Sample records for surgery physiology indications

  1. Performance Indicators in Spine Surgery. (United States)

    St-Pierre, Godefroy Hardy; Yang, Michael H; Bourget-Murray, Jonathan; Thomas, Ken C; Hurlbert, Robin John; Matthes, Nikolas


    Systematic review. To elucidate how performance indicators are currently used in spine surgery. The Patient Protection and Affordable Care Act has given significant traction to the idea that healthcare must provide value to the patient through the introduction of hospital value-based purchasing. The key to implementing this new paradigm is to measure this value notably through performance indicators. MEDLINE, CINAHL Plus, EMBASE, and Google Scholar were searched for studies reporting the use of performance indicators specific to spine surgery. We followed the Prisma-P methodology for a systematic review for entries from January 1980 to July 2016. All full text articles were then reviewed to identify any measure of performance published within the article. This measure was then examined as per the three criteria of established standard, exclusion/risk adjustment, and benchmarking to determine if it constituted a performance indicator. The initial search yielded 85 results among which two relevant studies were identified. The extended search gave a total of 865 citations across databases among which 15 new articles were identified. The grey literature search provided five additional reports which in turn led to six additional articles. A total of 27 full text articles and reports were retrieved and reviewed. We were unable to identify performance indicators. The articles presenting a measure of performance were organized based on how many criteria they lacked. We further examined the next steps to be taken to craft the first performance indicator in spine surgery. The science of performance measurement applied to spine surgery is still in its infancy. Current outcome metrics used in clinical settings require refinement to become performance indicators. Current registry work is providing the necessary foundation, but requires benchmarking to truly measure performance. 1.

  2. [Indications for surgery in thyroiditis]. (United States)

    Diaconescu, M R; Glod, M; Costea, I; Grigorovici, M; Diaconescu, S


    Inflammatory processes of the thyroid represents a main proportion of the gland's pathology but the majority of them are treated by medical methods, surgery being indicated. In 14 cases (3%) from 464 operations for different thyroid conditions we have encountered authentic inflammatory lesions in 9 cases of Hashimoto's thyroiditis (two associated with papillary thyroid carcinoma and one with malignant lymphoma), two cases of Riedel's thyroiditis and respectively de Quervain thyoiditis, tuberculous thyroiditis and actynomicosis one case each. The common lymphoplasmacytic infiltration in Basedow's disease was not considered likewise as the inflammatory nespecific lesions encountered in benign and malignant pathology of the gland. The clinical and imagistic data, biological evaluation and titer of anticorps but particularly the paraffine examination together with intraoperative estimations are decisive for the diagnosis. Firm diagnosis of thyroiditis was rarely affirmed before operation, surgical indication being formulated on clinical criterions dominated by cancer suspicion. Among these are diffuse or (multi)nodular thyromegaly with a dominant nodule with recent appearance and rapid growing in temporal and geographic proximity of Chemobyl disaster, with hard consistence, celsian or compressive features and adenopathy. More added the imagistic signs but especially suspect aspects of the FNAB (follicular or with Hürthle cells smears) and also of the frozen sections. Certainty diagnosis was established by paraffine examination not always without hesitations or reexamination (Hashimoto's thyroiditis diagnosed in one case was finally a malignant lymphoma). Large removal decided after intraoperative findings induced for the most of patients a definitive hypothyroidism. All the diagnosis resources must be exhausted for the diagnosis of the inflammatory lesions of the thyroid to avoid unnecessary surgery. On the other side the chronic overstimulation by the TSH of the

  3. Contemporary indications for transsphenoidal pituitary surgery. (United States)

    Miller, Brandon A; Ioachimescu, Adriana G; Oyesiku, Nelson M


    To analyze current indications for transsphenoidal pituitary surgery. The current literature regarding transsphenoidal surgery for all subtypes of pituitary adenomas and other sellar lesions was examined. Alternate approaches for pituitary surgery were also reviewed. Transsphenoidal surgery continues to be the mainstay of surgical treatment for pituitary tumors, and has good outcomes in experienced hands. Pre- and postoperative management of pituitary tumors remains an important part of the treatment of patients with pituitary tumors. Even as medical and surgical treatment for pituitary tumors evolves, transsphenoidal surgery remains a mainstay of treatment. Outcomes after transshenoidal surgery have improved over time. Neurosurgeons must be aware of the indications, risks and alternatives to transsphenoidal pituitary surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Indicators for surgery in adhesive bowel obstruction. (United States)

    Rajanikmanth, P V; Kate, V; Ananthakrishnan, N


    There is lack of data on risk factors, which, if present, would indicate the need for surgery in patients with adhesive bowel obstruction. A Cohort of 100 consecutive patients with adhesive obstruction was studied prospectively to compare clinical and investigative parameters between the operative and conservative group. It was found that female gender, previous obstetric or gynaecological procedures, pulse and BP on admission, nature of nasogastric aspirate, single distended loop on abdominal x-ray as also predominant ileal distension were independent factors indicating a high probability of surgical intervention. Patients with 2 or more risk factors had 12 times higher probability of surgery and in those with 3 or more the relative risk was 30 times. Patients with such risk factors should be monitored closely after admission and should be taken for surgery after an initial short trial of conservative measures.

  5. Physiological and haematological indices of two Nigerian goat ...

    African Journals Online (AJOL)

    Introducing an indigenous or exotic breed to unfamiliar environment paves way for livestock improvement. This study examined the physiological and haematological indices of 24Red Sokoto (RS) and West African Dwarf (WAD) goats reared under uniform condition in Ilorin, to determine adaptability of RS goats over a ...

  6. Genetic analysis of field and physiological indicators of drought ...

    African Journals Online (AJOL)

    In order to study the inheritance of field, physiological and metabolite indicators of drought tolerance in wheat, an eight-parental diallel cross, excluding reciprocals, was grown in a randomized complete block design (RCBD) with three replications under two different water regimes (irrigated and rainfed). Significant ...

  7. Physiological indicators of pathologic video game use in adolescence. (United States)

    Coyne, Sarah M; Dyer, W Justin; Densley, Rebecca; Money, Nathan M; Day, Randal D; Harper, James M


    Pathologic video game use (PVGU) has been associated with a host of negative psychological, physical, and social outcomes during adolescence; however, little research has examined physiological predictors of such use. The purpose of the study was to examine physiological predictors of the development of PVGU across adolescence. The article involves a 1-year longitudinal study across midadolescence. Participants were 374 adolescents and their parents from a large metropolitan area in the Northwest United States. PVGU was assessed via questionnaire, as were a number of control variables. A number of physiological indicators including respiratory sinus arrhythmia (RSA) and galvanic skin conductance (indices of parasympathetic and sympathetic nervous system activity, respectively) were measured during baseline, a cognitively stimulating task (Rubik's cube), and a family problem-solving task. Less RSA withdrawal to a cognitively simulating task was related to greater pathologic video game symptoms, but less RSA withdrawal to a family problem-solving task was associated with the presence of pathologic video game symptoms (p video game symptoms (p < .01). These findings suggest that adolescents who do not find cognitive tasks stimulating physiologically have a greater severity of PVGU. Additionally, adolescents who show physiological signs of stress in a family task were more likely to have PVGU symptoms and only girls have more severe PVGU levels. This study is the first to show that physiological indicators predict PVGU over time in adolescence and has important implications regarding the prevention and treatment of PVGU in adolescence. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  8. Driver's mental workload prediction model based on physiological indices. (United States)

    Yan, Shengyuan; Tran, Cong Chi; Wei, Yingying; Habiyaremye, Jean Luc


    Developing an early warning model to predict the driver's mental workload (MWL) is critical and helpful, especially for new or less experienced drivers. The present study aims to investigate the correlation between new drivers' MWL and their work performance, regarding the number of errors. Additionally, the group method of data handling is used to establish the driver's MWL predictive model based on subjective rating (NASA task load index [NASA-TLX]) and six physiological indices. The results indicate that the NASA-TLX and the number of errors are positively correlated, and the predictive model shows the validity of the proposed model with an R 2 value of 0.745. The proposed model is expected to provide a reference value for the new drivers of their MWL by providing the physiological indices, and the driving lesson plans can be proposed to sustain an appropriate MWL as well as improve the driver's work performance.

  9. Indications and contraindications for surgery in esophageal cancer

    International Nuclear Information System (INIS)

    Carriquiry, G.


    In this story we will present the main problems that we have as a surgeons at the moment to decide the indication for surgery in patients with esophageal cancer. Undoubtedly, the patient that will be submitted to surgery must have strict criteria in order to obtain good results. The patient must be compensated from respiratory, cardiovascular, hepatic and renal point of view with a (IMC) above 20, with Karnofsky index above 80% (wanders well), that declares the acceptance of surgery as well as the conserved appetite. After deciding the surgery according to the general conditions, should be discuss the type of procedure, based primarily on tumor topography, because there are different results both morbidity and long-term survival. The indications for resection or palliative surgery depend on the tumor stage. The indications for resection surgery with conventional or eventual extended lymphadenectomy require a patient in good condition, good experience the surgical team and a good hospital support. In tumor stage I the indication is a supposedly curative surgery. The tumor stages II b, III and IV are the heritage of palliative surgery, with or without tumor resection. The age is not an absolute contraindication for surgery, but the hypertension, liver cirrhosis, respiratory diseases with severe functional impact, ischemic heart disease, dilated heart with lowered LVEF, severe psychological disorders and the loss of appetite are contraindication. The morbidity and mortality has declined markedly due to technological advances and specialization of surgical groups, so that surgery is still the best treatment for selected patients

  10. Effects of maxillary sinus floor elevation surgery on maxillary sinus physiology

    NARCIS (Netherlands)

    Timmenga, NM; Raghoebar, GM; Liem, RSB; van Weissenbruch, R; Manson, WL; Vissink, A

    In a prospective study, the effects of elevation surgery of the maxillary sinus floor on maxillary sinus physiology were assessed. Seventeen consecutive patients without preoperative anamnestic, clinical and radiological signs of maxillary sinusitis underwent sinus floor elevation surgery with iliac

  11. Physiological indices of seawater readiness in postspawning steelhead kelts (United States)

    Buelow, Jessica; Moffitt, Christine M.


    Management goals to improve the recovery of steelhead (Oncorhynchus mykiss) stocks at risk of extinction include increasing the proportion of postspawning fish that survive and spawn again. To be successful, postspawning steelhead (kelts) migrating downstream to the ocean must prepare physiologically and physically for a seawater transition. We sampled blood, gill filaments, and evaluated the external condition of migrating kelts from an ESA-listed population in the Snake/Columbia River system over two consecutive years to evaluate their physiological readiness for transition to seawater. We chose attributes often considered as measures of preparation for seawater in juveniles, including gill Na+,K+ ATPase activity, plasma electrolytes and hormones to consider factors related to external condition, size and sex. We found kelts in good external condition had plasma profiles similar to downstream-migrating smolts. In addition, we found more than 80% of kelts ranked in good external condition had smolt-like body silvering. We compared measures from migrating kelts with samples obtained from hatchery fish at the time of spawning to confirm that Na+, K+ ATPase activity in kelts was significantly elevated over spawning fish. We found significant differences in gill Na+, K+ ATPase activity in migrating kelts between the years of sampling, but little indication of influence of fish condition. We conclude that the postspawning steelhead sampled exhibited a suite of behaviours, condition and physiology characteristic of fish prepared for successful transition to a seawater environment.

  12. Quality Management and Key Performance Indicators in Oncologic Esophageal Surgery. (United States)

    Gockel, Ines; Ahlbrand, Constantin Johannes; Arras, Michael; Schreiber, Elke Maria; Lang, Hauke


    Ranking systems and comparisons of quality and performance indicators will be of increasing relevance for complex "high-risk" procedures such as esophageal cancer surgery. The identification of evidence-based standards relevant for key performance indicators in esophageal surgery is essential for establishing monitoring systems and furthermore a requirement to enhance treatment quality. In the course of this review, we analyze the key performance indicators case volume, radicality of resection, and postoperative morbidity and mortality, leading to continuous quality improvement. Ranking systems established on this basis will gain increased relevance in highly complex procedures within the national and international comparison and furthermore improve the treatment of patients with esophageal carcinoma.

  13. Laparoscopic anti-reflux surgery : indications, techniques and physiological effects

    NARCIS (Netherlands)

    Broeders, J.A.J.L.


    Gastro-oesophageal reflux disease (GORD) is a highly prevalent chronic disorder in which retrograde flow of gastric contents into the oesophagus causes troublesome symptoms or lesions. Proton pump inhibitor (PPI) therapy controls reflux disease in 95% of the patients and the remaining 5% have

  14. Physiological Indices of Pilots' Abilities Under Varying Task Demands. (United States)

    Wang, Zhen; Zheng, Lingxiao; Lu, Yanyu; Fu, Shan


    This study investigated pilots' ability by examining the effects of flight experience and task demand on physiological reactions, and analyzing the diagnostic meanings underlying correlated parameters. A total of 12 experienced pilots and 12 less experienced pilots performed 4 simulated flight tasks, including normal and emergency situations. Fixation duration (FD), saccade rate (SR), blink rate (BR), heart rate (HR), respiration rate (RR), and respiration amplitude (RA) were measured during the tasks. More experienced pilots adapted their SR flexibly to changing task demands and had significantly lower SR than less experienced pilots during emergency tasks (29.6 ± 20.0 vs. 70.1 ± 67.1 saccades/min). BR, HR, and RR were affected by pilot experience but not by task demand. More experienced pilots had lower BR, HR, and RR than less experienced pilots during both normal tasks (BR: 14.3 ± 13.0 vs. 32.9 ± 25.8 blinks/min; HR: 72.7 ± 7.9 vs. 83.2 ± 7.2 bpm; RR: 15.4 ± 2.1 vs. 19.5 ± 5.2 breaths/min) and emergency tasks (BR: 10.2 ± 5.0 vs. 32.3 ± 20.8 blinks/min; HR: 73.3 ± 7.3 vs. 82.2 ± 11.6 bpm; RR: 15.6 ± 1.9 vs. 18.0 ± 3.2 breaths/min). FD and RA were not sensitive to either flight experience or task demand. Physiological reactions have the potential to reflect pilots' ability from different aspects. SR and BR could indicate pilots' differences in information access strategy. HR and RR could reflect a pilot's physical fitness. These findings are useful for understanding a pilot's ability.

  15. Altered male physiologic function after surgery for prostate cancer: couple perspective

    Directory of Open Access Journals (Sweden)

    Matvey Tsivian


    Full Text Available Purpose: Both the diagnosis of prostate cancer (PCa and the physiologic outcomes of surgical treatment impact the male’s psychological sphere. However, current research advocates a refocusing of outcomes directed to the PCa “couple”. Herein we acquire insight into perspective and concordance regarding male physiological function from the standpoint of a couple recovering from PCa surgery. Materials and methods: Couples whereby the male partner had undergone primary surgical treatment for PCa were mailed a Retrospective Sexual Survey (RSS packet consisting of male and female partner questionnaires. RSS questions surveyed physiological changes in libido, foreplay, erection and arousal, orgasm and ejaculation in addition to perceived psychological impact. Patients’ and partners’ scores were evaluated to determine the concordance of both individual items as well as domain sums. Results: Twenty-eight couples completed the questionnaires. Only about 40% of men and women were happy with their levels of sexual interest with 82% concordance. Urine loss during orgasm was reported by 43% of men; the majority of participants were bothered by it. Ejaculation changes were observed by 96% of men (concordance 96% with most reporting anejaculation. A change in orgasm experience was noted by 86% of men (and 36% of their female partners, p < 0.0001. Despite the change, the majority of men and women reported being satisfied with their ability to climax. Conclusion: Our results indicate that patients and their female partners may interpret differently the same physiological outcomes of PCa surgery. This information could be useful to better counsel the PCa couple and help patients and partners adjust after surgery.

  16. Toward physiological indices of emotional state driving future ebook interactivity

    Directory of Open Access Journals (Sweden)

    Jan B.F. van Erp


    Full Text Available Ebooks of the future may respond to the emotional experience of the reader. (Neuro- physiological measures could capture a reader’s emotional state and use this to enhance the reading experience by adding matching sounds or to change the storyline therewith creating a hybrid art form in between literature and gaming. We describe the theoretical foundation of the emotional and creative brain and review the neurophysiological indices that can be used to drive future ebook interactivity in a real life situation. As a case study, we report the neurophysiological measurements of a bestselling author during nine days of writing which can potentially be used later to compare them to those of the readers. In designated calibration blocks, the artist wrote emotional paragraphs for emotional (IAPS pictures. Analyses showed that we can reliably distinguish writing blocks from resting but we found no reliable differences related to the emotional content of the writing. The study shows that measurements of EEG, heart rate (variability, skin conductance, facial expression and subjective ratings can be done over several hours a day and for several days in a row. In follow-up phases, we will measure 300 readers with a similar setup.

  17. Current status of indications for surgery in peptic ulcer disease. (United States)

    Jamieson, G G


    The eradication of Helicobacter pylori in patients with peptic ulcer disease has greatly diminished the need for antiulcer surgery. However, in societies where such drug therapy is considered too expensive and because occasional patients remain refractory to optimal medical therapy, elective surgery for duodenal ulcer disease is still carried out. If the required expertise is available, it can be undertaken laparoscopically. The advent of endoscopic therapies such as heater probe therapy and injection sclerotherapy has also greatly diminished the need for emergency surgery in bleeding peptic ulcer disease. Once again, however, when such therapy fails surgery is still indicated. Even with perforated peptic ulcer disease the role of surgery has receded somewhat, but here not because of changes in drug therapy. Nonoperative management of perforation is indicated in fit patients if the diagnosis is in doubt, in any patient when surgical facilities are unavailable (e.g., remote geographic areas, on board ship), or when a patient is extremely ill either because of co-morbidity or late presentation of the disease. Operation should be considered in all patients when the perforation is established to be unsealed, particularly after

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

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


    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:

  19. [Comparative analysis of efficiency indicators in ambulatory surgery]. (United States)

    Rodríguez Ortega, María; Porrero Carro, José Luis; Aranaz Andrés, Jesús María; Castillo Fe, María José; Alonso García, María Teresa; Sánchez-Cabezudo Díaz-Guerra, Carlos


    To find comparative elements for quality control in major ambulatory surgery (MAS) units. Descriptive and comparative study of the Ambulatory Care Index (AI) and Substitution Index (SI) in the Santa Cristina Hospital Surgery Service (Madrid, Spain) compared to Key Indicators (KI) of the National Health Service (NHS). 7,817 MAS procedures (between 2006 and 2014) were analysed. The average annual AI was 54%, higher (p <0.0001) than «ambulatory surgery» KI. The hernia outpatient procedures (average 72%) were also superior to the national KI (p <0.0001), but ambulatory haemorrhoidectomy (average 33.6%) was clearly lower (p <0.0001). KI of the NHS are useful and allow to establish a proper development in the global AI and hernia outpatient surgery with opportunities for improvement in haemorrhoidectomy. Their collection should be careful, not including minor surgeries. Also, their usefulness could be increased if data was broken down by speciality and by complexity. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. [Indicators of healthcare quality in day surgery (2010-2012)]. (United States)

    Martínez Rodenas, F; Codina Grifell, J; Deulofeu Quintana, P; Garrido Corchón, J; Blasco Casares, F; Gibanel Garanto, X; Cuixart Vilamajó, L; de Haro Licer, J; Vazquez Dorrego, X


    Monitoring quality indicators in Ambulatory Surgery centers is fundamental in order to identify problems, correct them and prevent them. Given their large number, it is essential to select the most valid ones. The objectives of the study are the continuous improvement in the quality of healthcare of day-case surgery in our center, by monitoring selective quality parameters, having periodic information on the results and taking corrective measures, as well as achieving a percentage of unplanned transfer and cancellations within quality standards. Prospective, observational and descriptive study of the day-case surgery carried out from January 2010 to December 2012. Unplanned hospital admissions and cancellations on the same day of the operation were selected and monitored, along with their reasons. Hospital admissions were classified as: inappropriate selection, medical-surgical complications, and others. The results were evaluated each year and statistically analysed using χ(2) tests. A total of 8,300 patients underwent day surgery during the 3 years studied. The day-case surgery and outpatient index increased by 5.4 and 6.4%, respectively (P<.01). Unexpected hospital admissions gradually decreased due to the lower number of complications (P<.01). Hospital admissions, due to an extended period of time in locoregional anaesthesia recovery, also decreased (P<.01). There was improved prevention of nausea and vomiting, and of poorly controlled pain. The proportion of afternoon admissions was significantly reduced (P<.01). The cancellations increased in 2011 (P<.01). The monitoring of quality parameters in day-case surgery has been a useful tool in our clinical and quality management. Globally, the unplanned transfer and cancellations have been within the quality standards and many of the indicators analysed have improved. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  1. Association between human and animal thermal comfort indices and physiological heat stress indicators in dairy calves. (United States)

    Kovács, L; Kézér, F L; Ruff, F; Szenci, O; Jurkovich, V


    Warm summer episodes have a significant effect on the overall health and well-being of young cattle; however, it is not known which temperature measure should be used for estimating heat stress in dairy calves. In this study, generalized linear mixed-effects models were used to estimate the relationships between thermal comfort indices and animal-based heat stress indicators in sixteen Holstein bull calves that were housed in individual calf hutches. Data were collected under continental weather characteristics over a 5-day period: day 1 (lower-temperature day), days 2 and 3 (heat stress days), and a 2-day post-stress period. Relative humidity, ambient temperature, the heat index, the humidex and five different temperature-humidity indices (THI) were used as thermal indices. Physiological variables monitored included respiratory rate, rectal temperature, ear skin temperature and heart rate. The heat index and the humidex measuring human thermal comfort were more closely associated with physiological measures than were the ambient temperature or the THIs (in case of heat index: R 2 = 0.87 for respiratory rate, R 2 = 0.63 for rectal temperature, R 2 = 0.70 for ear skin temperature, and R 2 = 0.78 for heart rate, respectively; in case of humidex: R 2 = 0.85 for respiratory rate, R 2 = 0.60 for rectal temperature, R 2 = 0.68 for ear skin temperature, and R 2 = 0.75 for heart rate, respectively). Based on our results, parameters of human outdoor comfort seem better to estimate heat stress in dairy calves in a continental region than those of THIs or ambient temperature. Copyright © 2018. Published by Elsevier Inc.

  2. Interpretation of physiological indicators of motivation: Caveats and recommendations. (United States)

    Richter, Michael; Slade, Kate


    Motivation scientists employing physiological measures to gather information about motivation-related states are at risk of committing two fundamental errors: overstating the inferences that can be drawn from their physiological measures and circular reasoning. We critically discuss two complementary approaches, Cacioppo and colleagues' model of psychophysiological relations and construct validation theory, to highlight the conditions under which these errors are committed and provide guidance on how to avoid them. In particular, we demonstrate that the direct inference from changes in a physiological measure to changes in a motivation-related state requires the demonstration that the measure is not related to other relevant psychological states. We also point out that circular reasoning can be avoided by separating the definition of the motivation-related state from the hypotheses that are empirically tested. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Using lichens as physiological indicators of sulfurous pollutants

    Energy Technology Data Exchange (ETDEWEB)

    Sundstroem, K R; Haellgren, J E


    Lichens are known to be extremely sensitive to sulfurous pollutants and have thus disappeared from the regions around urban areas. The authors give the physiological background to this sensitivity and an outline for a test system for sulfurous pollutants based on lichens.

  4. Physiological Indicators of Workload in a Remotely Piloted Aircraft Simulation (United States)


    cognitive workload. That is, both cognitive underload and overload can negatively impact performance (Young & Stanton, 2002). One solution to...Report contains color. 14. ABSTRACT Toward preventing performance decrements associated with mental overload in remotely piloted aircraft (RPA...operations, the current research investigated the feasibility of using physiological measures to assess cognitive workload. Two RPA operators were

  5. Toward physiological indices of emotional state driving future ebook interactivity

    NARCIS (Netherlands)

    Erp, J.B.F. van; Hogervorst, M.A.; Werf, Y.D. van der


    Ebooks of the future may respond to the emotional experience of the reader. (Neuro-) physiological measures could capture a reader's emotional state and use this to enhance the reading experience by adding matching sounds or to change the storyline therewith creating a hybrid art form in between

  6. Toward physiological indices of emotional state driving future ebook interactivity

    NARCIS (Netherlands)

    van Erp, Johannes Bernardus Fransiscus; Hogervorst, Maarten A.; van der Werf, Ysbrand D.


    Ebooks of the future may respond to the emotional experience of the reader. (Neuro-) physiological measures could capture a reader’s emotional state and use this to enhance the reading experience by adding matching sounds or to change the storyline therewith creating a hybrid art form in between

  7. Chronic pancreatitis: indications to surgery and remote results assessment criteria

    Directory of Open Access Journals (Sweden)

    A. V. Klimenko


    Full Text Available Present indications to surgery include intractable pain syndrome, severe dilation of the Wirsung’s duct, strictures and stones in the Wirsung’s duct, pancreatic pseudocysts, duodenal stenosis and obstructive jaundice because of “inflammatory mass” in the pancreatic head. But these absolute indications mean that in the most cases pancreatic exocrine and endocrine functions are already decompensated. Therefore it is important to produce new indications to surgical treatment of the CP in early stages. Also it is necessary to make such remote results assessment criteria that will allow to range among parenchymapreserving and resectional technics according to anatomical and functional parameters. Goal: to adjust indications to surgical treatment of the CP according to leading pathogenetic factors and develop criteria to assess remote results. Patients and methods: 122 CP patients have undergone surgery. There were 103 (84,4% men and – 19 (15,6% women, mean age - 45. Alcohol etiology of the CP was in 79 (64,8% patients, postpancreonecrotic – in 29 (23,8%, biliary – in 6 (4,9%, idiopathic – in 8 (6,6%. Wirsung’s duct diameter of 4 – 8 mm – was in 65 (53,3% patients, 8 – 12 and more – in 57 (46,7%. By Shalimov classification there were “pseudotumorous” – in 39 (31,9%, “calculouse” – in 40 (32,8%, fibrose-cystic – in 17 (13,9%, fibrose-degenerative with adjacent organs involvement and hampering of their function – in 26 (21,4% patients. All patients had pain syndrome and 79 (64,8% – exocrine and endocrine insufficiency. All patients underwent abdominal CT-scan, fecal elastase test, C-peptide, endogenic insulin, glucose, immunehystochemical investigation of biopsy samples taken from body corpus and tale simultaneously etc. Results: We have found that gastroenterologists poorly recognize “surgical” type of CP and restrain patients from being directed to surgical pancreatologists for surgical therapy. We

  8. Melanosome evolution indicates a key physiological shift within feathered dinosaurs. (United States)

    Li, Quanguo; Clarke, Julia A; Gao, Ke-Qin; Zhou, Chang-Fu; Meng, Qingjin; Li, Daliang; D'Alba, Liliana; Shawkey, Matthew D


    Inference of colour patterning in extinct dinosaurs has been based on the relationship between the morphology of melanin-containing organelles (melanosomes) and colour in extant bird feathers. When this relationship evolved relative to the origin of feathers and other novel integumentary structures, such as hair and filamentous body covering in extinct archosaurs, has not been evaluated. Here we sample melanosomes from the integument of 181 extant amniote taxa and 13 lizard, turtle, dinosaur and pterosaur fossils from the Upper-Jurassic and Lower-Cretaceous of China. We find that in the lineage leading to birds, the observed increase in the diversity of melanosome morphologies appears abruptly, near the origin of pinnate feathers in maniraptoran dinosaurs. Similarly, mammals show an increased diversity of melanosome form compared to all ectothermic amniotes. In these two clades, mammals and maniraptoran dinosaurs including birds, melanosome form and colour are linked and colour reconstruction may be possible. By contrast, melanosomes in lizard, turtle and crocodilian skin, as well as the archosaurian filamentous body coverings (dinosaur 'protofeathers' and pterosaur 'pycnofibres'), show a limited diversity of form that is uncorrelated with colour in extant taxa. These patterns may be explained by convergent changes in the key melanocortin system of mammals and birds, which is known to affect pleiotropically both melanin-based colouration and energetic processes such as metabolic rate in vertebrates, and may therefore support a significant physiological shift in maniraptoran dinosaurs.

  9. Physiological basis of clinically used coronary hemodynamic indices

    NARCIS (Netherlands)

    Spaan, Jos A. E.; Piek, Jan J.; Hoffman, Julien I. E.; Siebes, Maria


    In deriving clinically used hemodynamic indices such as fractional flow reserve and coronary flow velocity reserve, simplified models of the coronary circulation are used. In particular, myocardial resistance is assumed to be independent of factors such as heart contraction and driving pressure.

  10. Physiological markers in insects indicating treatment with ionizing radiation

    International Nuclear Information System (INIS)

    Nation, J.L.; Smittle, B.J.; Milne, K.R.


    Seven markers or tests that can be applied to 3rd instars of the Caribbean fruit fly as indicators of exposure to ionizing radiation are described, including (1) whole body melanization, (2) phenoloxidase spot test, (3) quantitative phenoloxidase measurement, (4) measurement of the ratio between size of the supraesophageal ganglion and the proventriculus, (5) development of imaginal discs, (6) number of hemocytes in one μl of hemolymph, and (7) larval weight. The markers work best and are most definitive when larvae are exposed to at least 50 Gy no later than the first day of the 3rd instar. All of the tests are sensitive enough to be applied to a single 3rd instar larva. Combinations of some of the tests could be used on a single larva. Tests (1) and (2) are easiest to use and require no specific technical training, and seem to have the most potential for practical use in quarantine. (author)

  11. Different geomagnetic indices as an indicator for geo-effective solar storms and human physiological state (United States)

    Dimitrova, Svetla


    A group of 86 healthy volunteers were examined on each working day during periods of high solar activity. Data about systolic and diastolic blood pressure, pulse pressure, heart rate and subjective psycho-physiological complaints were gathered. MANOVA was employed to check the significance of the influence of three factors on the physiological parameters. The factors were as follows: (1) geomagnetic activity estimated by daily amplitude of H-component of the local geomagnetic field, Ap- and Dst-index; (2) gender; and (3) the presence of medication. Average values of systolic, diastolic blood pressure, pulse pressure and subjective complaints of the group were found to increase significantly with geomagnetic activity increment.

  12. The assessment of neural injury following open heart surgery by physiological tremor analysis. (United States)

    Németh, Adám; Hejjel, László; Ajtay, Zénó; Kellényi, Lóránd; Solymos, Andor; Bártfai, Imre; Kovács, Norbert; Lenkey, Zsófia; Cziráki, Attila; Szabados, Sándor


    The appearance of post-operative cognitive dysfunction as a result of open heart surgery has been proven by several studies. Focal and/or sporadic neuron damage emerging in the central nervous system may not only appear as cognitive dysfunction, but might strongly influence features of physiological tremor. We investigated 110 patients (age: 34-73 years; 76 male, 34 female; 51 coronary artery bypass grafting (CABG), 25 valve replacement, 25 combined open heart surgery, 9 off-pump CABG) before surgery and after open-heart surgery on the 3(rd) to 5(th) post-operative day. The assessment of the physiological tremor analysis was performed with our newly developed equipment based on the Analog Devices ADXL 320 JPC integrated accelerometer chip. Recordings were stored on a PC and spectral analysis was performed by fast Fourier transformation (FFT). We compared power integrals in the 1-4 Hz, 4-8 Hz and 8-12 Hz frequency ranges and these were statistically assessed by the Wilcoxon rank correlation test. We found significant changes in the power spectrum of physiological tremor. The spectrum in the 8-12 Hz range (neuronal oscillation) decreased and a shift was recognised to the lower spectrum (p open heart surgery.

  13. Influence of Music on Preoperative Anxiety and Physiologic Parameters in Women Undergoing Gynecologic Surgery. (United States)

    Labrague, Leodoro J; McEnroe-Petitte, Denise M


    The aim of this study was to determine the influence of music on anxiety levels and physiologic parameters in women undergoing gynecologic surgery. This study employed a pre- and posttest experimental design with nonrandom assignment. Ninety-seven women undergoing gynecologic surgery were included in the study, where 49 were allocated to the control group (nonmusic group) and 48 were assigned to the experimental group (music group). Preoperative anxiety was measured using the State Trait Anxiety Inventory (STAI) while noninvasive instruments were used in measuring the patients' physiologic parameters (blood pressure [BP], pulse [P], and respiration [R]) at two time periods. Women allocated in the experimental group had lower STAI scores (t = 17.41, p music during the preoperative period in reducing anxiety and unpleasant symptoms in women undergoing gynecologic surgery. © The Author(s) 2014.

  14. Indications for and outcomes of tertiary referrals in refractive surgery

    NARCIS (Netherlands)

    Patryn, Eliza K.; Vrijman, Violette; Nieuwendaal, Carla P.; van der Meulen, Ivanka J. E.; Mourits, Maarten P.; Lapid-Gortzak, Ruth


    To review the spectrum of disease, symptomatology, and management offered to patients referred for a second opinion after refractive surgery. A prospective cohort study was done on all patients referred from October 1, 2006, to September 30, 2011, to a tertiary eye clinic after refractive surgery of

  15. Phrenic Nerve Palsy and Regional Anesthesia for Shoulder Surgery: Anatomical, Physiologic, and Clinical Considerations. (United States)

    El-Boghdadly, Kariem; Chin, Ki Jinn; Chan, Vincent W S


    Regional anesthesia has an established role in providing perioperative analgesia for shoulder surgery. However, phrenic nerve palsy is a significant complication that potentially limits the use of regional anesthesia, particularly in high-risk patients. The authors describe the anatomical, physiologic, and clinical principles relevant to phrenic nerve palsy in this context. They also present a comprehensive review of the strategies for reducing phrenic nerve palsy and its clinical impact while ensuring adequate analgesia for shoulder surgery. The most important of these include limiting local anesthetic dose and injection volume and performing the injection further away from the C5-C6 nerve roots. Targeting peripheral nerves supplying the shoulder, such as the suprascapular and axillary nerves, may be an effective alternative to brachial plexus blockade in selected patients. The optimal regional anesthetic approach in shoulder surgery should be tailored to individual patients based on comorbidities, type of surgery, and the principles described in this article.

  16. Relationship Between Kinematic and Physiological Indices During Braking Events of Different Intensities. (United States)

    Musicant, Oren; Botzer, Assaf; Laufer, Ilan; Collet, Christian


    Objective To study the relationship between physiological indices and kinematic indices during braking events of different intensities. Background Based on mental workload theory, driving and other task demands may generate changes in physiological indices, such as the driver's heart rate and skin conductance. However, no attempts were made to associate changes in physiological indices with changes in vehicle kinematics that result from the driver attempts to meet task demands. Method Twenty-five drivers participated in a field experiment. We manipulated braking demands using roadside signs to communicate the speed (km/h) before braking (50 or 60) and the target speed for braking (30 or to a complete stop). In an additional session, we asked drivers to brake as if they were responding to an impending collision. We analyzed the relationship between the intensities of braking events as measured by deceleration values (g) and changes in heart rate, heart rate variability, and skin conductance. Results All physiological indices were associated with deceleration intensity. Especially salient were the differences in physiological indices between the intensive (|g| > 0.5) and nonintensive braking events. The strongest relationship was between braking intensity and skin conductance. Conclusions Skin conductance, heart rate, and heart rate variability can mirror the mental workload elicited by varying braking intensities. Application Associating vehicle kinematics with physiological indices related to short-term driving events may help improve the performance of driver assistance systems.

  17. Invasive physiological indices to determine the functional significance of coronary stenosis

    Directory of Open Access Journals (Sweden)

    Firas R. AL-Obaidi


    Full Text Available Physiological measurements are now commonly used to assess coronary lesions in the cardiac catheterisation laboratory, and this practice is evidence-based and supported by clinical guidelines. Fractional flow reserve is currently the gold standard method to determine whether coronary lesions are functionally significant, and is used to guide revascularization. There are however several other physiological measurements that have been proposed as alternatives to the fractional flow reserve. This review aims to comprehensively discuss physiological indices that can be used in the cardiac catheterisation laboratory to determine the functional significance of coronary lesions. We will focus on their advantages and disadvantages, and the current evidence supporting their use. Keywords: Coronary physiology, Fractional flow reserve, Resting physiological indices, Coronary flow reserve

  18. Indices of resective surgery effectiveness for intractable nonlesional focal epilepsy. (United States)

    Blume, Warren T; Ganapathy, Gobi R; Munoz, David; Lee, Donald H


    Among 70 patients with intractable focal epilepsy and no specific lesion, as determined by both MRI (magnetic resonance imaging) and histopathology, outcome after resective surgery was polarized: 26 (37%) became seizure free (SF), and 27 (39%) were not helped. Eighteen (42%) of 43 standard temporal resections rendered patients SF, somewhat more than eight (30%) of 27 other procedures. To seek reliable prognostic factors, the subsequent correlative data compared features of the 26 SF patients with those of the 27 not helped. Although ictal semiology guided the site of surgical resection, it and other aspects of seizure and neurologic history failed to predict surgical outcome. However, two aspects of preoperative scalp EEGs correlated with SF outcomes: (a) among 25 patients in whom >50% of clinical seizures arose from the later resected lobe and no other origins, 18 (72%) became SF compared with seven (28%) of 25 with other ictal profiles; (b) 13 (93%) of 14 temporal lobe patients whose interictal and ictal EEGs lacked features indicative of multifocal epileptogenesis became SF compared with five (33%) of 15 with such components. The considered need for subdural (SD) EEG reduced SF outcome from 18 (90%) of 20 patients without SD to eight (24%) of 33 with SD; this likely reflected an insufficient congruity of ictal semiology and interictal and ictal scalp EEG for localizing epileptogenesis. Within this SD group, >50% of clinical seizure origins from a later resected lobe increased SF outcome somewhat: from two (14%) of 14 without this attribute to six (40%) of 15 with it; 100% of such origins increased SF outcome from two (12%) of 16 to six (46%) of 13.

  19. Indication for cataract surgery. Do we have evidence of who will benefit from surgery?

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte


    . To overcome this shortage of evidence, many systems have been developed internationally to prioritize patients on waiting lists for cataract surgery, but the Swedish NIKE (Nationell Indikationsmodell för Katarakt Ekstraktion) is the only system where an association to the preoperative scoring of a patient has...... been related to outcome of cataract surgery. We advise that clinicians are inspired by the NIKE system when they decide which patients to operate to ensure that surgery is only offered to patients who are expected to benefit from cataract surgery....

  20. Effects of preoperative administration of butorphanol or meloxicam on physiologic responses to surgery in ball pythons. (United States)

    Olesen, Mette G; Bertelsen, Mads F; Perry, Steve F; Wang, Tobias


    To characterize physiologic responses of ball pythons (Python regius) following a minor surgical procedure and investigate the effects of 2 commonly used analgesics on this response. 15 healthy ball pythons. Snakes were randomly assigned to receive 1 of 3 treatments: meloxicam (0.3 mg/kg [0.14 mg/lb]; n = 5), butorphanol (5 mg/kg [2.3 mg/lb]; 5), or saline (0.9% NaCl) solution (5) before catheterization of the vertebral artery. Plasma concentrations of catecholamines and cortisol, blood pressure, heart rate, and blood gas values were measured at various times for 72.5 hours after catheterization. The 72.5-hour point was defined as baseline. Heart rate of ball pythons increased significantly during the first hour following surgery. Mean plasma epinephrine concentration increased slightly at 2.5 hours after surgery, whereas mean plasma cortisol concentration increased beginning at 1.5 hours, reaching a maximum at 6.5 hours. Mean blood pressure increased within the first hour but returned to the baseline value at 2.5 hours after surgery. After 24.5 hours, blood pressure, heart rate, and plasma hormone concentrations remained stable at baseline values. There were no significant differences in values for physiologic variables between snakes that received saline solution and those that received meloxicam or butorphanol. Measurement of physiologic variables provides a means of assessing postoperative pain in snakes. Meloxicam and butorphanol at the dosages used did not decrease the physiologic stress response and did not appear to provide analgesic effects in ball pythons.

  1. Tribute to a triad: history of splenic anatomy, physiology, and surgery--part 1. (United States)

    McClusky, D A; Skandalakis, L J; Colborn, G L; Skandalakis, J E


    The spleen is an enigmatic organ with a peculiar anatomy and physiology. Though our understanding of this organ has improved vastly over the years, the spleen continues to produce problems for the surgeon, the hematologist, and the patient. The history of the spleen is full of fables and myths, but it is also full of realities. In the Talmud, the Midrash, and the writings of Hippocrates, Plato, Aristotle, Galen, and several other giants of the past, one can find a lot of Delphian and Byzantine ambiguities. At that time, splenectomy was the art of surgery for many splenic diseases. From antiquity to the Renaissance, efforts were made to study the structure, functions, and anatomy of the spleen. Vesalius questioned Galen; and Malpighi, the founder of microscopic anatomy, gave a sound account of the histology and the physiologic destiny of the spleen. Surgical inquiry gradually became a focal point, yet it was still not clear what purpose the spleen served. It has been within the past 50 years that the most significant advances in the knowledge of the spleen and splenic surgery have been made. The work of Campos Christo in 1962 about the segmental anatomy of the spleen helped surgeons perform a partial splenectomy, thereby avoiding complications of postsplenectomy infection. With the recent successes of laparoscopic splenectomy in selected cases, the future of splenic surgery will undoubtedly bring many more changes.

  2. Causes of failures and indications for refundoplication of antireflux surgery

    Directory of Open Access Journals (Sweden)

    Khubolov A.M.


    Full Text Available The aim is to study reasons for repeated fundoplication and possible variants of cardia correction in patients suffering from hiatal hernia and reflux esophagitis. Material and methods. Results of antireflux correction in 118 patients suffering from hiatal hernia have been studied, such results have been observed for the period of up to 36 months. Results. Most recurrent cases have been characterized by anatomical background for repeat hernia development, such as migration of fundoplication cuff, inconsistency, extreme traction of tissues that form gastric cuff or derived technique of fundoplication during previous operation. It has been found out that the subjective assessment of patients' condition after fundoplication is one of the most important criteria in deciding whether the repeated intervention is needed. Conclusion. Analysis of long-term results of the repeated antireflux surgery has revealed that quality-of-life index of patients having undergone repeated surgery may be compared to that of a healthy person. Traditional fundoplication of Nissen with non-tractional surgical intervention should be the method of choice for treatment of recurrent hiatal hernias.

  3. Evaluation of mental stress by physiological indices derived from finger plethysmography. (United States)

    Minakuchi, Emiko; Ohnishi, Eriko; Ohnishi, Junji; Sakamoto, Shigeko; Hori, Miyo; Motomura, Miwa; Hoshino, Junichi; Murakami, Kazuo; Kawaguchi, Takayasu


    Quantitative evaluation of mental stress is important to prevent stress-related disorders. Finger plethysmography (FPG) is a simple noninvasive method to monitor peripheral circulation, and provides many physiological indices. Our purpose is to investigate how FPG-derived indices reflect on mental stress, and to clarify any association between these physiological indices and subjective indices of mental stress. Thirty-one healthy women (mean age, 22 years ± 2) participated. The participants rested by sitting on a chair for 10 min. They then performed a computerized version of the Stroop color-word conflict test (CWT) for 10 min. Finally, they rested for 10 min. FPG was recorded throughout the experiment. The participants completed a brief form of the Profile of Mood States (POMS) questionnaire before and after the test. Using the FPG data, we conducted chaos analysis and fast Fourier transform analysis, and calculated chaotic attractors, the largest Lyapunov exponent, a high-frequency (HF) component, a low-to-high-frequency (LF/HF) ratio, finger pulse rate and finger pulse wave amplitude. The HF component decreased and the LF/HF ratio increased significantly during the test (P stress. Our findings indicate that FPG is one of the easiest methods to evaluate mental stress quantitatively. In particular, the largest Lyapunov exponent and the LF/HF ratio might be associated with acute mental stress. Farther examination is needed to find any association between the physiological indices and various types of mental stress.

  4. Educators' emotion regulation strategies and their physiological indicators of chronic stress over 1 year. (United States)

    Katz, Deirdre A; Harris, Alexis; Abenavoli, Rachel; Greenberg, Mark T; Jennings, Patricia A


    Studies show teaching is a highly stressful profession and that chronic work stress is associated with adverse health outcomes. This study analysed physiological markers of stress and self-reported emotion regulation strategies in a group of middle school teachers over 1 year. Chronic physiological stress was assessed with diurnal cortisol measures at three time points over 1 year (fall, spring, fall). The aim of this longitudinal study was to investigate the changes in educators' physiological level of stress. Results indicate that compared to those in the fall, cortisol awakening responses were blunted in the spring. Further, this effect was ameliorated by the summer break. Additionally, self-reported use of the emotion regulation strategy reappraisal buffered the observed blunting that occurred in the spring. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Physiological responses of the seagrass Posidonia oceanica as indicators of fish farm impact

    International Nuclear Information System (INIS)

    Perez, Marta; Garcia, Tania; Invers, Olga; Ruiz, Juan Manuel


    The development of aquaculture along the Mediterranean coastline degrades the marine environment, in particular Posidonia oceanica meadows, which, in extreme cases, show high mortality. Here we studied the effects of organic matter and nutrient input from the effluents of three fish farms, located along the Mediterranean coast, on P. oceanica physiology. For this purpose, we measured physiological variables such as total nitrogen (N) content, free amino acid (FAA) concentration and composition, N stable isotope ratio (δ 15 N), total phosphorus (P) content and total non-structural carbohydrate (TNC) content in plant tissues and epiphytes affected by organic discharges (highly impacted stations: HI, and less impacted stations: LI) and compared these results with those obtained in references sites (control stations: C). For all the descriptors analyzed in P. oceanica epiphytes, the values recorded in the vicinity of cages were, in general, much higher than those in C. Leaves did not respond consistently in any case. Total N content and δ 15 N in epiphytes together with the total P content in rhizomes and epiphytes were the physiological descriptors that showed the most consistent responses to fish farm effluents. On the basis of these observations, we conclude that fish farm activities strongly affect the physiological parameters of nearby P. oceanica meadows. We propose that changes in these physiological parameters may be useful indicators of marine environmental degradation in studies that monitor the effects of fish farming

  6. Physiological responses of the seagrass Posidonia oceanica as indicators of fish farm impact

    Energy Technology Data Exchange (ETDEWEB)

    Perez, Marta [Departament d' Ecologia, Universitat de Barcelona Avda. Diagonal 645, 08028 Barcelona (Spain); Garcia, Tania [Departament d' Ecologia, Universitat de Barcelona Avda. Diagonal 645, 08028 Barcelona (Spain)], E-mail:; Invers, Olga [Departament d' Ecologia, Universitat de Barcelona Avda. Diagonal 645, 08028 Barcelona (Spain); Ruiz, Juan Manuel [Instituto Espanol de Oceanografia C/Varadero 1, 30740 San Pedro del Pinatar, Murcia (Spain)


    The development of aquaculture along the Mediterranean coastline degrades the marine environment, in particular Posidonia oceanica meadows, which, in extreme cases, show high mortality. Here we studied the effects of organic matter and nutrient input from the effluents of three fish farms, located along the Mediterranean coast, on P. oceanica physiology. For this purpose, we measured physiological variables such as total nitrogen (N) content, free amino acid (FAA) concentration and composition, N stable isotope ratio ({delta}{sup 15}N), total phosphorus (P) content and total non-structural carbohydrate (TNC) content in plant tissues and epiphytes affected by organic discharges (highly impacted stations: HI, and less impacted stations: LI) and compared these results with those obtained in references sites (control stations: C). For all the descriptors analyzed in P. oceanica epiphytes, the values recorded in the vicinity of cages were, in general, much higher than those in C. Leaves did not respond consistently in any case. Total N content and {delta}{sup 15}N in epiphytes together with the total P content in rhizomes and epiphytes were the physiological descriptors that showed the most consistent responses to fish farm effluents. On the basis of these observations, we conclude that fish farm activities strongly affect the physiological parameters of nearby P. oceanica meadows. We propose that changes in these physiological parameters may be useful indicators of marine environmental degradation in studies that monitor the effects of fish farming.

  7. Patient-perceived surgical indication influences patient expectations of surgery for degenerative spinal disease. (United States)

    Wilson, Thomas J; Franz, Eric; Vollmer, Carolyn F; Chang, Kate W-C; Upadhyaya, Cheerag; Park, Paul; Yang, Lynda J-S


    Patients frequently have misconceptions regarding diagnosis, surgical indication, and expected outcome following spinal surgery for degenerative spinal disease. In this study, we sought to understand the relationship between patient-perceived surgical indications and patient expectations. We hypothesized that patients reporting appendicular symptoms as a primary surgical indication would report a higher rate of having expectations met by surgery compared to those patients reporting axial symptoms as a primary indication. Questionnaires were administered to patients who had undergone surgery for degenerative spinal disease at 2 tertiary care institutions. Questions assessed perception of the primary indication for undergoing surgery (radicular versus axial), whether the primary symptom improved after surgery, and whether patient expectations were met with surgery. Outcomes of interest included patient-reported symptomatic improvement following surgery and expectations met by surgery. Various factors were assessed for their relationship to these outcomes of interest. There were 151 unique survey respondents. Respondents were nearly split between having a patient-perceived indication for surgery as appendicular symptoms (55.6%) and axial symptoms (44.4%). Patient-perceived surgical indication being appendicular symptoms was the only factor predictive of patient-reported symptomatic improvement in our logistic regression model (OR 2.614; 95% CI 1.218-5.611). Patient-perceived surgical indication being appendicular symptoms (OR 3.300; 95% CI 1.575-6.944) and patient-reported symptomatic improvement (OR 33.297; 95% CI 12.186-90.979) were predictive of patients reporting their expectations met with surgery in both univariate and multivariate logistic regression modeling. We found that patient-reported appendicular symptoms as the primary indication for surgery were associated with a higher rate of both subjective improvement following surgery and having expectations met

  8. Indications, output and types of eyelid surgeries in a tertiary eye care ...

    African Journals Online (AJOL)

    ... function and cosmesis as much as is possible. We reviewed the indications, output and types of eyelid surgeries over a seven year period. Method: The minor and major surgical log books of the eye theatre were retrospectively reviewed to obtain information on all patients who had eyelid surgery within the study period.

  9. European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery

    NARCIS (Netherlands)

    Querleu, Denis; Planchamp, Francois; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Cristiana; van der Zee, Ate; Vergote, Ignace; du Bois, Andreas

    Objectives The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit

  10. Food availability is expressed through physiological stress indicators in nestling white ibis: A food supplementation experiment (United States)

    Herring, G.; Cook, Mark I.; Gawlik, D.E.; Call, Erynn M.


    Physiological responses to environmental stress such as adrenocortical hormones and cellular stress proteins have recently emerged as potentially powerful tools for investigating physiological effects of avian food limitation. However, little is known about the physiological stress responses of free-living nestling birds to environmental variation in food availability. We experimentally tested how hydrologically mediated changes in food availability affect the physiological stress responses of juvenile white ibises Eudocimus albus in a fluctuating wetland. We provided supplementary food to free-living nestlings during 2years with contrasting hydrologic and food availability conditions, and used plasma (PCORT) and faecal (FCORT) corticosterone and heat shock proteins (HSP60 and HSP70) from first-hatched (A-nestlings) and second-hatched (B-nestlings) to detect relatively short- to long-term responses to food limitation. Nestling physiological stress responses were relatively low in all treatments during the year with optimal food availability, but PCORT, FCORT and HSP60 levels increased during the poor food year. FCORT and HSP60 responses were clearly due to nutritional condition as elevated concentrations were evident primarily in control nestlings. Significant year by hatch order interactions for both FCORT and HSP60 revealed that these increases were largely incurred by B-nestlings. FCORT and HSP60 responses were also well developed early in neonatal development and remained elevated for the duration of the experiment suggesting a chronic stress response. PCORT and HSP70 were less informative stress responses. The nutritionally mediated increases in FCORT and HSP60 provide compelling evidence that white ibis nestlings can be physiologically affected by environmental food levels. FCORT and HSP60 are effective indicators of nutritional mediated stress for nestling white ibises and potentially for other species prone to capture or handling stress. ?? 2010 The Authors

  11. NIKE: a new clinical tool for establishing levels of indications for cataract surgery. (United States)

    Lundström, Mats; Albrecht, Susanne; Håkansson, Ingemar; Lorefors, Ragnhild; Ohlsson, Sven; Polland, Werner; Schmid, Andrea; Svensson, Göran; Wendel, Eva


    The purpose of this study was to construct a new clinical tool for establishing levels of indications for cataract surgery, and to validate this tool. Teams from nine eye clinics reached an agreement about the need to develop a clinical tool for setting levels of indications for cataract surgery and about the items that should be included in the tool. The tool was to be called 'NIKE' (Nationell Indikationsmodell för Kataraktextraktion). The Canadian Cataract Priority Criteria Tool served as a model for the NIKE tool, which was modified for Swedish conditions. Items included in the tool were visual acuity of both eyes, patients' perceived difficulties in day-to-day life, cataract symptoms, the ability to live independently, and medical/ophthalmic reasons for surgery. The tool was validated and tested in 343 cataract surgery patients. Validity, stability and reliability were tested and the outcome of surgery was studied in relation to the indication setting. Four indication groups (IGs) were suggested. The group with the greatest indications for surgery was named group 1 and that with the lowest, group 4. Validity was proved to be good. Surgery had the greatest impact on the group with the highest indications for surgery. Test-retest reliability test and interexaminer tests of indication settings showed statistically significant intraclass correlations (intraclass correlation coefficients [ICCs] 0.526 and 0.923, respectively). A new clinical tool for indication setting in cataract surgery is presented. This tool, the NIKE, takes into account both visual acuity and the patient's perceived problems in day-to-day life because of cataract. The tool seems to be stable and reliable and neutral towards different examiners.

  12. Comprehensive Analysis of Large Sets of Age-Related Physiological Indicators Reveals Rapid Aging around the Age of 55 Years. (United States)

    Lixie, Erin; Edgeworth, Jameson; Shamir, Lior


    While many studies show a correlation between chronological age and physiological indicators, the nature of this correlation is not fully understood. To perform a comprehensive analysis of the correlation between chronological age and age-related physiological indicators. Physiological aging scores were deduced using principal component analysis from a large dataset of 1,227 variables measured in a cohort of 4,796 human subjects, and the correlation between the physiological aging scores and chronological age was assessed. Physiological age does not progress linearly or exponentially with chronological age: a more rapid physiological change is observed around the age of 55 years, followed by a mild decline until around the age of 70 years. These findings provide evidence that the progression of physiological age is not linear with that of chronological age, and that periods of mild change in physiological age are separated by periods of more rapid aging. © 2015 S. Karger AG, Basel.

