sangramento e contaminação abdominal, em doentes traumatizados, nos limites de suas reservas fisiológicas. Este conceito se estendeu para as lesões torácicas, onde manobras relativamente simples, podem abreviar o tempo operatório de doentes in extremis. Este artigo tem como objetivo, revisar as diversas técnicas de controle de dano em órgãos torácicos, que devem ser de conhecimento do cirurgião que atua na emergência.

The art and science of photography in hand surgery.

Science.gov (United States)

Wang, Keming; Kowalski, Evan J; Chung, Kevin C

2014-03-01

High-quality medical photography plays an important role in teaching and demonstrating the functional capacity of the hands as well as in medicolegal documentation. Obtaining standardized, high-quality photographs is now an essential component of many surgery practices. The importance of standardized photography in facial and cosmetic surgery has been well documented in previous studies, but no studies have thoroughly addressed the details of photography for hand surgery. In this paper, we provide a set of guidelines and basic camera concepts for different scenarios to help hand surgeons obtain appropriate and informative high-quality photographs. A camera used for medical photography should come equipped with a large sensor size and an optical zoom lens with a focal length ranging anywhere from 14 to 75 mm. In a clinic or office setting, we recommend 6 standardized views of the hand and 4 views for the wrist; additional views should be taken for tendon ruptures, nerve injuries, or other deformities of the hand. For intraoperative pictures, the camera operator should understand the procedure and pertinent anatomy in order to properly obtain high-quality photographs. When digital radiographs are not available and radiographic film must be photographed, it is recommended to reduce the exposure and change the color mode to black and white to obtain the best possible pictures. The goal of medical photography is to present the subject in an accurate and precise fashion. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Smolt physiology and endocrinology: Chapter 5

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McCormick, Stephen D.; McCormick, Stephen D.; Farrell, Anthony Peter; Brauner, Colin J.

2012-01-01

The parr-smolt transformation of anadromous salmonids is a suite of behavioral, morphological, and physiological changes that are preparatory for downstream migration and seawater entry. The timing of smolt development varies among species, occurring soon after hatching in pink and chum salmon and after one to several years in Atlantic salmon. In many species the transformation is size dependent and occurs in spring, mediated through photoperiod and temperature cues. Smolt development is stimulated by several hormones including growth hormone, insulin-like growth factor-1, cortisol, and thyroid hormones, whereas prolactin is generally inhibitory. Increased salinity tolerance is one of the most important and tractable changes, and is caused by alteration in the function of the major osmoregulatory organs, the gill, gut, and kidney. Increased abundance of specific ion transporters (Na+/K+-ATPase, Na+/K+/Cl− cotransporter and apical Cl− channel) in gill ionocytes results in increased salt secretory capacity, increased growth and swimming performance in seawater, and higher marine survival.

The impact of a preloaded intraocular lens delivery system on operating room efficiency in routine cataract surgery.

Science.gov (United States)

Jones, Jason J; Chu, Jeffrey; Graham, Jacob; Zaluski, Serge; Rocha, Guillermo

2016-01-01

The aim of this study was to evaluate the operational impact of using preloaded intraocular lens (IOL) delivery systems compared with manually loaded IOL delivery processes during routine cataract surgeries. Time and motion data, staff and surgery schedules, and cost accounting reports were collected across three sites located in the US, France, and Canada. Time and motion data were collected for manually loaded IOL processes and preloaded IOL delivery systems over four surgery days. Staff and surgery schedules and cost accounting reports were collected during the 2 months prior and after introduction of the preloaded IOL delivery system. The study included a total of 154 routine cataract surgeries across all three sites. Of these, 77 surgeries were performed using a preloaded IOL delivery system, and the remaining 77 surgeries were performed using a manual IOL delivery process. Across all three sites, use of the preloaded IOL delivery system significantly decreased mean total case time by 6.2%-12.0% (Psystem also decreased surgeon lens time, surgeon delays, and eliminated lens touches during IOL preparation. Compared to a manual IOL delivery process, use of a preloaded IOL delivery system for cataract surgery reduced total case time, total surgeon lens time, surgeon delays, and eliminated IOL touches. The time savings provided by the preloaded IOL delivery system provide an opportunity for sites to improve routine cataract surgery throughput without impacting surgeon or staff capacity.

A new approach to homeostatic regulation: towards a unified view of physiological and ecological concepts.

Directory of Open Access Journals (Sweden)

Cédric L Meunier

Full Text Available Stoichiometric homeostasis is the ability of an organism to keep its body chemical composition constant, despite varying inputs. Stoichiometric homeostasis therefore constrains the metabolic needs of consumers which in turn often feed on resources not matching these requirements. In a broader context, homeostasis also relates to the capacity of an organism to maintain other biological parameters (e.g. body temperature at a constant level over ambient environmental variations. Unfortunately, there are discrepancies in the literature and ecological and physiological definitions of homeostasis are disparate and partly contradictory. Here, we address this matter by reviewing the existing knowledge considering two distinct groups, regulators and conformers and, based on examples of thermo- and osmoregulation, we propose a new approach to stoichiometric homeostasis, unifying ecological and physiological concepts. We suggest a simple and precise graphical way to identify regulators and conformers: for any given biological parameter (e.g. nutrient stoichiometry, temperature, a sigmoidal relation between internal and external conditions can be observed for conformers while an inverse sigmoidal response is characteristic of regulators. This new definition and method, based on well-studied physiological mechanisms, unifies ecological and physiological approaches and is a useful tool for understanding how organisms are affected by and affect their environment.

Regulatory Physiology

Science.gov (United States)

Lane, Helen W.; Whitson, Peggy A.; Putcha, Lakshmi; Baker, Ellen; Smith, Scott M.; Stewart, Karen; Gretebeck, Randall; Nimmagudda, R. R.; Schoeller, Dale A.; Davis-Street, Janis

1999-01-01

As noted elsewhere in this report, a central goal of the Extended Duration Orbiter Medical Project (EDOMP) was to ensure that cardiovascular and muscle function were adequate to perform an emergency egress after 16 days of spaceflight. The goals of the Regulatory Physiology component of the EDOMP were to identify and subsequently ameliorate those biochemical and nutritional factors that deplete physiological reserves or increase risk for disease, and to facilitate the development of effective muscle, exercise, and cardiovascular countermeasures. The component investigations designed to meet these goals focused on biochemical and physiological aspects of nutrition and metabolism, the risk of renal (kidney) stone formation, gastrointestinal function, and sleep in space. Investigations involved both ground-based protocols to validate proposed methods and flight studies to test those methods. Two hardware tests were also completed.

Aerobic Capacity in Persons with Multiple Sclerosis: a Systematic Review and Meta-Analysis : A Systematic Review and Meta-Analysis

NARCIS (Netherlands)

Langeskov-Christensen, Martin; Heine, Martin; Kwakkel, Gert; Dalgas, Ulrik

Background Aerobic capacity (VO2max) is a strong health and performance predictor and is regarded as a key physiological measure in the healthy population and in persons with multiple sclerosis (PwMS). However, no studies have tried to synthesize the existing knowledge regarding VO2max in PwMS.

Nigerian Journal of Physiological Sciences

African Journals Online (AJOL)

Nigerian Journal of Physiological Sciences (Niger. J. Physiol. Sci.) is a biannual publication of the Physiological Society of Nigeria. It covers diverse areas of research in physiological sciences, publishing reviews in current research areas and original laboratory and clinical research in physiological sciences. Other websites ...

Chewing Over Physiology Integration

Science.gov (United States)

Abdulkader, Fernando; Azevedo-Martins, Anna Karenina; de Arcisio Miranda, Manoel; Brunaldi, Kellen

2005-01-01

An important challenge for both students and teachers of physiology is to integrate the differentareas in which physiological knowledge is didactically divided. In developing countries, such an issue is even more demanding, because budget restrictions often affect the physiology program with laboratory classes being the first on the list when it…

Choosing surgery

DEFF Research Database (Denmark)

Thorstensson, Carina; Lohmander, L; Frobell, Richard

2009-01-01

-depth qualitative interviews were conducted with young (aged 18-35), physically active individuals with ACL rupture who were participating in a RCT comparing training and surgical reconstruction with training only. 22/34 were randomised to training only but crossed over to surgery. Of these, 11 were interviewed......ABSTRACT: BACKGROUND: The objective was to understand patients' views of treatment after acute anterior cruciate ligament (ACL) injury, and their reasons for deciding to request surgery despite consenting to participate in a randomised controlled trial (to 'cross-over'). METHODS: Thirty-four in...... before surgery, and 11 were interviewed at least 6 months after surgery. To provide additional information, 12 patients were interviewed before randomisation. Interviews were audio-recorded, transcribed and analysed using the Framework approach. RESULTS: Strong preference for surgery was commonplace...

Antioxidant capacity contributes to protection of ketone bodies against oxidative damage induced during hypoglycemic conditions.

Science.gov (United States)

Haces, María L; Hernández-Fonseca, Karla; Medina-Campos, Omar N; Montiel, Teresa; Pedraza-Chaverri, José; Massieu, Lourdes

2008-05-01

Ketone bodies play a key role in mammalian energy metabolism during the suckling period. Normally ketone bodies' blood concentration during adulthood is very low, although it can rise during starvation, an exogenous infusion or a ketogenic diet. Whenever ketone bodies' levels increase, their oxidation in the brain rises. For this reason they have been used as protective molecules against refractory epilepsy and in experimental models of ischemia and excitotoxicity. The mechanisms underlying the protective effect of these compounds are not completely understood. Here, we studied a possible antioxidant capacity of ketone bodies and whether it contributes to the protection against oxidative damage induced during hypoglycemia. We report for the first time the scavenging capacity of the ketone bodies, acetoacetate (AcAc) and both the physiological and non-physiological isomers of beta-hydroxybutyrate (D- and L-BHB, respectively), for diverse reactive oxygen species (ROS). Hydroxyl radicals (.OH) were effectively scavenged by D- and L-BHB. In addition, the three ketone bodies were able to reduce cell death and ROS production induced by the glycolysis inhibitor, iodoacetate (IOA), while only D-BHB and AcAc prevented neuronal ATP decline. Finally, in an in vivo model of insulin-induced hypoglycemia, the administration of D- or L-BHB, but not of AcAc, was able to prevent the hypoglycemia-induced increase in lipid peroxidation in the rat hippocampus. Our data suggest that the antioxidant capacity contributes to protection of ketone bodies against oxidative damage in in vitro and in vivo models associated with free radical production and energy impairment.

Preoperative cancer cachexia and short-term outcomes following surgery.

Science.gov (United States)

Mason, Meredith C; Garcia, Jose M; Sansgiry, Shubhada; Walder, Annette; Berger, David H; Anaya, Daniel A

2016-10-01

Cancer cachexia is an important measure of physiologic reserve associated with worse survival and represents an actionable factor for the cancer population. However, the incidence of cachexia in surgical cancer patients and its impact on postoperative outcomes are currently unknown. A prospective cohort study enrolling patients having elective cancer surgery (2012-2014) at a Veterans Affairs tertiary referral center. Preoperative cancer cachexia (weight loss ≥5% over 6-mo period before surgery) was the predictor of interest. The primary outcome was 60-d postoperative complications (VA Surgical Quality Improvement Program). Patients were grouped by body mass index (BMI) category (cachexia and BMI was tested for the primary outcome. Multivariate logistic regression was used to examine the association between preoperative cachexia and postoperative complications. Of 253 patients, 16.6% had preoperative cachexia, and 51.8% developed ≥ 1 postoperative complications. Complications were more common in cachectic patients (64.3% versus 49.3%, P = 0.07). This association varied by BMI category, and interaction analysis was significant for those with normal or underweight BMI (BMI cachexia was associated with higher odds of postoperative complications (odds ratios, 5.08 [95% confidence intervals, 1.18-21.88]; P = 0.029). Additional predictors of complications included major surgery (3.19 [1.24-8.21], P = 0.01), ostomy (4.43 [1.68-11.72], P = 0.003), and poor baseline performance status (2.31 [1.05-5.08], P = 0.03). Cancer cachexia is common in surgical patients, and is an important predictor of postoperative complications, though its effect varies by BMI. As a modifiable predictor of worse outcomes, future studies should examine the role of cachexia treatment before cancer surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

Not All Abdomens Are the Same: A Comparison of Damage Control Surgery for Intra-abdominal Sepsis versus Trauma.

Science.gov (United States)

Smith, Jason W; Nash, Nick; Procter, Levi; Benns, Matthew; Franklin, Glen A; Miller, Keith; Harbrecht, Brian G; Bernard, Andrew C

2016-05-01

Damage control surgery (DCS) was developed to manage exsanguinating trauma patients, but is increasingly applied to the management of peritoneal sepsis and abdominal catastrophes. Few manuscripts compare the outcomes of these surgeries on disparate patient populations. A multi-institutional three group propensity score matched case cohort study comparing penetrating trauma (PT-DCS), blunt trauma (BT-DCS), and intraperitoneal sepsis (IPS-DCS) was performed comparing patients treated with DSC between 2008 and 2013. Propensity scoring was performed using demographic and presenting physiologic data. Four hundred and twelve patients were treated with DCS across two institutions. Propensity matching for age, gender, and initial Acute Physiology and Chronic Health Evaluation II score 80 identified 80 patients per group for comparison. Rate of primary fascial closure was lowest in the IPS-DCS group, and highest in the penetrating trauma DCS group. Intra-abdominal complication rates were highest in the IPS-DCS group. IPS-DCS had increased time to definitive closure compared with the other two groups (RR 1.8; 1.3-2.2; P eight days were more than twice the risk of death at 90 days across all groups. (RR 2.15; 1.2-3.5; P managed via DCS.

Transoral endoscopic surgery versus conventional thoracoscopic surgery for thoracic intervention: safety and efficacy in a canine survival model.

Science.gov (United States)

Liu, Chien-Ying; Chu, Yen; Wu, Yi-Cheng; Yuan, Hsu-Chia; Ko, Po-Jen; Liu, Yun-Hen; Liu, Hui-Ping

2013-07-01

Transoral endoscopic surgery has been shown to be feasible and safe in both humans and animal models. The purpose of this study was to evaluate the safety and efficacy of transoral and conventional thoracoscopy for thoracic exploration, surgical lung biopsy, and pericardial window creation. The animals (n = 20) were randomly assigned to the transoral endoscopic approach group (n = 10) or conventional thoracoscopic approach group (n = 10). Transoral thoracoscopy was performed with a flexible bronchoscope via an incision over the vestibulum oris. In conventional thoracoscopy, access to the thoracic cavity was obtained through a thoracic incision. Surgical outcomes (body weight, operating time, operative complications, and time to resumption of normal diet), physiologic parameters (respiratory rate, body temperature), inflammatory parameters [white blood cell (WBC) counts and C-reactive protein (CRP)], and pulmonary parameters (arterial blood gases) were compared for both procedures. The surgical lung biopsy and pericardial window creation were successfully performed in all animals except one animal in the transoral group. There was no significant difference in operating times between the groups. The increase in WBC in the transoral thoracoscopy group was significantly smaller on postoperative day 1 than in the conventional thoracoscopy group (p = 0.0029). The transoral group had an earlier return to preoperative body temperature (p = 0.041) and respiratory rate (p = 0.045) on day 7. With respect to pulmonary parameters, there was no significant difference in blood pH, pCO2, or PaCO2 between the transoral and transthoracic groups. All animals survived without complications 14 days after surgery. This study demonstrated that the transoral approach was comparable to conventional thoracoscopic surgery for lung biopsy and pericardial window creation in terms of safety and efficacy.

The Effect of Metabolic and Bariatric Surgery on DNA Methylation Patterns.

Science.gov (United States)

Morcillo, Sonsoles; Macías-González, Manuel; Tinahones, Francisco J

2017-08-30

Metabolic and bariatric surgery (MBS) is considered to be the most effective treatment for obesity. Not only due to the significant weight reduction but also because of the many health benefits associated with it. In the last 5 years, several studies have suggested that epigenetic modifications could be involved in the mechanisms underlying the response to bariatric surgery. In this review, we will compile the different studies (2012-2017) concerning the effect of this surgical procedure on DNA methylation patterns (the most studied epigenetic marker) and its association with metabolic improvement. This is an emerging area, and currently, there are not many studies in the literature. The aim is to show what has been done so far and what the future direction in this emerging area might be. Recent findings have shown how metabolic and bariatric surgery modifies the DNA methylation profile of the specific genes associated with the pathophysiology of the disease. The studies were performed in morbidly obese subjects, mainly in women, with the aim of reducing weight and improving the obesity-associated comorbidities. DNA methylation has been measured both in specific tissue and in peripheral blood samples. In general, studies about site-specific DNA methylation have shown a change in the methylation profile after surgery, whereas the studies analyzing global DNA methylation are not so conclusive. Summing up, metabolic and bariatric surgery can modify the DNA methylation profile of different genes and contributes to the metabolic health benefits that are often seen after metabolic and bariatric surgery. Although there are still many issues to be resolved, the capacity to revert the DNA methylation profile of specific sites opens a window for searching for target markers to treat obesity-related comorbidities.

