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.


    Directory of Open Access Journals (Sweden)

    Mojca Globočnik-Petrovič


    Full Text Available Background. Vitreoretinal surgery is the second most frequent surgery after cataract extraction. It is indicated in the treatment of various vitreous and retinal disorders such as diabetic retinopathy, proliferative vitreoretinopathy, endophthalmitis, penetrating and perforating injuries of the eye. 400 vitreoretinal operations were done in University Eye Clinic in Ljubljana last year which is three times more like years ago. Almost third of all vitreoretinal operations were done on patients with diabetic retinopathy, 22% on patients with proliferative vitreoretinopathy, 10% on traumatic eyes and 14% were reoperations. Remaining 28% of operations were done on eyes with different diagnoses such as macular diseases, retinal detachment, haematovitreus, endophthalmitis and dropped nucleus.During vitrectomy, vitreous opacities are excised and abnormal structural changes above and beneath the retina can be removed. Depending on the type of retinal disease different types of vitreous cavity tamponade such as silicone oil, gas or intraocular saline are used.Conclusions. Improved knowledge of the pathohistology of abnormal vitreoretinal structural changes and new surgical techniques have resulted in improved anatomical and visual results of vitreoretinal surgery. The list of indications has expanded and some macular diseases which were untreatable a few years ago can now be routinely operated with good results.

  3. Geomagnetic Indices Variations And Human Physiology (United States)

    Dimitrova, S.


    A group of 86 volunteers was examined on each working day in autumn 2001 and in spring 2002. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were registered. Pulse pressure (PP) was calculated. Data about subjective psycho-physiological complaints (SPPC) were also gathered. Altogether 2799 recordings were obtained. ANOVA was employed to check the significance of influence of daily amplitude of H-component of local geomagnetic field, daily planetary Ap-index and hourly planetary Dst-index on the physiological parameters examined. Post hoc analysis was performed to elicit the significance of differences in the factors levels. Average values of SBP, DBP, PP and SPPC of the group were found to increase statistically significantly and biologically considerably with the increase of geomagnetic indices.

  4. Indications & predisposing factors of crown lengthening surgery

    Directory of Open Access Journals (Sweden)

    Arghavan Amini-Behbahani


    Full Text Available Introduction: Since crown lengthening surgery could be accompanied by stress, pain and discomfort, knowledge about its predisposing factors could reduce the demands for such surgery.The aim of this study was to identify the most important indications of crown lengthening surgery in order to present new ideas to clinicians on how to reduce the need for this surgery. Methods: This cross-sectional study was done on 470 patients (aged 12-89 years referred for crown lengthening surgery. The patients' demographic data and their reasons for surgery, the teeth restoration condition and its type, condition of the opposite tooth, type of fractured cusp (posterior teeth, root canal therapy condition and quality, and size of existing intracanal posts were recorded in a data sheet. Data were analyzed by using SPSS software.The chi-square and fisher exact test were used for statistical analysis. The significant difference was p<0.05. Results: The most frequent indication in men and women was dental caries followed by tooth fracture.The second upper premolars and first lower molars needed crown lengthening surgery more often, respectively. Conclusions: Since dental caries and fracture are the most important factors that predispose teeth to crown lengthening surgery, controlling caries with a regular recall sequence can reduce the need for such surgery, especially in the elderly.

  5. Stress in Laboratory Juvenile Rabbits: Physiological Indicators

    Directory of Open Access Journals (Sweden)

    Adina Baias


    Full Text Available The aim of this study was to assess the effect of stress on the main physiologic indicators: body temperature, heart rate, respiratory rate, urinary cortisol and creatinine levels and fecal corticosterone in juvenile rabbits (Oryctolagus cuniculus. One seven-week old group-reared rabbits were kept in individual isolation for 24 hours in metabolic cages. This caused the increase at the skin level of the mean body temperature measured, from 31.2°C to 31.5°C, also an increase of the mean heart rate, from 201 beats/min. to 217 beats/min. and an increase of the mean respiratory rate from 47 respirations/min. to 55 respirations/min. At the end of the individual isolation period, the average urinary cortisol/creatinine ratio was of: 9.09 x 10-6 and the average value of fecal corticosterone was 557 ng/g. Isolation of group-reared individuals, represents a stress factor that influence the welfare of animals used in scientific experiments, in this respect, fecal corticosterone and urinary cortisol measurements represent an useful non-invasive method for the stress assessment in laboratory animals used for scientific purposes.

  6. [Surgery of renoureteral lithiasis. Current indications]. (United States)

    González Enguita, C; Calahorra Fernández, F J; Cabrera Pérez, J; García Cardoso, J; Rodríguez-Miñón Cifuentes, J L; García de la Peña, E; Vela Navarrete, R


    Today, the issue about kidney and ureteral stone and their management is based on ESWL (Extracorporeal Shock Wave Lithotripsy) like singly or as a part of combination therapy. In some cases, endoscopic procedures (URS, PNL) with contact lithotripsy, is the first-line treatment. Retroperitoneoscopic is a therapeutical option in some hospitals. Open stone surgery is now drastically reducing and the endoscopic and extracorporeal methods are increasing, overcoat ESWL in those hospitals who has an own lithotripter. The optimal results of non-invasive procedures, and the ESWL advantages for the patients (outpatient and anesthesia-free treatment, decreased morbidity,...), has caused limited annual indications of open surgery for stone disease even a complete disappearance in many center. The Stone and Lithotripsy Unit of "Jiménez Díaz" Foundation (FJD) (Madrid), who has an own lithotipter (Modulith SL 20, STORZ) make an evaluation of 54 patients treated with open surgery (1990-2000) in order to reflect on the indications. Nephrectomy for serious paremquimal lithiasic lesions (complicated pyelonefhritis, xantogranulomatosis....) is not included. The open surgery techniques for stone diseases were the classic according to every case: pielolithotomy (simple or extended +/- infundibulolithotomy), anatrophic nephrotomy, ureterolithotomy,.... At the same time it should be resolved those anomalous structures or obstruction associated to the stone disease (congenital hydroneprosis, ureterocele,...). Now days are difficult cases of stone diseases to be managed for any methods included open surgery. It's the renal complex stone. Of course, surgery is the best option, the more effectively choice. When endoscopic procedures (URS, NPL) fall and the stone is synthomatic must be operated. When they are serious situation (septic shock, complications derived from the others methods,...). It's necessary an urgent and effectively treatment and it's the open surgery. Open surgery is

  7. 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.

  8. 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 ...

  9. 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 problem solving was related to greater pathologic 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.

  10. Oncoplastic breast surgery: indications, techniques and perspectives. (United States)

    Munhoz, Alexandre Mendonça; Montag, Eduardo; Gemperli, Rolf


    Breast-conservation surgery (BCS) is established as a safe option for most women with early breast cancer. Recently, advances in oncoplastic techniques have reduced surgical trauma and thus are capable of preserving the breast form and quality of life. In spite of the most BCS defects can be managed with primary closure, the aesthetic outcome may be unpredictable. Oncoplastic reconstruction may begin at the time of BCS (immediate), weeks (delayed-immediate) or months to years afterwards (delayed). With immediate reconstruction, the surgical process is smooth, since both procedures can be associated in one operative setting. Additionally, it permits wider excision of the tumor, with a superior mean volume of the specimen and potentially reducing the incidence of margin involvement. The oncoplastic techniques are related to volume displacement or replacement procedures including local flaps, latissimus dorsi myocutaneous flap and reduction mammaplasty/masthopexy. Regardless of the fact that there is no consensus concerning the best approach, the criteria are determined by the surgeon's experience and the size of the defect in relation to the size of the remaining breast. On the basis of our 15-year experience, it is possible to identify trends in types of breast defects and to develop an algorithm for immediate BCS reconstruction on the basis of the initial breast volume, the extent/location of glandular tissue ressection and the remaining available breast tissue. The main advantages of the technique utilized should include reproducibility, low interference with the oncologic treatment and long-term results. Surgical planning should include the patients's preferences, and chiefly addressing individual reconstructive requirements, enabling each patient to receive an individual "custom-made" reconstruction.

  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. Physiological Indicators in the Welfare Assessment of Riding Horses

    Directory of Open Access Journals (Sweden)

    Silvana Popescu


    Full Text Available The welfare assessment of horses includes the evaluation of their ability to cope with the challenges of theirenvironment and of work given to them. The aim of this study was to evaluate the welfare of 12 clinically healthyhorses from a riding school, using physiological indicators. Double determinations were made (in winter and inspring of 2011 by a set of two tests each time, before and after physical effort. The clinical parameters (heart andrespiratory rate were in the normal range at 20 minutes after effort, decreasing towards the resting values. Slightlyhigher values were recorded in the spring comparing with the winter, but the differences were not statisticallysignificant (P>0.05. Even if were in the normal range, the results of the haematology tests and the blood sugarvalues showed clearly the response of the horses’ organisms to exercise. The serum cortisol concentrations presentedan effort dependent elevation and higher values of the basic level were observed in the spring than in winter. Theother stress-response indicator recorded, the neutrophyle-lymphocyte ratio, showed dynamics correlated with that ofthe cortisol level. The physiological indicators tested in this study proved their real value in the riding horses’welfare assessment.

  13. 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

  14. Physiological and psychological indices of fatigue during static contractions. (United States)

    Kilbom, A; Gamberale, F; Persson, J; Annwall, G


    The development of fatigue and the relationship between psychological and physiological indices of fatigue were studied in a group of 18 male subjects during static contractions. Exercise was performed as a static elbow flexion at 25% MVC. Heart rate (HR), intraarterial blood pressure (BP) and surface EMG [mean amplitude (MA) and central frequency (CF)] were studied during contractions sustained until exhaustion. The amount of effort expended (relative to total exhaustion) and the rating of perceived pain were recorded following contractions interrupted after 20, 30 . . . 80, and 100% of endurance time. HR, BP and EMG amplitude responses were similar to those previously recorded. The decline in CF occurred in two phases, possibly related to a change in motor unit recruitment after the initial 70% of endurance time. The subjects overestimated the amount of effort expended and thus underestimated their endurance capacity. The best correlation between perceived effort and physiological responses was obtained using blood pressure data, whereas changes in EMG data did not parallel the psychological responses. It is concluded that the perception of effort during a static contraction is produced through a complex process, in which several influences of peripheral and central origin are integrated.

  15. 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.

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

    DEFF Research Database (Denmark)

    Kessel, Line; Andresen, Jens; Erngaard, Ditte


    The need for cataract surgery is expected to rise dramatically in the future due to the increasing proportion of elderly citizens and increasing demands for optimum visual function. The aim of this study was to provide an evidence-based recommendation for the indication of cataract surgery based....... 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....

  17. 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.

  18. [Indications and surveillance of platelet transfusions in surgery]. (United States)

    Coffe, C; Bardiaux, L; Couteret, Y; Devillers, M; Leroy, M; Morel, P; Pouthier-Stein, F; Hervé, P


    Surgery, after hematology, is the biggest consumer of homologous platelet concentrates. Platelet transfusion is indicated to prevent or control bleeding associated with deficiencies in platelet number or function. In surgery, general patterns (in function of pre-surgery platelet count) can be adopted in most of the indications for platelets. In emergency situations, and in some particular cases (related to the patient, the type of operation, etc.), the transfusion procedure depends on the team's experience, the results of the available clinical and biological tests, and the drugs. Strict monitoring is required during the transfusion procedure. The efficacy of the transfusion must be controlled 1 h and 24 hours after the transfusion, and a number of factors must be assessed, namely the immunological impact of the transfusion (on red blood cells, leukocytes and platelets) and the occurrence of infectious diseases transmitted via transfusion. In addition, for a possible future transfusion, a strategy must be proposed.

  19. 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.

  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. [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.

  2. Review of post bariatric surgery effects on common genitourinary physiology. (United States)

    Yacoubian, Aline A; Nasr, Rami


    Obesity is a worldwide challenging health problem. Weight loss through medical management of obesity has not always been successful, thus, giving rise to the need for surgical intervention. Bariatric surgery has been shown to be helpful for morbidly obese patients. However, studies have also shown the effect of surgery on stone formation, fertility and erectile function. This review summarizes the main findings of several studies that analyze stone formation and fertility in men as well as erectile function post bariatric surgery. The underlying pathophysiologic alterations post bariatric surgery include increased absorption of oxalate leading to hyperoxaluria, hypocitraturia and increased urinary calcium oxalate supersaturation. Contradicting data exist on the effect of bariatric surgery on fertility and erectile function. Further studies are needed to analyze the mechanisms. Copyright® by the International Brazilian Journal of Urology.

  3. 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

  4. 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

  5. Revisional Bariatric/Metabolic Surgery: What Dictates Its Indications? (United States)

    Ma, Pearl; Reddy, Subhash; Higa, Kelvin D


    Bariatric/metabolic surgery is currently the only effective long-term treatment for morbid obesity- and obesity-related diseases such as diabetes, heart disease, hypertension, obstructive sleep apnea, and dyslipidemia. In addition, bariatric/metabolic surgery has been shown to significantly reduce the incidence of diabetes and cancer and prolong life when compared to non-surgical therapies. However, as obesity is a chronic disease, recidivism of weight and comorbid conditions can occur. In addition, the surgical construct can lead to long-term consequences such as marginal ulceration, bowel obstruction, reflux, and nutritional deficiencies. Despite these drawbacks, prospective randomized controlled studies and long-term longitudinal population-based comparative studies greatly favor surgical intervention as opposed to traditional lifestyle, diet, and exercise programs. Revisional surgery can be quite complex and technically challenging and may offer the patient a wide variety of solutions for treatment of weight recidivism and complications after primary operations. Given the paucity of high quality published data, we have endeavored to provide indications for revisions after bariatric surgery.

  6. Effect of essential oil jasmine inhalation on physiological index of laparotomy patients in general surgery department.

    Directory of Open Access Journals (Sweden)

    Mohammad yadegary


    Conclusion: The physiologic parameters were markedly improved in intervention group after Jasmine essential oil inhalation compared to the control group, which prevented sudden and severe changes in patients waiting for surgery. Therefore, Jasmine essential oil inhalation may be an effective factor in reducing the anxiety and avoiding extreme changes in physiological parameters in patients which could be recommended in clinical situations.

  7. Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery


    Moreira Júnior,Hélio; Moreira,José P. T.; Isaac,Raniere R.; Almeida,Arminda C. de; Moreira,Hélio; Klug,Wilmar A.


    ORIGINAL CONTRIBUTION: understand the reasons why Duhamel surgery results in clinical improvement of constipation in patients with Chagasic colopathy. BACKGROUND: Duhamel surgery is one of the most widespread techniques for the treatment of Chagasic megacolon, with low rates of recurrence of constipation. OBJECTIVE: evaluate the anatomical and physiological changes in the pelvic diaphragm of patients with chagasic colopathy, as well as changes occurring after undergoing Duhamel surgery. DESIG...

  8. Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery


    Hélio Moreira Júnior; José P.T. Moreira; Raniere R. Isaac; Arminda C. de Almeida; Hélio Moreira; Wilmar A. Klug


    Original contribution: understand the reasons why Duhamel surgery results in clinical improvement of constipation in patients with Chagasic colopathy. Background: Duhamel surgery is one of the most widespread techniques for the treatment of Chagasic megacolon, with low rates of recurrence of constipation. Objective: evaluate the anatomical and physiological changes in the pelvic diaphragm of patients with chagasic colopathy, as well as changes occurring after undergoing Duhamel surgery. Desig...

  9. Aerobic exercise: bioenergetics, physiological adjustments, fatigue and performance indices

    Directory of Open Access Journals (Sweden)

    Fabrizio Caputo


    Full Text Available The objective of this study was to present relevant updated information regarding the physiological determinants of aerobic training and performance. In contrast to common concepts, the aerobic metabolism rapidly responds to energy requirements,with the anaerobic and aerobic energy systems equally contributing to total energy production during maximal exercise lasting about 75 s. However, in the case of longer exercise duration the possible mechanisms of fatigue related to anaerobic metabolism are still the main determinants of exercise tolerance. Prolonged exercise (more than one hour can be limited by several factors such as substrate depletion, water and electrolyte disturbance, or problems related to thermoregulation leading to an increase in body temperature. The most important variables of endurance performance have been organizedinto a model that integrates factors such as maximum oxygen uptake (VO2max, blood lactate thresholds, and muscle efficiency. For highly trained athletes, in addition to a high VO2max, success in endurance events also requires the ability to exercise forprolonged periods at a high percentage of VO2max, as well as to efficiently convert the energy produced into muscle work. Depending on the duration of the aerobic event, the training sessions should be aimed at improving VO2max, anaerobic lactate capacity andacidosis tolerance in the case of short-lasting events and aerobic capacity for events of intermediate duration, and at increasing muscle glycogen content and fat utilization in the case of long-lasting events.