  13. Relationship between physiological indices and aerobic performance tests in short and medium term of elite cyclists

    Directory of Open Access Journals (Sweden)

    Eduardo Bernardo Sangali


    Full Text Available Few studies allow usto verify which physiological responses are associated with performance in anational elite cycling group. Therefore, this study aimed to determine and correlate various physiological and aerobic indices with performance in 4 and 20 km time trials in high-level cyclists. The sample consisted of 14 male professional cyclists of the national elite group (28.5 ± 4.7 years old, 73.47 ± 8.29 kg, 176 ± 6.76cm, who performed a progressive test in laboratory to determine maximal oxygen consumption (VO2max: 62.23 ± 8.28 ml•kg-1•min-1, intensity relative to VO2max(iVO2max: 500.83 ± 58.65w, movement economy (EM: 0.1166 ± 0.0362 ml•kg•min•w-1, and the first and second ventilatory threshold (LV1: 348.21 ±43.26 w; LV2: 417.86 ± 60.79 w, respectively. They also performed two time trial performance tests of 4 and 20km. For the correlation between physiological indices and trial performance, Pearson correlation coefficient(p< 0.05 was used. No correlation was found between the physiological indices (VO2max absolute and relative, iVO2max, EM, LV1 and LV2 andperformance in 4 km (r= 0.38; 0.16; -0.33; 0.20; -0.50; -0.20, respectivelyand 20 km (r= 0.24; 0.01; -0.13; -0.12; -0.48; -0.19, respectively time trialin high level athletes. These results suggest that these variables are not able to explain the performance in time trials in the respective lengths, probably due to the subjects’ homogeneity.

  14. Exterior indicators and physiological signs' indices of juveniles Salmo salar L. in the rivers of the Kola Peninsula

    Directory of Open Access Journals (Sweden)

    Anokhina V. S.


    Full Text Available The range of background values of main parameters of the exterior and indices of morphophysiological features of autumn juvenile salmon Salmon salar L. in four rivers of the Kola Peninsula not affected by hatchery production have been investigated. The importance of such studies is associated with intensification of artificial reproduction of salmon and occurrence of hatchery fish with characters different from wild individuals in the rivers. Currently hatchery reproduction of Atlantic salmon is not carried out in the European North of Russia, however, the need to choose a local salmon population for further hatchery reproduction is obvious. Accumulation of biological data on salmon in the rivers of the Kola Peninsula is important for population monitoring of wild stocks. Samples of juveniles widely varying in size have been collected by electrofishing in the Rivers Pechenga, Zapadnaya Litsa and Titovka of the Barents Sea basin, as well as in the tributaries of the River Varzuga inflowing the White Sea. For each sample individual and group indices of elongation, girth and massiveness have been calculated. The physiological state of the fish has been assessed with allowance for the fatness factor (according to Clark and indices of internal organs. It has been found that in the autumn season (September the average statistical values of the morphological indices characterizing the appearance of the fry from four rivers differ with a high degree of reliability. Individual fluctuations in morphological parameters are in the range of values: elongation – from 311 to 725 %; girth – from 41 to 85 %; massiveness – from 150 to 530 %. The mean values of morphophysiological indices for each of the four river populations have been presented. The obtained values of the studied parameters of juveniles of Atlantic salmon can be used for subsequent monitoring of populations.

  15. Effect of age, sex and physiological stages on hematological indices of Banni buffalo (Bubalus bubalis). (United States)

    Patel, Mehul D; Lateef, Abdul; Das, Hemen; Patel, Ajay S; Patel, Ajay G; Joshi, Axay B


    To determine the physiological baseline values for hematological indices of Banni buffalo (Bubalus bubalis) as well as to assess their alteration due to age, sex and physiological stages. A total of 42 clinically healthy Banni buffaloes were categorized into seven groups (n=6): Group I (male calves ≤1 year), Group II (bulls >1 year), Group III (female calves ≤1 year), Group IV (pregnant lactating buffaloes), Group V (non-pregnant lactating buffaloes), Group VI (pregnant dry buffaloes), and Group VII (non-pregnant dry buffaloes). Blood samples collected aseptically from all the experimental groups were analyzed employing automated hematology analyzer. The data obtained were statistically analyzed; the mean and standard deviations were calculated and set as the reference values. The erythrocytic indices viz. total erythrocytes count (TEC), hemoglobin, and packed cell volume (PCV) were significantly higher in bulls as compared to that of male calves unlike mean corpuscular volume, mean corpuscular hemoglobin (MCH), and MCH concentration. The female calves had higher TEC and PCV than the adult buffaloes irrespective of sex. The total leukocyte count (TLC) and neutrophil counts in male calves were significantly lower than the bulls unlike the eosinophil, while monocyte and basophil remained unchanged with age. The TLC, differential leukocyte count and platelet count varied non-significantly among the adult female groups at different physiological stages. However, neutrophils were found to be apparently higher in lactating buffaloes. The present study would be helpful for physiological characterization of this unique buffalo breed of Gujarat. Further, data generated may be a tool for monitoring the health and prognosis as well as diagnosis of diseases.

  16. Physiological Motion and Registration of Abnormalities in Liver During Focused Ultrasound Surgery (United States)

    Chauhan, Sunita; Rh, Abhilash

    Continuous deformation and dislocation of soft tissues in the abdominal and thoracic region presents a major issue for effective targeting of all non-invasive ablative modalities such as radiotherapy/surgery and Focused Ultrasound Surgery. Most significant among these is the movement of the target organs due to physiological processes such as respiration. The movement is found to be most significant for liver and kidneys. We studied movement and compensation strategies with the aim to implement them during ultrasound ablation using our robotic system for targeted FUS dose delivery. The motion pattern of the liver can be assumed to be in a single plane as it closely follows the movement of the diaphragm. However, the movement of kidneys is three dimensional and follows complicated patterns. Kidney motion is highly subject specific and has poor repeatability. In our research, we quantify the relation of liver movement and the breathing pattern so as to achieve real-time movement compensation using a prediction-correlation approach.

  17. Evaluation of wheat genotypes for salinity tolerance using physiological indices as screening tool

    International Nuclear Information System (INIS)

    Zafar, S.; Niaz, M.; Kausar, A.


    Salinity is a major threat to world food security, to ensure future food needs of an increasing world population, development of salt tolerant crop varieties are necessary. Effective screening techniques for salinity tolerance would be beneficial in developing high yielding and salt tolerant wheat varieties. In the present study, an attempt for rapid screening of wheat genotypes for salt tolerance was made. Twenty wheat genotypes were evaluated for salinity tolerance under laboratory/green-house conditions using different physiological indices like germination stress tolerance index (GSI), shoot length stress tolerance index (SLSI), root length stress tolerance index (RLSI) , shoot dry biomass stress tolerance index (SDSI). The data was pooled together to different multivariate techniques including correlation and cluster analysis to assess the diversity for salt tolerance in wheat genotypes. Highly significant and positive correlations were found between GSI, SDWSI and RDWSI. Cluster analysis classified 20 genotypes into three divergent groups. The members of first cluster (Abadgharr, Bhakkar-2000, Chakwal-86, Kiran-95, LU-26-S, Margalla-99, Marvi Pak-81, Sarsabaz) exhibited adequate degree of salt tolerance on the basis of various physiological stress tolerance indices, whereas, cluster-2 included genotypes (Bhattai, Pasban-90, Shafaq-2006, Soghat-90) with medium level of salt tolerance and cluster-3 consisted of wheat genotypes (Inqilab-91, Iqbal-2000, Kohistan-97, PARI-73, Punjab-90, Sehar-2006 and Uqab-6) with lower level of salt tolerance and did not perform upto the mark. On the basis of results and scores obtained, indicated that physiological indices can be used as a selection tool for salinity tolerance in wheat. (author)

  18. Assessment of emergency general surgery care based on formally developed quality indicators. (United States)

    Ingraham, Angela; Nathens, Avery; Peitzman, Andrew; Bode, Allison; Dorlac, Gina; Dorlac, Warren; Miller, Preston; Sadeghi, Mahsa; Wasserman, Deena D; Bilimoria, Karl


    Emergency general surgery outcomes vary widely across the United States. The utilization of quality indicators can reduce variation and assist providers in administering care aligned with established recommendations. Previous quality indicators have not focused on emergency general surgery patients. We identified indicators of high-quality emergency general surgery care and assessed patient- and hospital-level compliance with these indicators. We utilized a modified Delphi technique (RAND Appropriateness Methodology) to develop quality indicators. Through 2 rankings, an expert panel ranked potential quality indicators for validity. We then examined historic compliance with select quality indicators after 4 nonelective procedures (cholecystectomy, appendectomy, colectomy, small bowel resection) at 4 academic centers. Of 25 indicators rated as valid, 13 addressed patient-level quality and 12 addressed hospital-level quality. Adherence with 18 indicators was assessed. Compliance with performing a cholecystectomy for acute cholecystitis within 72 hours of symptom onset ranged from 45% to 76%. Compliance with surgery start times within 3 hours from the decision to operate for uncontained perforated viscus ranged from 20% to 100%. Compliance with exploration of patients with small bowel obstructions with ischemia/impending perforation within 3 hours of the decision to operate was 0% to 88%. For 3 quality indicators (auditing 30-day unplanned readmissions/operations for patients previously managed nonoperatively, monitoring time to source control for intra-abdominal infections, and having protocols for bypass/transfer), none of the hospitals were compliant. Developing indicators for providers to assess their performance provides a foundation for specific initiatives. Adherence to quality indicators may improve the quality of emergency general surgery care provided for which current outcomes are potentially modifiable. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Ability to Discriminate Between Sustainable and Unsustainable Heat Stress Exposures-Part 2: Physiological Indicators. (United States)

    Garzón-Villalba, Ximena P; Wu, Yougui; Ashley, Candi D; Bernard, Thomas E


    There are times when it is not practical to assess heat stress using environmental metrics and metabolic rate, and heat strain may provide an alternative approach. Heat strain indicators have been used for decades as tools for monitoring physiological responses to work in hot environments. Common indicators of heat strain are body core temperature (assessed here as rectal temperature Tre), heart rate (HR), and average skin temperature (Tsk). Data collected from progressive heat stress trials were used to (1) demonstrate if physiological heat strain indicators (PHSIs) at the upper limit of Sustainable heat stress were below generally accepted limits; (2) suggest values for PHSIs that demonstrate a Sustainable level of heat stress; (3) suggest alternative PHSIs; and (4) determine if metabolic rate was an effect modifier. Two previous progressive heat stress studies included 176 trials with 352 pairs of Sustainable and Unsustainable exposures over a range of relative humidities and metabolic rates using 29 participants. To assess the discrimination ability of PHSIs, conditional logistic regression and stepwise logistic regression were used to find the best combinations of predictors of Unsustainable exposures. The accuracy of the models was assessed using receiver operating characteristic curves. Current recommendations for physiological heat strain limits were associated with probabilities of Unsustainable greater than 0.5. Screening limits for Sustainable heat stress were Tre of 37.5°C, HR of 105 bpm, and Tsk of 35.8°C. Tsk alone resulted in an area under the curve of 0.85 and the combination of Tsk and HR (area under the curve = 0.88) performed the best. The adjustment for metabolic rate was statistically significant for physiological strain index or ∆Tre-sk as main predictors, but its effect modification was negligible and could be ignored. Based on the receiver operating characteristic curve, PHSIs (Tre, HR, and Tsk) can accurately predict Unsustainable heat

  20. Laparoscopic surgery for benign and malign diseases of the digestive system: indications, limitations, and evidence. (United States)

    Küper, Markus Alexander; Eisner, Friederike; Königsrainer, Alfred; Glatzle, Jörg


    The laparoscopic technique was introduced in gastrointestinal surgery in the mid 1980s. Since then, the development of this technique has been extraordinary. Triggered by technical innovations (stapling devices or coagulation/dissecting devices), nowadays any type of gastrointestinal resection has been successfully performed laparoscopically and can be performed laparoscopically dependent on the patient's condition. This summary gives an overview over 30 years of laparoscopic surgery with focus on today's indications and evidence. Main indications remain the more common procedures, e.g., appendectomy, cholecystectomy, bariatric procedures or colorectal resections. For all these indications, the laparoscopic approach has become the gold standard with less perioperative morbidity. Regarding oncological outcome there have been several high-quality randomized controlled trials which demonstrated equivalency between laparoscopic and open colorectal resections. Less common procedures like esophagectomy, oncological gastrectomy, liver and pancreatic resections can be performed successfully as well by an experienced surgeon. However, the evidence for these special indications is poor and a general recommendation cannot be given. In conclusion, laparoscopic surgery has revolutionized the field of gastrointestinal surgery by reducing perioperative morbidity without disregarding surgical principles especially in oncological surgery.

  1. Shaping Physiological Indices, Swimming Technique, and Their Influence on 200m Breaststroke Race in Young Swimmers

    Directory of Open Access Journals (Sweden)

    Marek Strzala


    Full Text Available The aim of this study was to investigate somatic properties and physiological capacity, and analyze kinematic parameters in the 200 m breaststroke swimming race. Twenty-seven male swimmers participated in the study. They were 15.7±1.98 years old. Their average height was 1.80 ± 0.02 m and lean body mass (LBM was 62.45 ± 8.29 kg. Physiological exercise capacity was measured in two separate 90 sec. all-out tests, one for the arms and second for legs. During the tests total work of arm cranking (TWAR and cycling (TWLG as well as peak of VO2 for arm (VO2peakAR and leg (VO2peakLG were measured. The underwater swimmers body movements were recorded during the all-out swimming 200m breaststroke speed test using an underwater camera installed on a portable trolley. The swimming kinematic parameters and propulsive or non-propulsive movement phases of the arms and legs as well as average speed (V200, surface speed (V200surface and swimming speed in turn zones (V200turns were extracted. V200surface was significantly related to the percentage of leg propulsion and was shown to have large effect on VO2peakLG in the Cohen analysis. V200turns depended significantly on the indicators of physiological performance and body structure: TWAR, VO2peak LG and LBM, LBM, which in turn strongly determined the measured results of TWAR, TWLG, VO2peakAR and VO2peakLG. The V200turns and V200surface were strongly associated with V200, 0.92, p < 0.001 and 0.91, p < 0.001 respectively. In each lap of the 200m swimming there was an increased percentage of propulsion of limb movement observed simultaneously with a reduction in the gliding phase in the breaststroke cycles.

  2. Readmission After Gynecologic Surgery: A Comparison of Procedures for Benign and Malignant Indications. (United States)

    Cory, Lori; Latif, Nawar; Brensinger, Colleen; Zhang, Xiaochen; Giuntoli, Robert L; Burger, Robert A; Morgan, Mark; Ko, Emily


    To compare 30-day postsurgical readmission rates and associated risk factors for readmission among women undergoing gynecologic surgery for benign and malignant conditions. In a retrospective cohort study, we identified patients after surgery for benign and malignant gynecologic conditions in the National Surgical Quality Improvement Program database between January 1, 2011, and December 31, 2012. Data collected included surgical factors, perioperative characteristics, surgical complications, and 30-day readmissions. The primary study outcome was readmission rates after gynecologic surgery for benign and oncologic conditions. Secondary study outcomes were risk factors associated with readmission among gynecologic surgeries performed for benign and oncologic conditions. Approximately 3% (1,444/46,718) compared with 8.2% (623/7,641) of patients who underwent gynecologic surgery for benign and malignant indications, respectively, were readmitted (P<.01). Compared with patients with benign surgical indications, those with uterine cancer (readmission rate 6.6%; odds ratio [OR] 2.21, 95% CI 1.95-2.51), ovarian cancer (readmission rate 10.9%; OR 3.82, 95% CI 3.29-4.45), and cervical cancer (readmission rate 10.1%; OR 3.51, 95% CI 2.71-4.53) were more likely to be readmitted. In multivariable models, independent risk factors for readmission for gynecologic cancer surgery included worse preoperative conditions (OR 1.49, 95% CI 1.17-1.90) and major complications (OR 17.84, 95% CI 14.19-22.43). In comparison, independent risk factors for readmission after surgery for benign indications included comorbid conditions (OR 1.36, 95% CI 1.18-1.57), operative time (15-59 minutes: referent; 60 minutes or greater: 1.37, 95% CI 1.14-1.63) and major complications (OR 53.91, 95% CI 46.98-61.85). Among gynecologic surgeries, those performed for oncologic indications were associated with readmission rates 2.8 times that of surgeries performed for benign indications. In adjusted models

  3. Surgical Navigation: A Systematic Review of Indications, Treatments, and Outcomes in Oral and Maxillofacial Surgery. (United States)

    Azarmehr, Iman; Stokbro, Kasper; Bell, R Bryan; Thygesen, Torben


    This systematic review investigates the most common indications, treatments, and outcomes of surgical navigation (SN) published from 2010 to 2015. The evolution of SN and its application in oral and maxillofacial surgery have rapidly developed over recent years, and therapeutic indications are discussed. A systematic search in relevant electronic databases, journals, and bibliographies of the included articles was carried out. Clinical studies with 5 or more patients published between 2010 and 2015 were included. Traumatology, orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal were the areas of interests. The search generated 13 articles dealing with traumatology; 5, 6, 2, and 0 studies were found that dealt with the topics of orthognathic surgery, cancer and reconstruction surgery, skull-base surgery, and foreign body removal, respectively. The average technical system accuracy and intraoperative precision reported were less than 1 mm and 1 to 2 mm, respectively. In general, SN is reported to be a useful tool for surgical planning, execution, evaluation, and research. The largest numbers of studies and patients were identified in the field of traumatology. Treatment of complex orbital fractures was considerably improved by the use of SN compared with traditionally treated control groups. SN seems to be a very promising addition to the surgical toolkit. Planning details of the surgical procedure in a 3-dimensional virtual environment and execution with real-time guidance can significantly improve precision. Among factors to be considered are the financial investments necessary and the learning curve. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. All rights reserved.

  4. Cosmetic surgery volume and its correlation with the major US stock market indices. (United States)

    Gordon, Chad R; Pryor, Landon; Afifi, Ahmed M; Benedetto, Paul X; Langevin, C J; Papay, Francis; Yetman, Randall; Zins, James E


    As a consumer-driven industry, cosmetic plastic surgery is subject to ebbs and flows as the economy changes. There have been many predictions about the short, intermediate, and long-term impact on cosmetic plastic surgery as a result of difficulties in the current economic climate, but no studies published in the literature have quantified a direct correlation. The authors investigate a possible correlation between cosmetic surgery volume and the economic trends of the three major US stock market indices. A volume analysis for the time period from January 1992 to October 2008 was performed (n = 7360 patients, n = 8205 procedures). Four cosmetic procedures-forehead lift (FL), rhytidectomy (Rh), breast augmentation (BA), and liposuction (Li)-were chosen; breast reduction (BRd), breast reconstruction (BRc), and carpal tunnel release (CTR) were selected for comparison. Case volumes for each procedure and fiscal quarter were compared to the trends of the S&P 500, Dow Jones (DOW), and NASDAQ (NASD) indices. Pearson correlation statistics were used to evaluate a relationship between the market index trends and surgical volume. P values indices. FL (n =312) only correlated to the NASD (P = .021) and did not reach significance with the S&P 500 (P = .077) or DOW (P = .14). BRd and BRc demonstrated a direct correlation to two of the three stock market indices, whereas CTR showed an inverse (ie, negative) correlation to two of the three indices. This study, to our knowledge, is the first to suggest a direct correlation of four cosmetic and two reconstructive plastic surgery procedures to the three major US stock market indices and further emphasizes the importance of a broad-based plastic surgery practice in times of economic recession.

  5. Regional anesthesia for pediatric knee surgery: a review of the indications, procedures, outcomes, safety, and challenges

    Directory of Open Access Journals (Sweden)

    Muhly WT


    Full Text Available Wallis T Muhly, Harshad G Gurnaney, Arjunan GaneshDepartment of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Pennsylvania, PA, USAAbstract: The indications for surgery on the knee in children and adolescents share some similarity to adult practice in that there are an increasing number of sports-related injuries requiring surgical repair. In addition, there are some unique age-related conditions or congenital abnormalities that may present as indications for orthopedic intervention at the level of the knee. The efficacy and safety of peripheral nerve blocks (PNBs for postoperative analgesia following orthopedic surgery has been well established in adults. Recent studies have also demonstrated earlier functional recovery after surgery in patients who received PNBs. In children, PNB is gaining popularity, and increasing data are emerging to demonstrate the feasibility, efficacy, and safety in this population. In this paper, we will review some of the most common indications for surgery involving the knee in children and the anatomy of knee, associated dermatomal and osteotomal innervation, and the PNBs most commonly used to produce analgesia at the level of the knee. We will review the evidence in support of regional anesthesia in children in terms of both the quality conferred to the immediate postoperative care and the role of continuous PNBs in maintaining effective analgesia following discharge. Also we will discuss some of the subtle challenges in utilizing regional anesthesia in the pediatric patient including the use of general anesthesia when performing regional anesthesia and the issue of monitoring for compartment syndrome. Finally, we will offer some thoughts about areas of practice that are in need of further investigation.Keywords: pediatric surgery, regional anesthesia, analgesia, knee surgery

  6. Indications and Morbidity of Reoperative Thyroid Surgeries in a Military Hospital of Senegal

    Directory of Open Access Journals (Sweden)

    Abdou Sy


    Full Text Available Objectives. To describe reoperative thyroid surgeries in our department. Study Design. Retrospective cross-sectional and descriptive study at the Ouakam Military Hospital in Dakar (Senegal, over a period of eight and a half years. Methods. The study involved all records of patients who had a reoperative thyroidectomy regardless of the indication and time of the second surgery. Parameters evaluated for first and reoperative surgery were time interval between the two surgeries, operative indications, surgical procedures, intraoperative findings, pathological examination, and morbidity. Results. 30 records of patients were selected out of a total of 698 thyroidectomies (4.3%. Thyroid cancers diagnosed on first surgical specimens were the first indications of reoperations (46.67% followed by neck hematoma (20%. Completion thyroidectomy with a prophylactic central lymph nodes dissection was the most performed surgical procedure (43.33% followed by haemostasis (20%. During reoperation, we found active bleeding (20%, textiloma (6.67%, and fourth branchial cleft fistula (3.33%. The morbidity accounted for 10%: lymphorrhea, permanent hypocalcemia, and permanent recurrent nerve palsy, in one case, respectively. There were no statistically significant differences between the morbidity in patients reoperated on and the one for patients operated on once. Conclusion. We did not find an increased risk of postoperative morbidity after reintervention.

  7. Analysis of physiology and biochemistry indicators of garrison and field training troops at high altitude

    Directory of Open Access Journals (Sweden)

    Lu LIU


    Full Text Available Objective To investigate the effects of plateau hypoxia environment on the physiology and biochemistry indicators of troops executing different combat mission. Methods Troops included the soldiers in camp (station altitude 4030m and 4600m and those soldiers in field training (altitude 4300m for one month. Blood samples were collected and the physiology and biochemistry indicators were detected including heart rate (HR, blood pressure (BP, oxygen saturation (SpO2 and the concentrations of hemoglobin (Hb, serum total protein (TP, albumin (ALB and globulin (GLB, the ratio of albumin and globulin (A/G, concentrations of total cholesterol (TC, triglycerides (TG, high-density lipoprotein cholesterol (HDL-C and low density lipoprotein cholesterol (LDL-C, creatine kinase (CK, lactic dehydrogenase (LDH, aspartate aminotransferase (AST, alanine aminotransferase (ALT and AST/ALT. Results The HR was significantly higher in soldiers of field training (82.25±14.10 beats/min than in soldiers stationed in camp (74.18±9.02 beats/min, P0.05. The concentration of Hb and the prevalence of plateau polycythemia were significantly higher in soldiers of field training (211.6±17.4g/L and 55.6% than in soldiers stationed in camp (199.3±22.7g/L and 25.7%, P0.05. The concentration of serum LDH was significantly higher and the abnormality rate of LDH was also higher in soldiers of field training (273.70±136.74U/L and 72.7% than in soldiers stationed in camp (205.19±77.94 U/L and 51.1%, P<0.01 and P<0.05. Conclusions The protein nutrition in plateau soldiers is sufficient, but the prevalence of plateau polycythemia, dyslipidemia and the abnormality rate of LDH were higher in soldiers of field training than in soldiers stationed in camp. Regular physical examination should be taken into consideration, early prevention and treatment is also important. DOI: 10.11855/j.issn.0577-7402.2017.10.13

  8. Behavioural and physiological measures indicate subtle variations in the emotional valence of young pigs. (United States)

    Leliveld, Lisette M C; Düpjan, Sandra; Tuchscherer, Armin; Puppe, Birger


    showed lower frequency parameters (bandwidth, maximum frequency, 25% and 50% quartiles) compared to those of the positively conditioned pigs. In any of the statistically significant results, the conditioning accounted for 1.5-11.9% of variability in the outcome variable. Hence, we conclude that repeated moderate aversive and rewarding events have weak but measurable effects on some aspects of behaviour and physiology in young pigs, possibly indicating changes in emotional valence, which could ultimately affect their welfare. The combination of ethophysiological indicators, i.e., the concurrent examination of heart rate measures, behavioural responses and especially vocalisation patterns, as used in the current study, might be a useful way of examining subtle effects on emotional valence in further studies. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. GLUT4 in the endocrine pancreas--indicating an impact in pancreatic islet cell physiology? (United States)

    Bähr, I; Bazwinsky-Wutschke, I; Wolgast, S; Hofmann, K; Streck, S; Mühlbauer, E; Wedekind, D; Peschke, E


    The glucose transporter GLUT4 is well known to facilitate the transport of blood glucose into insulin-sensitive muscle and adipose tissue. In this study, molecular, immunohistochemical, and Western blot investigations revealed evidence that GLUT4 is also located in the mouse, rat, and human endocrine pancreas. In addition, high glucose decreased and insulin elevated the GLUT4 expression in pancreatic α-cells. In contrast, high glucose increased GLUT4 expression, whereas insulin led to a reduced expression level of the glucose transporter in pancreatic β-cells. In vivo experiments showed that in pancreatic tissue of type 2 diabetic rats as well as type 2 diabetic patients, the GLUT4 expression is significantly increased compared to the nondiabetic control group. Furthermore, type 1 diabetic rats exhibited reduced GLUT4 transcript levels in pancreatic tissue, whereas insulin treatment of type 1 diabetic animals enhanced the GLUT4 expression back to control levels. These data provide evidence for the existence of GLUT4 in the endocrine pancreas and indicate a physiological relevance of this glucose transporter as well as characteristic changes in diabetic disease. © Georg Thieme Verlag KG Stuttgart · New York.

  10. Effect of a Grain Extract on Certain Digestive Physiological Indicators in Early Weaned Rabbits

    Directory of Open Access Journals (Sweden)

    Melinda Kovács


    Full Text Available The effect of a non-medicated diet with or without a grain extract feed additive (benzoquinones as main active ingredients on the growth of rabbits and certain physiological indicators of the digestive tract was examined. One-day-old rabbits of average birth weight were distributed into litters of eight, and these litters were randomly divided into three groups (21-22 litters/group. The control group (Group C received a basal diet. The diet fed to rabbits of Group IM, was supplemented with a feed additive containing natural basic ingredients (Immunovet-HBM, 1 kg/t; the diet fed to Group M was medicated (tiamulin, oxytetracycline and diclazuril. Three days prior to kindling and up to weaning at 21 days of age of the pups, the does were fed one of the three diets ad libitum. Young rabbits were allowed to consume the same diets beside their mother’s milk before weaning. Significant (p p p < 0.05 higher in the C and IM group than in M rabbits. The proportion of butyric acid was lower than that of propionic acid even on the 42nd day in Group M. From the results of this study it is clear that the early weaning of rabbits can be accomplished by the use of a non-medicated diet without any decrease in weight gain. In our study the grain extract feed additive exerted a beneficial effect by increasing the pancreatic enzyme activity and maintaining a better VFA ratio.

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

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


    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.

  12. Effects of four weeks of repeated sprint training on physiological indices in futsal players

    Directory of Open Access Journals (Sweden)

    Paulo Cesar do Nascimento


    Full Text Available DOI:   The aim of this study was to investigate the effects of short repeated-sprint ability (RSA training on the neuromuscular and physiological indices in U17 futsal players during the competitive period. Fourteen players were divided into two groups: intervention group (n = 8 and control group (n = 6. Both groups performed a repeated maximal sprint test (40-m MST, intermittent shuttle-running test (Carminatti’s test and vertical jumps before and after the training period. The intervention group was submitted to an additional four-week repeated sprints program, twice a week, while the control group maintained their normal training routine. There was no significant interaction between time and groups for all variables analysed (p > 0.05. However, a significant main effect was observed for time (p < 0.01 indicating an increase on speed at heart rate deflection point (VHRDP and the continuous jump performance while the peak lactate (40m-LACpeak and sprint decrement decreased after training, in both groups. Still, based on effect sizes (ES the greater changes with practical relevance were verified for intervention group in important variables such as peak velocity (ES = 0,71, VHRDP (ES = 0,83 and 40m-LACpeak (ES = 1,00. This study showed that RSA-based and normal training routine are equally effective in producing changes in the analysed variables during a short period of intervention. However, the effect size suggests that four weeks of RSA training would be a minimum time that could induce the first changes of futsal player’s physical fitness.

  13. Orthognathic surgery in patients over 40 years of age: indications and special considerations. (United States)

    Peacock, Zachary S; Lee, Cameron C Y; Klein, Katherine P; Kaban, Leonard B


    To assess indications, incidence, patient experience, and outcomes of orthognathic surgery in patients over 40 years of age. This was a retrospective cohort study of all patients who underwent orthognathic surgical procedures at Massachusetts General Hospital from 1995 to 2012. Demographic variables, including age, gender, indications, date, and type of operation, were documented. Patients were divided into 2 groups by date of operation: 1) 1995 to 2002 and 2) 2003 to 2012. The predictor variable was age (>40 vs orthognathic surgery varies by age and gender. Older patients, particularly men, tend to seek treatment for functional rather than esthetic reasons. Patients older than 40 years had longer hospital stays and an increased rate of postoperative hardware removal. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  14. European Society of Gynaecologic Oncology Quality Indicators for Advanced Ovarian Cancer Surgery. (United States)

    Querleu, Denis; Planchamp, François; Chiva, Luis; Fotopoulou, Christina; Barton, Desmond; Cibula, David; Aletti, Giovanni; Carinelli, Silvestro; Creutzberg, Carien; Davidson, Ben; Harter, Philip; Lundvall, Lene; Marth, Christian; Morice, Philippe; Rafii, Arash; Ray-Coquard, Isabelle; Rockall, Andrea; Sessa, Cristiana; van der Zee, Ate; Vergote, Ignace; du Bois, Andreas


    The surgical management of advanced ovarian cancer involves complex surgery. Implementation of a quality management program has a major impact on survival. The goal of this work was to develop a list of quality indicators (QIs) for advanced ovarian cancer surgery that can be used to audit and improve the clinical practice. This task has been carried out under the auspices of the European Society of Gynaecologic Oncology (ESGO). Quality indicators were based on scientific evidence and/or expert consensus. A 4-step evaluation process included a systematic literature search for the identification of potential QIs and the documentation of scientific evidence, physical meetings of an ad hoc multidisciplinarity International Development Group, an internal validation of the targets and scoring system, and an external review process involving physicians and patients. Ten structural, process, or outcome indicators were selected. Quality indicators 1 to 3 are related to achievement of complete cytoreduction, caseload in the center, training, and experience of the surgeon. Quality indicators 4 to 6 are related to the overall management, including active participation to clinical research, decision-making process within a structured multidisciplinary team, and preoperative workup. Quality indicator 7 addresses the high value of adequate perioperative management. Quality indicators 8 to 10 highlight the need of recording pertinent information relevant to improvement of quality. An ESGO-approved template for the operative report has been designed. Quality indicators were described using a structured format specifying what the indicator is measuring, measurability specifications, and targets. Each QI was associated with a score, and an assessment form was built. The ESGO quality criteria can be used for self-assessment, for institutional or governmental quality assurance programs, and for the certification of centers. Quality indicators and corresponding targets give

  15. Technogenic impact on physiological and cytogenic indices of reproductive organs of Tilia genus representatives

    Directory of Open Access Journals (Sweden)

    T. I. Iusypiva


    Full Text Available This paper addresses the problem of technogenic pollution which is a dramatic stress-factor for plants effectively acting as a green filter for cleaning air, water, and soil. It results in their growth rate changes, seasonal development speed deviations and plant appearance variations. Green belt to consume industrial emissions and to create the esthetic look seems to be an urgent matter to deal with technogenic pollution. Lime tree decorative characteristics depend significantly on the state of their reproductive organs (flower, inflorescence and fruit. On the other hand, biometric indices of woody plant reproductive organs are sensitive parameters characterizing the plant response to pollutants. The study discusses complex environmental pollution impact caused by sulfur (IV and nitrogen (IV oxides as well as heavy metals on physiological and cytogenetic characteristics of reproductive organs of Tіlia L. genus representatives in conditions of steppe Prydniprovye. The research objectives were T. amurensis L. аnd T. cordаta Mill. Samples were collected in May and June 2014 on two sample areas. The research area borders with both heavy traffic road and Interpipe NTRP CJSC, Dnipropetrovsk, Ukraine, that features such pollutants as SO2, NO2, iron, manganese, zinc, mercury, chrome. The control area is located in the Botanical garden of Oles Honchar Dnipropetrovsk National University. The research proved that biometric and cytogenetic parameters of generic organo of Tilia genus representatives were dramatically sensitive to the impact of pollutants. Moreover, T. cordаta was the most sensitive among species under study to multicomponent environmental pollution when assessed by criteria of suppression of woody plant reproductive capacity formation. The other benefit of this study consisted in monitoring of the blossom rate of both species that appeared to scale down substantially in the technogenic environment. Man-induced stress factors caused

  16. Indications for surgery in acute pancreatitis on the basis of abdominal CT in the early stage

    International Nuclear Information System (INIS)

    Cho, Keishoku; Nakasaku, Osamu; Kim, Jung-hyo; Hatakeyama, Gen


    Acute pancreatitis clinically manifests various degrees of severity. In the present study, we performed a retrospective study on 39 cases of acute pancreatitis and examined the indications for surgery and infection as an aggravating factor in acute pancreatitis on the basis of CT in the early stage (about 48 hours after onset). CT in the early stage of acute pancreatitis permits objective determination of the extent of lesion enlargement. The cases could be classified into three grades: severe (CT score ≥ 6; surgical therapy), moderate (CT score = 5, 4; medical therapy possible), and mild (CT score ≤ 3; medical therapy) as determined by CT. Emergency surgery was performed in seven of 10 patients in whom pancreatitis was judged to be severe on the basis of CT and clinical findings. Of the seven, four had infection in the early stage (within 48 hours after onset). Three of the four had MOF complications and died. Two of the three patients without infection were relieved. The extent of inflammatory lesions of severe pancreatitis was severe by CT, and the CT scores were especially high in cases with infection. Infection in the early stage of acute pancreatitis was thus thought to be an serious aggravating factor. It was concluded, therefore, that, in the early stage, CT was very useful as a helpful guide to early judgement and an indicator for emergency surgery. (author)

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

    DEFF Research Database (Denmark)

    Kehlet, Henrik


    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....

  18. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N


    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...

  19. Effect of Planting Date and Biological and Chemical Fertilizers on Phenology and Physiological Indices of Peanuts

    Directory of Open Access Journals (Sweden)

    A Sepehri


    Full Text Available Introduction Peanut (Arachis hypogaea L. is an annual herbaceous plant in Fabaceae which grown in tropical to temperate regions worldwide for extracting its seed oil and nut consumption. Select the optimum planting date is one of the most important agricultural techniques that comply with the seed yield is maximized . For instance, delay planting date can reduce the number of fertile nodes and the number of pods per plant. The delay in planting date reduces total dry matter (TDM, leaf area index (LAI, crop growth rate (CGR and yield in bean (Phaseolus vulgaris L.. Daneshian et al., (2008 reported that the delay in planting date reduced sunflower (Helianthus annuus yield due to high temperatures in early growth which shortened flowering time and reduced solar radiation. On the other hand, due to increase importance of environmental issues has been attending biofertilizers to replace chemical fertilizers. Biofertilizers has formed by beneficial bacteria and fungi that each of them are produced for a specific purpose, such as nitrogen fixation, release of phosphate, potassium and iron ions of insoluble compound. The use of nitrogen fertilizer with slow-releasing ability stimulated shoot growth in soybean (Glycine max and be created more LAI in the reproductive process, particularly during grain filling stage and finally increased seed yield . Therefore, this study was conducted in order to evaluate the interaction of biological and chemical fertilizers in the purpose of achieving sustainable agriculture with emphasis of the effects of various planting dates on physiological parameters and growth of peanut in Hamadan. Materials and Methods In order to investigate the effects of planting date on important physiological indices of peanuts (Arachis hypogaea L. under the influence of biological and chemical fertilizers. A field experiment was conducted in the research farm of Bu-Ali Sina University, Hamedan during 2013 growing season. This study was

  20. Maternal separation modulates short-term behavioral and physiological indices of the stress response. (United States)

    Litvin, Yoav; Tovote, Philip; Pentkowski, Nathan S; Zeyda, Thomas; King, Lanikea B; Vasconcellos, Amy J; Dunlap, Christopher; Spiess, Joachim; Blanchard, D Caroline; Blanchard, Robert J


    Early-life stress produces an anxiogenic profile in adulthood, presumably by activating the otherwise quiescent hypothalamic-pituitary-adrenal (HPA) axis during the vulnerable 'stress hyporesponsive period'. While the long-term effects of such early-life manipulations have been extensively characterized, little is known of the short-term effects. Here, we compared the short-term effects of two durations of maternal separation stress and one unseparated group (US) on behavioral and physiological indices of the stress response in rat pups. Separations included 3h on each of 12days, from postnatal day (PND) 2 to 13 (MS2-13) and 3days of daily, 6-h separation from PND11-13 (MS11-13). On PND14 (Experiment 1), both MS2-13 and MS11-13 produced marked reductions in freezing toward an adult male conspecific along with reduced levels of glucocorticoid type 2 (GR) and CRF type-1 (CRF(1)) receptor mRNA in the hippocampus. Group MS2-13 but not MS11-13 produced deficits in stressor-induced corticosterone secretion, accompanied by reductions in body weight. Our results suggest that GR and/or CRF(1) levels, not solely the magnitude of corticosterone secretion, may be involved in the modulation of freezing. In a second experiment, we aimed to extend these findings by testing male and female separated and unseparated pups' unconditioned defensive behaviors to cat odor on PND26, and subsequent cue+context conditioning and extinction throughout postnatal days 27-32. Our results show that maternal separation produced reductions in unconditioned freezing on PND26, with MS2-13 showing stronger deficits than MS11-13. However, separation did not affect any other defensive behaviors. Furthermore, separated rats failed to show conditioned freezing, although they did avoid the no-odor block conditioned cue. There were no sex differences other than weight. We suggest that maternal separation may have produced these changes by disrupting normal development of hippocampal regions involved in

  1. 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


    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...

  2. Indications for spine surgery: validation of an administrative coding algorithm to classify degenerative diagnoses (United States)

    Lurie, Jon D.; Tosteson, Anna N.A.; Deyo, Richard A.; Tosteson, Tor; Weinstein, James; Mirza, Sohail K.


    Study Design Retrospective analysis of Medicare claims linked to a multi-center clinical trial. Objective The Spine Patient Outcomes Research Trial (SPORT) provided a unique opportunity to examine the validity of a claims-based algorithm for grouping patients by surgical indication. SPORT enrolled patients for lumbar disc herniation, spinal stenosis, and degenerative spondylolisthesis. We compared the surgical indication derived from Medicare claims to that provided by SPORT surgeons, the “gold standard”. Summary of Background Data Administrative data are frequently used to report procedure rates, surgical safety outcomes, and costs in the management of spinal surgery. However, the accuracy of using diagnosis codes to classify patients by surgical indication has not been examined. Methods Medicare claims were link to beneficiaries enrolled in SPORT. The sensitivity and specificity of three claims-based approaches to group patients based on surgical indications were examined: 1) using the first listed diagnosis; 2) using all diagnoses independently; and 3) using a diagnosis hierarchy based on the support for fusion surgery. Results Medicare claims were obtained from 376 SPORT participants, including 21 with disc herniation, 183 with spinal stenosis, and 172 with degenerative spondylolisthesis. The hierarchical coding algorithm was the most accurate approach for classifying patients by surgical indication, with sensitivities of 76.2%, 88.1%, and 84.3% for disc herniation, spinal stenosis, and degenerative spondylolisthesis cohorts, respectively. The specificity was 98.3% for disc herniation, 83.2% for spinal stenosis, and 90.7% for degenerative spondylolisthesis. Misclassifications were primarily due to codes attributing more complex pathology to the case. Conclusion Standardized approaches for using claims data to accurately group patients by surgical indications has widespread interest. We found that a hierarchical coding approach correctly classified over 90

  3. Aging and Variability of Individual Differences: A Longitudinal Analysis of Social, Psychological, and Physiological Indicators. (United States)

    Maddox, George L.; Douglass, Elizabeth B.

    This paper explores the relationship between age and individual differences. Two hypotheses were tested through the use of repeated measures of functioning in terms of social, psychological, and physiological parameters: (1) individual differences do not decrease with age, and (2) individuals tend to maintain the same rank in relation to age peers…

  4. [Individual physical performance capacity with physiological and biochemical indicators of stress]. (United States)

    Bergert, K D; Nestler, K; Böttger, H; Schettler, R


    22 health male subjects were exposed by a combination of physical exercises and heat. Strain related physiological and biochemical parameters were measured. Different individual reactions were obtained under controlled conditions. In dependence on the individual performance an increased mobilisation of lactat, free fatty acids and catecholamines were found. The determination of aerob physical performance can be applied for the evaluation of working capacity.

  5. Group housing during gestation affects the behaviour of sows and the physiological indices of offspring piglets at weaning (United States)

    In order to compare the behaviour of sows in stalls and group housing systems, and the physiological indices of their offspring, 28 sows were randomly distributed into 2 systems with 16 sows in stalls, and the other 12 sows were divided into 3 groups with 4 sows per pen. The area per sow in stalls a...

  6. A 5-year perspective over robotic general surgery: indications, risk factors and learning curves. (United States)

    Sgarbură, O; Tomulescu, V; Blajut, C; Popescu, I


    Robotic surgery has opened a new era in several specialties but the diffusion of medical innovation is slower indigestive surgery than in urology due to considerations related to cost and cost-efficiency. Studies often discuss the launching of the robotic program as well as the technical or clinical data related to specific procedures but there are very few articles evaluating already existing robotic programs. The aims of the present study are to evaluate the results of a five-year robotic program and to assess the evolution of indications in a center with expertise in a wide range of thoracic and abdominal robotic surgery. All consecutive robotic surgery cases performed in our center since the beginning of the program and prior to the 31st of December 2012 were included in this study, summing up to 734 cases throughout five years of experience in the field. Demographic, clinical, surgical and postoperative variables were recorded and analyzed.Comparative parametric and non-parametric tests, univariate and multivariate analyses and CUSUM analysis were performed. In this group, the average age was 50,31 years. There were 60,9% females and 39,1% males. 55,3% of all interventions were indicated for oncological disease. 36% of all cases of either benign or malignant etiology were pelvic conditions whilst 15,4% were esogastric conditions. Conversion was performed in 18 cases (2,45%). Mean operative time was 179,4Â+-86,06 min. Mean docking time was 11,16Â+-2,82 min.The mean hospital length of stay was 8,54 (Â+-5,1) days. There were 26,2% complications of all Clavien subtypes but important complications (Clavien III-V) only represented 6,2%.Male sex, age over 65 years old, oncological cases and robotic suturing were identified as risk factors for unfavorable outcomes. The present data support the feasibility of different and complex procedures in a general surgery department as well as the ascending evolution of a well-designed and well-conducted robotic program. From

  7. The hemiclamshell approach in thoracic surgery: indications and associated morbidity in 50 patients. (United States)

    Lebreton, Guillaume; Baste, Jean-Marc; Thumerel, Matthieu; Delcambre, Frédéric; Velly, Jean-Françis; Jougon, Jacques


    This retrospective study was carried out to evaluate the indications for and outcomes of the hemiclamshell (HCS) approach (longitudinal partial sternotomy with antero-lateral thoracotomy) in patients undergoing mass resection in thoracic surgery. All patients (50) who underwent a HCS procedure in our department, between July 1996 and July 2005, were studied retrospectively, analyzing the indications, morbidity and outcome (pain, neurological or shoulder defects, mortality) at one month and one year. The main indications were apical tumours (38%), tumours of the cervicothoracic junction (46%) and chest wall (10%), and 'bulky' tumours (6%). One-month mortality was 6%. Two patients suffered from a chylothorax and one from phrenic paralysis. The postoperative analgesic requirements were similar to those after other thoracic surgery approaches. Twelve percent of patients suffered pain at one month and 6% at one year. Shoulder dysfunction was observed in 10% of patients at one month and 6% at one year. In conclusion, the HCS surgical approach was associated with an uncomplicated postoperative course. This anterior approach is suitable for apical tumours, tumours of the cervicothoracic junction and 'bulky' lung tumours, providing good access for control of the large vessels and radical mediastinal clearance.

  8. Effect of fast track surgery on anxiety index and stress indices in patients undergoing laparoscopic cholecystectomy

    Directory of Open Access Journals (Sweden)

    LU Xia


    Full Text Available ObjectiveTo investigate the effect of fast track surgery (FTS on anxiety index and stress indices in patients undergoing laparoscopic cholecystectomy. MethodsThe patients who were hospitalized in Department of General Surgery, The Second People′s Hospital of Lanzhou, from March 2015 to July 2016 and underwent laparoscopic cholecystectomy were enrolled and randomly divided into FTS group and conventional treatment group, with 200 patients in each group. The patients in the FTS group were given FTS in the perioperative period, and those in the conventional treatment group were given conventional treatment. The C-reactive protein (CRP level, white blood cell count (WBC, and interleukin-6 (IL-6 level were measured on admission, at 1 hour before surgery, and at 24 and 48 hours after surgery, as well as the anxiety index in Hamilton anxiety scale (HAMA. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsThere was no significant difference in anxiety index between the FTS group and the conventional treatment group on admission (P>0.05; at 1 hour before surgery and at 24 and 48 hours after surgery, there were significant differences in anxiety index between the two groups (χ2=12.73, 13.17, and 14.12, all P<0.05. On admission and at 1 hour before surgery, there were no significant differences in the CRP level, WBC, and IL-6 level between the FTS group and the conventional treatment group (all P>0.05; at 24 and 48 hours after surgery, there were significant differences in the CRP level, WBC, and IL-6 level between the two groups [CRP24h: 8.47±0.78 mg/L vs 17.56±1.31 mg/L, t=17.63, P<0.05; WBC24h: (8.3±3.4×109/L vs (10.2±3.8×109/L, t=21.62, P<0.05; IL-624h: 127.43±37.46 ng/L vs 146.25±42.56 ng/L, t=2632, P<0.05; CRP48h:(6.57±1.27 mg/L vs (10.76±1.25 mg/L,t=19.25,P<0.05;WBC48h:(7.1±2.3×109/L vs (9.3±2.4×109/L

  9. Evaluation of eco-physiological indicators in Northeast Asia dryland regions based on MODIS products and ecological models (United States)

    Kang, W.


    Ecosystem carbon-energy-water circles have significant effect on function and structure and vice verse. Based on these circles mechanism, some eco-physiological indicators, like Transpiration (T), gross primary productivity (GPP), light use efficiency (LUE) and water use efficiency (WUE), are commonly applied to assess terrestrial ecosystem function and structure dynamics. The ecosystem weakened function and simple structure in Northeast dryland regions resulted from land degradation or desertification, which could be demonstrated by above-mentioned indicators. In this study, based on MODIS atmosphere (MYD07, MYD04, MYD06 data) and land products (MYD13A2 NDVI, MYD11A1 LST, MYD15A2 LAI and land cover data), we first retrieved transpiration and LUE via Penman-Monteith Model and modified Vegetation Photosynthesis Model (VPM), respectively; and then evaluated dynamics of these eco-physiological indicators (Tair, VPD, T, LUE, GPP and WUE) and some hotspots were found for next land degradation assessment. The results showed: (1) LUE and WUE are lower in barren or sparsely vegetated area and grasslands than in forest and croplands. (2) Whereas, all indicators presented higher variability in grassland area, particularly in east Mongolia. (3) GPP and transpiration have larger variability than other indicators due to fraction of absorbed Photosynthetically active radiation (FPAR). These eco-physiological indicators are expected to continue to change under future climate change and to help to assess land degradation from ecosystem energy-water-carbon perspectives.

  10. Development and pilot study of an essential set of indicators for general surgery services. (United States)

    Soria-Aledo, Victor; Angel-Garcia, Daniel; Martinez-Nicolas, Ismael; Rebasa Cladera, Pere; Cabezali Sanchez, Roger; Pereira García, Luis Francisco


    At present there is a lack of appropriate quality measures for benchmarking in general surgery units of Spanish National Health System. The aim of this study is to present the selection, development and pilot-testing of an initial set of surgical quality indicators for this purpose. A modified Delphi was performed with experts from the Spanish Surgeons Association in order to prioritize previously selected indicators. Then, a pilot study was carried out in a public hospital encompassing qualitative analysis of feasibility for prioritized indicators and an additional qualitative and quantitative three-rater reliability assessment for medical record-based indicators. Observed inter-rater agreement, prevalence adjusted and bias adjusted kappa and non-adjusted kappa were performed, using a systematic random sample (n=30) for each of these indicators. Twelve out of 13 proposed indicators were feasible: 5 medical record-based indicators and 7 indicators based on administrative databases. From medical record-based indicators, 3 were reliable (observed agreement >95%, adjusted kappa index >0.6 or non-adjusted kappa index >0.6 for composites and its components) and 2 needed further refinement. Currently, medical record-based indicators could be used for comparison purposes, whilst further research must be done for validation and risk-adjustment of outcome indicators from administrative databases. Compliance results in the adequacy of informed consent, diagnosis-to-treatment delay in colorectal cancer, and antibiotic prophylaxis show room for improvement in the pilot-tested hospital. Copyright © 2016 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  11. Morphoanatomical and physiological changes in Bauhinia variegata L. as indicators of herbicide diuron action. (United States)

    Lima, Dêmily Andrômeda de; Müller, Caroline; Costa, Alan Carlos; Batista, Priscila Ferreira; Dalvi, Valdnéa Casagrande; Domingos, Marisa


    The wide use of the herbicide diuron has compromised surrounding uncultivated areas, resulting in acute and/or chronic damage to non-target plants. Thus, the aim of this research was to evaluate physiological and morphoanatomical responses in Bauhinia variegata L. plants to different doses of diuron. Seedlings of 90-day-old B. variegata were transplanted into 10liter pots. After an acclimation period (about 30 days), treatments consisting of different diuron doses were applied: 0 (control), 400, 800, 1600, and 2400g ai ha -1 . The experiment was conducted in a randomized block design in a 5×5 factorial scheme with five doses of diuron five evaluation times, and five replicates per treatment. Anatomical and physiological injuries were observed in leaves of Bauhina variegata 10h after diuron application. Disruption of waxes was observed on both sides of the leaves of plants exposed since the lowest dose. Plasmolysis in cells were observed in treated leaves; more severe damage was observed in plants exposed to higher doses, resulting in rupture of epidermis. The diuron herbicide also caused gradual reduction in the gas exchange and chlorophyll fluorescence variables. Among the morphoanatomical and physiological variables analyzed, the non-invasive ones (e.g., ETR, Y II , and F v /F m ) may be used as biomarkers of diuron action in association with visible symptoms. In addition, changes in leaf blade waxes and chlorophyll parenchyma damage may also be considered additional leaf biomarkers of diuron herbicide action. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Pelvic Fixation in Adult and Pediatric Spine Surgery: Historical Perspective, Indications, and Techniques: AAOS Exhibit Selection. (United States)

    Jain, Amit; Hassanzadeh, Hamid; Strike, Sophia A; Menga, Emmanuel N; Sponseller, Paul D; Kebaish, Khaled M


    Achieving solid osseous fusion across the lumbosacral junction has historically been, and continues to be, a challenge in spine surgery. Robust pelvic fixation plays an integral role in achieving this goal. The goals of this review are to describe the history of and indications for spinopelvic fixation, examine conventional spinopelvic fixation techniques, and review the newer S2-alar-iliac technique and its outcomes in adult and pediatric patients with spinal deformity. Since the introduction of Harrington rods in the 1960s, spinal instrumentation has evolved substantially. Indications for spinopelvic fixation as a means to achieve lumbosacral arthrodesis include a long arthrodesis (five or more vertebral levels) or use of three-column osteotomies in the lower thoracic or lumbar spine, surgical treatment of high-grade spondylolisthesis, and correction of lumbar deformity and pelvic obliquity. A variety of techniques have been described over the years, including Galveston iliac rods, Jackson intrasacral rods, the Kostuik transiliac bar, iliac screws, and S2-alar-iliac screws. Modern iliac screws and S2-alar-iliac screws are associated with relatively low rates of pseudarthrosis. S2-alar-iliac screws have the advantages of less implant prominence and inline placement with proximal spinal anchors. Collectively, these techniques provide powerful methods for obtaining control of the pelvis in facilitating lumbosacral arthrodesis. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  13. Quantifying the cognitive cost of laparo-endoscopic single-site surgeries: Gaze-based indices. (United States)

    Di Stasi, Leandro L; Díaz-Piedra, Carolina; Ruiz-Rabelo, Juan Francisco; Rieiro, Héctor; Sanchez Carrion, Jose M; Catena, Andrés


    Despite the growing interest concerning the laparo-endoscopic single-site surgery (LESS) procedure, LESS presents multiple difficulties and challenges that are likely to increase the surgeon's cognitive cost, in terms of both cognitive load and performance. Nevertheless, there is currently no objective index capable of assessing the surgeon cognitive cost while performing LESS. We assessed if gaze-based indices might offer unique and unbiased measures to quantify LESS complexity and its cognitive cost. We expect that the assessment of surgeon's cognitive cost to improve patient safety by measuring fitness-for-duty and reducing surgeons overload. Using a wearable eye tracker device, we measured gaze entropy and velocity of surgical trainees and attending surgeons during two surgical procedures (LESS vs. multiport laparoscopy surgery [MPS]). None of the participants had previous experience with LESS. They performed two exercises with different complexity levels (Low: Pattern Cut vs. High: Peg Transfer). We also collected performance and subjective data. LESS caused higher cognitive demand than MPS, as indicated by increased gaze entropy in both surgical trainees and attending surgeons (exploration pattern became more random). Furthermore, gaze velocity was higher (exploration pattern became more rapid) for the LESS procedure independently of the surgeon's expertise. Perceived task complexity and laparoscopic accuracy confirmed gaze-based results. Gaze-based indices have great potential as objective and non-intrusive measures to assess surgeons' cognitive cost and fitness-for-duty. Furthermore, gaze-based indices might play a relevant role in defining future guidelines on surgeons' examinations to mark their achievements during the entire training (e.g. analyzing surgical learning curves). Copyright © 2017 Elsevier Ltd. All rights reserved.