Can ammonia tolerance amongst lichen functional groups be explained by physiological responses?

International Nuclear Information System (INIS)

Munzi, S.; Cruz, C.; Branquinho, C.; Pinho, P.; Leith, I.D.; Sheppard, L.J.

2014-01-01

Ammonia (NH 3 ) empirical critical levels for Europe were re-evaluated in 2009, based mainly on the ecological responses of lichen communities without acknowledging the physiological differences between oligotrophic and nitrophytic species. Here, we compare a nitrogen sensitive lichen (Evernia prunastri) with a nitrogen tolerant one (Xanthoria parietina), focussing on their physiological response (Fv/Fm) to short-term NH 3 exposure and their frequency of occurrence along an NH 3 field gradient. Both frequency and Fv/Fm of E. prunastri decreased abruptly above 3 μg m −3 NH 3 suggesting direct adverse effects of NH 3 on its photosynthetic performance. By contrast, X. parietina increased its frequency with NH 3 , despite showing decreased capacity of photosystem II above 50 μg m −3 NH 3 , suggesting that the ecological success of X. parietina at ammonia-rich sites might be related to indirect effects of increased nitrogen (NH 3 ) availability. These results highlight the need to establish NH 3 critical levels based on oligotrophic lichen species. - Highlights: • Physiological response and ecological behavior were compared in two contrasting lichens. • NH 3 reduces Fv/Fm in both the N sensitive E. prunastri and the N tolerant X. parietina. • In the field frequency of occurrence correlated with NH 3 concentration. • NH 3 indirectly provides the nitrophytic X. parietina with ecological advantages. • Oligotrophs more accurately indicate increasing NH 3 concentrations than nitrophytes. - Physiological response to ammonia helps to explain lichen functional groups

Intravenous iron sucrose for treatment of anemia in gynecology patients awaiting surgery

OpenAIRE

Animesh Gandhi; Meena N. Satia

2016-01-01

Background: Anemia refers to reduction in the total circulatory erythrocyte mass which results in decrease in the oxygen carrying capacity of the blood. Patients who require a surgical intervention as regards their complaints are many a times denied fitness because of anemia. Current anesthetic and surgical practice ideally recommend a hemoglobin level of > 10 g/dl or a hematocrit of >30 % for any surgical intervention. Surgery is postponed until cause of anemia is identified and the anemia c...

Changes in Dietary Intake and Eating Behavior in Adolescents After Bariatric Surgery: an Ancillary Study to the Teen-LABS Consortium.

Science.gov (United States)

Sarwer, David B; Dilks, Rebecca J; Spitzer, Jacqueline C; Berkowitz, Robert I; Wadden, Thomas A; Moore, Renee H; Chittams, Jesse L; Brandt, Mary L; Chen, Mike K; Courcoulas, Anita P; Harmon, Carroll M; Helmrath, Michael A; Michalsky, Marc P; Xanthakos, Stavra A; Zeller, Meg H; Jenkins, Todd M; Inge, Thomas H

2017-12-01

A growing number of studies suggest that bariatric surgery is safe and effective for adolescents with severe obesity. However, surprisingly little is known about changes in dietary intake and eating behavior of adolescents who undergo bariatric surgery. Investigate changes in dietary intake and eating behavior of adolescents with obesity who underwent bariatric surgery (n = 119) or lifestyle modification (LM) (n = 169). University-based health systems METHODS: A prospective investigation of 288 participants (219 female and 69 male) prior to bariatric surgery or LM and again 6, 12, and 24 months (surgery patients only) after treatment. Measures included changes in weight, macronutrient intake, eating behavior, and relevant demographic and physiological variables. Adolescents who underwent bariatric surgery experienced significantly greater weight loss than those who received LM. The two groups differed in self-reported intake of a number of macronutrients at 6 and 12 months from baseline, but not total caloric intake. Patients treated with surgery, compared to those treated with LM, also reported significantly greater reductions in a number of disordered eating symptoms. After bariatric surgery, greater weight loss from postoperative month 6 to 12 was associated with self-reported weight consciousness, craving for sweets, and consumption of zinc. Adolescents who underwent bariatric surgery, compared to those who received LM, reported significantly greater reductions in weight after 1 year. They also reported greater reductions in disordered eating symptoms. These findings provide new information on changes in dietary intake and eating behavior among adolescents who undergo bariatric surgery.

Do physiological measures predict selected CrossFit(®) benchmark performance?

Science.gov (United States)

Butcher, Scotty J; Neyedly, Tyler J; Horvey, Karla J; Benko, Chad R

2015-01-01

CrossFit(®) is a new but extremely popular method of exercise training and competition that involves constantly varied functional movements performed at high intensity. Despite the popularity of this training method, the physiological determinants of CrossFit performance have not yet been reported. The purpose of this study was to determine whether physiological and/or muscle strength measures could predict performance on three common CrossFit "Workouts of the Day" (WODs). Fourteen CrossFit Open or Regional athletes completed, on separate days, the WODs "Grace" (30 clean and jerks for time), "Fran" (three rounds of thrusters and pull-ups for 21, 15, and nine repetitions), and "Cindy" (20 minutes of rounds of five pull-ups, ten push-ups, and 15 bodyweight squats), as well as the "CrossFit Total" (1 repetition max [1RM] back squat, overhead press, and deadlift), maximal oxygen consumption (VO2max), and Wingate anaerobic power/capacity testing. Performance of Grace and Fran was related to whole-body strength (CrossFit Total) (r=-0.88 and -0.65, respectively) and anaerobic threshold (r=-0.61 and -0.53, respectively); however, whole-body strength was the only variable to survive the prediction regression for both of these WODs (R (2)=0.77 and 0.42, respectively). There were no significant associations or predictors for Cindy. CrossFit benchmark WOD performance cannot be predicted by VO2max, Wingate power/capacity, or either respiratory compensation or anaerobic thresholds. Of the data measured, only whole-body strength can partially explain performance on Grace and Fran, although anaerobic threshold also exhibited association with performance. Along with their typical training, CrossFit athletes should likely ensure an adequate level of strength and aerobic endurance to optimize performance on at least some benchmark WODs.

Do physiological measures predict selected CrossFit® benchmark performance?

Science.gov (United States)

Butcher, Scotty J; Neyedly, Tyler J; Horvey, Karla J; Benko, Chad R

2015-01-01

Purpose CrossFit® is a new but extremely popular method of exercise training and competition that involves constantly varied functional movements performed at high intensity. Despite the popularity of this training method, the physiological determinants of CrossFit performance have not yet been reported. The purpose of this study was to determine whether physiological and/or muscle strength measures could predict performance on three common CrossFit “Workouts of the Day” (WODs). Materials and methods Fourteen CrossFit Open or Regional athletes completed, on separate days, the WODs “Grace” (30 clean and jerks for time), “Fran” (three rounds of thrusters and pull-ups for 21, 15, and nine repetitions), and “Cindy” (20 minutes of rounds of five pull-ups, ten push-ups, and 15 bodyweight squats), as well as the “CrossFit Total” (1 repetition max [1RM] back squat, overhead press, and deadlift), maximal oxygen consumption (VO2max), and Wingate anaerobic power/capacity testing. Results Performance of Grace and Fran was related to whole-body strength (CrossFit Total) (r=−0.88 and −0.65, respectively) and anaerobic threshold (r=−0.61 and −0.53, respectively); however, whole-body strength was the only variable to survive the prediction regression for both of these WODs (R2=0.77 and 0.42, respectively). There were no significant associations or predictors for Cindy. Conclusion CrossFit benchmark WOD performance cannot be predicted by VO2max, Wingate power/capacity, or either respiratory compensation or anaerobic thresholds. Of the data measured, only whole-body strength can partially explain performance on Grace and Fran, although anaerobic threshold also exhibited association with performance. Along with their typical training, CrossFit athletes should likely ensure an adequate level of strength and aerobic endurance to optimize performance on at least some benchmark WODs. PMID:26261428

The Role of Clitoral Anatomy in Female to Male Sex Reassignment Surgery

Directory of Open Access Journals (Sweden)

Vojkan Vukadinovic

2014-01-01

Full Text Available Introduction. Controversies on clitoral anatomy and its role in female sexual function still make clitoral reconstructive surgery very challenging. We evaluated the role of clitoral anatomic features in female to male sex reassignment surgery. Material and Methods. The study included 97 female transsexuals, aged from 18 to 41 years, who underwent single stage metoidioplasty between March 2008 and January 2013. The operative technique involved vaginectomy, the release of clitoral ligaments and urethral plate, urethroplasty by combining buccal mucosa graft and genital flaps, and scrotoplasty with insertion of testicle prostheses. Postoperative questionnaire was used to evaluate aesthetic, functional, and sexual outcome. Results. The mean followup was 30 months. The mean length of the neophallus was 7 cm, compared to mean preoperative length of the hypertrophied clitoris of 3.3 cm. Complications occurred in 27.84% of all patients, related mostly to urethroplasty. Voiding while standing was achieved in all cases. None of the patients had problems in sexual arousal, masturbation, or orgasms. Conclusion. Accurate knowledge of the clitoral anatomy, physiology, and neurovascular supply is crucial for a successful outcome of female to male sex reassignment surgery. Our approach appears to ensure overall satisfaction and high quality of sexual life.

Ocean warming and acidification: Unifying physiological principles linking organism response to ecosystem change?

Science.gov (United States)

Pörtner, H. O.; Bock, C.; Lannig, G.; Lucassen, M.; Mark, F. C.; Stark, A.; Walther, K.; Wittmann, A.

2011-12-01

The effects of ocean warming and acidification on individual species of marine ectothermic animals may be based on some common denominators, i.e. physiological responses that can be assumed to reflect unifying principles, common to all marine animal phyla. Identification of these principles requires studies, which reach beyond the species-specific response, and consider multiple stressors, for example temperature, CO2 or extreme hypoxia. Analyses of response and acclimation include functional traits of physiological performance on various levels of biological organisation, from changes in the transcriptome to patterns of acid-base regulation and whole animal thermal tolerance. Conclusions are substantiated by comparisons of species and phyla from temperate, Arctic and Antarctic ecosystems and also benefit from the interpretation of paleo-patterns based on the use of a unifying physiological concept, suitable to integrate relevant environmental factors into a more comprehensive picture. Studying the differential specialization of animals on climate regimes and their sensitivity to climate leads to improved understanding of ongoing and past ecosystem change and should then support more reliable projections of future scenarios. For example, accumulating CO2 causes disturbances in acid-base status. Resilience to ocean acidification may be reflected in the capacity to compensate for these disturbances or their secondary effects. Ion and pH regulation comprise thermally sensitive active and passive transfer processes across membranes. Specific responses of ion transporter genes and their products to temperature and CO2 were found in fish, crustaceans and bivalves. However, compensation may cause unfavourable shifts in energy budget and beyond that hamper cellular and mitochondrial metabolism, which are directly linked to the animal's aerobic performance window. In crabs, oysters and, possibly, fishes, a narrowing of the thermal window is caused by moderate increases in

Pain and cardiorespiratory responses of children during physiotherapy after heart surgery

Directory of Open Access Journals (Sweden)

Adriana Sanches Garcia Araujo

2014-04-01

Full Text Available Objective: The aim of the present study was to determine the occurrence of pain and changes in blood pressure, heart rate, respiratory rate, and arterial oxygen saturation associated with physiotherapy in children undergoing cardiac surgery. Methods: Eighteen extubated children were assessed for the presence of pain using the face, legs, activity, cry, consolability scale, and blood pressure, heart rate, respiratory rate and arterial oxygen saturation were simultaneously recorded. The physiological parameters were measured at the following time periods: immediately before physiotherapy, five and 10 minutes after the beginning of physiotherapy, and five minutes after its end. Pain was assessed immediately before physiotherapy, ten minutes after the beginning of physiotherapy and five minutes after its end. Pain and physiological changes were assessed by the Friedman test and the correlation between the physiological parameters and the pain scores was assessed by the Spearman test. Results: Pain increased during physiotherapy and decreased significantly after it compared to pre-physiotherapy scores. Systolic blood pressure and heart rate increased significantly after 10 minutes of the beginning of physiotherapy. Arterial oxygen saturation tended to decrease during physiotherapy and to increase after it, although without significance. The correlation between pain scores and the physiological variables was significant only for systolic blood pressure and heart rate ten minutes after the beginning of physiotherapy. Conclusion: Manipulation after the beginning of physiotherapy seems to be accompanied by significant pain and by important associated cardiovascular changes. Apparent analgesia and improved respiratory function were observed after respiratory physiotherapy.

Carotid artery surgery

Science.gov (United States)

Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

Mitochondrial respiratory capacity remains stable despite a comprehensive and sustained increase in insulin sensitivity in obese patients undergoing gastric bypass surgery

DEFF Research Database (Denmark)

Lund, M T; Larsen, S; Hansen, M

2018-01-01

will correlate with a corresponding change in mitochondrial respiratory capacity over the same time period. METHODS: Insulin sensitivity was evaluated using the hyperinsulinaemic-euglycaemic clamp technique, and skeletal muscle mitochondrial respiratory capacity was evaluated by high-resolution respirometry...

Acid-base buffering in organ preservation solutions as a function of temperature: new parameters for comparing buffer capacity and efficiency.

Science.gov (United States)

Baicu, Simona C; Taylor, Michael J

2002-08-01

Control of acidity and preventing intracellular acidosis are recognized as critical properties of an effective organ preservation solution. Buffer capacity and efficiency are therefore important for comparing the relative merits of preservation fluids for optimum hypothermic storage, but these parameters are not available for the variety of organ preservation solutions of interest in transplantation today. Moreover, buffer capacity is dependent upon both concentration and pH such that buffer capacity is not easily predicted for a complex solution containing multiple buffer species. Using standard electrometric methods to measure acid dissociation constants, this study was undertaken to determine the maximum and relative buffer capacities of a variety of new and commonly used hypothermic preservation solutions as a function of temperature. The reference data provided by these measurements show that comparative buffer capacity and efficiency vary widely between the commonly used solutions. Moreover, the fluids containing zwitterionic sulfonic acid buffers such as Hepes possess superior buffering for alpha-stat pH regulation in the region of physiological importance.

Lung surgery - discharge

Science.gov (United States)

... Lung biopsy - discharge; Thoracoscopy - discharge; Video-assisted thoracoscopic surgery - discharge; VATS - discharge ... milk) for 2 weeks after video-assisted thoracoscopic surgery and 6 to 8 weeks after open surgery. ...

Physiological Importance and Mechanisms of Protein Hydrolysate Absorption

Science.gov (United States)

Zhanghi, Brian M.; Matthews, James C.

Understanding opportunities to maximize the efficient digestion and assimilation by production animals of plant- and animal-derived protein products is critical for farmers, nutritionists, and feed manufacturers to sustain and expand the affordable production of high quality animal products for human consumption. The challenge to nutritionists is to match gastrointestinal tract load to existing or ­inducible digestive and absorptive capacities. The challenge to feed manufacturers is to develop products that are efficient substrates for digestion, absorption, and/or both events. Ultimately, the efficient absorption of digesta proteins depends on the mediated passage (transport) of protein hydrosylate products as dipeptides and unbound amino acids across the lumen- and blood-facing membranes of intestinal absorptive cells. Data testing the relative efficiency of supplying protein as hydrolysates or specific dipeptides versus as free amino acids, and the response of animals in several physiological states to feeding of protein hydrolysates, are presented and reviewed in this chapter. Next, data describing the transport mechanisms responsible for absorbing protein hydrolysate digestion products, and the known and putative regulation of these mechanisms by their substrates (small peptides) and hormones are presented and reviewed. Several conclusions are drawn regarding the efficient use of protein hydrolysate-based diets for particular physiological states, the economically-practical application of which likely will depend on technological advances in the manufacture of protein hydrolysate products.

Gastroenterological surgery for patients with chronic respiratory insufficiency.