  10. 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.

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

    African Journals Online (AJOL)



    Oct 10, 2011 ... indicating the involvement of both additive and non-additive gene action in their inheritance. Ys, STI and. WUE revealed highly significant differences for SCA, hence non-additive gene action was predominant for these traits. The best general combiners with positive effects, for improvement of Yp, Ys, STI, ...

  12. 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.

  13. Physiologic, psychologic, and metabolic consequences of bariatric surgery. (United States)

    Mango, Victoria L; Frishman, William H


    The successful management of obesity is essential to treat effectively its associated comorbidities such as systemic hypertension, diabetes, dyslipidemias, and obstructive sleep apnea. Current weight loss recommendations include reduced caloric intake, exercise, and pharmacologic treatments that often result in a minimal weight loss that is rarely maintained. Conversely, surgical procedures such as Roux-en-Y gastric bypass, adjustable gastric banding, vertical banded gastroplasty, or biliopancreatic diversion result in a more successful and maintained long-term weight loss. Bariatric surgery-induced weight loss is associated with improvements in cardiovascular risk factors such as systemic hypertension, hypertriglyceridemia, and low levels of high-density lipoprotein cholesterol. However, hypercholesterolemia does not appear to benefit from surgically induced weight loss. Patients also note improvement in associated respiratory comorbidities such as asthma and obstructive sleep apnea as well as diabetes. Although the risks of bariatric surgery are numerous, including gastrointestinal and respiratory complications and associated nutritional deficiencies, in an appropriately selected surgical candidate, as detailed by National Institutes of Health guidelines, the surgical treatment of obesity warrants serious consideration.

  14. Physiological and molecular responses to bariatric surgery: markers or mechanisms underlying T2DM resolution? (United States)

    Hutch, Chelsea R; Sandoval, Darleen A


    Bariatric surgery is currently the most effective treatment for obesity and associated comorbidities, including rapid resolution of type 2 diabetes mellitus (T2DM). Although the weight loss itself has substantial impact, bariatric surgery also has weight loss-independent effects on T2DM. Several variations of bariatric surgery exist, including the widely studied Roux-en-Y gastric bypass and vertical sleeve gastrectomy. The success of both of these bariatric surgeries was originally attributed to restrictive and malabsorptive modes of action; however, mounting evidence from both human and animal studies implicates mechanisms beyond surgery-induced mechanical changes to the gastrointestinal (GI) system. In fact, with bariatric surgery comes a spectrum of physiological responses, including postprandial enhancement of gut peptide and bile acids levels, restructuring of microbial composition, and changes in GI function and morphology. Although many of these processes are also essential for glucoregulation, the independent role of each in the success of surgery is still an open question. In this review, we explore whether these changes are necessary for the improvements in body mass and glucose homeostasis or whether they are simply markers of the physiological effect of surgery. © 2016 New York Academy of Sciences.

  15. 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)

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


    Tsivian,Matvey; Janice M.,Mayes; Krupski,Tracey L.; Mouraviev,Vladimir; Donatucci,Craig F.; Polascik,Thomas J.


    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...

  17. Evaluation of mental stress by physiological indices derived from finger plethysmography


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


    Background 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. Methods Thirty-one healthy women (mean age, 22 years ? 2) participated....

  18. 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 control group. This study provides empirical evidence to support the use of music during the preoperative period in reducing anxiety and unpleasant symptoms in women undergoing gynecologic surgery. © The Author(s) 2014.

  19. [Changes in indications for surgery in the management of diverticulitis]. (United States)

    Galli, Raffaele; Schnüriger, Beat; Brügger, Lukas; Inderbitzin, Daniel


    Diverticulitis is a common disease in western countries and its incidence is increasing especially among young patients. Colonic diverticulosis, incidentally diagnosed by endoscopy or CT-scanning, has no immediate clinical consequences. Progression to diverticulitis develops in only 4 % of cases. In the last decades management of diverticular disease evolved and expectative treatment and less invasive techniques have gained importance. Elective resection has traditionally been advised after a second episode of diverticulitis or after a first episode if the patient was less than 50 years of age or complicated disease occurred. Recent changes in understanding the natural history of diverticular disease have substantially modified treatment paradigms. Elective resection in case of recurrent diverticular disease should be performed on a individual basis and in cases with complications like intestinal obstruction or fistulas. Primary anastomosis is an option even in emergency surgery due to colonic perforation, while diverting operations are indicated for selected patient groups with a high risk profile. Several prospective studies showed good results for laparoscopic drainage and lavage in the setting of perforated diverticulitis with generalized peritonitis, though this concept needs to be controlled with randomized clinical trials before application into the daily practice. This article should provide a short overview of trends in the surgical treatment of diverticulitis, help to understand the natural history of the disease and thereby explain the currently lower frequency of surgical interventions for diverticulitis.

  20. 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.

  1. 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

  2. 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.

  3. Indications for surgery in advanced/metastatic GIST. (United States)

    Ford, Samuel J; Gronchi, Alessandro


    Gastrointestinal stromal tumours (GISTs) are a relatively rare entity and often present as a locally advanced tumour or with metastatic disease. Complete surgical resection is the only means of cure in localised disease; however, imatinib therapy has greatly advanced the management of GIST and is established as both an adjunct to surgery in high-risk cases and as principle therapy in metastatic disease. Surgery in advanced GIST has undergone a renaissance in recent years with the potential for a combined treatment approach with either neoadjuvant imatinib in locally advanced primary disease or as an adjunct to imatinib in those with metastases or recurrent disease. Neoadjuvant imatinib can render a locally advanced primary GIST resectable, allow less invasive procedures or promote preservation of function, especially if the tumour is located in an anatomically difficult position. The role of surgery in metastatic or recurrent disease is more controversial and case selection is critical. The potential benefit is difficult to quantify, although surgery may have a limited favourable impact on progression-free survival and overall survival for those patients whose disease is responding to imatinib or those with limited focal progression. Patients with imatinib resistant disease should not be offered surgery unless as an emergency where palliative intervention may be justified. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. Animal models in bariatric surgery--a review of the surgical techniques and postsurgical physiology. (United States)

    Rao, Raghavendra S; Rao, Venkatesh; Kini, Subhash


    Bariatric surgery is considered the most effective current treatment for morbid obesity. Since the first publication of an article by Kremen, Linner, and Nelson, many experiments have been performed using animal models. The initial experiments used only malabsorptive procedures like intestinal bypass which have largely been abandoned now. These experimental models have been used to assess feasibility and safety as well as to refine techniques particular to each procedure. We will discuss the surgical techniques and the postsurgical physiology of the four major current bariatric procedures (namely, Roux-en-Y gastric bypass, gastric banding, sleeve gastrectomy, and biliopancreatic diversion). We have also reviewed the anatomy and physiology of animal models. We have reviewed the literature and presented it such that it would be a reference to an investigator interested in animal experiments in bariatric surgery. Experimental animal models are further divided into two categories: large mammals that include dogs, cats, rabbits, and pig and small mammals that include rats and mice.

  5. pulmonary indices in post—abdominal surgery patients

    African Journals Online (AJOL)

    Apical; lateral—costal; postero-basal and diaphragmatic breathing exercises. The elective ... Vital capacity and peak expiratory flow rates were measured daily after each exercise training session. ... that breathing exercise training improved vital capacity and peak expiratory flow rate of the abdominal surgery patients. It was.

  6. [Advanced age--indication or contraindication for laparoscopic colorectal surgery?]. (United States)

    Gunka, I; Dostalík, J; Martínek, L; Guńková, P; Mazur, M; Vávra, P


    The aim of this study was to evaluate the results of laparoscopically-assisted (LAC) and open (OC) colorectal surgery in elderly patients (a 75 years) and to compare them to a cohort of younger patients (Patients who underwent elective laparoscopically-assisted or open colorectal surgery in the period between January 2001 and December 2009 were included in the analysis. The primary end point was the incidence of short-term postoperative morbidity and mortality, long-term overall and colorectal cancer specific survival which were analyzed in relation to the age and operative technique. During the study period, 557 elective laparoscopic and 404 elective open colorectal operations were performed. 190 patients (20 %) were older than 75 years, 99 of which underwent laparoscopic and 91 open surgery. In geriatric patients, the open approach was associated with increase of postoperative morbidity, statistically nonsignificant (LAC > or = 75 years 30% vs. OC or = 75 years 30% vs. LAC patients were associated with a significant increase of postoperative complications compared to younger patients (OC > or = 75 years 40% vs. OC geriatric patients (LAC > or = 75 years 5% vs. OC > or = 75 years 3%, p=0,548). Mortality rate did not differ in both age groups operated laparoscopically (LAC > or = 75 years 5% vs. LAC or = 75 years 3% vs. OC or = 75 years 43 +/- 8% vs. LAC or = 75 years 76 +/- 9% vs. LAC or = 75 years 67 +/- 7% vs. OC patients surgical technique did not influenced overall five year survival (LAC > or = 75 years 43 +/- 8% vs. OC > or = 75 years 35 +/- 7%, p = 0,428), even five year colorectal cancer specific survival (LAC . or = 75 years 76 +/- 9% vs. OC a 75 years 69 +/- 7%, p = 0,393). Laparoscopically-assisted colorectal surgery should be particularly considered in geriatric patients, for the reason of lower incidence of postoperative complications. Oncological safety of miniinvasive approach in the treatment of colorectal cancer is valid also for the specific

  7. Indications and Use of Isotretinoin in Facial Plastic Surgery. (United States)

    Heppt, Markus V; Kirchberger, Michael C; Ruzicka, Thomas; Berking, Carola; Heppt, Werner J


    Isotretinoin is a first generation retinoid with pleiotropic effects on keratinocyte differentiation, proliferation, and activity of sebaceous glands. For years, there has been intense debate on whether the use of isotretinoin combined with cosmetic or surgical procedures is safe and potentially more efficient than either therapy alone. Due to delays in wound healing and keloid formation, conservative recommendations were not to combine isotretinoin with any plastic surgery or local treatment at 6 to 12 months after discontinuation of the drug. However, there is increasing evidence that a combination approach is not only safe, but may also provide excellent cosmetic outcomes in acne scars, sebaceous gland hyperplasia, and thick-skinned patients undergoing facial plastic surgery. In particular, low-dose regimens of isotretinoin may offer advantages over standard dosage treatments because of better tolerability and safety in long-term use adjunct with surgical interventions. In this article, the authors aim to summarize the current evidence on the use of isotretinoin in facial plastic surgery and to share their experience from selected patients. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. 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.

  9. Patients with single ventricle physiology undergoing noncardiac surgery are at high risk for adverse events. (United States)

    Brown, Morgan L; DiNardo, James A; Odegard, Kirsten C


    Patients with single ventricle physiology are at increased anesthetic risk when undergoing noncardiac surgery. To review the outcomes of anesthetics for patients with single ventricle physiology undergoing noncardiac surgery. This study is a retrospective chart review of all patients who underwent a palliative procedure for single ventricle physiology between January 1, 2007 and January 31, 2014. Anesthetic and surgical records were reviewed for noncardiac operations that required sedation or general anesthesia. Any noncardiac operation occurring prior to completion of a bidirectional Glenn procedure was included. Diagnostic procedures, including cardiac catheterization, insertion of permanent pacemaker, and procedures performed in the ICU, were excluded. During the review period, 417 patients with single ventricle physiology had initial palliation. Of these, 70 patients (16.7%) underwent 102 anesthetics for 121 noncardiac procedures. The noncardiac procedures included line insertion (n = 23); minor surgical procedures such as percutaneous endoscopic gastrostomy or airway surgery (n = 38); or major surgical procedures including intra-abdominal and thoracic operations (n = 41). These interventions occurred on median day 60 of life (1-233 days). The procedures occurred most commonly in the operating room (n = 79, 77.5%). Patients' median weight was 3.4 kg (2.4-15 kg) at time of noncardiac intervention. In 102 anesthetics, 26 patients had an endotracheal tube or tracheostomy in situ, 57 patients underwent endotracheal intubation, and 19 patients had a natural or mask airway. An intravenous induction was performed in 77 anesthetics, an inhalational induction in 17, and a combination technique in 8. The median total anesthetic time was 126 min (14-594 min). In 22 anesthetics (21.6%), patients were on inotropic support upon arrival; an additional 24 patients required inotropic support (23.5%), of which dopamine was the most common medication. There were 10

  10. Surgery is not indicated for the treatment of premature ejaculation (United States)

    Anaissie, James; Yafi, Faysal A.


    Premature ejaculation (PE) is considered the most common male sexual disorder, affecting up to 75% of men at some point in their lives. While medical management is the mainstay of therapy, surgical options such as dorsal nerve neurectomy (DNN), hyaluronic acid (HA) gel glans penis augmentation, and circumcision have been studied as alternative forms of treatment. Preliminary studies have suggested that DNN and HA gel glans penis augmentation are relatively safe and effective, but due to a lack of large, multicenter, randomized-control trials with long-term follow-up, the International Society of Sexual Medicine (ISSM) has been unable to endorse DNN or HA gel glans penis augmentation as options in the treatment of PE. Conflicting data regarding the efficacy and safety of circumcision has similarly led to its exclusion from ISSM recommendations for the treatment of PE. Ethical concerns, particularly the fundamental concept of non-maleficence, are also barriers to the implementation of surgery for PE. PMID:27652232

  11. 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.

  12. 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

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. Physiology (United States)

    Kay, Ian


    Underlying recent developments in health care and new treatments for disease are advances in basic medical sciences. This edition of "Webwatch" focuses on sites dealing with basic medical sciences, with particular attention given to physiology. There is a vast amount of information on the web related to physiology. The sites that are included here…

  18. 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.

  19. 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 (Pgynecologic 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, worse preoperative conditions and surgical complications remained independent risk factors associated with the higher rate of readmission among patients with gynecologic cancer.

  20. Passive acoustic monitoring of human physiology during activity indicates health and performance of soldiers and firefighters (United States)

    Scanlon, Michael V.


    The Army Research Laboratory has developed a unique gel-coupled acoustic physiological monitoring sensor that has acoustic impedance properties similar to the skin. This facilitates the transmission of body sounds into the sensor pad, yet significantly repels ambient airborne noises due to an impedance mismatch. The sensor's sensitivity and bandwidth produce excellent signatures for detection and spectral analysis of diverse physiological events. Acoustic signal processing detects heartbeats, breaths, wheezes, coughs, blood pressure, activity, motion, and voice for communication and automatic speech recognition. The health and performance of soldiers, firefighters, and other first responders in strenuous and hazardous environments can be continuously and remotely monitored with body-worn acoustic sensors. Comfortable acoustic sensors can be in a helmet or in a strap around the neck, chest, and wrist. Noise-canceling sensor arrays help remove out-of-phase motion noise and enhance covariant physiology by using two acoustic sensors on the front sides of the neck and two additional acoustic sensors on each wrist. Pulse wave transit time between neck and wrist acoustic sensors will indicate systolic blood pressure. Larger torso-sized arrays can be used to acoustically inspect the lungs and heart, or built into beds for sleep monitoring. Acoustics is an excellent input for sensor fusion.

  1. 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.

  2. Use of behavioral and physiological indicators to evaluate Scaphirhynchus sturgeon spawning success (United States)

    DeLonay, A.J.; Papoulias, D.M.; Wildhaber, M.L.; Annis, M.L.; Bryan, J.L.; Griffith, S.A.; Holan, S.H.; Tillitt, D.E.