    The effects of detomidine on cloacal temperature, respiratory rate, and heart rates, were evaluated in domestic pigeons. Six birds were used in each of four treatment groups. Detomidine was administered at a dose range of 250µg/kg, 500 µg/kg, 750µg/kg, and 1000 µg/kg intramuscularly. In each of the mentioned doses, the above physiological parameters were determined and recorded before the drug administration and at interval of 15minutes, up to the time when the birds recovered from sedation. ...

  15. Indications for Use of Damage Control Surgery in Civilian Trauma Patients: A Content Analysis and Expert Appropriateness Rating Study. (United States)

    Roberts, Derek J; Bobrovitz, Niklas; Zygun, David A; Ball, Chad G; Kirkpatrick, Andrew W; Faris, Peter D; Brohi, Karim; D'Amours, Scott; Fabian, Timothy C; Inaba, Kenji; Leppäniemi, Ari K; Moore, Ernest E; Navsaria, Pradeep H; Nicol, Andrew J; Parry, Neil; Stelfox, Henry T


    To characterize and evaluate indications for use of damage control (DC) surgery in civilian trauma patients. Although DC surgery may improve survival in select, severely injured patients, the procedure is associated with significant morbidity, suggesting that it should be used only when appropriately indicated. Two investigators used an abbreviated grounded theory method to synthesize indications for DC surgery reported in peer-reviewed articles between 1983 and 2014 into a reduced number of named, content-characteristic codes representing unique indications. An international panel of trauma surgery experts (n = 9) then rated the appropriateness (expected benefit-to-harm ratio) of the coded indications for use in surgical practice. The 1107 indications identified in the literature were synthesized into 123 unique pre- (n = 36) and intraoperative (n = 87) indications. The panel assessed 101 (82.1%) of these indications to be appropriate. The indications most commonly reported and assessed to be appropriate included pre- and intraoperative hypothermia (median temperature 10 units), inability to close the abdominal wall without tension, development of abdominal compartment syndrome during attempted abdominal wall closure, and need to reassess extent of bowel viability. This study identified a comprehensive list of candidate indications for use of DC surgery. These indications provide a practical foundation to guide surgical practice while studies are conducted to evaluate their impact on patient care and outcomes.

  16. The relationships between environmental and physiological heat stress indices in Muslim women under the controlled thermal conditions

    Directory of Open Access Journals (Sweden)

    Peymaneh Habibi


    Full Text Available Aims: The aim of this study was to evaluate the relationship between environmental and physiological heat stress indices based on heart rate (HR, oral temperature for the estimation of heat strain, in veiled women in hot-dry condition in the climate chamber. Materials and Methods: The experimental study was carried out on 36 healthy Muslim women in hot-dry climatic conditions (wet bulb globe temperature (WBGT = 22-32°C in low workload for 2 h. The HR, oral temperature and WBGT index were measured. The obtained data were analyzed using descriptive statistics and Pearson correlation tests. Results: The results of the Pearson test indicated that physiological strain index was a high correlation (r = 0.975 with WBGT index (P < 0.05. Also, there was a good correlation among WBGT and HR (r = 0.779 and oral temperature (r = 0.981. Conclusion: The findings of this study illustrated that there is a good correlation between environmental and physiological heat stress indices in veiled women with Islamic clothing at the low workload over the action limit (WBGT = 31°C. So that it can be concluded that the WBGT 22-32°C is a good indicator of the heat strain in veiled women with Islamic clothing.

  17. Non-indicated use of prophylactic antibiotics in gynaecological surgery at an academic tertiary medical centre. (United States)

    Kremer, Kevin M; Foster, Raymond T; Drobnis, Erma Z; Hyde, Kassie J; Brennaman, Lisa M


    Surgical site infections (SSI) are the most common surgical complication. Perioperative antibiotics can reduce SSI when used properly. Despite guidelines from The American College of Obstetrics and Gynecology, non-indicated antibiotic use is widespread which exposes women to unnecessary risks. This study represents a quality improvement analysis assessing surgeon compliance with established guidelines regarding antibiotic use in gynaecological surgery. This is a single centre, retrospective study examining gynaecological procedures over two years. Cases were identified using Current Procedure Terminology codes. Perioperative antibiotics were used contrary to published guidelines in 199 of 1046 cases. Three variables were independently associated with inappropriate administration of perioperative antibiotics: entrance into abdominal cavity, higher EBL, and longer procedures. Impact statement Overuse of antibiotics has unintended consequences including allergic sequelae, extended length of hospital stay, increased healthcare costs, and the formation of antibiotic-resistant organisms. Antibiotic stewardship programmes have been shown to reduce the number of resistant pathogens, decrease incidence of Clostridium difficile colitis, and decrease length of hospital stay without increasing infection rates. Further outcomes-based research is needed regarding the use of antibiotic stewardship programmes in gynaecological surgery.

  18. Changes of visual-field global indices after cataract surgery in primary open-angle glaucoma patients. (United States)

    Seol, Bo Ram; Jeoung, Jin Wook; Park, Ki Ho


    To determine changes of visual-field (VF) global indices after cataract surgery and the factors associated with the effect of cataracts on those indices in primary open-angle glaucoma (POAG) patients. A retrospective chart review of 60 POAG patients who had undergone phacoemulsification and intraocular lens insertion was conducted. All of the patients were evaluated with standard automated perimetry (SAP; 30-2 Swedish interactive threshold algorithm; Carl Zeiss Meditec Inc.) before and after surgery. VF global indices before surgery were compared with those after surgery. The best-corrected visual acuity, intraocular pressure (IOP), number of glaucoma medications before surgery, mean total deviation (TD) values, mean pattern deviation (PD) value, and mean TD-PD value were also compared with the corresponding postoperative values. Additionally, postoperative peak IOP and mean IOP were evaluated. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with the effect of cataract on global indices. Mean deviation (MD) after cataract surgery was significantly improved compared with the preoperative MD. Pattern standard deviation (PSD) and visual-field index (VFI) after surgery were similar to those before surgery. Also, mean TD and mean TD-PD were significantly improved after surgery. The posterior subcapsular cataract (PSC) type showed greater MD changes than did the non-PSC type in both the univariate and multivariate logistic regression analyses. In the univariate logistic regression analysis, the preoperative TD-PD value and type of cataract were associated with MD change. However, in the multivariate logistic regression analysis, type of cataract was the only associated factor. None of the other factors was associated with MD change. MD was significantly affected by cataracts, whereas PSD and VFI were not. Most notably, the PSC type showed better MD improvement compared with the non-PSC type after cataract surgery

  19. Characterizing scientific production of Italian Oral Surgery professionals through evaluation of bibliometric indices. (United States)

    Tetè, Stefano; Zizzari, Vincenzo Luca; De Carlo, Alessandro; Lorusso, Felice; Di Nicola, Marta; Piattelli, Adriano; Gherlone, Enrico; Polimeni, Antonella


    The aim of this study was to characterize the scientific production of Italian Oral Surgery professionals by evaluating different bibliometric indices. The bibliometric evaluation was conducted on the Scopus Database upon all the Active Members joining three important Italian scientific societies in Oral Surgery (SIdCO, SIO, and SICOI). The scientific production was analysed by considering the number of total publications, number of total citations, h-index, and hc-index. Moreover, the overall sample was divided into two groups (Academics and Not Academics), according to the fact the professionals had or not a university position, and then into sub-groups according to the different career lengths. Statistical analyses were performed to compare the scientific productivity amongst groups. For all the considered parameters a lack of homogeneity between groups was reported, and significantly greater mean values were recorded for the Academics compared to the Not Academics Group. Moreover, the h-index values increased more regularly as the career length progressed than the hc-index values, even if the last seemed to be less variable. h- and hc-indices are both stable bibliometric parameters, but as the hc-index values are related not only to the number of citation but also to their age, it seems to be less influenced by the authors' career length. Bibliometric analysis of the scientific production in dentistry may facilitate the recognition of factors that may further enhance research activity and clinical performance and be useful for a comparative assessment of authors or research groups in terms of quality and quantity of the scientific production.

  20. Types and Indications of Colostomy and Determinants of Outcomes of Patients After Surgery. (United States)

    Engida, Abebe; Ayelign, Tsehay; Mahteme, Bekele; Aida, Tilahun; Abreham, Berhane


    Colostomy is one of the commonest life saving procedures done worldwide with an intention of either decompression of an obstructed colon or diversion of stool. Indications may vary from region to region. Attending morbidity and mortality is significant. the objective of this study was to Determine the common indications and types of colostomy, and outcomes of patients operated at SPHMMC. A retrospective medical records of patients, operation log book and nursing records review was done in a two-year period between January 2011 and December 2013 at the College Teaching Hospital, St Paul's Hospital Millennium Medical, Addis Ababa. During the two years, 253 colostomies were done and 219(86.6%) cases used for analysis. Of these, 151(68.9%) were males. Age ranged from 15 to 85 years with a mean of 50.8. Most of the surgeries, 196(89.5%), were done for emergency conditions. The three most common indications were gangrenous sigmoid volvulus, 102(46.6%), colorectal cancers, 46(21.0%, and abdominal injuries, 28(12.8%). The commonest type of colostomy done was Hartman's colostomy, 179(81.7.1%), gangrenous sigmoid volvulus being the predominant indication, 102(57%). Loop colostomy constituted 35(16%) of all the colostomies. Penetrating abdominal injuries was the main indication 15(42.9%). Overall, 157 complications were seen on 106(48.4%) patients. The most common complications were surgical site infection, 51(23.3%), hospital acquired pneumonia, (10.5%), and wound dehiscence, 17(7.8%). The mortality rate was 9.6% (21). Gangrenous sigmoid volvulus is the leading indication for colostomy. Mortality and morbidity rates are high. Aggressive resuscitation, early prompt operation and post op close follow-up should be emphasized.

  1. The not-so-bitter pill: Effects of combined oral contraceptives on peripheral physiological indicators of emotional reactivity. (United States)

    Armbruster, Diana; Kirschbaum, Clemens; Strobel, Alexander


    Combined oral contraceptives (COC) are used by millions of women worldwide. Although findings are not entirely consistent, COC have been found to impact on brain function and, thus, to modulate affective processes. Here, we investigated electro-physiological responses to emotional stimuli in free cycling women in both the early follicular and late luteal phase as well as in COC users. Skin conductance response (SCR), startle reflex, corrugator and zygomaticus activity were assessed. COC users showed reduced overall startle magnitude and SCR amplitude, but heightened overall zygomaticus activity, although effect sizes were small. Thus, COC users displayed reduced physiological reactions indicating negative affect and enhanced physiological responses signifying positive affect. In free cycling women, endogenous 17β-estradiol levels were associated with fear potentiated startle in both cycle phases as well as with SCR and zygomaticus activity during the follicular phase. Testosterone was associated with corrugator and zygomaticus activity during the luteal phase, while progesterone levels correlated with corrugator activity in the follicular phase. To the contrary, in COC users, endogenous hormones were not associated with electro-physiological measures. The results further underscore the importance of considering COC use in psychophysiological studies on emotional processing. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Effect of Foot Massage on Physiologic Indicators in Critically Ill Patients Admitted in the I.C.U

    Directory of Open Access Journals (Sweden)

    H Alavi- Majd


    Full Text Available Introduction: Intensive care unit is one of the most stressful wards for patients and it is estimated that 30 to70 percent of patients experience severe physiologic stress during admission. Some of the physiologic responses to stress include increase in metabolic rate with consequent increase in body temperature, increase in cardiac output and contraction power and subsequently increase in blood pressure, heart rate and sodium accumulation, bronchodilation and increase in respiration rate. Control of homodynamic condition and vital signs is an essential and important practice in intensive care units for stabilizing physiologic indicators. Massage is one of the methods that can be used for this purpose. The purpose of this research was to determine the effect of foot massage on physiologic indicators including pulse, respiration rate, mean arterial pressure, temperature and arterial blood oxygen saturation. Methods: 46 patients with brain stroke who were hospitalized in the intensive care unit of Tajrish Shohada hospital were studied.The validity of information record form was determined with content validity and the validity of instruments was established using valid marks. The reliability of instruments was assessed with test-re-test after calibration. Information was collected on second, third and fourth days after ICU admission at 4 to 6 pm. For this purpose, the physiologic indicators were controlled and after 10 minute, the patients underwent 5-minute foot stroke massage and then at 10 and 30-minute intervals, physiologic indicators were controlled again. Data was analyzed by ANOVA statistical method. Results: Findings showed that pulse rate, respiratory rate and mean arterial blood pressure significantly decreased after 5 minute foot massage (p< 0.001 and the value of these indicators 10 minutes after foot massage was less than the values 10 minute before massage. Also, arterial oxygen conc. 10 minute after foot massage was more than the

  3. Basic physiological systems indicator's informative assessment for children and adolescents obesity diagnosis tasks (United States)

    Marukhina, O. V.; Berestneva, O. G.; Emelyanova, Yu A.; Romanchukov, S. V.; Petrova, L.; Lombardo, C.; Kozlova, N. V.


    The healthcare computerization creates opportunities to the clinical decision support system development. In the course of diagnosis, doctor manipulates a considerable amount of data and makes a decision in the context of uncertainty basing upon the first-hand experience and knowledge. The situation is exacerbated by the fact that the knowledge scope in medicine is incrementally growing, but the decision-making time does not increase. The amount of medical malpractice is growing and it leads to various negative effects, even the mortality rate increase. IT-solution's development for clinical purposes is one of the most promising and efficient ways to prevent these effects. That is why the efforts of many IT specialists are directed to the doctor's heuristics simulating software or expert-based medical decision-making algorithms development. Thus, the objective of this study is to develop techniques and approaches for the body physiological system's informative value assessment index for the obesity degree evaluation based on the diagnostic findings.

  4. Physiological assessment of coronary lesion severity: fractional flow reserve versus nonhyperaemic indices. (United States)

    Robertson, Keith E; Hennigan, Barry; Berry, Colin; Oldroyd, Keith G


    Coronary angiography alone cannot accurately identify the haemodynamic impact of a coronary artery stenosis. Current international guidelines for myocardial revascularization recommend that inducible ischaemia should be demonstrated before the consideration of percutaneous coronary intervention. Invasive physiological assessment of coronary stenosis severity has increasingly been utilized for this purpose and use of the best validated technique, fractional flow reserve (FFR), has been shown to improve clinical outcomes in patients with stable and unstable coronary artery disease. This has led to the use of FFR being recommended in international revascularization guidelines, despite which, clinical uptake has been limited. One potential reason for slow adoption has been the requirement for maximal hyperaemia at the time of FFR measurement, usually achieved by the administration of pharmacological vasodilators such as adenosine. In some healthcare systems, adenosine is expensive and, in addition, its use can be associated with significant, albeit transient, adverse effects that patients (and some operators) find uncomfortable. Consequently, several methods of nonhyperaemic lesion assessment and their potential role in decision making have been reported. In this review we will review and discuss the current evidence for hyperaemic and nonhyperaemic methods of lesion assessment. We will also look at hybrid strategies that utilize both hyperaemic and nonhyperaemic methods as a means of potentially maintaining diagnostic accuracy while minimizing the requirement for adenosine administration and discuss whether or not they represent viable clinical alternatives.

  5. Extracorporeal CO2 removal: Technical and physiological fundaments and principal indications. (United States)

    Romay, E; Ferrer, R


    In recent years, technological improvements have reduced the complexity of extracorporeal membrane oxygenation devices. This have enabled the development of specific devices for the extracorporeal removal of CO2. These devices have a simpler configuration than extracorporeal membrane oxygenation devices and uses lower blood flows which could reduce the potential complications. Experimental studies have demonstrated the feasibility, efficacy and safety of extracorporeal removal of CO2 and some of its effects in humans. This technique was initially conceived as an adjunct therapy in patients with severe acute respiratory distress syndrome, as a tool to optimize protective ventilation. More recently, the use of this technique has allowed the emergence of a relatively new concept called "tra-protective ventilation"whose effects are still to be determined. In addition, the extracorporeal removal of CO2 has been used in patients with exacerbated hypercapnic respiratory failure with promising results. In this review we will describe the physiological and technical fundamentals of this therapy and its variants as well as an overview of the available clinical evidence, focused on its current potential. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

  6. Effect of transportation during periods of high ambient temperature on physiologic and behavioral indices of beef heifers. (United States)

    Theurer, Miles E; White, Brad J; Anderson, David E; Miesner, Matt D; Mosier, Derek A; Coetzee, Johann F; Amrine, David E


    To determine the effect of transportation during periods of high ambient temperature on physiologic and behavioral indices of beef heifers. 20 heifers (mean body weight, 217.8 kg). Ten heifers were transported 518 km when the maximum ambient temperature was ≥ 32.2°C while the other 10 heifers served as untransported controls. Blood samples were collected from transported heifers at predetermined intervals during the transportation period. For all heifers, body weights, nasal and rectal temperatures, and behavioral indices were measured at predetermined intervals for 3 days after transportation. A week later, the entire process was repeated such that each group was transported twice and served as the control twice. Transported heifers spent more time near the hay feeder on the day of transportation, had lower nasal and rectal temperatures for 24 hours after transportation, and spent more time lying down for 2 days after transportation, compared with those indices for control heifers. Eight hours after transportation, the weight of transported heifers decreased 6%, whereas that of control heifers increased 0.6%. At 48 hours after initiation of transportation, weight, rectal temperature, and time spent at various pen locations did not differ between transported and control heifers. Cortisol concentrations were higher 4 hours after initiation of transportation, compared with those determined just prior to transportation. Results indicated transportation during periods of high ambient temperatures caused transient changes in physiologic and behavioral indices of beef heifers.

  7. Improvement in Creatinine Clearance after Open Heart Surgery in Infants as an Early Indicator of Surgical Success. (United States)

    Dagan, Amit; Dagan, Ovadia


    Early surgical correction of congenital heart malformations in neonates and small infants may be complicated by acute kidney injury (AKI), which is associated with higher morbidity and mortality rates, especially in patients who require dialysis. Glomerular filtration rate (GFR) is considered the best measurement of renal function which, in neonates and infants, is highly dependent on heart function. To determine whether measurements of creatinine clearance after open heart surgery in neonates and young infants can serve as an early indicator of surgical success or AKI. We conducted a prospective observational study in 19 neonates and small infants (body weight creatinine clearance and albumin excretion was performed before and during surgery and four times during 48 hours after surgery. Mean creatinine clearance was lowest during surgery (25.2 ± 4. ml/min/1.73 m2) and increased significantly in the first 16 hours post-surgery (45.7 ± 6.3 ml/min/1.73 m2). A similar pattern was noted for urine albumin which was highest during surgery (203 ± 31 µg/min) and lowest (93 ± 20 µg/min) 48 hours post-surgery. AKI occurred in four patients, and two patients even required dialysis. All six showed a decline in creatinine clearance and an increase in urine albumin between 8 and 16 hours post-surgery. In neonates and small infants undergoing open heart surgery, a significant improvement in creatinine clearance in the first 16 hours postoperatively is indicative of a good surgical outcome. This finding has important implications for the early evaluation and treatment of patients in the intensive care unit on the first day post-surgery.

  8. [Perioperative transfusion of erythrocyte concentrates during elective surgery: introduction of a protocol for indications]. (United States)

    Ortega Andrés, M C; Abad Gosálbez, A; López Sánchez, P; Martínez Aparisi, A; Ortí Lucas, R; Aranda Arrufat, A; Madrid Rondón, V


    The aim of this paper is, first, to know the actual situation of the perioperatory red cell transfusion for elective surgery in our hospital. In a second phase and prospectively, we tested guidelines for red cell perioperatory transfusion in order to observe the change of transfusions. Then, we compared the results between the basal and postintervention periods. We performed an aleatory assay with two periods, basal and interventionist. Basal period: 151 patients undergoing elective surgery with perioperatory blood requested and general anesthesia. Intervention period: We applied a transfusion guidelines protocol for perioperatory red cell transfusion from the Hospital's Transfusion Committee, also a questionnaire to evaluate the medical indication; We studied 164 patients with clinical features like the basal period. Study/results variables: preoperative blood request, perioperatively transfusion, number of packed red-cell units transfused, crossmatch--to--transfusion ratio, haemoglobin level pre and posttransfusion. No significant drop of the cross match-transfusion ratio was observed after intervention. There is a slight reduction of the crossmatch--to--transfusion ratio, although these value is high (4.48), due to an increase of the transfusion keeping the percentage of appropriate transfusions. The most frequent reason (53%) of inadequate transfusion is the active bleeding. 1) The transfusional activity of the Marina Alta Hospital supposes approximately 17% of the request and 6% of the global transfusion. 2) The introduction of a protocol of perioperative transfusion instructions suppose a small decrease of the crossmatch--to--transfusion ratio, without statistical significance. This slight reduction is due to an increase of transfusion in the post-intervention period, since in this period there is a group of older age patients and with greater percentage of associated pathology. 3) The rate of appropriate transfusions in both periods is similar. 4) The

  9. Pulmonary metastases, surgery and prognostic indicators: review of 8 - year experience

    International Nuclear Information System (INIS)

    Qureshi, R.; Prakash, D.; Al-Jilaihawi, A.N.


    Value of survey and prognostic indicators for pulmonary metastases were studied to establish appropriate criteria for patient selection influencing long-term survival at Hairmyres Hospital, East Kilbride, Glasgow, U.K. Between 1988 an 1996, 28 patients were treatment for pulmonary metastases mainly with metastasectomy, 21 patients had resections with curative intent. Unfortunately, 7 patients were unsuitable for surgery. At subsequent relapse, 2 patients had second stage surgery, while 15 patients had adjuvant therapies (chemotherapy / radiotherapy / combination). The origin of primary tumor was epithelial in 17 (60.71%) cases, sarcoma in 4(14.29%) germ cell carcinoma in 3(10.71) melanoma in 1(3.57%), and 3 (10.71%) were of unknown histology. Actuarial survival amongst the patients who had resection with curative intent and for incomplete resection, inoperable or unfit patients were 61.9% and 21.5% at 1st year, 23.8% and 8% a 5 year,14.2% and 3% at 10 years. Overall median survival was 36 months after a mean follow-up of 48 moths with the range being 1-98 months and 14 month for lateral group. 4(19%) patients of same group died during follow up with mean follow-up of 48 months with mean survival of 30.7 months. Among formal group, the 5 year survival was 17.8% with disease-free interval of greater or equal 6 months, and in 3.5% less than 6 months respectively. Median survival of 37 months for solitary / unilateral lesions, 25 months for multiple / bilateral lesions, 108 months for germ cell tumor, 24 months for other histologies, 36 months with adjuvant therapy and 25 months with such measure. univariate analysis confirmed that metastasectomy is a safe, potentially curative procedure for better prognosis of solitary metastases, disease-free interval (DFI) of greater or equal to 6 months, germ cell tumor and adjuvant therapy in selected cases. (author)

  10. Hormonal, metabolic and physiological effects of laparoscopic surgery using a detomidine-buprenorphine combination in standing horses. (United States)

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


    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.

  11. Myocardial capillary permeability for small hydrophilic indicators during normal physiological conditions and after ischemia and reperfusion

    DEFF Research Database (Denmark)

    Svendsen, J H


    Myocardial capillary permeability for small hydrophilic solutes (51Cr-EDTA or 99mTc-DTPA) has been measured using intracoronary indicator bolus injection and external radioactivity registration (the single injection, residue detection method). The method is based on kinetic separation...

  12. Physiologically based indices of volumetric capnography in patients receiving mechanical ventilation. (United States)

    Romero, P V; Lucangelo, U; Lopez Aguilar, J; Fernandez, R; Blanch, L


    Several indices of ventilatory heterogeneity can be identified from the expiratory CO2 partial pressure or CO2 elimination versus volume curves. The aims of this study were: 1) to analyse several computerizable indices of volumetric capnography in order to detect ventilatory disturbances; and 2) to establish the relationship between those indices and respiratory system mechanics in subjects with normal lungs and in patients with acute respiratory distress syndrome (ARDS), both receiving mechanical ventilation. We studied six normal subjects and five patients with early ARDS mechanically ventilated at three levels of tidal volume (VT). Respiratory system mechanics were assessed by end-expiratory and end-inspiratory occlusion methods, respectively. We determined Phase III slopes, Fletcher's efficiency index, Bohr's dead space (VD,Bohr/VT), and the ratio of alveolar ejection volume to tidal volume (VAE/VT) from expiratory capnograms, as a function of expired volume. Differences between normal subjects and ARDS patients were significant both for capnographic and mechanical parameters. Changes in VT significantly altered capnographic indices in normal subjects, but failed to change ventilatory mechanics and VAE/VT in ARDS patients. After adjusting for breathing pattern, VAE/VT exhibited the best correlation with the mechanical parameters. In conclusion, volumetric capnography, and, specifically, the ratio of alveolar ejection volume to tidal volume allows evaluation and monitoring of ventilatory disturbances in patients with adult respiratory distress syndrome.

  13. Phospholipid Fatty Acids as Physiological Indicators of Paracoccus denitrificans Encapsulated in Silica Sol-Gel Hydrogels

    Directory of Open Access Journals (Sweden)

    Josef Trögl


    Full Text Available The phospholipid fatty acid (PLFA content was determined in samples of Paracoccus denitrificans encapsulated in silica hydrogel films prepared from prepolymerized tetramethoxysilane (TMOS. Immediately after encapsulation the total PLFA concentration was linearly proportional to the optical density (600 nm of the input microbial suspension (R2 = 0.99. After 7 days this relationship remained linear, but with significantly decreased slope, indicating a higher extinction of bacteria in suspensions of input concentration 108 cells/mL and higher. trans-Fatty acids, indicators of cytoplasmatic membrane disturbances, were below the detection limit. The cy/pre ratio (i.e., ratio of cyclopropylated fatty acids (cy17:0 + cy19:0 to their metabolic precursors (16:1ω7 + 18:1ω7, an indicator of the transition of the culture to a stationary growth-phase, decreased depending on co-immobilization of nutrients in the order phosphate buffer > mineral medium > Luria Broth rich medium. The ratio, too, was logarithmically proportional to cell concentration. These results confirm the applicability of total PLFA as an indicator for the determination of living biomass and cy/pre ratio for determination of nutrient limitation of microorganisms encapsulated in sol-gel matrices. This may be of interest for monitoring of sol-gel encapsulated bacteria proposed as optical recognition elements in biosensor construction, as well as other biotechnological applications.

  14. Myocardial capillary permeability for small hydrophilic indicators during normal physiological conditions and after ischemia and reperfusion

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup


    Myocardial capillary permeability for small hydrophilic solutes (51Cr-EDTA or 99mTc-DTPA) has been measured using intracoronary indicator bolus injection and external radioactivity registration (the single injection, residue detection method). The method is based on kinetic separation of the inje......Myocardial capillary permeability for small hydrophilic solutes (51Cr-EDTA or 99mTc-DTPA) has been measured using intracoronary indicator bolus injection and external radioactivity registration (the single injection, residue detection method). The method is based on kinetic separation...... including microvascular alterations. In open chest dogs transitory increases in capillary extraction fraction and PdS for small hydrophilic solutes were seen following 20 minutes of regional myocardial ischemia and reperfusion. This response could be inhibited by treatment directed against superoxide...


    Directory of Open Access Journals (Sweden)



    Full Text Available Our research monitored the response of some welfare indicators in sport horses during transport by assessing the intensity of stress during travel time, changes in heart rate, cortisol, lactic acid and creatinine levels. The horses included in the study were separated into 2 groups: horses that were transported for the first time (A n: 12 and horses that had been previously transported (B n: 10. The values of the indicators varied between the two groups regardless of the fact that travel length and transport conditions were almost identical. The heart rate and cortisol levels were elevated in horses from group A as compared to the ones in group B while the latter showed increased levels of these indicators upon repeating the loading and unloading (100-130 nmol/l. The recorded value of lactic acid was higher for the first group (2,2 mmol/l, only until the moment when the horses adapted to the effort, after which it decreased (1,8 mmol/l. Transport of horses under certain conditions related to their adjusting to manhandling during loading and unloading operations, as well as the animals’ temper, may be considered a stress factor with significant depreciating effect on horse welfare.

  16. Risk assessment of cadmium-contaminated soil on plant DNA damage using RAPD and physiological indices

    International Nuclear Information System (INIS)

    Liu Wan; Yang, Y.S.; Li, P.J.; Zhou, Q.X.; Xie, L.J.; Han, Y.P.


    Impact assessment of contaminants in soil is an important issue in environmental quality study and remediation of contaminated land. A random amplified polymorphic DNA (RAPD) 'fingerprinting' technique was exhibited to detect genotoxin-induced DNA damage of plants from heavy metal contaminated soil. This study compared the effects occurring at molecular and population levels in barley seedlings exposed to cadmium (Cd) contamination in soil. Results indicate that reduction of root growth and increase of total soluble protein level in the root tips of barley seedlings occurred with the ascending Cd concentrations. For the RAPD analyses, nine 10-base pair (bp) random RAPD primers (decamers) with 60-70% GC content were found to produce unique polymorphic band patterns and subsequently were used to produce a total of 129 RAPD fragments of 144-2639 base pair in molecular size in the root tips of control seedlings. Results produced from nine primers indicate that the changes occurring in RAPD profiles of the root tips following Cd treatment included alterations in band intensity as well as gain or loss of bands compared with the control seedlings. New amplified fragments at molecular size from approximately 154 to 2245 bp appeared almost for 10, 20 and 40 mg L -1 Cd with 9 primers (one-four new polymerase chain reaction, (PCR) products), and the number of missing bands enhanced with the increasing Cd concentration for nine primers. These results suggest that genomic template stability reflecting changes in RAPD profiles were significantly affected and it compared favourably with the traditional indices such as growth and soluble protein level at the above Cd concentrations. The DNA polymorphisms detected by RAPD can be applied as a suitable biomarker assay for detection of the genotoxic effects of Cd stress in soil on plants. As a tool in risk assessment the RAPD assay can be used in characterisation of Cd hazard in soil

  17. Critical osmotic, ionic and physiological indicators of salinity tolerance in cotton (gossypium hirsutum l.) for cultivar selection

    International Nuclear Information System (INIS)

    Munis, M.F.H.; Tu, L.; Ziaf, K; Tan, J.; Deng, F.; Zhang, X.


    Salinity affects the germination, growth and ultimately the yield of cotton (Gossypium hirsutum L.) which demands reliable traits for the evaluation and selection of salt tolerant cultivars. Here, ten major osmotic, ionic and physiological parameters have been studied to distinguish the effect of salinity in two different cultivars of cotton. Plants were grown in hydroponic system and exposed to different salinity levels of NaCl followed by its recovery under non saline conditions. Data was recorded at three different stages i.e., before stress, after stress and after recovery for comparative study. Recovery assay proved to be very helpful in extracting reliable results. Both cultivars showed significantly different response to Na+ and K+ accumulation and phenotypically salt tolerant cultivar (Coker 312) accumulated less Na+ and more K+ in comparison with susceptible (Simian 3). Decrease in leaf area, seed germination and seedling growth were also conclusive to differentiate these cultivars. We also found other physiological parameters like relative leaf water content (RLWC), plant fresh-weight (PFW), plant dry-weight (PDW), relative growth rate (RGR) and stomatal behavior as good indicators of salinity but could not find their significant role to differentiate two closely relevant cultivars regarding salinity tolerance. Our studies revealed that proline accumulation and chlorophyll concentration are not significant to be used as accurate indicators to characterize the sensitivity of cotton cultivars to salinity. We found post-recovery analysis to be very useful in understanding the role and behavior of different indicators of salinity. (author)

  18. Physiological values of some blood indicators in selected dwarf rabbit breeds

    Directory of Open Access Journals (Sweden)

    V. Šimek


    Full Text Available The aim of the present study was to evaluate the effect of breed on haematological and biochemical indicators in 3 dwarf rabbit breeds. In the experiment, 30 sexually intact dwarf rabbit females aged 6 mo were used. With the sole exception of white blood cells and haematocrit value, breed had the most significant effect on the majority of haematological indicators monitored. The red blood cell count was higher in the Dwarf Lop compared to the Netherland Dwarf (+1.91×1012 cells/L; P<0.05 and also the Teddy Dwarf (+1.32×1012 cells/L; P<0.05. For haemoglobin concentration, a higher value was found in the Netherland Dwarf than in the Teddy Dwarf (+39.29 g/L; P<0.05 and the Dwarf Lop (+26.36 g/L; P<0.05. For erythrocytic indicators, the highest values of mean corpuscular volume, mean corpuscular haemoglobin and mean corpuscular haemoglobin concentration were found in the Netherland Dwarf. The breed had a significant effect on the urea and potassium values. A higher value of urea was recorded in the Dwarf Lop compared to the Teddy Dwarf (+1.56 mmol/L; P<0.05. For potassium, a higher value was found in the Netherland Dwarf compared to the Teddy Dwarf (+0.85 mmol/L; P<0.05. In addition, a significantly positive correlation (P<0.05 was found between the live weight of dwarf females and values of haematocrit (0.49, albumin (0.54, alanine aminotransferase (0.51, and aspartate aminotransferase (0.41, while a significantly negative correlation (P<0.05 was found between their live weight and values of triacylglycerols (–0.44, alkaline phosphatase (–0.38 and inorganic phosphorus (–0.52.

  19. Do preoperative pulmonary function indices predict morbidity after coronary artery bypass surgery?

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    Mahdi Najafi


    Full Text Available Context: The reported prevalence of chronic obstructive pulmonary disease (COPD varies among different groups of cardiac surgical patients. Moreover, the prognostic value of preoperative COPD in outcome prediction is controversial. Aims: The present study assessed the morbidity in the different levels of COPD severity and the role of pulmonary function indices in predicting morbidity in patients undergoing coronary artery bypass graft (CABG. Settings and Design: Patients who were candidates for isolated CABG with cardiopulmonary bypass who were recruited for Tehran Heart Center-Coronary Outcome Measurement Study. Methods: Based on spirometry findings, diagnosis of COPD was considered based on Global Initiative for Chronic Obstructive Lung Disease category as forced expiratory volume in 1 s [FEV1]/forced vital capacity 75% predicted, mild (FEV1 60-75% predicted, moderate (FEV1 50-59% predicted, severe (FEV1<50% predicted. The preoperative pulmonary function indices were assessed as predictors, and postoperative morbidity was considered the surgical outcome. Results: This study included 566 consecutive patients. Patients with and without COPD were similar regarding baseline characteristics and clinical data. Hypertension, recent myocardial infarction, and low ejection fraction were higher in patients with different degrees of COPD than the control group while male gender was more frequent in control patients than the others. Restrictive lung disease and current cigarette smoking did not have any significant impact on postoperative complications. We found a borderline P = 0.057 with respect to respiratory failure among different patients of COPD severity so that 14.1% patients in control group, 23.5% in mild, 23.4% in moderate, and 21.9% in severe COPD categories developed respiratory failure after CABG surgery. Conclusion: Among post-CABG complications, patients with different levels of COPD based on STS definition, more frequently developed

  20. Using Castration Surgery in Male Rats to Demonstrate the Physiological Effects of Testosterone on Seminal Vesicle Anatomy in an Undergraduate Laboratory Setting (United States)

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


    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…

  1. Influence of low stress handling during clinical visit on physiological and behavioural indicators in adult dogs: a preliminary study

    Directory of Open Access Journals (Sweden)

    Bruno Scalia


    Full Text Available Low stress handling techniques or “Fear Free principles” in veterinary clinics are becoming an important research area aimed at improving small animal welfare, considering that the majority of dogs who undergo clinical examinations exhibit fear or anxiety signs. Objective of this study was to compare a number of physiological and behavioural indicators using low stress handling (LSH and traditional (TT techniques in order to assess whether the LSH approach had a positive impact on the dog’s welfare. Eight adult dogs were filmed while undergoing both LSH and TT visits (separated by a distance of seven weeks. The same usual sequence of events was followed for both visits (e. g. muzzle wearing, heart and lungs stethoscope examination, etc. except that 1 during the LSH visit, the dog was free to explore the environment (while receiving treats and play for five minutes before and after the visit 2 throughout the medical examination the veterinarians’ attitude and handling techniques were always aimed at preventing stress and guaranteeing the best physical support possible. The videos were then evaluated for the number of fear and stress signs the subjects showed. The examined physiological variables were respiration (breath/min, heart rate (HR and rectal temperature (RT. Physiological variables were analysed by t-Test for paired data while frequency of behavioural fear indicators by Wilcoxon signed-rank test. Rectal temperature was within range in both groups but significantly higher (P<0.05 during LSH visit, while low head, lip licks and whale eye behaviours were significantly higher (P<0.05 during TT visit. These results suggest that low stress handling decreases frequency of some fear-related behaviours and could improve the quality of human-dog interactions. Future research that aims to replicate and further investigate these results in a large canine population is required.

  2. Hydrophysical correlation and water mass indication of optical physiological parameters of picophytoplankton in Prydz Bay during autumn 2008. (United States)

    Zhang, Fang; Ma, Yuxin; Lin, Ling; He, Jianfeng


    Flow cytometry (FCM) is efficient in detecting both abundance and optical physiological parameters including cell size and cellular carbon content-side scatter (SSC), carotenoids-green and orange fluorescence (FL1 and FL2), and red fluorescence-chlorophylls (FL3) can be obtained by FCM. The utilization of these physiological parameters in indicating water masses in Prydz Bay was investigated for the first time. Picophytoplankton were very sensitive to hydrophysical changes and present distinct characteristics of water masses: Picophytoplankton in water closer to the Amery Ice Shelf were more affected by salinity than by temperature, while temperature became more important than salinity the nearer the picophytoplankton were to the deep sea. The picophytoplankton dealt with declines in light by increasing the size of cells, which increase the fixation of carbon. This can also be increased by high temperature and salinity. Pure water masses can increase the content of chlorophylls and cellular carbon. Generally, the distributions of all the five parameters at upper water depths were less affected by temperature and salinity than by water masses; and these parameters can be as indicators to Summer Surface Water (SSW), Winter Water (WW) and Continental Shelf Water (CSW). Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Computer-assisted surgery in orthopedic oncology : Technique, indications, and a descriptive study of 130 cases

    NARCIS (Netherlands)

    Gerbers, Jasper G.; Stevens, Martin; Ploegmakers, Joris J. W.; Bulstra, Sjoerd K.; Jutte, Paul C.


    Background and purpose - In orthopedic oncology, computerassisted surgery (CAS) can be considered an alternative to fluoroscopy and direct measurement for orientation, planning, and margin control. However, only small case series reporting specific applications have been published. We therefore

  4. Practical X-ray diagnostics orthopedics and trauma surgery. Indication, adjustment technique and radiation protection

    International Nuclear Information System (INIS)

    Flechtenmacher, Johannes; Sabo, Desiderius


    The book on X-ray diagnostics in orthopedics and trauma surgery includes the following chapters: 1. Introduction: radiation protection, equipment technology radiological diagnostics of skeleton carcinomas, specific aspects of trauma surgery, special aspects of skeleton radiology for children. 2. X-ray diagnostics of different anatomical regions: ankle joint, knee, hips and pelvis, hand and wrist joint, elbow, shoulder, spinal cord. 3. Appendix: radiation protection according to the X-ray regulations.

  5. Response of Physiological Growth Indices and Bulb Dry Yield of Onion (Allium cepa L. Genotypes to Priming and Seed Size

    Directory of Open Access Journals (Sweden)

    M. Izadkhah


    Full Text Available Introduction Priming is one of the most common methods of improving seed quality, which significantly affects their storability. Seed priming is a seed treatment that allows imbibition and activation of the initial metabolic events associated with seed germination, but prevents radicle emergence and growth. In other words, phase one and two of seed water imbibition curve are passed, but seeds do not enter the third phase of water uptake. Then seeds are dried back to their original water content. Seed priming is a pre-sowing strategy for influencing seed germination and seedling development by modulating pre-germination metabolic activity prior to emergence of the radicle and generally enhances germination rate and plant performance. Naturally, when speed and percentage emergence of germinating seeds are being high, growing sources like light, water and nutrient will be more used. Another factor that can affect the seed germination and seedling establishment is the seed size. As generally known, among producing factors, seed as the first consumer store, plays an important role in the transfer of genetic characters and improvement of qualitative and quantitative traits of production. One of the most important factors in maximizing crop yield is planting high quality seed. Seed size is an important physical indicator of seed quality that affects vegetative growth and is frequently related to yield, market grade factors and harvest efficiency. In the present paper, effects of different pre-sowing treatments and seed size on physiological growth indices and bulb dry yield of onion cultivars were investigated. Materials and Methods In order to determine the response of physiological growth indices and bulb dry yield of onion to priming and seed size, a field experiment was conducted in 2012-2013 cropping season at Agriculture and Natural Resources Research Center of East, Azarbayjan, Iran. This experiment was a factorial experiment based on a

  6. The prediction of success in kickboxing based on the analysis of morphofunctional, physiological, biomechanical and psychophysiological indicators

    Directory of Open Access Journals (Sweden)

    L.V. Podrigalo


    Full Text Available Purpose: To substantiate and develop a methodology for predicting success in kickboxing on the basis of analysis of morphofunctional, physiological, biomechanical and psychophysiological indicators. Material: it was examined athletes of kickboxing (n=185, age 18.58 +- 0.46 years. It was studied the features of physical development (n = 18. The main biomechanical parameters (n=45 were determined. Goniometric indices of limb joints (n=29 were studied. It was studied the features of psychophysiological reactions (n =76. The adaptive capabilities of the cardiovascular system were studied (n=17. The prognostication is carried out by means of a sequential Wald procedure. Prognostic coefficients and their informativity were calculated. Results: a prognostic table was developed containing the indicators of the functional state of kickboxing athletes. The table includes 31 criteria, the informativeness of which varied within 115,45 - 2,23. The content of the forecast consists in: an evaluation of the results; determination of the corresponding prognostic coefficient; summation of coefficients. The threshold was set at the level +- 13, which corresponds to a probability of 95% (p<0,05. Exceeding the positive threshold means a high level of success for the athlete. When the negative threshold is reached, the probability of success is low. Conclusions: The proposed methodology is based on a sequential analysis of Wald. The technique is a simple, informative and objective tool for monitoring and predicting the status of athletes.

  7. Associations between Psychosocial and Physiological Factors and Diabetes Health Indicators in Asian and Pacific Islander Adults with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Dongmei Li


    Full Text Available The associations between psychosocial and physiological factors and diabetes’ health indicators have not been widely investigated among Asians and Pacific Islanders. We hypothesize that health behaviour and depression are directly or indirectly associated with diabetes’ health indicators such as BMI, glycemic control, general health, and diabetes quality of life. Our hypothesis was tested through a structural equation modelling (SEM approach. Questionnaires that assessed health behaviour, depression, general health, diabetes quality of life, and haemoglobin A1c (HbA1c, along with patients’ demographic information, were obtained from 207 Asian and Pacific Islander adults with type 2 diabetes. IBM SPSS Amos 20 was used for the SEM analysis at 5% level of significance, and the goodness fit of the SEM model was also evaluated. The final SEM model showed that diet and exercise and foot care had positive associations, while depression had a negative association with diabetes’ health indicators. The results highlighted the importance of exercise and depression in diabetes patients’ BMI, glycemic control, general health, and quality of life, which provide evidence for the need to alleviate patients’ depression besides education and training in diet and exercise in future intervention studies among Asians and Pacific Islanders with type 2 diabetes.

  8. Indications for radiation therapy and surgery in the treatment of fibromatosis

    International Nuclear Information System (INIS)

    Spear, M.A.; Jennings, L.C.; Efird, J.T.; Mankin, H.J.; Springfield, D.S.; Gebhardt, M.C.; Spiro, I.J.; Rosenberg, A.E.; Suit, H.D.


    Purpose: To determine the roles of radiation and surgery in treating fibromatosis (desmoid tumors). Methods and Materials: Records of 92 patients treated at the Massachusetts General Hospital between 1971 and 1992 were analyzed. Treatment consisted of: radiation, 15 tumors; surgery, 37 tumors; radiation plus surgery, 40 tumors. Radiation doses ranged from 10 Gy to 72 Gy, and were delivered as megavoltage external beam, brachytherapy or a combination. Minimum follow up was 1 year (median 6.2 yrs). The margin status of resected specimens included: 14 negative, 11 negative at 18 yrs and 0% for age <18 yrs. Conclusions: Surgery remains the primary treatment of choice for fibromatosis. Radiation therapy, however, is also effective either as a primary treatment or a surgical adjuvent. Additional advantage in recurrence free survival with peri-operative treatment was seen in patients for whom negative margins were not achieved. Thus, radiation might be recommended to these patients, particularly if the lesion is located such that further recurrence and resection could result in a significant functional or cosmetic defect. Radiation would also be recommended as a primary therapy for those in which a primary resection could not be expected without such deficits. It should also be noted when considering the potential consequences of recurrence that these lesions may often fail locally even with negative margins. Of further interest lesions located in the planter or palmer regions appear as a different disease entity, with a very benign course in adults and an extremely aggressive course in children

  9. First year experience of robotic-assisted laparoscopic surgery with 153 cases in a general surgery department: indications, technique and results. (United States)

    Tomulescu, V; Stănciulea, O; Bălescu, I; Vasile, S; Tudor, St; Gheorghe, C; Vasilescu, C; Popescu, I


    suggests that robotic surgery is feasible and worth of clinical application. The best indications for robotic surgery are the procedures that require a small operating field, a fine a precise dissection (suitable for pelvic and gastric lymphadenectomy, nerve sparing in total mesorectal excision) and safe intracorporeal sutures.

  10. Psychometric Indices of Post Bariatric Surgery Self-Management Behaviors Questionnaire

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    Zahra Sobhani


    Full Text Available Abstract Background: Bariatric surgery is the most effective intervention for treating severe obesity and patient's adherence to self-management behaviors is essential to reduce complications after surgery. The purpose of this study was to investigate the psychometric properties of BSSQ in Iranian population. Materials and Methods: The statistical society was all of the obese patients that underwent laparoscopic obesity surgery in Shiraz Ghadir Mother & Child Hospital from December 2016 till June 2016, and 201 of them (149 females and 52 males were selected by using available sampling method. They responded to demographic characteristics, post bariatric surgery self-management behaviors questionnaire and general and specific adherence scales. For validity, methods such as content validity, structural validity (factor analysis and correlation analysis, simultaneous validity were used. The reliability of the questionnaire was determined by using bisection and internal stability methods by Cronbach s alpha. Results: According to the results of explatory factor analysis, sisx factors including eating behaviors, physical activity, fruits, vegitables, grain and protein intake, fluid intake and dumping syndrome management were elicited, that these 6 factors explained 61.54% of variance of self-management behaviors. Total score of correlation matrix BSSQ with GAS & SAS were 0.363 and 0.702. For reliability, the Cronbach's alpha coefficient of this instrument was found 0.90 and guttman split-half coefficient was 0.78. Conclusion: Results show that BSSQ has an acceptable validity and reliability and it can be used for assessing the post bariatric surgery self-management behaviors in Iranian population.

  11. Short- and long-term behavioural, physiological and stoichiometric responses to predation risk indicate chronic stress and compensatory mechanisms. (United States)

    Van Dievel, Marie; Janssens, Lizanne; Stoks, Robby


    Prey organisms are expected to use different short- and long-term responses to predation risk to avoid excessive costs. Contrasting both types of responses is important to identify chronic stress responses and possible compensatory mechanisms in order to better understand the full impact of predators on prey life history and population dynamics. Using larvae of the damselfly Enallagma cyathigerum, we contrasted the effects of short- and long-term predation risk, with special focus on consequences for body stoichiometry. Under short-term predation risk, larvae reduced growth rate, which was associated with a reduced food intake, increased metabolic rate and reduced glucose content. Under long-term predation risk, larvae showed chronic predator stress as indicated by persistent increases in metabolic rate and reduced food intake. Despite this, larvae were able to compensate for the short-term growth reduction under long-term predation risk by relying on physiological compensatory mechanisms, including reduced energy storage. Only under long-term predation risk did we observe an increase in body C:N ratio, as predicted under the general stress paradigm (GSP). Although this was caused by a predator-induced decrease in N content, there was no associated increase in C content. These stoichiometric changes could not be explained by GSP responses because, under chronic predation risk, there was no decrease in N-rich proteins or increase in C-rich fat and sugars; instead glycogen decreased. Our results highlight the importance of compensatory mechanisms and the value of explicitly integrating physiological mechanisms to obtain insights into the temporal dynamics of non-consumptive effects, including effects on body stoichiometry.

  12. Seasonal variation in biochemical indicators of physiological status in Euphausia superba from Port Foster, Deception Island, Antarctica (United States)

    Cullen, M.; Kaufmann, R. S.; Lowery, M. S.


    Seasonal changes in biochemical indicators of physiological status were analyzed in abdominal muscle of the Antarctic krill, Euphausia superba, collected from Port Foster, Deception Island, an active volcano located in the Shetland Island chain west of the Antarctic Peninsula. Krill were collected with a 10 m 2 MOCNESS trawl during four cruises (November 1999, February, May, November 2000). RNA:DNA mirrored the chlorophyll a concentration, with the highest values found during seasons of abundant phytoplankton. Activities of the glycolytic enzyme lactate dehydrogenase (LDH) and the mitochondrial enzyme citrate synthase (CS) were significantly higher in male krill when compared to females of similar size, indicating that their burst and aerobic swimming performance may be higher than females throughout the year. RNA:DNA ratio and enzyme activities were highly elevated in summer as compared to the earliest spring sampling period. Krill showed significant seasonal changes in LDH activity, with lowest values in spring and highest values in summer (females) or autumn (males). Krill showed significant seasonal changes in CS activity with highest values in summer. Protein and % water varied significantly among seasons for both males and females. Lower CS activity and RNA:DNA ratio suggest krill exhibit reduced metabolism during the winter when phytoplankton production is reduced, perhaps enhancing survival. Lower enzyme activities in female krill in early spring suggest they may achieve greater metabolic suppression during overwintering.

  13. Effect of Foliar Application of Micro Nutrients on Physiological Growth Indices and Total Dry Matter Yield of Forage Corn

    Directory of Open Access Journals (Sweden)

    A. Soleymani


    Full Text Available In order to evaluate the effect of foliar application of micro nutrients on physiological growth indices and total dry matter yield of forage corn. Field experiment was conducted in 2006 at Bersian village Isfahan. A randomized complete block design with four replications was used. Plant treated with 8 foliar application treatments (Fe, Zn, Cu, Mn, Fe + Mn, Cu + Zn, Fe + Mn + Cu + Zn and control. The responses to foliar application in total dry weight, LAI and CGR appeared to differ between the treatments, but there is no significant difference in NAR between the treatments. Maximum leaf area index gained in foliar application of Fe but there is significant difference between this treatment and other treatments except foliar application of Zn and Fe + Mn. Foliar application of Fe and Fe + Mn result to maximum total dry weight, but there is no significant difference between these treatments and foliar application of Zn, Mn, Mn + Cu and Fe + Zn + Cu +Mn. Maximum and minimum NAR gained in foliar application of Mn and control treatments respectively. Maximum CGR gained in foliar application of Zn, there is significant difference between this treatment and others. Control treatment in comparison with others shows minimum value in all measured factors. The results indicate that foliar application of micro nutrients particularly Fe and Fe+Mn may be suitable to product maximum total dry matter yield under similar condition.

  14. [Management of spinal metastasis by minimal invasive surgery technique: Surgical principles, indications: A literature review]. (United States)

    Toquart, A; Graillon, T; Mansouri, N; Adetchessi, T; Blondel, B; Fuentes, S


    Spinal metastasis are getting more frequent. This raises the question of pain and neurological complications, which worsen the functional and survival prognosis of this oncological population patients. The surgical treatment must be the most complete as possible: to decompress and stabilize without delaying the management of the oncological disease. Minimal invasive surgery techniques are by definition, less harmful on musculocutaneous plan than opened ones, with a comparable efficiency demonstrated in degenerative and traumatic surgery. So they seem to be applicable and appropriate to this patient population. We detailed different minimal invasive techniques proposed in the management of spinal metastasis. For this, we used our experience developed in degenerative and traumatic pathologies, and we also referred to many authors, establishing a literature review thanks to Pubmed, Embase. Thirty eight articles were selected and allowed us to describe different techniques: percutaneous methods such as vertebro-/kyphoplasty and osteosynthesis, as well as mini-opened surgery, through a posterior or anterior way. We propose a surgical approach using these minimal invasive techniques, first according to the predominant symptom (pain or neurologic failure), then characteristics of the lesions (number, topography, type…) and the deformity degree. Whatever the technique, the main goal is to stabilize and decompress, in order to maintain a good quality of life for these fragile patients, without delaying the medical management of the oncological disease. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. Relationship Between Remotely-sensed Vegetation Indices, Canopy Attributes and Plant Physiological Processes: What Vegetation Indices Can and Cannot Tell Us About the Landscape (United States)

    Glenn, Edward P.; Huete, Alfredo R.; Nagler, Pamela L.; Nelson, Stephen G.