Science.gov (United States)

Shimada, M; Kano, T; Matsuzaki, Y; Miyazaki, N; Ninomiya, K

1998-01-01

The aim of this study was to clarify the surgical indications for patients with chronic respiratory insufficiency. Fourteen patients with chronic respiratory insufficiency who underwent abdominal surgical procedures, were retrospectively studied. The surgical indications were carefully determined based primarily on the performance status (PS) of each patient and cardiopulmonary function tests. A PS of equal to or less than 3, which meant the patient's status required bed rest > 50% of the time, and the need for assistance in performing normal activities were all factors considered for surgical indications. During the period studied, two patients were excluded from the surgical indications due to the fact that one was at a terminal stage of pulmonary disease and was completely bedridden (PS = 4), while the other demonstrated active pneumonia with a considerable amount of purulent sputa. Regarding the pulmonary function tests for patients who underwent surgery, the lowest limits of those examinations were as follows: 810 ml of vital capacity (VC), 23.8% of predicted VC, 610 ml of forced expiratory volume in one second (FEV1.0), 38.6% of predicted FEV1.0, 50.5 mmHg of PaO2 while inhaling 4 liters of oxygen and 73.8 mmHg of PaCO2. No surgery related mortality or hospital death within 30 days after operation was observed. Only two patients had cardiopulmonary complications (consisting of pulmonary edema with atrial fibrillation in one patient, and acute myocardial infarction in another patient). However, neither pneumonia, prolonged ventilatory support for more than 2 days, nor the need for a tracheostomy after surgery was observed. Gastroenterological surgery is thus considered to be indicated even for patients with chronic respiratory insufficiency, as long as the PS can be maintained (PS of equal to or less than 3) and no active pneumonia with a considerable amount of purulent sputa is present.

Physiological responses of genotypes soybean to simulated drought stress

Directory of Open Access Journals (Sweden)

Eleonóra Krivosudská

2016-12-01

Full Text Available The objective of this research was to investigate possible genetic variation in the sensitivity of soybean cultivars for nitrogen fixation rates in response to soil drying. The work confirmed that the selected physiological characteristics (RWC, osmotic potential, stress index and created nodules on roots are good evaluating parameters for the determination of water stress in plant. In the floricultural year 2014 an experiment with four genetic resources of soybean was launched. Sowing of Maverick (USA, Drina (HRV, Nigra (SVK and Polanka (CZK genotypes was carried out in the containers of 15 l capacity. This stress had a negative impact on the physiological parameters. By comparing the RWC values, the decrease was more significant at the end of dehydration, which was monitored in Maverick and Drina genotypes using the Nitrazon inoculants and water stress effect. Inoculated stressed Nigra and Polanka genotypes have kept higher water content till the end of dehydration period. Also the proline accumulation was monitored during the water stress, whilst higher content of free proline reached of Maverick. More remarkable decrease of osmotic potential was again registered in a foreign Drina and Maverick genotypes in the inoculated variations. Nigra and Polanka genotypes responses not so significant in the given conditions.

Capacity of small groups of muscles to accomplish precision grasping tasks.

Science.gov (United States)

Towles, Joseph D; Valero-Cuevas, Francisco J; Hentz, Vincent R

2013-01-01

An understanding of the capacity or ability of various muscle groups to generate endpoint forces that enable grasping tasks could provide a stronger biomechanical basis for the design of reconstructive surgery or rehabilitation for the treatment of the paralyzed or paretic hand. We quantified two-dimensional endpoint force distributions for every combination of the muscles of the index finger, in cadaveric specimens, to understand the capability of muscle groups to produce endpoint forces that accomplish three common types of grasps-tripod, tip and lateral pinch-characterized by a representative level of Coulomb friction. We found that muscle groups of 4 or fewer muscles were capable of generating endpoint forces that enabled performance of each of the grasping tasks examined. We also found that flexor muscles were crucial to accomplish tripod pinch; intrinsic muscles, tip pinch; and the dorsal interosseus muscle, lateral pinch. The results of this study provide a basis for decision making in the design of reconstructive surgeries and rehabilitation approaches that attempt to restore the ability to perform grasping tasks with small groups of muscles.

Dual-radionuclide simultaneous gastric emptying and bile transit study after gastric surgery with double-tract reconstruction

International Nuclear Information System (INIS)

Nakajima, Kenichi; Kawano, Masaya; Kinami, Shinichi; Fujimura, Takashi; Miwa, Koichi; Tonami, Norihisa

2005-01-01

The physiology of gastrointestinal transfer function after proximal gastrectomy with bypass-tract reconstruction is not well understood. We applied a simultaneous dual-radionuclide method with a hepatobiliary imaging and gastric emptying study to evaluate physiologic alterations occurring after surgery. Nineteen patients with early gastric cancer, including 9 preoperative control patients and 10 who had proximal gastrectomy and double-tract reconstruction surgery were examined by dual-radionuclide hepatobiliary and gastric emptying studies ( 99m Tc PMT and 111 In DTPA). Retention fraction in the stomach at 3 minutes (R3) and 60 minutes (R60) and gastric emptying half-time (GET) were calculated. Bile reflux and mixture of bile and food were also evaluated. The retention fractions of R3 and R60 were significantly lower in the double-tract reconstruction group than those in the preoperative group. GET differed significantly between the double-tract and preoperative groups (20.7 min±7.1 min and 36.2 min±11.0 min, p=0.0018). The mixture of bile and food was not good in the double-tract reconstruction group (p=0.014 vs. preoperative). Patients with a large residual stomach showed slower initial emptying (p=0.0068) and a better mixture of bile and food (p=0.058) compared to those with a small residual stomach. The bile reflux was not significantly increased after surgery. The dual-radionuclide gastrointestinal and hepatobiliary imaging was feasible and could demonstrate characteristic transit patterns of the foods and bile in the double-tract reconstruction procedure. A larger residual stomach, if possible, is desirable to provide better transfer and mixing of bile and foods. (author)

Enhanced Recovery After Surgery Protocols in Major Urologic Surgery

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Natalija Vukovic

2018-04-01

Full Text Available The purpose of the reviewThe analysis of the components of enhanced recovery after surgery (ERAS protocols in urologic surgery.Recent findingsERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%. Several clinical pathways were introduced to improve perioperative course and reduce the length of hospital stay. These protocols differ from ERAS modalities in other surgeries. The reasons for this are longer operative time, increased risk of perioperative transfusion and infection, and urinary diversion achieved using transposed intestinal segments. Previous studies in this area analyzed the need for mechanical bowel preparation, postoperative nasogastric tube decompression, as well as the duration of urinary drainage. Furthermore, the attention has also been drawn to perioperative fluid optimization, pain management, and bowel function.SummaryNotwithstanding partial resemblance between the pathways in major urologic surgery and other pelvic surgeries, there are still scarce guidelines for ERAS protocols in urology, which is why further studies should assess the importance of preoperative medical optimization, implementation of thoracic epidural anesthesia and analgesia, and perioperative nutritional management.

Applications of piezoelectric surgery in endodontic surgery: a literature review.

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Abella, Francesc; de Ribot, Joan; Doria, Guillermo; Duran-Sindreu, Fernando; Roig, Miguel

2014-03-01

Piezosurgery (piezoelectric bone surgery) devices were developed to cut bone atraumatically using ultrasonic vibrations and to provide an alternative to the mechanical and electrical instruments used in conventional oral surgery. Indications for piezosurgery are increasing in oral and maxillofacial surgery, as in other disciplines, such as endodontic surgery. Key features of piezosurgery instruments include their ability to selectively cut bone without damaging adjacent soft tissue, to provide a clear operative field, and to cut without generating heat. Although piezosurgery instruments can be used at most stages of endodontic surgery (osteotomy, root-end resection, and root-end preparation), no published data are available on the effect of piezosurgery on the outcomes of endodontic surgery. To our knowledge, no study has evaluated the effect of piezosurgery on root-end resection, and only 1 has investigated root-end morphology after retrograde cavity preparation using piezosurgery. We conducted a search of the PubMed and Cochrane databases using appropriate terms and keywords related to the use and applications of piezoelectric surgery in endodontic surgery. A hand search also was conducted of issues published in the preceding 2 years of several journals. Two independent reviewers obtained and analyzed the full texts of the selected articles. A total of 121 articles published between January 2000 and December 2013 were identified. This review summarizes the operating principles of piezoelectric devices and outlines the applications of piezosurgery in endodontic surgery using clinical examples. Piezosurgery is a promising technical modality with applications in several aspects of endodontic surgery, but further studies are necessary to determine the influence of piezosurgery on root-end resection and root-end preparation. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Corynebacterium glutamicum for Sustainable Bioproduction: From Metabolic Physiology to Systems Metabolic Engineering.

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Becker, Judith; Gießelmann, Gideon; Hoffmann, Sarah Lisa; Wittmann, Christoph

Since its discovery 60 years ago, Corynebacterium glutamicum has evolved into a workhorse for industrial biotechnology. Traditionally well known for its remarkable capacity to produce amino acids, this Gram-positive soil bacterium, has become a flexible, efficient production platform for various bulk and fine chemicals, materials, and biofuels. The central turnstile of all these achievements is our excellent understanding of its metabolism and physiology. This knowledge base, together with innovative systems metabolic engineering concepts, which integrate systems and synthetic biology into strain engineering, has upgraded C. glutamicum into one of the most successful industrial microorganisms in the world.

Penile venous surgery for treating erectile dysfunction: Past, present, and future perspectives with regard to new insights in venous anatomy

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Cheng-Hsing Hsieh

2016-06-01

Full Text Available In the physiologic model of normal erectile function, a healthy veno-occlusive mechanism is essential to initiate and maintain a rigid erection. The surgical treatment of patients with venous leakage, which is synonymous with corporoveno-occlusive dysfunction (CVOD, was based on the decreased venous outflow during the erection process. The initial reports of short-term results were promising, but the long-term benefits of penile venous ligation surgery were limited. Most clinical guideline panels concluded that surgeries performed in an attempt to limit the venous outflow of the penis were not recommended. Consequently, this surgery was nearly abandoned in most medical societies worldwide. These unfavorable postoperative outcomes seemed attributable to the indispensable usage of electrocautery and insufficient venous management, based on conventional penile venous anatomy. Advances in better understanding of human penile venous anatomy has enabled the development of refined penile venous stripping surgery. The thorough stripping surgery is an even more radical procedure, which is an even more radical procedure, and seems to be a viable option for the treatment of CVOD, however, there is still a need for further study with well-defined diagnostic criteria, and standardized patient and partner outcome assessment.

Postoperative Pulmonary Dysfunction and Mechanical Ventilation in Cardiac Surgery

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Rafael Badenes

2015-01-01

Full Text Available Postoperative pulmonary dysfunction (PPD is a frequent and significant complication after cardiac surgery. It contributes to morbidity and mortality and increases hospitalization stay and its associated costs. Its pathogenesis is not clear but it seems to be related to the development of a systemic inflammatory response with a subsequent pulmonary inflammation. Many factors have been described to contribute to this inflammatory response, including surgical procedure with sternotomy incision, effects of general anesthesia, topical cooling, and extracorporeal circulation (ECC and mechanical ventilation (VM. Protective ventilation strategies can reduce the incidence of atelectasis (which still remains one of the principal causes of PDD and pulmonary infections in surgical patients. In this way, the open lung approach (OLA, a protective ventilation strategy, has demonstrated attenuating the inflammatory response and improving gas exchange parameters and postoperative pulmonary functions with a better residual functional capacity (FRC when compared with a conventional ventilatory strategy. Additionally, maintaining low frequency ventilation during ECC was shown to decrease the incidence of PDD after cardiac surgery, preserving lung function.

Abnormal lung gallium-67 uptake preceding pulmonary physiologic impairment in an asymptomatic patient with Pneumocystis carinii pneumonia

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Reiss, T.F.; Golden, J.

1990-01-01

Pneumocystis carinii pneumonia was suggested by a diffuse, bilateral pulmonary uptake of gallium-67 in an asymptomatic, homosexual male with the antibody to the immunodeficiency virus (HIV) who was undergoing staging evaluation for lymphoma clinically localized to a left inguinal lymph node. Chest radiograph and pulmonary function evaluation, including lung volumes, diffusing capacity and arterial blood gases, were within normal limits. Bronchoalveolar lavage revealed Pneumocystis carinii organisms. In this asymptomatic, HIV-positive patient, active alveolar infection, evidenced by abnormal gallium-67 scanning, predated pulmonary physiologic abnormalities. This observation raises questions concerning the natural history of this disease process and the specificity of physiologic tests for excluding disease. It also has implications for the treatment of neoplasia in the HIV-positive patient population

Psycho-Physiological Associates of Dyspnea in Hospitalized Patients with Interstitial Lung Diseases: A Cross-Sectional Study.

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Zhou, Yan Hua; Mak, Yim Wah

2017-10-24

Dyspnea has been found to be an independent predictor of mortality among patients with respiratory diseases and is often regarded as a difficult symptom to control in patients with interstitial lung diseases (ILDs). Previous studies have found an association of psychological and physiological factors with dyspnea among patients with chronic obstructive airway diseases. However, symptom management of hospitalized patients with ILDs has been hampered by difficulty in priority, since they are often admitted with multiple psycho-physiological needs. This study examined the prevalence of dyspnea and the psycho-physiological factors associated with it among hospitalized Chinese patients with ILDs. We studied 165 hospitalized patients with ILDs recruited consecutively over three months in a public hospital in Guangzhou, China. Dyspnea and common psycho-physiological factors, including cough symptoms, activity capacity, lung function, physical and mental health status, and anxiety and depression symptoms, were measured. By ordered logistic regression, level of dyspnea statistically significantly affected performance in a six-minute walk test and physical functioning in work or other regular daily activities in hospitalized patients with ILDs. Respiratory rehabilitation with an appropriate intensity of exercise training or other strategies for enhancing the physical functioning of this population with moderate and severe levels of dyspnea should be prioritized.

Age-dependent leaf physiology and consequences for crown-scale carbon uptake during the dry season in an Amazon evergreen forest.

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Albert, Loren P; Wu, Jin; Prohaska, Neill; de Camargo, Plinio Barbosa; Huxman, Travis E; Tribuzy, Edgard S; Ivanov, Valeriy Y; Oliveira, Rafael S; Garcia, Sabrina; Smith, Marielle N; Oliveira Junior, Raimundo Cosme; Restrepo-Coupe, Natalia; da Silva, Rodrigo; Stark, Scott C; Martins, Giordane A; Penha, Deliane V; Saleska, Scott R

2018-03-04

Satellite and tower-based metrics of forest-scale photosynthesis generally increase with dry season progression across central Amazônia, but the underlying mechanisms lack consensus. We conducted demographic surveys of leaf age composition, and measured the age dependence of leaf physiology in broadleaf canopy trees of abundant species at a central eastern Amazon site. Using a novel leaf-to-branch scaling approach, we used these data to independently test the much-debated hypothesis - arising from satellite and tower-based observations - that leaf phenology could explain the forest-scale pattern of dry season photosynthesis. Stomatal conductance and biochemical parameters of photosynthesis were higher for recently mature leaves than for old leaves. Most branches had multiple leaf age categories simultaneously present, and the number of recently mature leaves increased as the dry season progressed because old leaves were exchanged for new leaves. These findings provide the first direct field evidence that branch-scale photosynthetic capacity increases during the dry season, with a magnitude consistent with increases in ecosystem-scale photosynthetic capacity derived from flux towers. Interactions between leaf age-dependent physiology and shifting leaf age-demographic composition are sufficient to explain the dry season photosynthetic capacity pattern at this site, and should be considered in vegetation models of tropical evergreen forests. © 2018 The Authors. New Phytologist © 2018 New Phytologist Trust.

Evidence or eminence in abdominal surgery: Recent improvements in perioperative care

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Segelman, Josefin; Nygren, Jonas

2014-01-01

Repeated surveys from Europe, the United States, Australia, and New Zealand have shown that adherence to an evidence-based perioperative care protocol, such as Enhanced Recovery After Surgery (ERAS), has been generally low. It is of great importance to support the implementation of the ERAS protocol as it has been shown to improve outcomes after a number of surgical procedures, including major abdominal surgery. However, despite an increasing awareness of the importance of structured perioperative management, the implementation of this complex protocol has been slow. Barriers to implementation involve both patient- and staff-related factors as well as practice-related issues and resources. To support efficient and successful implementation, further educational and structural measures have to be made on a national or regional level to improve the standard of general health care. Besides postoperative morbidity, biological and physiological variables have been quite commonly reported in previous ERAS studies. Little information, however, has been obtained on cost-effectiveness, long-term outcomes, quality of life and patient-related outcomes, and these issues remain important areas of research for future studies. PMID:25469030

Patient Safety in Spine Surgery: Regarding the Wrong-Site Surgery

OpenAIRE

Lee, Seung-Hwan; Kim, Ji-Sup; Jeong, Yoo-Chul; Kwak, Dae-Kyung; Chun, Ja-Hae; Lee, Hwan-Mo

2013-01-01

Patient safety regarding wrong site surgery has been one of the priority issues in surgical fields including that of spine care. Since the wrong-side surgery in the DM foot patient was reported on a public mass media in 1996, the wrong-site surgery issue has attracted wide public interest as regarding patient safety. Despite the many wrong-site surgery prevention campaigns in spine care such as the operate through your initial program by the Canadian Orthopaedic Association, the sign your sit...

Dental Implant Surgery

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... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ... to find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring ...