    Thirty gravid, female shovelnose sturgeon (Scaphirhynchus platorynchus) were captured in the Lower Missouri River in March 2004 to evaluate the effectiveness of physiology, telemetry and remote sensor technology coupled with change point analysis in identifying when and where Scaphirhynchus sturgeon spawn. Captured sturgeons were instrumented with ultrasonic transmitters and with archival data storage tags (DST) that recorded temperature and pressure. Female sturgeon were tracked through the suspected spawning period. Thereafter, attempts were made to recapture fish to evaluate spawning success. At the time of transmitter implantation, blood and an ovarian biopsy were taken. Reproductive hormones and cortisol were measured in blood. Polarization indices and germinal vesicle breakdown were assessed on the biopsied oocytes to determine readiness to spawn. Behavioral data collected using telemetry and DST sensors were used to determine the direction and magnitude of possible spawning-related movements and to identify the timing of potential spawning events. Upon recapture observations of the ovaries and blood chemistry provided measures of spawning success and comparative indicators to explain differences in observed behavior. Behavioral and physiological indicators of spawning interpreted along with environmental measures may assist in the determination of variables that may cue sturgeon reproduction and the conditions under which sturgeon successfully spawn.


    Directory of Open Access Journals (Sweden)

    Prystupa Tetyana


    Full Text Available The research objective is defining the influence of exposure to heat during the Finnish sauna treatment in the morning hours on selected physiological indices in men, who were monitored during a series of three sauna treatments in a row. 74 healthy men took part in the studies. Body weight and its composition was diagnosed with the help of TANITA BODY COMPOSITION ANALYZER TBF-300 based on bioelectrical impedance analysis. The conducted research confirm the hypothesis about the positive effect of the Finnish sauna on the body mass components, such as body mass, BMI, TBW (kg and % body fat.

  4. Biomusic: An auditory interface for detecting physiological indicators of anxiety in children

    Directory of Open Access Journals (Sweden)

    Stephanie Cheung


    Full Text Available For children with profound disabilities affecting communication, it can be extremely challenging to identify salient emotions such as anxiety that if left unmanaged, can lead to hypertension, cardiovascular disease, and other psychological diagnoses. Physiological signals of the autonomic nervous system are indicative of anxiety, but can be difficult to interpret for non-specialist caregivers. This paper evaluates an auditory interface for intuitive detection of anxiety from physiological signals. The interface, called Biomusic, maps physiological signals to music (i.e. electrodermal activity to melody; skin temperature to musical key; heart rate to drum beat; respiration to a whooshing embellishment resembling the sound of an exhalation. The Biomusic interface was tested in two experiments. Biomusic samples were generated from physiological recordings of typically developing children (n=10 and children with autism spectrum disorders (n=5 during relaxing and anxiety-provoking conditions. Adult participants (n=16 were then asked to identify anxious or relaxed states by listening to the samples. In a classification task with 30 biomusic samples (1 relaxed state, 1 anxious state per child classification accuracy, sensitivity, and specificity were 80.8% (standard error (SE = 2.3%, 84.9% (SE = 3.0%, and 76.8% (SE = 3.9%, respectively. Participants were able to form an early and accurate impression of the anxiety state within 12.1 seconds (SE = 0.7 seconds of hearing the Biomusic with very little training (i.e. < 10 minutes and no contextual information. Biomusic holds promise for monitoring, communication, and biofeedback systems for anxiety management.

  5. 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.

  6. The effect of nature sounds on physiological indicators among patients in the cardiac care unit. (United States)

    Ghezeljeh, Tahereh Najafi; Nasari, Maryam; Haghani, Hamid; Rezaei Loieh, Habiballah


    Environmental noises may create physiological and psychological disorders in patients hospitalized in the CCU. Therefore, this study was conducted to investigate the effects of nature sounds on physiological indicators among patients in the CCU. This randomized clinical trial was conducted on 93 patients hospitalized in the cardiac care units of three teaching hospitals in 2016. The patients were selected using the convenient method with three randomized blocks. The patients were assigned into three groups as nature sounds, silence that received a set of headphones without playing sounds, and control groups. In addition to routine care, the patients in the intervention group listened to nature sounds for 30 min using a set of headphones for two days. The patients in the control group only received routine care. In addition to routine care, the patients in the silence group used a set of headphones for 30 min to block noises and no sound was played for them. Physiological indicators such as heartbeat rate, systolic and diastolic blood pressures, respiration rate, and arterial O 2 saturation were assessed using monitoring devices. Descriptive and inferential statistics were used for data analysis via the SPSS software. Nature sounds and silence had no statistically significant effects on physiological indicators. However, a statistically significant difference was reported in the heart rate in the nature sound group before and after the intervention in the first day of the intervention (P = 0.046). In the second day of the intervention, there were statistically significant differences in the diastolic blood pressure in the nature sounds group (P = 0.028), heart rate (P = 0.001) and diastolic blood pressure (P = 0.013) in the silence group, and heart rate (P = 0.014) in the control group before and after the intervention. Listening to nature sounds or the use of headphones blocked environmental noises and could influence mean arterial pressure. Future

  7. 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

  8. 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.

  9. 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 significant. Three of the four cosmetic surgery procedures investigated (Rh, n = 1540; Li, n = 1291; BA, n = 1959) demonstrated a direct (ie, positive) statistical correlation to all three major market 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.

  10. The effect of two different interval-training programmes on physiological and performance indices. (United States)

    Sindiani, Mahmood; Eliakim, Alon; Segev, Daria; Meckel, Yoav


    The aim of the present study was to compare the effect of an increasing-distance, interval-training programme and a decreasing-distance, interval-training programme, matched for total distance, on aerobic and anaerobic physiological indices. Forty physical education students were randomly assigned to either the increasing- or decreasing-distance, interval-training group (ITG and DTG), and completed two similar relevant sets of tests before and after six weeks of training. One training programme consisted of increasing-distance interval-training (100-200-300-400-500 m) and the other decreasing-distance interval training (500-400-300-200-100 m). While both training programmes led to a significant improvement in VO 2 max (ES = 0.83-1.25), the improvement in the DTG was significantly greater than in the ITG (14.5 ± 3.6 vs. 7.8 ± 3.2%, p training programmes led to a significant improvement in all anaerobic indices (ES = 0.83-1.63), the improvements in peak power (15.7 ± 7.8 vs. 8.9 ± 4.7), mean power (10.6 ± 5.4 vs. 6.8 ± 4.4), and fatigue index (18.2 ± 10.9 vs. 7.0 ± 14.2) were significantly greater in the DTG compared to the ITG (p training programmes on aerobic and anaerobic fitness, the DTG showed significant superiority over the ITG in improving aerobic and anaerobic performance capabilities. Coaches and athletes should therefore be aware that, in spite of identical total work, an interval-training programme might induce different physiological impacts if the order of intervals is not identical.

  11. Reoperations in bariatric surgery - indications and initial evaluation of postoperative complications. (United States)

    Kuchinka, Jakub; Nawacki, Łukasz; Bryk, Piotr; Matykiewicz, Jarosław; Wawrzycka, Iwona; Kozieł, Dorota; Rogula, Tomasz; Głuszek, Stanisław


    Obesity, at present, seems to be a very serious health problem all over the world. The surgery is said to be the most successful treatment of obesity. With the increase in the quantity of conducted bariatric procedures, the number of revision treatments increases as well. The aim of the study was to analyze the indications, results and complications after repeated bariatric surgeries. The repeated bariatric procedures performed in 2009-2015 have been retrospectively analyzed. The endpoint of the study was the evaluation of early surgical treatment results-up to 30th day after repeated surgery. Overall, amongs 103 obese patients with a BMI over 35 kg / m2, qualified for bariatric treatment 7 revision surgeries were conducted (6.8%). Two operations were carried out by laporotomy, other by laparoscopy. In the study group, neither any deaths were noted in perioperative period nor life-threatening complications. The frequency of complications-Surgical site infection and bleeding from the staple lines of stapler in the study group appeared to be 28.6%. Qualification for repeated bariatric surgeries should be based on a thorough analysis of the condition of the patient, previous outcome of the bariatric treatment: evaluation of weight loss as well as possible complications of the original surgery.

  12. 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.

  13. 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

  14. Anatomical and physiological changes in pelvic diaphragm in patients with chagasic megacolon submitted to Duhamel surgery

    Directory of Open Access Journals (Sweden)

    Hélio Moreira Júnior


    Full Text Available Original contribution: understand the reasons why Duhamel surgery results in clinical improvement of constipation in patients with Chagasic colopathy. Background: Duhamel surgery is one of the most widespread techniques for the treatment of Chagasic megacolon, with low rates of recurrence of constipation. Objective: evaluate the anatomical and physiological changes in the pelvic diaphragm of patients with chagasic colopathy, as well as changes occurring after undergoing Duhamel surgery. Design: clinical data and results of cinedefecography, electromanometry and anorectal ultrasound of the anal canal were evaluated in patients with Chagasic colopathy, before and after Duhamel surgery. Location: Service of Coloproctology – Departament of Surgery, Faculdade de Medicina da Universidade Federal de Goiás. Patients: patients with positive serology for Chagas Disease, with constipation and radiological megacolon, who presented consecutively to the Chagas outpatient clinic and freely agreed to participate in this study, were prospectively included. Results: a total of 20 patients were included, with a mean age of 53.2 years, of which 16 were women. The following parameters were observed in the postoperative period: change in bowel frequency, of, on average, one evacuation every ten days to daily bowel movement; 16 patients used laxatives preoperatively and only one did, intermittently, in postoperative period. Electromanometry showed, postoperatively, a decrease in anal resting pressure (60.88 to 37.2 mmHg p < 0.001 and anal squeeze pressures (244.3 mL to 161.25 p = 0.01, whereas ultrasound showed that 75% of the patients had abnormalities of the internal anal sphincter in the posterior anal canal juxtaposed to the pulled-through colon. Postoperative rectal emptying observed in cinedefecographic tests occurred more quickly and with less effort when compared with the preoperative findings. There was a change in the anorectal angle postoperatively

  15. 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

  16. The effect of creatine supplementation on muscle fatigue and physiological indices following intermittent swimming bouts. (United States)

    Dabidi Roshan, V; Babaei, H; Hosseinzadeh, M; Arendt-Nielsen, L


    We evaluated the effect of Creatine (Cr) supplementation on muscle fatigue and physiological indices after intermittent swimming bouts in trained swimmers. Sixteen healthy non-elite swimmers (19±4 years, 75±12 kg) were randomly assigned into two groups of either Cr supplementation or placebo and performed six repeated sprints swimming bouts of 50-m departing every 120 seconds. The Cr group was supplemented 4 times a day for 6 days. Blood lactate, Creatine Kinase (CK), creatinine, heart rate, best repeated sprint (RSb) and mean repeated sprint (RSm) times, and percentage of speed decrement (%Dec) were measured at the various phases of swimming bouts. Repeated measure ANOVA and independent t-student tests showed CK and blood lactate concentration increased gradually after the third and sixth swimming bouts. % Dec in Cr group was significantly lower after 3rd swimming bout, also heart rate in Cr group was associated with lower increase in HR mean (Psupplementation may improve swimming performance and reduce increased blood lactate levels following intermittent sprint swimming bouts. In conclusion Cr supplementation in trained swimmers may improve anaerobic performance and heart rate variations independent of the effect of intensive sprint swimming bouts.

  17. Current indications of low-level laser therapy in plastic surgery: a review. (United States)

    Hersant, Barbara; SidAhmed-Mezi, Mounia; Bosc, Romain; Meningaud, Jean Paul


    The aim of this comprehensive review is assess the relevant indications of LLLT in plastic surgery. Low-level laser therapy (LLLT) is a safe adjunct treatment for a myriad indications such as pain, musculoskeletal disorders, or oral mucositis in cancer patients. A systematic literature review was performed using the automated computerized PubMed search, with the key words low-level laser therapy and plastic surgery. In vivo and in vitro comparative studies conducted in humans or animals were included. A total of 113 articles were retrieved for screening, and 40 articles were analyzed for data extraction: 28 on animals and 12 on humans. Thirteen studies on animals showed that LLLT had efficacy in the improvement of flap survival. LLLT on a single spot over the pedicle area of the flap or near the base of the flap seemed to be superior to multi-irradiation. Also, LLLT seemed to improve chronic burn scars in humans, and acute wound healing in animals. On the contrary, LLLT cannot be considered as a valid therapeutic option for venous ulcers. The published studies on alopecia did not show that LLLT had efficacy for this indication, and on skin aging only two studies are reported showing that LLLT globally improved aging of skin. No side effects have been reported. More comparative studies are needed to validate and widen the medical indications of LLLT in plastic surgery.

  18. A case study of infant physiologic response to skin-to-skin contact following surgery for complex congenital heart disease (United States)

    Harrison, Tondi M.; Ludington-Hoe, Susan


    Background Infants with complex congenital heart disease requiring surgical intervention within the first days or weeks of life may be the most seriously ill infants needing intensive nursing and medical care immediately after birth. Skin to skin contact (SSC) is well-accepted and practiced as a positive therapeutic intervention in premature infants, but is not routinely offered to infants in cardiac intensive care units. Physiologic effects of SSC in the congenital heart disease population must be examined before recommending incorporation of SSC into standard care routines. Objective The purpose of this case study was to describe the physiologic response to a single session of SSC in an 18-day-old infant with hypoplastic left heart syndrome. Methods Repeated measures of heart rate, respiratory rate, oxygen saturation, blood pressure, and temperature were recorded 30 minutes prior to SSC, during SSC (including interruptions for bottle and breast feedings), and 10 minutes after SSC was completed. Results All physiologic parameters were clinically acceptable throughout the 135-minute observation. Conclusion This case study provides beginning evidence that SSC is safe in full-term infants following surgery for complex congenital heart disease. Further research with a larger sample is needed to examine effects of SSC on infant physiology before surgery and earlier in the postoperative time period as well as on additional outcomes such as length of stay, maternal-infant interaction, and neurodevelopment. PMID:25325374

  19. [Perineal regional anaesthesia: indications in gynaecologic and proctologic surgery and in obstetric]. (United States)

    Bolandard, F; Bonnin, M; Duband, P; Mission, J-P; Bazin, J-E


    Perineal and proctologic surgery is well known as very painful. The apparition of new specific needles, long acting and less toxic local anaesthetics and neurostimulation allowed reconsidering some old forgotten techniques. Those blocks appear really useful to optimize multimodal postoperative analgesia and postoperative rehabilitation. After anatomic review, authors describe perineal regional anaesthesia and discuss about main indications and advantages, in the eyes of their experience and bibliographic review.

  20. Combined environmental stress and physiological strain indices for physical training guidelines. (United States)

    Moran, Daniel S; Pandolf, Kent B; Heled, Yuval; Gonzalez, Richard R


    The purpose of this study was to develop guidelines based on the previously described environmental stress index (ESI) and physiological strain index (PSI) for work-rest cycles (WRC) during training, especially in the military. The ESI was introduced as a potential substitute for the Wet Bulb Globe Temperature Index because of the very high correlation coefficients between them. The ESI is constructed from the fast-reading meteorological response sensors ambient temperature (Ta), relative humidity (RH), and global radiation (GR), which require only a few seconds to reach equilibrium. The ESI, the first stress index using direct measurements of solar radiation (SR), is calculated as follows: ESI = 0.63Ta - 0.03RH + 0.002SR + 0.0054 (Ta x RH) - 0.073(0.1 + SR)(-1). The PSI is based on heart rate (HR) and rectal temperature (Tre) and can indicate heat strain online and analyze databases. The PSI is constructed as follows: PSI = 5(Tret - Tre0) x (39.5 - Tre0)(-1) + 5(HRt - HR0) x (180 - HR0)(-1), where Tre0 and HR0 are the initial Tre and HR, and Tret and HRt are simultaneous measurements taken at any time. The PSI is scaled from 0 to 10, whereby the respective variables, PSIHR and PSITre, representing the cardiovascular and thermoregulation systems, can contribute up to five units to the overall strain assessment. To integrate the PSI and ESI, we decided to use only the PSIHR component, which represents the metabolic rate and the strain reflected by the cardiovascular system. Furthermore, PSIHR is easier to measure, is easier to implement, and simplifies the integration with ESI. Concomitantly, PSIHR categorizes the strain between 0 and 5, the higher the value, the higher the strain. We believe that the use of the PSI WRC values will help in decreasing the risk of future heat injuries.