    Vegetation indices (VIs) are among the oldest tools in remote sensing studies. Although many variations exist, most of them ratio the reflection of light in the red and NIR sections of the spectrum to separate the landscape into water, soil, and vegetation. Theoretical analyses and field studies have shown that VIs are near-linearly related to photosynthetically active radiation absorbed by a plant canopy, and therefore to light-dependent physiological processes, such as photosynthesis, occurring in the upper canopy. Practical studies have used time-series VIs to measure primary production and evapotranspiration, but these are limited in accuracy to that of the data used in ground truthing or calibrating the models used. VIs are also used to estimate a wide variety of other canopy attributes that are used in Soil-Vegetation-Atmosphere Transfer (SVAT), Surface Energy Balance (SEB), and Global Climate Models (GCM). These attributes include fractional vegetation cover, leaf area index, roughness lengths for turbulent transfer, emissivity and albedo. However, VIs often exhibit only moderate, non-linear relationships to these canopy attributes, compromising the accuracy of the models. We use case studies to illustrate the use and misuse of VIs, and argue for using VIs most simply as a measurement of canopy light absorption rather than as a surrogate for detailed features of canopy architecture. Used this way, VIs are compatible with “Big Leaf” SVAT and GCMs that assume that canopy carbon and moisture fluxes have the same relative response to the environment as any single leaf, simplifying the task of modeling complex landscapes. PMID:27879814

  16. Relationship Between Remotely-sensed Vegetation Indices, Canopy Attributes and Plant Physiological Processes: What Vegetation Indices Can and Cannot Tell Us About the Landscape

    Directory of Open Access Journals (Sweden)

    Stephen G. Nelson


    Full Text Available Vegetation indices (VIs are among the oldest tools in remote sensing studies. Although many variations exist, most of them ratio the reflection of light in the red and NIR sections of the spectrum to separate the landscape into water, soil, and vegetation. Theoretical analyses and field studies have shown that VIs are near-linearly related to photosynthetically active radiation absorbed by a plant canopy, and therefore to light-dependent physiological processes, such as photosynthesis, occurring in the upper canopy. Practical studies have used time-series VIs to measure primary production and evapotranspiration, but these are limited in accuracy to that of the data used in ground truthing or calibrating the models used. VIs are also used to estimate a wide variety of other canopy attributes that are used in Soil-Vegetation-Atmosphere Transfer (SVAT, Surface Energy Balance (SEB, and Global Climate Models (GCM. These attributes include fractional vegetation cover, leaf area index, roughness lengths for turbulent transfer, emissivity and albedo. However, VIs often exhibit only moderate, non-linear relationships to these canopy attributes, compromising the accuracy of the models. We use case studies to illustrate the use and misuse of VIs, and argue for using VIs most simply as a measurement of canopy light absorption rather than as a surrogate for detailed features of canopy architecture. Used this way, VIs are compatible with "Big Leaf" SVAT and GCMs that assume that canopy carbon and moisture fluxes have the same relative response to the environment as any single leaf, simplifying the task of modeling complex landscapes.

  17. Group housing during gestation affects the behaviour of sows and the physiological indices of offspring at weaning. (United States)

    Zhou, Q; Sun, Q; Wang, G; Zhou, B; Lu, M; Marchant-Forde, J N; Yang, X; Zhao, R


    To compare the behaviour of sows and the physiological indices of their offspring in stall and group-housing systems, 28 sows were randomly distributed into two systems with 16 sows in stalls, and the other 12 sows were divided into three groups with four sows per pen. The area per sow in stalls and groups was 1.2 and 2.5 m2, respectively. Back fat depth of the sow was measured. Salivary cortisol concentration of the sows, colostrum composition and piglets' serum biochemical indicators were evaluated. The behaviour of the sows, including agonistic behaviour, non-agonistic social behaviour, stereotypical behaviour and other behaviours at weeks 2, 9 and 14 of pregnancy were analysed. The results showed no differences in the back fat depth of sows. Colostrum protein, triglyceride, triiodothyronine, thyroxine and prolactin concentrations in the whey also demonstrated no significant differences between the two housing systems. Salivary cortisol concentration was significantly higher in the sows housed in groups than the sows in stalls. The concentrations of serum total cholesterol and low-density lipoprotein (LDL) cholesterol were significantly higher in the offspring of sows housed in groups (P=0.006 and 0.005, respectively). The GLM procedure for repeated measures analysis showed the frequency of drinking, and non-agonistic social behaviour was significantly higher in the sows housed in groups than the sows in stalls; yet the frequency of agonistic and sham chewing demonstrated the opposite direction. The duration of standing was significantly longer in the sows housed in groups, but the sitting and stereotypical behaviour duration were significantly shorter compared with the sows in stalls. These results indicated that group housing has no obvious influence on the colostrum composition of sows; however, it was better for sows to express their non-agonistic social behaviour and reduce the frequency of agonistic behaviour and stereotypical behaviour. Meanwhile, group

  18. Indication of Cognitive Change and Associated Risk Factor after Thoracic Surgery in the Elderly: A Pilot Study

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    Kay Kulason


    Full Text Available Background: This pilot study investigated the effects of partial pulmonary lobectomy lung surgery on cognitive functions of elderly Japanese patients. It is recognized that elderly patients undergoing surgery have increased risk of Postoperative Cognitive Decline (POCD, a condition in which learning, memory, and processing speed is greatly reduced after surgery. Since elderly patients are more likely to exhibit symptoms of POCD, the incidence is increasing as the population receiving surgery is aging.Methods: Cognitive function was measured for all subjects (n = 12 before and after surgery using three different cognitive tests: Mini-Mental Status Exam-Japanese (MMSE-J, Frontal Assessment Battery (FAB, and a computerized Cogstate Brief Battery (CBB. Changes in these measures indicate changes in cognitive function. In addition, the 12-item General Health Questionnaire (GHQ-12, the Geriatric Depression Scale (GDS, and the 5-item Quality of Life questionnaire (QOL-5 were administered at each time point to measure mental and emotional state. Changes in outcome measures were analyzed via Wilcoxon signed-rank test. Exploratory correlation analysis was conducted using Spearman’s rho.Results: Data show a decline in detection (DET; p = 0.045 and identification (IDN; p = 0.038. Spearman’s correlation coefficient show a significant correlation between postoperative DET scores and postoperative IDN scores (ρ = 0.78, p = 0.005, a significant correlation between change in IDN and baseline GHQ-12 scores (ρ = -0.595, p = 0.027, and a significant correlation between change in one-back (OBK scores and duration of anesthesia (ρ = -0.72, p = 0.012.Discussion: This was the first report to examine cognitive decline after major thoracic surgery in Japanese patients. Previous studies have evidenced that POCD is a common phenomenon after surgery, and that age is a major risk factor. The CCB measured significant change in two cognitive domains: attention and

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

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


    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.

  20. Eyelid contracture may indicate recurrent basal cell carcinoma, even after Mohs' micrographic surgery. (United States)

    Ong, Lorraine Y; Lane, Carol M


    Mohs' micrographic surgery (MMS) is an effective means of margin control in the management of periocular basal cell carcinomas (BCC). We describe three cases of recurrent BCC that presented with progressive eyelid contracture after MMS. They illustrate high-risk factors for recurrence, namely large tumor size, medial canthal location, previous treatment, and aggressive histological features. Careful long-term surveillance with serial photography may identify early eyelid contracture and thus assist in the detection of recurrent BCC after MMS and improve patient outcome.

  1. Indications for Elective Tracheostomy in Reconstructive Surgery in Patients With Oral Cancer. (United States)

    Leiser, Yoav; Barak, Michal; Ghantous, Yasmine; Yehudai, Noam; Abu El-Naaj, Imad


    Oral cancer surgery carries a high risk of upper airway obstruction; yet optimal airway management approach remains controversial. The purpose of the present study was to evaluate the use of tracheostomy in oncological patients undergoing oral cancer surgery with intra oral flap reconstruction. The study cohort included 75 patients with oral cancer, who underwent major intraoral resections and reconstruction with vascularized flaps. Thirty-six percent of the patients received elective tracheostomy (27 patients). Mean hospital stay of the patients with tracheostomy was 28.4 ± 12.5 days compared with 9.7 ± 2.1 days in the nontracheostomy patients. A scoring system rendered from this study suggests that patients with a total scoring at or above 8 should be considered for elective tracheostomy. With appropriate postoperative monitoring, selected patients can be managed without routine elective tracheostomy, yet, patients with comorbidities, mostly elderly patients, which undergo surgical resection and reconstruction in high-risk areas that can result in a bulky flap that pose danger to the postoperative airway, should receive elective tracheostomy.

  2. The treatment for acoustic neuromas. Indication and results of gamma knife radiosurgery and surgery

    International Nuclear Information System (INIS)

    Iwai, Yoshiyasu; Yamanaka, Kazuhiro; Uyama, Taichi; Morikawa, Toshie; Honda, Yuji; Matsusaka, Yasuhiro; Komiyama, Masaki; Yasui, Toshihiro


    We evaluated the treatment results of acoustic neuromas in the era of radiosurgery. We treated acoustic neuromas using the following strategy. Small to medium size tumors (below 3 cm) were treated by gamma knife radiosurgery and large tumors (above 3 cm) were treated using a combination of surgery and radiosurgery. Using gamma knife radiosurgery we were able to achieve 96.4% of clinical tumor growth control with 0.7% incidence of trigeminal neuropathy (without new facial neuropathy). We used low dose radiosurgery (average tumor marginal dose 11.8 Gy) with a follow-up of an average of 54 months. For the 17 patients with large tumors treated by the combination of surgery and radiosurgery who could be followed up for over 24 months after radiosurgery, we were able to preserve normal facial function (House-Brackmann grade I-II) in 70.6% of the patients after subtotal removal. High clinical tumor growth control for residual tumor was achieved in 94.1% of subjects with an average of 40 months follow-up. By using this strategy, the treatment outcome for acoustic neuroma is improved from the standpoint of functional outcome and maintaining the patient's quality of life. (author)

  3. Laparoscopic surgery for renal stones: is it indicated in the modern endourology era?

    Directory of Open Access Journals (Sweden)

    Andrei Nadu


    Full Text Available Purpose: To report the outcomes of laparoscopic surgery combined with endourological assistance for the treatment of renal stones in patients with associated anomalies of the urinary tract. To discuss the role of laparoscopy in kidney stone disease. Materials and Methods: Thirteen patients with renal stones and concomitant urinary anomalies underwent laparoscopic stone surgery combined with ancillary endourological assistance as needed. Their data were analyzed retrospectively including stone burden, associated malformations, perioperative complications and outcomes. Results: Encountered anomalies included ureteropelvic junction obstruction, horseshoe kidney, ectopic pelvic kidney, fussed-crossed ectopic kidney, and double collecting system. Treatment included laparoscopic pyeloplasty, pyelolithotomy, and nephrolithotomy combined with flexible nephroscopy and stone retrieval. Intraoperative complications were lost stones in the abdomen diagnosed in two patients during follow up. Mean number of stones removed was 12 (range 3 to 214. Stone free status was 77% (10/13 and 100% after one ancillary treatment in the remaining patients. One patient had a postoperative urinary leak managed conservatively. Laparoscopic pyeloplasty was successful in all patients according to clinical and dynamic renal scan parameters. Conclusions: In carefully selected patients, laparoscopic and endourological techniques can be successfully combined in a one procedure solution that deals with complex stone disease and repairs underlying urinary anomalies.

  4. Does Essure Cause Significant De Novo Pain? A Retrospective Review of Indications for Second Surgeries After Essure Placement. (United States)

    Kamencic, Huse; Thiel, Luke; Karreman, Erwin; Thiel, John

    To examine the surgical indications and pathologic findings in patients undergoing a second surgery after placement of the Essure permanent birth control system to determine the role of Essure in developing new-onset pelvic pain. Retrospective cohort (Canadian Task Force classification II-2). Tertiary-level hospital. Women who have had Essure placement and subsequent second surgery. Charts from women undergoing pelvic surgery after Essure placement from June 2002 to June 2013 were reviewed and the indication for the procedure, surgical and pathologic findings noted. Of 1430 patients, 62 (4.3%) had a second surgery after Essure placement, and 24 of these (1.6%) had a surgical indication not related to pain. The remaining 38 patients (2.7%) had either new-onset (n = 27) or worsening pre-existing pain (n = 11). In the new-onset pain group, 15 (1%) had surgical findings or pathology consistent with a painful gynecologic condition. In the remaining 12, 8 (0.5%) seemed to be related to some perforation or migration of the Essure device. In 4 patients (0.3%) with no other obvious cause for the new-onset pain, it was thus attributed to the Essure microinsert. Essure sterilization can be associated with new-onset pain or a worsening of a pre-existing painful gynecologic condition, although both are very rare. A careful and complete consent before placement and a thorough examination if pain does occur usually show some etiology for the pain other than the Essure insert. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

  5. Evaluation of severity and indication for surgery in acute pancreatitis on the basis of CT in the early stage

    International Nuclear Information System (INIS)

    Cho, Keishouku; Nakasaku, Osamu; Kim, Jung-hyo; Hatakeyama, Gen


    Acute pancreatitis clinically manifests various degrees of severity. In the present study, we performed a retrospective study on 32 cases of acute pancreatitis and examined the evaluation of severity and indication for surgery in acute pancreatitis on the basis of computed tomography (CT) at the early stage (about 48 hours after onset). CT in the early stage of acute pancreatitis permits objective determination of the extent of lesion enlargement. The cases could be classified into three grades, severe, moderate, and mild, as determined by CT. It was concluded, therefore, that in the early stage CT was very useful as an indicator for emergency surgery and a helpful guide to early judgement. Emergency surgery was performed on seven of nine cases in which pancreatitis was judged to be severe on the basis of abdominal CT and clinical findings. Of the seven, four had infection in the early stage (within 48 hours after onset). Three of the four had MOF complications and died. Two of three patients without infection were relieved. The pancreatitic lesion of the cases with infection was severe as assessed via CT and the CT score was especially high. Infection in the early stage of acute pancreatitis was thus thought to be a seriouns aggravating factor. A. severe (CT score ≥ 6: surgical therapy). B. moderate (CT score = 4,5: medical therapy possible). C. mild (CT score ≤ 3: medical therapy). (author)

  6. Bone grafting in surgery about the foot and ankle: indications and techniques. (United States)

    Fitzgibbons, Timothy C; Hawks, Michael A; McMullen, Scott T; Inda, David J


    Bone grafting is a common procedure in foot and ankle surgery. Historically, autogenous bone graft has most often been harvested from the ipsilateral iliac crest. However, other sites offer similar volumes of cancellous bone and are associated with fewer complications. The ipsilateral proximal tibia, distal tibia, and calcaneus provide adequate amounts of bone graft material for most arthrodesis procedures about the foot and ankle. Emerging techniques have enabled the development of a seemingly unlimited supply of alternative bone graft materials with osteoconductive properties. The osteoprogenitor cells in bone marrow aspirates can be concentrated by use of selective retention systems. These aspirate-matrix composites may be combined with allograft preparations, resulting in a product that promotes osteoconduction, osteoinduction, and osteogenesis with limited morbidity.

  7. Spatio-temporal patterns of chlorophyll fluorescence and physiological and structural indices acquired from hyperspectral imagery as compared with carbon fluxes measured with eddy covariance

    NARCIS (Netherlands)

    Zarco-Tejada, P.J.; Morales Sierra, A.; Testi, L.; Villalobos, F.


    This study provides insight into the assessment of the spatio-temporal trends of chlorophyll fluorescence, narrow-band physiological indices, and structural indices acquired with a hyperspectral imager flown over a flux tower in a canopy characterized by small seasonal structural changes and a

  8. A single session of meditation reduces of physiological indices of anger in both experienced and novice meditators. (United States)

    Fennell, Alexander B; Benau, Erik M; Atchley, Ruth Ann


    The goal of the present study was to explore how anger reduction via a single session of meditation might be measured using psychophysiological methodologies. To achieve this, 15 novice meditators (Experiment 1) and 12 practiced meditators (Experiment 2) completed autobiographical anger inductions prior to, and following, meditation training while respiration rate, heart rate, and blood pressure were measured. Participants also reported subjective anger via a visual analog scale. At both stages, the experienced meditators' physiological reaction to the anger induction reflected that of relaxation: slowed breathing and heart rate and decreased blood pressure. Naïve meditators exhibited physiological reactions that were consistent with anger during the pre-meditation stage, while after meditation training and a second anger induction they elicited physiological evidence of relaxation. The current results examining meditation training show that the naïve group's physiological measures mimicked those of the experienced group following a single session of meditation training. Copyright © 2016. Published by Elsevier Inc.

  9. Functional Connectivity in Frontoparietal Network: Indicator of Preoperative Cognitive Function and Cognitive Outcome Following Surgery in Patients with Glioma. (United States)

    Lang, Stefan; Gaxiola-Valdez, Ismael; Opoku-Darko, Michael; Partlo, Lisa A; Goodyear, Bradley G; Kelly, John J P; Federico, Paolo


    Patients with diffuse glioma are known to have impaired cognitive functions preoperatively. However, the mechanism of these cognitive deficits remains unclear. Resting-state functional connectivity in the frontoparietal network (FPN) is associated with cognitive performance in healthy subjects. For this reason, it was hypothesized that functional connectivity of the FPN would be related to cognitive functioning in patients with glioma. To assess this relationship, preoperative cognitive status was correlated to patient-specific connectivity within the FPN. Further, we assessed whether connectivity could predict neuropsychologic outcome following surgery. Sixteen patients with diffuse glioma underwent neuropsychologic assessment and preoperative functional magnetic resonance imaging using task (n-back) and resting-state scans. Thirteen patients had postoperative cognitive assessment. An index of patient-specific functional connectivity in the FPN was derived by averaging connectivity values between 2 prefrontal and 2 parietal cortex regions defined by activation during the n-back task. The relationship of these indices with cognitive performance was assessed. Higher average connectivity within the FPN is associated with lower composite cognitive scores. Higher connectivity of the parietal region of the tumor-affected hemisphere is associated specifically with lower fluid cognition. Lower connectivity of the parietal region of the nontumor hemisphere is associated with worse neuropsychologic outcome 1 month after surgery. Resting-state functional connectivity between key regions of the FPN is associated with cognitive performance in patients with glioma and is related to cognitive outcome following surgery. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Association of decision-making in spinal surgery with specialty and emotional involvement-the Indications in Spinal Surgery (INDIANA) survey. (United States)

    Sollmann, Nico; Morandell, Carmen; Albers, Lucia; Behr, Michael; Preuss, Alexander; Dinkel, Andreas; Meyer, Bernhard; Krieg, Sandro M


    Although recent trials provided level I evidence for the most common degenerative lumbar spinal disorders, treatment still varies widely. Thus, the Indications in Spinal Surgery (INDIANA) survey explores whether decision-making is influenced by specialty or personal emotional involvement of the treating specialist. Nationwide, neurosurgeons and orthopedic surgeons specialized in spine surgery were asked to answer an Internet-based questionnaire with typical clinical patient cases of lumbar disc herniation (DH), lumbar spinal stenosis (SS), and lumbar degenerative spondylolisthesis (SL). The surgeons were assigned to counsel a patient or a close relative, thus creating emotional involvement. This was achieved by randomly allocating the surgeons to a patient group (PG) and relative group (RG). We then compared neurosurgeons to orthopedic surgeons and the PG to the RG regarding treatment decision-making. One hundred twenty-two spine surgeons completed the questionnaire (response rate 78.7%). Regarding DH and SS, more conservative treatment among orthopedic surgeons was shown (DH: odds ratio [OR] 4.1, 95% confidence interval [CI] 1.7-9.7, p = 0.001; SS: OR 3.9, CI 1.8-8.2, p emotional involvement (PG vs. RG) did not affect these results for any of the three cases (DH: p = 0.213; SS: p = 0.097; SL: p = 0.924). The high response rate indicates how important the issues raised by this study actually are for dedicated spine surgeons. Moreover, there are considerable variations in decision-making for the most common degenerative lumbar spinal disorders, although there is high-quality data from large multicenter trials available. Emotional involvement, though, did not influence treatment recommendations.

  11. What indication, morbidity and mortality for central pancreatectomy in oncological surgery? A systematic review. (United States)

    Santangelo, Michele; Esposito, Anna; Tammaro, Vincenzo; Calogero, Armando; Criscitiello, Carmen; Roberti, Giuseppe; Candida, Maria; Rupealta, Niccolò; Pisani, Antonio; Carlomagno, Nicola


    Conventional pancreatic resections for pancreatic neck and body diseases include pancreaticoduodenectomy, distal pancreatectomy with or without splenectomy, and total pancreatectomy. Recent studies have reported encouraging results of non-traditional pancreatic resections, including central pancreatectomy (CP), for central pancreatic disease. This surgical approach offers the potentials of low postoperative morbidity and preservation of metabolic functions. This study performs a systematic review on CP. A comprehensive literature search was conducted, for the period 1992-2015, on three worldwide databases: PubMed, Scopus, ISI-Web of Knowledge. We focused on indications, morbidity and mortality of this surgical procedure. The review shows that CP is particularly suitable for small-medium size diseases localized into the pancreatic body. This procedure is associated with an increased postoperative morbidity but an excellent postoperative pancreatic function. CP is a safe and effective procedure when performed following the right indications. Copyright © 2015 IJS Publishing Group Limited. Published by Elsevier Ltd. All rights reserved.

  12. [Indications of efficacy of bariatric surgery in the management of morbid obesity]. (United States)

    Pascual, J M; Rodilla, E


    Its indications should only be considered in patients with morbid obesity (BMI>40 kg/m2) or severe obesity (BMI>35 kg/m2) with serious associated comorbidity. In general, significant weight loss with marked improvement of the cardiovascular comorbidity is obtained. There are still no studies that show long term survival. It must be stressed that the patients should follow a subsequent and continuous medical monitoring to prevent important secondary metabolic complications.

  13. Sigmoid stricture associated with diverticular disease should be an indication for elective surgery with lymph node clearance. (United States)

    Venara, A; Toqué, L; Barbieux, J; Cesbron, E; Ridereau-Zins, C; Lermite, E; Hamy, A


    The literature concerning stricture secondary to diverticulitis is poor. Stricture in this setting should be an indication for surgery because (a) of the potential risk of cancer and (b) morbidity is not increased compared to other indications for colectomy. The goal of this report is to study the post-surgical morbidity and the quality of life in patients after sigmoidectomy for sigmoid stricture associated with diverticular disease. This is a monocenter retrospective observational study including patients with a preoperative diagnosis of sigmoid stricture associated with diverticular disease undergoing operation between Jan 1, 2007 and Dec 31, 2013. The GastroIntestinal Quality of Life Index was used to assess patient satisfaction. Sixteen patients were included of which nine were female. Median age was 69.5 (46-84) and the median body mass index was 23.55kg/m(2) (17.2-28.4). Elective sigmoidectomy was performed in all 16 patients. Overall, complications occurred in five patients (31.2%) (4 minor complications and 1 major complication according to the Dindo and Clavien Classification); none resulted in death. Pathology identified two adenocarcinomas (12.5%). The mean GastroIntestinal Quality of Life Index was 122 (67-144) and 10/11 patients were satisfied with their surgical intervention. Sigmoid stricture prevents endoscopic exploration of the entire colon and thus it may prove difficult to rule out a malignancy. Surgery does not impair the quality of life since morbidity is similar to other indications for sigmoidectomy. For these reasons, we recommend that stricture associated with diverticular disease should be an indication for sigmoidectomy including lymph node clearance. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Pre-operative indicators for mortality following hip fracture surgery: a systematic review and meta-analysis. (United States)

    Smith, Toby; Pelpola, Kelum; Ball, Martin; Ong, Alice; Myint, Phyo Kyaw


    hip fracture is a common and serious condition associated with high mortality. This study aimed to identify pre-operative characteristics which are associated with an increased risk of mortality after hip fracture surgery. systematic search of published and unpublished literature databases, including EMBASE, MEDLINE, AMED, CINAHL, PubMed and the Cochrane Library, was undertaken to identify all clinical studies on pre-operative predictors of mortality after surgery in hip fracture with at least 3-month follow-up. Data pertaining to the study objectives was extracted by two reviewers independently. Where study homogeneity was evidence, a meta-analysis of pooled relative risk and 95% confidence intervals was performed for mortality against pre-admission characteristics. fifty-three studies including 544,733 participants were included. Thirteen characteristics were identified as possible pre-operative indicators for mortality. Following meta-analysis, the four key characteristics associated with the risk of mortality up to 12 months were abnormal ECG (RR: 2.00; 95% CI: 1.45, 2.76), cognitive impairment (RR: 1.91; 95% CI: 1.35, 2.70), age >85 years (RR: 0.42; 95% CI: 0.20, 0.90) and pre-fracture mobility (RR: 0.13; 95% CI: 0.05, 0.34). Other statistically significant pre-fracture predictors of increased mortality were male gender, being resident in a care institution, intra-capsular fracture type, high ASA grade and high Charlson comorbidity score on admission. this review has identified the characteristics of patients with a high risk of mortality after a hip fracture surgery beyond the peri-operative period who may benefit from comprehensive assessment and appropriate management. CRD42012002107. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email:

  15. Analysis of Quality Indicators for Colorectal Cancer Surgery in Units Accredited by the Spanish Association of Coloproctology. (United States)

    de la Portilla, Fernando; Builes, Sergio; García-Novoa, Alejandra; Espín, Eloy; Kreisler, Esther; Enríquez-Navascues, José María; Biondo, Sebastiano; Codina, Antonio


    Currently, there is growing interest in analyzing the results from surgical units and the implementation of quality standards in order to identify good healthcare practices. Due to this fact, the Spanish Association of Coloproctology (AECP) has developed a unit accreditation program that contemplates basic standards. The aim of this article is to evaluate and analyze the specific quality indicators for the surgical treatment of colorectal cancer, established by the program. Data were collected from colorectal units during the accreditation process. We analyzed prospectively collected data from elective colorectal surgeries at 18 Spanish coloproctology units during the period 2013-2017. Three main and four secondary quality indicators were considered. Colon and rectal surgeries were analyzed independently; furthermore, results were compared according to surgical approach. A total of 3090 patients were included in the analysis. The global anastomotic leak rate was 7.8% (6.6% colon vs 10.6% rectum), while the surgical site infection rate was 12.6% (11.4% colon vs 14.8% rectum). Overall 30-day mortality was 2.3%, and anastomotic leak-related mortality was 10.2%. There were higher surgical site infection and mortality rates in the patients operated by open approach, however there was no difference in the anastomotic leak rate when compared with minimally invasive approaches. The evaluation of these results has determined optimal quality indices for the units accredited in the treatment of colorectal cancer. Furthermore, it allows us to establish realistic references in our country, thereby providing a better understanding and comparison of outcomes. Copyright © 2018 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Prolonged Activated Clotting Time after Protamine Administration Does Not Indicate Residual Heparinization after Cardiopulmonary Bypass in Pediatric Open Heart Surgery. (United States)

    Yamamoto, Tomohiro; Wolf, Hans-Gerd; Sinzobahamvya, Nicodème; Asfour, Boulos; Hraska, Victor; Schindler, Ehrenfried


    In open heart surgery, heparinization is commonly neutralized using an empirical heparin:protamine ratio ranging between 1:1 and 1:1.5. However, these ratios may result in protamine overdose that should be avoided for its negative side effects on the coagulation system. This study aimed to indicate the appropriate treatment for prolonged activated clotting time (ACT) after protamine administration following cardiopulmonary bypass (CPB) in pediatric open heart surgery by investigating the underlying reasons for it. Twenty-seven children (open heart surgery were included. Heparin was administered only before CPB (400 IU/kg) and in the pump priming volume for CPB (2,000 IU) and was neutralized by 1:1 protamine after CPB. The blood heparin concentration was measured using anti-Xa assay. ACT and blood concentrations of heparin, coagulation factors, thrombin-antithrombin complex, and prothrombin fragment 1 + 2 were assessed. A rotational thromboelastometry (ROTEM; Tem International GmbH, München, Bayern, Germany) was used to confirm the coagulation status and residual heparin after protamine administration. Anti-Xa assay showed that there is no residual heparin in the blood after 1:1 protamine administration. Nevertheless, ACT (128.89 ± 3.09 seconds before heparin administration) remained prolonged (177.14 ± 5.43 seconds at 10 minutes after protamine, 182.00 ± 5.90 seconds at 30 minutes after protamine). The blood concentrations of coagulation factors were significantly lower than those before heparin administration (p < 0.01). The low FIBTEM MCF of ROTEM (4.43 ± 0.32 mm) at 10 minutes after protamine indicated low fibrinogen concentration. Prolonged ACT after heparin neutralization by 1:1 protamine administration does not necessarily indicate residual heparin, but low blood concentrations of coagulation factors should be considered as a reason as well. Accordingly, supply of coagulation factors instead of additional protamine should be

  17. Bone-anchored hearing aid (BAHA: indications, functional results, and comparison with reconstructive surgery of the ear

    Directory of Open Access Journals (Sweden)

    Bento, Ricardo Ferreira


    Full Text Available Introduction: The bone-anchored hearing aid (BAHA is a bone conduction hearing device that transmits sound directly into the inner ear. It is mainly used in patients with conductive hearing loss associated with aural atresia, but it is also used in those with mixed and sensorineural hearing loss. Goals: To review the main indications for BAHA, to analyze the audiometric results and its benefits for patients and compare them with other treatment modalities, and to compare the literature data with our sample of 13 patients. Method: The research was performed using a database covering works in English, Spanish, and Portuguese, with no limitations in the years when the procedures were performed. We compared the literature data with our results for the 13 patients who underwent BAHA implantation between the years 2000 and 2009. Results: Most of the studies showed that BAHA has great advantages over reconstructive surgery in terms of hearing results, complications, and disease recurrence. The postoperative results for our 13 patients were satisfactory and comparable with the results from the literature, with closure of the air-bone gap in 7 patients and achieving an air-bone gap of 10 dB in 6 patients. No postoperative complications were observed. Conclusion: BAHA is a better treatment option than reconstructive surgery for patients with bilateral deafness. It is a relatively simple surgical procedure with few complications and good hearing results. Recent studies have examined its use in conductive and unilateral sensorineural hearing loss.

  18. Use of the long-term quality of life assessment in the decision to indicate surgery in patients with chronic rhinosinusitis. (United States)

    Marambaia, Pablo Pinillos; Lima, Manuela Garcia; Macario, Hélder; Gomes, Amaury de Machado; Gomes, Leonado Marques; Marambaia, Melina Pinillos; Santos, Otávio Marambaia Dos


    Quality-of-life questionnaires have been used to support decision-making in patients with chronic rhinosinusitis in the past decade. The choice of treatment in practice, however, also considers the patient's decision. To assess the long-term quality of life of patients with chronic rhinosinusitis who decided to avoid surgery. This is a prospective longitudinal study with a group of patients with chronic rhinosinusitis, with and without indication for surgery, with application of the questionnaire SNOT-22 in two periods: between 2011 and 2012 and between June and August 2016, via email. Data were collected from 42 patients, of which 13 presented indications for surgery and 29 were not indicated for surgery. The average quality of life score was 42.1 (±16.4) in the group with an indication for surgery and 40.6 (±23.4) in the group without this indication, p=0.84. All the patients were assessed by a single doctor with blinding in relation to the initial score. No differences were detected between the groups. The impact of the chronic rhinosinusitis was reduced even among the patients with the indication for surgery. Both groups scored over 40. This study can help predict the impact of the chronic rhinosinusitis over time and better adjust expectations with non-surgical treatment. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  19. [Effect of indications and pre-existing conditions on the result of McDonald's cervix-closure surgery]. (United States)

    Avar, Z; Tóth, B; Zacher, P


    Authors have performed the McDonald cerclage operation on 172 gravidae because of cervical incompetence. From these pregnancies 80.2 per cent of the infants have survived over the sixth day. While with operations performed on the basis of extended indications for surgery an effect of 56.5 per cent was achieved, it was in cases of classical ones 92.8 per cent. Two complicated cases are reported caused by blastospores or bacteria respectively, isolated also in the vaginal secretion which have ascended into the uterine cavity. Both cases resulted in fetal death and in a septic condition of the mother. It is emphasized that the normal vaginal bioflora is essential condition for the cervical suture.

  20. Elevated cranial ultrasound resistive indices are associated with improved neurodevelopmental outcomes one year after pediatric cardiac surgery: A single center pilot study. (United States)

    Jenks, Christopher L; Hernandez, Ana; Stavinoha, Peter L; Morris, Michael C; Tian, Fenghua; Liu, Hanli; Garg, Parvesh; Forbess, Joseph M; Koch, Joshua

    To determine if a non-invasive, repeatable test can be used to predict neurodevelopmental outcomes in patients with congenital heart disease. This was a prospective study of pediatric patients less than two months of age undergoing congenital heart surgery at the Children's Health Children's Medical Center at Dallas. Multichannel near-infrared spectroscopy (NIRS) was utilized during the surgery, and ultrasound (US) resistive indices (RI) of the major cranial vessels were obtained prior to surgery, immediately post-operatively, and prior to discharge. Pearson's correlation, Fischer exact t test, and Fischer r to z transformation were used where appropriate. A total of 16 patients were enrolled. All had US data. Of the sixteen patients, two died prior to the neurodevelopmental testing, six did not return for the neurodevelopmental testing, and eight patients completed the neurodevelopmental testing. There were no significant correlations between the prior to surgery and prior to discharge US RI and neurodevelopmental outcomes. The immediate post-operative US RI demonstrated a strong positive correlation with standardized neurodevelopmental outcome measures. We were able to demonstrate qualitative differences using multichannel NIRS during surgery, but experienced significant technical difficulties implementing consistent monitoring. A higher resistive index in the major cerebral blood vessels following cardiac surgery in the neonatal period is associated with improved neurological outcomes one year after surgery. Obtaining an ultrasound with resistive indices of the major cerebral vessels prior to and after surgery may yield information that is predictive of neurodevelopmental outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Are optical indices good proxies of seasonal changes in carbon fluxes and stress-related physiological status in a beech forest? (United States)

    Nestola, E; Scartazza, A; Di Baccio, D; Castagna, A; Ranieri, A; Cammarano, M; Mazzenga, F; Matteucci, G; Calfapietra, C


    This study investigates the functionality of a Mediterranean-mountain beech forest in Central Italy using simultaneous determinations of optical measurements, carbon (C) fluxes, leaf eco-physiological and biochemical traits during two growing seasons (2014-2015). Meteorological variables showed significant differences between the two growing seasons, highlighting a heat stress coupled with a reduced water availability in mid-summer 2015. As a result, a different C sink capacity of the forest was observed between the two years of study, due to the differences in stressful conditions and the related plant physiological status. Spectral indices related to vegetation (VIs, classified in structural, chlorophyll and carotenoid indices) were computed at top canopy level and used to track CO 2 fluxes and physiological changes. Optical indices related to structure (EVI 2, RDVI, DVI and MCARI 1) were found to better track Net Ecosystem Exchange (NEE) variations for 2014, while indices related to chlorophylls (SR red edge, CL red edge, MTCI and DR) provided better results for 2015. This suggests that when environmental conditions are not limiting for forest sink capacity, structural parameters are more strictly connected to C uptake, while under stress conditions indices related to functional features (e.g., chlorophyll content) become more relevant. Chlorophyll indices calculated with red edge bands (SR red edge, NDVI red edge, DR, CL red edge) resulted to be highly correlated with leaf nitrogen content (R 2 >0.70), while weaker, although significant, correlations were found with chlorophyll content. Carotenoid indices (PRI and PSRI) were strongly correlated with both chlorophylls and carotenoids content, suggesting that these indices are good proxies of the shifting pigment composition related to changes in soil moisture, heat stress and senescence. Our work suggests the importance of integrating different methods as a successful approach to understand how changing climatic

  2. Sinus Surgery (United States)

    ... 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 ...

  3. A study of the indication for conservative surgery in adult hydronephrosis based on presurgery post-contrast computed tomography (CT) finding

    International Nuclear Information System (INIS)

    Kawai, Noriyasu; Tsugaya, Masayuki; Sakagami, Hiroshi; Sasaki, Shoichi; Kohri, Kenjiro


    The cases with adult hydronephrosis are usually performed either conservative surgery or nephrectomy according to the grade of residual renal function. The residual renal function of adult hydronephrosis are usually suspected with analysis of concentration and/or clearance of the renal urine content after percutaneous nephrostomy. However, percutaneous nephrostomy is invasive and risky. On the other hand, post-contrast computed tomography (CT) is non-invasive. We studied whether post-contrast CT is available for the assessment of residual renal function of adult hydronephrosis and also studied the indication for conservative surgery of adult hydronephrosis on post-contrast CT. Conservative surgery or nephrectomy was performed in 14 patients with adult hydronephrosis in the duration from April, 1986 to March, 1995. All of 14 patients (14 kidneys) hydronephrosis were retrospectively studied of the character in the indication for conservative surgery by post-contrast CT before surgery. The indication for conservative surgery of adult hydronephrosis on post-contrast CT are well enhanced renal parenchyma exist round the kidney, even if it is very thin, and excretion of contrast medium to renal calyx are showed. It was concluded that post-contrast CT might be useful for the assessment of residual renal function of adult hydronephrosis. (author)

  4. Physiological and behavioral indices of emotion dysregulation as predictors of outcome from cognitive behavioral therapy and acceptance and commitment therapy for anxiety. (United States)

    Davies, Carolyn D; Niles, Andrea N; Pittig, Andre; Arch, Joanna J; Craske, Michelle G


    Identifying for whom and under what conditions a treatment is most effective is an essential step toward personalized medicine. The current study examined pre-treatment physiological and behavioral variables as predictors and moderators of outcome in a randomized clinical trial comparing cognitive behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for anxiety disorders. Sixty individuals with a DSM-IV defined principal anxiety disorder completed 12 sessions of either CBT or ACT. Baseline physiological and behavioral variables were measured prior to entering treatment. Self-reported anxiety symptoms were assessed at pre-treatment, post-treatment, and 6- and 12-month follow-up from baseline. Higher pre-treatment heart rate variability was associated with worse outcome across ACT and CBT. ACT outperformed CBT for individuals with high behavioral avoidance. Subjective anxiety levels during laboratory tasks did not predict or moderate treatment outcome. Due to small sample sizes of each disorder, disorder-specific predictors were not tested. Future research should examine these predictors in larger samples and across other outcome variables. Lower heart rate variability was identified as a prognostic indicator of overall outcome, whereas high behavioral avoidance was identified as a prescriptive indicator of superior outcome from ACT versus CBT. Investigation of pre-treatment physiological and behavioral variables as predictors and moderators of outcome may help guide future treatment-matching efforts. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. A zero phase adaptive fuzzy Kalman filter for physiological tremor suppression in robotically assisted minimally invasive surgery. (United States)

    Sang, Hongqiang; Yang, Chenghao; Liu, Fen; Yun, Jintian; Jin, Guoguang; Chen, Fa


    Hand physiological tremor of surgeons can cause vibration at the surgical instrument tip, which may make it difficult for the surgeon to perform fine manipulations of tissue, needles, and sutures. A zero phase adaptive fuzzy Kalman filter (ZPAFKF) is proposed to suppress hand tremor and vibration of a robotic surgical system. The involuntary motion can be reduced by adding a compensating signal that has the same magnitude and frequency but opposite phase with the tremor signal. Simulations and experiments using different filters were performed. Results show that the proposed filter can avoid the loss of useful motion information and time delay, and better suppress minor and varying tremor. The ZPAFKF can provide less error, preferred accuracy, better tremor estimation, and more desirable compensation performance, to suppress hand tremor and decrease vibration at the surgical instrument tip. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  6. Effects of Soil Fertilizers on Growth Indices, Morpho-Physiological Traits and Potassium content of Baurley Tobacco Cultivar

    Directory of Open Access Journals (Sweden)

    M. R. Tadayon


    Full Text Available Introduction Tobacco with scientific name of (Nicotiana tabacum L. belongs to Solanaceae family is one of the important industrial crops in the world that plays a critical role in economy of producing countries and its income from various products had a major share of the national income. Tobacco is an annual, short day length and self pollinated crop that its chromosomal number is 2n=48. The yield of plants depends upon several production factors. Among these proper, balanced nutrition plays a significant role. The main purpose of fertilization in tobacco plants not only the quantity but quality should be considered. Now tobacco farmers apply a large amount of fertilizer to improve yields, but these actions not only decrease tobacco leaf quality, but also cause fertilizer pollution. Organic and chemical fertilizers use has played a significant role in increase of crop yield. The use of compost and vermicompost in the soil, generally in order to maintain and increase aggregate stability and fertility of soils for farming and gardening in the past decade has been of particular importance. Increasing soil organic matter stocks and stability by addition of organic amendment offers a good way to substantially improve soil quality and therefore agricultural sustainability. The objective of this study was evaluate the effect of chemical and organic fertilizer on morpho-physiological and yield of tobacco in field conditions. Materials and Methods In order to study the effects of organic and chemical fertilizers on morpho-physiological traits of baurley tobacco cultivar, an experiment was counducted as based on a randomized complete block design with three replications during growing season of 2012-2013 at the research field of Shahrekord University located in 50º 49´ E longitude and 32º21´ N latitude.with sea level of 2116 meter. Treatments included chemical fertilizers based on the tobacco needs and soil test results, compost based on the tobacco

  7. Physiologic Responses to Infrarenal Aortic Cross-Clamping during Laparoscopic or Conventional Vascular Surgery in Experimental Animal Model: Comparative Study

    Directory of Open Access Journals (Sweden)

    María F. Martín-Cancho


    Full Text Available The aim of this study was to compare the hemodynamic and ventilatory effects of prolonged infrarenal aortic cross-clamping in pigs undergoing either laparotomy or laparoscopy. 18 pigs were used for this study. Infrarenal aortic crossclamping was performed for 60 minutes in groups I (laparotomy, n=6 and II (laparoscopy, n=6. Group III (laparoscopy, n=6 underwent a 120-minute long pneumoperitoneum in absence of aortic clamping (sham group. Ventilatory and hemodynamic parameters and renal function were serially determined in all groups. A significant decrease in pH and significant increase in PaCO2 were observed in group II, whereas no changes in these parameters were seen in group I and III. All variables returned to values similar to baseline in groups I and II 60 minutes after declamping. A significant increase in renal resistive index was evidenced during laparoscopy, with significantly higher values seen in Group II. Thus a synergic effect of pneumoperitoneum and aortic cross-clamping was seen in this study. These two factors together cause decreased renal perfusion and acidosis, thus negatively affecting the patient's general state during this type of surgery.

  8. Understanding key performance indicators for breast support: An analysis of breast support effects on biomechanical, physiological and subjective measures during running. (United States)

    Risius, Debbie; Milligan, Alexandra; Berns, Jason; Brown, Nicola; Scurr, Joanna


    To assess the effectiveness of breast support previous studies monitored breast kinematics and kinetics, subjective feedback, muscle activity (EMG), ground reaction forces (GRFs) and physiological measures in isolation. Comparing these variables within one study will establish the key performance variables that distinguish between breast supports during activities such as running. This study investigates the effects of changes in breast support on biomechanical, physiological and subjective measures during running. Ten females (34D) ran for 10 min in high and low breast supports, and for 2 min bare breasted (2.8 m·s -1 ). Breast and body kinematics, EMG, expired air and heart rate were recorded. GRFs were recorded during 10 m overground runs (2.8 m·s -1 ) and subjective feedback obtained after each condition. Of the 62 variables measured, 22 kinematic and subjective variables were influenced by changes in breast support. Willingness to exercise, time lag and superio-inferior breast velocity were most affected. GRFs, EMG and physiological variables were unaffected by breast support changes during running. Breast displacement reduction, although previously advocated, was not the most sensitive variable to breast support changes during running. Instead breast support products should be assessed using a battery of performance indicators, including the key kinematic and subjective variables identified here.

  9. Effects of lead contamination on soil microbial activity and rice physiological indices in soil-Pb-rice (Oryza sativa L.) system. (United States)

    Zeng, Lu-Sheng; Liao, Min; Chen, Cheng-Li; Huang, Chang-Yong


    The effect of lead (Pb) treatment on the soil microbial activities (soil microbial biomass and soil basal respiration) and rice physiological indices were studied by greenhouse pot experiment. Pb was applied as lead acetate at six different levels in two different paddy soils, namely 0 (control), 100, 300, 500, 700, 900 mg kg-1 soil. The results showed that the application of Pb at lower level (500 mg Pb kg-1 soil), which might be the critical concentration of Pb causing a significant decline in the soil microbial activities. However, the degree of influence on soil microbial activities by Pb was related to the clay and organic matter contents of the soils. On the other hand, when the level of Pb treatments increased to 500 mg kg-1, there was ecological risk for both soil microbial activities and plants. The results also revealed that there was a consistent trend that the chlorophyll contents increased initially, and then decreased gradually with increase in Pb concentration. Pb was effective in inducing proline accumulation and its toxicity causes oxidative stress in rice plants. In a word, soil microbial activities and rice physiological indices, therefore, may be sensitive indicators reflecting environmental stress in soil-Pb-rice system.

  10. Effects of lead contamination on soil enzymatic activities, microbial biomass, and rice physiological indices in soil-lead-rice (Oryza sativa L.) system. (United States)

    Zeng, Lu S; Liao, Min; Chen, Cheng L; Huang, Chang Y


    The effect of lead (Pb) treatment on the soil enzymatic activities, soil microbial biomass, rice physiological indices and rice biomass were studied in a greenhouse pot experiment. Six levels of Pb viz. 0(CK), 100, 300, 500, 700, 900 mg/kg soil were applied in two types of paddy soils. The results showed that Pb treatment had a stimulating effect on soil enzymatic activities and microbial biomass carbon (Cmic) at low concentration and an inhibitory influence at higher concentration. The degree of influence on enzymatic activities and Cmic by Pb was related to the clay and organic matter contents of the soils. When the Pb treatment was raised to the level of 500 mg/kg, ecological risk appeared both to soil microorganisms and plants. The results also revealed a consistent trend of increased chlorophyll contents and rice biomass initially, maximum at a certain Pb treatment, and then decreased gradually with the increase in Pb concentration. Pb was effective in inducing proline accumulation and its toxicity causes oxidative stress in rice plants. Therefore, it was concluded that soil enzymatic activities, Cmic and rice physiological indices, could be sensitive indicators to reflect environmental stress in soil-lead-rice system.

  11. Cosmetic surgery growth and correlations with financial indices: a comparative study of the United Kingdom and United States from 2002-2011. (United States)

    Nassab, Reza; Harris, Paul


    Over the past 10 years, there has been significant fluctuation in the yearly growth rates for cosmetic surgery procedures in both the United States and the United Kingdom. The authors compare cosmetic surgical procedure rates in the United Kingdom and United States with the macroeconomic climate of each region to determine whether there is a direct relationship between cosmetic surgery rates and economic health. The authors analyzed annual cosmetic surgery statistics from the British Association of Aesthetic Plastic Surgeons and the American Society for Aesthetic Plastic Surgery for 2002-2011 against economic indices from both regions, including the gross domestic product (GDP), consumer prices indices (CPI), and stock market reports. There was a 285.9% increase in the United Kingdom and a 1.1% increase in the United States in the number of procedures performed between 2002 and 2011. There were significant positive correlations between the number of cosmetic procedures performed in the United Kingdom and both the GDP (r = 0.986, P failed to show a significant relationship with any indices. UK interest rates showed a significant negative correlation (r = -0.668, P indices are accurate indicators of numbers of procedures being performed in the United Kingdom, whereas rates in the United States seem independent of those factors.

  12. CA-125–indicated asymptomatic relapse confers survival benefit to ovarian cancer patients who underwent secondary cytoreduction surgery

    Directory of Open Access Journals (Sweden)

    Wang Fang


    Full Text Available Abstract Background There is no consensus regarding the management of ovarian cancer patients, who have shown complete clinical response (CCR to primary therapy and have rising cancer antigen CA-125 levels but have no symptoms of recurrent disease. The present study aims to determine whether follow-up CA-125 levels can be used to identify the need for imaging studies and secondary cytoreductive surgery (CRS. Methods We identified 410 ovarian cancer patients treated at The University of Texas MD Anderson Cancer Center between 1984 and 2011. These patients had shown CCR to primary therapy. Follow-up was conducted based on the surveillance protocol of the MD Anderson Cancer Center. We used the Cox proportional hazards model and log-rank test to assess the associations between the follow-up CA-125 levels and secondary CRS and survival duration. Results The CA-125 level of 1.68 × nadir was defined as the indicator of recurrent disease (p  1.68 × nadir at relapse (55.7 and 10.4 months; p = 0.04 and 0.01, respectively. The overall and progression free survival duration of patients with asymptomatic relapse and underwent a secondary CRS was longer than that of patients with symptomatic relapse (p = 0.02 and 0.04 respectively. Conclusions The increase of serum CA-125 levels is an early warning of clinical relapse in ovarian cancer. Using CA-125 levels in guiding the treatment of patients with asymptomatic recurrent ovarian cancer, who have shown CCR to primary therapy, can facilitate optimal secondary CRS and extend the survival duration of the patients.

  13. Proteomics indicators of the rapidly shifting physiology from whole mountain pine beetle, Dendroctonus ponderosae (Coleoptera: Curculionidae, adults during early host colonization.

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    Caitlin Pitt

    Full Text Available We developed proteome profiles for host colonizing mountain pine beetle adults, Dendroctonus ponderosae Hopkins (Coleoptera: Curculionidae. Adult insects were fed in pairs on fresh host lodgepole pine, Pinus contorta Dougl. ex Loud, phloem tissue. The proteomes of fed individuals were monitored using iTRAQ and compared to those of starved beetles, revealing 757 and 739 expressed proteins in females and males, respectively, for which quantitative information was obtained. Overall functional category distributions were similar for males and females, with the majority of proteins falling under carbohydrate metabolism (glycolysis, gluconeogenesis, citric acid cycle, structure (cuticle, muscle, cytoskeleton, and protein and amino acid metabolism. Females had 23 proteins with levels that changed significantly with feeding (p<0.05, FDR<0.20, including chaperones and enzymes required for vitellogenesis. In males, levels of 29 proteins changed significantly with feeding (p<0.05, FDR<0.20, including chaperones as well as motor proteins. Only two proteins, both chaperones, exhibited a significant change in both females and males with feeding. Proteins with differential accumulation patterns in females exhibited higher fold changes with feeding than did those in males. This difference may be due to major and rapid physiological changes occurring in females upon finding a host tree during the physiological shift from dispersal to reproduction. The significant accumulation of chaperone proteins, a cytochrome P450, and a glutathione S-transferase, indicate secondary metabolite-induced stress physiology related to chemical detoxification during early host colonization. The females' activation of vitellogenin only after encountering a host indicates deliberate partitioning of resources and a balancing of the needs of dispersal and reproduction.

  14. Physiology of the fuel ethanol strain Saccharomyces cerevisiae PE-2 at low pH indicates a context-dependent performance relevant for industrial applications. (United States)

    Della-Bianca, Bianca E; de Hulster, Erik; Pronk, Jack T; van Maris, Antonius J A; Gombert, Andreas K


    Selected Saccharomyces cerevisiae strains are used in Brazil to produce the hitherto most energetically efficient first-generation fuel ethanol. Although genome and some transcriptome data are available for some of these strains, quantitative physiological data are lacking. This study investigates the physiology of S. cerevisiae strain PE-2, widely used in the Brazilian fuel ethanol industry, in comparison with CEN.PK113-7D, a reference laboratory strain, focusing on tolerance to low pH and acetic acid stress. Both strains were grown in anaerobic bioreactors, operated as batch, chemostat or dynamic continuous cultures. Despite their different backgrounds, biomass and product formation by the two strains were similar under a range of conditions (pH 5 or pH cells, incubated at pH 1.5, indicated a superior survival of glucose-depleted PE-2 cells, when compared with either CEN.PK113-7D or a commercial bakers' strain. These results indicate that the sulfuric acid washing step, used in the fuel ethanol industry to decrease bacterial contamination due to non-aseptic operation, might have exerted an important selective pressure on the microbial populations present in such environments. © 2014 Federation of European Microbiological Societies. Published by John Wiley & Sons Ltd. All rights reserved.

  15. Skin perfusion pressure as an indicator of tissue perfusion in valvular heart surgery: Preliminary results from a prospective, observational study.

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    Young Song

    Full Text Available Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB. We evaluated whether skin perfusion pressure (SPP can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline, during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h. Lactate was further measured until postoperative 48 h. Association of SPP with lactate and 30-day morbidity comprising myocardial infarction, acute kidney injury, stroke, prolonged intubation, sternal infection, reoperation, and mortality was assessed. Among the lactate levels, postoperative 6 h peak value was most closely linked to composite of 30-day morbidity. The SPP value during CPB and its % change from the baseline value were significantly associated with the postoperative 6 h peak lactate (r = -0.26, P = 0.030 and r = 0.47, P = 0.001, respectively. Optimal cut-off of % decrease in SPP during CPB from baseline value for the postoperative 6 h hyperlactatemia was 48% (area under curve, 0.808; 95% confidence interval (CI, 0.652-0.963; P = 0.001. Decrease in SPP >48% during CPB from baseline value was associated with a 12.8-fold increased risk of composite endpoint of 30-day morbidity (95% CI, 1.48-111.42; P = 0.021 on multivariate logistic regression. Large decrease in SPP during CPB predicts postoperative 6 h hyperlactatemia and 30-day morbidity, which implicates a promising role of SPP monitoring in the achievement of optimal perfusion during CPB.

  16. Skin perfusion pressure as an indicator of tissue perfusion in valvular heart surgery: Preliminary results from a prospective, observational study. (United States)

    Song, Young; Soh, Sarah; Shim, Jae-Kwang; Park, Kyoung-Un; Kwak, Young-Lan


    Hemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h. Lactate was further measured until postoperative 48 h. Association of SPP with lactate and 30-day morbidity comprising myocardial infarction, acute kidney injury, stroke, prolonged intubation, sternal infection, reoperation, and mortality was assessed. Among the lactate levels, postoperative 6 h peak value was most closely linked to composite of 30-day morbidity. The SPP value during CPB and its % change from the baseline value were significantly associated with the postoperative 6 h peak lactate (r = -0.26, P = 0.030 and r = 0.47, P = 0.001, respectively). Optimal cut-off of % decrease in SPP during CPB from baseline value for the postoperative 6 h hyperlactatemia was 48% (area under curve, 0.808; 95% confidence interval (CI), 0.652-0.963; P = 0.001). Decrease in SPP >48% during CPB from baseline value was associated with a 12.8-fold increased risk of composite endpoint of 30-day morbidity (95% CI, 1.48-111.42; P = 0.021) on multivariate logistic regression. Large decrease in SPP during CPB predicts postoperative 6 h hyperlactatemia and 30-day morbidity, which implicates a promising role of SPP monitoring in the achievement of optimal perfusion during CPB.