Late Onset of CSF Rhinorrhea in a Postoperative Transsphenoidal Surgery Patient Following Robotic-Assisted Abdominal Hysterectomy

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Justin T. Dowdy MD

2014-01-01

Full Text Available Cerebrospinal fluid (CSF leak is the most commonly encountered perioperative complication in transsphenoidal surgery for pituitary lesions. Direct closure with a combination of autologous fat, local bone, and/or synthetic grafts remains the standard of care for leaks encountered at the time of surgery as well as postoperatively. The development of the vascularized nasoseptal flap as a closure technique has increased the surgeon’s capacity to correct even larger openings in the dura of the sella as well as widely exposed anterior skull base defects. Yet these advances in the technical nuances for management of post-transsphenoidal CSF leak are useless without the ability to recognize a CSF leak by physical examination, clinical history, biochemical testing, or radiographic assessment. Here, we report a case of a patient who developed a CSF leak 28 years after transsphenoidal surgery, precipitated by a robotic-assisted hysterectomy during which increased intra-abdominal pressure and steep Trendelenberg positioning were both factors. Given the remote nature of the patient’s transsphenoidal surgery and relative paucity of data regarding such a complication, the condition went unrecognized for several months. We review the available literature regarding risk and pathophysiology of CSF leak following abdominal surgery and propose the need for increased vigilance in identification of such occurrences with the increasing acceptance and popularity of minimally invasive abdominal and pelvic surgeries as standards in the field.

Exercise capacity is associated with endothelin-1 release during emotional excitement in coronary artery disease patients.

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Tulppo, Mikko P; Piira, Olli-Pekka; Hautala, Arto J; Kiviniemi, Antti M; Miettinen, Johanna A; Huikuri, Heikki V

2014-08-01

Endothelin-1 (ET-1), a potent vasoconstrictor, IL-6, and catecholamines are increased and heart rate variability [SD of normal to normal R-R intervals (SDNN)] decreased during emotional excitement, but individual responses vary. We tested the hypothesis that exercise capacity is associated with physiological responses caused by real-life emotional excitement. We measured the plasma levels of ET-1, IL-6, catecholamines, heart rate, and SDNN in enthusiastic male ice hockey spectators (n = 51; age, 59 ± 9 years) with stable coronary artery disease (CAD) at baseline and during the Finnish National Ice Hockey League's final play-off matches. Maximal exercise capacity (METs) by bicycle exercise test and left ventricular ejection fraction (LVEF) were measured on a separate day. ET-1 response from baseline to emotional excitement correlated with maximal METs (r = -0.30; P = 0.040). In a linear stepwise regression analysis age, body mass index (BMI), METs, LVEF, basal ET-1, and subjective experience of excitement were entered the model as independent variables to explain ET-1 response. This model explained 27% of ET-1 response (P = 0.003). Maximal METs were most strongly correlated with ET-1 response (β = -0.45; partial correlation r = -0.43; P = 0.002), followed by BMI (β = -0.31; partial correlation r = -0.31; P = 0.033) and LVEF (β = -0.30; partial correlation r = -0.33; P = 0.023). Exercise capacity may protect against further cardiovascular events in CAD patients, because it is associated with reduced ET-1 release during emotional excitement. Copyright © 2014 the American Physiological Society.

Clinical Review: Management of weaning from cardiopulmonary bypass after cardiac surgery

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Marc Licker

2012-01-01

Full Text Available A sizable number of cardiac surgical patients are difficult to wean off cardiopulmonary bypass (CPB as a result of structural or functional cardiac abnormalities, vasoplegic syndrome, or ventricular dysfunction. In these cases, therapeutic decisions have to be taken quickly for successful separation from CPB. Various crisis management scenarios can be anticipated which emphasizes the importance of basic knowledge in applied cardiovascular physiology, knowledge of pathophysiology of the surgical lesions as well as leadership, and communication between multiple team members in a high-stakes environment. Since the mid-90s, transoesophageal echocardiography has provided an opportunity to assess the completeness of surgery, to identify abnormal circulatory conditions, and to guide specific medical and surgical interventions. However, because of the lack of evidence-based guidelines, there is a large variability regarding the use of cardiovascular drugs and mechanical circulatory support at the time of weaning from the CPB. This review presents key features for risk stratification and risk modulation as well as a standardized physiological approach to achieve successful weaning from CPB.

STUDY OF PHYSIOLOGICAL PROFILE OF INDIAN BOXERS

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Gulshan Lal Khanna

2006-07-01

Full Text Available The present study was conducted to study the morphological, physiological and biochemical characteristics of Indian National boxers as well as to assess the cardiovascular adaptation to graded exercise and actual boxing round. Two different studies were conducted. In the first study [N = 60, (junior boxers below-19 yrs, n = 30, (senior boxers-20-25 yrs, n = 30] different morphological, physiological and biochemical parameters were measured. In the second study (N = 21, Light Weight category- <54 kg, n = 7; Medium weight category <64 kg, n = 7 and Medium heavy weight category <75 kg, n = 7 cardiovascular responses were studied during graded exercise protocol and actual boxing bouts. Results showed a significantly higher (p < 0.05 stature, body mass, LBM, body fat and strength of back and grip in senior boxers compared to juniors. Moreover, the senior boxers possessed mesomorphic body conformation where as the juniors' possessed ectomorphic body conformation. Significantly lower (p < 0.05 aerobic capacity and anaerobic power were noted in junior boxers compared to seniors. Further, significantly higher (p < 0.05 maximal heart rates and recovery heart rates were observed in the seniors as compared to the juniors. Significantly higher maximum heart rates were noted during actual boxing compared to graded exercise. Blood lactate concentration was found to increase with the increase of workload during both graded exercise and actual boxing round. The senior boxers showed a significantly elevated (p < 0.05 levels of hemoblobin, blood urea, uric acid and peak lactate as compared to junior boxers. In the senior boxers significantly lower levels of total cholesterol, triglyceride and LDLC were observed as compared to junior boxers. No significant change has been noted in HDLC between the groups. The age and level of training in boxing has significant effect on Aerobic, anaerobic component. The study of physiological responses during graded exercise

Corrective Jaw Surgery

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Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

Hip Replacement Surgery

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... Outreach Initiative Breadcrumb Home Health Topics English Español Hip Replacement Surgery Basics In-Depth Download Download EPUB ... PDF What is it? Points To Remember About Hip Replacement Surgery Hip replacement surgery removes damaged or ...

Mathematical physiology

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Sneyd, James

2009-01-01

There has been a long history of interaction between mathematics and physiology. This book looks in detail at a wide selection of mathematical models in physiology, showing how physiological problems can be formulated and studied mathematically, and how such models give rise to interesting and challenging mathematical questions. With its coverage of many recent models it gives an overview of the field, while many older models are also discussed, to put the modern work in context. In this second edition the coverage of basic principles has been expanded to include such topics as stochastic differential equations, Markov models and Gibbs free energy, and the selection of models has also been expanded to include some of the basic models of fluid transport, respiration/perfusion, blood diseases, molecular motors, smooth muscle, neuroendrocine cells, the baroreceptor loop, turboglomerular oscillations, blood clotting and the retina. Owing to this extensive coverage, the second edition is published in two volumes. ...

Enhanced Recovery After Surgery: The Plastic Surgery Paradigm Shift.

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Bartlett, Erica L; Zavlin, Dmitry; Friedman, Jeffrey D; Abdollahi, Aariane; Rappaport, Norman H

2017-12-14

With a focus on providing high quality care and reducing facility based expenses there has been an evolution in perioperative care by way of enhanced recovery after surgery (ERAS). ERAS allows for a multidisciplinary and multimodal approach to perioperative care which not only expedites recovery but maximizes patient outcomes. This paradigm shift has been generally accepted by most surgical specialties, including plastic surgery. The goal of this study was to evaluate the impact of ERAS on outcomes in cosmetic plastic surgery. A prospective study consisting of phone call questionnaires was designed where patients from two senior plastic surgeons (N.H.R. and J.D.F.) were followed. The treatment group (n = 10) followed an ERAS protocol while the control group (n = 12) followed the traditional recovery after surgery which included narcotic usage. Patients were contacted on postoperative days (POD) 0 through 7+ and surveyed about a number of outcomes measures. The ERAS group demonstrated a significant reduction in postoperative pain on POD 0, 1, 2, and 3 (all P plastic surgery. The utility lies in the ability to expedite patient's recovery while still providing quality care. This study showed a reduction in postoperative complaints by avoiding narcotics without an increase in complications. Our findings signify the importance of ERAS protocols within cosmetic plastic surgery. 4. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Management of intraoperative fluid balance and blood conservation techniques in adult cardiac surgery.

Science.gov (United States)

Vretzakis, George; Kleitsaki, Athina; Aretha, Diamanto; Karanikolas, Menelaos

2011-02-01

Blood transfusions are associated with adverse physiologic effects and increased cost, and therefore reduction of blood product use during surgery is a desirable goal for all patients. Cardiac surgery is a major consumer of donor blood products, especially when cardiopulmonary bypass (CPB) is used, because hematocrit drops precipitously during CPB due to blood loss and blood cell dilution. Advanced age, low preoperative red blood cell volume (preoperative anemia or small body size), preoperative antiplatelet or antithrombotic drugs, complex or re-operative procedures or emergency operations, and patient comorbidities were identified as important transfusion risk indicators in a report recently published by the Society of Cardiovascular Anesthesiologists. This report also identified several pre- and intraoperative interventions that may help reduce blood transfusions, including off-pump procedures, preoperative autologous blood donation, normovolemic hemodilution, and routine cell saver use.A multimodal approach to blood conservation, with high-risk patients receiving all available interventions, may help preserve vital organ perfusion and reduce blood product utilization. In addition, because positive intravenous fluid balance is a significant factor affecting hemodilution during cardiac surgery, especially when CPB is used, strategies aimed at limiting intraoperative fluid balance positiveness may also lead to reduced blood product utilization.This review discusses currently available techniques that can be used intraoperatively in an attempt to avoid or minimize fluid balance positiveness, to preserve the patient's own red blood cells, and to decrease blood product utilization during cardiac surgery.

Corrective Jaw Surgery

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Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, ... to find out more. Wisdom Teeth Management Wisdom Teeth Management An impacted wisdom tooth can damage neighboring ...

Gastric Sleeve Surgery

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... Videos for Educators Search English Español Gastric Sleeve Surgery KidsHealth / For Teens / Gastric Sleeve Surgery What's in ... or buying healthy food ) Preparing for Gastric Sleeve Surgery Preparing for this major operation takes months of ...

The physiological stress response and oxidative stress biomarkers in rainbow trout and brook trout from selenium-impacted streams in a coal mining region

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Miller, L.L.; Rasmussen, J.B.; Palace, V.P.; Hontela, A. [University of Lethbridge, Lethbridge, AB (Canada). Dept. of Biological Science

2009-11-15

Selenium (Se) is an essential element that can be toxic at concentrations slightly greater than those required for homeostasis. The main chronic toxic effects of Se in fish are teratogenic deformities, but Se can also activate the physiological stress response and redox cycle with reduced glutathione causing oxidative damage. Rainbow trout, Oncorhynchus mykiss, appear to be more sensitive to Se than brook trout, Salvelinus fontinalis. The objective of this study was to compare the physiological stress response (plasma cortisol, glucose, triiodothyronine, thyroxine, gill Na+/K+ ATPase, cortisol secretory capacity, K and liver somatic index) and oxidative stress biomarkers (liver GSH, GPx, lipid peroxidation, vitamin A and vitamin E) in rainbow trout (RNTR) and brook trout (BKTR) collected from reference and Se-exposed streams. The physiological stress response was not impaired (cortisol secretory capacity unchanged); although there were species differences in plasma cortisol and plasma glucose levels. Liver GSH, GPx and vitamin levels were higher in RNTR than BKTR, but lipid peroxidation levels were not different. The elevated GSH reserves may make RNTR more sensitive to Se-induced lipid peroxidation, but this may be offset by the RNTR's higher antioxidant (GPx and vitamin) levels. Species-specific biochemical differences may mediate differences in Se sensitivity and be used in aquatic Se risk assessments.

Frequency-specific insight into short-term memory capacity.

Science.gov (United States)

Feurra, Matteo; Galli, Giulia; Pavone, Enea Francesco; Rossi, Alessandro; Rossi, Simone

2016-07-01

The digit span is one of the most widely used memory tests in clinical and experimental neuropsychology for reliably measuring short-term memory capacity. In the forward version, sequences of digits of increasing length have to be reproduced in the order in which they are presented, whereas in the backward version items must be reproduced in the reversed order. Here, we assessed whether transcranial alternating current stimulation (tACS) increases the memory span for digits of young and midlife adults. Imperceptibly weak electrical currents in the alpha (10 Hz), beta (20 Hz), theta (5 Hz), and gamma (40 Hz) range, as well as a sham stimulation, were delivered over the left posterior parietal cortex, a cortical region thought to sustain maintenance processes in short-term memory through oscillatory brain activity in the beta range. We showed a frequency-specific effect of beta-tACS that robustly increased the forward memory span of young, but not middle-aged, healthy individuals. The effect correlated with age: the younger the subjects, the greater the benefit arising from parietal beta stimulation. Our results provide evidence of a short-term memory capacity improvement in young adults by online frequency-specific tACS application. Copyright © 2016 the American Physiological Society.

La day surgery centralizzata: l’appropriatezza clinica e organizzativa come leva di creazione di valore sanitario

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Bruno Vogliolo

2001-12-01

Full Text Available In the last years Public Health Service has been trying to find out solutions in order to improve its health value added creation capacity. The implementation of the Day-surgery division mainly aims to follow that direction, since it enables the improvement of the ratio between efficacy, quality and healthcare suitability and on the other hand efficiency, costs and modality of better resources utilization. The centralization of Day-surgery activities proposes some innovative characteristics, concerning that it introduces an organizational model focused on needs and it performs the separation of the clinic and therapeutic activities from the ones involving the assistance. Both economic and qualitative advantages deriving from the changes stand out in term of: - high possibility of activities’ scheduling; - improved customer satisfaction; - rationalisation of day-hospital recovery, with positive effects on the inpatients; - improved hospital economic stability. This study was carried out with the support of the multiple-skill group composed of doctors, nurses, administrative staff as well as experts in the field of organisation with an aim to provide the full outline of the necessary competences. The proposed discussion reflects the multidisciplinary view of the problem and different perspectives. Each of them regards particular aspects and implications indicated as following: - clinical perspective, related to the possibility of day-surgery interventions both from the medical and the anaesthetic point of view; - organisational perspective, which refers to the possible day-surgery models in conjunction with the organisational model and their peculiarities; - operative perspective, which consist of the analysis of the ideal structural dimension, flows of activities among all services involved and the analysis of the productive capability; (number of necessary beds, staff dimension and a relapse of the operation activities needs; - economic

Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery

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Katja Tangermann-Gerk

2013-10-01

Full Text Available Laser surgery provides a number of advantages over conventional surgery. However, it implies large risks for sensitive tissue structures due to its characteristic non-tissue-specific ablation. The present study investigates the discrimination of nine different ex vivo tissue types by using uncorrected (raw autofluorescence spectra for the development of a remote feedback control system for tissue-selective laser surgery. Autofluorescence spectra (excitation wavelength 377 ± 50 nm were measured from nine different ex vivo tissue types, obtained from 15 domestic pig cadavers. For data analysis, a wavelength range between 450 nm and 650 nm was investigated. Principal Component Analysis (PCA and Quadratic Discriminant Analysis (QDA were used to discriminate the tissue types. ROC analysis showed that PCA, followed by QDA, could differentiate all investigated tissue types with AUC results between 1.00 and 0.97. Sensitivity reached values between 93% and 100% and specificity values between 94% and 100%. This ex vivo study shows a high differentiation potential for physiological tissue types when performing autofluorescence spectroscopy followed by PCA and QDA. The uncorrected autofluorescence spectra are suitable for reliable tissue discrimination and have a high potential to meet the challenges necessary for an optical feedback system for tissue-specific laser surgery.

Epiretinal membrane surgery

DEFF Research Database (Denmark)

Hamoudi, Hassan; Correll Christensen, Ulrik; La Cour, Morten

2017-01-01

Purpose: To assess the impact of combined phacoemulsification-vitrectomy and sequential surgery for idiopathic epiretinal membrane (ERM) on refractive error (RE) and macular morphology. Methods: In this prospective clinical trial, we allocated phakic eyes with ERM to (1) cataract surgery and subs......Purpose: To assess the impact of combined phacoemulsification-vitrectomy and sequential surgery for idiopathic epiretinal membrane (ERM) on refractive error (RE) and macular morphology. Methods: In this prospective clinical trial, we allocated phakic eyes with ERM to (1) cataract surgery...... and achieved spherical equivalent); secondary outcomes were best-corrected visual acuity (BCVA), and incidence of cystoid macular oedema (CME) defined as >10% increment of central subfield macular thickness (CSMT). Results: Sixty-two eyes were enrolled. The mean RE showed a small myopic shift of -0.36D in all...... between the groups. Four cases (17%) in the CAT group had resolved visual complaints and improved BCVA after cataract surgery resulting in no need for PPV within the follow-up period. Conclusion: Surgery for idiopathic ERM in phakic eyes with either phaco-vitrectomy or sequential surgery are equal...