  1. [Determination of physiological indices in Albizzia julibrissin Durazz seedlings under alkaline stress with visible spectrophotometry]. (United States)

    Zhou, Jian; Zhang, Lin; Yuan, De-Yi; Qi, An-Guo


    There is a large area of saline-alkali soil in our country, and soil alkalization is always a problem affecting urban gardening. To examine the capacity of alkaline resistance of Albizzia julibrissin Durazz seedlings, the contents of MDA, soluble sugar and proline, and the activity of POD and SOD in Albizzia julibrissin durazz tree body were measured by means of visible spectrophotometry. Also, the change patterns of the five indexes with different treatment concentration and time were analyzed. Attempts were then made to elucidate the physiological mechanism of how alkaline stress affects the growth of the Albizzia julibrissin durazz tree, which could provide theoretical foundation for planting and gardening and an approach to dealing with the difficulties in planting and gardening in saline and alkaline area. The results showed that with the increase in Na2 CO3 concentration, the contents of MDA and soluble sugar in the leaves slowly ascended when the treatment concentration was lower than 75 mmol x L(-1), and then rapidly increased when the treatment concentration was higher than 75 mmol x L(-1); There were significant differences between different treatments. Proline content exhibited the same change pattern with MDA and soluble sugar. It slowly ascended when the treatment concentration was lower than 100 mmol x L(-1), whereas it sharply increased when the treatment concentration was above 100 mmol x L(-1); The changes in SOD and POD were similar, showing a unimodal pattern. However, the treatment concentration corresponding to the maximum of SOD and POD was 50 and 75 mmol x L(-1), respectively. With the changes in stress time, in addition, the contents of MDA treated with the same concentration increased gradually. However, praline, soluble sugar, SOD and POD changed irregularly. These results indicated that Albizzia julibrissin Durazz could resist the alkaline stress by modulating values of physical indexes such as the contents of MDA, soluble sugar and

  2. Significance of preoperative calculation of uterine weight as an indicator for preserving the uterus in pelvic reconstructive surgery. (United States)

    Sheng, Qingsong; Ma, Ning; Huang, Huijuan; Xu, Bo; He, Chunni; Song, Yanfeng


    Recently, increasing evidence has shown that uterus preservation is beneficial for pelvic organ prolapse (POP) patients, both physiologically and psychologically. However, the preoperative indicators for uterus preservation have rarely been examined. The current study was designed to determine the relationship between the preoperative evaluated uterus weight and the operation selection (preserving the uterus or not) in pelvic reconstructive surgery (PRS) using vaginal meshes. First, in a series of 96 patients undergoing hysterectomy, the uterine weight was calculated by preoperative ultrasound measurements, and was then compared with the postoperative actual weight of the uterus. Subsequently, in a series of 65 patients undergone PRS using vaginal meshes and preserving the uterus, the uterine weight was calculated by preoperative ultrasound measurements. Lastly, in a series of 43 patients with a uterine weight > 56.12 g who had undergone PRS using vaginal meshes, the operation success rate in patients with a preserved uterus was compared to patients for whom the uterus was not preserved. The results showed that uterus weight can be evaluated by ultrasound and used as a preoperative indicator for whether the uterus should be preserved or not in PRS when using vaginal meshes. It was indicated that preoperative evaluation of uterine weight is beneficial for surgical planning and guidance.

  3. The Effect of Foot Massage on Physiological Indicators of Female Patients with CVA Admitted in the ICU

    Directory of Open Access Journals (Sweden)

    Z Moshtaqeshgh


    Full Text Available Introduction: Intensive care unit is one of stressful wards for patients and stress creates some alterations in physiologic indicators of patients. So it is necessary to use a low expense and comforting method to stabilize physiologic indicators. The purpose of the present research is to determine the effect of foot massage on physiologic indicators including pulse, respiration, mean arterial pressure, temperature and arterial blood oxygen saturation. Methods: This research was a quasi experimental study and a clinical trial with repeated measures in which 46 patients with brain stroke hospitalized in intensive care unit of Tajrish Shohada Hospital in Tehran were studied. Information was collected 10 minutes before and 10 and 30 minute intervals after foot stroke massage on the second, third and fourth days of ICU admission. Data was analyzed with repeated measures ANOVA statistical method. Results: Findings showed that after 5-minute foot massage, pulse rate, respiratory rate and mean arterial blood pressure significantly decreased (P<0.001 and spo2 increased (P<0.001. Decreasing temperature was significant but alterations were little and clinically it can be said that body temperature had no alteration and approximately remained constant. Conclusion: Findings showed that parasympathetic activity after foot massage results in alteration of various body physiologic responses, relaxes patients and decreases their anxiety. Therefore anxiety of patients can decreased with using a simple, low expense and non invasive method and can stabilize physiologic indicators and decrease effects of vital signs instability.

  4. 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

  5. Pregnancy outcomes and nutritional indices after 3 types of bariatric surgery performed at a single institution. (United States)

    Mead, Nancy C; Sakkatos, Panagiotis; Sakellaropoulos, George C; Adonakis, George L; Alexandrides, Theodore K; Kalfarentzos, Fotis


    Nutritional status during pregnancy and the effects of nutritional deficiencies on pregnancy outcomes after bariatric surgery is an important issue that warrants further study. The objective of this study was to investigate pregnancy outcomes and nutritional indices after restrictive and malabsorptive procedures. We investigated pregnancy outcomes of 113 women who gave birth to 150 children after biliopancreatic diversion (BPD), Roux-en-Y gastric bypass (RYGB), and sleeve gastrectomy (SG) between June 1994 and December 2011. Biochemical indices and pregnancy outcomes were compared among the different types of surgery and to overall 20-year hospital data, as well as to 56 presurgery pregnancies in 36 women of the same group. Anemia was observed in 24.2% and 15.6% of pregnancies after BPD and RYGB, respectively. Vitamin B12 levels decreased postoperatively in all groups, with no further decrease during pregnancy; however, low levels were observed not only after BPD (11.7%) and RYGB (15.6%), but also after SG (13.3%). Folic acid levels increased. Serum albumin levels decreased in all groups during pregnancy, but hypoproteinemia was seen only after BPD. Neonates after BPD had significantly lower average birth weight without a higher frequency of low birth weight defined asnutritional supplement guidelines are followed. Closer monitoring is required in pregnancies after malabsorptive procedures especially regarding protein nutrition. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  6. 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)

  7. Tonsil surgery in Sweden 2013-2015. Indications, surgical methods and patient-reported outcomes from the National Tonsil Surgery Register. (United States)

    Hallenstål, Niclas; Sunnergren, Ola; Ericsson, Elisabeth; Hemlin, Claes; Hessén Söderman, Anne-Charlotte; Nerfeldt, Pia; Odhagen, Erik; Ryding, Marie; Stalfors, Joacim


    To describes how tonsil surgery was performed in Sweden from 2013 to 2015 with data from the National Tonsil Surgery Registry in Sweden (NTSRS). The registry collects data from both professionals and patients through questionnaires. A total of 33,870 tonsil surgeries were analysed, comprising approximately 80% of all tonsil surgeries in Sweden from 2013 to 2015. The two most common procedures were tonsillectomy (41%) and tonsillotomy with adenoidectomy (38%). Tonsillectomy was most commonly performed to treat frequent tonsillitis, while the main indication for tonsil surgery with combined adenoidectomy and for tonsillotomy alone was upper airway obstruction. The most commonly used techniques were cold steel (70%) for tonsillectomy/adenotonsillectomy and radiofrequency (79%) for tonsillotomy/adenotonsillotomy. Ninety-five percent of patients reported symptom relief after 180 d. Day surgery was utilised in 70% of the surgeries. The rate of readmission due to post-tonsillectomy haemorrhage was 5.1%. Male patients more often underwent tonsil surgery at preschool ages due to upper airway obstruction; in comparison, female patients to a larger extent underwent surgery in their early teens because of previous infections. The NTSRS provides an opportunity to survey tonsil surgery in Sweden and to launch and follow up improvement programmes as desired.

  8. 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

  9. 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…

  10. Evaluation of indicated non-cosmetic panniculectomy at time of gynecologic surgery. (United States)

    Rasmussen, Ryan W; Patibandla, Jay R; Hopkins, Michael P


    To report postoperative outcomes among patients undergoing indicated non-cosmetic panniculectomy at the time of gynecologic surgery. Medical charts were retrospectively reviewed for patients who underwent panniculectomy coupled with gynecologic surgery at a university-affiliated hospital in the USA in 1990-2014. The data reviewed included age, body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters), surgical procedure, estimated blood loss, pathology, wound complication, diabetes, hypertension, smoking, and readmission rate. One-way analysis of variance and logistic regression were used to evaluate the data. In total, 300 patients underwent panniculectomy; the mean age was 51 years and the mean BMI was 46. Overall, there were 94 (31.3%) complications, including 85 (28.3%) cases of superficial cellulitis and 9 (3.0%) cases of surgical-site infection. In logistic regression, diabetes, hypertension, and smoking were significant predictors of wound complications, identifying 78% of women who subsequently developed wound complications. Panniculectomy combined with gynecologic surgery was found to be safe and effective for obese patients, with an acceptable incidence of wound infection. History of diabetes, hypertension, and smoking increased the risk of postoperative wound complications. These factors will help to predict patients at risk of wound complication. © 2017 International Federation of Gynecology and Obstetrics.

  11. 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...

  12. 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...

  13. Visualization and simulated surgery of the left ventricle in the virtual pathological heart of the Virtual Physiological Human (United States)

    McFarlane, N. J. B.; Lin, X.; Zhao, Y.; Clapworthy, G. J.; Dong, F.; Redaelli, A.; Parodi, O.; Testi, D.


    Ischaemic heart failure remains a significant health and economic problem worldwide. This paper presents a user-friendly software system that will form a part of the virtual pathological heart of the Virtual Physiological Human (VPH2) project, currently being developed under the European Commission Virtual Physiological Human (VPH) programme. VPH2 is an integrated medicine project, which will create a suite of modelling, simulation and visualization tools for patient-specific prediction and planning in cases of post-ischaemic left ventricular dysfunction. The work presented here describes a three-dimensional interactive visualization for simulating left ventricle restoration surgery, comprising the operations of cutting, stitching and patching, and for simulating the elastic deformation of the ventricle to its post-operative shape. This will supply the quantitative measurements required for the post-operative prediction tools being developed in parallel in the same project. PMID:22670207

  14. 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.

  15. 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.

  16. 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.

  17. Clinical indications and perspectives for intraoperative cone-beam computed tomography in oral and maxillofacial surgery. (United States)

    Pohlenz, Philipp; Blessmann, Marco; Blake, Felix; Heinrich, Sven; Schmelzle, Rainer; Heiland, Max


    Intraoperative cone-beam computerized tomography (CBCT) imaging has been introduced in oral and maxillofacial surgery. Using midfacial fractures as the pioneer model, this study describes the spectrum of further promising clinical indications for intraoperative CBCT and a clinical combination with intraoperative navigation. One hundred seventy-nine patients admitted for surgical treatment of the facial skeleton were included in the study. Intraoperatively, 3-dimensional images were generated with the mobile CBCT scanner Arcadis Orbic 3D, obtained from Siemens Medical Solutions, in a variety of indications. The acquisition of the data sets was uncomplicated, and image quality was sufficient to assess the postoperative result in all cases. In the example of a facial gunshot injury, a navigation system for intraoperative localization of the metal foreign bodies was used.

  18. Non-fusion surgery for degenerative spondylolisthesis using artificial ligament stabilization: surgical indication and clinical results. (United States)

    Kanayama, Masahiro; Hashimoto, Tomoyuki; Shigenobu, Keiichi; Oha, Fumihiro; Ishida, Takashi; Yamane, Shigeru


    A retrospective study. To report midterm clinical and radiographic results of Graf artificial ligament stabilization in the treatment of degenerative spondylolisthesis and to evaluate the role of this procedure and its surgical indications for surgical success. Nonfusion surgeries including artificial disc replacement and ligamentoplasty are increasingly gaining interest to avoid adverse effects of spinal fusion. Sixty-four consecutive patients with degenerative spondylolisthesis underwent artificial ligament stabilization. Surgical indication was symptomatic degenerative spondylolisthesis with adjacent segment pathologies (6.3%). One patient (1.6%) underwent consequent spinal arthrodesis at the ligamentoplasty level. Artificial ligament stabilization did not improve the vertebral slip but maintained lordosis and preserved segmental motion in 80% of patients. This procedure is an effective alternative to spinal arthrodesis in the treatment of symptomatic degenerative spondylolisthesis (Grade I) with minimal disc space narrowing and coronal facet tropism.

  19. 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.

  20. Selection of students in the sports section of physiological mobility indicators

    Directory of Open Access Journals (Sweden)

    Nebesnaya V.V.


    Full Text Available It is examined the relationship between the structural units coaching impacts and responses to them, the body of athletes. The study involved 60 athletes aged 16-18 years. A comparative analysis of physiological parameters of different types of functional mobility of the surveyed sports and physical activity assessment of the impact on the physical performance of athletes is shown. It is established that the appropriate training sessions and to determine the positive effect of physical activity, you need to take into account individual typological features of the central nervous system.

  1. Assessment of salinity tolerance in rice using seedling based morpho-physiological indices

    Directory of Open Access Journals (Sweden)

    Syed Adeel Zafar


    Full Text Available Background: Salinity is among the most damaging abiotic stresses for rice production which limits its growing area. The present research was conducted to evaluate five rice varieties for salinity tolerance at seedling stage. Methods: Experiment was conducted in triplicate and in two sets. One set was grown as a control (non-stress and other as salt stressed. Salt stress of 15 dS/m was applied to one set of rice seedlings under controlled conditions. Data for different growth related morpho-physiological traits, i.e. germination percentage, root and shoot length, seedling fresh and dry weight, Na+ and K+ uptake were recorded after 15 days of seedling emergence under control as well as salinity condition. Results: Significant differences were observed among the genotypes under both the treatments and interaction of the evaluated traits suggested a significant variability among the rice genotypes under salt stress. NIAB-IRRI-9, Basmati-198 and KSK-133 were proved to be relatively salt tolerant varieties as they showed good performance for the recorded parameters. However, Basmati-385 was observed a salt sensitive variety due to highest reduction in seedling fresh and dry weight along with the maximum Na+ uptake. Conclusion: Based on obtained results, it was concluded that the evaluated morpho-physiological traits were useful to screen rice cultivars for salinity stress. In addition, NIAB-IRRI-9, Basmati-198 and KSK-133 can be used in breeding programs as tolerant check and Basmati-385 can be used as sensitive check.

  2. 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...

  3. 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.

  4. Indications for extra full projection anatomical cohesive silicone gel implants in cosmetic and reconstructive breast surgery. (United States)

    Mario, Avelina I; Molina, Alexandra R; Malata, Charles M


    In 2003, a new extra full projection (EFP) anatomic cohesive silicone gel breast implant was introduced onto the European market. This review presents the early experience of a single surgeon with this new implant over a 29-month period. Between 2003 and 2006, the McGhan Style 410 EFP breast implants were inserted for highly selected indications. Twenty-eight patients received a total of 47 EFP implants. Their age range was 23 to 66 years (mean: 46 years). The implant was used in 6 primary and 7 revisional cosmetic breast augmentation patients. The series included 9 postmastectomy breast reconstructions. In further, 6 patients the implant was used to revise existing breast reconstructions. After a mean follow-up period of 31 months, there were no infections, malrotations, or significant capsular contractures and no patients have required revisional implant surgery. The novel implant was successfully used to address specific challenges in cosmetic and reconstructive breast surgery. These included large skin envelopes in breast augmentation patients declining mastopexy, complicated implant exchanges, and suboptimal prosthetic breast reconstructions. This prosthesis may prove a useful addition to the range of breast implants available, especially when there is an overlap of challenging esthetic problems.