  17. Effects of castration method and frequency of intramuscular injections of ketoprofen on behavioral and physiological indicators of pain in beef cattle. (United States)

    Moya, D; González, L A; Janzen, E; Caulkett, N A; Fireheller, E; Schwartzkopf-Genswein, K S


    Two experiments were conducted to determine the effect of a single or multiple intramuscular (i.m.) injection of ketoprofen and castration technique on physiological and behavioral indicators of pain in beef calves. A total of 150 bull calves (284.8 ± 22.7 kg BW) were used in both experiments, each 1 conducted as a 3 × 2 factorial design, where main factors included castration technique--no castration (CT), surgical (SU), or band (BA)--and drug administration--physiological solution (PS) or i.m. injection of ketoprofen (KP; 3 mg Anafen/kg BW) in the neck of calves. Animals were weighed weekly during the experiment to calculate ADG. Behavioral responses indicative of pain and discomfort during the castration procedure were documented using a visual analog score (VAS) by an experienced observer who was blind to the treatments. Movements of the animals in the chute during castration were quantified using a strain gauge system mounted on the head gate to evaluate the escape response of the cattle. Pens were equipped with an automated feed bunk monitoring system enabling feed intake and feeding behavior to be continuously monitored for each individual. Thermographic images of the scrotal area were evaluated 24 and 0.5 h before castration, 0.5, 1, 24, 48, and 270 h postcastration, and weekly thereafter until the end of the trial. Blood samples were obtained postcastration to evaluate changes in total white blood cell (WBC) count and neutrophil-to-lymphocyte (N:L) ratio. Saliva samples were taken 24 and 0.5 h before castration, immediately after castration, and 0.5, 1, 2, 5, 24, and 48 h and then 5, 7, and 14 d after castration to determine cortisol concentration. Scrotal temperature, VAS, total WBC, N:L ratio, salivary cortisol, mobility, and pressure exerted in the chute were greater (P castration. Also, BA calves had a greater (P castration and a lower feed intake and ADG at wk 2 and 3 and wk 6 and 7 after castration, respectively, compared to CT. Treatment KP had

  18. Is aortic lymphadenectomy indicated in locally advanced cervical cancer after neoadjuvant chemotherapy followed by radical surgery? A retrospective study on 261 women. (United States)

    Martinelli, F; Signorelli, M; Bogani, G; Ditto, A; Chiappa, V; Perotto, S; Scaffa, C; Lorusso, D; Raspagliesi, F


    The aim of this study was to estimate the rate of aortic lymph nodes (LN) metastases/recurrences among patients affected by locally advanced stage cancer patients (LACC), treated with neoadjuvant chemotherapy (NACT) and radical surgery. Retrospective evaluation of consecutive 261 patients affected by LACC (stage IB2-IIB), treated with NACT followed by radical surgery at National Cancer Institute, Milan, Italy, between 1990 and 2011. Stage at presentation included stage IB2, IIA and IIB in 100 (38.3%), 50 (19.2%) and 111 (42.5%) patients, respectively. Squamous cell carcinoma accounted for more than 80%, followed by adenocarcinoma or adenosquamous cancers (20%). Overall, 56 women (21.5%) had LN metastases. Four out of 83 women (5%) who underwent both pelvic and aortic LN dissection had aortic LN metastases, and all women had concomitant pelvic and aortic LN metastases. Only one woman out of 178 (0.5%) who underwent pelvic lymphadenectomy only, had an aortic LN recurrence. Overall 2% of women (5/261) had aortic LN metastases/recurrence. Our data suggest that aortic lymphadenectomy at the time of surgery is not routinely indicated in LACC after NACT, but should reserved in case of bulky LN in both pelvic and/or aortic area. The risk of isolated aortic LN relapse is negligible. Further prospective studies are warranted. Copyright © 2016 Elsevier Ltd, BASO ~ the Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  19. Effects of Relaxing and Arousing Music during Imagery Training on Dart-Throwing Performance, Physiological Arousal Indices, and Competitive State Anxiety. (United States)

    Kuan, Garry; Morris, Tony; Kueh, Yee Cheng; Terry, Peter C


    Music that is carefully selected to match the requirements of activities and the characteristics of individuals has been shown to produce significant impacts on performance enhancement (Priest et al., 2004). There is also evidence that music can enhance imagery (Grocke and Wigram, 2007), although few studies have investigated the effects of music on imagery in the context of sport skills. In the present study, the effects of relaxing and arousing music during imagery on dart-throwing performance, physiological arousal indices, and competitive state anxiety, were investigated among 63 novice dart throwers. Participants had moderate-to-high imagery ability and were randomly assigned to unfamiliar relaxing music (URM), unfamiliar arousing music (UAM), or no music (NM) groups. Performance was assessed by 40 dart throws at a concentric circles dartboard before and after 12 imagery sessions over 4 weeks. Measures of galvanic skin response (GSR), peripheral temperature (PT), and heart rate (HR) were taken during imagery sessions 1 and 12, and the Competitive State Anxiety Inventory-2 Revised (CSAI-2R) was administered prior to the pre- and post-intervention performance task. Dart-throwing gain scores were significantly higher for URM than for UAM and NM, with no significant difference between UAM and NM (URM = 37.24 ± 5.66, UAM = 17.57 ± 5.30, and NM = 13.19 ± 6.14, F 2,62 = 5.03, p = 0.01, η 2 = 0.14). GSR, PT, and HR reflected lower arousal for URM than for UAM or NM. Significant decreases in somatic anxiety were evident for URM and UAM but not NM. Significant decreases in cognitive anxiety were evident for URM and NM but not UAM. Significant increases in self-confidence were evident for URM but not UAM or NM. Performance improved in all three conditions but URM was associated with the largest performance gain, the lowest physiological indices of arousal, and the most positive CSAI-2R profiles. Listening to relaxing music during imagery may have benefits for

  20. Effects of Relaxing and Arousing Music during Imagery Training on Dart-Throwing Performance, Physiological Arousal Indices, and Competitive State Anxiety

    Directory of Open Access Journals (Sweden)

    Garry Kuan


    Full Text Available Music that is carefully selected to match the requirements of activities and the characteristics of individuals has been shown to produce significant impacts on performance enhancement (Priest et al., 2004. There is also evidence that music can enhance imagery (Grocke and Wigram, 2007, although few studies have investigated the effects of music on imagery in the context of sport skills. In the present study, the effects of relaxing and arousing music during imagery on dart-throwing performance, physiological arousal indices, and competitive state anxiety, were investigated among 63 novice dart throwers. Participants had moderate-to-high imagery ability and were randomly assigned to unfamiliar relaxing music (URM, unfamiliar arousing music (UAM, or no music (NM groups. Performance was assessed by 40 dart throws at a concentric circles dartboard before and after 12 imagery sessions over 4 weeks. Measures of galvanic skin response (GSR, peripheral temperature (PT, and heart rate (HR were taken during imagery sessions 1 and 12, and the Competitive State Anxiety Inventory-2 Revised (CSAI-2R was administered prior to the pre- and post-intervention performance task. Dart-throwing gain scores were significantly higher for URM than for UAM and NM, with no significant difference between UAM and NM (URM = 37.24 ± 5.66, UAM = 17.57 ± 5.30, and NM = 13.19 ± 6.14, F2,62 = 5.03, p = 0.01, η2 = 0.14. GSR, PT, and HR reflected lower arousal for URM than for UAM or NM. Significant decreases in somatic anxiety were evident for URM and UAM but not NM. Significant decreases in cognitive anxiety were evident for URM and NM but not UAM. Significant increases in self-confidence were evident for URM but not UAM or NM. Performance improved in all three conditions but URM was associated with the largest performance gain, the lowest physiological indices of arousal, and the most positive CSAI-2R profiles. Listening to relaxing music during imagery may have benefits for

  1. Effects of fumonisin B1 and mycotoxin binders on growth performance, tibia characteristics, gut physiology, and stress indicators in broiler chickens raised in different stocking densities. (United States)

    Lee, S; Kim, D-H; Keum, M-C; Han, E; An, B-K; Chang, H-H; Choi, Y-H; Moon, B-H; Lee, K-W


    The present study was carried out to investigate the effects of stocking density, fumonisin B1 (FB), and mycotoxin binder (TB) on growth performance, bone quality, physiological stress indicators, and gut health in broiler chickens. Day-old Ross 308 male broiler chicks (n = 1,440/experiment) were randomly allocated to 72 floor pens in a 3 × 2 × 2 factorial arrangement, using 3 stocking densities (12.5 birds/m2 [HSD], 10 birds/m2 [MSD], or 7.5 birds/m2 [LSD]), 2 levels of purified FB (0 or 10 ppm), and 2 levels of TB (0 or 0.2%). Each treatment had 6 replicates (n = 6/treatment) and experiments lasted 34 days. All data were analyzed using 3-way ANOVA with stocking density level, FB, and TB as main factors. Body weight gain and feed intake were lower (P FB-contaminated diet exhibited a higher feed-to-gain ratio compared with those fed an FB-free diet (P FB-contaminated diet compared with the control diet-fed counterparts. Significant interaction (P FB and TB on serum NO levels was noted. In summary, increasing stocking density lowered growth performance and bone quality, but increased the H/L ratio. Dietary TB did not affect FB-induced increases in the feed-to-gain ratio. No interaction was observed between stocking density and FB for the measured variables.

  2. Shaping long-term primate development: Telomere length trajectory as an indicator of early maternal maltreatment and predictor of future physiologic regulation. (United States)

    Drury, Stacy S; Howell, Brittany R; Jones, Christopher; Esteves, Kyle; Morin, Elyse; Schlesinger, Reid; Meyer, Jerrold S; Baker, Kate; Sanchez, Mar M


    The molecular, neurobiological, and physical health impacts of child maltreatment are well established, yet mechanistic pathways remain inadequately defined. Telomere length (TL) decline is an emerging molecular indicator of stress exposure with definitive links to negative health outcomes in maltreated individuals. The multiple confounders endemic to human maltreatment research impede the identification of causal pathways. This study leverages a unique randomized, cross-foster, study design in a naturalistic translational nonhuman primate model of infant maltreatment. At birth, newborn macaques were randomly assigned to either a maltreating or a competent control mother, balancing for sex, biological mother parenting history, and social rank. Offspring TL was measured longitudinally across the first 6 months of life (infancy) from peripheral blood. Hair cortisol accumulation was also determined at 6, 12, and 18 months of age. TL decline was greater in animals randomized to maltreatment, but also interacted with biological mother group. Shorter TL at 6 months was associated with higher mean cortisol levels through 18 months (juvenile period) when controlling for relevant covariates. These results suggest that even under the equivalent social, nutritional, and environmental conditions feasible in naturalistic translational nonhuman primate models, early adverse caregiving results in lasting molecular scars that foreshadow elevated health risk and physiologic dysregulation.

  3. Effects of Planting Date and Plant Density on Physiological Indices, Quantity and Quality Traits of Two Varieties of Marigold (Calendula officinalis L.

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    A Sepehri


    Full Text Available Introduction Marigold (Calendula officinalis L. is originated from North West Africa and Mediterranean area, is a medicinal plant used for several purposes. It is an annual herb or short-lived perennial from the Asteraceae family with yellow or orange flowers. The Marigold has been used as a traditional medicine and food dye, but is currently used as an anti-inflammatory and wound healer. It is grown for drug, obtained from the flowers. The flowers blossom during summer three or more times per year. The essential oil of yellow or orange petals of Calendula officinalis L. is one of the important yield components which is used for food and medicine. Moreover, the seed has an oil content of 5-20 %. Seed oil could be used as a binder in paints, coating and cosmetics. Growth, development and production of medicinal plants, as well as other plants are affected by genetic and agronomic factors. Planting date and plant density are two most important factors that can affect yield and yield components. Planting date affects the quantity and quality of secondary metabolites of medicinal plants. The optimum sowing date and plant density can improve the light and temperature absorption and other factors during the growing season. The positive effects of optimal planting date and plant density has been described by a number of researchers. The Plant population is dependent on the plant characters, growth period, time and method of cultivation. Also, the suitable sowing date has advantages for maximum production. Early sowing in the spring causes weakly establishment of plant and late planting date shortens growth period and simultaneous flowering period due to high temperature in summer. In this study, the effects of plant density and planting date on physiological indices, quantity and quality of two varieties of spare and compact marigold has been evaluated. Materials and Methods In order to determine the effects of planting date and plant density on

  4. Effects of Curcuma longa rhizome powder on egg quality, performance and some physiological indices of laying hens fed different levels of metabolizable energy. (United States)

    Mirbod, Mahsa; Mahdavi, Amir Hossein; Samie, Abdol-Hossein; Mehri, Mehran


    High-energy diets of laying hens may improve roductive performance, although some negative effects may also appear with respect to egg quality and physiological parameters. Curcuma longa rhizome powder (CRP) has beneficial effects on health indices of the birds through antioxidant and antimicrobial properties, especially when the birds experience nutritional stress. Increasing dietary CRP enhanced egg quality by improving eggshell thickness and hardness but decreasing yolk cholesterol content (P < 0.05). The best feed conversion ratio was obtained in birds fed high-apparent metabolizable energy (AME) diets supplemented with 2.0 g kg -1 CRP (P < 0.05). Although increasing dietary AME elevated the serum concentration of triglycerides (P < 0.05) and enzymatic activities of alanine aminotransferase and aspartate aminotransferase (P < 0.05), dietary inclusion of CRP alleviates the blood levels of these enzymes (P < 0.01). Low level of dietary CRP boosted the immune responses to Newcastle virus (P < 0.01) and sheep red blood cells (P < 0.05) antigens but decreased the heterophil to lymphocyte ratio (P < 0.05). Inclusion of at least 2.0 g kg -1 CRP in the diet of laying decreased Escherichia coli enumerations in the ileal content (P < 0.01) and improved villus height, crypt depth and goblet cell numbers (P < 0.05). An improvement in the productive performance of laying hens fed high-energy diets might be associated with decreasing health indices and product quality, which could potentially be amended by nutritional modifications such as incorporating medicinal herbs in the feed. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  5. A retrospective study of the indications and outcomes of capsular tension ring insertion during cataract surgery at a tertiary teaching hospital

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    Wang BZ


    Full Text Available Bob Z Wang, Elsie Chan, Rasik B Vajpayee The Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia; Centre for Eye Research Australia, University of Melbourne, East Melbourne, Victoria, Australia Background: The purpose was to determine preoperative indications, intraoperative procedures, and outcomes of capsular tension ring (CTR insertion during cataract surgery. Methods: A review of all patients undergoing cataract surgery with insertion of a CTR between July 2000 and June 2010 was conducted at The Royal Victorian Eye and Ear Hospital, a large tertiary teaching hospital in Victoria, Australia. Information relating to each patient's demographic details, preoperative assessment, surgical procedure, and postoperative assessment were obtained. Results: Eighty-four eyes of 82 patients were included in this study. The main indications for CTR insertion were previous trauma, pseudoexfoliation syndrome, and mature cataracts. Twenty-one eyes (25.0% did not have any obvious preoperative indication. A posterior capsule tear was the most common intraoperative complication (3.6%. An intraocular lens was successfully implanted in the bag in 72 eyes (85.7%. Postoperatively, the most common complications were a decentered intraocular lens (8.3% and persistent corneal edema (6.0%. Overall, 61 eyes (72.6% had better postoperative visual acuity compared with preoperative acuity, with 67 patients (79.8% achieving vision of 20/40 or better. Conclusion: For the majority of cases, CTR use in complex cataract surgeries is associated with improved postoperative outcomes. CTR implantation is most commonly required in patients with known risk factors for zonular instability. Keywords: capsular tension ring, cataract extraction, indications, outcomes

  6. Cutaneous Mitochondrial PO2, but Not Tissue Oxygen Saturation, Is an Early Indicator of the Physiologic Limit of Hemodilution in the Pig. (United States)

    Römers, Luuk H L; Bakker, Charlotte; Dollée, Nathalie; Hoeks, Sanne E; Lima, Alexandre; Raat, Nicolaas J H; Johannes, Tanja; Stolker, Robert J; Mik, Egbert G


    Hemodilution is a consequence of fluid replacement during blood loss and is limited by the individual ability to compensate for decreasing hemoglobin level. We tested the ability of a novel noninvasive method for measuring cutaneous mitochondrial PO2 (mitoPO2) to detect this threshold early. Anesthetized and ventilated pigs were hemodynamically monitored and randomized into a hemodilution (n = 12) or a time control (TC) group (n = 14). MitoPO2 measurements were done by oxygen-dependent delayed fluorescence of protoporphyrin IX after preparation of the skin with 20% 5-aminolevulinic acid cream. Tissue oxygen saturation (StO2) was measured with near infrared spectroscopy on the thoracic wall. After baseline measurements, progressive normovolemic hemodilution was performed in the hemodilution group in equal steps (500 ml blood replaced by 500 ml Voluven; Fresenius Kabi AG, Germany). Consecutive measurements were performed after 20-min stabilization periods and repeated 8 times or until the animal died. The TC animals remained stable with regard to hemodynamics and mitoPO2. In the hemodilution group, mitoPO2 became hemoglobin-dependent after reaching a threshold of 2.6 ± 0.2 g/dl. During hemodilution, hemoglobin and mitoPO2 decreased (7.9 ± 0.2 to 2.1 ± 0.2 g/dl; 23.6 ± 2 to 9.9 ± 0.8 mmHg), but StO2 did not. Notably, mitoPO2 dropped quite abruptly (about 39%) at the individual threshold. We observed that this decrease in mitoPO2 occurred at least one hemodilution step before changes in other conventional parameters. Cutaneous mitoPO2 decreased typically one hemodilution step before occurrence of significant alterations in systemic oxygen consumption and lactate levels. This makes mitoPO2 a potential early indicator of the physiologic limit of hemodilution and possibly a physiologic trigger for blood transfusion.

  7. Hospital Outcome and Risk Indices of Mortality after redo-mitral valve surgery in Potential Candidates for Transcatheter Procedures: Results From a European Registry. (United States)

    Onorati, Francesco; Mariscalco, Giovanni; Reichart, Daniel; Perrotti, Andrea; Gatti, Giuseppe; De Feo, Marisa; Rubino, Antonio; Santarpino, Giuseppe; Biancari, Fausto; Detter, Christian; Santini, Francesco; Faggian, Giuseppe


    Transcatheter mitral valve-in-valve/valve-in-ring procedures (TM-VIVoR) are increasing. The authors aimed to identify independent predictors for hospital mortality in redo mitral valve surgery as possible future selection criteria for TM-VIVoR. Retrospective multicenter registry. Tertiary university and community hospitals. Two-hundred and sixty patients (out of 920 enrolled) who are potentially candidates for TM-VIVoR undergoing redo-surgery. Redo mitral surgery. Regression analyzes and receiver operating characteristic (ROC) curves identified independent predictors of death. Patients potentially candidates for TM-VIVoR reported significant hospital mortality (9.2%; EuroSCORE II: 13.2 ± 13.1, Society of Thoracic Surgeons [STS] score: 6.2 ± 3.1) and major morbidity (3.8% acute myocardial infarction, 5% stroke, 16.9% perioperative respiratory failure, 16.5% acute renal insufficiency, 25% massive transfusions). EuroSCORE II (odds ration [OR] 1.06; confidence interval [CI] 1.01-1.10; p = 0.005), STS score (OR 1.58; CI 1.27-1.97; p = 0.001), age at surgery (OR 1.05; CI 1.00-1.15; p = 0.05), preoperative dialysis (OR 2.5; CI 1.8-12.6; p = 0.042), left ventricular ejection fraction (LVEF) 13.1; 70.8% sensitivity and 68.2% specificity) and better prediction for STS score (AUC: 0.81; cut-off value: 7.4; 75.0% sensitivity and 66.2% specificity). Quintiles stratification identified EuroSCORE II ≥18.7 (5th quintile, observed mortality: 19.3%) and STS score >9.1 as strong predictors of death within each risk-categorization (OR 5.9 and 12.1, respectively). High EuroSCORE II and STS scores, advanced age at surgery, LVEF indications for TM-VIVoR in the redo-mitral surgery scenario. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Transanal endoscopic micro-surgery (TEMS) for the management of large or sessile rectal adenomas: a review of the technique and indications. (United States)

    Papagrigoriadis, Savvas


    In this review article the surgical technique of Transanal Endoscopic Microsurgery (TEMS) is examined. A number of techniques have been used to treat adenomas of the rectum. The treatment of large adenomas which occupy a large surface of the rectal lumen or adenomas which are flat and grow in a "carpet-like" fashion is particularly challenging. Major rectal surgery carries a risk of morbidity and mortality, particularly in elderly and unfit patients. Although local excision with transanal resection (TAR) and the Kraske sacral operation have been used in the past, during the last twenty years TEMS has become the method of choice for those lesions. TEMS is efficient and minimally invasive. The technique allows the patient to recover rapidly and the incidence of complications is much lower than that of major surgery. In case of recurrence the option of repeat TEMS or major surgery remain available. TEMS has been slow to gain popularity mainly for reasons of cost and steep learning curve but it is now an established procedure and a valuable therapeutic option which is particularly useful for elderly and unfit patients. Gastroenterologists should be aware of the nature and indications of TEMS in order to advise and refer selected patients with rectal adenomas accordingly.

  9. Size of mural nodule as an indicator of surgery for branch duct intraductal papillary mucinous neoplasm of the pancreas during follow-up

    International Nuclear Information System (INIS)

    Uehara, Hiroyuki; Ishikawa, Osamu; Katayama, Kazuhiro


    A mural nodule is a strong predictive factor for malignancy in branch duct intraductal papillary mucinous neoplasm (IPMN) of the pancreas, but the nodule size has hardly been considered. The aim of this study was to investigate whether a mural nodule of 10 mm was appropriate as an indicator of surgery for IPMN during follow-up. The follow-up outcomes of 100 patients who had branch duct IPMN without mural nodules or who had branch duct IPMN with mural nodules of less than 9 mm in a tertiary care setting were investigated retrospectively. The patients underwent abdominal ultrasound (US) every 3 months and additional imaging examinations or cytologic examination of pancreatic juice when necessary. Surgery was recommended to them when a mural nodule developed or when a nodule enlarged and reached 10 mm. During an average follow-up period of 97 months, branch duct IPMNs developed mural nodules that reached 10 mm in 5 patients (0.62% per year). In one patient the IPMN was revealed to be non-invasive carcinoma by resection, 1 IPMN was shown to be malignant by further follow-up, and 3 were not resected because of refusal or the patient's age. In 7 patients, mural nodules stayed within 9 mm. The remaining 88 patients lacked mural nodules in their branch duct IPMNs throughout the follow-up. The occurrence of invasive carcinoma around the IPMN was not indicated by imaging examinations in any patient. Univariate analysis showed that the size of the cyst at baseline significantly predicted the development of a mural nodule that reached 10 mm during follow-up (P=0.05). A mural nodule of 10 mm is appropriate as an indicator of surgery in the follow-up of branch duct IPMN. (author)

  10. [Indication for limited surgery on small lung cancer tumors measuring 1cm or less in diameter on preoperative computed tomography and long-term results]. (United States)

    Togashi, K; Koike, T; Emura, I; Usuda, H


    Non-invasive lung cancers showed a good prognosis after limited surgery. But it is still uncertain about invasive lung cancers. We investigated the indications for limited surgery for small lung cancer tumors measuring 1 cm or less in diameter on preoperative computed tomography (CT). This study retrospectively analyzed of 1,245 patients who underwent complete resection of lung cancer between 1989 and 2004 in our hospital. Sixty-two patients (5%) had tumors measuring 1 cm or less in diameter. The probability of survival was calculated using the Kaplan-Meier method. All diseases were detected by medical checkup, 52 % of the patients were not definitively diagnosed with lung cancer before surgery. Adenocarcinoma was histologically diagnosed in 49 patients (79%). Other histologic types included squamous cell carcinoma (8), large cell carcinoma (1), small cell carcinoma (1), carcinoid (2), and adenosquamous cell carcinoma (1). Fifty-seven patients (92%) showed pathologic stage IA. The other stages were IB (2), IIA (1), and IIIB (2). There were 14 bronchioloalveolar carcinomas (25% of IA diseases). The 5-year survival rates of IA patients were 90%. The 5-year survival rate of patients with tumors measuring 1cm or less diameter was 91% after lobectomy or pneumonectomy, and 90% after wedge resection or segmentectomy. There were 3 deaths from cancer recurrence, while there were no deaths in 14 patients with bronchioloalveolar carcinoma After limited surgery, non-invasive cancer showed good long-term results, while invasive cancer showed a recurrence rate of 2.3% to 79% even though the tumor measured 1 cm or less in diameter on preoperative CT.

  11. ABSI (A Body Shape Index) and ARI (Anthropometric Risk Indicator) in Bariatric Surgery. First Application on a Bariatric Cohort and Possible Clinical Use. (United States)

    Consalvo, Vincenzo; Krakauer, Jesse C; Krakauer, Nir Y; Canero, Antonio; Romano, Mafalda; Salsano, Vincenzo


    BMI (body mass index) is used to identify candidates for bariatric surgery, with a criterion of BMI ≥ 40. For lesser degrees of obesity, BMI 35-39.9, comorbidities are also considered. A Body Shape Index (ABSI) was derived to correct WC (waist circumference) for BMI and height. ABSI has been shown to be a linear predictor of long-term mortality across the range of BMI. Anthropometric risk indicator (ARI) combines the complementary contributions of BMI and ABSI and further improves mortality hazard prediction. We report for the first time ABSI and ARI for a bariatric surgical cohort at baseline and with 3-year follow-up. ABSI and BMI were calculated for 101 subjects from our bariatric surgery center database at baseline and after 3 years of follow-up. Raw values for BMI and ABSI were converted to Z scores and ARI values based on sex- and age-specific normals and risk associations from the National Health and Nutrition Examination Survey (NHANES) III sample of the US general population. Baseline scores for the anthropometric variables BMI and ABSI and the corresponding ARI were all higher than for the NHANES population sample. At 3-year post surgery, all three measures decreased significantly. While baseline BMI did not predict the change in mortality risk by ARI, baseline ABSI did (r = - 0.73), as did baseline ARI (r = - 0.94). Sleeve gastrectomy lowers ABSI and the associated mortality risk estimated from population studies after 3 years of follow-up. Considering our results, bariatric surgical candidates with BMI in the range of 35 to 39.9 with an increased ABSI-related mortality risk may have considerable survival benefit from bariatric surgery, even in the absence of qualifying comorbidities. 2814.

  12. [Distance covered in walking test after heart surgery in patients over 70 years of age: outcome indicator for the assessment of quality of care in intensive rehabilitation]. (United States)

    De Feo, Stefania; Mazza, Antonio; Camera, Federica; Maestri, Antonella; Opasich, Cristina; Tramarin, Roberto


    For quality-of-care assessment of rehabilitation programs after cardiac surgery, measures of functional recovery have been proposed as outcome indicators. Aim of this study was to evaluate the feasibility, the safety and the informative content of the 6-min walking test (6 WT) performed in elderly patients soon after admission in an intensive rehabilitation program after cardiac surgery. Population consists of 115 consecutive over-70 patients admitted to an in-hospital rehabilitation program after cardiac surgery. Within 7 days of admission, in 107 patients (93%) clinical conditions allowed the execution of a 6 WT, on ECG telemetry monitoring. Resting and exertional heart rate, score of fatigue (Borg Scale 1 divided by 20), symptoms, ECG alterations and arrhythmias were recorded. Other considered variables were: comorbidity (Charlson index), length of stay and complications occurring during the whole surgical and rehabilitation in-hospitalisation stay, disability (nursing needs: Maslow and nursing chart), functional status at discharge, left ventricular ejection fraction, number of exercise treatment sessions, self-perceived health-status at admission and at discharge (EuroQoL questionnaire). The mean walked distance was 194 +/- 93 m. No complication neither ECG alteration occurred during the 6 WT; only isolated premature ventricular beats were recorded in 26 pts. Heart rate increased from 86 +/- 13 at rest to 95 +/- 17 bpm at the end of the 6 WT (p needs, self-perceived health-status and functional capacity at discharge differed between patients who performed the 6 WT within 4 days compared with those who did it later, and between patients who walked < or = 120 m (lower quartile) compared with those who walked more. In elderly patients after cardiac surgery the 6 WT performed within the first week of admission in rehabilitation unit is feasible and safe. Simple cut-offs like timing of the 6 WT and walking performance identify more severe patients with lower

  13. Results of surgery in symptomatic non-hydrocephalic pineal cysts: role of magnetic resonance imaging biomarkers indicative of central venous hypertension. (United States)

    Eide, Per Kristian; Ringstad, Geir


    We have previously proposed that pineal cysts (PCs) may result in crowding of the pineal recess, causing symptoms due to compression of the internal cerebral veins and central venous hypertension. In the present study, we compared clinical outcome of different treatment modalities in symptomatic individuals with non-hydrocephalic PCs. The study included all patients managed surgically for non-hydrocephalic PCs in our Department of Neurosurgery over a 10-year period. We applied a questionnaire to determine occurrence of symptoms before and after surgery, which allowed the use of a grading scale for symptom severity. Magnetic resonance imaging (MRI) biomarkers indicative of central venous hypertension were assessed before and after surgery. Relief of symptoms after surgery was most efficiently obtained by complete microsurgical cyst removal [n = 15; no (0/15), some (1/15) or marked (14/15) improvement], and to a lesser extent by microsurgical cyst fenestration [n = 6; no (2/6), some (4/6) or marked (0/6) improvement]. Shunt surgery was not successful [n = 6; no (5/6), some (1/6) or marked (0/6) improvement]. In all patients, the proposed MRI biomarkers gave evidence of central venous hypertension (PC grades 2-4). Microsurgical cyst removal provided marked symptom relief in symptomatic individuals with non-hydrocephalic PCs and MRI biomarkers of central venous hypertension. The hypothesis that PC-induced crowding of the pineal recess may compromise venous run-off and induce a central venous hypertension syndrome deserves further study.

  14. Quality indicators for colorectal cancer surgery and care according to patient-, tumor-, and hospital-related factors

    International Nuclear Information System (INIS)

    Mathoulin-Pélissier, Simone; Bécouarn, Yves; Belleannée, Geneviève; Pinon, Elodie; Jaffré, Anne; Coureau, Gaëlle; Auby, Dominique; Renaud-Salis, Jean-Louis; Rullier, Eric


    Colorectal cancer (CRC) care has improved considerably, particularly since the implementation of a quality of care program centered on national evidence-based guidelines. Formal quality assessment is however still needed. The aim of this research was to identify factors associated with practice variation in CRC patient care. CRC patients identified from all cancer centers in South-West France were included. We investigated variations in practices (from diagnosis to surgery), and compliance with recommended guidelines for colon and rectal cancer. We identified factors associated with three colon cancer practice variations potentially linked to better survival: examination of ≥12 lymph nodes (LN), non-use and use of adjuvant chemotherapy for stage II and stage III patients, respectively. We included 1,206 patients, 825 (68%) with colon and 381 (32%) with rectal cancer, from 53 hospitals. Compliance was high for resection, pathology report, LN examination, and chemotherapy use for stage III patients. In colon cancer, 26% of stage II patients received adjuvant chemotherapy and 71% of stage III patients. 84% of stage US T3T4 rectal cancer patients received pre-operative radiotherapy. In colon cancer, factors associated with examination of ≥12 LNs were: lower ECOG score, advanced stage and larger hospital volume; factors negatively associated were: left sided tumor location and one hospital district. Use of chemotherapy in stage II patients was associated with younger age, advanced stage, emergency setting and care structure (private and location); whereas under-use in stage III patients was associated with advanced age, presence of comorbidities and private hospitals. Although some changes in practices may have occurred since this observational study, these findings represent the most recent report on practices in CRC in this region, and offer a useful methodological approach for assessing quality of care. Guideline compliance was high, although some organizational

  15. Evaluation and optimisation of current milrinone prescribing for the treatment and prevention of low cardiac output syndrome in paediatric patients after open heart surgery using a physiology-based pharmacokinetic drug-disease model. (United States)

    Vogt, Winnie


    Milrinone is the drug of choice for the treatment and prevention of low cardiac output syndrome (LCOS) in paediatric patients after open heart surgery across Europe. Discrepancies, however, among prescribing guidance, clinical studies and practice pattern require clarification to ensure safe and effective prescribing. However, the clearance prediction equations derived from classical pharmacokinetic modelling provide limited support as they have recently failed a clinical practice evaluation. Therefore, the objective of this study was to evaluate current milrinone dosing using physiology-based pharmacokinetic (PBPK) modelling and simulation to complement the existing pharmacokinetic knowledge and propose optimised dosing regimens as a basis for improving the standard of care for paediatric patients. A PBPK drug-disease model using a population approach was developed in three steps from healthy young adults to adult patients and paediatric patients with and without LCOS after open heart surgery. Pre- and postoperative organ function values from adult and paediatric patients were collected from literature and integrated into a disease model as factorial changes from the reference values in healthy adults aged 20-40 years. The disease model was combined with the PBPK drug model and evaluated against existing pharmacokinetic data. Model robustness was assessed by parametric sensitivity analysis. In the next step, virtual patient populations were created, each with 1,000 subjects reflecting the average adult and paediatric patient characteristics with regard to age, sex, bodyweight and height. They were integrated into the PBPK drug-disease model to evaluate the effectiveness of current milrinone dosing in achieving the therapeutic target range of 100-300 ng/mL milrinone in plasma. Optimised dosing regimens were subsequently developed. The pharmacokinetics of milrinone in healthy young adults as well as adult and paediatric patients were accurately described with an

  16. [Indication, type of resection and results of surgery in cases of lung tuberculosis. A historical and regional overview]. (United States)

    Hillejan, L; Nemat, A; Marra, A; Stamatis, G


    Pulmonary tuberculosis has become a rare indication for surgical intervention in all industrial nations. Over a period of 10 years we overview 193 patients who were suffering this disease and underwent thoracotomy. Main indication (79.8 %) was pulmonary nodules, of unknown origin. In this cases wedge resection was performed. Expanded resectional techniques were necessary in cases of cavernes, superinfected bronchiectasis, bronchial stenosis, hemoptysis and destroyed lungs due to tuberculosis. Considering the heterogenous groups of patients, the perioperative morbidity (21.8 %) and mortality (0.5 %) has to be regarded in comparison to the data found in the literature.

  17. Leaf d15N as a physiological indicator of the responsiveness of N2-fixing alfalfa plants to elevated [CO2], temperature and low water availability

    Directory of Open Access Journals (Sweden)

    Idoia eAriz


    Full Text Available The natural 15N/14N isotope composition (δ15N of a tissue is a consequence of its N source and N physiological mechanisms in response to the environment. It could potentially be used as a tracer of N metabolism in plants under changing environmental conditions, where primary N metabolism may be complex, and losses and gains of N fluctuate over time. In order to test the utility of δ15N as an indicator of plant N status in N2-fixing plants grown under various environmental conditions, alfalfa (Medicago sativa L. plants were subjected to distinct conditions of [CO2] (400 versus 700 mol mol-1, temperature (ambient versus ambient + 4ºC and water availability (fully watered versus water deficiency - WD. As expected, increased [CO2] and temperature stimulated photosynthetic rates and plant growth, whereas these parameters were negatively affected by WD. The determination of δ15N in leaves, stems, roots and nodules showed that leaves were the most representative organs of the plant response to increased [CO2] and WD. Depletion of heavier N isotopes in plants grown under higher [CO2] and WD conditions reflected decreased transpiration rates, but could also be related to a higher N demand in leaves, as suggested by the decreased leaf N and total soluble protein (TSP contents detected at 700 mol mol-1 [CO2] and WD conditions. In summary, leaf δ15N provides relevant information integrating parameters which condition plant responsiveness (e.g. photosynthesis, TSP, N demand and water transpiration to environmental conditions.

  18. Development and Validation of an Agency for Healthcare Research and Quality Indicator for Mortality After Congenital Heart Surgery Harmonized With Risk Adjustment for Congenital Heart Surgery (RACHS-1) Methodology. (United States)

    Jenkins, Kathy J; Koch Kupiec, Jennifer; Owens, Pamela L; Romano, Patrick S; Geppert, Jeffrey J; Gauvreau, Kimberlee


    The National Quality Forum previously approved a quality indicator for mortality after congenital heart surgery developed by the Agency for Healthcare Research and Quality (AHRQ). Several parameters of the validated Risk Adjustment for Congenital Heart Surgery (RACHS-1) method were included, but others differed. As part of the National Quality Forum endorsement maintenance process, developers were asked to harmonize the 2 methodologies. Parameters that were identical between the 2 methods were retained. AHRQ's Healthcare Cost and Utilization Project State Inpatient Databases (SID) 2008 were used to select optimal parameters where differences existed, with a goal to maximize model performance and face validity. Inclusion criteria were not changed and included all discharges for patients model includes procedure risk group, age (0-28 days, 29-90 days, 91-364 days, 1-17 years), low birth weight (500-2499 g), other congenital anomalies (Clinical Classifications Software 217, except for 758.xx), multiple procedures, and transfer-in status. Among 17 945 eligible cases in the SID 2008, the c statistic for model performance was 0.82. In the SID 2013 validation data set, the c statistic was 0.82. Risk-adjusted mortality rates by center ranged from 0.9% to 4.1% (5th-95th percentile). Congenital heart surgery programs can now obtain national benchmarking reports by applying AHRQ Quality Indicator software to hospital administrative data, based on the harmonized RACHS-1 method, with high discrimination and face validity. © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

  19. Current Trends in and Indications for Endoscopy-Assisted Breast Surgery for Breast Cancer: Results from a Six-Year Study Conducted by the Taiwan Endoscopic Breast Surgery Cooperative Group (United States)

    Lai, Hung-Wen; Chen, Shou-Tung; Chen, Dar-Ren; Chen, Shu-Ling; Chang, Tsai-Wang; Kuo, Shou-Jen; Kuo, Yao-Lung; Hung, Chin-Sheng


    Background Endoscopy-assisted breast surgery (EABS) performed through minimal axillary and/or periareolar incisions is a possible alternative to open surgery for certain patients with breast cancer. In this study, we report the early results of an EABS program in Taiwan. Methods The medical records of patients who underwent EABS for breast cancer during the period May 2009 to December 2014 were collected from the Taiwan Endoscopic Breast Surgery Cooperative Group database. Data on clinicopathologic characteristics, type of surgery, method of breast reconstruction, complications and recurrence were analyzed to determine the effectiveness and oncologic safety of EABS in Taiwan. Results A total of 315 EABS procedures were performed in 292 patients with breast cancer, including 23 (7.8%) patients with bilateral disease. The number of breast cancer patients who underwent EABS increased initially from 2009 to 2012 and then stabilized during the period 2012–2014. The most commonly performed EABS was endoscopy-assisted total mastectomy (EATM) (85.4%) followed by endoscopy-assisted partial mastectomy (EAPM) (14.6%). Approximately 74% of the EATM procedures involved breast reconstruction, with the most common types of reconstruction being implant insertion and autologous pedicled TRAM flap surgery. During the six-year study period, there was an increasing trend in the performance of EABS for the management of breast cancer when total mastectomy was indicated. The positive surgical margin rate was 1.9%. Overall, the rate of complications associated with EABS was 15.2% and all were minor and wound-related. During a median follow-up of 26.8 (3.3–68.6) months, there were 3 (1%) cases of local recurrence, 1 (0.3%) case of distant metastasis and 1 (0.3%) death. Conclusion The preliminary results from the EABS program in Taiwan show that EABS is a safe procedure and results in acceptable cosmetic outcome. These findings could help to promote this under-used surgical technique

  20. Stress among Parents of Children with and without Autism Spectrum Disorder: A Comparison Involving Physiological Indicators and Parent Self-Reports. (United States)

    Padden, Ciara; James, Jack E


    Parents of children with Autism Spectrum Disorder (ASD) have been reported as experiencing higher levels of stress and poorer physical health than parents of typically developing children. However, most of the relevant literature has been based on parental self-reports of stress and health. While research on physiological outcomes has grown in recent years, gaps still exist in our understanding of the physiological effects, if any, of stress related to parenting a child with ASD. The present study compared parent-reported stress, anxiety, and depression, as well as selected physiological measures of stress (i.e., cortisol, alpha-amylase, and ambulatory blood pressure and heart rate) between matched groups of parents of children with ( N =  38) and without ( N  = 38) ASD. Participants completed questionnaires, collected saliva samples for the purpose of measuring cortisol and alpha-amylase, and wore an ambulatory blood pressure monitor for 24 h. Parents of children with ASD reported significantly higher levels of parental distress, anxiety, and depression than parents of typically developing children. Parent-reported distress, anxiety, depression, and health were not correlated with physiological measures. With the exception that parents of children with ASD had significantly lower cortisol levels 30 min after waking, no other significant group differences were found for physiological measures. Parents of children with ASD reported significantly higher use of a number of adaptive coping strategies (e.g., emotional support) in comparison to parents of typically developing children. Results are discussed in the context of implications for future research directions, stress research, and practical implications for parental support.

  1. Computer-aided design and computer-aided modeling (CAD/CAM) generated surgical splints, cutting guides and custom-made implants: Which indications in orthognathic surgery? (United States)

    Scolozzi, P


    The purpose of the present report was to describe our indications, results and complications of computer-aided design and computer-aided modeling CAD/CAM surgical splints, cutting guides and custom-made implants in orthognathic surgery. We analyzed the clinical and radiological data of ten consecutive patients with dentofacial deformities treated using a CAD/CAM technique. Four patients had surgical splints and cutting guides for correction of maxillomandibular asymmetries, three had surgical cutting guides and customized internal distractors for correction of severe maxillary deficiencies and three had custom-made implants for additional chin contouring and/or mandibular defects following bimaxillary osteotomies and sliding genioplasty. We recorded age, gender, dentofacial deformity, surgical procedure and intra- and postoperative complications. All of the patients had stable cosmetic results with a high rate of patient satisfaction at the 1-year follow-up examination. No intra- and/or postoperative complications were encountered during any of the different steps of the procedure. This study demonstrated that the application of CAD/CAM patient-specific surgical splints, cutting guides and custom-made implants in orthognathic surgery allows for a successful outcome in the ten patients presented in this series. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  2. Nasal Physiology (United States)

    ... Caregivers Contact ARS HOME ANATOMY Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy Skull Base Anatomy Virtual Anatomy Disclosure ... Patient Education About this Website Font Size + - Home > ANATOMY > Nasal Physiology Nasal Anatomy Sinus Anatomy Nasal Physiology Nasal Endoscopy ...

  3. Emotional processes in patients undergoing coronary artery bypass graft surgeries with extracorporeal circulation in view of selected indicators of the inflammatory condition. (United States)

    Płotek, Włodzimierz; Pielok, Joanna; Cybulski, Marcin; Samborska, Regina


    The aim of this study was to describe positive and negative emotions in patients undergoing coronary artery bypass graft (CABG) surgeries with extracorporeal circulation and the correlations between emotions and basic indicators of the inflammatory condition: C-reactive protein (CRP) concentration, body temperature, and leukocyte count. Standardized tools were used to select 52 patients (aged 47-63 years, 6 women--11.5% and 46 men--88.5%) without dementia or depression. The Positive and Negative Affect Schedule (PANAS) was used to examine positive affect (PA) and negative affect (NA) and the State-Trait Anxiety Inventory (STAI X1 and X2) was used to examine the anxiety level. The patients underwent CABG surgery according to a common anesthesia protocol and for 5 consecutive days they were observed in the ward, where selected indicators of the inflammatory condition were monitored. A detailed description of the results of examinations of emotions was presented. The patients with low PA-trait level, high NA-trait level, and high anxiety-trait level (STAI X2) exhibited statistically significantly higher body temperatures than the other patients in the postoperative period. The patients with high NA-trait and anxiety-state levels (STAI X1) had statistically significantly lower CRP levels in the postoperative period than the patients with low NA-trait and anxiety-state levels (STAI X1). Patients undergoing CABG operations express both positive and negative affects. The changes in the inflammatory markers are expressed mostly by CRP concentration. There exist relationships between the result of tests assessing emotions and the markers of the inflammatory condition.

  4. Re-resection rates after breast-conserving surgery as a performance indicator: introduction of a case-mix model to allow comparison between Dutch hospitals. (United States)

    Talsma, A K; Reedijk, A M J; Damhuis, R A M; Westenend, P J; Vles, W J


    Re-resection rate after breast-conserving surgery (BCS) has been introduced as an indicator of quality of surgical treatment in international literature. The present study aims to develop a case-mix model for re-resection rates and to evaluate its performance in comparing results between hospitals. Electronic records of eligible patients diagnosed with in-situ and invasive breast cancer in 2006 and 2007 were derived from 16 hospitals in the Rotterdam Cancer Registry (RCR) (n = 961). A model was built in which prognostic factors for re-resections after BCS were identified and expected re-resection rate could be assessed for hospitals based on their case mix. To illustrate the opportunities of monitoring re-resections over time, after risk adjustment for patient profile, a VLAD chart was drawn for patients in one hospital. In general three out of every ten women had re-surgery; in about 50% this meant an additive mastectomy. Independent prognostic factors of re-resection after multivariate analysis were histological type, sublocalisation, tumour size, lymph node involvement and multifocal disease. After correction for case mix, one hospital was performing significantly less re-resections compared to the reference hospital. On the other hand, two were performing significantly more re-resections than was expected based on their patient mix. Our population-based study confirms earlier reports that re-resection is frequently required after an initial breast-conserving operation. Case-mix models such as the one we constructed can be used to correct for variation between hospitals performances. VLAD charts are valuable tools to monitor quality of care within individual hospitals. Copyright © 2011 Elsevier Ltd. All rights reserved.

  5. Physiologic effects of bowel preparation

    DEFF Research Database (Denmark)

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


    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...


    African Journals Online (AJOL)


    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.

  7. Expectations of Sinus Surgery (United States)

    ... 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 ...

  8. Midline submental intubation might be the preferred alternative to oral and nasal intubation in elective oral and craniomaxillofacial surgery when indicated. (United States)

    Jin, Huijun; Patil, Pavan Manohar


    No consensus exists to date regarding the best method of controlling the airway for oral or craniomaxillofacial surgery when orotracheal and nasotracheal intubations are unsuccessful or contraindicated. The most commonly used method of tracheostomy has been associated with a high degree of morbidity. Therefore, the present study was conducted to determine the indications, safety, efficacy, time required, drawbacks, complications, and costs of the midline submental intubation (SMI) approach in elective oral and craniomaxillofacial surgical procedures. A retrospective case series study was used to evaluate the surgical, financial, and photographic records of all patients who had undergone oral or craniomaxillofacial operations at Sharda University School of Dental Sciences, Greater Noida, from April 2006 to March 2014. The indications, drawbacks, time required for the procedure, ability to provide a secure airway, intra- and postoperative complications, and additional costs associated with SMI were analyzed. Of the 2,823 patients treated, the present study included 120 patients (97 men and 23 women, aged 19 to 60 years). The average time required for SMI was 10 ± 2 minutes. No episode of intraoperative oxygen desaturation was noted. One intraoperative complication, an injury to the ventral surface of the tongue, was encountered. Two patients developed infection at the skin incision site. No significant additional cost was incurred with the use of SMI. SMI has been successfully used in elective oral and craniomaxillofacial surgical procedures for which oral and nasal intubations were either not indicated or not possible. The advantages include a quick procedure, insignificant complications, the ability to provide a stable airway, and no added costs, making SMI a quick, safe, efficient, and cost-effective alternative in such cases. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Rice Physiology (United States)

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


    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...

  10. Bone biology and physiology: Part I. The fundamentals. (United States)

    Buck, Donald W; Dumanian, Gregory A


    The principles of bone biology and physiology permeate all subspecialty practices in plastic and reconstructive surgery from hand surgery to aesthetic surgery. Despite its importance in our practices, the biology of bone healing and bone physiology rarely surfaces within textbooks, literature reviews, or residency curricula. In this article, the authors present the first of a two-part series reviewing the important concepts of bone biology and bone physiology relevant to plastic surgery in an effort to ameliorate this educational gap.

  11. Selenium sources in the diet of dairy cows and their effects on milk production and quality, on udder health and on physiological indicators of heat stress

    Directory of Open Access Journals (Sweden)

    Carlos E. Oltramari


    Full Text Available Twenty-four dairy cows, with daily average milk production of 18.1 kg, were fed diets containing different selenium (Se sources. The purpose of this paper is to evaluate the effects of such diets on milk production and quality, on the occurrence of mastitis, and on physiological variables. During the experimental period (124 days, all the cows received the same diet: a total mixed feed with 0.278 1 DM of selenium. In the inorganic Se treatment, the selenium source was sodium selenite and in the organic Se treatment the source was selenium yeast (Saccharomyces cerevisiae CNCM I-3060. There were no significant differences in milk yield or in Se concentration in the milk. No significant differences between the treatments were observed in protein, lactose, solids-not-fat andpercentage of total solids. The animals subjected to the organic Se treatment presented higher (P=0.013 percentage of milk fat and lower (P=0.014 somatic cell count (SCC than those subjected to the inorganic Se treatment. There was no significant difference in subclinical mastitisas determined by the California Mastitis Test (CMT between the treatments. However, both Se sources reduced the incidence of mastitis (subclinical positive mastitis and strongly positive mastitis between the pre-experimental and experimental phases. There was no significant difference in rectal temperature (RT between the treatments. Respiratory frequency (RF was lower (P=0.027 in the inorganic treatment than in the organic one, whereas haircoat temperature (HT was lower (P=0.007 in the organic treatment than in the inorganic one.

  12. Practical X-ray diagnostics orthopedics and trauma surgery. Indication, adjustment technique and radiation protection; Praktische Roentgendiagnostik Orthopaedie und Unfallchirurgie. Indikation, Einstelltechnik, Strahlenschutz

    Energy Technology Data Exchange (ETDEWEB)

    Flechtenmacher, Johannes [Ortho-Zentrum am Ludwigsplatz, Karlsruhe (Germany); Sabo, Desiderius [Klinik St. Elisabeth, Heidelberg (Germany). Sportopaedic Heidelberg


    The book on X-ray diagnostics in orthopedics and trauma surgery includes the following chapters: 1. Introduction: radiation protection, equipment technology radiological diagnostics of skeleton carcinomas, specific aspects of trauma surgery, special aspects of skeleton radiology for children. 2. X-ray diagnostics of different anatomical regions: ankle joint, knee, hips and pelvis, hand and wrist joint, elbow, shoulder, spinal cord. 3. Appendix: radiation protection according to the X-ray regulations.

  13. Season, Transport Duration and Trailer Compartment Effects on Blood Stress Indicators in Pigs: Relationship to Environmental, Behavioral and Other Physiological Factors, and Pork Quality Traits

    Directory of Open Access Journals (Sweden)

    Roberta Sommavilla


    Full Text Available The objective of this study was to assess the effects of the season, travel duration and trailer compartment location on blood creatine-kinase (CK, lactate and cortisol concentrations in 384 pigs and assess their relationships with trailer temperature, heart rate and gastrointestinal tract temperature (GTT, behavior, carcass damage scores and meat quality. Blood CK was greater in pigs transported in summer (p = 0.02, after 18 h transportation (p < 0.001 and in pigs located in C4, C5 and C10 (p = 0.002. In winter, the concentration of blood lactate was higher (p = 0.04 in pigs transported for 6 h in C5. Pigs located in C10 showed higher (p = 0.01 concentration of cortisol than those transported for 18h in C4 in summer. The highest correlations were between blood cortisol and GTT (r = 0.53; p < 0.001, and between blood CK and GTT (r = 0.41; p < 0.001, truck temperature (r = 0.42; p < 0.001, and pHu in the longissimus muscle (r = 0.41; p < 0.001. In conclusion, although increased blood cortisol and CK levels appear to indicate a physical stress condition in transported pigs, the weak to moderate correlations with environmental and other animal welfare indicators suggest that blood stress parameters can only be used as a complementary measurement in the assessment of the pigs’ response to transport stress.

  14. [ The new 2010 Ghent criteria for the indication to surgical treatment of patients affected by Marfan syndrome. Experience of a single cardiac surgery center]. (United States)

    Grego, Susanna; Nardi, Paolo; Gislao, Valentina; Nicolò, Francesca; D'Annolfo, Antonella; Marcucci, Rosaria; Bovio, Emanuele; Versaci, Francesco; Chiariello, Luigi


    The diagnosis and surgical treatment of patients with Marfan syndrome remain controversial. It is of utmost importance to identify patients at risk for acute aortic events to establish the correct surgical timing and the appropriate surgical treatment. From May 2008 to December 2012, 500 patients were screened at the Marfan Presidium of the Tor Vergata University Hospital of Rome (Italy). Patients were evaluated by a cardiac surgeon, including echocardiographic, orthopedic, ophthalmologic and dental examinations. All patients received genetic counseling, and genetic sampling was performed if appropriate. The diagnosis of Marfan syndrome was confirmed in 146 patients (29.2%). Fifty-four patients (37%) underwent cardiac surgery on the aortic root, 4 patients had surgery on the mitral valve, 13 patients had combined surgery; 11 cases were emergent surgery for acute aortic dissection. Twenty-eight patients (52%) were operated on at our Division: 13 underwent valve-sparing aortic root replacement (David procedure), 1 underwent Yacoub remodeling procedure and 14 underwent Bentall procedure. Following the establishment of the Marfan Center, the David aortic valve-sparing operation was the most frequently performed procedure compared to the previous period of surgical activity (63 vs 22%, psyndromes. Early surgical treatment is recommended in these patients to achieve optimal results of valve-sparing procedures and life-saving management, especially for patients who live far away from a cardiac surgery center.

  15. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... misalignment of jaws and teeth. Surgery can improve chewing, speaking and breathing. While the patient's appearance may ... indicate the need for corrective jaw surgery: Difficulty chewing, or biting food Difficulty swallowing Chronic jaw or ...