Robotic liver surgery

Science.gov (United States)

Leung, Universe

2014-01-01

Robotic surgery is an evolving technology that has been successfully applied to a number of surgical specialties, but its use in liver surgery has so far been limited. In this review article we discuss the challenges of minimally invasive liver surgery, the pros and cons of robotics, the evolution of medical robots, and the potentials in applying this technology to liver surgery. The current data in the literature are also presented. PMID:25392840

Learning From Experience: Improving Early Tracheal Extubation Success After Congenital Cardiac Surgery.

Science.gov (United States)

Winch, Peter D; Staudt, Anna M; Sebastian, Roby; Corridore, Marco; Tumin, Dmitry; Simsic, Janet; Galantowicz, Mark; Naguib, Aymen; Tobias, Joseph D

2016-07-01

The many advantages of early tracheal extubation following congenital cardiac surgery in young infants and children are now widely recognized. Benefits include avoiding the morbidity associated with prolonged intubation and the consequences of sedation and positive pressure ventilation in the setting of altered cardiopulmonary physiology. Our practice of tracheal extubation of young infants in the operating room following cardiac surgery has evolved and new challenges in the arena of postoperative sedation and pain management have appeared. Review our institutional outcomes associated with early tracheal extubation following congenital cardiac surgery. Inclusion criteria included all children less than 1 year old who underwent congenital cardiac surgery between October 1, 2010, and October 24, 2013. A total of 416 patients less than 1 year old were included. Of the 416 patients, 234 underwent tracheal extubation in the operating room (56%) with 25 requiring reintubation (10.7%), either immediately or following admission to the cardiothoracic ICU. Of the 25 patients extubated in the operating room who required reintubation, 22 failed within 24 hours of cardiothoracic ICU admission; 10 failures were directly related to narcotic doses that resulted in respiratory depression. As a result of this review, we have instituted changes in our cardiothoracic ICU postoperative care plans. We have developed a neonatal delirium score, and have adopted the "Kangaroo Care" approach that was first popularized in neonatal ICUs. This provision allows for the early parental holding of infants following admission to the cardiothoracic ICU and allows for appropriately selected parents to sleep in the same beds alongside their postoperative children.

Pediatric heart surgery

Science.gov (United States)

Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

Can ammonia tolerance amongst lichen functional groups be explained by physiological responses?

Science.gov (United States)

Munzi, S; Cruz, C; Branquinho, C; Pinho, P; Leith, I D; Sheppard, L J

2014-04-01

Ammonia (NH3) empirical critical levels for Europe were re-evaluated in 2009, based mainly on the ecological responses of lichen communities without acknowledging the physiological differences between oligotrophic and nitrophytic species. Here, we compare a nitrogen sensitive lichen (Evernia prunastri) with a nitrogen tolerant one (Xanthoria parietina), focussing on their physiological response (Fv/Fm) to short-term NH3 exposure and their frequency of occurrence along an NH3 field gradient. Both frequency and Fv/Fm of E. prunastri decreased abruptly above 3 μg m(-3) NH3 suggesting direct adverse effects of NH3 on its photosynthetic performance. By contrast, X. parietina increased its frequency with NH3, despite showing decreased capacity of photosystem II above 50 μg m(-3) NH3, suggesting that the ecological success of X. parietina at ammonia-rich sites might be related to indirect effects of increased nitrogen (NH3) availability. These results highlight the need to establish NH3 critical levels based on oligotrophic lichen species. Copyright © 2014 Elsevier Ltd. All rights reserved.

[Construction and analysis of a monitoring system with remote real-time multiple physiological parameters based on cloud computing].

Science.gov (United States)

Zhu, Lingyun; Li, Lianjie; Meng, Chunyan

2014-12-01

There have been problems in the existing multiple physiological parameter real-time monitoring system, such as insufficient server capacity for physiological data storage and analysis so that data consistency can not be guaranteed, poor performance in real-time, and other issues caused by the growing scale of data. We therefore pro posed a new solution which was with multiple physiological parameters and could calculate clustered background data storage and processing based on cloud computing. Through our studies, a batch processing for longitudinal analysis of patients' historical data was introduced. The process included the resource virtualization of IaaS layer for cloud platform, the construction of real-time computing platform of PaaS layer, the reception and analysis of data stream of SaaS layer, and the bottleneck problem of multi-parameter data transmission, etc. The results were to achieve in real-time physiological information transmission, storage and analysis of a large amount of data. The simulation test results showed that the remote multiple physiological parameter monitoring system based on cloud platform had obvious advantages in processing time and load balancing over the traditional server model. This architecture solved the problems including long turnaround time, poor performance of real-time analysis, lack of extensibility and other issues, which exist in the traditional remote medical services. Technical support was provided in order to facilitate a "wearable wireless sensor plus mobile wireless transmission plus cloud computing service" mode moving towards home health monitoring for multiple physiological parameter wireless monitoring.

Surgical specialty procedures in rural surgery practices: implications for rural surgery training.

Science.gov (United States)

Sticca, Robert P; Mullin, Brady C; Harris, Joel D; Hosford, Clint C

2012-12-01

Specialty procedures constitute one eighth of rural surgery practice. Currently, general surgeons intending to practice in rural hospitals may not get adequate training for specialty procedures, which they will be expected to perform. Better definition of these procedures will help guide rural surgery training. Current Procedural Terminology codes for all surgical procedures for 81% of North Dakota and South Dakota rural surgeons were entered into the Dakota Database for Rural Surgery. Specialty procedures were analyzed and compared with the Surgical Council on Resident Education curriculum to determine whether general surgery training is adequate preparation for rural surgery practice. The Dakota Database for Rural Surgery included 46,052 procedures, of which 5,666 (12.3%) were specialty procedures. Highest volume specialty categories included vascular, obstetrics and gynecology, orthopedics, cardiothoracic, urology, and otolaryngology. Common procedures in cardiothoracic and vascular surgery are taught in general surgical residency, while common procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology are usually not taught in general surgery training. Optimal training for rural surgery practice should include experience in specialty procedures in obstetrics and gynecology, orthopedics, urology, and otolaryngology. Copyright © 2012 Elsevier Inc. All rights reserved.

Is preoperative spirometry a predictive marker for postoperative complications after colorectal cancer surgery?

Science.gov (United States)

Tajima, Yuki; Tsuruta, Masashi; Yahagi, Masashi; Hasegawa, Hirotoshi; Okabayashi, Koji; Shigeta, Kohei; Ishida, Takashi; Kitagawa, Yuko

2017-09-01

Spirometry is a basic test that provides much information about pulmonary function; it is performed preoperatively in almost all patients undergoing colorectal cancer (CRC) surgery in our hospital. However, the value of spirometry as a preoperative test for CRC surgery remains unknown. The aim of this study was to determine whether spirometry is useful to predict postoperative complications (PCs) after CRC surgery. The medical records of 1236 patients who had preoperative spirometry tests and underwent CRC surgery between 2005 and 2014 were reviewed. Preoperative spirometry results, such as forced vital capacity (FVC), one-second forced expiratory volume (FEV1), %VC (FVC/predicted VC) and FEV1/FVC (%FEV1), were analyzed with regard to PCs, including pneumonia. PCs were found in 383 (30.9%) patients, including 218 (56%) with surgical site infections, 67 (17%) with bowel obstruction, 62 (16%) with leakage and 20 (5.2%) with pneumonia. Of the spirometry results, %VC was correlated with PC according to logistic regression analysis (odds ratio, OR = 0.99, 95% confidence interval, CI = 0.98-0.99; P = 0.034). Multivariate analysis after adjusting for male sex, age, laparoscopic surgery, tumor location, operation time and blood loss showed that a lower %VC tends to be a risk factor for PC (OR = 0.99, 95% CI = 0.98-1.002; P = 0.159) and %VC was an independent risk factor for postoperative pneumonia in PCs (OR = 0.97, 95% CI = 0.94-0.99; P = 0.049). In CRC surgery, %VC may be a predictor of postoperative complications, especially pneumonia. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Cosmetic Surgery Training in Plastic Surgery Residency Programs

Directory of Open Access Journals (Sweden)

Colton H. L. McNichols, MD

2017-09-01

Conclusions:. There is an increase in dedicated cosmetic surgery rotations and fewer residents believe they need a fellowship to practice cosmetic surgery. However, the comfort level of performing facial aesthetic and body contouring procedures remains low particularly among independent residents.

Breast Cancer Surgery

Science.gov (United States)

FACTS FOR LIFE Breast Cancer Surgery The goal of breast cancer surgery is to remove the whole tumor from the breast. Some lymph nodes ... might still be in the body. Types of breast cancer surgery There are two types of breast cancer ...

Physiological responses of red mangroves to the climate in the Florida Everglades

Science.gov (United States)

Barr, Jordan G.; Fuentes, Jose D.; Engel, Vic; Zieman, Joseph C.

2009-06-01

This manuscript reports the findings of physiological studies of red mangrove (Rhizophora mangle L.) conducted from June to August 2001 and from May to June 2003 in the Florida Everglades. In situ physiological measurements were made using environmentally controlled gas exchange systems. The field investigations were carried out to define how regional climate constrains mangrove physiology and ecosystem carbon assimilation. In addition, maximum carboxylation and photosynthetic active radiation (PAR) limited carbon assimilation capacities were investigated during the summer season to evaluate whether ecophysiological models developed for mesophyte plant species can be applied to mangroves. Under summertime conditions in the Florida Everglades, maximum foliar carbon dioxide (CO2) assimilation rates reached 18 μmol CO2 m-2 s-1. Peak molar stomatal conductance to water vapor (H2O) diffusion reached 300 mmol H2O m-2 s-1. Maximum carboxylation and PAR-limited carbon assimilation rates at the foliage temperature of 30°C attained 76.1 ± 23.4 μmol CO2 m-2 s-1 and 128.1 ± 32.9 μmol (e-) m-2 s-1, respectively. Environmental stressors such as the presence of hypersaline conditions and high solar irradiance loading (>500 W m-2 or >1000 μmoles of photons m-2 s-1 of PAR) imposed sharp reductions in carbon assimilation rates and suppressed stomatal conductance. On the basis of both field observations and model analyses, it is also concluded that existing ecophysiological models need to be modified to consider the influences of hypersaline and high radiational loadings on the physiological responses of red mangroves.

Leptin expression in ruminants: nutritional and physiological regulations in relation with energy metabolism.

Science.gov (United States)

Chilliard, Y; Delavaud, C; Bonnet, M

2005-07-01

Leptin, mainly produced in adipose tissue (AT), is a protein involved in the central and/or peripheral regulation of body homeostasis, energy intake, storage and expenditure, fertility and immune functions. Its role is well documented in rodent and human species, but less in ruminants. This review is focused on some intrinsic and extrinsic factors which regulate adipose tissue leptin gene expression and leptinemia in cattle, sheep, goat and camel: age, physiological status (particularly pregnancy and lactation) in interaction with long-term (adiposity) and short-term effects of feeding level, energy intake and balance, diet composition, specific nutrients and hormones (insulin, glucose and fatty acids), and seasonal non-dietary factors such as photoperiod. Body fatness strongly regulates leptin and its responses to other factors. For example, leptinemia is higher after underfeeding or during lactation in fat than in lean animals. Physiological status per se also modulates leptin expression, with lactation down-regulating leptinemia, even when energy balance (EB) is positive. These results suggest that leptin could be a link between nutritional history and physiological regulations, which integrates the animal's requirements (e.g., for a pregnancy-lactation cycle), predictable food availability (e.g., due to seasonal variations) and potential for survival (e.g., body fatness level). Reaching permissive leptin thresholds should be necessary for pubertal or postpartum reproductive activity. In addition to the understanding of leptin yield regulation, these data are helpful to understand the physiological significance of changes in leptin secretion and leptin effects, and how husbandry strategies could integrate the adaptative capacities of ruminant species to their environment.

An overview of surgery-first approach: Recent advances in orthognathic surgery.

Science.gov (United States)

Sharma, Vipul Kumar; Yadav, Kirti; Tandon, Pradeep

2015-01-01

The disadvantages of having orthodontic interventions both before and after orthognathic surgery include a long treatment time of 7-47 months and temporary worsening of facial appearance. Nowadays, the concept of surgery-first, followed by orthodontic treatment is applied to orthognathic surgery cases in different orthodontic centers in the world. This concept and technique is called "surgery-first-orthognathic-approach" or "surgery-first approach" (SFA) rigid fixation (skeletal anchorage system) of the bony segments and regional acceleratory phenomenon were keys to broad implementation of the SFA. This article is intended to provide an overview of SFA including indications, general and specific guidelines, different protocol variations, success rate and potential problems.

Comparability and repeatability of three commonly used methods for measuring endurance capacity.

Science.gov (United States)

Baxter-Gilbert, James; Mühlenhaupt, Max; Whiting, Martin J

2017-12-01

Measures of endurance (time to exhaustion) have been used to address a wide range of questions in ecomorphological and physiological research, as well as being used as a proxy for survival and fitness. Swimming, stationary (circular) track running, and treadmill running are all commonly used methods for measuring endurance. Despite the use of these methods across a broad range of taxa, how comparable these methods are to one another, and whether they are biologically relevant, is rarely examined. We used Australian water dragons (Intellagama lesueurii), a species that is morphologically adept at climbing, swimming, and running, to compare these three methods of endurance and examined if there is repeatability within and between trial methods. We found that time to exhaustion was not highly repeatable within a method, suggesting that single measures or a mean time to exhaustion across trials are not appropriate. Furthermore, we compared mean maximal endurance times among the three methods, and found that the two running methods (i.e., stationary track and treadmill) were similar, but swimming was distinctly different, resulting in lower mean maximal endurance times. Finally, an individual's endurance rank was not repeatable across methods, suggesting that the three endurance trial methods are not providing similar information about an individual's performance capacity. Overall, these results highlight the need to carefully match a measure of performance capacity with the study species and the research questions being asked so that the methods being used are behaviorally, ecologically, and physiologically relevant. © 2018 Wiley Periodicals, Inc.

Assessing the components of adaptive capacity to improve conservation and management efforts under global change.

Science.gov (United States)

Nicotra, Adrienne B; Beever, Erik A; Robertson, Amanda L; Hofmann, Gretchen E; O'Leary, John

2015-10-01

Natural-resource managers and other conservation practitioners are under unprecedented pressure to categorize and quantify the vulnerability of natural systems based on assessment of the exposure, sensitivity, and adaptive capacity of species to climate change. Despite the urgent need for these assessments, neither the theoretical basis of adaptive capacity nor the practical issues underlying its quantification has been articulated in a manner that is directly applicable to natural-resource management. Both are critical for researchers, managers, and other conservation practitioners to develop reliable strategies for assessing adaptive capacity. Drawing from principles of classical and contemporary research and examples from terrestrial, marine, plant, and animal systems, we examined broadly the theory behind the concept of adaptive capacity. We then considered how interdisciplinary, trait- and triage-based approaches encompassing the oft-overlooked interactions among components of adaptive capacity can be used to identify species and populations likely to have higher (or lower) adaptive capacity. We identified the challenges and value of such endeavors and argue for a concerted interdisciplinary research approach that combines ecology, ecological genetics, and eco-physiology to reflect the interacting components of adaptive capacity. We aimed to provide a basis for constructive discussion between natural-resource managers and researchers, discussions urgently needed to identify research directions that will deliver answers to real-world questions facing resource managers, other conservation practitioners, and policy makers. Directing research to both seek general patterns and identify ways to facilitate adaptive capacity of key species and populations within species, will enable conservation ecologists and resource managers to maximize returns on research and management investment and arrive at novel and dynamic management and policy decisions. © 2015 Society for

Assessing the components of adaptive capacity to improve conservation and management efforts under global change

Science.gov (United States)

Nicotra, Adrienne; Beever, Erik; Robertson, Amanda; Hofmann, Gretchen; O’Leary, John

2015-01-01

Natural-resource managers and other conservation practitioners are under unprecedented pressure to categorize and quantify the vulnerability of natural systems based on assessment of the exposure, sensitivity, and adaptive capacity of species to climate change. Despite the urgent need for these assessments, neither the theoretical basis of adaptive capacity nor the practical issues underlying its quantification has been articulated in a manner that is directly applicable to natural-resource management. Both are critical for researchers, managers, and other conservation practitioners to develop reliable strategies for assessing adaptive capacity. Drawing from principles of classical and contemporary research and examples from terrestrial, marine, plant, and animal systems, we examined broadly the theory behind the concept of adaptive capacity. We then considered how interdisciplinary, trait- and triage-based approaches encompassing the oft-overlooked interactions among components of adaptive capacity can be used to identify species and populations likely to have higher (or lower) adaptive capacity. We identified the challenges and value of such endeavors and argue for a concerted interdisciplinary research approach that combines ecology, ecological genetics, and eco-physiology to reflect the interacting components of adaptive capacity. We aimed to provide a basis for constructive discussion between natural-resource managers and researchers, discussions urgently needed to identify research directions that will deliver answers to real-world questions facing resource managers, other conservation practitioners, and policy makers. Directing research to both seek general patterns and identify ways to facilitate adaptive capacity of key species and populations within species, will enable conservation ecologists and resource managers to maximize returns on research and management investment and arrive at novel and dynamic management and policy decisions.