  5. Minimally invasive approach to thyroid gland surgery--indications, methods, first results. (United States)

    Dimov, R; Kanchev, R; Apostolov, I; Boev, B; Ivanov, T; Hinov, A; Doikov, I; Cheshmedzhiev, N; Mitev, K; Spasov, Y; Dimova, R


    After the introduction of minimally invasive operative techniques in the surgery of organs located in body cavities, extensive work has been done in the last five years with respect to their application in thyroid gland surgery as well. In 2011, 406 patients underwent thyroid surgery at the Department of Surgery, Kaspela General Hospital for Active Treatment EOOD - Plovdiv. The study involved 48 of these patients, chosen at random and divided into two groups (A-minimally invasive thyroidectomy (MIT) - 26 patients, and B - minimally invasive video-assisted thyroidectomy (MIVAT) - 22 patients). All patients included in the study were selected on the basis of presence of one or more indeterminate nodules (fine needle aspiration biopsy - FNAB) sized up to 3.5 cm, with normal size of the thyroid gland up to 20-25 cm2, detected by preoperative ultrasonography. The study excluded patients with recurrent goitre, malignant disease of the thyroid gland and evidence of preoperative radiation therapy in the area of the head, neck and/or upper mediastinum. The preoperative investigation included history, physical examination, blood indices, echography, gamma camera and FNAB. Sensation of pain was evaluated by the patients according to a visual analogue scale, where lack of pain was evaluated as 0, and the most severe pain was evaluated as 10. The average duration of the hospitalization of patients undergoing MIT was 16 +/- 3.14 hours, whereas the patients undergoing MIVAT had to stay at the hospital for 18 +/- 3.56 hours. No complications were registered regarding the recurrent laryngeal nerves (RLN), as well as the operative wound. It should be noted that in all patients the course of the respective RLN was identified during the operative intervention, visually in most cases, or by electrostimulation. Postoperative hypoparathyroidism, registered by measuring the level of serum calcium, was observed in one visual analogue scale, as well as in the administration of pain

  6. Meek micrografting history, indications, technique, physiology and experience: a review article. (United States)

    Quintero, Eduardo Camacho; Machado, Jesús Francisco Escrivá; Robles, Roger Andres Damian


    Traumatic loss of skin, particularly in major burns, requires skin grafting to repair the tissue. For a large burn, where donor sites are limited, the skin graft may need to be expanded. In addition, rapid wound closure is a large factor in successful recovery and is usually achieved by debridement and skin grafting. Micrografting was introduced by Meek and involved dividing the skin into small pieces, allowing for up to a tenfold skin expansion. We conducted a review of the literature, searched via Medline, Pubmed and Embase (from 1958 to June 2017), searching to identify studies and reports of micrografting. We searched using the Medical Subject Headings (MeSH) 'micrograft', 'micrograft technique', 'Meek', 'Meek technique', 'Parker Cicero', 'major burn treatment' and 'mesh skin graft'. We analysed 24 articles in which the description and modifications presented by the micrograft technique were presented, along with evidence that supports or rejects its use. The consensus was for the use of micrografting in burns of >30% total body surface area (TBSA). On poor wound beds, the evaluation of re-epithelialisation had greater success due to low metabolic demands and greater skin coverage compared with control groups (pMeek' group, the micrograft group had fewer surgeries (10 versus 19.75), shorter average length of hospital stay (51 days versus 120.5 days; p30% TBSA, with inadequate donor sites and comorbidities, such as diabetes. However, disadvantages include a 'polka dot' appearance on healing and the fact the initial surgeries, creating the micrograft squares, are labour-intensive.

  7. District-level surgery in Uganda: Indications, interventions and perioperative mortality. (United States)

    Löfgren, Jenny; Kadobera, Daniel; Forsberg, Birger C; Mulowooza, Jude; Wladis, Andreas; Nordin, Pär


    The world's poorest 2 billion people, benefit from no more than about 3.5% of the world's operative procedures. The burden of surgical disease is greatest in Africa, where operations could save many lives. Previous facility-based studies have described operative procedure caseloads, but prospective studies investigating interventions, indications and perioperative mortality rates (POMR), are rare. A prospective, questionnaire-based collection of data on all major and minor operative procedures was undertaken at 2 hospitals in rural Uganda covering 4 and 3 months in 2011, respectively. Data included patient characteristics, indications for the interventions performed, and outcome after surgery. We recorded 2,790 operative procedures on 2,701 patients. The rate of major operative procedures per 100,000 population per year was 225. Patients undergoing major operative procedures (n = 1,051) were mostly women (n = 923; 88%) because most interventions were performed owing to pregnancy-related complications (n = 747; 67%) or gynecologic conditions (n = 114; 10%). General operative interventions registered included herniorrhaphy (n = 103; 9%), exploratory laparotomy (n = 60; 5%), and appendectomy (n = 31; 3%). The POMR for major operative procedures was 1% (n = 14) and was greatest after exploratory laparotomy (13%; n = 8) and caesarean delivery (1%; n = 4). Most deaths (n = 16) were a result of sepsis (n = 10-11) or hemorrhage (n = 3-5). The volume of surgery was low relative to the size of the catchment population. The POMR was high. Exploratory laparotomy and caesarean section were identified as high-risk procedures. Increased availability of blood, improved perioperative monitoring, and early intervention could be part of a solution to reduce the POMR. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Soil eco-physiological indicators from a coal mining area in El Bierzo District (Spain). (United States)

    Díaz Puente, Fco. Javier; Mejuto Mendieta, Marcos; Cardona García, Ana Isabel; Rodríguez Gallego, Vergelina; García Álvarez, Avelino


    CIEMAT. Avda. Complutense, 22. 28040 Madrid. Spain. The El Bierzo carboniferous basin (León, N.W. of Spain) is placed in a tenth of the surface of this district, in the area called "Bierzo Alto". Coal has been mined in El Bierzo from the late XVIII century, having been intensely exploited during the XX century. The mining activity has left a heritage of withdrawed mining structures. Nowadays some mining activity remains in the area, and new exploitations based on open pit processes, cause the burial of natural soil with overlaying mine tailings. Characterization and study of the edaphic landscapes in the area is a necessary activity within the framework of its overall restoration planning, also providing fundamental information for the design and monitoring of waste coal recovery activities. For this work eight zones were chosen, representing the spatial variability within the upper basin of the Rodrigatos river, into the Bierzo Alto, including reference areas not affected by mining activities. In addition three mine tailings outside the area are included in this work to cover the variability of restoration processes. After a first study, based on physical, physico-chemical and chemical characteristics of soils, we have continued the study including some eco-physiological parameters. The objective of this work is to identify potential soil disruption, its extent and causes. Soil microbial activity is influenced by a wide set of soil characteristics. Eco-physiological parameters analysed in this work are: • Microbial Biomass carbon • Basal Respirometry • Maximum respiratory rate Microbial biomass carbon was analysed according the Substrate Induced Respirometry (SIR) method. Relational parameters such as metabolic quotient (CO2-C/Cmic) and the Cmic/Corg ratio have been obtained from these variables. Our results shown that soil microbial biomass carbon is strongly influenced by the water holding capacity (WHC) of the samples (R=0,895) as well as by organic

  9. 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

  10. 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.

  11. Proteogenomic Analysis of a Hibernating Mammal Indicates Contribution of Skeletal Muscle Physiology to the Hibernation Phenotype. (United States)

    Anderson, Kyle J; Vermillion, Katie L; Jagtap, Pratik; Johnson, James E; Griffin, Timothy J; Andrews, Matthew T


    Mammalian hibernation is a strategy employed by many species to survive fluctuations in resource availability and environmental conditions. Hibernating mammals endure conditions of dramatically depressed heart rate, body temperature, and oxygen consumption yet do not show the typical pathological response. Because of the high abundance and metabolic cost of skeletal muscle, not only must it adjust to the constraints of hibernation, but also it is positioned to play a more active role in the initiation and maintenance of the hibernation phenotype. In this study, MS/MS proteomic data from thirteen-lined ground squirrel skeletal muscles were searched against a custom database of transcriptomic and genomic protein predictions built using the platform Galaxy-P. This proteogenomic approach allows for a thorough investigation of skeletal muscle protein abundance throughout their circannual cycle. Of the 1563 proteins identified by these methods, 232 were differentially expressed. These data support previously reported physiological transitions, while also offering new insight into specific mechanisms of how their muscles might be reducing nitrogenous waste, preserving mass and function, and signaling to other tissues. Additionally, the combination of proteomic and transcriptomic data provides unique opportunities for estimating post-transcriptional regulation in skeletal muscle throughout the year and improving genomic annotation for this nonmodel organism.

  12. [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

  13. 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)

  14. Outcomes of anterior lumbar interbody fusion surgery based on indication: a prospective study. (United States)

    Rao, Prashanth J; Loganathan, Ajanthan; Yeung, Vivian; Mobbs, Ralph J


    There is limited information on clinical outcomes after anterior lumbar interbody fusion (ALIF) based on the indications for surgery. To compare the clinical and radiological outcomes of ALIF for each surgical indication. This prospective clinical study included 125 patients who underwent ALIF over a 2-year period. The patients were evaluated preoperatively and postoperatively. Outcome measures included the Short Form-12, Oswestry Disability Index, Visual Analog Scale, and Patient Satisfaction Index. After a mean follow-up of 20 months, the clinical condition of the patients was significantly better than their preoperative status across all indications. A total of 108 patients had a Patient Satisfaction Index score of 1 or 2, indicating a successful clinical outcome in 86%. Patients with degenerative disk disease (with and without radiculopathy), spondylolisthesis, and scoliosis had the best clinical response to ALIF, with statistically significant improvement in the Short Form-12, Oswestry Disability Index, and Visual Analog Scale. Failed posterior fusion and adjacent segment disease showed statistically significant improvement in all of these clinical outcome scores, although the mean changes in the Short Form-12 Mental Component Summary, Oswestry Disability Index, and Visual Analog Scale (back pain) were lower. The overall radiological fusion rate was 94.4%. Superior radiological outcomes (fusion >90%) were observed in patients with degenerative disk disease (with and without radiculopathy), spondylolisthesis, and failed posterior fusion, whereas in adjacent segment disease, it was 80%. ALIF is an effective treatment for degenerative disk disease (with and without radiculopathy) and spondylolisthesis. Although results were promising for scoliosis, failed posterior fusion, and adjacent segment disease, further studies are necessary to establish the effectiveness of ALIF in these conditions.

  15. 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.

  16. 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...

  17. 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.

  18. Endoscopic Ear Surgery: Critical Review of Anatomy and Physiology of Normal and Reconstructive Middle Ear. (United States)

    Udagatti, Vithal D; Dinesh Kumar, Rajendran


    Middle ear anatomy is complex hence it is difficult to study the microscopic vibration of tympanic membrane and ossicles. The basic research has been done in few centres. Our experience is based on clinical data. The lack of quantitative understanding of structural and functional relationship in the mechanical response of the normal and reconstructed middle ear is major factor in poor hearing results after surgery (Merchant et al. in J Laryngol Otol 112:715-731, 1998). The vibration pattern of tympanic membrane changes with different frequencies. It depends upon shape, position and tension of tympanic membrane. Sometimes reconstructed tympanic membrane loses its shape and tension and thus its vibratory response (Pusalkar and Steinbach in Transplants and implants in otology II, 1992). Then what should be the shape, position, tension of the tympanic membrane and the ossicles. In order to have a serviceable hearing, dry and safe ear, there is a necessity of answering all these queries by us.

  19. Influence of data quality on computed Dutch hospital quality indicators: a case study in colorectal cancer surgery

    NARCIS (Netherlands)

    Dentler, Kathrin; Cornet, Ronald; ten Teije, Annette; Tanis, Pieter; Klinkenbijl, Jean; Tytgat, Kristien; de Keizer, Nicolette


    Background: Our study aims to assess the influence of data quality on computed Dutch hospital quality indicators, and whether colorectal cancer surgery indicators can be computed reliably based on routinely recorded data from an electronic medical record (EMR). Methods: Cross-sectional study in a

  20. 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.

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

    African Journals Online (AJOL)

    Eyelid surgeries were performed on 237 eyes of 221 persons, 121(54.8%) were males. Mean age was 30.3 ± 17.8 years. Eyelid lacerations, chalazia, and eyelid tumours accounted for 30%, 25.8%, 21% of all morbidities respectively. 249 eyelid surgeries were performed, 246 (98.8%) as minor procedures and 3(1.2%) as ...

  2. Indications for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in elderly patients with peritoneal malignancy. (United States)

    Kitai, Toshiyuki; Yamanaka, Kenya; Miyauchi, Yuya; Kawashima, Masahiro


    A combination of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS + HIPEC) is effective for some peritoneal malignancies. However, the indications for elderly patients remain unclear, with substantial postoperative morbidity and mortality being problematic. Clinical data were analyzed in 42 patients undergoing CRS + HIPEC for peritoneal malignancy. The primary tumor was located in the appendix in 32 cases and elsewhere in 10 cases. Operative results and survival data were compared between patients aged ≥70 and Elderly patients had a higher peritoneal cancer index (32.0 vs. 21.5), higher CA19-9 level (189.0 vs. 28.1), and higher frequency of grade 4-5 complications (5/9 vs. 2/26) than the younger patients. Grade 4-5 respiratory failure occurred in three elderly patients. There was a significant difference of postoperative survival between the elderly patients and younger patients, with 5-year survival rates being 41.3 and 74.2%, respectively (p = 0.0166). The poor prognosis of elderly patients was related to the higher frequency of grade 4-5 complications. Elderly patients were referred for treatment with more advanced disease than younger patients. An age ≥70 years was associated with more frequent grade 4-5 complications and worse survival. Performing CRS + HIPEC in elderly patients should be considered carefully due to the risk of severe complications, especially respiratory failure.

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

    Directory of Open Access Journals (Sweden)

    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

  4. Tomographic index as auxiliary criteria for surgery indication in fracture dislocation of acetabulum posterior wall

    Directory of Open Access Journals (Sweden)

    Fujiki Edison N


    Full Text Available Abstract There are situations which the tomographic exam is done on the affected hip or situations where the contralateral hip presents abnormalities that make it impossible to compare. In this study we aimed to evaluate a tomographic index that does not require comparison between the both hips. Twenty two patients with unilateral acetabular fracture dislocation with fracture of posterior wall were studied. We established the relationship between the remaining posterior wall and the femoral head diameter (head/wall index-H/W index. We evaluated 45 two-dimensional computed tomography scan in normal hips and established the H/W index. In 45 normal hips we simulated a posterior wall fracture with involvement of 25% and 30% of the posterior wall and calculated the H/W index. We divided into five groups with five different H/W index (fractured group with non surgical treatment; fractured group; normal group; normal group with simulated fracture of 25% and; 30% of the posterior wall. 2.4 was the lowest limit of confidence interval of the group with 25% of the posterior wall fracture. When we analyzed the confidence interval of the 30% fracture group the upper limit of the confidence interval was 2.7, close to the lower limit of the surgical group that was 2.9. Thus, we suggest the 2.4 the H/W index limit as an auxiliary criteria to indicate whether or not to operate. H/W index is helpful to decide whether or not surgery indication in the fracture dislocation of the posterior wall of the acetabulum.

  5. Behavioral and physiological indices related to BMI in a cohort of primary schoolchildren in Greece. (United States)

    Manios, Yannis; Yiannakouris, Nikos; Papoutsakis, Constantina; Moschonis, George; Magkos, Faidon; Skenderi, Katerina; Zampelas, Antonis


    The purpose of this study was to investigate the differences between normal weight and overweight primary schoolchildren in terms of certain cardiovascular disease (CVD) risk factors and furthermore to identify behavioral correlates significantly affecting their body mass index (BMI). The sample consisted of 198 children with a mean age of 11.5 +/- 0.4 years (106 females and 92 males). Data was obtained on children anthropometry, plasma lipids, plasma glucose, dietary intake, cardiorespiratory fitness, and physical activity. Significant gender differences were observed for most of these parameters, with boys being more active and fit but also spending more time on sedentary activities and exhibiting higher intake of energy and fat compared to girls. Using the International Obesity Task Force's (IOTF) BMI cut-off points, the prevalence of overweight and obesity was estimated to be 35.6% and 6.7% among boys and 25.7% and 6.7% among girls, respectively. Overweight and obese children had higher levels of plasma triglycerides (TG) and total cholesterol to HDL-cholesterol (TC/HDL-C) ratio and lower levels of HDL-C and physical fitness compared to their normal-weight peers. Among the behavioral variables tested, only participation in organized sports, cardiorespiratory fitness, and TV watching were significantly correlated with BMI, while energy and fat intake were found to have no significant effect. The current study suggests that even in childhood, overweight and obesity are indicative of an unfavorable lipidemic profile. Among the behavioral parameters known to affect BMI, those found to exert a significant effect were organized physical activities, cardiorespiratory fitness, and TV watching, but not energy or fat intake. (c) 2004 Wiley-Liss, Inc.