  16. New Modalities for the Administration of Inhaled Nitric Oxide in Intensive Care Units After Cardiac Surgery or for Neonatal Indications: A Prospective Observational Study. (United States)

    Gaudard, Philippe; Barbanti, Claudio; Rozec, Bertrand; Mauriat, Philippe; M'rini, Mimoun; Cambonie, Gilles; Liet, Jean Michel; Girard, Claude; Leger, Pierre Louis; Assaf, Ziad; Damas, Pierre; Loron, Gauthier; Lecourt, Laurent; Amour, Julien; Pouard, Philippe


    Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed. Concomitant pulmonary vasodilator treatments, safety data, and outcome were also collected. Quantitative data are expressed as median (25th, 75th percentile). Over 1 year, 236 patients were included from 14 equipped and trained centers: 117 adults and 81 children with PH associated with cardiac surgery and 38 neonates with persistent PH of the newborn. Inhaled NO was initiated before intensive care unit (ICU) admission in 57%, 12.7%, and 38.9% with an initial dose of 10 (10, 15) ppm, 20 (18, 20) ppm, and 17 (11, 20) ppm, and a median duration of administration of 3.9 (1.9, 6.1) days, 3.8 (1.8, 6.8) days, and 3.1 (1.0, 5.7) days, respectively, for the adult population, pediatric cardiac group, and newborns. The treatment was performed using administration synchronized to the mechanical ventilation. The dose was gradually decreased before withdrawal in 86% of the cases according to the usual procedure of each center. Adverse events included rebound effect for 3.4% (95% confidence interval [CI], 0.9%-8.5%) of adults, 1.2% (95% CI, 0.0%-6.7%) of children, and 2.6% (95% CI, 0.1%-13.8%) of neonates and methemoglobinemia exceeded 2.5% for 5 of 62 monitored patients. Other pulmonary vasodilators were associated with NO in 23% of adults, 95% of children, and 23.7% of neonates. ICU stay was respectively 10 (6, 22) days, 7.5 (5.5, 15) days, and 9 (8, 15) days and ICU mortality was 22.2%, 6.2%, and 7.9% for adults, children, and neonates, respectively. This study confirms the safety

  17. Sex Effect on Obesity Indices and Metabolic Outcomes in Patients with Obese Obstructive Sleep Apnea and Type 2 Diabetes After Laparoscopic Roux-en-Y Gastric Bypass Surgery: a Preliminary Study. (United States)

    Xu, Huajun; Zhang, Pin; Han, Xiaodong; Yu, Haoyong; Di, Jianzhong; Zou, Jianyin; Wang, Yuyu; Qian, Yingjun; Tu, Yinfang; Bao, Yuqian; Yi, Hongliang; Guan, Jian; Yin, Shankai; Jia, Weiping


    Roux-en-Y gastric bypass (RYGB) surgery is an effective therapy for obstructive sleep apnea (OSA). However, little attention has been paid to the treatment goals systematically stratified by sex. The objective of this study was to assess how sex differences affect obesity indices and metabolic outcomes after RYGB surgery. A sleep questionnaire was conducted and medical histories were taken. Full-night polysomnography (PSG), anthropometric variables, and blood samples were collected. Thirty-five consecutive patients with OSA who underwent laparoscopic RYGB surgery were prospectively examined for at least 6 months were included in the study. Significant improvements (p obesity indices, and metabolic outcomes [except low-density lipoprotein in men and high-density lipoprotein (HDL) in women] were obtained in men and women with OSA. Men had higher baseline triglyceride (TG) (p women. However, only TG in men improved more than in women (p = 0.02). Sleep parameters, obesity indices, and metabolic outcomes after RYGB surgery were of similar magnitude in women and men with OSA. Alleviating sleep and obesity problems was correlated with metabolic outcomes in men and women.

  18. Microbial physiology and soil CO2 efflux after 9 years of soil warming in a temperate forest - no indications for thermal adaptations. (United States)

    Schindlbacher, Andreas; Schnecker, Jörg; Takriti, Mounir; Borken, Werner; Wanek, Wolfgang


    Thermal adaptations of soil microorganisms could mitigate or facilitate global warming effects on soil organic matter (SOM) decomposition and soil CO2 efflux. We incubated soil from warmed and control subplots of a forest soil warming experiment to assess whether 9 years of soil warming affected the rates and the temperature sensitivity of the soil CO2 efflux, extracellular enzyme activities, microbial efficiency, and gross N mineralization. Mineral soil (0-10 cm depth) was incubated at temperatures ranging from 3 to 23 °C. No adaptations to long-term warming were observed regarding the heterotrophic soil CO2 efflux (R10 warmed: 2.31 ± 0.15 μmol m(-2)  s(-1) , control: 2.34 ± 0.29 μmol m(-2)  s(-1) ; Q10 warmed: 2.45 ± 0.06, control: 2.45 ± 0.04). Potential enzyme activities increased with incubation temperature, but the temperature sensitivity of the enzymes did not differ between the warmed and the control soils. The ratio of C : N acquiring enzyme activities was significantly higher in the warmed soil. Microbial biomass-specific respiration rates increased with incubation temperature, but the rates and the temperature sensitivity (Q10 warmed: 2.54 ± 0.23, control 2.75 ± 0.17) did not differ between warmed and control soils. Microbial substrate use efficiency (SUE) declined with increasing incubation temperature in both, warmed and control, soils. SUE and its temperature sensitivity (Q10 warmed: 0.84 ± 0.03, control: 0.88 ± 0.01) did not differ between warmed and control soils either. Gross N mineralization was invariant to incubation temperature and was not affected by long-term soil warming. Our results indicate that thermal adaptations of the microbial decomposer community are unlikely to occur in C-rich calcareous temperate forest soils. © 2015 The Authors. Global Change Biology published by John Wiley & Sons Ltd.

  19. Cell response to surgery.

    LENUS (Irish Health Repository)

    Ni Choileain, Niamh


    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.

  20. Transanal endoscopic micro-surgery (TEMS) for the management of large or sessile rectal adenomas: a review of the technique and indications


    Papagrigoriadis, Savvas


    In this review article the surgical technique of Transanal Endoscopic Microsurgery (TEMS) is examined. A number of techniques have been used to treat adenomas of the rectum. The treatment of large adenomas which occupy a large surface of the rectal lumen or adenomas which are flat and grow in a "carpet-like" fashion is particularly challenging. Major rectal surgery carries a risk of morbidity and mortality, particularly in elderly and unfit patients. Although local excision with transanal res...

  1. Orthognathic Surgery

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Thygesen, Torben Henrik


    The literature shows that the indications for orthognathic surgery (OS) are often functional problems and unsatisfactory facial esthetics. This study investigated the esthetic outcomes and overall satisfaction following OS. Somatosensory change is a relatively common complication and its influence...... on the level of satisfaction was studied. The social-networking web site Facebook was used to identify the study population. An online questionnaire was performed using the website SurveyMonkey. In all, 105 (9%) respondents from the Danish Facebook group about OS, called Kaebeoperation (jaw surgery), were...... in beauty than women (P = 0.030). Sixty-four percent replied that their attractiveness had been increased after OS. Eighty-six percent were happy with the results and 89% would recommend the surgery to others in need. No significant differences in esthetic results and satisfaction were seen with regard...

  2. Physiological parameters

    International Nuclear Information System (INIS)

    Natera, E.S.


    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

  3. Factors Influencing Nonabsolute Indications for Surgery in Patients With Lower Urinary Tract Symptoms Suggestive of Benign Prostatic Hyperplasia: Analysis Using Causal Bayesian Networks

    Directory of Open Access Journals (Sweden)

    Myong Kim


    Full Text Available Purpose To identify the factors affecting the surgical decisions of experienced physicians when treating patients with lower urinary tract symptoms that are suggestive of benign prostatic hyperplasia (LUTS/BPH. Methods Patients with LUTS/BPH treated by two physicians between October 2004 and August 2013 were included in this study. The causal Bayesian network (CBN model was used to analyze factors influencing the surgical decisions of physicians and the actual performance of surgery. The accuracies of the established CBN models were verified using linear regression (LR analysis. Results A total of 1,108 patients with LUTS/BPH were analyzed. The mean age and total prostate volume (TPV were 66.2 (±7.3, standard deviation years and 47.3 (±25.4 mL, respectively. Of the total 1,108 patients, 603 (54.4% were treated by physician A and 505 (45.6% were treated by physician B. Although surgery was recommended to 699 patients (63.1%, 589 (53.2% actually underwent surgery. Our CBN model showed that the TPV (R=0.432, treating physician (R=0.370, bladder outlet obstruction (BOO on urodynamic study (UDS (R=0.324, and International Prostate Symptom Score (IPSS question 3 (intermittency; R=0.141 were the factors directly influencing the surgical decision. The transition zone volume (R=0.396, treating physician (R=0.340, and BOO (R=0.300 directly affected the performance of surgery. Compared to the LR model, the area under the receiver operating characteristic curve of the CBN surgical decision model was slightly compromised (0.803 vs. 0.847, P<0.001, whereas that of the actual performance of surgery model was similar (0.801 vs. 0.820, P=0.063 to the LR model. Conclusions The TPV, treating physician, BOO on UDS, and the IPSS item of intermittency were factors that directly influenced decision-making in physicians treating patients with LUTS/BPH.

  4. Regulatory Physiology (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


    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.

  5. Mathematical physiology

    CERN Document Server

    Sneyd, James


    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. ...

  6. Causes and indications for reoperation in valve replacement and coronary artery bypass graft (CABG in 915 patients in cardiac surgery department in Imam Khomeini Hospital, 1374-77

    Directory of Open Access Journals (Sweden)

    Radmehr H


    Full Text Available Valvular and coronary artery disease are among the most important causes of disability and death in the world and Iran as well. Every year, half a million death because of these diseases is reported in United State. The incidence of degenerative and valvular diseases of heart is increasing. Considering the industrialization of our country, the incidence of these kind of problems are increasing as well. In this study, there is an attempt to recognize the causes of cardiac surgery. We conducted a retrospective study in 915 cardiac surgery patients (630 CABG and 285 valve replacement from 1374 to 1377. In CABG patients, there were 46 cases of reoperation (78.3 percent male 21.7 percent female. The most reoperations for bleeding was less than 24 hours in 90.3 percent. In valvular patients the causes of reoperation were: A Valvular complications (female/male=3/1, B Non valvular complications (female/male=1/3. The most common nonvalvular complication was bleeding (66.6 percent. The most common valvular complication was bioprosthetic valve degeneration. The meantime between two operation in valvular complications was 11.8 years. In all cases (915 the incidence of bleeding was 3.8 percent, mediastinitis 0.8 percent, cardiac tamponade 0.8 percent and GI bleeding 0.5 percent.

  7. Physiological pseudomyopia. (United States)

    Jones, R


    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.

  8. Development of a Unifying Target and Consensus Indicators for Global Surgical Systems Strengthening: Proposed by the Global Alliance for Surgery, Obstetric, Trauma, and Anaesthesia Care (The G4 Alliance). (United States)

    Haider, Adil; Scott, John W; Gause, Colin D; Meheš, Mira; Hsiung, Grace; Prelvukaj, Albulena; Yanocha, Dana; Baumann, Lauren M; Ahmed, Faheem; Ahmed, Na'eem; Anderson, Sara; Angate, Herve; Arfaa, Lisa; Asbun, Horacio; Ashengo, Tigistu; Asuman, Kisembo; Ayala, Ruben; Bickler, Stephen; Billingsley, Saul; Bird, Peter; Botman, Matthijs; Butler, Marilyn; Buyske, Jo; Capozzi, Angelo; Casey, Kathleen; Clayton, Charles; Cobey, James; Cotton, Michael; Deckelbaum, Dan; Derbew, Miliard; deVries, Catherine; Dillner, Jeanne; Downham, Max; Draisin, Natalie; Echinard, David; Elneil, Sohier; ElSayed, Ahmed; Estelle, Abigail; Finley, Allen; Frenkel, Erica; Frykman, Philip K; Gheorghe, Florin; Gore-Booth, Julian; Henker, Richard; Henry, Jaymie; Henry, Orion; Hoemeke, Laura; Hoffman, David; Ibanga, Iko; Jackson, Eric V; Jani, Pankaj; Johnson, Walter; Jones, Andrew; Kassem, Zeina; Kisembo, Asuman; Kocan, Abbey; Krishnaswami, Sanjay; Lane, Robert; Latif, Asad; Levy, Barbara; Linos, Dimitrios; Linz, Peter; Listwa, Louis A; Magee, Declan; Makasa, Emmanuel; Marin, Michael L; Martin, Claude; McQueen, Kelly; Morgan, Jamie; Moser, Richard; Neighbor, Robert; Novick, William M; Ogendo, Stephen; Omigbodun, Akinyinka; Onajin-Obembe, Bisola; Parsan, Neil; Philip, Beverly K; Price, Raymond; Rasheed, Shahnawaz; Ratel, Marjorie; Reynolds, Cheri; Roser, Steven M; Rowles, Jackie; Samad, Lubna; Sampson, John; Sanghvi, Harshadkumar; Sellers, Marchelle L; Sigalet, David; Steffes, Bruce C; Stieber, Erin; Swaroop, Mamta; Tarpley, John; Varghese, Asha; Varughese, Julie; Wagner, Richard; Warf, Benjamin; Wetzig, Neil; Williamson, Susan; Wood, Joshua; Zeidan, Anne; Zirkle, Lewis; Allen, Brendan; Abdullah, Fizan


    After decades on the margins of primary health care, surgical and anaesthesia care is gaining increasing priority within the global development arena. The 2015 publications of the Disease Control Priorities third edition on Essential Surgery and the Lancet Commission on Global Surgery created a compelling evidenced-based argument for the fundamental role of surgery and anaesthesia within cost-effective health systems strengthening global strategy. The launch of the Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care in 2015 has further coordinated efforts to build priority for surgical care and anaesthesia. These combined efforts culminated in the approval of a World Health Assembly resolution recognizing the role of surgical care and anaesthesia as part of universal health coverage. Momentum gained from these milestones highlights the need to identify consensus goals, targets and indicators to guide policy implementation and track progress at the national level. Through an open consultative process that incorporated input from stakeholders from around the globe, a global target calling for safe surgical and anaesthesia care for 80% of the world by 2030 was proposed. In order to achieve this target, we also propose 15 consensus indicators that build on existing surgical systems metrics and expand the ability to prioritize surgical systems strengthening around the world.

  9. Exercise physiology

    DEFF Research Database (Denmark)

    Kiens, Bente; Richter, Erik; Wojtaszewski, Jørgen


    The passing of Professor Bengt Saltin on September 12, 2014 truly marks the end of an era. As editor of the Journal of Applied Physiology and one of Bengt’s many collaborators and colleagues, I wanted the Journal to celebrate his many seminal contributions by means of an Editorial. Professor Bent...

  10. Environmental physiology

    International Nuclear Information System (INIS)



    Summaries of research projects conducted during 1978 and 1979 are presented. Subject areas include: the effects of environmental pollutants on homeostasis of the hematopoietic system; pollutant effects on steroid metabolism; pollutant effects on pulmonary macrophages; effects of toxic gases on lung cells; the development of immunological methods for assessing lung damage at the cellular level; the response of erythropoietin concentration to various physiological changes; and the study of actinide metabolism in monkey skeletons

  11. Metabolic Surgery

    DEFF Research Database (Denmark)

    Pareek, Manan; Schauer, Philip R; Kaplan, Lee M


    The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown...... the superiority of surgery over medical treatment alone in achieving improved glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms seem to extend beyond the magnitude of weight loss alone and include improvements in incretin profiles, insulin secretion, and insulin sensitivity....... Moreover, observational data suggest that the reduction in cardiovascular risk factors translates to better patient outcomes. This review describes commonly used metabolic surgical procedures and their current indications and summarizes the evidence related to weight loss and glycemic outcomes. It further...

  12. [Thymus surgery in a general surgery department]. (United States)

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


    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.

  13. Changes in myocardial lactate, pyruvate and lactate-pyruvate ratio during cardiopulmonary bypass for elective adult cardiac surgery: Early indicator of morbidity

    Directory of Open Access Journals (Sweden)

    P M Kapoor


    Full Text Available Background: Myocardial lactate assays have been established as a standard method to compare various myocardial protection strategies. This study was designed to test whether coronary sinus (CS lactates, pyruvate and lactate-pyruvate (LP ratio correlates with myocardial dysfunction and predict postoperative outcomes. Materials and Methods: This prospective observational study was conducted on 40 adult patients undergoing elective cardiac surgery with the aid of cardiopulmonary bypass (CPB. CS blood sampling was done for estimation of myocardial lactate (ML, pyruvate (MP and lactate-pyruvate ratio (MLPR namely: pre-CPB (T 1 , after removal of aortic cross clamp (T 2 and 30 minutes post-CPB (T 3 . Results: Baseline myocardial LPR strongly correlated with Troponin-I at T1 (s: 0.6. Patients were sub grouped according to the median value of myocardial lactate (2.9 at baseline T1 into low myocardial lactate (LML group, mean (2.39±0.4 mmol/l, n=19 and a high myocardial lactate (HML group, mean (3.65±0.9 mmol/l, n=21. A significant increase in PL, ML, MLPR and TropI occurred in both groups as compared to baseline. Patients in HML group had significant longer period of ICU stay. Patients with higher inotrope score had significantly higher ML (T2, T3. ML with a baseline value of 2.9 mmol/l had 70.83% sensitivity and 62.5% specificity (ROC area: 0.7109 Std error: 0.09 while myocardial pyruvate with a baseline value of 0.07 mmol/l has 79.17% sensitivity and 68.75% specificity (ROC area: 0.7852, Std error: 0.0765 for predicting inotrope requirement after CPB. Conclusion: CS lactate, pyruvate and LP ratio correlate with myocardial function and can predict postoperative outcome.

  14. Is deciduousness a key to climate resilience among iconic California savanna oak species? Relating phenological habits to seasonal indicators of tree physiological and water stress across field, hyperspectral, drone (UAS)-based multispectral and thermal image data (United States)

    Mayes, M. T.; Caylor, K. K.; Ehlmann, B. L.; Greenberger, R. N.; Estes, L. D.


    In California (CA) savannas, oak trees (genus Quercus) play keystone roles in water and nutrient cycling, support biodiversity and many land-use activities. Declines in oak basal area of up to 25% from the 1930s-2000s, which have occurred alongside climate trends such as increasing variability of rainfall and prevalence of hotter droughts, threaten the services and ecological functions these trees provide. It is particularly unclear how climate relates to productivity and stress across oak species. Past work has found that seedling recruitment has varied inversely with "deciduousness." That is, evergreen oaks (e.g. Quercus agrifola. Coast Live Oak) are reproducing more successfully than drought-deciduous (e.g. Quercus douglassi, Blue Oak), which in turn are more successful than fully deciduous species (e.g. Quercus lobata, Valley Oak). However, there is poor understanding of how these ecological trends by species, corresponding with phenological habit, relate to physiological and ecohydrological processes such as carbon assimilation, water or nutrient use efficiency in mature tree stands. This limits predictive capability for which species will be most resilient to harsher future growing conditions, and, how to monitor stress and productivity in long-lived mature oak communities across landscapes via tools including remotely sensed data. This project explores how ecophysiological variables (e.g. stomatal conductance) relate to phenological habits across three oak species (Coast Live, Blue and Valley) over a seasonal dry-down period in Santa Barbara County, CA. Our goal is to probe if deciduousness is a key to resilience in productivity and water stress across iconic oak species. We test relationships between leaf and canopy-level field data, and indicators from multiple new sources of remotely sensed data, including ground hyperspectral, drone (UAS)-based multi-spectral and thermal image data, as means of monitoring tree physiological and water stress from scales

  15. Occupational physiology

    CERN Document Server

    Toomingas, Allan; Tornqvist, Ewa Wigaeus


    In a clear and accessible presentation, Occupational Physiology focuses on important issues in the modern working world. Exploring major public health problems-such as musculoskeletal disorders and stress-this book explains connections between work, well-being, and health based on up-to-date research in the field. It provides useful methods for risk assessment and guidelines on arranging a good working life from the perspective of the working individual, the company, and society as a whole.The book focuses on common, stressful situations in different professions. Reviewing bodily demands and r

  16. Turbinate surgery (United States)

    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 ...

  17. Bariatric Surgery (United States)

    ... 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 ...

  18. Lung surgery (United States)

    ... 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, ...

  19. Plastic Surgery (United States)

    ... 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 " ...

  20. Behavioural and physiological indicators of shelter dogs' welfare: reflections on the no-kill policy on free-ranging dogs in Italy revisited on the basis of 15 years of implementation. (United States)

    Cafazzo, S; Maragliano, L; Bonanni, R; Scholl, F; Guarducci, M; Scarcella, R; Di Paolo, M; Pontier, D; Lai, O; Carlevaro, F; Bucci, E; Cerini, N; Carlevaro, L; Alfieri, L; Fantini, C; Natoli, E


    The Italian National Law 281 of 1991 forbids the euthanatization of free-ranging dogs, unless they have an incurable illness or are proved to be dangerous. Without neglecting the undeniable benefits of the "no-kill" policy, nevertheless it has brought about a chronic overpopulation in shelters and, as a result, higher costs of management and welfare problems since some dogs remain in the shelter for life. In 2004-2008, the Istituto Zooprofilattico Sperimentale of the Lazio and Tuscany regions carried out a survey in the Lazio Region to verify the effects of the Italian National Law 281/91 on free-ranging dog management following 15 years from its implementation. One of the aims of the study was an assessment of the welfare of dogs in a shelter sample (8 shelters out of 47 censused in the Lazio Region). 97 mixed-breed dogs were selected, their behaviour was studied and a blood sample was taken for each dog in order to determine the individual blood concentration of cortisol and the amount of oxidative damage (level of dRoms), as well as the amount of antioxidants to cope with it. Moreover, the total leukocyte count (leukogram) was accomplished. We ran general backward stepwise regression models using "level of antioxidant", "level of dRoms" and "level of serum cortisol" as dependent variables respectively. The results showed that the most important variable that improved the level of welfare of dogs consisted in having the opportunity to regularly go out of the cage for a walk, whereas other variables like gender, size of the cage (small, medium, large), being alone in the cage, and being neutered/entire, had no significant effect on the physiological indicators of welfare. Dogs that enjoyed the regular walk had a higher total antioxidant capacity, and performed a lower frequency of displacing activities and stereotyped behaviour. Moreover, oxidative stress parameters seem to be indicators well matched with behavioural indicators of stress. Thus, for the first time

  1. Gastric and intestinal surgery. (United States)

    Fossum, Theresa W; Hedlund, Cheryl S


    Gastric surgery is commonly performed to remove foreign bodies and correct gastric dilatation-volvulus and is less commonly performed to treat gastric ulceration or erosion, neoplasia, and benign gastric outflow obstruction. Intestinal surgery, although commonly performed by veterinarians, should never be considered routine. The most common procedures of the small intestinal tract performed in dogs and cats include enterotomy and resection/anastomosis. Surgery of the large intestine is indicated for lesions causing obstruction, perforations, colonic inertia, or chronic inflammation.

  2. [Nerve growth factor and the physiology of pain: the relationships among interoception, sympathetic neurons and the emotional response indicated by the molecular pathophysiology of congenital insensitivity to pain with anhidrosis]. (United States)

    Indo, Yasuhiro


    Nerve growth factor (NGF) is a neurotrophic factor essential for the survival and maintenance of neurons. Congenital insensitivity to pain with anhidrosis (CIPA) is caused by loss-of-function mutations in NTRK1, which encodes a receptor tyrosine kinase, TrkA, for NGF. Mutations in NTRK1 cause the selective loss of NGF-dependent neurons, including both NGF-dependent primary afferents and sympathetic postganglionic neurons, in otherwise intact systems. The NGF-dependent primary afferents are thinly myelinated AΔ or unmyelinated C-fibers that are dependent on the NGF-TrkA system during development. NGF-dependent primary afferents are not only nociceptive neurons that transmit pain and temperature sensation, but also are polymodal receptors that play essential roles for interoception by monitoring various changes in the physiological status of all tissues in the body. In addition, they contribute to various inflammatory processes in acute, chronic and allergic inflammation. Together with sympathetic postganglionic neurons, they maintain the homeostasis of the body and emotional responses via interactions with the brain, immune and endocrine systems. Pain is closely related to emotions that accompany physical responses induced by systemic activation of the sympathetic nervous system. In contrast to a negative image of emotions in daily life, Antonio Damasio proposed the 'Somatic Marker Hypothesis', wherein emotions play critical roles in the decision-making and reasoning processes. According to this hypothesis, reciprocal communication between the brain and the body-proper are essential for emotional responses. Using the pathophysiology of CIPA as a foundation, this article suggests that NGF-dependent neurons constitute a part of the neuronal network required for homeostasis and emotional responses, and indicates that this network plays important roles in mediating the reciprocal communication between the brain and the body-proper.

  3. Physiological Acoustics (United States)

    Young, Eric D.

    The analysis of physiological sound in the peripheral auditory system solves three important problems. First, sound energy impinging on the head must be captured and presented to the transduction apparatus in the ear as a suitable mechanical signal; second, this mechanical signal needs to be transduced into a neural representation that can be used by the brain; third, the resulting neural representation needs to be analyzed by central neurons to extract information useful to the animal. This chapter provides an overview of some aspects of the first two of these processes. The description is entirely focused on the mammalian auditory system, primarily on human hearing and on the hearing of a few commonly used laboratory animals (mainly rodents and carnivores). Useful summaries of non-mammalian hearing are available [1]. Because of the large size of the literature, review papers are referenced wherever possible.

  4. Adaptive capability as indicated by behavioral and physiological responses, plasma HSP70 level, and PBMC HSP70 mRNA expression in Osmanabadi goats subjected to combined (heat and nutritional) stressors (United States)

    Shilja, Shaji; Sejian, V.; Bagath, M.; Mech, A.; David, C. G.; Kurien, E. K.; Varma, Girish; Bhatta, Raghavendra


    A study was conducted to assess the impact of heat and nutritional stress simultaneously on the adaptive capability as indicated by behavioral and physiological responses, plasma heat shock protein 70 (HSP70) level, and peripheral blood mononuclear cells (PBMC) HSP70 gene expression in goats. Twenty-four adult Osmanabadi bucks (average body weight (BW) 16.0 kg) were used in the present study. The bucks were divided into four groups viz., C ( n = 6; control), HS ( n = 6; heat stress), NS ( n = 6; nutritional stress), and CS ( n = 6; combined stress). The study was conducted for a period of 45 days. C and HS bucks had ad libitum access to their feed while NS and CS bucks were under restricted feed (30 % intake of C bucks) to induce nutritional stress. The HS and CS bucks were exposed to solar radiation for 6 h a day between 10:00 a.m. and 4:00 p.m. to induce heat stress. The data was analyzed using repeated measures analysis of variance. The standing time differed significantly ( P < 0.01) between ad libitum fed groups (C and HS) and restricted feeding groups (NS and CS). The highest ( P < 0.01) lying time was recorded in the CS group while the lowest in the C and HS groups. The highest ( P < 0.01) drinking frequency was also recorded in the CS group. Water intake recorded was significantly ( P < 0.01) higher in both the HS and CS groups. The highest respiration rate (RR), pulse rate (PR), and rectal temperature (RT) during the afternoon were also recorded in the CS group. Further, skin temperature of the head, flank, and scrotum during the afternoon was also higher ( P < 0.01) in the CS group. In addition, both plasma HSP70 concentration and PBMC HSP70 messenger RNA (mRNA) transcript expression were also significantly ( P < 0.01) higher in the CS group. It can be concluded from this study that when two stressors occur simultaneously, they may have severe impact on adaptive capabilities of Osmanabadi bucks as compared to that would occur individually. Further, the

  5. Detecting adverse events in surgery: comparing events detected by the Veterans Health Administration Surgical Quality Improvement Program and the Patient Safety Indicators. (United States)

    Mull, Hillary J; Borzecki, Ann M; Loveland, Susan; Hickson, Kathleen; Chen, Qi; MacDonald, Sally; Shin, Marlena H; Cevasco, Marisa; Itani, Kamal M F; Rosen, Amy K


    The Patient Safety Indicators (PSIs) use administrative data to screen for select adverse events (AEs). In this study, VA Surgical Quality Improvement Program (VASQIP) chart review data were used as the gold standard to measure the criterion validity of 5 surgical PSIs. Independent chart review was also used to determine reasons for PSI errors. The sensitivity, specificity, and positive predictive value of PSI software version 4.1a were calculated among Veterans Health Administration hospitalizations (2003-2007) reviewed by VASQIP (n = 268,771). Nurses re-reviewed a sample of hospitalizations for which PSI and VASQIP AE detection disagreed. Sensitivities ranged from 31% to 68%, specificities from 99.1% to 99.8%, and positive predictive values from 31% to 72%. Reviewers found that coding errors accounted for some PSI-VASQIP disagreement; some disagreement was also the result of differences in AE definitions. These results suggest that the PSIs have moderate criterion validity; however, some surgical PSIs detect different AEs than VASQIP. Future research should explore using both methods to evaluate surgical quality. Published by Elsevier Inc.

  6. Space Physiology within an Exercise Physiology Curriculum (United States)

    Carter, Jason R.; West, John B.


    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…

  7. A novel method for reproducibly measuring the effects of interventions to improve emotional climate, indices of team skills and communication, and threat to patient outcome in a high-volume thoracic surgery center. (United States)

    Nurok, Michael; Lipsitz, Stuart; Satwicz, Paul; Kelly, Andrea; Frankel, Allan


    To create and test a reproducible method for measuring emotional climate, surgical team skills, and threats to patient outcome by conducting an observational study to assess the impact of a surgical team skills and communication improvement intervention on these measurements. Observational study. Operating rooms in a high-volume thoracic surgery center from September 5, 2007, through June 30, 2008. Thoracic surgery operating room teams. Two 90-minute team skills training sessions focused on findings from a standardized safety culture survey administered to all participants and highlighting positive and problematic aspects of team skills, communication, and leadership. The sessions created an interactive forum to educate team members on the importance of communication and to role-play optimal interactive and communication strategies. Calculated indices of emotional climate, team skills, and threat to patient outcome. The calculated communication and team skills score improved from the preintervention to postintervention periods, but the improvement extinguished during the 3 months after the intervention (P skills and communication and decrease a calculated score of threats to patient outcome. However, the effect is only durable for threats to patient outcome.

  8. Falso Aneurisma Femoral Iatrogénico: Ainda uma indicação para a Cirurgia Convencional? Iatrogenic femoral pseudoaneurysm: still an indication for conventional surgery?

    Directory of Open Access Journals (Sweden)

    Nelson Oliveira


    Full Text Available Introdução: Os Falsos Aneurismas (FA são uma das complicações mais frequentemente associadas à punção femoral diagnóstica e de intervenção cardíaca. A sua abordagem terapêutica tem evoluído no sentido da preponderância das técnicas não invasivas sendo a Cirurgia Convencional cada vez menos frequentemente praticada. Objectivos: Os autores propõem a propósito de um caso clínico, e através de uma revisão da literatura discutir a abordagem terapêutica dos FA e as indicações da Cirurgia Convencional. Caso clínico: Doente de sessenta e um anos, sexo masculino, com antecedentes de hipertensão arterial, doença coronária com enfarte agudo do miocárdio prévio, miocardiopatia dilatada, fibrilhação auricular paroxística sendo portador de cardiodesfibrilhador. Foi submetido a cateterismo cardíaco por via femoral direita para ablação do Feixe de His, tendo sido referenciado ao Serviço de Angiologia e Cirurgia Vascular por desenvolvimento progressivo de massa pulsátil dolorosa acompanhada de hipostesia da face anterior da coxa. A Angiodinografia confirmou a presença de falso aneurisma da artéria femoral profunda direita com 3cm de maior diâmetro e a presença de uma fístula entre a artéria e a veia femorais superficiais direitas. Por abordagem cirúrgica aberta, foi realizada a exclusão do falso aneurisma e rafia da artéria e veia femorais superficiais. Conclusão: A abordagem de primeira linha dos falsos aneurismas iatrogénicos pós cateterismo cardíaco é não invasiva mas a Cirurgia Convencional detém ainda um lugar primordial para um grupo restrito de doentes.Introduction: Pseudoaneurysms (PAN are one of the most common complications of cardiac catheterization. Treatment has evolved towards a less invasive approach, reducing the number of Open repairs. Objectives: The authors propose to discuss the contemporary management of PAN and the remaining indications for Conventional Surgical Repair based upon a case

  9. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ... here to find out more. Dental Implant Surgery Dental Implant Surgery Dental implant surgery is, of course, surgery, ...

  10. On the use of the lichen Ramalina celastri (Spreng.) Krog. and Swinsc. as an indicator of atmospheric pollution in the province of Cordoba, Argentina, considering both lichen physiological parameters and element concentrations

    International Nuclear Information System (INIS)

    Jasan, R.C.; Pla, R.R.; Verburg, T.G.; Wolterbeek, H.Th.; Pignata, M.L.


    The lichen Ramalina celastri (Spreng.) Krog. and Swinsc. was used to study trace-element atmospheric pollution in Cordoba (Argentina). 38 samples from a 1999 campaign were analyzed by NAA and a number of physiological parameters was determined. In first-ever comparisons, no correlations were found between altitude, physiological parameters and determined elements, which allowed the full comparison of element data in lichen samples throughout the whole survey area. After the application of Monte Carlo assisted factor analysis to the elemental matrix, five source profiles were found and mapped. The attribution of the sources is discussed. (author)

  11. Image-guided surgery. (United States)

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


    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.

  12. Robotic surgery (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: ...

  13. Nose Surgery (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, ...

  14. After Surgery (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 ...

  15. Challenging a classic myth: pneumoperitoneum associated with acute diverticulitis is not an indication for open or laparoscopic emergency surgery in hemodynamically stable patients. A 10-year experience with a nonoperative treatment. (United States)

    Costi, Renato; Cauchy, François; Le Bian, Alban; Honart, Jean-François; Creuze, Nicolas; Smadja, Claude


    In patients presenting with acute diverticulitis (AD) and signs of acute peritonitis, the presence of extradigestive air (EDA) on a computer tomography (CT) scan is often considered to indicate the need for emergency surgery. Although the traditional management of "perforated" AD is open sigmoidectomy, more recently, laparoscopic drainage/lavage (usually followed by delayed elective sigmoidectomy) has been reported. The aim of this retrospective study is to evaluate the results of nonoperative management of emergency patients presenting with AD and EDA. The outcomes of 39 consecutive hemodynamically stable patients (23 men, mean age = 54.7 years) who were admitted with AD and EDA and were managed nonoperatively (antibiotic and supportive treatment) at a tertiary-care university hospital between January 2001 and June 2010 were retrospectively collected and analyzed. These included morbidity (Clavien-Dindo) and treatment failure (need for emergency surgery or death). A univariate analysis of clinical, radiological, and laboratory criteria with respect to treatment failure was performed. Results of delayed elective laparoscopic sigmoidectomy were also analyzed. There was no mortality. Thirty-six of the 39 patients (92.3%) did not need surgery (7 patients required CT-guided abscess drainage). Mean hospital stay was 8.1 days. Duration of symptoms, previous antibiotic administration, severe sepsis, PCR level, WBC concentration, and the presence of abdominal collection were associated with treatment failure, whereas "distant" location of EDA and free abdominal fluid were not. Five patients had recurrence of AD and were treated medically. Seventeen patients (47.2%) underwent elective laparoscopic sigmoidectomy for which mean operative time was 246 min (range = 100-450) and the conversion rate was 11.8%. Mortality was nil and the morbidity rate was 41.2%. Mean postoperative stay was 7.1 days (range = 4-23). Nonoperative management is a viable option in most emergency

  16. Thyroid Surgery (United States)

    ... 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 ...


    African Journals Online (AJOL)

    or whether the blood supply of the mucosal and submucosal ... 1942, the normal physiological pressure of 8 to 10 cm water is ... Conclusion: Small bowel serosal injuries do not perforate or leak at physiological intraluminal pressures, either at ...

  18. Minimally invasive orthognathic surgery. (United States)

    Resnick, Cory M; Kaban, Leonard B; Troulis, Maria J


    Minimally invasive surgery is defined as the discipline in which operative procedures are performed in novel ways to diminish the sequelae of standard surgical dissections. The goals of minimally invasive surgery are to reduce tissue trauma and to minimize bleeding, edema, and injury, thereby improving the rate and quality of healing. In orthognathic surgery, there are two minimally invasive techniques that can be used separately or in combination: (1) endoscopic exposure and (2) distraction osteogenesis. This article describes the historical developments of the fields of orthognathic surgery and minimally invasive surgery, as well as the integration of the two disciplines. Indications, techniques, and the most current outcome data for specific minimally invasive orthognathic surgical procedures are presented.

  19. Environmental physiology

    International Nuclear Information System (INIS)

    Duffy, P.H.; Sacher, G.A.; Staffeldt, E.F.


    The analysis of lifetime effects of ionizing radiation was at first directed almost exclusively toward effects on disease incidence and life-span, because these kinds of cumulative damage were the most prominent and serious late effects of ionizing radiation. The experimental program of our team on the effects of life-time gamma-ray exposure on the survival of mice and other rodent species was completed several years ago, but important analysis and modeling efforts continue. A report of one aspect of this analytical effort is included here. A life is measured better by a lifetime productivity score than by years alone. The importance of productivity measures of the toxic action of energy by-products is increased now that the fossil fuel products are receiving attention, because the inhaled combustion products, in particular, have their major effect on work performance and low-level chronic disease, instead of on life shortening by terminal cancer. The first stages of a program to develop simple measures of performance capacity in rodents, based on indices of energy metabolism, motor activity, and body temperature, are described. The quadratic relation of survival time to daily dose was studied for 15 mammalian species

  20. Produção e indicadores fisiológicos de alface sob hidroponia com água salina Production and physiologic indicators of lettuce grown in hydroponics with saline water

    Directory of Open Access Journals (Sweden)

    Dalva Paulus


    at the moment an essential activity, facing the rising demand of fresh water, as for the agricultural activity as for the urban and industrial supplying. This study aimed to evaluate production and physiologic indicators of lettuce in hydroponic system with the use of saline waters. The experiment was carried out in a greenhouse in the period from December 2007 to January 2008, in Piracicaba, Brazil. The experimental design was randomized blocks in factorial scheme - five salinity levels obtained with the addition of NaCl, which resulted in different water electrical conductivity levels (dS m-1: 0,42, 1,53, 3,52, 5,55, 7,43 - and two cultivars of lettuce - Veronica and Pira Roxa. It was determined the fresh and dry mass of leaves, stem, roots and shoot and the content of nitrate, proline and chlorophyll. The increase of water salinity reduced lineally the fresh and dry mass of leaves, stem, roots and shoot. The cv Verônica produced 36% and 57% more shoot fresh and dry mass, respectively, than Pira Roxa. The cv. Pira Roxa accumulated 25% more nitrate (3008 mg L-1, presented 50% more total chlorophyll (1,46 mg g-1fresh mass and 71,43% more proline (0,21 µM g fresh mass- 1 than the cv Verônica, showing a mechanism of avoiding salinity stress. Cultivars Pira Roxa and Veronica presented loss of 69% and 64% of commercial productivity, respectively, when the most saline water (7,43 dS m-1 was used. In the other hand dry matter was reduced in 53% and 44%, respectively, for cv. Pira Roxa and Verônica in the most saline water. The results obtained in this study can indicate the possibility of using saline water as an alternative for the production of vegetables, specially for growers that have saline water available but restricted fresh water, even with reduction of productivity.

  1. Circadian physiology of metabolism. (United States)

    Panda, Satchidananda


    A majority of mammalian genes exhibit daily fluctuations in expression levels, making circadian expression rhythms the largest known regulatory network in normal physiology. Cell-autonomous circadian clocks interact with daily light-dark and feeding-fasting cycles to generate approximately 24-hour oscillations in the function of thousands of genes. Circadian expression of secreted molecules and signaling components transmits timing information between cells and tissues. Such intra- and intercellular daily rhythms optimize physiology both by managing energy use and by temporally segregating incompatible processes. Experimental animal models and epidemiological data indicate that chronic circadian rhythm disruption increases the risk of metabolic diseases. Conversely, time-restricted feeding, which imposes daily cycles of feeding and fasting without caloric reduction, sustains robust diurnal rhythms and can alleviate metabolic diseases. These findings highlight an integrative role of circadian rhythms in physiology and offer a new perspective for treating chronic diseases in which metabolic disruption is a hallmark. Copyright © 2016, American Association for the Advancement of Science.

  2. [Gases in vitreoretinal surgery]. (United States)

    Janco, L; Vida, R; Bartos, M; Villémová, K; Izák, M


    To evaluate the importance and benefits of using gases in vitreoretinal surgery. The gases represent a wide group of substances used in eye surgery for more than 100 years. The role of intraocular gases in vitreoretinal surgery is irreplaceable. Their use is still considered to be the "gold standard". An important step in eye surgery was the introduction of expanding gases--sulfur hexafluoride and perfluorocarbons into routine clinical practice. The most common indications for the use of intraocular gases are: retinal detachment, idiopathic macular hole, complications of vitreoretinal surgery and others. The introduction of intraocular gases into routine clinical practice, along with other modern surgical techniques resulted in significant improvement of postoperative outcomes in a wide range of eye diseases. Understanding the principles of intraocular gases use brings the benefits to the patient and physician as well. Due to their physical and chemical properties they pose far the best and most appropriate variant of intraocular tamponade. Gases also bring some disadvantages, such as difficulties in detailed fundus examination, visual acuity testing, ultrasonographic examination, difficulties in application of intravitreal drugs or reduced possibility of retina laser treatment. The gases significantly change optical system properties of the eye. The use of gases in vitreoretinal surgery has significantly increased success rate of retinal detachment surgery, complicated posterior segment cases, trauma, surgery of the macula and other diseases.

  3. Bariatric Surgery for Obesity. (United States)

    le Roux, Carel W; Heneghan, Helen M


    In this review, the authors discuss the indications for and the published outcomes of commonly performed bariatric procedures, including weight loss, perioperative morbidity and mortality, late complications, as well as the impact of bariatric surgery on comorbidities, cardiovascular risk, and mortality. They also briefly discuss the mechanisms by which bariatric/metabolic surgery causes such significant weight loss and health gain. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. The Effects Of An Exercise Physiology Program on Physical Fitness Variables, Body Satisfaction, and Physiology Knowledge. (United States)

    Perry, Arlette C.; Rosenblatt, Evelyn S.; Kempner, Lani; Feldman, Brandon B.; Paolercio, Maria A.; Van Bemden, Angie L.


    Examined the effects of an exercise physiology program on high school students' physical fitness, body satisfaction, and physiology knowledge. Intervention students received exercise physiology theory and active aerobic and resistance exercise within their biology course. Data from student surveys and measurements indicated that the integrated…

  5. Corrective Jaw Surgery

    Medline Plus

    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 ...


    African Journals Online (AJOL)

    in the endoscopy room. GENERAL SURGERY. T du Toit, O C Buchel, S J A Smit. Department of Surgery, University of the Free State, Bloemfontein, ... The lack of video instrumentation in developing countries: Redundant fibre-optic instruments (the old. “eye scope”) are still being used. This instrument brings endoscopists ...


    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.

  8. Choosing surgery

    DEFF Research Database (Denmark)

    Thorstensson, Carina; Lohmander, L; Frobell, Richard


    -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...

  9. Índices fisiológicos e de crescimento de um porta-enxerto de aceroleira sob estresse salino Physiological and growth indices of a West Indian Cherry rootstock under saline stress

    Directory of Open Access Journals (Sweden)

    Marcelo T. Gurgel


    Full Text Available Na literatura há registros de variações na fisiologia e no desenvolvimento de genótipos diversos em condições de estresse salino. Não se encontrando informações nesse sentido, sobre aceroleira, conduziu-se este trabalho com o objetivo de se avaliar os efeitos da salinidade sobre o clone BV1, através de variáveis fisiológicas e de crescimento, na fase de formação de porta-enxerto. Os estudos foram realizados no Campo Experimental de Pacajus (EMBRAPA, na cidade de Pacajus, CE, testando-se seis níveis de salinidade da água de irrigação (condutividade elétrica, variando de 0,5 a 5,5 dS m-1, preparada mantendo-se a proporção 7:2:1 entre Na:Ca:Mg, respectivamente. O sistema radicular da aceroleira é mais sensível à salinidade que a parte aérea, assim como a fitomassa seca total quando comparada com a área foliar. A eficiência da aceroleira em produzir matéria nova por unidade de matéria preexistente, aumenta com a elevação do nível de salinidade da água de irrigação. A velocidade de crescimento e a fotossíntese líquida da aceroleira decrescem com o aumento do estresse salino.It is known that the physiological behavior of the plants under saline stress conditions vary among genotypes. Considering non existence of references about effect of salinity in West Indian Cherry plants, the objective of this study was to evaluate such effects on the growth and physiology of the clone BV1 rootstock. The studies were carried out at the Experimental Center of Pacajus (EMBRAPA, in the city of Pacajus - CE. The treatments studied were six levels of salinity of the irrigation water (electrical conductivity varying from 0.5 to 5.5 dS m-1. The results obtained show that the efficiency of the West Indian Cherry to produce new matter in relation to preexisting increases with the elevation of salinity. The root system of the West Indian Cherry is more affected than the aerial parts by water salinity. The growth velocity and the net

  10. Cataract Surgery (United States)

    ... Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology ... Are Cataracts? Pediatric Cataracts Cataract Diagnosis and Treatment Cataract Surgery IOL Implants: Lens Replacement After Cataracts ...

  11. Brain surgery (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  12. Foot Surgery (United States)

    ... coding trends along with compliance guidelines and practice marketing materials, APMA has you covered whether you are ... crutches after the surgery or in a cast. Fusions: Fusions are usually performed to treat arthritic or ...

  13. Hemorrhoid surgery (United States)

    ... this page: // Hemorrhoid surgery To use the sharing features on this page, please enable JavaScript. Hemorrhoids are swollen veins around the anus. They may ...


    African Journals Online (AJOL)

    Department of Plastic and Reconstructive Surgery Sefako Makgatho Health Science University, ... We report on a pilot study on the use of a circumareolar excision and the use of .... and 1 gynecomastia patient) requested reduction in NAC size.


    African Journals Online (AJOL)

    influence medical students in pursuing a career in surgery. ... training, females reported significantly higher levels of agreement that surgical training would be better overseas when ..... mentoring surgical research or educational lectures and.


    African Journals Online (AJOL)

    1 Department of Surgery, Nelson R Mandela School of Medicine, University of ... in 51 reports. Four reports were illegible; one was conducted by a junior consultant, two by a fourth year trainee specialist ... The study period was 12 months from.

  17. Laparoscopic bariatric surgery for the treatment of severe hypertriglyceridemia

    Directory of Open Access Journals (Sweden)

    Sung-Yu Hsu


    Conclusion: Bariatric surgery can be successfully used as a metabolic surgery in severe hypertriglyceridemia patients at risk of acute pancreatitis. However, control of triglyceride levels prior to bariatric surgery is indicated.

  18. Comparação de indicadores físicos e fisiológicos entre atletas profissionais de futsal e futebol Comparison of physical and physiological indicators between professional futsal and soccer athletes

    Directory of Open Access Journals (Sweden)

    Renan Felipe Hartmann Nunes


    Full Text Available Muitos profissionais do esporte periodizam o treinamento do futebol e do futsal de forma semelhante. Todavia, pouco se conhece das respostas físicas e fisiológicas dos atletas de futsal. Esse estudo comparou perfil antropométrico, capacidade aeróbia e produção de potência entre atletas profissionais de futsal e futebol. Onze jogadores de futsal (idade 24,1±2,4anos e 21 jogadores de futebol (idade 22,6±3,6anos do sexo masculino submeteram-se a duas sessões experimentais: (I avaliação antropométrica, teste de esforço máximo em esteira e (II teste de velocidade de 30 metros (capacidade de sprint repetido, CSR. Empregou-se teste t para amostras independentes, permitindo verificar possíveis diferenças entre as modalidades (pMany professional sports training periodize soccer and futsal similarly. However, little is known about physical and physiological responses of futsal players. This study compared anthropometric, aerobic capacity and power production among professional indoor and outdoor soccer players. Eleven futsal players (age 24.1±2.4 years and 21 soccer players (age 22.6±3.6 years males underwent two experimental sessions: (i anthropometric measurements, maximal effort test treadmill and (II test speed of 30 meters (repeated sprint ability, CSA. It was applied t-test for independent samples to verify possible differences between the modalities (p>0,05. The futsal players showed higher values of HR VT (177,2±10 e 67,1±10,8 bpm VO2max ;VO2VT; %VO2max (62,5±4,3 e 52,1±4,6; 58,7±5,6 e 43,1±4,6; 76±8,4 e 93,9±5,3 ml·kg-1·min-1 compared with soccer players, respectively. These results demonstrate the need for specific methods of training for outdoor and indoor soccer.

  19. Chewing Over Physiology Integration (United States)

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


    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…

  20. Plant Physiology in Greenhouses

    NARCIS (Netherlands)

    Heuvelink, E.; Kierkels, T.


    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

  1. Metabolic surgery: quo vadis? (United States)

    Ramos-Leví, Ana M; Rubio Herrera, Miguel A


    The impact of bariatric surgery beyond its effect on weight loss has entailed a change in the way of regarding it. The term metabolic surgery has become more popular to designate those interventions that aim at resolving diseases that have been traditionally considered as of exclusive medical management, such as type 2 diabetes mellitus (T2D). Recommendations for metabolic surgery have been largely addressed and discussed in worldwide meetings, but no definitive consensus has been reached yet. Rates of diabetes remission after metabolic surgery have been one of the most debated hot topics, with heterogeneity being a current concern. This review aims to identify and clarify controversies regarding metabolic surgery, by focusing on a critical analysis of T2D remission rates achieved with different bariatric procedures, and using different criteria for its definition. Indications for metabolic surgery for patients with T2D who are not morbidly obese are also discussed. Copyright © 2013 SEEN. Published by Elsevier Espana. All rights reserved.

  2. [Nutritional implications of bariatric surgery on the gastrointestinal tract]. (United States)

    Rubio, M A; Moreno, C


    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.

  3. Doppler radar physiological sensing

    CERN Document Server

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


    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.

  4. Tennis elbow surgery (United States)

    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 ...

  5. Corrective Jaw Surgery

    Medline Plus

    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 ...

  6. Mohs micrographic surgery (United States)

    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 ...

  7. Restoration of the jawline and the neck after bariatric surgery. (United States)

    Sclafani, Anthony P


    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.

  8. Intestinal Surgery. (United States)

    Desrochers, André; Anderson, David E


    A wide variety of disorders affecting the intestinal tract in cattle may require surgery. Among those disorders the more common are: intestinal volvulus, jejunal hemorrhage syndrome and more recently the duodenal sigmoid flexure volvulus. Although general principles of intestinal surgery can be applied, cattle has anatomical and behavior particularities that must be known before invading the abdomen. This article focuses on surgical techniques used to optimize outcomes and discusses specific disorders of small intestine. Diagnoses and surgical techniques presented can be applied in field conditions. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. CT after transsphenoidal surgery

    International Nuclear Information System (INIS)

    Tazawa, Satoru


    Two hundred and ten CT studies of 95 patients after transsphenoidal surgery were reviewed. Spheno-ethmoid opacificaiton, intrasellar hematoma and gas bubbles were noted within 2 weeks after surgery. Bone defect of the sellar floor and bone stent were seen on coronal scans in most cases. The packing material frequently disappeared on follow-up studies. Hormonal assessment of the functioning tumor, according to which the effect of treatment was evaluated, was correlated with CT findings. Because differentiation between postoperative changes and residual mass was difficult, there was no definite CT criteria to indicate residual functioning tumor except upward convexity of the diaphragma sellae on CT more than 3 months after surgery. Initial follow up CT study is recommended to be performed at about 3 months after surgery, at which time the immediate postoperative inflammatory changes have been disappeared. The incidence of recurrence was 3/47 (6%), which was shown on follow-up CT from 4 to 10 years after surgery. Therefore, subsequent CT study should be done in every year or two, taking the clinical symptoms and hormonal data into consideration. (author)

  10. Innovations in Bariatric Surgery. (United States)

    Zhu, Catherine; Pryor, Aurora D


    Surgery has consistently been demonstrated to be the most effective long-term therapy for the treatment of obesity. However, despite excellent outcomes with current procedures, most patients with obesity- and weight-related comorbidities who meet criteria for surgical treatment choose not to pursue surgery out of fear of operative risks and complications or concerns about high costs. Novel minimally invasive procedures and devices may offer alternative solutions for patients who are hesitant to pursue standard surgical approaches. These procedures may be used for primary treatment of obesity, early intervention for patients approaching morbid obesity, temporary management prior to bariatric surgery, or revision of bypass surgery associated with weight regain. Novel bariatric procedures can in general be divided into four categories: endoluminal space-occupying devices, gastric suturing and restrictive devices, absorption-limiting devices, and neural-hormonal modulating devices. Many of these are only approved as short-term interventions, but these devices may be effective for patients desiring low-risk procedures or a transient effect. We will see the expansion of indications and alternatives for metabolic surgery as these techniques gain approval.

  11. CT after transsphenoidal surgery

    Energy Technology Data Exchange (ETDEWEB)

    Tazawa, Satoru [Tohoku Univ., Sendai (Japan). School of Medicine


    Two hundred and ten CT studies of 95 patients after transsphenoidal surgery were reviewed. Spheno-ethmoid opacificaiton, intrasellar hematoma and gas bubbles were noted within 2 weeks after surgery. Bone defect of the sellar floor and bone stent were seen on coronal scans in most cases. The packing material frequently disappeared on follow-up studies. Hormonal assessment of the functioning tumor, according to which the effect of treatment was evaluated, was correlated with CT findings. Because differentiation between postoperative changes and residual mass was difficult, there was no definite CT criteria to indicate residual functioning tumor except upward convexity of the diaphragma sellae on CT more than 3 months after surgery. Initial follow up CT study is recommended to be performed at about 3 months after surgery, at which time the immediate postoperative inflammatory changes have been disappeared. The incidence of recurrence was 3/47 (6%), which was shown on follow-up CT from 4 to 10 years after surgery. Therefore, subsequent CT study should be done in every year or two, taking the clinical symptoms and hormonal data into consideration. (author).


    African Journals Online (AJOL)

    surgery. Since the first laparoscopic treatment of hydatid disease was described in 1992,14 there has been a steady growth in reports of the laparoscopic treatment of hydatid cysts of liver. Although early reported laparoscopic treatment of liver hydatid disease was confined to simple drainage, more advanced laparoscopic ...


    African Journals Online (AJOL)

    Department of Surgery, University of Cape Town Health Sciences Faculty, Groote Schuur Hospital, Observatory, Cape Town,. South Africa ... included all district, regional and tertiary hospitals in the nine provinces. Clinics and so-called ..... large contingency of senior general surgeons from countries such as Cuba, who have ...


    African Journals Online (AJOL)

    meet the criteria for damage control surgery, and ligation of the AVC is a .... There were two vertebral body fractures, one penetrating brain injury from a gunshot wound to the head, one ... two hand fractures, three haemothoraces, one pelvic fracture, .... One patient with an intimal flap injury to his left common iliac artery ...


    African Journals Online (AJOL)

    Schwab , using a three-phase approach.5 In 1998, Moore et al. extended the concept and described the five-stage approach.6. The aim of damage control surgery is to prevent severely injured patients from developing the “lethal triad” of hypothermia, coagulopathy and worsening acidosis, as this confers a dismal prognosis ...

  16. Rodding Surgery (United States)

    ... Physical activity prior to surgery,  Length of the operation; anesthesia issues,  Reason for the choice of rod,  Time in the hospital,  Length of recovery time at home,  Pain management including control of muscle spasms,  The rehabilitation plan. ...