Effect of Roux-en-Y gastric bypass on liver mitochondrial dynamics in a rat model of obesity.

Science.gov (United States)

Sacks, Jessica; Mulya, Anny; Fealy, Ciaran E; Huang, Hazel; Mosinski, John D; Pagadala, Mangesh R; Shimizu, Hideharu; Batayyah, Esam; Schauer, Philip R; Brethauer, Stacy A; Kirwan, John P

2018-02-01

Bariatric surgery provides significant and durable improvements in glycemic control and hepatic steatosis, but the underlying mechanisms that drive improvements in these metabolic parameters remain to be fully elucidated. Recently, alterations in mitochondrial morphology have shown a direct link to nutrient adaptations in obesity. Here, we evaluate the effects of Roux-en-Y gastric bypass (RYGB) surgery on markers of liver mitochondrial dynamics in a diet-induced obesity Sprague-Dawley (SD) rat model. Livers were harvested from adult male SD rats 90-days after either Sham or RYGB surgery and continuous high-fat feeding. We assessed expression of mitochondrial proteins involved in fusion, fission, mitochondrial autophagy (mitophagy) and biogenesis, as well as differences in citrate synthase activity and markers of oxidative stress. Gene expression for mitochondrial fusion genes, mitofusin 1 (Mfn1; P fasting plasma insulin. In the RYGB group, citrate synthase activity was increased (P < 0.02) and reactive oxygen species (ROS) was decreased compared to the Sham control group (P < 0.05), although total antioxidant capacity was unchanged between groups. These data are the first to show an association between RYGB surgery and improved markers of liver mitochondrial dynamics. These observed improvements may be related to weight loss and reduced energetic demand on the liver, which could facilitate normalization of glucose homeostasis and protect against hepatic steatosis. © 2018 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

Corrective Jaw Surgery

Medline Plus

Full Text Available ... their surgery, orthognathic surgery is performed to correct functional problems. Jaw Surgery can have a dramatic effect on many aspects of life. Following are some of the conditions that may ... front, or side Facial injury Birth defects Receding lower jaw and ...

Robotics and general surgery.

Science.gov (United States)

Jacob, Brian P; Gagner, Michel

2003-12-01

Robotics are now being used in all surgical fields, including general surgery. By increasing intra-abdominal articulations while operating through small incisions, robotics are increasingly being used for a large number of visceral and solid organ operations, including those for the gallbladder, esophagus, stomach, intestines, colon, and rectum, as well as for the endocrine organs. Robotics and general surgery are blending for the first time in history and as a specialty field should continue to grow for many years to come. We continuously demand solutions to questions and limitations that are experienced in our daily work. Laparoscopy is laden with limitations such as fixed axis points at the trocar insertion sites, two-dimensional video monitors, limited dexterity at the instrument tips, lack of haptic sensation, and in some cases poor ergonomics. The creation of a surgical robot system with 3D visual capacity seems to deal with most of these limitations. Although some in the surgical community continue to test the feasibility of these surgical robots and to question the necessity of such an expensive venture, others are already postulating how to improve the next generation of telemanipulators, and in so doing are looking beyond today's horizon to find simpler solutions. As the robotic era enters the world of the general surgeon, more and more complex procedures will be able to be approached through small incisions. As technology catches up with our imaginations, robotic instruments (as opposed to robots) and 3D monitoring will become routine and continue to improve patient care by providing surgeons with the most precise, least traumatic ways of treating surgical disease.

Using measures of single-cell physiology and physiological state to understand organismic aging.

Science.gov (United States)

Mendenhall, Alexander; Driscoll, Monica; Brent, Roger

2016-02-01

Genetically identical organisms in homogeneous environments have different lifespans and healthspans. These differences are often attributed to stochastic events, such as mutations and 'epimutations', changes in DNA methylation and chromatin that change gene function and expression. But work in the last 10 years has revealed differences in lifespan- and health-related phenotypes that are not caused by lasting changes in DNA or identified by modifications to DNA or chromatin. This work has demonstrated persistent differences in single-cell and whole-organism physiological states operationally defined by values of reporter gene signals in living cells. While some single-cell states, for example, responses to oxygen deprivation, were defined previously, others, such as a generally heightened ability to make proteins, were, revealed by direct experiment only recently, and are not well understood. Here, we review technical progress that promises to greatly increase the number of these measurable single-cell physiological variables and measureable states. We discuss concepts that facilitate use of single-cell measurements to provide insight into physiological states and state transitions. We assert that researchers will use this information to relate cell level physiological readouts to whole-organism outcomes, to stratify aging populations into groups based on different physiologies, to define biomarkers predictive of outcomes, and to shed light on the molecular processes that bring about different individual physiologies. For these reasons, quantitative study of single-cell physiological variables and state transitions should provide a valuable complement to genetic and molecular explanations of how organisms age. © 2015 The Authors. Aging Cell published by the Anatomical Society and John Wiley & Sons Ltd.

Orthopedic surgery in cerebral palsy: Instructional course lecture

Directory of Open Access Journals (Sweden)

Deepak Sharan

2017-01-01

Full Text Available Orthopedic surgery (OS plays an important role in the management of cerebral palsy (CP. The objectives of OS are to optimize functions and prevent deformity. Newer developments in OS for CP include emphasis on hip surveillance, minimally invasive procedures, use of external fixators instead of plates and screws, better understanding of lever arm dysfunctions (that can only be corrected by bony OS, orthopedic selective spasticity-control surgery, and single-event multilevel lever arm restoration and anti spasticity surgery, which have led to significant improvements in gross motor function and ambulation, especially in spastic quadriplegia, athetosis, and dystonia. The results of OS can be dramatic and life altering for the person with CP and their caregivers if it is performed meticulously by a specialized surgical team, at the appropriate age, for the correct indications, employing sound biomechanical principles and is followed by physician-led, protocol based, intensive, multidisciplinary, institutional rehabilitation, and long term followup. However, OS can be a double-edged sword, and if performed less than optimally, and without the supporting multidisciplinary medical and rehabilitation team, expertise and infrastructure, it often leads to significant functional worsening of the person with CP, including irretrievable loss of previous ambulatory capacity. OS must be integrated into the long term management of the person with CP and should be anticipated and planned at the optimal time and not viewed as a “last resort” intervention or failure of rehabilitation. This instructional course lecture reviews the relevant contemporary principles and techniques of OS in CP.

Lung Function before and Two Days after Open-Heart Surgery

Directory of Open Access Journals (Sweden)

Charlotte Urell

2012-01-01

Full Text Available Reduced lung volumes and atelectasis are common after open-heart surgery, and pronounced restrictive lung volume impairment has been found. The aim of this study was to investigate factors influencing lung volumes on the second postoperative day. Open-heart surgery patients (n=107, 68 yrs, 80% male performed spirometry both before surgery and on the second postoperative day. The factors influencing postoperative lung volumes and decrease in lung volumes were investigated with univariate and multivariate analyses. Associations between pain (measured by numeric rating scale and decrease in postoperative lung volumes were calculated with Spearman rank correlation test. Lung volumes decreased by 50% and were less than 40% of the predictive values postoperatively. Patients with BMI >25 had lower postoperative inspiratory capacity (IC (33±14% pred. than normal-weight patients (39±15% pred., (P=0.04. More pain during mobilisation was associated with higher decreases in postoperative lung volumes (VC: r=0.33, P=0.001; FEV1: r=0.35, P≤0.0001; IC: r=0.25, P=0.01. Patients with high BMI are a risk group for decreased postoperative lung volumes and should therefore receive extra attention during postoperative care. As pain is related to a larger decrease in postoperative lung volumes, optimal pain relief for the patients should be identified.

Lung Function before and Two Days after Open-Heart Surgery.

Science.gov (United States)

Urell, Charlotte; Westerdahl, Elisabeth; Hedenström, Hans; Janson, Christer; Emtner, Margareta

2012-01-01

Reduced lung volumes and atelectasis are common after open-heart surgery, and pronounced restrictive lung volume impairment has been found. The aim of this study was to investigate factors influencing lung volumes on the second postoperative day. Open-heart surgery patients (n = 107, 68 yrs, 80% male) performed spirometry both before surgery and on the second postoperative day. The factors influencing postoperative lung volumes and decrease in lung volumes were investigated with univariate and multivariate analyses. Associations between pain (measured by numeric rating scale) and decrease in postoperative lung volumes were calculated with Spearman rank correlation test. Lung volumes decreased by 50% and were less than 40% of the predictive values postoperatively. Patients with BMI >25 had lower postoperative inspiratory capacity (IC) (33 ± 14% pred.) than normal-weight patients (39 ± 15% pred.), (P = 0.04). More pain during mobilisation was associated with higher decreases in postoperative lung volumes (VC: r = 0.33, P = 0.001; FEV(1): r = 0.35, P ≤ 0.0001; IC: r = 0.25, P = 0.01). Patients with high BMI are a risk group for decreased postoperative lung volumes and should therefore receive extra attention during postoperative care. As pain is related to a larger decrease in postoperative lung volumes, optimal pain relief for the patients should be identified.

Robotic surgery

Science.gov (United States)

... with this type of surgery give it some advantages over standard endoscopic techniques. The surgeon can make ... Elsevier Saunders; 2015:chap 87. Muller CL, Fried GM. Emerging technology in surgery: Informatics, electronics, robotics. In: ...

After Surgery

Science.gov (United States)

... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

Threatening the Heart and Mind of Gender Stereotypes: Can Imagined Contact Influence the Physiology of Stereotype Threat?

OpenAIRE

Allen, Ben

2012-01-01

Research shows that when a gender stereotype is made salient and the target of the stereotype is asked to perform in the stereotyped domain, targets of the stereotype often perform at a lower level compared to situations when the stereotype was not made salient (Spencer, Steele, & Quinn, 1999). Current models of stereotype threat show that increased physiological arousal and reduced working memory capacity partially explain this decrement in performance (Ben-Zeev, Fein, & Inzlicht, 2005; Sch...

Physiological responses in a variable environment: relationships between metabolism, hsp and thermotolerance in an intertidal-subtidal species.

Directory of Open Access Journals (Sweden)

Yun-wei Dong

Full Text Available Physiological responses to temperature reflect the evolutionary adaptations of organisms to their thermal environment and the capability of animals to tolerate thermal stress. Contrary to conventional metabolism theory, increasing environmental temperatures have been shown to reduce metabolic rate in rocky-eulittoral-fringe species inhabiting highly variable environments, possibly as a strategy for energy conservation. To study the physiological adaptations of an intertidal-subtidal species to the extreme and unpredictable heat stress of the intertidal zone, oxygen consumption rate and heat shock protein expression were quantified in the sea cucumber Apostichopus japonicus. Using simulate natural temperatures, the relationship between temperature, physiological performance (oxygen consumption and heat shock proteins and thermotolerance were assessed. Depression of oxygen consumption rate and upregulation of heat shock protein genes (hsps occurred in sequence when ambient temperature was increased from 24 to 30°C. Large-scale mortality of the sea cucumber occurred when temperatures rose beyond 30°C, suggesting that the upregulation of heat shock proteins and mortality are closely related to the depression of aerobic metabolism, a phenomenon that is in line with the concept of oxygen- and capacity-limited thermal tolerance (OCLTT. The physiologically-related thermotolerance of this sea cucumber should be an adaptation to its local environment.

Understanding the physiology and adaptation of staphylococci: a post-genomic approach.

Science.gov (United States)

Becker, Karsten; Bierbaum, Gabriele; von Eiff, Christof; Engelmann, Susanne; Götz, Friedrich; Hacker, Jörg; Hecker, Michael; Peters, Georg; Rosenstein, Ralf; Ziebuhr, Wilma

2007-11-01

Staphylococcus aureus as well as coagulase-negative staphylococci are medically highly important pathogens characterized by an increasing resistance rate toward many antibiotics. Although normally being skin and mucosa commensals, some staphylococcal species and strains have the capacity to cause a wide range of infectious diseases. Many of these infections affect immunocompromised patients in hospitals. However, community-acquired staphylococcal infections due to resistant strains are also currently on the rise. In the light of this development, there is an urgent need for novel anti-staphylococcal therapeutic and prevention strategies for which a better understanding of the physiology of these bacteria is an essential prerequisite. Within the past years, staphylococci have been in the focus of genomic research, resulting in the determination and publication of a range of full-genome sequences of different staphylococcal species and strains which provided the basis for the design and application of DNA microarrays and other genomic tools. Here we summarize the results of the project group 'Staphylococci' within the research network 'Pathogenomics' giving new insights into the genome structure, molecular epidemiology, physiology, and genetic adaptation of both S. aureus and coagulase-negative staphylococci.

Using the reactive scope model to understand why stress physiology predicts survival during starvation in Galápagos marine iguanas.

Science.gov (United States)

Romero, L Michael

2012-05-01

Even though the term "stress" is widely used, a precise definition is notoriously difficult. Notwithstanding this difficulty, stress continues to be an important concept in biology because it attempts to describe how animals cope with environmental change under emergency conditions. Without a precise definition, however, it becomes nearly impossible to make testable a priori predictions about how physiological and hormonal systems will respond to emergency conditions and what the ultimate impact on the animal will be. The reactive scope model is a recent attempt to formulate testable predictions. This model provides a physiological basis to explain why corticosterone negative feedback, but not baseline corticosterone concentrations, corticosterone responses to acute stress, or the interrenal capacity to secrete corticosterone, is correlated with survival during famine conditions in Galápagos marine iguanas. Reactive scope thus provides a foundation for interpreting and predicting physiological stress responses. Copyright © 2011 Elsevier Inc. All rights reserved.

Assessment of hospital surge capacity using the MACSIM simulation system: a pilot study.

Science.gov (United States)

Lennquist Montán, K; Riddez, L; Lennquist, S; Olsberg, A C; Lindberg, H; Gryth, D; Örtenwall, P

2017-08-01

The aim of this study was to use a simulation model developed for the scientific evaluation of methodology in disaster medicine to test surge capacity (SC) in a major hospital responding to a simulated major incident with a scenario copied from a real incident. The tested hospital was illustrated on a system of magnetic boards, where available resources, staff, and patients treated in the hospital at the time of the test were illustrated. Casualties were illustrated with simulation cards supplying all data required to determine procedures for diagnosis and treatment, which all were connected to real consumption of time and resources. The first capacity-limiting factor was the number of resuscitation teams that could work parallel in the emergency department (ED). This made it necessary to refer severely injured to other hospitals. At this time, surgery (OR) and intensive care (ICU) had considerable remaining capacity. Thus, the reception of casualties could be restarted when the ED had been cleared. The next limiting factor was lack of ventilators in the ICU, which permanently set the limit for SC. At this time, there was still residual OR capacity. With access to more ventilators, the full surgical capacity of the hospital could have been utilized. The tested model was evaluated as an accurate tool to determine SC. The results illustrate that SC cannot be determined by testing one single function in the hospital, since all functions interact with each other and different functions can be identified as limiting factors at different times during the response.

A comparison of physiological strain of carriers in underground manual coal mines in India

Energy Technology Data Exchange (ETDEWEB)

Saha, R.; Dey, N.C.; Samanta, A.; Biswas, R. [University College of Medical Science, Lumbini (Nepal). Dept. of Physics

2008-07-15

Thirty nine healthy carriers (23-57 years of age) were investigated in underground manual coal mines in West Bengal, India during two different work spells of a single work shift. We compared physiological strain of workers <40 and {ge} 40 years of age. For both groups, mean heart rate was 124-133 beats/min, with a mean corresponding relative cardiac cost of 50-66%. Maximum aerobic capacities were estimated indirectly, following a standard step test protocol. Average oxygen consumption was 1.07-1.1 l/min, with an energy expenditure of 5.35-5.5 kcal/min among both age groups. Acceptable levels of physiological strain were well encroached, and older workers faced the maximum burden. The tasks studied were heavy to very heavy in nature. The weight of load carriage at a spontaneously chosen speed and the prevailing environmental conditions merit serious attention. There is extreme need of ergonomic interventions in reducing the postural load and musculoskeletal discomforts in this population.