  6. 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.

  7. Effect of exogenously application selected phytohormonal substances on the physiological and morphological indicators of Philadelphus x hybrid in containers

    Directory of Open Access Journals (Sweden)

    Martin Jonáš


    Full Text Available The experiment was established in order to eliminate the effect of stress factors acting on woody plants cultivated in containers. The timber Philadelphus x hybrid ’Mont Blanc’. The timber was in 1.5 l containers. The experiment was evaluated effect of exogenouse application of phytohormonal substances on select physiological indicators (stomatal conductance, chlorophyll fluorescence and chlorophyll content, were measured three times during the vegetation. Morphological indicators (diameter of root neck, total length of shoots and number of shoots, were evaluated at the end of vegetation. Phytohormones affecting the impact of stress on plants were used for the purpose. Abscisic acid, 24- epibrassinolid, kinetin and spermine were applied by spraying the leaf in three concentrations (0.01 mg.l−1, 0.1 mg.l−1 a 1 mg.l−1. In the results were found highly significant differences compared to controls with other variants, especially in the evaluation of physiological parameters. The most significant influence on the stomatal conductance was observed in the variants treated with abscisic acid. Application 24- epibrassinolid significantly increased the chlorophyll content in comparison with control variant. Morphological parameters reached the best results in variants treated with 24- epibrassinolid and spermine.

  8. Correlation between Surgeon's experience, surgery complexity and the alteration of stress related physiological parameters. (United States)

    Marrelli, Massimo; Gentile, Stefano; Palmieri, Francesca; Paduano, Francesco; Tatullo, Marco


    In the present work we analyzed the hormonal (salivary Cortisol; sC), immune (salivary Immunoglobulin A; sIgA) and cardiovascular (Heart rate, HR, and systolic blood pressure, SBP) responses induced by stress conditions in oral surgeons, randomly recruited according to their expertise level. Each surgeon performed three different surgical procedures with increasing degrees of technical difficulty and under time-limited conditions, to assess whether these variants may influence the risks of stress-induced secondary hypertension among the involved health professionals. sC and sIgA samples and cardiovascular function measurements were taken up before, during, and two hours after every surgery. Salivary samples and cardiovascular measurements were taken also during non-surgical days, as baseline controls. We observed that more experienced surgeons showed a higher stress management ability compared to those with less experience or, generally, younger, which are more exposed to the risks of developing secondary hypertension. Nevertheless, indipendently of sex and experience, oral surgeons are constantly exposed to high risks of developing stress-related diseases. On the basis of the issues addressed and the results obtained, we have highlighted the importance of the investigated stress biomarkers to monitor and to prevent stress-related pathologies among oral surgeons. This approach is aimed to emphasize the significance of these specific stress-biomarkers, which represent a powerful instrument to evaluate stress levels in oral surgeons, and that may help to reduce the most severe life-threatening risks to which they are daily exposed. In conclusion, final goal of this study is to suggest an useful guideline to monitor the stress levels of oral and maxillofacial surgeons in order to improve their quality of life, which is inevitably reflected on the quality of the performances provided and, finally, to prevent possible mistakes in their daily activities.

  9. Correlation between Surgeon's experience, surgery complexity and the alteration of stress related physiological parameters.

    Directory of Open Access Journals (Sweden)

    Massimo Marrelli

    Full Text Available In the present work we analyzed the hormonal (salivary Cortisol; sC, immune (salivary Immunoglobulin A; sIgA and cardiovascular (Heart rate, HR, and systolic blood pressure, SBP responses induced by stress conditions in oral surgeons, randomly recruited according to their expertise level.Each surgeon performed three different surgical procedures with increasing degrees of technical difficulty and under time-limited conditions, to assess whether these variants may influence the risks of stress-induced secondary hypertension among the involved health professionals. sC and sIgA samples and cardiovascular function measurements were taken up before, during, and two hours after every surgery. Salivary samples and cardiovascular measurements were taken also during non-surgical days, as baseline controls.We observed that more experienced surgeons showed a higher stress management ability compared to those with less experience or, generally, younger, which are more exposed to the risks of developing secondary hypertension. Nevertheless, indipendently of sex and experience, oral surgeons are constantly exposed to high risks of developing stress-related diseases.On the basis of the issues addressed and the results obtained, we have highlighted the importance of the investigated stress biomarkers to monitor and to prevent stress-related pathologies among oral surgeons. This approach is aimed to emphasize the significance of these specific stress-biomarkers, which represent a powerful instrument to evaluate stress levels in oral surgeons, and that may help to reduce the most severe life-threatening risks to which they are daily exposed. In conclusion, final goal of this study is to suggest an useful guideline to monitor the stress levels of oral and maxillofacial surgeons in order to improve their quality of life, which is inevitably reflected on the quality of the performances provided and, finally, to prevent possible mistakes in their daily activities.

  10. 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…

  11. Indications for destructive eye surgeries among adults in a tertiary eye care center in North CENTRAL Nigeria. (United States)

    Odugbo, O P; Wade, P D; Samuel, O J; Mpyet, C D


    Destructive eye surgery is a management option offered patients when further retention of the globe is likely to affect ocular and general health or jeopardize survival. Indications for this procedure vary and could reflect the pattern of severe or end stage ocular morbidities in a given environment. To assess the indications for destructive eye surgeries and to ascertain the proportion avoidable. Jos University Teaching Hospital, Jos, Nigeria. The ophthalmic surgical database of our facility was retrospectively reviewed to obtain information on patients who had destructive eye surgery from January 2008 - December 2015. These included demographics, clinical features, preoperative diagnosis, indication for surgery and type of destructive eye surgeries. The total number of ophthalmic surgeries within the study period was also computed. The data was entered into Epi Info statistical software, version3.4 (Epi InfoTM, Atlanta, Georgia,USA) and analyzed after validation by double entry. Eighty five destructive eye surgeries consisting of 2.5% of all surgical operations were performed on adults (aged ≥18years). There were 51(60%) males with a male: female ratio of 1.5:1 (pexenteration. The main indications for destructive eye surgeries included trauma to the eyes in 39(45.9%), intractable infections in 32(37.6%), tumours in 7(8.2%) and painful blind eye in 3(3.5%); anterior staphyloma and phthisis bulbi each accounted for 2(2.4%). We observed that an adult male was four times more likely to lose an eye from trauma than a female (p<0.05). An individual was less likely to lose an eye to trauma with increasing age (p<0.05) but more likely to lose an eye to intractable infection with increasing age (p<0.001). There is a downtrend in the frequency of destructive eye surgeries in our center with males more likely to lose an eye to trauma and the elderly more likely to lose an eye to infection. Most of the indications for eye removal are avoidable.

  12. Trends in corneal transplant surgery in Ireland: indications and outcomes of corneal transplant surgery and intraocular lens opacification following Descemet's stripping automated endothelial keratoplasty. (United States)

    Quigley, C; McElnea, E; Fahy, G


    To evaluate the indications for corneal transplantation, the procedures carried out, and the postoperative outcomes and to compare these with previous Irish corneal transplant studies. A retrospective review of the case notes of all patients who underwent corneal transplantation under the care of a single surgeon, from 2008 to 2015, was performed. The risk factors for postoperative complications including transplant failure were examined. During the period studied, 42 corneal transplant surgeries were carried out on 40 eyes of 38 patients, 24 of whom were male (63%), median age at surgery was 62 years (range 23-96 years). The most common indication for transplantation was pseudophakic corneal decompensation associated with Fuch's endothelial dystrophy (FED) (n = 13). Seventeen penetrating keratoplasties, 23 lamellar keratoplasties, and two amniotic membrane transplant procedures were carried out. Transplant failure resulting in corneal oedema or repeat corneal transplant surgery (n = 4, 10%), was associated with previous transplant failure in the eye; odds ratio (OR) = 1.58 (p = 0.05), and with comorbid FED, OR = 1.50 (p = 0.02). Intraocular lens opacification occurred in one lens following DSAEK, giving an incidence rate of 7%. Pseudophakic corneal decompensation is the commonest indication for corneal transplant surgery, with lamellar keratoplasty the most frequent approach in our cohort, reflecting developments observed in corneal transplant surgery elsewhere. Prior corneal transplant failure and Fuch's dystrophy remain important risk factors for failure. The risk of intraocular lens opacification and its potential effects on vision should be elaborated prior to endothelial keratoplasty.

  13. 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.

  14. 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

  15. Revision Surgery for Zygoma Reduction: Causes, Indications, Solutions, and Results from a 5-Year Review of 341 Cases. (United States)

    Lee, Sang Woo; Jeong, Yeon Woo; Myung, Yujin


    Many patients undergo a revision surgery after malar reduction, which is one of the most popular aesthetic surgeries in Asia. We reviewed the leading causes of revision for malar reduction surgery to establish proper indications for revision, seek adequate surgical strategies, and share the results from revision surgical cases. A retrospective review was conducted involving 341 patients who underwent malar reduction reoperation between March 2010 and June 2015. Surgical strategies were decided based upon specific problems and complaints from the previous surgery. Facial photographs, cephalography, and computed tomography images were analyzed, and a patient satisfaction survey was conducted before and after the surgery. A total of 341 patients (321 women, 20 men; average age, 26.6 years, range 18-40 years) were included. The main causes of reoperations were subjective dissatisfaction and nonunion-related symptoms. Undercorrection of the zygomatic body and arch (n = 175, 51.3%) was the most frequent reason for dissatisfaction. The patients underwent revision surgeries via different techniques and strategies based on previous problems from primary surgery, and postoperative patient satisfaction was high. Complications occurred in 35 patients (10.3%) after revision. Based on the results of this study, patient dissatisfaction with the procedure can be minimized beforehand through accurate goal identification and careful planning. Bone nonunion is usually due to excessive bone resection during zygoma reduction surgery. Careful selection of the reposition site and appropriate fixation based on a thorough understanding of masseter action are essential in ensuring satisfactory outcomes without adverse side effects. 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 .

  16. The Role of Subtotal Petrosectomy in Cochlear Implant Surgery-A Report of 32 Cases and Review on Indications

    NARCIS (Netherlands)

    Free, Rolien H.; Falcioni, Maurizio; Di Trapani, Giuseppe; Giannuzzi, Anna Lisa; Russo, Alessandra; Sanna, Mario

    Objective: To report and review 32 cases of subtotal petrosectomy (SP) in cochlear implant (CI) surgery and to define the indications and contraindications for this procedure Study Design: Retrospective case review + case reports. Setting: Tertiary skull base center. Patients: Cochlear implant

  17. Oxygen flux as an indicator of physiological stress in aquatic organisms: a real-time biomonitoring system of water quality (United States)

    Sanchez, Brian C.; Yale, Gowri; Chatni, Rameez; Ochoa-Acuña, Hugo G.; Porterfield, D. Marshall; Mclamore, Eric S.; Sepúlveda, María S.


    The detection of harmful chemicals and biological agents in real time is a critical need for protecting water quality. We studied the real-time effects of five environmental contaminants with differing modes of action (atrazine, pentachlorophenol, cadmium chloride, malathion, and potassium cyanide) on respiratory oxygen consumption in 2-day post-fertilization fathead minnow (Pimephales promelas) eggs. Our objective was to assess the sensitivity of fathead minnow eggs using the self-referencing micro-optrode technique to detect instantaneous changes in oxygen consumption after brief exposures to low concentrations of contaminants. Oxygen consumption data indicated that the technique is indeed sensitive enough to reliably detect physiological alterations induced by all contaminants. After 2 h of exposure, we identified significant increases in oxygen consumption upon exposure to pentachlorophenol (100 and 1000 μg/L), cadmium chloride (0.0002 and 0.002 μg/L), and atrazine (150 μg/L). In contrast, we observed a significant decrease in oxygen flux after exposures to potassium cyanide (5.2, 22, and 44 μg/L) and atrazine (1500 μg/L). No effects were detected after exposures to malathion (200 and 340 μg/L). We have also tested the sensitivity of Daphnia magna embryos as another animal model for real-time environmental biomonitoring. Our results are so far encouraging and support further development of this technology as a physiologically coupled biomonitoring tool for the detection of environmental toxicants.

  18. [Quality indicators for surgery of rectal cancer : Evidence-based development of a set of indicators for quality]. (United States)

    Wiegering, A; Buhr, H-J; Klinger, C; Fürst, A; Schiedeck, T; Schwandner, O; Stelzner, S; Germer, C-T


    The definition of valid quality indicators is an essential task of medical self-administration and quality assurance. Based on the literature and the results of the Study, Documentation, and Quality Center (StuDoQ) Rectal Cancer Registry, we suggest the following QIs: rate of circumferential resection margin (CRM) positive resected material, rate of anastomotic leak in patients with anastomoses, rate of abdominal wound healing disorders and rate of patients with newly established permanent urinary diversion. Additionally, a new marker, the MTL30, which subsumes patient death within 30 days after the index operation, patient transfer to another acute hospital within 30 days after the index operation or a length of inpatient hospital stay of more than 30 days.

  19. 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.

  20. 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.

  1. 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

  2. [The delayed OP--indications for surgery of lumbar disc herniations]. (United States)

    Mayer, H M


    In Germany, lumbar disc herniations require surgical treatment in about 50,000 patients/year. The clinical and socio-economical results are determined by the preoperative duration of symptoms and preoperative time out of work (highly predictive). Other parameters such as severity of neurological deficits, morphology of disc herniation, age, associated diseases, type of surgery, working conditions or litigation processes are only weak predictors of outcome. Postoperative improvement of clinical symptoms as well as professional reintegration is strongly determined by the time period between onset of symptoms and surgery. Surgery performed "too early" diminishes the chance for improvement by conservative therapy. If surgery is performed "too late" the risk of a bad result is high, and the reintegration of the patient into his preoperative social and professional activities may be prevented. The duration of conservative therapy including so-called semi-invasive procedures is critical in this sense. If a therapeutic success (= professional and social reintegration) cannot be achieved by conservative measures and if there is a clear morphological correlate (= disc herniations with corresponding clinical symptoms) of the clinical symptoms an early change of the strategy towards surgical therapy is recommended.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Surgery (United States)

    ... and sterile gloves. Before the surgery begins, a time out is held during which the surgical team confirms ... the Consumer Version. DOCTORS: Click here for the Professional Version What Participants Need to Know About Clinical ...

  5. Metabolite profiles of nodulated alfalfa plants indicate that distinct stages of nodule organogenesis are accompanied by global physiological adaptations. (United States)

    Barsch, Aiko; Tellström, Verena; Patschkowski, Thomas; Küster, Helge; Niehaus, Karsten


    An effective symbiosis between Sinorhizobium meliloti and its host plant Medicago sativa is dependent on a balanced physiological interaction enabling the microsymbiont to fix atmospheric nitrogen. Maintenance of the symbiotic interaction is regulated by still poorly understood control mechanisms. A first step toward a better understanding of nodule metabolism was the determination of characteristic metabolites for alfalfa root nodules. Furthermore, nodules arrested at different developmental stages were analyzed in order to address metabolic changes induced during the progression of nodule formation. Metabolite profiles of bacteroid-free pseudonodule extracts indicated that early nodule developmental processes are accompanied by photosynthate translocation but no massive organic acid formation. To determine metabolic adaptations induced by the presence of nonfixing bacteroids, nodules induced by mutant S. meliloti strains lacking the nitrogenase protein were analyzed. The bacteroids are unable to provide ammonium to the host plant, which is metabolically reflected by reduced levels of characteristic amino acids involved in ammonium fixation. Elevated levels of starch and sugars in Fix(-) nodules provide strong evidence that plant sanctions preventing a transformation from a symbiotic to a potentially parasitic interaction are not strictly realized via photosynthate supply. Instead, metabolic and gene expression data indicate that alfalfa plants react to nitrogen-fixation-deficient bacteroids with a decreased organic acid synthesis and an early induction of senescence. Noneffective symbiotic interactions resulting from plants nodulated by mutant rhizobia also are reflected in characteristic metabolic changes in leaves. These are typical for nitrogen deficiency, but also highlight metabolites potentially involved in sensing the N status.