  17. Empirical Productivity Indices and Indicators

    NARCIS (Netherlands)

    B.M. Balk (Bert)


    textabstractThe empirical measurement of productivity change (or difference) by means of indices and indicators starts with the ex post profit/loss accounts of a production unit. Key concepts are profit, leading to indicators, and profitability, leading to indices. The main task for the productivity

  18. Carotid artery surgery (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 ...

  19. Epilepsy surgery: Recommendations for India

    Directory of Open Access Journals (Sweden)

    Chandra P


    Full Text Available The following article recommends guidelines for epilepsy surgery for India. This article reviews the indications, the various surgical options available and the outcome of surgery for drug resistant epilepsy based on current evidence. Epilepsy surgery is a well-established option for patients who have been diagnosed to have drug resistant epilepsy (DRE (on at least two appropriate, adequate anti-epileptic drugs (AEDs (either in monotherapy or in combination with continuing seizures, where the presurgical work-up has shown concordance of structural imaging (magnetic resonance imaging and electrical mapping data (electroencephalography (EEG, video EEG. There may be a requirement of functional imaging techniques in a certain number of DRE like positron emission tomography (PET, single photon emission tomography, (SPECT. Invasive monitoring should be restricted to a few when all noninvasive investigations are inconclusive, there is a dual pathology or there is a discordance of noninvasive data. The types of surgery could be curative (resective surgeries: amygdalo hippocampectomy, lesionectomy and multilobar resections; functional surgeries: hemispherotomy and palliative (multiple subpial transaction, corpus callosotomy, vagal nerve stimulation. Epilepsy surgery in indicated cases has a success range from 50 to 86% in achieving seizure freedom as compared with < 5% success rate with AEDs only in persons with DRE. Centers performing surgery should be categorized into Level I and Level II.

  20. Indications for coronary angiography

    International Nuclear Information System (INIS)

    Kaltenbach, M.; Vallbracht, C.


    Today selective coronary angiography, introduced by Sones in 1957, is used as clinical routine for diagnosing morphological changes in the coronary arteries. Hitherto, more recent techniques such as digital subtraction angiography cannot provide comparable information. Strict criteria for its indication depending on possible therapeutic consequences, have to be applied, although the risk is low with a letality of 0.01 to 0.05 percent. Radionuclear investigations can be used as additional tool in selected cases. The careful indication for coronary angiography usually implies the possible need for coronary bypass graft surgery of balloon angioplasty. (orig./MG) [de

  1. Do Food Preferences Change After Bariatric Surgery? (United States)

    Gero, Daniel; Steinert, Robert E; le Roux, Carel W; Bueter, Marco


    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.

  2. Advances in physiological computing

    CERN Document Server

    Fairclough, Stephen H


    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.

  3. Phun Week: Understanding Physiology (United States)

    Limson, Mel; Matyas, Marsha Lakes


    Topics such as sports, exercise, health, and nutrition can make the science of physiology relevant and engaging for students. In addition, many lessons on these topics, such as those on the cardiovascular, respiratory, and digestive systems, align with national and state life science education standards. Physiology Understanding Week (PhUn…

  4. Emergency surgery for Crohn's disease. (United States)

    Smida, Malek; Miloudi, Nizar; Hefaiedh, Rania; Zaibi, Rabaa


    Surgery has played an essential role in the treatment of Crohn's disease. Emergency can reveal previously unknown complications whose treatment affects prognosis. Indicate the incidence of indications in emergent surgery for Crohn's disease. Specify the types of procedures performed in these cases and assess the Results of emergency surgery for Crohn's disease postoperatively,  in short , medium and long term. Retrospective analysis of collected data of 38 patients, who underwent surgical resection for Crohn's disease during a period of 19 years from 1992 to 2011 at the department of surgery in MONGI SLIM Hospital, and among them 17 patients underwent emergency surgery for Crohn's disease. In addition to socio-demographic characteristics and clinical presentations of our study population, we evaluated the indications, the type of intervention, duration of evolution preoperative and postoperative complications and overall prognosis of the disease. Of the 38 patients with Crohn's disease requiring surgical intervention, 17/38 patients underwent emergency surgery. Crohn's disease was inaugurated by the complications requiring emergency surgery in 11 patients. The mean duration of symptoms prior to surgery was 1.5 year. The most common indication for emergency surgery was acute intestinal obstruction (n=6) followed by perforation and peritonitis (n=5). A misdiagnosis of appendicitis was found in 4 patients and a complicated severe acute colitis for undiagnosed Crohn's disease was found in 2 cases. The open conventional surgery was performed for 15 patients. Ileocolic resection was the most used intervention. There was one perioperative mortality and 5 postoperative morbidities. The mean of postoperative hospital stay was 14 days (range 4-60 days). Six patients required a second operation during the follow-up period. The incidence of emergency surgery for Crohn's disease in our experience was high (17/38 patients), and is not as rare as the published estimates

  5. Waste indicators

    Energy Technology Data Exchange (ETDEWEB)

    Dall, O.; Lassen, C.; Hansen, E. [Cowi A/S, Lyngby (Denmark)


    The Waste Indicator Project focuses on methods to evaluate the efficiency of waste management. The project proposes the use of three indicators for resource consumption, primary energy and landfill requirements, based on the life-cycle principles applied in the EDIP Project. Trial runs are made With the indicators on paper, glass packaging and aluminium, and two models are identified for mapping the Danish waste management, of which the least extensive focuses on real and potential savings. (au)

  6. Waste indicators

    International Nuclear Information System (INIS)

    Dall, O.; Lassen, C.; Hansen, E.


    The Waste Indicator Project focuses on methods to evaluate the efficiency of waste management. The project proposes the use of three indicators for resource consumption, primary energy and landfill requirements, based on the life-cycle principles applied in the EDIP Project. Trial runs are made With the indicators on paper, glass packaging and aluminium, and two models are identified for mapping the Danish waste management, of which the least extensive focuses on real and potential savings. (au)

  7. Preparing for Surgery (United States)

    ... 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 ...

  8. Corrective Jaw Surgery

    Medline Plus

    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 ...

  9. Corrective Jaw Surgery (United States)

    ... 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 ...

  10. Corrective Jaw Surgery

    Medline Plus

    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 ...

  11. Facial Cosmetic Surgery (United States)

    ... 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 ...

  12. Heart bypass surgery (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 - ...

  13. Quality indicators

    DEFF Research Database (Denmark)

    Hjorth-Andersen, Christian


    In recent literature it has been suggested that consumers need have no knowledge of product quality as a number of quality indicators (or signals) may be used as substitutes. Very little attention has been paid to the empirical verification of these studies. The present paper is devoted...... to the issue of how well these indicators perform, using market data provided by consumer magazines from 3 countries. The results strongly indicate that price is a poor quality indicator. The paper also presents some evidence which suggests that seller reputation and easily observable characteristics are also...

  14. Personalities in female domesticated pigs : behavioural and physiological indications

    NARCIS (Netherlands)

    Ruis, Marko A W; te Brake, J.H.A.; van de Burgwal, J.A.; de Jong, Ingrid C; Blokhuis, H.J; Koolhaas, Jaap M.

    The inconclusive evidence so far on the existence of distinct personality types in domesticated pigs, led us to perform the present experiment. A total of 128 gilts from 31 sows were systematically studied from birth to slaughter in two identical trials. Intra-test consistency in individual

  15. Application of physiological and biochemical indices as a screening ...

    African Journals Online (AJOL)

    With a view to understanding the traits which can be used as a quick criteria for drought tolerance, field and laboratory experiments were used to evaluate nine wheat (Triticum aestivum L.) genotypes; seven local varieties with two introduced genotypes from International Center for Agricultural Research in the Dry Areas ...

  16. Genetic analysis of field and physiological indicators of drought ...

    African Journals Online (AJOL)



    Oct 10, 2011 ... and the quantum yield was recorded after dark adaptation using a. MINI-PAM ... Quantum yield = Fv / Fm ..... quantum yield of photosynthetic electron transport and quenching of ... The theory and analysis of diallel crosses.

  17. General indicators

    International Nuclear Information System (INIS)


    This document summarizes the main 2002 energy indicators for France. A first table lists the evolution of general indicators between 1973 and 2002: energy bill, price of imported crude oil, energy independence, primary and final energy consumption. The main 2002 results are detailed separately for natural gas, petroleum and coal (consumption, imports, exports, production, stocks, prices). (J.S.)

  18. Surgery of the Forestomach. (United States)

    Lozier, Joseph W; Niehaus, Andrew J


    Indications for rumen surgery include rumen tympany (bloat), toxic plant ingestion, to provide enteral nutrition, to perform elective cannula placement, and to access other forestomach compartments (reticulum/omasum). The rumen is a highly contaminated viscus and special care should be taken to avoid peritoneal contamination from rumen contents. Diseases causing forestomach dysfunction and surgical procedures on the forestomach compartments are discussed here. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Solar Indices (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Collection includes a variety of indices related to solar activity contributed by a number of national and private solar observatories located worldwide. This...

  20. Anaesthetic Management of Conjoined Twins′ Separation Surgery

    Directory of Open Access Journals (Sweden)

    Kolli S Chalam


    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.

  1. Reproduction, physiology and biochemistry (United States)

    This chapter summarizes fundamental knowledge and recent discoveries about the reproduction, physiology and biochemistry of plant-parasitic nematodes. Various types of reproduction are reviewed, including sexual reproduction and mitotic and meiotic parthenogenesis. Although much is known about the p...

  2. Endogenous Pyrogen Physiology. (United States)

    Beisel, William R.


    Discusses the physiology of endogenous pyrogen (EP), the fever-producing factor of cellular origin. Included are: its hormone-like role, its molecular nature, bioassay procedures, cellular production and mechanisms of EP action. (SA)

  3. Antifibrinolytics in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Achal Dhir


    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.

  4. Biophysics and cell physiology

    International Nuclear Information System (INIS)

    Mazur, P.


    Progress is reported on research activities in the fields of physiology and low-temperature biology of mammalian embryos; effects of sub-zero temperatures on eggs and embryos of sea urchins; survival of frozen-thawed human red cells; effects of radiation on physiology of Escherichia coli; transfer of triplet electronic energy in dinucleotides; effects of x radiation on DNA degradation; energy deposition by neutrons; photosynthesis; excision repair of uv-induced pyrimidine dimers in DNA of plant cells

  5. Physiology of Ramadan fasting


    Shokoufeh Bonakdaran


    Considering the emphasis of Islam on the importance of fasting, Muslims attempt to fast from dawn until sunset during the holy month of Ramadan. Fasting is associated with several benefits for normal and healthy individuals. However, it could pose high risks to the health of diabetic patients due to certain physiological changes. This study aimed to compare the physiological changes associated with fasting in healthy individuals and diabetic patients during Ramadan. Furthermore, we reviewed t...

  6. Surgery for trigger finger. (United States)

    Fiorini, Haroldo Junior; Tamaoki, Marcel Jun; Lenza, Mário; Gomes Dos Santos, Joao Baptista; Faloppa, Flávio; Belloti, Joao Carlos


    injection group compared with 38/56 (or 678 per 1000; ranging from 366 to 1000) in the open surgery group, RR 3.69 (95% CI 1.99 to 6.85), for an absolute risk difference that 49% more had pain with open surgery (33% to 66% more); relative change translates to worsening of 269% (585% to 99% worse) (one trial, 105 participants).Because of very low quality evidence from two trials we are uncertain whether open surgery improve resolution of trigger finger in the follow-up at six to 12 months, when compared with steroid injection (131/140 observed in the open surgery group compared with 80/130 in the control group; RR 1.48, 95% CI 0.79 to 2.76); evidence was downgraded due to study design flaws, inconsistency and imprecision. Low-quality evidence from two trials and few event rates (270 participants) from six up to 12 months of follow-up, we are uncertain whether open surgery increased the risk of adverse events (incidence of infection, tendon injury, flare, cutaneous discomfort and fat necrosis) (18/140 observed in the open surgery group compared with 17/130 in the control group; RR 1.02, 95% CI 0.57 to 1.84) and neurovascular injury (9/140 observed in the open surgery group compared with 4/130 in the control group; RR 2.17, 95% CI 0.7 to 6.77). Twelve participants (8 versus 4) did not complete the follow-up, and it was considered that they did not have a positive outcome in the data analysis. We are uncertain whether open surgery was more effective than steroid injection in improving hand function or participant satisfaction as studies did not report these outcomes. Low-quality evidence indicates that, compared with steroid injection, open surgical treatment in people with trigger finger, may result in a less recurrence rate from six up to 12 months following the treatment, although it increases the incidence of pain during the first follow-up week. We are uncertain about the effect of open surgery with regard to the resolution rate in follow-up at six to 12 months, compared

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

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


    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.

  8. 30 Years of Robotic Surgery. (United States)

    Leal Ghezzi, Tiago; Campos Corleta, Oly


    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.

  9. Personalized physiological medicine. (United States)

    Ince, Can


    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.

  10. Applications of piezoelectric surgery in endodontic surgery: a literature review. (United States)

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


    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.

  11. 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

  12. 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.


    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

  13. Virtual Reality for Pain Management in Cardiac Surgery (United States)

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


    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

  14. Revisional Bariatric Surgery. (United States)

    Switzer, Noah J; Karmali, Shahzeer; Gill, Richdeep S; Sherman, Vadim


    Revisional bariatric procedures are increasingly common. With more primary procedures being performed to manage severe obesity and its complications, 5% to 8% of these procedures will fail, requiring revisional operation. Reasons for revisional bariatric surgery are either primary inadequate weight loss, defined as less than 25% excess body weight loss, or weight recidivism, defined as a gain of more than 10 kg based on the nadir weight; however, each procedure also has inherit specific complications that can also be indications for revision. This article reviews the history of each primary bariatric procedure, indications for revision, surgical options, and subsequent outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Advanced Applications of Robotics in Digestive Surgery (United States)

    Patriti, Alberto; Addeo, Pietro; Buchs, Nicolas; Casciola, Luciano; Morel, Philippe


    Laparoscopy is widely recognized as feasible and safe approach to many oncologic and benign digestive conditions and is associated with an improved early outcome. Robotic surgery promises to overcome intrinsic limitations of laparoscopic surgery by a three-dimensional view and wristed instruments widening indications for a minimally invasive approach. To date, the more interesting applications of robotic surgery are those operations restricted to one abdominal quadrant and requiring a fine dissection and digestive reconstruction. While robot-assisted rectal and gastric surgery are becoming well-accepted options among the surgical community, applications of robotics in hepato-biliary and pancreatic surgery are still debated. PMID:23905029

  16. Operational indicators

    International Nuclear Information System (INIS)


    The chapter presents the operational indicators related to budget, travel costs and tickets, the evolution of the annual program for regulatory inspection, the scientific production, requested patents and the numbers related to the production of the services offered by the Institution

  17. Laboratory reptile surgery: principles and techniques. (United States)

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


    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.

  18. Physiologic stress interventions in cardiac imaging

    International Nuclear Information System (INIS)

    Buda, A.J.


    Physiologic stress interventions are designed to assess the reserve capability of coronary flow and myocardial function. In the normal individual, a sufficiently intense physiologic stress may increase coronary flow and cardiac output by 500% to 600%. However, in patients with cardiac disease, these reserve responses may be absent, or considerably blunted. Thus, physiologic stress testing has proved extremely helpful in detecting cardiac abnormalities when resting cardiac function appears normal. Although dynamic exercise remains the standard approach to physiologic stress testing, a number of other interventions have been used, including: (1) isometric exercise, (2) atrial pacing, (3) cold pressor testing, (4) postextrasystolic potentiation, (5) volume loading, and (6) negative intrathoracic pressure. Each of these may be considered an alternative physiologic intervention whenever dynamic exercise is not feasible. These alternative approaches are important since, in our experience, 20% to 30% of subjects are unable to perform dynamic exercise, or exercise inadequately to produce a sufficiently intense cardiac stress. This chapter reviews physiologic considerations, indications, contraindications, protocols, and results of these physiologic stress interventions when used in combination with cardiac radionuclide procedures

  19. Human physiology in space (United States)

    Vernikos, J.


    The universality of gravity (1 g) in our daily lives makes it difficult to appreciate its importance in morphology and physiology. Bone and muscle support systems were created, cellular pumps developed, neurons organised and receptors and transducers of gravitational force to biologically relevant signals evolved under 1g gravity. Spaceflight provides the only microgravity environment where systematic experimentation can expand our basic understanding of gravitational physiology and perhaps provide new insights into normal physiology and disease processes. These include the surprising extent of our body's dependence on perceptual information, and understanding the effect and importance of forces generated within the body's weightbearing structures such as muscle and bones. Beyond this exciting prospect is the importance of this work towards opening the solar system for human exploration. Although both appear promising, we are only just beginning to taste what lies ahead.

  20. Plant Physiology and Development

    DEFF Research Database (Denmark)

    Taiz, Lincoln; Zeiger, Eduardo; Møller, Ian Max

    Throughout its twenty-two year history, the authors of Plant Physiology have continually updated the book to incorporate the latest advances in plant biology and implement pedagogical improvements requested by adopters. This has made Plant Physiology the most authoritative, comprehensive......, and widely used upper-division plant biology textbook. In the Sixth Edition, the Growth and Development section (Unit III) has been reorganized and expanded to present the complete life cycle of seed plants from germination to senescence. In recognition of this enhancement, the text has been renamed Plant...... Physiology and Development. As before, Unit III begins with updated chapters on Cell Walls and Signals and Signal Transduction. The latter chapter has been expanded to include a discussion of major signaling molecules, such as calcium ions and plant hormones. A new, unified chapter entitled Signals from...

  1. Perioperative factors associated with pressure ulcer development after major surgery (United States)


    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

  2. Simultaneous versus sequential penetrating keratoplasty and cataract surgery. (United States)

    Hayashi, Ken; Hayashi, Hideyuki


    To compare the surgical outcomes of simultaneous penetrating keratoplasty and cataract surgery with those of sequential surgery. Thirty-nine eyes of 39 patients scheduled for simultaneous keratoplasty and cataract surgery and 23 eyes of 23 patients scheduled for sequential keratoplasty and secondary phacoemulsification surgery were recruited. Refractive error, regular and irregular corneal astigmatism determined by Fourier analysis, and endothelial cell loss were studied at 1 week and 3, 6, and 12 months after combined surgery in the simultaneous surgery group or after subsequent phacoemulsification surgery in the sequential surgery group. At 3 and more months after surgery, mean refractive error was significantly greater in the simultaneous surgery group than in the sequential surgery group, although no difference was seen at 1 week. The refractive error at 12 months was within 2 D of that targeted in 15 eyes (39%) in the simultaneous surgery group and within 2 D in 16 eyes (70%) in the sequential surgery group; the incidence was significantly greater in the sequential group (P = 0.0344). The regular and irregular astigmatism was not significantly different between the groups at 3 and more months after surgery. No significant difference was also found in the percentage of endothelial cell loss between the groups. Although corneal astigmatism and endothelial cell loss were not different, refractive error from target refraction was greater after simultaneous keratoplasty and cataract surgery than after sequential surgery, indicating a better outcome after sequential surgery than after simultaneous surgery.

  3. Cassava biology and physiology. (United States)

    El-Sharkawy, Mabrouk A


    Cassava or manioc (Manihot esculenta Crantz), a perennial shrub of the New World, currently is the sixth world food crop for more than 500 million people in tropical and sub-tropical Africa, Asia and Latin America. It is cultivated mainly by resource-limited small farmers for its starchy roots, which are used as human food either fresh when low in cyanogens or in many processed forms and products, mostly starch, flour, and for animal feed. Because of its inherent tolerance to stressful environments, where other food crops would fail, it is often considered a food-security source against famine, requiring minimal care. Under optimal environmental conditions, it compares favorably in production of energy with most other major staple food crops due to its high yield potential. Recent research at the Centro Internacional de Agricultura Tropical (CIAT) in Colombia has demonstrated the ability of cassava to assimilate carbon at very high rates under high levels of humidity, temperature and solar radiation,which correlates with productivity across all environments whether dry or humid. When grown on very poor soils under prolonged drought for more than 6 months, the crop reduce both its leaf canopy and transpiration water loss, but its attached leaves remain photosynthetically active, though at greatly reduced rates. The main physiological mechanism underlying such a remarkable tolerance to drought was rapid stomatal closure under both atmospheric and edaphic water stress, protecting the leaf against dehydration while the plant depletes available soil water slowly during long dry periods. This drought tolerance mechanism leads to high crop water use efficiency values. Although the cassava fine root system is sparse, compared to other crops, it can penetrate below 2 m soil,thus enabling the crop to exploit deep water if available. Leaves of cassava and wild Manihot possess elevated activities of the C4 enzyme PEP carboxylase but lack the leaf Kranz anatomy typical of C4

  4. Using virtual reality to control preoperative anxiety in ambulatory surgery patients: A pilot study in maxillofacial and plastic surgery. (United States)

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


    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.

  5. 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 ...

  6. 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 ...

  7. Tennis elbow surgery - discharge (United States)

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed a ...

  8. Lung surgery - discharge (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. ...

  9. Gastric Sleeve Surgery (United States)

    ... 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 ...

  10. Hip Replacement Surgery (United States)

    ... 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 ...

  11. Dental Implant Surgery (United States)

    ... 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 ...

  12. Corrective Jaw Surgery

    Medline Plus

    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 ...

  13. Corrective Jaw Surgery

    Medline Plus

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Giulio Gasparini


    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.

  15. Computational Modeling in Liver Surgery

    Directory of Open Access Journals (Sweden)

    Bruno Christ


    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.

  16. 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 ...

  17. Simulated Exercise Physiology Laboratories. (United States)

    Morrow, James R., Jr.; Pivarnik, James M.

    This book consists of a lab manual and computer disks for either Apple or IBM hardware. The lab manual serves as "tour guide" for the learner going through the various lab experiences. The manual contains definitions, proper terminology, and other basic information about physiological principles. It is organized so a step-by-step procedure may be…

  18. Physiology Flies with Time. (United States)

    Sehgal, Amita


    The 2017 Nobel Prize in Medicine or Physiology has been awarded to Jeffrey Hall, Michael Rosbash, and Michael Young for elucidating molecular mechanisms of the circadian clock. From studies beginning in fruit flies, we now know that circadian regulation pervades most biological processes and has strong ties to human health and disease. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Personalized physiological medicine

    NARCIS (Netherlands)

    Ince, Can


    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

  20. Physiological responses to hypothermia. (United States)

    Wood, Thomas; Thoresen, Marianne


    Therapeutic hypothermia is the only treatment currently recommended for moderate or severe encephalopathy of hypoxic‒ischaemic origin in term neonates. Though the effects of hypothermia on human physiology have been explored for many decades, much of the data comes from animal or adult studies; the latter originally after accidental hypothermia, followed by application of controlled hypothermia after cardiac arrest or trauma, or during cardiopulmonary bypass. Though this work is informative, the effects of hypothermia on neonatal physiology after perinatal asphyxia must be considered in the context of a prolonged hypoxic insult that has already induced a number of significant physiological sequelae. This article reviews the effects of therapeutic hypothermia on respiratory, cardiovascular, and metabolic parameters, including glycaemic control and feeding requirements. The potential pitfalls of blood‒gas analysis and overtreatment of physiological changes in cardiovascular parameters are also discussed. Finally, the effects of hypothermia on drug metabolism are covered, focusing on how the pharmacokinetics, pharmacodynamics, and dosing requirements of drugs frequently used in neonatal intensive care may change during therapeutic hypothermia. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. The Face of Physiology

    Directory of Open Access Journals (Sweden)

    Paul White


    Full Text Available This article explores the relationship between the physiology of the emotions and the display of character in Victorian Britain. Charles Bell and others had begun to link certain physiological functions, such as respiration, with the expression of feelings such as fear, regarding the heart and other internal organs as instruments by which the emotions were made visible. But a purely functional account of the emotions, which emerged through the development of reflex physiology during the second half of the century, would dramatically alter the nature of feelings and the means of observing them. At the same time, instinctual or acquired sympathy, which had long underpinned the accurate reading of expressions, became a problem to be surmounted by new 'objectively'. Graphic recording instruments measuring a variety of physiological functions and used with increasing frequency in clinical diagnostics became of fundamental importance for tracing the movement of feelings during the period prior to the development of cinematography. They remained, in the form of devices such as the polygraph, a crucial and controversial means of measuring affective states, beneath the potentially deceptive surface of the body.

  2. Physiological Effects of Touching Wood

    Directory of Open Access Journals (Sweden)

    Harumi Ikei


    Full Text Available This study aimed to clarify the physiological effects of touching wood with the palm, in comparison with touching other materials on brain activity and autonomic nervous activity. Eighteen female university students (mean age, 21.7  ±  1.6 years participated in the study. As an indicator of brain activity, oxyhemoglobin (oxy-Hb concentrations were measured in the left/right prefrontal cortex using near-infrared time-resolved spectroscopy. Heart rate variability (HRV was used as an indicator of autonomic nervous activity. The high-frequency (HF component of HRV, which reflected parasympathetic nervous activity, and the low-frequency (LF/HF ratio, which reflected sympathetic nervous activity, were measured. Plates of uncoated white oak, marble, tile, and stainless steel were used as tactile stimuli. After sitting at rest with their eyes closed, participants touched the materials for 90 s. As a result, tactile stimulation with white oak significantly (1 decreased the oxy-Hb concentration in the left/right prefrontal cortex relative to marble, tile, and stainless steel and (2 increased ln(HF-reflected parasympathetic nervous activity relative to marble and stainless steel. In conclusion, our study revealed that touching wood with the palm calms prefrontal cortex activity and induces parasympathetic nervous activity more than other materials, thereby inducing physiological relaxation.

  3. Cochlear implant revision surgeries in children. (United States)

    Amaral, Maria Stella Arantes do; Reis, Ana Cláudia Mirândola B; Massuda, Eduardo T; Hyppolito, Miguel Angelo


    The surgery during which the cochlear implant internal device is implanted is not entirely free of risks and may produce problems that will require revision surgeries. To verify the indications for cochlear implantation revision surgery for the cochlear implant internal device, its effectiveness and its correlation with certain variables related to language and hearing. A retrospective study of patients under 18 years submitted to cochlear implant Surgery from 2004 to 2015 in a public hospital in Brazil. Data collected were: age at the time of implantation, gender, etiology of the hearing loss, audiological and oral language characteristics of each patient before and after Cochlear Implant surgery and any need for surgical revision and the reason for it. Two hundred and sixty-five surgeries were performed in 236 patients. Eight patients received a bilateral cochlear implant and 10 patients required revision surgery. Thirty-two surgeries were necessary for these 10 children (1 bilateral cochlear implant), of which 21 were revision surgeries. In 2 children, cochlear implant removal was necessary, without reimplantation, one with cochlear malformation due to incomplete partition type I and another due to trauma. With respect to the cause for revision surgery, of the 8 children who were successfully reimplanted, four had cochlear calcification following meningitis, one followed trauma, one exhibited a facial nerve malformation, one experienced a failure of the cochlear implant internal device and one revision surgery was necessary because the electrode was twisted. The incidence of the cochlear implant revision surgery was 4.23%. The period following the revision surgeries revealed an improvement in the subject's hearing and language performance, indicating that these surgeries are valid in most cases. Copyright © 2018 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  4. Breast Reduction Surgery (United States)

    ... considering breast reduction surgery, consult a board-certified plastic surgeon. It's important to understand what breast reduction surgery entails — including possible risks and complications — as ...

  5. Avian reproductive physiology (United States)

    Gee, G.F.; Gibbons, Edward F.; Durrant, Barbara S.; Demarest, Jack


    Knowledge of the many physiological factors associated with egg production , fertility, incubation, and brooding in nondomestic birds is limited. Science knows even less about reproduction in most of the 238 endangered or threatened birds. This discussion uses studies of nondomestic and, when necessary, domestic birds to describe physiological control of reproduction. Studies of the few nondomestic avian species show large variation in physiological control of reproduction. Aviculturists, in order to successfully propagate an endangered bird, must understand the bird's reproductive peculiarities. First, investigators can do studies with carefully chosen surrogate species, but eventually they need to confirm the results in the target endangered bird. Studies of reproduction in nondomestic birds increased in the last decade. Still, scientists need to do more comparative studies to understand the mechanisms that control reproduction in birds. New technologies are making it possible to study reproductive physiology of nondomestic species in less limiting ways. These technologies include telemetry to collect information without inducing stress on captives (Howey et al., 1987; Klugman, 1987), new tests for most of the humoral factors associated with reproduction, and the skill to collect small samples and manipulate birds without disrupting the physiological mechanisms (Bercovitz et al., 1985). Managers are using knowledge from these studies to improve propagation in zoological parks, private and public propagation facilities, and research institutions. Researchers need to study the control of ovulation, egg formation, and oviposition in the species of nondomestic birds that lay very few eggs in a season, hold eggs in the oviduct for longer intervals, or differ in other ways from the more thoroughly studied domestic birds. Other techniques that would enhance propagation for nondomestlc birds include tissue culture of cloned embryonic cells, cryopreservation of embryos


    Özlü, Zeynep Karaman; Bilican, Pınar


    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.

  7. [The role of antiarrhythmic surgery in 2004]. (United States)

    Guiraudon, G M


    In 2004, surgery for cardiac arrhythmias addresses essentially atrial fibrillation. Surgery is only a rare alternative for other cardiac arrhythmias in center that still have the surgical skill. Surgery for atrial fibrillation has the definite advantage of concomitant exclusion of the left atrial appendage which is the predominant site of intra-atrial thrombi with the associated risk of severe thrombo-embolic events. Our experience with surgery for lone atrial fibrillation, using the Corridor III operation, shows that surgery is associated with high efficacy and long term control of arrhythmia when the surgical technique is well performed. Failures were associated with incomplete line of block or exclusion. This experience shows the necessity of postoperative EP testing. Initially performed using open heart technique, surger for atrial fibrillation is now performed using mini-invasive technique. Indications for surgery for lone atrial fibrillation will decreased while other strategies are developing. To remain competitive surgery must have high efficacy and use mini-invasive techniques. i.e.: closed off pump beating heart via port access. Surgery for atrial fibrillation concomitant with other cardiac surgical repairs yields remarkable results, without increased surgical risk. Their indications go beyond mitral valve pathology. Future developments imply the following conditions: atrial surgery must not increase morbidity, and its cost-effectiveness must be documented. Combined surgery must be testable and tested to gain valid pathophysiological data to improve surgical rationales. Its impact in terms of survival, prevention of thrombo-embolic events and quality of life will be documented by clinical trials.

  8. Advances in hard nucleus cataract surgery

    Directory of Open Access Journals (Sweden)

    Wei Cui


    Full Text Available Security and perfect vision and fewer complications are our goals in cataract surgery, and hard-nucleus cataract surgery is always a difficulty one. Many new studies indicate that micro-incision phacoemulsification in treating hard nucleus cataract is obviously effective. This article reviews the evolution process of hard nuclear cataract surgery, the new progress in the research of artificial intraocular lens for microincision, and analyse advantages and disadvantages of various surgical methods.

  9. The place of robotics in gynecologic surgery. (United States)

    Quemener, J; Boulanger, L; Rubod, C; Cosson, M; Vinatier, D; Collinet, P


    Robot-assisted laparoscopic gynecologic surgery has undergone widespread development in recent years. The surgical literature on this subject continues to grow. The goal of this article is to summarize the principal indications for robotic assistance in gynecologic surgery and to offer a general overview of the principal articles dealing with robotic surgery for both benign and malignant disease. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  10. [Robotics in pediatric surgery]. (United States)

    Camps, J I


    Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.

  11. Pathophysiology and clinical implications of peroperative fluid management in elective surgery

    DEFF Research Database (Denmark)

    Holte, Kathrine


    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...


    Schanaider, Alberto


    To analyze critically the effectiveness and value of bibliometric indicators in journals of Surgery or Cardiovacular Surgery in the context of the postgraduate programs of CAPES Medicine III. A sampling with 16 academic programs and one professional master of Medicine III, encompassing the General and Digestive System Surgery, Cardiovascular Surgery and Multidisciplinary courses with such contents, was evaluated. Thomson Reuters/ISI (JCR), Elsevier/Scopus (SJR), and also Scielo databases were used. Only in seven programs, the teachers had an average of Qualis A1 articles greater than the others strata. Eleven journals in the surgical area are in stratum A1 (5%) and it reaches 25% in Cardiovascular Surgery. Among the six journals with the largest number of publications Qualis A1 in area Medicine III, five are from non-specific areas. The Acta Cirúrgica Brasileira represented 58% of the publications in the stratum A2. There are some obstacles in the Qualis classification with little uniformity among the Medicine areas I, II and III. A permanent committee should be set to update the Qualis, composed by the three medical areas. It should be considered using other index databases and the unification of the Qualis criteria for journals in medicine. Rating criteria of multi and transdisciplinary journals need to be reviewed. It is essential an institutional financial support for national journals chosen by peers aiming to provide a full computerization process and a professional reviewer of the English language, in order to increase the impact factor. Analisar criticamente a eficácia e valor de indicadores bibliométricos dos periódicos da Cirurgia e Cirurgia Cardiovascular no contexto dos Programas de Pós-Graduação da área Medicina III da CAPES. Foi avaliada uma amostragem com 16 programas acadêmicos e um mestrado profissional da área de Medicina III, compreendendo a Cirurgia Geral e do Aparelho Digestivo, a Cirurgia Cardiovascular e Cursos Multidisciplinares


    African Journals Online (AJOL)

    throughout the world.1,2 A similar increase has been reflected in South Africa.3 ..... The minimum recordable temperature was indicated as ≤ 35 °C on the digital thermometer used on all patients ... Despite advice being given to referring doctors, it is not ... prior to transfer, the management of neonates prior to and.

  14. Renal phosphate handling: Physiology

    Directory of Open Access Journals (Sweden)

    Narayan Prasad


    Full Text Available Phosphorus is a common anion. It plays an important role in energy generation. Renal phosphate handling is regulated by three organs parathyroid, kidney and bone through feedback loops. These counter regulatory loops also regulate intestinal absorption and thus maintain serum phosphorus concentration in physiologic range. The parathyroid hormone, vitamin D, Fibrogenic growth factor 23 (FGF23 and klotho coreceptor are the key regulators of phosphorus balance in body.

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


    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

  16. Corrective Jaw Surgery

    Medline Plus

    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 ...

  17. The future of robotics in hand surgery. (United States)

    Liverneaux, P; Nectoux, E; Taleb, C


    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.

  18. Applied physiology of triathlon. (United States)

    O'Toole, M L; Douglas, P S


    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

  19. Thoracic damage control surgery. (United States)

    Gonçalves, Roberto; Saad, Roberto


    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.

  20. Laparoscopic and open stone surgery

    NARCIS (Netherlands)

    Hruza, Marcel; Zuazu, Jorge Rioja; Goezen, Ali Serdar; de La Rosette, Jean J. M. C. H.; Rassweiler, Jens J.


    INTRODUCTION: Due to the increasing spread and technical enhancement of endourological methods, open surgery for renal and ureteral calculi almost disappeared. MATERIALS AND METHODS: Based on an actual review of literature, we describe indications, technique and clinical importance of the open and

  1. Indicações e contra-indicações para realização das operações bariátricas Bariatric surgery indications and contraindications

    Directory of Open Access Journals (Sweden)

    Adriano Segal


    Full Text Available A obesidade, condição cuja prevalência vem aumentando em níveis de epidemia no mundo inteiro, compartilha com os transtornos psiquiátricos de pesado preconceito tanto entre a população leiga quanto entre os profissionais de Saúde. Quando se considera a associação entre estas patologias, observa-se uma pobreza de dados quer em termos caracterização desta associação quer em termos de tratamentos específicos. Neste artigo, tópicos relativos à interface entre estes aspectos e a realização de operações bariátricas, assim como um breve resumo de suas indicações serão abordados, à luz da literatura mundial e da experiência dos autores.Obesity and psychiatric disorders share an overwhelming moral prejudice, seen not only between lay people but also between health professionals. When the association of these groups of disorders is taken into account, a relative lack of studies designed to characterize that association or to address at specific treatment strategies is observed. In this paper, the interrelationship between these aspects and bariatric surgical procedures as well as a brief description of their indications will be addressed according to world literature and the authors personal experience.

  2. Principles of laser surgery. Advantages and disadvantages. (United States)

    Ballow, E B


    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.

  3. Optimizing transfusion in vascular surgery: is bloodless surgery an option? (United States)

    Shander, Aryeh


    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.

  4. Cardiovascular anatomy and physiology in the female. (United States)

    Wingate, S


    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.

  5. Comprehensive review on endonasal endoscopic sinus surgery (United States)

    Weber, Rainer K.; Hosemann, Werner


    Endonasal endoscopic sinus surgery is the standard procedure for surgery of most paranasal sinus diseases. Appropriate frame conditions provided, the respective procedures are safe and successful. These prerequisites encompass appropriate technical equipment, anatomical oriented surgical technique, proper patient selection, and individually adapted extent of surgery. The range of endonasal sinus operations has dramatically increased during the last 20 years and reaches from partial uncinectomy to pansinus surgery with extended surgery of the frontal (Draf type III), maxillary (grade 3–4, medial maxillectomy, prelacrimal approach) and sphenoid sinus. In addition there are operations outside and beyond the paranasal sinuses. The development of surgical technique is still constantly evolving. This article gives a comprehensive review on the most recent state of the art in endoscopic sinus surgery according to the literature with the following aspects: principles and fundamentals, surgical techniques, indications, outcome, postoperative care, nasal packing and stents, technical equipment. PMID:26770282

  6. The emergence of Applied Physiology within the discipline of Physiology. (United States)

    Tipton, Charles M


    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

  7. Back surgery: Modern medical pitfall. (United States)

    Smith, Jc


    Medical iatrogenesis is at an all-time high with increasing deaths, disability, and costs compounded by unnecessary and ineffective surgeries despite the warnings from WHO, the US Public Health Service, and the Institute of Medicine. One area in particular, failed back surgeries, has drawn increasing attention by researchers due to disproved medical theories and surgical treatments. Paradoxically, while spinal manipulative therapy has been shown to achieve better results for this epidemic of low back pain in particular, medical and insurance programs often limit or boycott this inexpensive and effective treatment, indicating the solution to lowering medical costs and iatrogenesis now rests with political and economic factors primarily.

  8. Physiology of woody plants

    CERN Document Server

    Hazewinkel, Michiel; Pallardy, Stephen G


    This completely revised classic volume is an up-to-date synthesis of the intensive research devoted to woody plants. Intended primarily as a text for students and a reference for researchers, this interdisciplinary book should be useful to a broad range of scientists from agroforesters, agronomists, and arborists to plant pathologists, ecophysiologists, and soil scientists. Anyone interested in plant physiology will find this text invaluable. Key Features * Includes supplementary chapter summaries and lists of general references * Provides a solid foundation of reference information * Thoroughly updated classic text/reference.

  9. Metabolic Surgery in Korea: What to Consider before Surgery

    Directory of Open Access Journals (Sweden)

    Mi-Kyung Kim


    Full Text Available Obesity is increasing globally and represents a significant global health problem because it predisposes towards various diseases, such as type 2 diabetes mellitus, cardiovascular disease, degenerative joint disease, and certain types of cancer. Numerous studies have shown that bariatric surgery reduces body mass and ameliorates obesity-related complications, such as hypertension and hyperglycemia, suggesting that surgery is the most effective therapeutic option for severely obese and obese diabetic patients. Recent international guidelines recommend surgical treatment for diabetic patients with class III obesity (body mass index [BMI] >40 kg/m2, regardless of their level of glycemic control or the complexity of their glucose-lowering regimens, and for patients with class II obesity (BMI 35.0 to 39.9 kg/m2 and hyperglycemia that is poorly controlled despite appropriate lifestyle and pharmacological therapy. The most popular procedures are Roux-en-Y gastric bypass and sleeve gastrectomy, but new procedures with better outcomes have been reported. For optimal surgical outcome, comprehensive management including assessments of a medical condition, nutrition, mental health, and social support is needed before and after surgery. However, there is still a lack of understanding regarding metabolic surgery in Korea. Therefore, this article reviews indications for metabolic surgery in patients with a specific focus on the situation in Korea.

  10. Surgery in current therapy for infective endocarditis (United States)

    Head, Stuart J; Mokhles, M Mostafa; Osnabrugge, Ruben LJ; Bogers, Ad JJC; Kappetein, A Pieter


    The introduction of the Duke criteria and transesophageal echocardiography has improved early recognition of infective endocarditis but patients are still at high risk for severe morbidity or death. Whether an exclusively antibiotic regimen is superior to surgical intervention is subject to ongoing debate. Current guidelines indicate when surgery is the preferred treatment, but decisions are often based on physician preferences. Surgery has shown to decrease the risk of short-term mortality in patients who present with specific symptoms or microorganisms; nevertheless even then it often remains unclear when surgery should be performed. In this review we i) systematically reviewed the current literature comparing medical to surgical therapy to evaluate if surgery is the preferred option, ii) performed a meta-analysis of studies reporting propensity matched analyses, and iii), briefly summarized the current indications for surgery. PMID:21603594

  11. Starting physiology: bioelectrogenesis. (United States)

    Baptista, Vander


    From a Cartesian perspective of rational analysis, the electric potential difference across the cell membrane is one of the fundamental concepts for the study of physiology. Unfortunately, undergraduate students often struggle to understand the genesis of this energy gradient, which makes the teaching activity a hard task for the instructor. The topic of bioelectrogenesis encompasses multidisciplinary concepts, involves several mechanisms, and is a dynamic process, i.e., it never turns off during the lifetime of the cell. Therefore, to improve the transmission and acquisition of knowledge in this field, I present an alternative didactic model. The design of the model assumes that it is possible to build, in a series of sequential steps, an assembly of proteins within the membrane of an isolated cell in a simulated electrophysiology experiment. Initially, no proteins are inserted in the membrane and the cell is at a baseline energy state; the extracellular and intracellular fluids are at thermodynamic equilibrium. Students are guided through a sequence of four steps that add key membrane transport proteins to the model cell. The model is simple at the start and becomes progressively more complex, finally producing transmembrane chemical and electrical gradients. I believe that this didactic approach helps instructors with a more efficient tool for the teaching of the mechanisms of resting membrane potential while helping students avoid common difficulties that may be encountered when learning this topic. Copyright © 2015 The American Physiological Society.

  12. Physiology of bile secretion. (United States)

    Esteller, Alejandro


    The formation of bile depends on the structural and functional integrity of the bile-secretory apparatus and its impairment, in different situations, results in the syndrome of cholestasis. The structural bases that permit bile secretion as well as various aspects related with its composition and flow rate in physiological conditions will first be reviewed. Canalicular bile is produced by polarized hepatocytes that hold transporters in their basolateral (sinusoidal) and apical (canalicular) plasma membrane. This review summarizes recent data on the molecular determinants of this primary bile formation. The major function of the biliary tree is modification of canalicular bile by secretory and reabsorptive processes in bile-duct epithelial cells (cholangiocytes) as bile passes through bile ducts. The mechanisms of fluid and solute transport in cholangiocytes will also be discussed. In contrast to hepatocytes where secretion is constant and poorly controlled, cholangiocyte secretion is regulated by hormones and nerves. A short section dedicated to these regulatory mechanisms of bile secretion has been included. The aim of this revision was to set the bases for other reviews in this series that will be devoted to specific issues related with biliary physiology and pathology.

  13. Financial Anxiety, Physiological Arousal, and Planning Intention

    Directory of Open Access Journals (Sweden)

    John Grable


    Full Text Available Results from this exploratory clinical study indicate that financial anxiety—holding an unhealthy attitude about one’s financial situation—and physiological arousal—the physical precursor to behavior—play important roles in shaping consumer intention to engage in future financial planning activity. Findings suggest that those who are most likely to engage the services of a financial adviser exhibit low levels of financial anxiety and moderate to high levels of physiological arousal. The least likely to seek the help of a financial adviser are those who exhibit high financial anxiety and low physiological arousal. Results support findings documented in the literature that high anxiety levels often lead to a form of self-imposed helplessness. In order to move those experiencing financial anxiety towards financial solutions, financial advisers ought to take steps to simultaneously reduce financial stressors and stimulate arousal as a way to promote behavioral change and help seeking.

  14. An Electrochemistry Study of Cryoelectrolysis in Frozen Physiological Saline. (United States)

    Manuel, Thomas J; Munnangi, Pujita; Rubinsky, Boris


    Cryoelectrolysis is a new minimally invasive tissue ablation surgical technique that combines the processes of electrolysis and solid/liquid phase transformation (freezing). This study investigated this new technique by measuring the pH front propagation and the changes in resistance in a tissue simulant made of physiological saline gel with a pH dye as a function of the sample temperature in the high subzero range above the eutectic. Results demonstrated that effective electrolysis can occur in a high subzero freezing milieu and that the propagation of the pH front is only weakly dependent on temperature. These observations are consistent with a mechanism involving ionic movement through the concentrated saline solution channels between ice crystals at subfreezing temperatures above the eutectic. Moreover, results suggest that Joule heating in these microchannels may cause local microscopic melting, the observed weak dependence of pH front propagation on temperature, and the large changes in resistance with time. A final insight provided by the results is that the pH front propagation from the anode is more rapid than from the cathode, a feature indicative of the electro-osmotic flow from the cathode to the anode. The findings in this paper may be critical for designing future cryoelectrolytic ablation surgery protocols.

  15. Primary care physician decision making regarding referral for bariatric surgery

    DEFF Research Database (Denmark)

    Stolberg, Charlotte Røn; Hepp, Nicola; Juhl, Anna Julie Aavild


    the decision to refer patients for surgery. Only 9% of the respondents indicated that bariatric surgery should be the primary treatment option for severe obesity in the future. Conclusion: Danish PCPs express severe concerns about surgical and medical complications following bariatric surgery. This might...

  16. Management of intraoperative fluid balance and blood conservation techniques in adult cardiac surgery. (United States)

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


    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.

  17. Home geriatric physiological measurements. (United States)

    Tamura, Toshiyo


    In an ageing society, the elderly can be monitored with numerous physiological, physical and passive devices. Sensors can be installed in the home for continuous mobility assistance and unobtrusive disease prevention. This review presents several modern sensors, which improve the quality of life and assist the elderly, disabled people and their caregivers. The main concept of geriatric sensors is that they are capable of providing assistance without limiting or disturbing the subject's daily routine, giving him or her greater comfort, pleasure and well-being. Furthermore, this review includes associated technologies of wearable/implantable monitoring systems and the 'smart-house' project. This review concludes by discussing future challenges of the future aged society.

  18. Home geriatric physiological measurements

    International Nuclear Information System (INIS)

    Tamura, Toshiyo


    In an ageing society, the elderly can be monitored with numerous physiological, physical and passive devices. Sensors can be installed in the home for continuous mobility assistance and unobtrusive disease prevention. This review presents several modern sensors, which improve the quality of life and assist the elderly, disabled people and their caregivers. The main concept of geriatric sensors is that they are capable of providing assistance without limiting or disturbing the subject's daily routine, giving him or her greater comfort, pleasure and well-being. Furthermore, this review includes associated technologies of wearable/implantable monitoring systems and the ‘smart-house’ project. This review concludes by discussing future challenges of the future aged society. (topical review)

  19. Nutrition Following Pancreatic Surgery (United States)

    ... BACK Contact Us DONATE NOW GENERAL DONATION PURPLESTRIDE Nutrition Following Pancreatic Surgery Home Facing Pancreatic Cancer Living with Pancreatic Cancer Diet and Nutrition Nutrition Following Pancreatic Surgery Ver esta página en ...

  20. Blood donation before surgery (United States)

    ... page: // Blood donation before surgery To use the sharing features on ... team. Related MedlinePlus Health Topics Blood Transfusion and Donation Surgery Browse the Encyclopedia A.D.A.M., ...

  1. Cosmetic ear surgery (United States)

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  2. Open heart surgery (United States)

    ... this page: // Open heart surgery To use the sharing features on this ... large arteries connected to the heart. The term "open heart surgery" means that you are connected to a ...

  3. Pediatric heart surgery - discharge (United States)

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 434. ...

  4. Refractive corneal surgery - discharge (United States)

    ... surgery. Avoid contact sports (such as boxing and football) for the first 4 weeks after surgery. DO ... herein should not be used during any medical emergency or for the diagnosis or treatment of any ...

  5. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... best performed by a trained surgeon with specialized education and training. Click here to find out more. ... more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  6. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... more surgeries depending on the extent of the repair needed. Click here to find out more. Corrective ... more surgeries depending on the extent of the repair needed. Click here to find out more. Corrective ...

  7. Surgery for pancreatic cancer (United States)

    ... laparoscopically (using a tiny video camera) or using robotic surgery depends on: The extent of the surgery ... by URAC, also known as the American Accreditation HealthCare Commission ( URAC's accreditation program is ...

  8. Anti-reflux surgery (United States)

    ... surgery. You may need another surgery in the future if you develop new reflux symptoms or swallowing ... Diseases of the esophagus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: ...

  9. Blepharoplasty (Eyelid Surgery) (United States)

    ... Blepharoplasty (BLEF-uh-roe-plas-tee) is a type of surgery that repairs droopy eyelids and may involve ... tobacco and drugs. Your expectations. An honest discussion of your hopes and motivation for surgery will help set the stage for ...

  10. Smoking and surgery (United States)

    Surgery - quitting smoking; Surgery - quitting tobacco; Wound healing - smoking ... Tar, nicotine, and other chemicals from smoking can increase your risk of many health problems. These include heart and blood vessel problems, such as: Blood clots and aneurysms in ...

  11. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Jaw Surgery Download Download the ebook for further information Corrective jaw, or orthognathic surgery is performed by ... your treatment. Correction of Common Dentofacial Deformities ​ ​ The information provided here is not intended as a substitute ...

  12. Cosmetic breast surgery - discharge (United States)

    ... this page: // Cosmetic breast surgery - discharge To use the sharing features on this page, please enable JavaScript. You had cosmetic breast surgery to change the size or shape ...

  13. Shoulder surgery - discharge (United States)

    ... this page: // Shoulder surgery - discharge To use the sharing features on this page, please enable JavaScript. You had shoulder surgery to repair the tissues inside or around your ...

  14. Weight Loss Surgery (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you cannot lose weight ... obesity. There are different types of weight loss surgery. They often limit the amount of food you ...

  15. Obstructive pneumonia: an indication for surgery in mega aorta syndrome. (United States)

    Kalkat, Maninder S; Bonser, Robert S


    A 76-year-old woman with annuloaortic ectasia, aortic regurgitation, and aneurysmal dilatation extending from the root to mid descending aorta presented with symptoms of bronchial compression and obstructive pneumonitis. Despite vigorous antibiotic treatment and physiotherapy, the pneumonitis persisted with clinical and radiologic deterioration. An emergency operation was performed to relieve bronchial compression. The operation comprised homograft aortic root replacement with prosthetic replacement of the arch and descending aorta. Postoperatively the pneumonia rapidly resolved.

  16. Physiology for engineers applying engineering methods to physiological systems

    CERN Document Server

    Chappell, Michael


    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...

  17. The physiology of mountain biking. (United States)

    Impellizzeri, Franco M; Marcora, Samuele M


    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.

  18. Oral dosing of chemical indicators for in vivo monitoring of Ca2+ dynamics in insect muscle.

    Directory of Open Access Journals (Sweden)


    Full Text Available This paper proposes a remarkably facile staining protocol to visually investigate dynamic physiological events in insect tissues. We attempted to monitor Ca2+ dynamics during contraction of electrically stimulated living muscle. Advances in circuit miniaturization and insect neuromuscular physiology have enabled the hybridization of living insects and man-made electronic components, such as microcomputers, the result of which has been often referred as a Living Machine, Biohybrid, or Cyborg Insect. In order for Cyborg Insects to be of practical use, electrical stimulation parameters need to be optimized to induce desired muscle response (motor action and minimize the damage in the muscle due to the electrical stimuli. Staining tissues and organs as well as measuring the dynamics of chemicals of interest in muscle should be conducted to quantitatively and systematically evaluate the effect of various stimulation parameters on the muscle response. However, existing staining processes require invasive surgery and/or arduous procedures using genetically encoded sensors. In this study, we developed a non-invasive and remarkably facile method for staining, in which chemical indicators can be orally administered (oral dosing. A chemical Ca2+ indicator was orally introduced into an insect of interest via food containing the chemical indicator and the indicator diffused from the insect digestion system to the target muscle tissue. We found that there was a positive relationship between the fluorescence intensity of the indicator and the frequency of electrical stimulation which indicates the orally dosed indicator successfully monitored Ca2+ dynamics in the muscle tissue. This oral dosing method has a potential to globally stain tissues including neurons, and investigating various physiological events in insects.

  19. Oral dosing of chemical indicators for in vivo monitoring of Ca2+ dynamics in insect muscle. (United States)

    Ferdinandus; Arai, Satoshi; Ishiwata, Shin'ichi; Suzuki, Madoka; Sato, Hirotaka


    This paper proposes a remarkably facile staining protocol to visually investigate dynamic physiological events in insect tissues. We attempted to monitor Ca2+ dynamics during contraction of electrically stimulated living muscle. Advances in circuit miniaturization and insect neuromuscular physiology have enabled the hybridization of living insects and man-made electronic components, such as microcomputers, the result of which has been often referred as a Living Machine, Biohybrid, or Cyborg Insect. In order for Cyborg Insects to be of practical use, electrical stimulation parameters need to be optimized to induce desired muscle response (motor action) and minimize the damage in the muscle due to the electrical stimuli. Staining tissues and organs as well as measuring the dynamics of chemicals of interest in muscle should be conducted to quantitatively and systematically evaluate the effect of various stimulation parameters on the muscle response. However, existing staining processes require invasive surgery and/or arduous procedures using genetically encoded sensors. In this study, we developed a non-invasive and remarkably facile method for staining, in which chemical indicators can be orally administered (oral dosing). A chemical Ca2+ indicator was orally introduced into an insect of interest via food containing the chemical indicator and the indicator diffused from the insect digestion system to the target muscle tissue. We found that there was a positive relationship between the fluorescence intensity of the indicator and the frequency of electrical stimulation which indicates the orally dosed indicator successfully monitored Ca2+ dynamics in the muscle tissue. This oral dosing method has a potential to globally stain tissues including neurons, and investigating various physiological events in insects.