Outcome of patients undergoing open heart surgery at the Uganda heart institute, Mulago hospital complex.

Science.gov (United States)

Aliku, Twalib O; Lubega, Sulaiman; Lwabi, Peter; Oketcho, Michael; Omagino, John O; Mwambu, Tom

2014-12-01

Heart disease is a disabling condition and necessary surgical intervention is often lacking in many developing countries. Training of the superspecialties abroad is largely limited to observation with little or no opportunity for hands on experience. An approach in which open heart surgeries are conducted locally by visiting teams enabling skills transfer to the local team and helps build to build capacity has been adopted at the Uganda Heart Institute (UHI). We reviewed the progress of open heart surgery at the UHI and evaluated the postoperative outcomes and challenges faced in conducting open heart surgery in a developing country. Medical records of patients undergoing open heart surgery at the UHI from October 2007 to June 2012 were reviewed. A total of 124 patients underwent open heart surgery during the study period. The commonest conditions were: venticular septal defects (VSDs) 34.7% (43/124), Atrial septal defects (ASDs) 34.7% (43/124) and tetralogy of fallot (TOF) in 10.5% (13/124). Non governmental organizations (NGOs) funded 96.8% (120/124) of the operations, and in only 4 patients (3.2%) families paid for the surgeries. There was increasing complexity in cases operated upon from predominantly ASDs and VSDs at the beginning to more complex cases like TOFs and TAPVR. The local team independently operated 19 patients (15.3%). Postoperative morbidity was low with arrhythmias, left ventricular dysfunction and re-operations being the commonest seen. Post operative sepsis occurred in only 2 cases (1.6%). The overall mortality rate was 3.2. Open heart surgery though expensive is feasible in a developing country. With increased direct funding from governments and local charities to support open heart surgeries, more cardiac patients access surgical treatment locally.

DEVELOPMENT OF PLASTIC SURGERY.

Science.gov (United States)

Pećanac, Marija Đ

2015-01-01

Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

Station Capacity

DEFF Research Database (Denmark)

Landex, Alex

2011-01-01

the probability of conflicts and the minimum headway times into account. The last method analyzes how optimal platform tracks are used by examining the arrival and departure pattern of the trains. The developed methods can either be used separately to analyze specific characteristics of the capacity of a station......Stations are often limiting the capacity of railway networks. This is due to extra need of tracks when trains stand still, trains turning around, and conflicting train routes. Although stations are often the capacity bottlenecks, most capacity analysis methods focus on open line capacity. Therefore...... for platform tracks and the probability that arriving trains will not get a platform track immediately at arrival. The third method is a scalable method that analyzes the conflicts in the switch zone(s). In its simplest stage, the method just analyzes the track layout while the more advanced stages also take...

KinoHaptics: An Automated, Wearable, Haptic Assisted, Physio-therapeutic System for Post-surgery Rehabilitation and Self-care.

Science.gov (United States)

Rajanna, Vijay; Vo, Patrick; Barth, Jerry; Mjelde, Matthew; Grey, Trevor; Oduola, Cassandra; Hammond, Tracy

2016-03-01

A carefully planned, structured, and supervised physiotherapy program, following a surgery, is crucial for the successful diagnosis of physical injuries. Nearly 50 % of the surgeries fail due to unsupervised, and erroneous physiotherapy. The demand for a physiotherapist for an extended period is expensive to afford, and sometimes inaccessible. Researchers have tried to leverage the advancements in wearable sensors and motion tracking by building affordable, automated, physio-therapeutic systems that direct a physiotherapy session by providing audio-visual feedback on patient's performance. There are many aspects of automated physiotherapy program which are yet to be addressed by the existing systems: a wide classification of patients' physiological conditions to be diagnosed, multiple demographics of the patients (blind, deaf, etc.), and the need to pursue patients to adopt the system for an extended period for self-care. In our research, we have tried to address these aspects by building a health behavior change support system called KinoHaptics, for post-surgery rehabilitation. KinoHaptics is an automated, wearable, haptic assisted, physio-therapeutic system that can be used by a wide variety of demographics and for various physiological conditions of the patients. The system provides rich and accurate vibro-haptic feedback that can be felt by the user, irrespective of the physiological limitations. KinoHaptics is built to ensure that no injuries are induced during the rehabilitation period. The persuasive nature of the system allows for personal goal-setting, progress tracking, and most importantly life-style compatibility. The system was evaluated under laboratory conditions, involving 14 users. Results show that KinoHaptics is highly convenient to use, and the vibro-haptic feedback is intuitive, accurate, and has shown to prevent accidental injuries. Also, results show that KinoHaptics is persuasive in nature as it supports behavior change and habit building

Remission of type 2 diabetes mellitus after bariatric surgery - comparison between procedures.

Science.gov (United States)

Fernández-Soto, María L; Martín-Leyva, Ana; González-Jiménez, Amalia; García-Rubio, Jesús; Cózar-Ibáñez, Antonio; Zamora-Camacho, Francisco J; Leyva-Martínez, María S; Jiménez-Ríos, Jose A; Escobar-Jiménez, Fernándo

2017-01-01

We aimed to assess the mid-term type 2 diabetes mellitus recovery patterns in morbidly obese patients by comparing some relevant physiological parameters of patients of bariatric surgery between two types of surgical procedures: mixed (roux-en-Y gastric bypass and biliopancreatic diversion) and restrictive (sleeve gastrectomy). This is a prospective and observational study of co-morbid, type 2 diabetes mellitus evolution in 49 morbidly obese patients: 37 underwent mixed surgery procedures and 12 a restrictive surgery procedure. We recorded weight, height, body mass index, and glycaemic, lipid, and nutritional blood parameters, prior to procedure, as well as six and twelve months post-operatively. In addition, we tested for differences in patient recovery and investigated predictive factors in diabetes remission. Both glycaemic and lipid profiles diminished significantly to healthy levels by 6 and 12 months post intervention. Type 2 diabetes mellitus showed remission in more than 80% of patients of both types of surgical procedures, with no difference between them. Baseline body mass index, glycated haemoglobin, and insulin intake, among others, were shown to be valuable predictors of diabetes remission one year after the intervention. The choice of the type of surgical procedure did not significantly affect the remission rate of type 2 diabetes mellitus in morbidly obese patients. (Endokrynol Pol 2017; 68 (1): 18-25).

Additional Surgery after Breast-Conserving Surgery Varies Widely

Science.gov (United States)

A study published in the Feb. 1, 2012, issue of JAMA found that the number of women who have one or more additional surgeries to remove suspected residual tumor tissue (re-excisions) following breast-conserving surgery (BCS) for breast cancer varies widely across surgeons and hospitals.

Physiological, biochemical, anthropometric, and biomechanical influences on exercise economy in humans

DEFF Research Database (Denmark)

Lundby, C; Montero, D; Gehrig, S

2017-01-01

and cycling EE within a single study. In 22 healthy males (VO2max range 45.5-72.1 mL·min-1·kg-1), no factor related to skeletal muscle structure (% slow-twitch fiber content, number of capillaries per fiber), mitochondrial properties (volume density, oxidative capacity, or mitochondrial efficiency...... were correlated (R2=.94; Pindividual running and cycling EE considering that during cycle ergometer exercise, the biomechanical influence on EE would be small because of the fixed......Interindividual variation in running and cycling exercise economy (EE) remains unexplained although studied for more than a century. This study is the first to comprehensively evaluate the importance of biochemical, structural, physiological, anthropometric, and biomechanical influences on running...

Effects of domestic effluent discharges on mangrove crab physiology: Integrated energetic, osmoregulatory and redox balances of a key engineer species.

Science.gov (United States)

Theuerkauff, Dimitri; Rivera-Ingraham, Georgina A; Mercky, Yann; Lejeune, Mathilde; Lignot, Jehan-Hervé; Sucré, Elliott

2018-03-01

Mangroves are increasingly used as biofiltering systems of (pre-treated) domestic effluents. However, these wastewater discharges may affect local macrofauna. This laboratory study investigates the effects of wastewater exposure on the mangrove spider crab Neosarmatium meinerti, a key engineering species which is known to be affected by waste waters in effluent-impacted areas. These effects were quantified by monitoring biological markers of physiological state, namely oxygen consumption, the branchial cavity ventilation rate, gill physiology and morphology, and osmoregulatory and redox balance. Adults acclimated to clean seawater (SW, 32 ppt) and freshwater (FW, ∼0 ppt) were compared to crabs exposed to wastewater for 5 h (WW, ∼0 ppt). Spider crabs exposed to WW increased their ventilation and whole-animal respiration rates by 2- and 3-fold respectively, while isolated gill respiration increased in the animals exposed to FW (from 0.5 to 2.3 and 1.1 nmol O 2 min -1  mg DW -1 for anterior and posterior gills, respectively) but was not modified in WW-exposed individuals. WW exposure also impaired crab osmoregulatory capacity; an 80 mOsm kg -1 decrease was observed compared to FW, likely due to decreased branchial NKA activity. ROS production (DCF fluorescence in hemolymph), antioxidant defenses (superoxide dismutase and catalase activities) and oxidative damage (malondialdehyde concentration) responses varied according to animal gender. Overall, this study demonstrates that specific physiological parameters must be considered when focusing on crabs with bimodal breathing capacities. We conclude that spider crabs exposed to WW face osmoregulatory imbalances due to functional and morphological gill remodeling, which must rapidly exhaust energy reserves. These physiological disruptions could explain the ecological changes observed in the field. Copyright © 2018. Published by Elsevier B.V.

Nose Surgery

Science.gov (United States)

... Patient Health Home Copyright © 2018 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2018. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

To mesh or not to mesh: a review of pelvic organ reconstructive surgery

Directory of Open Access Journals (Sweden)

Dällenbach P

2015-04-01

Full Text Available Patrick Dällenbach Department of Gynecology and Obstetrics, Division of Gynecology, Urogynecology Unit, Geneva University Hospitals, Geneva, Switzerland Abstract: Pelvic organ prolapse (POP is a major health issue with a lifetime risk of undergoing at least one surgical intervention estimated at close to 10%. In the 1990s, the risk of reoperation after primary standard vaginal procedure was estimated to be as high as 30% to 50%. In order to reduce the risk of relapse, gynecological surgeons started to use mesh implants in pelvic organ reconstructive surgery with the emergence of new complications. Recent studies have nevertheless shown that the risk of POP recurrence requiring reoperation is lower than previously estimated, being closer to 10% rather than 30%. The development of mesh surgery – actively promoted by the marketing industry – was tremendous during the past decade, and preceded any studies supporting its benefit for our patients. Randomized trials comparing the use of mesh to native tissue repair in POP surgery have now shown better anatomical but similar functional outcomes, and meshes are associated with more complications, in particular for transvaginal mesh implants. POP is not a life-threatening condition, but a functional problem that impairs quality of life for women. The old adage “primum non nocere” is particularly appropriate when dealing with this condition which requires no treatment when asymptomatic. It is currently admitted that a certain degree of POP is physiological with aging when situated above the landmark of the hymen. Treatment should be individualized and the use of mesh needs to be selective and appropriate. Mesh implants are probably an important tool in pelvic reconstructive surgery, but the ideal implant has yet to be found. The indications for its use still require caution and discernment. This review explores the reasons behind the introduction of mesh augmentation in POP surgery, and aims to

Conservation physiology of marine fishes

DEFF Research Database (Denmark)

Jørgensen, Christian; Peck, Myron A.; Antognarelli, Fabio

2012-01-01

At the end of May, 17 scientists involved in an EU COST Action on Conservation Physiology of Marine Fishes met in Oristano, Sardinia, to discuss how physiology can be better used in modelling tools to aid in management of marine ecosystems. Current modelling approaches incorporate physiology...... to different extents, ranging from no explicit consideration to detailed physiological mechanisms, and across scales from a single fish to global fishery resources. Biologists from different sub-disciplines are collaborating to rise to the challenge of projecting future changes in distribution and productivity...

Do Food Preferences Change After Bariatric Surgery?

Science.gov (United States)

Gero, Daniel; Steinert, Robert E; le Roux, Carel W; Bueter, Marco

2017-09-01

Insights into physiological mechanisms responsible for weight loss after bariatric surgery (BS) have challenged the traditional view that mechanical restriction and caloric malabsorption are major drivers of weight loss and health benefits after BS. Altered diet selection with an increased postoperative preference for low-sugar and low-fat food has also been implicated as a potential mechanism beyond mere reduction of calorie intake. However, the empirical support for this phenomenon is not uniform and evidence is largely based on indirect measurements, such as self-reported food intake data, which are prone to inaccuracy due to their subjective character. Most studies indicate that patients not only reduce their caloric intake after BS, but also show a reduced preference of food with high sugar and high fat content. So far, standard behavioral tests to directly measure changes in food intake behavior after BS have been mainly used in animal models. It remains unclear whether there are fundamental shifts in the palatability of high-fat and sugary foods after BS or simply a decrease in the appetitive drive to ingest them. Studies of appetitive behavior in humans after BS have produced equivocal results. Learning processes may play a role as changes in diet selection seem to progress with time after surgery. So far, direct measures of altered food selection in humans after BS are rare and the durability of altered food selection as well as the role of learning remains elusive.

Low capacity of erythrocytes to bind with immune complexes via C3b receptor in patients with systemic lupus erythematosus: correlation with pathological proteinuria

International Nuclear Information System (INIS)

Nojima, Y.; Terai, C.; Minota, S.; Takano, K.; Miyakawa, Y.; Takaku, F.

1985-01-01

Erythrocytes from 51 patients with systemic lupus erythematosus and 75 controls were tested for the capacity to bind aggregated human gamma-globulin labeled with radioiodine in the presence of complement. Both in patients and controls, a trimodal distribution of binding capacity was observed. Low (less than 9% of the added radioactivity), intermediate (9-17%), and high binding (more than 17%) were observed in 13, 58, and 29% in controls and in 49, 43 and 8% in lupus patients. The low binding capacity of erythrocytes persisted even after patients entered remission following steroid therapy. A genetic control of binding capacity was supported by familial surveys. Prevalence of pathological proteinuria was significantly higher in patients with low binding capacity than those with intermediate or high binding capacity (16/25 vs 7/26, P less than 0.01). These results indicate that an impaired physiological disposal of immune complexes via the erythrocyte C3b receptor in lupus patients may contribute to the development of renal involvement

Concomitant atrial fibrillation surgery for people undergoing cardiac surgery

Science.gov (United States)

Huffman, Mark D; Karmali, Kunal N; Berendsen, Mark A; Andrei, Adin-Cristian; Kruse, Jane; McCarthy, Patrick M; Malaisrie, S C

2016-01-01

Background People with atrial fibrillation (AF) often undergo cardiac surgery for other underlying reasons and are frequently offered concomitant AF surgery to reduce the frequency of short- and long-term AF and improve short- and long-term outcomes. Objectives To assess the effects of concomitant AF surgery among people with AF who are undergoing cardiac surgery on short-term and long-term (12 months or greater) health-related outcomes, health-related quality of life, and costs. Search methods Starting from the year when the first “maze” AF surgery was reported (1987), we searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (March 2016), MEDLINE Ovid (March 2016), Embase Ovid (March 2016), Web of Science (March 2016), the Database of Abstracts of Reviews of Effects (DARE, April 2015), and Health Technology Assessment Database (HTA, March 2016). We searched trial registers in April 2016. We used no language restrictions. Selection criteria We included randomised controlled trials evaluating the effect of any concomitant AF surgery compared with no AF surgery among adults with preoperative AF, regardless of symptoms, who were undergoing cardiac surgery for another indication. Data collection and analysis Two review authors independently selected studies and extracted data. We evaluated the risk of bias using the Cochrane ‘Risk of bias’ tool. We included outcome data on all-cause and cardiovascular-specific mortality, freedom from atrial fibrillation, flutter, or tachycardia off antiarrhythmic medications, as measured by patient electrocardiographic monitoring greater than three months after the procedure, procedural safety, 30-day rehospitalisation, need for post-discharge direct current cardioversion, health-related quality of life, and direct costs. We calculated risk ratios (RR) for dichotomous data with 95% confidence intervals (CI) using a fixed-effect model when heterogeneity was low (I2 ≤ 50%) and random

Physiological pseudomyopia.

Science.gov (United States)

Jones, R

1990-08-01

Objective refraction through plus fogging lenses and base-in prisms revealed that normally accommodation is not completely relaxed when the stimulus to accommodation is zero. The myopic shift in the refractive error due to this focus error of accommodation was defined as physiological pseudomyopia. Two previously established features of accommodation are responsible for this behavior: (1) accommodation acts as a proportional control system for steady-state responses; and (2) the rest focus of accommodation is nonzero. It is proposed that the hyperopic shift in refraction observed in cycloplegia is the result of elimination of physiological pseudomyopia.