  6. Resistance to levothyroxine in a bariatric surgery patient: an indication for liquid formulation? (United States)

    Hommel, Christophe; Delgrange, Etienne


    We report the case of a 49-year-old female patient with hypothyroidism who underwent bariatric surgery and developed severe hypothyroidism despite high doses of oral levothyroxine (L-T4) tablets. Initially, a high-dose L-T4 tablets absorption test was performed to exclude pseudo-malabsorption. In view of a modest increase in serum T4 levels, L-T4 liquid formulation absorption test was performed, and showed faster and more efficient absorption of thyroid hormones. We discuss the issue of distinguishing malabsorption from pseudo-malabsorption, review the literature concerning the benefits of liquid L-T4 in cases of impaired absorption such as bariatric surgery and consider the socio-economic implications of different liquid formulations.

  7. Combined drug and surgery treatment of plutonium-contaminated wounds: indications obtained using a rodent model. (United States)

    Griffiths, Nina M; Coudert, Sylvie; Wilk, Jean Claude; Renault, Daniel; Angulo, Jaime F; Van der Meeren, Anne


    There is an important requirement following accidental actinide contamination of wounds to limit the dissemination and retention of such alpha-emitting radionuclides. To reduce wound and systemic contamination, treatment approaches include chelation therapy with or without wound excision. However, it has been hypothesized that wound excision could lead to increased contaminant release and systemic organ retention. This study in the rat addresses this question. Anesthetized rats were contaminated with plutonium nitrate following wounding by deep incision of hind leg muscle. Excision of tissue at the contaminated site was performed 7 d later with or without Diethylene Triamine Pentaacetic Acid (DTPA) treatment (30 μmol kg⁻¹ i.v.). Pu urinary excretion was then measured for a further 3 d, and animals were euthanized at 14 d after contamination. Tissue samples were evaluated for Pu activity and histology. At 7 d after contamination, around 50% of the initial activity remained at the wound site. An average of 16% of this activity was then removed by surgery. Surgery alone resulted in increased urinary excretion, suggesting release from the wound site, but no subsequent increases in organ retention (bone, liver) were observed at 14 d. Indeed, organ Pu activity was slightly reduced. The combination of surgery and DTPA or DTPA treatment alone was much more effective than excision alone as shown by the markedly increased urinary Pu excretion and decreased tissue levels. This is the first report in an experimental rodent model of resection of Pu-contaminated wound. Urinary excretion data provide evidence for the release of activity as a result of surgery, but this does not appear to lead to further Pu organ retention. However, a combination of prior DTPA treatment with wound excision is particularly effective.

  8. 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.

  9. 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.

  10. 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

  11. Indication of Cognitive Change and Associated Risk Factor after Thoracic Surgery in the Elderly: A Pilot Study (United States)

    Kulason, Kay; Nouchi, Rui; Hoshikawa, Yasushi; Noda, Masafumi; Okada, Yoshinori; Kawashima, Ryuta


    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

  12. Indication of Cognitive Change and Associated Risk Factor after Thoracic Surgery in the Elderly: A Pilot Study. (United States)

    Kulason, Kay; Nouchi, Rui; Hoshikawa, Yasushi; Noda, Masafumi; Okada, Yoshinori; Kawashima, Ryuta


    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 psycomotor

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

    Directory of Open Access Journals (Sweden)

    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

  14. 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.

  15. CT of the paranasal sinuses is not a valid indicator for sinus surgery in CF patients

    DEFF Research Database (Denmark)

    Rasmussen, Jacob; Aanæs, Kasper; Norling, Rikke


    BACKGROUND: No guidelines comprise when or to what extent sinus surgery should be done in patients with cystic fibrosis (CF) or how a CT scan of the paranasal sinuses should influence the decision. Symptoms of rhinosinusitis and/or eradication of pathogenic bacteria from the sinuses are reasons......: There was no significant correlation between the CT score and detection of pus, pathogenic bacteria or symptoms. Pus and pathogenic bacteria were found in several cases without sinus opacification on the CT scan. Non pathogenic and sterile cultures were also found in sinuses with opacification. CONCLUSIONS: A CT scan...

  16. Pain assessment in the critically ill mechanically ventilated adult patients: Comparison between skin conductance algesimeter index and physiologic indicators. (United States)

    Khanna, Puneet; Chandralekha, Chandralekha; Pandey, Ravinder Kumar; Sharma, Ankur


    Critically ill patients are unable to communicate effectively, so it is difficult to assess their pain and analgesic requirement. Skin conductance algesimeter (SCA) index is a device that primarily measures changes in skin conductance real time to assess pain. We planned this quantitative prospective observational study to assess pain in the critically ill mechanically ventilated patients in comparison to physiologic indicators such as blood pressure and heart rate. A repeated measures design was chosen, and a sample size of 180 was taken from 60 patients with sepsis, acute exacerbations of chronic obstructive pulmonary disease, community-acquired pneumonia, and postsurgical patients in the Intensive Care Unit (ICU). The two painful procedures chosen were tracheal suction and patient positioning. The data were collected at rest, at tracheal suctioning, 20 min later at positioning of the patient, and final reading 20 min later. Three testing periods, each including 4 assessments for a total of 12 pain assessments with sixty patients, were completed during each patient's ICU course. A total of six assessments were done with the patient at rest and three each with pain stimulus of tracheal suctioning and patient positioning. There was a significant increase in both hemodynamic variables during painful procedures except for the heart rate during positioning. The correlation between the SCA index and Ramsay scale was negative and significant. This instrument might prove useful to measure pain in uncommunicative critically ill patients and to evaluate the effectiveness of analgesic treatment and adapt it.

  17. 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.

  18. 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.

  19. Surgery (United States)

    ... surgery has several common causes, including the following: Infections at the operative site Lung problems such as pneumonia or collapsed lung ... the trauma of an operation. The risk of infections at the operative site, DVTs, and UTIs can be decreased by meticulous ...

  20. 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

  1. 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.

  2. [Indication and timing of heart valve surgery - summery of the European guidelines]. (United States)

    Sündermann, Simon H; Reser, Diana; Czerny, Martin; Falk, Volkmar


    Most common heart valve diseases in western industrialized nations are the aortic valve stenosis and the mitral valve regurgitation. More seldom are a regurgitation of the aortic valve and mitral valve stenosis. Even more seldom are heart valve diseases of the Tricuspid and the pulmonary valve. The only curative therapy in severe heart valve disease is a surgical intervention. The timing is crucial for the outcome. Especially in asymptomatic patients it's difficult to find the right point of time for intervention due to missing realization of the health status. In 2013, the European Association for Cardio-Thoracic Surgery (EACTS) and the European Society of Cardiology (ESC) published guidelines according to the therapy in heart valve disease. Here we want to summarize the recommendations of these guidelines in regards of timing of the surgical intervention.

  3. 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.

  4. Cell death patterns in Arabidopsis cells subjected to four physiological stressors indicate multiple signalling pathways and cell cycle phase specificity. (United States)

    Pathirana, Ranjith; West, Phillip; Hedderley, Duncan; Eason, Jocelyn


    Corpse morphology, nuclear DNA fragmentation, expression of senescence-associated genes (SAG) and cysteine protease profiles were investigated to understand cell death patterns in a cell cycle-synchronised Arabidopsis thaliana cell suspension culture treated with four physiological stressors in the late G2 phase. Within 4 h of treatment, polyethylene glycol (PEG, 20 %), mannose (100 mM) and hydrogen peroxide (2 mM) caused DNA fragmentation coinciding with cell permeability to Evans Blue (EB) and produced corpse morphology corresponding to apoptosis-like programmed cell death (AL-PCD) with cytoplasmic retraction from the cell wall. Ethylene (8 mL per 250-mL flask) caused permeability of cells to EB without concomitant nuclear DNA fragmentation and cytoplasmic retraction, suggesting necrotic cell death. Mannose inducing glycolysis block and PEG causing dehydration resulted in relatively similar patterns of upregulation of SAG suggesting similar cell death signalling pathways for these two stress factors, whereas hydrogen peroxide caused unique patterns indicating an alternate pathway for cell death induced by oxidative stress. Ethylene did not cause appreciable changes in SAG expression, confirming necrotic cell death. Expression of AtDAD, BoMT1 and AtSAG2 genes, previously shown to be associated with plant senescence, also changed rapidly during AL-PCD in cultured cells. The profiles of nine distinct cysteine protease-active bands ranging in size from ca. 21.5 to 38.5 kDa found in the control cultures were also altered after treatment with the four stressors, with mannose and PEG again producing similar patterns. Results also suggest that cysteine proteases may have a role in necrotic cell death.

  5. [Symposium on the indications of surgery in chronic upper limb pain]. (United States)

    Bontoux, L; Fouquet, B; Laulan, J; Raimbeau, G; Roquelaure, Y; Vannier, I


    Chronic pain is a true disease with neuromuscular and psychosocial features. It affects the individual as a whole. The consultation should not be limited to a physical approach and the clinician should not shelter behind useless investigations. It is necessary to listen to the patient, to seek elements of catastrophism and hypervigilance, to unmask a strategy of avoidance, and to evaluate the socioprofessional context. Psychosocial factors are the determinant ones in chronicisation of the pain and therefore are the ones that have to be addressed in the process of treatment and professional reintegration. The place of surgery is limited to the treatment of a trigger point (starting factor) and only when it is actually causing real symptoms and when surgical treatment will lead to regression of all the symptoms. On the whole though, the signs are never localised and we find a diffuse hypersensitivity with secondary dysfunction of the whole upper limb, functional exclusion, features of deconditioning, and all in an unfavourable psychosocial context. Thus, the assessment must be multidisciplinary and ideally the treatment should be managed in a centre of rehabilitation.

  6. Physiological responses to brain stimulation during limbic surgery: further evidence of anterior cingulate modulation of autonomic arousal. (United States)

    Gentil, André Felix; Eskandar, Emad N; Marci, Carl David; Evans, Karleyton Conroy; Dougherty, Darin Dean


    In view of conflicting neuroimaging results regarding autonomic-specific activity within the anterior cingulate cortex (ACC), we investigated autonomic responses to direct brain stimulation during stereotactic limbic surgery. Skin conductance activity and accelerative heart rate responses to multi-voltage stimulation of the ACC (n = 7) and paralimbic subcaudate (n = 5) regions were recorded during bilateral anterior cingulotomy and bilateral subcaudate tractotomy (in patients that had previously received an adequate lesion in the ACC), respectively. Stimulations in both groups were accompanied by increased autonomic arousal. Skin conductance activity was significantly increased during ACC stimulations compared with paralimbic targets at 2 V (2.34 +/- .68 [score in microSiemens +/- SE] vs. .34 +/- .09, p = .013) and 3 V (3.52 +/- .86 vs. 1.12 +/- .37, p = .036), exhibiting a strong "voltage-response" relationship between stimulus magnitude and response amplitude (difference from 1 to 3 V = 1.15 +/- .90 vs. 3.52 +/- .86, p = .041). Heart rate response was less indicative of between-group differences. This is the first study of its kind aiming at seeking novel insights into the mechanisms responsible for central autonomic modulation. It supports a concept that interregional interactions account for the coordination of autonomic arousal.

  7. Evaluation of extended antibiotic prophylaxis in patients undergoing indicated non-cosmetic panniculectomy at the time of gynecologic surgery. (United States)

    Patibandla, Jay R; Kufel, Christina N; Hopkins, Michael P


    Panniculectomy at time of gynecologic surgery is used to improve visualization and prevent major complications in morbidly obese patients. We examine the role of extended antibiotic prophylaxis in prevention of surgical site infections (SSI), specifically based on patient risk factors (hypertension, diabetes, smoking). A prospective cohort study of all women who underwent panniculectomy at the time of gynecologic surgery from September 2014 to March 2016 at a university-affiliated hospital. The EAP cohort received standard antibiotics (cefazolin, 2 g) and continued oral antibiotic (doxycycline) for 10 days afterwards. Patients in this cohort were compared to historical controls from the same institution from 1990 to 2014. Specific attention was paid to the reduction of SSIs in patients with hypertension, diabetes, and a history of smoking. The mean age was 56.0 ± 12.6 years, and mean body mass index 44.5 ± 9.3 kg/m 2 (range 31-63.4 kg/m 2 ). The EAP cohort experienced fewer surgical-site infections overall, however these results were not significantly decreased from the historical controls, (13/56 [23.2%] vs 94/300 [31.3%]; P = 0.469). Though initially promising, extended antibiotic prophylaxis did not reduce surgical site infections in the obese women after indicated non-cosmetic panniculectomy at the time of gynecologic surgery. © 2018 Wiley Periodicals, Inc.

  8. Application of a new combined model including radiological indicators to predict difficult airway in patients undergoing surgery for cervical spondylosis. (United States)

    Xu, Mao; Li, Xiaoxi; Wang, Jun; Guo, Xiangyang


    Airway management is crucial in clinical anesthesia. Many complications associated with airway management result from unexpected difficult airway, but predicting a difficult airway is a major challenge. We investigated the efficacy of a new combined model including radiological indicators to predict difficult airway in patients undergoing surgery for cervical spondylosis, a population with a high incidence of difficult airway. We randomly enrolled 303 patients scheduled for elective surgery for cervical spondylosis at Peking University Third Hospital between August 2012 and March 2013. Preoperatively, patients were evaluated for difficult airway according to a clinical index and parameters on lateral cervical radiographs and magnetic resonance images. Difficult airway was defined as Cormack-Lehane grades III-IV. Logistic regression was used to identify a combined (clinical and radiological) model for difficult airway. A receiver operating characteristic (ROC) curve was used to describe the effectiveness of prediction. We identified three clinical predictive factors using the ROC curve: mouth opening, sternomental distance, and neck mobility. We created a clinical model using three factors: gender, age, and mouth opening, with odds ratios (OR) of 0.370, 1.034, and 0.358, respectively. Using the clinical and radiological parameters, we formulated a combined model with five risk factors: gender, mouth opening, atlanto-occipital gap, the angle from the second to sixth cervical vertebraes in the neutral position, and the angle difference of d (the angle between the laryngeal axis and the epiglottic axis) from the neutral position to extension (OR: 0.107, 0.355, 0.846, 1.057, and 0.952, respectively). The sensitivity and specificity of the combined model were 80.0% and 65.7%, respectively, and the ROC curve confirmed that the combined model was better than any single clinical predictor and the clinical model. The efficacy of the combined model including both clinical and

  9. 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.

  10. 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.

  11. 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.

  12. 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.

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

    Bento, Ricardo Ferreira; Kiesewetter, Alessandra; Ikari, Liliane Satomi; Brito, Rubens


     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.  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.  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.  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.  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.

  14. Effect of low light and high noise on behavioural activity, physiological indicators of stress and production in laying hens. (United States)

    O'connor, E A; Parker, M O; Davey, E L; Grist, H; Owen, R C; Szladovits, B; Demmers, T G M; Wathes, C M; Abeyesinghe, S M


    1. Commercial laying hens are commonly housed in noisy and dim environments, yet relatively little is known about whether these conditions, particularly in combination, have any effect on welfare or egg production. 2. The study was designed to investigate whether chronic exposure to continuous noise (60 dB(A) vs. 80 dB(A)) and/or light intensity (150 lux vs. 5 lux) during the critical period of coming into lay (16-24 weeks of age) influenced behaviour (activity, resting and feather maintenance), physiological stress (plasma corticosterone and heterophil to lymphocyte ratio) and production (number and weight of eggs laid) in laying hens. 3. Hens in the low light pens were less active and preened and dust-bathed more than those housed in 150 lux; hens in the high noise pens rested more frequently than those in quieter pens. 4. There was no evidence that chronic exposure to low light or high noise caused appreciable physiological stress but egg production was affected by these conditions. Hens kept in pens with low light or high noise laid fewer eggs per day than those kept in high light or low noise pens. These effects were additive, so that the fewest eggs were laid by hens subject to both low light and high noise. 5. These results show that low light intensity and continual high background noise have a detrimental effect on egg production in the early laying phase as well as influencing the time allocated to different behaviours. However there was no strong evidence for a physiological stress response to either of these conditions or their combination.