  20. Robotic liver surgery (United States)

    Leung, Universe


    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

  1. Cardiovascular magnetic resonance in adults with previous cardiovascular surgery. (United States)

    von Knobelsdorff-Brenkenhoff, Florian; Trauzeddel, Ralf Felix; Schulz-Menger, Jeanette


    Cardiovascular magnetic resonance (CMR) is a versatile non-invasive imaging modality that serves a broad spectrum of indications in clinical cardiology and has proven evidence. Most of the numerous applications are appropriate in patients with previous cardiovascular surgery in the same manner as in non-surgical subjects. However, some specifics have to be considered. This review article is intended to provide information about the application of CMR in adults with previous cardiovascular surgery. In particular, the two main scenarios, i.e. following coronary artery bypass surgery and following heart valve surgery, are highlighted. Furthermore, several pictorial descriptions of other potential indications for CMR after cardiovascular surgery are given.

  2. Hernia inguinal laparoscopic surgery

    International Nuclear Information System (INIS)

    Morelli Brum, R. . E mail:


    The purpose of this paper is to enhance treatment of inguinal hernia through a bibliographic study of its main complications and the analysis of a retrospective series of laparoscopic restorations performed by the author in the same private medical care center. From December 1994 through July 2003, ninety-nine patients were operated in 108 procedures.The technique employed was trans-abdominal peritoneal (TAPP)Follow-up covered over 2 years in 80% of patients with a relapse of 2.8%. Main morbidity was neuralgia due to a nerve being trapped, which fact required re-intervention.There was no mortality.The conclusion arrived at is that it is and excellent technique which requires a long learning curve and its main indication would be relapse of conventional surgery, bilateralism, coexistence with another laparoscopic abdominal pathology and doubts concerning contra lateral hernia

  3. Effect of hemorrhoidectomy on anorectal physiology. (United States)

    Vyslouzil, Kamil; Zboril, Pavel; Skalický, Pavel; Vomácková, Katherine


    The aim of this study was to determine whether overactivity of the anal sphincter in patients with hemorhhoids is primary or secondary and thus assess indication of lateral internal sphincterotomy to surgical treatment of hemorrhoids. Tonic contraction of the sphincter muscle in patients with advanced stages of hemorrhoids is considered by many authors as a primary cause, and therefore, they complete hemorrhoid surgery with lateral internal sphincteroomy. If hypertension of anal sphincter is secondary during hemorrhoid disease, lateral internal sphincterotomy is not indicated. Although examinations made immediately after sphincterotomy proved no changes of anal continence, certain sequelae of lateral internal sphincterotomy cannot be excluded and may later negatively affect patient's anal continence. The prospective study comprised 385 patients treated in 2002-2006 by Hemoron or surgery according to Milligan-Morgan or Longo. Patients with history of another disease of the anal canal, radiotherapy of pelvis, Crohn's disease or ulcerous colitis were excluded. Manometry was performed before and after surgery at intervals of 1, 3, 6 and 12 months after operation using a perfusion flow method, six-channels catheter with radial arrangement of channel tips. In all three groups (Hemoron, sec. Milligan-Morgan, sec. Longo), there were 60-65% of patients with third degree hemorrhoids. Normal resting anal pressure before surgery was recorded in only 25% of men and 30% of women. Patients with advanced hemorrhoid degrees were found to have significant hypertension of the anal sphincter. The most significantly improved state of sphincter overactivity was observed after surgery according to Longo and application of Hemoron. After surgery, according to Milligan-Morgan, recovery of anal sphincter tension was the longest; even 6 months after operation, a mean increased resting anal pressure persisted (91-110 mmHg) in 25% of men and 19% of women. After 12 months, recovery of anal

  4. Breast Cancer Surgery (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 ...

  5. 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 ...

  6. Pediatric heart surgery (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 ...

  7. Physiologic assessment of coronary artery fistula

    Energy Technology Data Exchange (ETDEWEB)

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


    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.

  8. Physiologic assessment of coronary artery fistula

    International Nuclear Information System (INIS)

    Gupta, N.C.; Beauvais, J.


    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

  9. To mesh or not to mesh: a review of pelvic organ reconstructive surgery (United States)

    Dällenbach, Patrick


    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

  10. Using your shoulder after surgery (United States)

    Shoulder surgery - using your shoulder; Shoulder surgery - after ... rotator cuff surgery or other ligament or labral surgery, you need to be careful with your shoulder. Ask the surgeon what arm movements are safe ...

  11. Procedures of Exercise Physiology Laboratories (United States)

    Bishop, Phillip A.; Fortney, Suzanne; Greenisen, Michael; Siconolfi, Steven F.; Bamman, Marcas M.; Moore, Alan D., Jr.; Squires, William


    This manual describes the laboratory methods used to collect flight crew physiological performance data at the Johnson Space Center. The Exercise Countermeasures Project Laboratory is a standard physiology laboratory; only the application to the study of human physiological adaptations to spaceflight is unique. In the absence of any other recently published laboratory manual, this manual should be a useful document staffs and students of other laboratories.

  12. Conservation physiology of marine fishes

    DEFF Research Database (Denmark)

    Jørgensen, Christian; Peck, Myron A.; Antognarelli, Fabio


    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...

  13. On a definition of the appropriate timing for surgical intervention in orthognathic surgery. (United States)

    Hernández-Alfaro, F; Guijarro-Martínez, R


    Together with the introduction of new orthodontic techniques and minimally invasive surgery protocols, the emergence of modern patient prototypes has given way to novel timing schemes for the handling of dento-maxillofacial deformities. The aim of this study was to define, justify, and systematize the appropriate timing for orthognathic surgery. A retrospective analysis of orthognathic surgery procedures carried out over a 3-year period was performed. Six timing schemes were defined: 'surgery first', 'surgery early', 'surgery late', 'surgery last', 'surgery only', and 'surgery never'. Gender, age at surgery, main motivation for treatment, orthodontic treatment length, and number of orthodontic appointments were evaluated. A total of 362 orthognathic procedures were evaluated. The most common approach was 'surgery late'. While aesthetic improvement was the leading treatment motivation in 'surgery first', 'surgery early', and 'surgery last' cases, occlusal optimization was the chief aim of 'surgery late'. Sleep-disordered breathing was the main indication for treatment in 'surgery only'. Compared to 'surgery late', orthodontic treatment was substantially shorter in 'surgery early' and 'surgery first' cases, but the number of orthodontic appointments was similar. In conclusion, the skilful management of dento-maxillofacial deformities requires a comprehensive analysis of patient-, orthodontist-, and surgeon-specific variables. Each timing approach has well-defined indications, treatment planning considerations, and orthodontic and surgical peculiarities. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Radical surgery compared with intracavitary cesium followed by radical surgery in cervical carcinoma stage IB

    Energy Technology Data Exchange (ETDEWEB)

    Tinga, D.J.; Bouma, J.; Aalders, J.G. (Dept. of Obstetrics and Gynaecology, State Univ. Hospital, Groningen (Netherlands)); Hollema, H. (Dept. of Pathology, State Univ. Hospital, Groningen (Netherlands))


    Forty-nine patients aged {le} 45 years, with cervical carcinoma stage IB ({le} 3 cm) were treated with either primary radical surgery (n = 26), or intracavitary irradiation followed by radical surgery (n = 23). With primary surgery, ovarian function had been preserved in 15 of the 25 patients, who were alive and well. Seven of the primary surgery patients were irradiated postoperatively and 2 others with a central recurrence were cured by irradiation. One other patient, who was not irradiated postoperatively, had an intestinal metastasis and died of the disease. If any of the adverse prognostic factors (as reported in the literature) had been considered as an indication for postoperative irradiation, 17 patients instead of 7 would have been irradiated after primary radical surgery. In the comparable group of 23 patients treated by intracavitary irradiation and radical surgery (and in 4 cases postoperative irradiation as well) there was no recurrence. There was no significant statistical difference between the treatment results in the cesium + surgery group and those who underwent primary radical surgery. Young patients with early cervical carcinoma without prognostic indicators for postoperative irradiation can benefit from primary radical surgery, because their ovarian function can be preserved. (authors).

  15. Radical surgery compared with intracavitary cesium followed by radical surgery in cervical carcinoma stage IB

    International Nuclear Information System (INIS)

    Tinga, D.J.; Bouma, J.; Aalders, J.G.; Hollema, H.


    Forty-nine patients aged ≤ 45 years, with cervical carcinoma stage IB (≤ 3 cm) were treated with either primary radical surgery (n = 26), or intracavitary irradiation followed by radical surgery (n = 23). With primary surgery, ovarian function had been preserved in 15 of the 25 patients, who were alive and well. Seven of the primary surgery patients were irradiated postoperatively and 2 others with a central recurrence were cured by irradiation. One other patient, who was not irradiated postoperatively, had an intestinal metastasis and died of the disease. If any of the adverse prognostic factors (as reported in the literature) had been considered as an indication for postoperative irradiation, 17 patients instead of 7 would have been irradiated after primary radical surgery. In the comparable group of 23 patients treated by intracavitary irradiation and radical surgery (and in 4 cases postoperative irradiation as well) there was no recurrence. There was no significant statistical difference between the treatment results in the cesium + surgery group and those who underwent primary radical surgery. Young patients with early cervical carcinoma without prognostic indicators for postoperative irradiation can benefit from primary radical surgery, because their ovarian function can be preserved. (authors)

  16. Smolt physiology and endocrinology (United States)

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


    Hormones play a critical role in maintaining body fluid balance in euryhaline fishes during changes in environmental salinity. The neuroendocrine axis senses osmotic and ionic changes, then signals and coordinates tissue-specific responses to regulate water and ion fluxes. Rapid-acting hormones, e.g. angiotensins, cope with immediate challenges by controlling drinking rate and the activity of ion transporters in the gill, gut, and kidney. Slow-acting hormones, e.g. prolactin and growth hormone/insulin-like growth factor-1, reorganize the body for long-term acclimation by altering the abundance of ion transporters and through cell proliferation and differentiation of ionocytes and other osmoregulatory cells. Euryhaline species exist in all groups of fish, including cyclostomes, and cartilaginous and teleost fishes. The diverse strategies for responding to changes in salinity have led to differential regulation and tissue-specific effects of hormones. Combining traditional physiological approaches with genomic, transcriptomic, and proteomic analyses will elucidate the patterns and diversity of the endocrine control of euryhalinity.

  17. Polyamines in plant physiology (United States)

    Galston, A. W.; Sawhney, R. K.


    The diamine putrescine, the triamine spermidine, and the tetramine spermine are ubiquitous in plant cells, while other polyamines are of more limited occurrence. Their chemistry and pathways of biosynthesis and metabolism are well characterized. They occur in the free form as cations, but are often conjugated to small molecules like phenolic acids and also to various macromolecules. Their titer varies from approximately micromolar to more than millimolar, and depends greatly on environmental conditions, especially stress. In cereals, the activity of one of the major polyamine biosynthetic enzymes, arginine decarboxylase, is rapidly and dramatically increased by almost every studied external stress, leading to 50-fold or greater increases in putrescine titer within a few hours. The physiological significance of this increase is not yet clear, although most recent work suggests an adaptive, protective role. Polyamines produced through the action of ornithine decarboxylase, by contrast, seem essential for DNA replication and cell division. The application of exogenous polyamines produces effects on patterns of senescence and morphogenesis, suggesting but not proving a regulatory role for polyamines in these processes. The evidence for such a regulatory role is growing.

  18. Clinical physiology grand rounds. (United States)

    Richards, Jeremy; Schwartzstein, Richard; Irish, Julie; Almeida, Jacqueline; Roberts, David


    Clinical Physiology Grand Rounds (CPGR) is an interactive, case-based conference for medical students designed to: (1) integrate preclinical and clinical learning; (2) promote inductive clinical reasoning; and (3) emphasise students as peer teachers. CPGR specifically encourages mixed learning level student interactions and emphasises the use of concept mapping. We describe the theoretical basis and logistical considerations for an interactive, integrative, mixed-learner environment such as CPGR. In addition, we report qualitative data regarding students' attitudes towards and perceptions of CPGR. Medical students from first to fourth year participate in a monthly, interactive conference. The CPGR was designed to bridge gaps and reinforce linkages between basic science and clinical concepts, and to incorporate interactive vertical integration between preclinical and clinical students. Medical education and content experts use Socratic, interactive teaching methods to develop real-time concept maps to emphasise the presence and importance of linkages across curricula. Student focus groups were held to assess attitudes towards and perceptions of the mixed-learner environment and concept maps in CPGR. Qualitative analyses of focus group transcripts were performed to develop themes and codes describing the students' impressions of CPGR. CPGR is a case-based, interactive conference designed to help students gain an increased appreciation of linkages between basic science and clinical medicine concepts, and an increased awareness of clinical reasoning thought processes. Success is dependent upon explicit attention being given to goals for students' integrated learning. © Blackwell Publishing Ltd 2013.

  19. Effectiveness of patient empowerment over stress related to knee arthroplasty surgery. (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.

  20. Vitreoretinal complications and vitreoretinal surgery in osteo-odonto-keratoprosthesis surgery. (United States)

    Lim, Laurence S; Ang, Chong Lye; Wong, Edmund; Wong, Doric W K; Tan, Donald T H


    To describe the indications for and approaches to vitreoretinal surgery in patients with osteo-odonto-keratoprosthesis (OOKP). Retrospective case series. This was a retrospective review of all patients who had undergone OOKP surgery between 2003 and 2012 at our center. OOKP procedures were performed for severe ocular surface disease according to the indications and techniques described in the patient demographics of the Rome-Vienna Protocol. Indications for retinal surgery, surgical outcomes, and intraoperative and postoperative complications were documented. Operative techniques were reviewed from the surgical records, and any subsequent surgeries were also recorded. Thirty-six patients underwent OOKP, and retinal surgery was indicated in 13 (36%). The indications for and approaches to surgery were retinal detachment repair using an Eckardt temporary keratoprosthesis; assessment of retina and optic nerve health prior to OOKP surgery, using either a temporary keratoprosthesis or an endoscope; endoscopic cyclophotocoagulation for intractable glaucoma; endoscopic trimming of a retroprosthetic membrane; or vitrectomy for endophthalmitis with visualization through the OOKP optic using the binocular indirect viewing system. In all cases, retinal surgical aims were achieved with a single procedure. Postoperative vitreous hemorrhage occurred in 16 patients (44%), but all resolved spontaneously. OOKPs represent the last hope for restoration of vision in severe ocular surface disease, and the retinal surgeon is frequently called upon in the assessment and management of these patients. Temporary keratoprostheses and endoscopic vitrectomies are valuable surgical tools in these challenging cases, improving functional outcomes without compromising OOKP success. Copyright © 2014 Elsevier Inc. All rights reserved.

  1. Does bariatric surgery improve adipose tissue function? (United States)

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


    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

  2. Macular thickness after glaucoma filtration surgery. (United States)

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


    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.


    Pećanac, Marija Đ


    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.

  4. Image-guided robotic surgery. (United States)

    Marescaux, Jacques; Solerc, Luc


    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.

  5. Experience with day stay surgery. (United States)

    Cohen, D; Keneally, J; Black, A; Gaffney, S; Johnson, A


    Potential advantages of day stay surgery are cost saving, improved utilization of staff and hospital facilities, and reduction of stress for the paediatric patient and his family. The successful program requires careful case selection, full operating and anesthetic facilities and good follow-up. Day stay surgery was initiated at Royal Alexandra Hospital for Children in 1974. Experience is reviewed in relation to the total number and nature of surgical admissions and the daily utilisation of the facility. Utilization has markedly increased in the past 2 yr. Current practice is reviewed with regard to initial assessment, preparation for surgery and overall management during the day admission. Parental attitudes towards day stay surgery were evaluated indicating both the advantages and the problems encountered. These related mainly to insufficient information, transport difficulties and afternoon operations. Recommendations for improving the day stay service are discussed with special reference to: (1) communication with the parents as to adequate pre-operative explanation, revision of the day stay information pamphlet and improved distribution, and clear postoperative instructions, (2) the timing of operations, and (3) transport and parking facilities.

  6. Laparoscopic Surgery for Recurrent Crohn's Disease

    Directory of Open Access Journals (Sweden)

    Antonino Spinelli


    Full Text Available In spite of the recent improvements in drug therapy, surgery still represents the most frequent treatment for Crohn's disease (CD complications. Laparoscopy has been widely applied over the last twenty years in colorectal surgery and was associated with lower postoperative pain, shorter hospitalization, faster return to daily activities, and better cosmetic results. Laparoscopy experienced a slower diffusion in inflammatory bowel disease surgery than in oncologic colorectal surgery, but proved to be safe and effective, and is currently considered the gold standard for the treatment of primary uncomplicated ileocolic CD. Indications for laparoscopy in CD have recently been widened to embrace more complicated or recurrent CD. This paper reviews the available data on the subset of recurrent CD patients. The reported results indicate that laparoscopy may be safely applied even in selected recurrent CD cases in hands of IBD surgeons with broad laparoscopic experience.

  7. Computed tomography-controlled stereotactic surgery

    International Nuclear Information System (INIS)

    Matsumoto, Keizo; Shichijo, Fumio; Gyoten, Tetsuya; Tomida, Keisuke; Miyake, Hajime


    A single use of coordinate system of computed tomography (CT) scanner is utilized for CT-controlled stereotactic surgery. Depth, direction and readjustment of target trajectory were defined by known values of cursor number in CT images and numbers of the sliding table indicator. We loaded calculation formulas into hand held computer to obtain immediate answers. Stereotactic apparatus consisted two main parts: the patient's head fixation and probe holder. Surgery was performed in cases of hypertensive intracerebral hemorrhage for evacuation of the hematomas successfully. Target accuracy was satisfactory. With further advance of this surgery, automatic stereotactic control with a special robot machine seeing possible. (author)

  8. Obesity - an indication for GLP-1 treatment?

    DEFF Research Database (Denmark)

    Torekov, S S; Madsbad, S; Holst, Jens Juul


    Obesity is common and associated with a high rate of morbidity and mortality; therefore, treatment is of great interest. At present, bariatric surgery is the only truly successful treatment of severe obesity. Mimicking one of the effects of bariatric surgery, namely the increased secretion...... of glucagon-like peptide (GLP)-1, by artificially increasing the levels of GLP-1 might prove successful as obesity treatment. Recent studies have shown that GLP-1 is a physiological regulator of appetite and food intake. The effect on food intake and satiety is preserved in obese subjects and GLP-1 may...... therefore have a therapeutic potential. The GLP-1 analogues result in a moderate average weight loss, which is clinically relevant in relation to reducing the risk of type 2 diabetes and cardiovascular disease. Inspired by the hormone profile after gastric bypass, a future strategy in obesity drug...

  9. 快速康复外科技术对腹腔镜胆囊切除术患者焦虑指数及应激指标的影响%Effect of fast track surgery on anxiety index and stress indices in patients undergoing laparoscopic cholecystectomy

    Institute of Scientific and Technical Information of China (English)

    芦霞; 贾海明; 米泰宇; 张文权; 高鹏


    Objective To investigate the effect of fast track surgery (FTS) on anxiety index and stress indices in patients undergoing laparo scopic cholecystectomy.Methods The patients who were hospitalized in Department of General Surgery,The Second People's Hospital of Lanzhou,from March 2015 to July 2016 and underwent laparoscopic cholecystectomy were enrolled and randomly divided into FTS group and conventional treatment group,with 200 patients in each group.The patients in the FTS group were given FTS in the perioperative period,and those in the conventional treatment group were given conventional treatment.The C-.reactive protein (CRP) level,white blood cell count (WBC),and interleukin-6 (IL-6) level were measured on admission,at 1 hour before surgery,and at 24 and 48 hours after surgery,as well as the anxiety index in Hamilton anxiety scale (HAMA).The t-test was used for comparison of continuous data between groups,and the chi-square test was used for comparison of categorical data between groups.Results There was no significant difference in anxiety index between the FTS group and the conventional treatment group on admission (P > 0.05);at 1 hour before surgery and at 24 and 48 hours after surgery,there were significant differences in anxiety index between the two groups (x2 =12.73,13.17,and 14.12,all P < 0.05).On admission and at 1 hour before surgery,there were no significant differences in the CRP level,WBC,and IL-6 level between the FTS group and the conventional treatment group (all P >0.05);at 24 and 48 hours after surgery,there were significant differences in the CRP level,WBC,and IL-6 level between the two groups [CRP24h:8.47 ±0.78 mg/L vs 17.56 ± 1.31 mg/L,t =17.63,P <0.05;WBC24h:(8.3 ± 3.4) × 109/L vs (10.2 ± 3.8) × 109/L,t =21.62,P < 0.05;IL-624h:127.43 ± 37.46 ng/L vs 146.25 ± 42.56 ng/L,t =26.32,P <0.05;CRP48h:(6.57 ±1.27) mg/L vs (10.76 ± 1.25) mg/L,t =19.25,P <0.05;WBC48h:(7.1 ±2.3) × 109/L vs (9.3 ±2.4) × 109/L,t =23.34,P

  10. Ergonomics in laparoscopic surgery

    Directory of Open Access Journals (Sweden)

    Supe Avinash


    Full Text Available Laparoscopic surgery provides patients with less painful surgery but is more demanding for the surgeon. The increased technological complexity and sometimes poorly adapted equipment have led to increased complaints of surgeon fatigue and discomfort during laparoscopic surgery. Ergonomic integration and suitable laparoscopic operating room environment are essential to improve efficiency, safety, and comfort for the operating team. Understanding ergonomics can not only make life of surgeon comfortable in the operating room but also reduce physical strains on surgeon.

  11. Language recovery after epilepsy surgery of the Broca's area

    Directory of Open Access Journals (Sweden)

    Lilit Mnatsakanyan

    Full Text Available Epilepsy surgery is indicated in select patients with drug-resistant focal epilepsy. Seizure freedom or significant reduction of seizure burden without risking new neurological deficits is the expected goal of epilepsy surgery. Typically, when the seizure onset zone overlaps with eloquent cortex, patients are excluded from surgery.We present a patient with drug-resistant frontal lobe epilepsy who underwent successful surgery with resection of Broca's area, primarily involving the pars triangularis (BA 45. We report transient expressive aphasia followed by recovery of speech. This case provides new insights into adult neuroplasticity of the language network. Keywords: Epilepsy surgery, Eloquent cortex, Language and epilepsy, Refractory epilepsy, Electrocorticography

  12. Surgery: a risky business. (United States)

    Vats, Amit; Nagpal, Kamal; Moorthy, Krishna


    The advancement of surgical technology has made surgery an increasingly suitable management option for an increasing number of medical conditions. Yet there is also a growing concern about the number of patients coming to harm as a result of surgery. Studies show that this harm can be prevented by better teamwork and communication in operating theatres. This article discusses the extent of adverse events in surgery and how effective teamwork and communication can improve patient safety. It also highlights the role checklists and briefing in improving teamwork and reducing human error in surgery.

  13. Heart valve surgery (United States)

    ... replacement; Valve repair; Heart valve prosthesis; Mechanical valves; Prosthetic valves ... surgery. Your heart valve has been damaged by infection ( endocarditis ). You have received a new heart valve ...

  14. Are more complex physiological models of forest ecosystems better choices for plot and regional predictions? (United States)

    Wenchi Jin; Hong S. He; Frank R. Thompson


    Process-based forest ecosystem models vary from simple physiological, complex physiological, to hybrid empirical-physiological models. Previous studies indicate that complex models provide the best prediction at plot scale with a temporal extent of less than 10 years, however, it is largely untested as to whether complex models outperform the other two types of models...

  15. "Oriental anthropometry" in plastic surgery

    Directory of Open Access Journals (Sweden)

    Senna-Fernandes Vasco


    Full Text Available Background : According to Chinese medicine, the acupuncture-points′ (acupoints locations are proportionally and symmetrically distributed in well-defined compartment zones on the human body surface Oriental Anthropometry" (OA. Acupoints, if considered as aesthetic-loci, might be useful as reference guides in plastic surgery (PS. Aim: This study aimed to use aesthetic-loci as anatomical reference in surgical marking of Aesthetic Plastic Surgery. Method: This was an observational study based on aesthetic surgeries performed in private clinic. This study was based on 106 cases, comprising of 102 women and 4 men, with ages varying from 07 to 73 years, and with heights of between 1.34 m and 1.80 m. Patients were submitted to aesthetic surgical planning by relating aesthetic-loci to conventional surgical marking, including breast surgeries, abdominoplasty, rhytidoplasty, blepharoplasty, and hair implant. The aesthetic-surgical-outcome (ASO of the patients was assessed by a team of plastic surgeons (who were not involved in the surgical procedures over a follow-up period of one year by using a numeric-rating-scale in percentage (% terms. A four-point-verbal-rating-scale was used to record the patients′ opinion of therapeutic-satisfaction (TS. Results: ASO was 75.3 ± 9.4% and TS indicated that most patients (58.5% obtained "good" results. Of the remainder, 38.7% found the results "excellent", and 2.8% found them "fair". Discussion and Conclusion : The data suggested that the use of aesthetic-loci may be a useful tool for PS as an anatomical reference for surgical marking. However, further investigation is required to assess the efficacy of the OA by providing the patients more reliable balance and harmony in facial and body contours surgeries.

  16. Less extensive surgery compared to extensive surgery

    DEFF Research Database (Denmark)

    Lauszus, Finn F; Petersen, Astrid C; Neumann, Gudrun


    -up by hospital data files, general practitioner, death certificate, and autopsy report. Revision of histopathology by a single pathologist. Main outcome measures: Survival and relapse by clinical data, stage, and type of surgery. RESULTS: The incidence of AGCT was 1.37 per year per 100,000 women (95% CI: 1.08, 1.......68). The median follow-up time was 15 years and for the 79 surviving women 22 years. Stage I was found in 94% of cases. Relapse occurred in 24% of women in stage I and 100% of the other stages. Survival in stage I was 95%, 89% and 84% after 5, 10 and 20 years respectively. Increased survival of stage I......: The survival of women was better in AGCT than in epithelial ovarian tumor. Age and type of surgery, besides stage, influenced survival. Total abdominal hysterectomy and bilateral salpingo-oophorectomy is the recommended treatment with advancing age. At younger age less extensive surgery was associated...

  17. Bioactive lipids in kidney physiology and pathophysiology

    Directory of Open Access Journals (Sweden)

    Daria Sałata


    Full Text Available Lipids not only have structural functions, but also play an important role as signaling and regulatory molecules and participate in many cellular processes such as proliferation, differentiation, migration, and apoptosis. Bioactive lipids act both as extracellular mediators, which are associated with receptors on the surface of cells, and intracellular mediators triggering different signal pathways. They are present and active in physiological conditions, and are also involved in the pathogenesis of inflammation, asthma, cancer, diabetes, and hypertension. Bioactive lipids such as derivatives of arachidonic acid and sphingolipids have an important role in renal development, physiology and in many renal diseases. Some of them are potential indicators of kidney damage degree and/or function of the transplanted kidneys.

  18. To mesh or not to mesh: a review of pelvic organ reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Dällenbach P


    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

  19. Critical differences between elective and emergency surgery: identifying domains for quality improvement in emergency general surgery. (United States)

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


    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.

  20. Annals of Pediatric Surgery

    African Journals Online (AJOL)

    The Annals of Pediatric Surgery is striving to fill an important niche that provides focus to clinical care, technical innovation and clinical research. The Annals of Pediatric Surgery has the responsibility to serve not only pediatric surgeons in the Middle East and North Africa but also should be an important conduit for scientific ...

  1. Safety in cardiac surgery

    NARCIS (Netherlands)

    Siregar, S.


    The monitoring of safety in cardiac surgery is a complex process, which involves many clinical, practical, methodological and statistical issues. The objective of this thesis was to measure and to compare safety in cardiac surgery in The Netherlands using the Netherlands Association for

  2. What Is Heart Surgery? (United States)

    ... kidneys, liver, and lungs. Stroke , which may cause short-term or permanent damage. Death. (Heart surgery is more likely to be life threatening in people who are very sick before the surgery.) Memory loss and other issues, such as problems concentrating or ...

  3. Annals of African Surgery

    African Journals Online (AJOL)

    The goal of the Annals of African Surgery is to provide a medium for the exchange of current information between surgeons in the African region. The journal embraces surgery in all its aspects; basic science, clinical research, experimental research, surgical education. It will assist surgeons in the region to keep abreast of ...

  4. About Hand Surgery (United States)

    ... Find a hand surgeon near you. © 2009 American Society for Surgery of the Hand. Definition developed by ASSH Council. Other Links CME Mission Statement and Disclaimer Policies and Technical Requirements Exhibits and Partners ASSH 822 W. Washington Blvd. ... 2018 by American Society for Surgery of the Hand × Search Tips Tip ...

  5. Lasik eye surgery - slideshow (United States)

    ... this page: // Lasik eye surgery - series—Normal anatomy To use the ... A.M. Editorial team. Related MedlinePlus Health Topics Laser Eye Surgery A.D.A.M., Inc. is accredited by ...

  6. LASIK - Laser Eye Surgery (United States)

    ... Refractive Surgery Procedures What Is Photorefractive Keratectomy (PRK)? LASIK — Laser Eye Surgery Leer en Español: LASIK—Cirugía ocular con láser ... loss of close-up focusing power. How the LASIK procedure works LASIK is performed while the patient ...

  7. Robust surgery loading

    NARCIS (Netherlands)

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


    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

  8. [Cognitive deterioration after surgery

    DEFF Research Database (Denmark)

    Steinmetz, J.; Rasmussen, L.S.


    Delirium and postoperative cognitive dysfunction are important and common complications after surgery. Risk factors are first of all increasing age and type of surgery, whereas the type of anaesthesia does not seem to play an important role. Mortality is higher among patients with cognitive...

  9. Hand Surgery: Anesthesia (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Hand Surgery Anesthesia Email to a friend * required ...

  10. Penile enlargement surgery. (United States)

    Alter, G J


    Aesthetic surgery to improve the appearance of the penis, scrotum, and pubic region has successfully evolved. Penile lengthening is performed by releasing the suspensory ligament of the penis followed by use of penile weights. Girth is increased by wrapping a dermal-fat graft around the penile circumference. The choice of surgery is determined by the patient's anatomy and desires.

  11. Anthropometric outcome of sagittal craniosynostosis following surgery

    International Nuclear Information System (INIS)

    Takagi, Toshinori; Morota, Nobuhito; Ihara, Satoshi; Kaneko, Tsuyoshi


    Several studies have shown good short-term outcomes after surgery for sagittal synostosis. However, the improvement in head shape usually regresses over the long term. The aim of this study was to compare anthropometric changes after surgery between osteoplastic expansion surgery and distraction osteogenesis for correcting sagittal synostosis. From November 2002 through December 2008, 17 patients with sagittal synostosis were analyzed. Anthropometric changes were assessed with cephalic indices obtained with computed tomography of the skull. The age of the patients at the time of surgery ranged from 2 to 25 months (mean, 8.2 months), and the follow-up period ranged from 6 to 63 months (mean, 17 months). In 16 patients, the cephalic index showed improvement immediately after surgery but gradually decreased in the follow-up period. The improving rate was decreased more after osteoplastic expansion surgery than after distraction osteogenesis (p<0.01). Although long-term follow-up is necessary, morphological improvement persists to a greater degree after distraction surgery. (author)

  12. Non-surgical complications following bariatric surgery

    Directory of Open Access Journals (Sweden)

    Polovina Snežana


    Full Text Available Bariatric surgery is the most efficient treatment for obesity and comorbidities. This treatment modality is the most potent for weight reduction with long-term weight maintenance and positive metabolic effects. The effect on weight loss and possible side effect depends of type of surgery. Micro and macronutrient deficiencies can occur after malapsorptive procedures. Iron deficiency occurs in almost half of patients following RYGB (Roux-en-Y gastric bypass. The main causes of iron deficiency are insufficient meat ingestion and lack of hydrochloric acid after removal of pylorus. B12 deficiency occured 6 months after RYGB in patients with oral supplementation of B12. Bone turnover increased three months after RYGB, and the levels of bone turnover markers increased 200% in next 12-18 months. Impaired vitamin D absorption leads to decreased calcium absorption and secondary hyperparathyroidism with lower bone mineral density. After the bariatric surgery, testosterone level becomes higher and all sexual quality indicators improving. Malapsorptive procedures with nutritive deficiency can cause oligo-astenozooteratospermia and male infertility. Due to the same reason pregnancy is not recommended in the first year bariatric surgery. Possible side effect of pregnancy within 12 months after surgery is fetal growth retardation. There is twice higher incidence for developing alcohol or other addition after bariatric surgery then in non-operated obese patients. The frequency of depressive episodes and suicide attempt is higher after bariatric surgery.

  13. Physiological factors influencing capillary growth. (United States)

    Egginton, S


    (1) Angiogenesis (growth of new capillaries from an existing capillary bed) may result from a mismatch in microvascular supply and metabolic demand (metabolic error signal). Krogh examined the distribution and number of capillaries to explore the correlation between O(2) delivery and O(2) consumption. Subsequently, the heterogeneity in angiogenic response within a muscle has been shown to reflect either differences in fibre type composition or mechanical load. However, local control leads to targetted angiogenesis in the vicinity of glycolytic fibre types following muscle stimulation, or oxidative fibres following endurance training, while heterogeneity of capillary spacing is maintained during ontogenetic growth. (2) Despite limited microscopy resolution and lack of specific markers, Krogh's interest in the structure of the capillary wall paved the way for understanding the mechanisms of capillary growth. Angiogenesis may be influenced by the response of perivascular or stromal cells (fibroblasts, macrophages and pericytes) to altered activity, likely acting as a source for chemical signals modulating capillary growth such as vascular endothelial growth factor. In addition, haemodynamic factors such as shear stress and muscle stretch play a significant role in adaptive remodelling of the microcirculation. (3) Most indices of capillarity are highly dependent on fibre size, resulting in possible bias because of scaling. To examine the consequences of capillary distribution, it is therefore helpful to quantify the area of tissue supplied by individual capillaries. This allows the spatial limitations inherent in most models of tissue oxygenation to be overcome generating an alternative approach to Krogh's tissue cylinder, the capillary domain, to improve descriptions of intracellular oxygen diffusion. © 2010 The Author. Acta Physiologica © 2010 Scandinavian Physiological Society.

  14. Antifibrinolytics in liver surgery

    Directory of Open Access Journals (Sweden)

    Jalpa Makwana


    Full Text Available Hyperfibrinolysis, a known complication of liver surgery and orthotopic liver transplantation (OLT, plays a significant role in blood loss. This fact justifies the use of antifibrinolytic drugs during these procedures. Two groups of drug namely lysine analogues [epsilon aminocaproic acid (EACA and tranexamic acid (TA] and serine-protease-inhibitors (aprotinin are frequently used for this purpose. But uniform data or guidelines on the type of antifibrinolytic drugs to be used, their indications and correct dose, is still insufficient. Antifibrinolytics behave like a double-edged sword. On one hand, there are benefits of less transfusion requirements but on the other hand there is potential complication like thromboembolism, which has been reported in several studies. We performed a systematic search in PubMed and Cochrane Library, and we included studies wherein antifibrinolytic drugs (EACA, TA, or aprotinin were compared with each other or with controls/placebo. We analysed factors like intraoperative red blood cell and fresh frozen plasma requirements, the perioperative incidence of hepatic artery thrombosis, venous thromboembolic events and mortality. Among the three drugs, EACA is least studied. Use of extensively studied drug like aprotinin has been restricted because of its side effects. Haemostatic effect of aprotinin and tranexamic acid has been comparable. However, proper patient selection and individualized treatment for each of them is required. Purpose of this review is to study various clinical trials on antifibrinolytic drugs and address the related issues like benefits claimed and associated potential complications.

  15. An overview of surgery-first approach: Recent advances in orthognathic surgery. (United States)

    Sharma, Vipul Kumar; Yadav, Kirti; Tandon, Pradeep


    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.

  16. Piezoelectric surgery in implant dentistry: clinical applications

    Directory of Open Access Journals (Sweden)

    Lydia Masako Ferreira


    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.

  17. 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)


    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.)

  18. The psychological impact of body contouring surgery

    DEFF Research Database (Denmark)

    Mikkelsen Lorenzen, Mike; Poulsen, Lotte; Poulsen, Signe


    INTRODUCTION: Body contouring surgery is associated with changes in body image and identity. The primary aim of the study was to investigate a multidisciplinary assessment of potential psychological challenges before and after body contouring surgery. METHODS: Eight pre- and post-operative patients...... relevant codes had been extracted. RESULTS: A total of seven psychological themes were iden- tified, indicating that surgery alone cannot improve the pa- tients’ psychological difficulties and that psychological care and management of the expected discomfort and body im- age is of considerable importance...... in providing continuity of care. CONCLUSIONS: The reported quality of life is of consider- able importance to patients undergoing body contouring surgery after massive weight loss. Our findings may provide useful information for surgeons and healthcare profes- sionals allowing them to develop patient education...

  19. Cleft Lip and Palate Surgery (United States)

    ... The experts in face, mouth and jaw surgery. Cleft Lip / Palate and Craniofacial Surgery This type of surgery is ... the carefully orchestrated, multiple-stage correctional program for cleft lip and palate patients. The goal is to help restore the ...

  20. Gamma knife surgery for craniopharyngioma

    International Nuclear Information System (INIS)

    Prasad, D.; Steiner, M.; Steiner, L.


    We present our results of Gamma Knife surgery for craniopharyngioma in nine patients. The current status of surgery, radiation therapy, intracavitary instillation of radionuclides and Gamma Knife surgery in the management of craniopharyngiomas is discussed. (author)

  1. Heart failure - surgeries and devices (United States)

    ... surgery; HF - surgery; Intra-aortic balloon pumps - heart failure; IABP - heart failure; Catheter based assist devices - heart failure ... problem may cause heart failure or make heart failure worse. Heart valve surgery may be needed to repair or ...

  2. The XIIIth International Physiological Congress in Boston in 1929: American physiology comes of age. (United States)

    Rall, Jack A


    In the 19th century, the concept of experimental physiology originated in France with Claude Bernard, evolved in Germany stimulated by the teaching of Carl Ludwig, and later spread to Britain and then to the United States. The goal was to develop a physicochemical understanding of physiological phenomena. The first International Physiological Congress occurred in 1889 in Switzerland with an emphasis on experimental demonstrations. The XIIIth Congress, the first to be held outside of Europe, took place in Boston, MA, in 1929. It was a watershed meeting and indicated that American physiology had come of age. Meticulously organized, it was the largest congress to date, with over 1,200 participants from more than 40 countries. Getting to the congress was a cultural adventure, especially for the 400 scientists and their families from over 20 European countries, who sailed for 10 days on the S.S. Minnekahda. Many of the great physiologists of the world were in attendance, including 22 scientists who were either or would become Nobel Laureates. There were hundreds of platform presentations and many experimental demonstrations. The meeting was not without controversy as a conflict, still not completely settled, arose over the discovery of ATP. After the meeting, hundreds of participants made a memorable trip to the Marine Biological Laboratory at Woods Hole, MA, which culminated in a "good old fashioned Cape Cod Clambake." Although not as spectacular as the 1929 congress, the physiological congresses have continued with goals similar to those established more than a century ago. Copyright © 2016 The American Physiological Society.

  3. Conservation physiology of animal migration (United States)

    Lennox, Robert J.; Chapman, Jacqueline M.; Souliere, Christopher M.; Tudorache, Christian; Wikelski, Martin; Metcalfe, Julian D.; Cooke, Steven J.


    Migration is a widespread phenomenon among many taxa. This complex behaviour enables animals to exploit many temporally productive and spatially discrete habitats to accrue various fitness benefits (e.g. growth, reproduction, predator avoidance). Human activities and global environmental change represent potential threats to migrating animals (from individuals to species), and research is underway to understand mechanisms that control migration and how migration responds to modern challenges. Focusing on behavioural and physiological aspects of migration can help to provide better understanding, management and conservation of migratory populations. Here, we highlight different physiological, behavioural and biomechanical aspects of animal migration that will help us to understand how migratory animals interact with current and future anthropogenic threats. We are in the early stages of a changing planet, and our understanding of how physiology is linked to the persistence of migratory animals is still developing; therefore, we regard the following questions as being central to the conservation physiology of animal migrations. Will climate change influence the energetic costs of migration? Will shifting temperatures change the annual clocks of migrating animals? Will anthropogenic influences have an effect on orientation during migration? Will increased anthropogenic alteration of migration stopover sites/migration corridors affect the stress physiology of migrating animals? Can physiological knowledge be used to identify strategies for facilitating the movement of animals? Our synthesis reveals that given the inherent challenges of migration, additional stressors derived from altered environments (e.g. climate change, physical habitat alteration, light pollution) or interaction with human infrastructure (e.g. wind or hydrokinetic turbines, dams) or activities (e.g. fisheries) could lead to long-term changes to migratory phenotypes. However, uncertainty remains

  4. Fostering improved anatomy and physiology instructor pedagogy. (United States)

    Mattheis, Allison; Jensen, Murray


    Despite widespread calls for reform in undergraduate science, technology, engineering, and mathematics education, effecting lasting change in instructor practice is challenging to achieve. This article describes the results of a 2-yr research study that involved efforts to develop the pedagogical expertise of a group of anatomy and physiology instructors at the college level. Data were collected through a series of individual interviews that included the use of the Teacher Beliefs Inventory questionnaire (23) along with observations onsite in participants' college classrooms and at process-oriented guided inquiry learning (POGIL) curriculum writing workshops. Findings indicated attitudinal shifts on the part of participants from teacher-centered to more student-centered pedagogy and supported the benefits of long-term professional development for instructors. Here, we documented the successful progress of these professors as they participated in a curriculum development process that emphasized student-centered teaching with the goal of promoting broader change efforts in introductory anatomy and physiology. Copyright © 2014 The American Physiological Society.

  5. New concepts in white adipose tissue physiology

    International Nuclear Information System (INIS)

    Proença, A.R.G.; Sertié, R.A.L.; Oliveira, A.C.; Campaãa, A.B.; Caminhotto, R.O.; Chimin, P.; Lima, F.B.


    Numerous studies address the physiology of adipose tissue (AT). The interest surrounding the physiology of AT is primarily the result of the epidemic outburst of obesity in various contemporary societies. Briefly, the two primary metabolic activities of white AT include lipogenesis and lipolysis. Throughout the last two decades, a new model of AT physiology has emerged. Although AT was considered to be primarily an abundant energy source, it is currently considered to be a prolific producer of biologically active substances, and, consequently, is now recognized as an endocrine organ. In addition to leptin, other biologically active substances secreted by AT, generally classified as cytokines, include adiponectin, interleukin-6, tumor necrosis factor-alpha, resistin, vaspin, visfatin, and many others now collectively referred to as adipokines. The secretion of such biologically active substances by AT indicates its importance as a metabolic regulator. Cell turnover of AT has also recently been investigated in terms of its biological role in adipogenesis. Consequently, the objective of this review is to provide a comprehensive critical review of the current literature concerning the metabolic (lipolysis, lipogenesis) and endocrine actions of AT

  6. New concepts in white adipose tissue physiology

    Energy Technology Data Exchange (ETDEWEB)

    Proença, A.R.G. [Universidade Estadual de Campinas, Laboratório de Biotecnologia, Faculdade de Ciências Aplicadas, Limeira, SP, Brasil, Laboratório de Biotecnologia, Faculdade de Ciências Aplicadas, Universidade Estadual de Campinas, Limeira, SP (Brazil); Sertié, R.A.L. [Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Fisiologia e Biofísica, São Paulo, SP, Brasil, Departamento de Fisiologia e Biofísica, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP (Brazil); Oliveira, A.C. [Universidade Estadual do Ceará, Instituto Superior de Ciências Biomédicas, Fortaleza, CE, Brasil, Instituto Superior de Ciências Biomédicas, Universidade Estadual do Ceará, Fortaleza, CE (Brazil); Campaãa, A.B.; Caminhotto, R.O.; Chimin, P.; Lima, F.B. [Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Fisiologia e Biofísica, São Paulo, SP, Brasil, Departamento de Fisiologia e Biofísica, Instituto de Ciências Biomédicas, Universidade de São Paulo, São Paulo, SP (Brazil)


    Numerous studies address the physiology of adipose tissue (AT). The interest surrounding the physiology of AT is primarily the result of the epidemic outburst of obesity in various contemporary societies. Briefly, the two primary metabolic activities of white AT include lipogenesis and lipolysis. Throughout the last two decades, a new model of AT physiology has emerged. Although AT was considered to be primarily an abundant energy source, it is currently considered to be a prolific producer of biologically active substances, and, consequently, is now recognized as an endocrine organ. In addition to leptin, other biologically active substances secreted by AT, generally classified as cytokines, include adiponectin, interleukin-6, tumor necrosis factor-alpha, resistin, vaspin, visfatin, and many others now collectively referred to as adipokines. The secretion of such biologically active substances by AT indicates its importance as a metabolic regulator. Cell turnover of AT has also recently been investigated in terms of its biological role in adipogenesis. Consequently, the objective of this review is to provide a comprehensive critical review of the current literature concerning the metabolic (lipolysis, lipogenesis) and endocrine actions of AT.

  7. Epiretinal membrane surgery

    DEFF Research Database (Denmark)

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


    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...

  8. Craniofacial Surgery Fellowship Websites. (United States)

    Silvestre, Jason; Agarwal, Divyansh; Taylor, Jesse A


    Applicants for craniofacial surgery fellowships utilize Internet-based resources like the San Francisco (SF) Match to manage applications. The purpose of this study was to evaluate the accessibility and content of craniofacial surgery fellowship websites (CSFWs). A list of available craniofacial surgery fellowships was compiled from directories of the American Society of Craniofacial Surgery (ACSFS) and SF Match. Accessibility of CSFWs was assessed via links from these directories and a Google search. Craniofacial surgery fellowship websites were evaluated on education and recruitment content and compared via program characteristics. Twenty-four of the 28 US-based craniofacial surgery fellowship programs had a CSFW (86%). The ACSFS and SF Match databases had limited CSFW accessibility, but a Google search revealed most CSFWs had the top search result (76%). In total, CSFWs provided an average of 39% of education and recruitment variables. While most programs provided fellowship program descriptions (96%), application links (96%), and faculty listings (83%), relatively few provided rotation schedules (13%), fellow selection process information (13%), or interview dates (8%). CSFW content did not vary by program location, faculty size, accreditation status, or institutional affiliations (P > 0.05). Craniofacial surgery fellowships often lack readily accessible websites from national program lists and have limited information for interested applicants. The consistent lack of online information across programs suggests future opportunities exist to improve these educational resources.

  9. The History of Hiatal Hernia Surgery (United States)

    Stylopoulos, Nicholas; Rattner, David W.


    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

  10. Education on the Business of Plastic Surgery During Training: A Survey of Plastic Surgery Residents. (United States)

    Ovadia, Steven A; Gishen, Kriya; Desai, Urmen; Garcia, Alejandro M; Thaller, Seth R


    Entrepreneurial skills are important for physicians, especially plastic surgeons. Nevertheless, these skills are not typically emphasized during residency training. Evaluate the extent of business training at plastic surgery residency programs as well as means of enhancing business training. A 6-question online survey was sent to plastic surgery program directors for distribution to plastic surgery residents. Responses from residents at the PGY2 level and above were included for analysis. Tables were prepared to present survey results. Hundred and sixty-six residents including 147 PGY2 and above residents responded to our survey. Only 43.5% reported inclusion of business training in their plastic surgery residency. A majority of residents reported they do not expect on graduation to be prepared for the business aspects of plastic surgery. Additionally, a majority of residents feel establishment of a formal lecture series on the business of plastic surgery would be beneficial. Results from our survey indicate limited training at plastic surgery programs in necessary business skills. Plastic surgery residency programs should consider incorporating or enhancing elements of business training in their curriculum. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors .

  11. 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.


    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

  12. Concomitant atrial fibrillation surgery for people undergoing cardiac surgery (United States)

    Huffman, Mark D; Karmali, Kunal N; Berendsen, Mark A; Andrei, Adin-Cristian; Kruse, Jane; McCarthy, Patrick M; Malaisrie, S C


    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

  13. [Alternative approaches in thyroid surgery]. (United States)

    Maurer, E; Wächter, S; Bartsch, D K


    In thyroid surgery multiple different cervical minimally invasive (partly endoscopically assisted) and extracervical endoscopic (partly robot-assisted) approaches have been developed in the last 20 years. The aim of all these alternative approaches to the thyroid gland is optimization of the cosmetic result. The indications for the use of alternative and conventional approaches are principally the same. Important requirements for the use of alternative methods are nevertheless a broad experience in conventional thyroid operations of the thyroid and adequate patient selection under consideration of the size of the thyroid and the underlying pathology. Contraindications for the use of alternative approaches are a large size of the thyroid gland including local symptoms, advanced carcinomas, reoperations and previous radiations of the anterior neck. The current article gives an overview of the clinically implemented alternative approaches for thyroid surgery. Of those the majority must still be considered as experimental. The alternative approaches to the thyroid gland can be divided in cervical minimally invasive, extracervical endosopic (robot-assisted) and transoral operations (natural orifice transluminal endoscopic surgery, NOTES). Since conventional thyroid operations are standardized procedures with low complication rates, alternative approaches to the thyroid gland are considered critically in Germany. The request for a perfect cosmetic result should not overweigh patients' safety. Only a few alternative approaches (e. g. MIVAT, RAT) can yet be considered as a safe addition in experienced hands in highly selected patients.

  14. Physiological Effects of Touching Coated Wood

    Directory of Open Access Journals (Sweden)

    Harumi Ikei


    Full Text Available This study examined the physiological effects of touching wood with various coating with the palm of the hand on brain activity and autonomic nervous activity. Participants were 18 female university students (mean age, 21.7 ± 1.6 years. As an indicator of brain activity, oxyhemoglobin concentrations were measured in the left and right prefrontal cortices using near-infrared time-resolved spectroscopy. Heart rate variability (HRV and heart rate were used as indicators of autonomic nervous activity. The high-frequency (HF component of HRV, which reflects parasympathetic nervous activity, and the low-frequency (LF/HF ratio, which reflects sympathetic nervous activity, were measured. Plates of uncoated, oil-finished, vitreous-finished, urethane-finished, and mirror-finished white oak wood were used as tactile stimuli. After sitting at rest with their eyes closed for 60 s, participants touched the stimuli with their palm for 90 s each. The results indicated that tactile stimulation with uncoated wood calmed prefrontal cortex activity (vs. urethane finish and mirror finish, increased parasympathetic nervous activity (vs. vitreous finish, urethane finish, and mirror finish, and decreased heart rate (vs. mirror finish, demonstrating a physiological relaxation effect. Further, tactile stimulation with oil- and vitreous-finished wood calmed left prefrontal cortex activity and decreased heart rate relative to mirror-finished wood.

  15. Physiological Effects of Touching Coated Wood. (United States)

    Ikei, Harumi; Song, Chorong; Miyazaki, Yoshifumi


    This study examined the physiological effects of touching wood with various coating with the palm of the hand on brain activity and autonomic nervous activity. Participants were 18 female university students (mean age, 21.7 ± 1.6 years). As an indicator of brain activity, oxyhemoglobin concentrations were measured in the left and right prefrontal cortices using near-infrared time-resolved spectroscopy. Heart rate variability (HRV) and heart rate were used as indicators of autonomic nervous activity. The high-frequency (HF) component of HRV, which reflects parasympathetic nervous activity, and the low-frequency (LF)/HF ratio, which reflects sympathetic nervous activity, were measured. Plates of uncoated, oil-finished, vitreous-finished, urethane-finished, and mirror-finished white oak wood were used as tactile stimuli. After sitting at rest with their eyes closed for 60 s, participants touched the stimuli with their palm for 90 s each. The results indicated that tactile stimulation with uncoated wood calmed prefrontal cortex activity (vs. urethane finish and mirror finish), increased parasympathetic nervous activity (vs. vitreous finish, urethane finish, and mirror finish), and decreased heart rate (vs. mirror finish), demonstrating a physiological relaxation effect. Further, tactile stimulation with oil- and vitreous-finished wood calmed left prefrontal cortex activity and decreased heart rate relative to mirror-finished wood.

  16. Surveys on surgery theory

    CERN Document Server

    Cappell, Sylvain; Rosenberg, Jonathan


    Surgery theory, the basis for the classification theory of manifolds, is now about forty years old. The sixtieth birthday (on December 14, 1996) of C.T.C. Wall, a leading member of the subject''s founding generation, led the editors of this volume to reflect on the extraordinary accomplishments of surgery theory as well as its current enormously varied interactions with algebra, analysis, and geometry. Workers in many of these areas have often lamented the lack of a single source surveying surgery theory and its applications. Because no one person could write such a survey, the editors ask

  17. Surveys on surgery theory

    CERN Document Server

    Cappell, Sylvain; Rosenberg, Jonathan


    Surgery theory, the basis for the classification theory of manifolds, is now about forty years old. There have been some extraordinary accomplishments in that time, which have led to enormously varied interactions with algebra, analysis, and geometry. Workers in many of these areas have often lamented the lack of a single source that surveys surgery theory and its applications. Indeed, no one person could write such a survey. The sixtieth birthday of C. T. C. Wall, one of the leaders of the founding generation of surgery theory, provided an opportunity to rectify the situation and produce a

  18. Physiology of fish endocrine pancreas. (United States)

    Plisetskaya, E M


    From the very beginning of physiological studies on the endocine pancreas, fish have been used as experimental subjects. Fish insulin was one of the first vertebrate insulins isolated and one of the first insulins whose primary and then tertiary structures were reported. Before a second pancreatic hormone, glucagon, was characterized, a physiologically active 'impurity', similar to that in mammalian insulin preparations, was found in fish insulins.Fish have become the most widely used model for studies of biosynthesis and processing of the pancreatic hormones. It seems inconceivable, therefore, that until the recent past cod and tuna insulins have been the only purified piscine islet hormones available for physiological experiments. The situation has changed remarkably during the last decade.In this review the contemporary status of physiological studies on the fish pancreas is outlined with an emphasis on the following topics: 1) contents of pancreatic peptides in plasma and in islet tissue; 2) actions of piscine pancreatic hormones in fish; 3) specific metabolic consequences of an acute insufficiency of pancreatic peptides; 4) functional interrelations among pancreatic peptides which differ from those of mammals. The pitfalls, lacunae and the perspectives of contemporary physiological studies on fish endocrine pancreas are outlined.

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


    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.

  20. 21 CFR 315.4 - Indications. (United States)


    ... of proposed indications for use include, but are not limited to, the following: (1) Structure delineation; (2) Functional, physiological, or biochemical assessment; (3) Disease or pathology detection or assessment; and (4) Diagnostic or therapeutic patient management. (b) Where a diagnostic radiopharmaceutical...