Infant temperament and parental stress in 3-month-old infants after surgery for complex congenital heart disease.

Science.gov (United States)

Torowicz, Deborah; Irving, Sharon Y; Hanlon, Alexandra L; Sumpter, Danica F; Medoff-Cooper, Barbara

2010-04-01

This study aimed to identify and compare differences in temperament and maternal stress between infants with complex congenital heart disease and healthy controls at 3 months of age. Study sample was drawn from an existing longitudinal study examining growth in infants with congenital heart disease when compared with healthy controls. Infant temperament and parental stress were measured in 129 mother-infant dyads. Inclusion criteria for infants with congenital heart disease were > or = 36-week postmenstrual age, > or = 2500 g at birth, surgery in first 6 weeks of life, and no major congenital anomalies or genetic syndromes. The Early Infancy Temperament Questionnaire and Parent Stress Index were the assessment tools used. Infants with single ventricular (SV) physiology were more negative in mood (F = 7.14, p parenting an irritable infant with SV physiology put these mothers at risk for high levels of stress. Results suggest the need for predischarge anticipatory guidance for parents to better understand and respond to the behavioral style of their infants, in particular, infants with SV physiology.

Aesthetic rhinoplasty plus brow, eyelid and conchal surgery: pitfalls - complications - prevention.

Science.gov (United States)

Gubisch, Wolfgang; Dacho, Andreas

2013-12-13

Within the last years aesthetic surgery enjoys greater popularity and acceptance. One of the most frequently asked operations has been the aesthetic rhinoplasty. Hardly any other field of surgery is exposed to such a critical analysis than aesthetic rhinoplasty because the results are so obvious. According to the "International Society of Aesthetic Surgery" (ISAPS) over 980,000 cosmetic rhinoplasties have been performed in 2010. This corresponds to 10.4% of all registered aesthetic procedures worldwide. Complications can not be eliminated in such a large number of nasal operations. Five to 15% of all patients re-consult a doctor for a revision because they are much dissatisfied with their final rhinoplasty result. Findings of the tip followed by functional problems and irregularities of the nasal dorsum are named most frequently. The responsible rhinosurgeon has to take into account all anatomical and physiological details and to consider ethical and psychological aspects in the pre-selection and postoperative care of the patient. Aesthetic surgeons should be acquainted with terms and definitions like body image, dysmorphophobia or Thersites complex. Acronyms, like "SIMON" or "SYLVIA", support the physician additionally to analyze and assess the patient. The following article describes the most frequent faults, complications and pitfalls after aesthetic rhinoplasty listed by the anatomical structure. Results will be analyzed and strategies and techniques will be suggested to correct the faults and to prevent them in the future. Furthermore psychologic, social and psychiatric aspects will be discussed and handling with aesthetic patients explained.

Effectiveness of patient empowerment over stress related to knee arthroplasty surgery.

Science.gov (United States)

Garzón-Rey, Jorge Mario; Arza-Valdés, Adriana; Nuevo-Gayoso, Montserrat; Aguiló, Jordi

This study aims to show evidence of the Empowerment Session's effectiveness through measurements of surgery related emotional stress before and after this session. The study was performed on 41 patients with knee arthroplasty surgery prescription by measuring the evolution of their emotional stress generated by surgery expectative, during the empowerment session. Two sets of measurements per patient were performed, before and after the empowerment session. Each set consisted of recording an electrocardiogram for 10min while the patients were seated and then applying two standard psychometric tests: State-Trait Anxiety Inventory test and Visual Analog Stress test. Differences in emotional stress were analyzed using psychometric tests and heart rate variability (HRV) analysis as stress biomarkers. Psychometric stress measurement shows a 17.8% reduction in stress according to the total stress scale value, and a 41.9% reduction in stress between test results before and after the session. Mean heart rate values increased by 7.4% with respect to the initial values, very low frequency power and total power also change in value suggesting more sympathetic and less parasympathetic activity. Both psychological and physiological measurements suggest the effectiveness of the empowerment session due to a significant increase in the wellness state of patients. Additionally, the correlation between psychometric tests and HRV indices demonstrates that both emotional stress indicators could be used as feedback on the empowerment sessions or as a reference to enhance surgical outcomes. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

Advances in physiological computing

CERN Document Server

Fairclough, Stephen H

2014-01-01

This edited collection will provide an overview of the field of physiological computing, i.e. the use of physiological signals as input for computer control. It will cover a breadth of current research, from brain-computer interfaces to telemedicine.

To mesh or not to mesh: a review of pelvic organ reconstructive surgery

Science.gov (United States)

Dällenbach, Patrick

2015-01-01

Pelvic organ prolapse (POP) is a major health issue with a lifetime risk of undergoing at least one surgical intervention estimated at close to 10%. In the 1990s, the risk of reoperation after primary standard vaginal procedure was estimated to be as high as 30% to 50%. In order to reduce the risk of relapse, gynecological surgeons started to use mesh implants in pelvic organ reconstructive surgery with the emergence of new complications. Recent studies have nevertheless shown that the risk of POP recurrence requiring reoperation is lower than previously estimated, being closer to 10% rather than 30%. The development of mesh surgery – actively promoted by the marketing industry – was tremendous during the past decade, and preceded any studies supporting its benefit for our patients. Randomized trials comparing the use of mesh to native tissue repair in POP surgery have now shown better anatomical but similar functional outcomes, and meshes are associated with more complications, in particular for transvaginal mesh implants. POP is not a life-threatening condition, but a functional problem that impairs quality of life for women. The old adage “primum non nocere” is particularly appropriate when dealing with this condition which requires no treatment when asymptomatic. It is currently admitted that a certain degree of POP is physiological with aging when situated above the landmark of the hymen. Treatment should be individualized and the use of mesh needs to be selective and appropriate. Mesh implants are probably an important tool in pelvic reconstructive surgery, but the ideal implant has yet to be found. The indications for its use still require caution and discernment. This review explores the reasons behind the introduction of mesh augmentation in POP surgery, and aims to clarify the risks, benefits, and the recognized indications for its use. PMID:25848324

Mechanisms of weight loss, diabetes control and changes in food choices after gastrointestinal surgery.

Science.gov (United States)

Papamargaritis, Dimitrios; Panteliou, Eleftheria; Miras, Alexander D; le Roux, Carel W

2012-12-01

The long-term effects of lifestyle changes, diet and medical therapy on obesity are limited. Bariatric surgery is the most effective long-term treatment with the greatest chances for amelioration of obesity-associated complications, including type 2 diabetes mellitus (T2DM). There is increasing evidence in the literature that bariatric operations have a profound effect on human physiology, by reducing hunger, increasing satiety, paradoxically increasing energy expenditure, and even promoting healthy food preferences. Some of these operations improve glucose homeostasis in patients with T2DM independently of weight loss. Changes in the gut hormone levels of glucagon-like peptide 1, peptide YY and ghrelin have been proposed as some of the mediators implicated in changing physiology. The aim of this review is to critically explore the current knowledge on the putative mechanisms of the change in weight and improvement in T2DM glycaemic control after the most commonly performed bariatric operations.

Inferring physiological energetics of loggerhead turtle (Caretta caretta) from existing data using a general metabolic theory.

Science.gov (United States)

Marn, Nina; Kooijman, S A L M; Jusup, Marko; Legović, Tarzan; Klanjšček, Tin

2017-05-01

Loggerhead turtle is an endangered sea turtle species with a migratory lifestyle and worldwide distribution, experiencing markedly different habitats throughout its lifetime. Environmental conditions, especially food availability and temperature, constrain the acquisition and the use of available energy, thus affecting physiological processes such as growth, maturation, and reproduction. These physiological processes at the population level determine survival, fecundity, and ultimately the population growth rate-a key indicator of the success of conservation efforts. As a first step towards the comprehensive understanding of how environment shapes the physiology and the life cycle of a loggerhead turtle, we constructed a full life cycle model based on the principles of energy acquisition and utilization embedded in the Dynamic Energy Budget (DEB) theory. We adapted the standard DEB model using data from published and unpublished sources to obtain parameter estimates and model predictions that could be compared with data. The outcome was a successful mathematical description of ontogeny and life history traits of the loggerhead turtle. Some deviations between the model and the data existed (such as an earlier age at sexual maturity and faster growth of the post-hatchlings), yet probable causes for these deviations were found informative and discussed in great detail. Physiological traits such as the capacity to withstand starvation, trade-offs between reproduction and growth, and changes in the energy budget throughout the ontogeny were inferred from the model. The results offer new insights into physiology and ecology of loggerhead turtle with the potential to lead to novel approaches in conservation of this endangered species. Copyright © 2017 Elsevier Ltd. All rights reserved.

Physiological response to drought stress in Camptotheca acuminata seedlings from two provenances

Directory of Open Access Journals (Sweden)

Yeqing eYing

2015-05-01

Full Text Available Drought stress is a key environmental factor limiting the growth and productivity of plants. The purpose of this study was to investigate the physiological responses of Camptotheca acuminata (C. acuminata to different drought stresses and compare the drought tolerance between the provenances Kunming (KM and Nanchang (NC, which are naturally distributed in different rainfall zones with annual rainfalls of 1000-1100 mm and 1600-1700 mm, respectively. We determined relative water content (RWC, chlorophyll content (Chl(a+b, net photosynthesis (Pn, gas exchange parameters, relative leakage conductivity (REC, malondialdehyde (MDA content and superoxide dismutase (SOD and peroxidase (POD activities of C. acuminata seedlings under both moderate (50% of maximum field capacity and severe drought stress (30% of maximum field capacity. As the degree of water stress increased, RWC, Chl(a+b content, Pn, stomatal conductance (Gs, transpiration rate (Tr and intercellular CO2 concentration (Ci values decreased, but water use efficiency (WUE, REC, MDA content and SOD and POD activities increased in provenances KM and NC. Under moderate and severe drought stress, provenance KM had higher RWC, Chl(a+b, Pn, WUE, SOD and POD and lower Gs, Tr, Ci and REC in leaves than provenance NC. The results indicated that provenance KM may maintain stronger drought tolerance via improvements in water-retention capacity, antioxidant enzyme activity and membrane integrity.

Organismal climatology: analyzing environmental variability at scales relevant to physiological stress.

Science.gov (United States)

Helmuth, Brian; Broitman, Bernardo R; Yamane, Lauren; Gilman, Sarah E; Mach, Katharine; Mislan, K A S; Denny, Mark W

2010-03-15

Predicting when, where and with what magnitude climate change is likely to affect the fitness, abundance and distribution of organisms and the functioning of ecosystems has emerged as a high priority for scientists and resource managers. However, even in cases where we have detailed knowledge of current species' range boundaries, we often do not understand what, if any, aspects of weather and climate act to set these limits. This shortcoming significantly curtails our capacity to predict potential future range shifts in response to climate change, especially since the factors that set range boundaries under those novel conditions may be different from those that set limits today. We quantitatively examine a nine-year time series of temperature records relevant to the body temperatures of intertidal mussels as measured using biomimetic sensors. Specifically, we explore how a 'climatology' of body temperatures, as opposed to long-term records of habitat-level parameters such as air and water temperatures, can be used to extrapolate meaningful spatial and temporal patterns of physiological stress. Using different metrics that correspond to various aspects of physiological stress (seasonal means, cumulative temperature and the return time of extremes) we show that these potential environmental stressors do not always occur in synchrony with one another. Our analysis also shows that patterns of animal temperature are not well correlated with simple, commonly used metrics such as air temperature. Detailed physiological studies can provide guidance to predicting the effects of global climate change on natural ecosystems but only if we concomitantly record, archive and model environmental signals at appropriate scales.

Physiological correlates of skating performance in women's and men's ice hockey.

Science.gov (United States)

Gilenstam, Kajsa M; Thorsen, Kim; Henriksson-Larsén, Karin B

2011-08-01

The purpose of the current investigation was to identify relationships between physiological off-ice tests and on-ice performance in female and male ice hockey players on a comparable competitive level. Eleven women, 24 ± 3.0 years, and 10 male ice hockey players, 23 ± 2.4 years, were tested for background variables: height, body weight (BW), ice hockey history, and lean body mass (LBM) and peak torque (PT) of the thigh muscles, VO2peak and aerobic performance (Onset of Blood Lactate Accumulation [OBLA], respiratory exchange ratio [RER1]) during an incremental bicycle ergometer test. Four different on-ice tests were used to measure ice skating performance. For women, skating time was positively correlated (p skating time was positively correlated to VO2peak (L O2·min(-1)) in the Acceleration test. The male group had significantly higher physiological test values in all variables (absolute and relative to BW) but not in relation to LBM. Selected off-ice tests predict skating performance for women but not for men. The group of women was significantly smaller and had a lower physiological performance than the group of men and were slower in the on-ice performance tests. However, gender differences in off-ice variables were reduced or disappeared when values were related to LBM, indicating a similar capacity of producing strength and aerobic power in female and male hockey players. Skating performance in female hockey players may be improved by increasing thigh muscle strength, oxygen uptake, and relative muscle mass.

The results of decompressive surgery and instrumented posterolateral fusion in refractory degenerative spondylolisthesis

Directory of Open Access Journals (Sweden)

Behtash H

2009-02-01

Full Text Available "nBackground: Degenerative spondylolisthesis is a common disease of the lumbar spine especially in older ones. The disease represents a challenge to the treating physician. At present, for those patients that deteriorate clinically, there are many proposed algorithms for the surgical treatment. This before and after study was undertaken to assess the surgical results of decompression and instrumented posterolateral fusion in these patients. "nMethods: The study population consisted of 23 patients who had undergone no prior surgery for degenerative spondylolisthesis on the lumbar spine. These patients were treated by decompression, bilateral posterolateral fusion, and segmental (pedicle screw instrumentation with mean follow-up of 29 months (range, 13-73 months. Finally, The clinical results were evaluated for all patients by means of an Oswestry Disability Index (ODI version 2.1, the Henderson's functional capacity, and persistence of leg symptoms, low back pain or claudication. Mann-Whitney and Chi-Square tests were used to assess the average values and comparison, respectively. "nResults: Henderson's functional capacity at the last visit session was excellent in 14 (60.9%, good in 7 (30.4%, fair in 2 (8.7% cases. ODI decreased from 72.2% (50-88% preoperatively to 14.4% (0-54% at the latest follow-up visit. A history of leg pain or claudication was correlated significantly with the amount of decline in ODI score and Henderson's functional capacity (p<0.05. "nConclusion: In spite of limited number of our patients, decompressive surgery plus instrumented posterolateral fusion is a safe, reliable, and satisfactory procedure for treating degenerative lumbar spondylolisthesis. This procedure may be done when conservative treatment was failed and psychological problems can be ruled out.

Physiological characteristics of badminton match play.

Science.gov (United States)

Faude, Oliver; Meyer, Tim; Rosenberger, Friederike; Fries, Markus; Huber, Günther; Kindermann, Wilfried

2007-07-01

The present study aimed at examining the physiological characteristics and metabolic demands of badminton single match play. Twelve internationally ranked badminton players (eight women and four men) performed an incremental treadmill test [VO(2peak = )50.3 +/- 4.1 ml min(-1) kg(-1) (women) and 61.8 +/- 5.9 ml min(-1) kg(-1) (men), respectively]. On a separate day, they played a simulated badminton match of two 15 min with simultaneous gas exchange (breath-by-breath) and heart rate measurements. Additionally, blood lactate concentrations were determined before, after 15 min and at the end of the match. Furthermore, the duration of rallies and rests in between, the score as well as the number of shots per rally were recorded. A total of 630 rallies was analysed. Mean rally and rest duration were 5.5 +/- 4.4 s and 11.4 +/- 6.0 s, respectively, with an average 5.1 +/- 3.9 shots played per rally. Mean oxygen uptake (VO(2)), heart rate (HR), and blood lactate concentrations during badminton matches were 39.6 +/- 5.7 ml min(-1) kg(-1) (73.3% VO(2peak)), 169 +/- 9 min(-1) (89.0% HR(peak)) and 1.9 +/- 0.7 mmol l(-1), respectively. For a single subject 95% confidence intervals for VO(2) and HR during match play were on average 45.7-100.9% VO(2peak) and 78.3-99.8% HR(peak). High average intensity of badminton match play and considerable variability of several physiological variables demonstrate the importance of anaerobic alactacid and aerobic energy production in competitive badminton. A well-developed aerobic endurance capacity seems necessary for fast recovery between rallies or intensive training workouts.

GENERAL SURGERY

African Journals Online (AJOL)

mean time to first surgery post burn was 11.5 days with a median volume of 0.73 mls/kg/% ..... Mode. Mean (SD). Upper limit. 95% CI. Lower limit. 95% CI. Mode. Elective surgery .... evaluating single-unit red blood cell transfusions in reducing.

Combined surgery versus cataract surgery alone for eyes with cataract and glaucoma.