  15. Changes of lidocaine concentration and physiological indices in dogs during anaesthesia with lidocaine and isoflurane combined with ketamine or fentanyl

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    Shi-Xia Zhang


    Full Text Available Fentanyl and ketamine are often used as adjuvants in intravenous anaesthesia to prolong analgesia. The aim of this study was to compare changes of the basic physiological variables of intravenous lidocaine administration in combination with ketamine or fentanyl, and to evaluate the impact of addition of fentanyl or ketamine to lidocaine on serum lidocaine concentrations in dogs after intravenous administration. During general anaesthesia, dogs of group L received 2% lidocaine intravenously, dogs of group LF received 2% lidocaine and fentanyl, and dogs of the group LK received 2% lidocaine and ketamine. The heart rate, systolic arterial pressure, diastolic arterial pressure, mean arterial pressure and rectal temperature decreased in all groups, and group LF showed the biggest effect on the basic physiological variables, with the lowest heart rate during the test, significantly decreased rectal temperature, and the most decreased values of arterial pressure. Blood for determination of serum lidocaine concentration was taken before anaesthesia and 5, 30, 60, 90, 120, 150 and 180 min after initial intravenous injection of drugs. Fentanyl and ketamine did not cause significant changes of serum lidocaine concentration in dogs and may be used as adjuvant in intravenous anaesthesia without a significant increase in lidocaine absorption.

  16. Diagnostic Performance of Resting and Hyperemic Invasive Physiological Indices to Define Myocardial Ischemia: Validation With 13N-Ammonia Positron Emission Tomography. (United States)

    Hwang, Doyeon; Jeon, Ki-Hyun; Lee, Joo Myung; Park, Jonghanne; Kim, Chee Hae; Tong, Yaliang; Zhang, Jinlong; Bang, Ji-In; Suh, Minseok; Paeng, Jin Chul; Na, Sang-Hoon; Cheon, Gi Jeong; Cook, Christopher M; Davies, Justin E; Koo, Bon-Kwon


    The authors sought to compare the diagnostic performance of fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and resting distal coronary artery pressure/aortic pressure (Pd/Pa) using 13 N-ammonia positron emission tomography (PET). The diagnostic performance of invasive physiological indices was reported to be different according to the reference to define the presence of myocardial ischemia. A total of 115 consecutive patients with left anterior descending artery stenosis who underwent both 13 N-ammonia PET and invasive physiological measurement were included. Optimal cutoff values and diagnostic performance of FFR, iFR, and resting Pd/Pa were assessed using PET-derived coronary flow reserve (CFR) and relative flow reserve (RFR) as references. To compare discrimination and reclassification ability, each index was compared with integrated discrimination improvement (IDI) and category-free net reclassification index (NRI). All invasive physiological indices correlated with CFR and RFR (all p values RFR RFR, FFR showed better discrimination and reclassification ability than resting indices (IDI = 0.170 and category-free NRI = 0.971 for iFR; IDI = 0.183 and category-free NRI = 1.058 for resting Pd/Pa; all p values RFR as a reference, FFR showed a better discrimination and reclassification ability than resting indices. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  17. Effects of Music Intervention on State Anxiety and Physiological Indices in Patients Undergoing Mechanical Ventilation in the Intensive Care Unit. (United States)

    Lee, Chiu-Hsiang; Lee, Chien-Ying; Hsu, Ming-Yi; Lai, Chiung-Ling; Sung, Yi-Hui; Lin, Chung-Ying; Lin, Long-Yau


    Patients in intensive care units (ICUs) often experience stress and anxiety. Although stress and anxiety can be pharmacologically attenuated, some drugs cause adverse side effects such as bradycardia, immobility, and delirium. There is thus a need for an alternative treatment with no substantial adverse effects. Music intervention is a potential alternative. In the present study, we used cortisol levels, subjective questionnaires, and physiological parameters to explore the anxiety-reducing effects of music intervention in a sample of ICU patients on mechanical ventilation. Patients admitted to the ICU for ≥ 24 hr were randomly assigned to the music intervention ( n = 41) or control group ( n = 44). Music group patients individually listened to music from 4:00 to 4:30 p.m.; control group patients wore headphones but heard no music for the same 30 min. Anxiety was measured using serum cortisol levels, the Chinese Version of the State-Trait Anxiety Inventory, the Visual Analogue Scale for Anxiety, heart rate, and blood pressure. After adjusting for demographics, analysis of covariance showed that the music group had significantly better scores for all posttest measures ( p adverse effects. However, the duration of the effect is unclear; thus, each patient's mood should be monitored after the music intervention.

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

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    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

  19. 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.

  20. 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.

  1. 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.

  2. 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 (lead acetate resulted in a slight increase in soil microbial activities compared with the control, and had an inhibitory influence at high concentration (>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.

  3. Monitoring water stress and fruit quality in an orange orchard under regulated deficit irrigation using narrow-band structural and physiological remote sensing indices (United States)

    Stagakis, S.; González-Dugo, V.; Cid, P.; Guillén-Climent, M. L.; Zarco-Tejada, P. J.


    This paper deals with the monitoring of water status and the assessment of the effect of stress on citrus fruit quality using structural and physiological remote sensing indices. Four flights were conducted over a citrus orchard in 2009 using an unmanned aerial vehicle (UAV) carrying a multispectral camera with six narrow spectral bands in the visible and near infrared. Physiological indices such as the Photochemical Reflectance Index (PRI570), a new structurally robust PRI formulation that uses the 515 nm as the reference band (PRI515), and a chlorophyll ratio (R700/R670) were compared against the Normalized Difference Vegetation Index (NDVI), Renormalized Difference Vegetation Index (RDVI) and Modified Triangular Vegetation Index (MTVI) canopy structural indices for their performance in tracking water status and the effects of sustained water stress on fruit quality at harvest. The irrigation setup in the commercial orchard was compared against a treatment scheduled to satisfy full requirements (based on estimated crop evapotranspiration) using two regulated deficit irrigation (RDI) strategies. The water status of the trees throughout the experiment was monitored with frequent field measurements of stem water potential (Ψx), while titratable acidity (TA) and total soluble solids (TSS) were measured at harvest on selected trees from each irrigation treatment. The high spatial resolution of the multispectral imagery (30 cm pixel size) enabled identification of pure tree crown components, extracting the tree reflectance from shaded, sunlit and aggregated pixels. The physiological and structural indices were then calculated from each tree at the following levels: (i) pure sunlit tree crown, (ii) entire crown, aggregating the within-crown shadows, and (iii) simulating a lower resolution pixel, including tree crown, sunlit and shaded soil pixels. The resulting analysis demonstrated that both PRI formulations were able to track water status, except when water stress

  4. Comparison the effect of two weaning methods from mechanical ventilation “spontaneous breathing trial” with “Synchronized Intermittent-Mandatory” on physiological indices

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    Mahmoudi Mokhtar


    Full Text Available Background and Objective: Weaning from mechanical ventilator due to the direct effect on patient’s physiologic indices is very risky action and if it is unsuccessful, it can lead to re-intubation of patient. The aim of the current study was to compare the effect of two weaning methods from mechanical ventilation “SBT” method with “SIMV” on physiological indices of ventilated patients. Materials and Method: In this clinical trial study, 44 intubated patients in intensive care units of one of the hospital in Arak in 2014 were selected through convenience sampling and then were randomly allocated into two intervention and control groups (each group 22 persons. In intervention group SBT method and in control group SIMV were used as weaning method from ventilation. Data collection was done thorugh using physiological indices and GCS score before, during and after the intervention Data were analyzed by using SPSS 20, paired T-test, independent T-test, repeated measures ANOVA and Greenhouse-Geisser. Results: In SBT group, the means of systolic blood pressure was (107.90 ± 5/2, heart rate (70.27 ± 7.2, respiration rate (14.90 ± 1.06 had significant reduction after intervention (from 9 to 12 Am (p < 0.001. Also, the mean of Pao2 (89.12 ± 1.16, mean of diastolic blood pressure (76.09 ± 4.6, O2 sat (93.09 ± 0.97 and  level of consciousness (14.90 ±0.21 had significant increase after intervention and physiologic status of patients was improved. In control group there was no significant difference among the measured indices. Conclusion: The results showed that “SBT” method leads to improvement of systolic and diastolic blood pressure, heart rate, Pao2, O2sat and level of consciousness of patients in intervention group. It is recommended to apply of this weaning method in intensive care unit.

  5. Effects of fatigue and time-out on physiological, time-motion indicators and in patterns of spatial organization of the teams in basketball


    Leite, Nuno


    The aim of this study was to identify the effects of fatigue on physiological variables, time-motion indicators and patterns of spatial organization of the teams in basketball. The study sample consisted of 10 basketball players of the under-18 with a mean age of 17.5 ± 0.3 years. There were two sessions: session a) game continuous (C1) 10 minutes - yo-yo intermittent recovery test (level 1) - 1 minute timeout – game continuous (C2) 10 minutes. Session b) game interrupted (I1) 5 minutes - 1 m...

  6. 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.

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

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    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.

  8. Evaluation of heart rate and blood pressure variability as indicators of physiological compensation to hemorrhage before shock. (United States)

    Scully, Christopher G; Kramer, George C; Strauss, David G


    Individual responses to hemorrhage vary, with varying periods of compensation before the development of shock. We characterized heart rate and blood pressure variability measures during hemorrhage of 25 mL/kgBody Weight for 15 min in conscious sheep (N = 7, 14 total hemorrhages) as markers of the transition from compensated to decompensated shock using the continuous wavelet transform. Heart rate-low frequency (HR-LF) and systolic blood pressure-low frequency (SBP-LF) indices were developed to represent the change in spectral power during hemorrhage as low-frequency (0.06 - 0.15 Hz) power divided by the sum of high (0.15 - 1.0 Hz)- and very low (0.02 - 0.06 Hz) frequency power. Heart rate rose from 96.3 (22.2) beats/min (mean [SD] across all trials) to a peak of 176.0 (25.4) beats/min occurring at a minimum time of 5.3 min to a maximum of 22.1 min (11.7 [1.6] min), depending on the trial, after the start of hemorrhage. During the HR-compensated response to hemorrhage, there was elevated HR-LF and SBP-LF in five of the seven animals. In these animals, HR-LF and SBP-LF dropped to below baseline levels around the time of the peak HR. The results from this conscious-animal study suggest that HR and SBP low-frequency power rise during the compensation phase of the response to hemorrhage in conscious sheep. Use of variability monitoring could aid in describing an individual's current response to hemorrhage and anticipation of impending decompensation; however, individual differences in the response limit this potential.

  9. 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.

  10. 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 Yeast extract - Peptone - Dextrose medium at low pH (2.7). Kinetics of viability loss of non-growing 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.

  11. [Current indications of open surgery for the treatment of renal lithiasis. Ureterocalycostomy as definitive treatment for lithiasis in a female with recurrent disease]. (United States)

    Miján Ortiz, Jose Luis; Valle Díaz de la Guardia, Francisco; Jiménez Pacheco, Antonio; Arrabal Martín, Miguel; Nogueras Ocaña, Mercedes; Zuluaga Gómez, Armando


    We describe one case of recurrent lithiasis associated with anatomical alteration of the renal pelvis related to previous surgery. The patient presented a urinary tract infection episode, complicated with pyonephrosis and septicemia. In the intravenous urography, infectious radiopaque pyelocaliceal multiple and complex lithiasis can be seen, as well as kidney hydronephrosis grade III-IV. Important pyelic sclerosis secondary to previous surgery on the renal unit was seen. Nephrectomy was performed with lower pole nephro-lithotomy and reconstruction of the upper urinary tract through ureterocalicostomy. Two and a half years after surgery, control urogram shows absence of urolithiasis and a slight delay of renal function. Ureterocalicostomy is indicated in cases of ureteropelvic junction obstruction associated with intrarenal pelvis caused by alterations of fusion, rotation or location of kidney. It is also indicated in cases of severe peripyelic fibrosis secondary to previous pyeloplasty failure or renal surgery. In our case, in addition to the infectious component of lithiasis, an anatomical alteration, probably secondary to previous surgery, caused the chronification of lithiasis. Facing such suspicion a surgical management was undertaken to eliminate the lithiasis and get a correct derivation of the working area of the kidney, in order to prevent further recurrences.

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


    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 CA-125 biochemical progression prior to clinically-defined relapse was 31 days (ranging from 1 to 391 days). The median number of the negative imaging studies for the clinical relapse findings in patients with a CA-125 level of CA-125 level at relapse was an independent predictor of overall and progression free survival in patients who had shown CCR to primary therapy (p = 0.04 and 0.02 respectively). The overall and progression free survival durations in patients with a CA-125 level ≤ 1.68 × nadir at relapse (69.4 and 13.8 months) were longer than those with a CA-125 level > 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

  13. Effects of maintenance of propofol-ketamine anesthesia with repeat bolus and constant rate infusion of propofol on physiological, biochemical, anesthetic and analgesic indices in dogs

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    Njoku Uchechukwu Njoku


    Full Text Available The research work was aimed at investigating physiological, biochemical, analgesic and anesthetic indices of dogs anesthetized with propofol-ketamine and maintained with repeat bolus and constant infusions of propofol. Eight dogs, assigned to two groups (n=4, were used in this study. All dogs were pre-medicated with atropine (at 0.03 mg/kg bwt and xylazine (at 2 mg/kg bwt. Anesthesia was induced by a concurrent administration of propofol (at 4 mg/kg bwt and ketamine (at 2.5 mg/kg bwt. Maintenance of anesthesia in Group 1 was done with a repeat bolus of propofol (at 2 mg/kg bwt, while in Group 2 it was done with a constant infusion of propofol (at 0.2 mg/kg bwt/min. Gastrotomy was performed in both groups, and anesthesia was maintained for 60 min. Physiological, analgesic, anesthetic parameters and plasma glucose concentration were measured. There was no significant (P>0.05 difference found in the analgesia and pedal reflex scores, durations of analgesia and recumbency, recovery time and standing time between the groups. The heart rate, respiratory rate and rectal temperature reduced significantly (P0.05 between the groups. In conclusion, both maintenance protocols are suitable for dogs, although the repeat bolus technique produces marked cardiopulmonary depression.

  14. Effects of movement music therapy with the Naruko clapper on psychological, physical and physiological indices among elderly females: a randomized controlled trial. (United States)

    Shimizu, Nobuko; Umemura, Tomohiro; Hirai, Takayoshi; Tamura, Taro; Sato, Kazuhiro; Kusaka, Yukinori


    Recent interventional studies have indicated that some exercise programs have beneficial physical and immunological effects for older people. Some evidence suggests that exercise programs involving music and/or a rhythmic movement component may be particularly beneficial. To assess the effects of a new type of movement music therapy (MMT) on physical, immunological, hormonal and psychosocial health parameters among older adults. 112 elderly female subjects (average age 73.62 ± 5.50 years) who performed little habitual exercise participated in this randomized, controlled, single-blinded intervention trial. The subjects were divided into two groups which participated in different exercise programs (experimental group: MMT; control group: simple exercise program). We assessed a comprehensive range of indices before and after the interventions, which lasted a total of 8 weeks. These indices included (1) the Philadelphia Geriatric Center morale scale, (2) self-rated health status, (3) physical function tests (e.g. blood pressure, pulmonary function, body balance, gait ability, muscle endurance, muscle-strength, and functional mobility), and (4) saliva analysis for physiological function indices (e.g. secretory immunoglobulin A (SIgA), chromogranin A, cortisol, and total protein). In comparisons between the MMT and control interventions in younger elderly subjects (≤74 years old), systolic blood pressure decreased (p = 0.02), pulmonary function improved (p = 0.05) and body balance improved (p = 0.04) in the MMT group, but not in the control group. The SIgA secretion rate of the experimental group remained significantly elevated (p = 0.02) 15 min after exercise compared with before exercise. There were no significant differences between interventions in psychosocial indices. In contrast, no significant differences were detected between interventions in any measures in the older elderly group (≥75 years old). These results indicate that the MMT, even with a short (8

  15. Quality indicators in ovarian cancer surgery: report from the French Society of Gynecologic Oncology (Societe Francaise d'Oncologie Gynecologique, SFOG). (United States)

    Querleu, D; Ray-Coquard, I; Classe, J M; Aucouturier, J S; Bonnet, F; Bonnier, P; Darai, E; Devouassoux, M; Gladieff, L; Glehen, O; Haie-Meder, C; Joly, F; Lécuru, F; Lefranc, J P; Lhommé, C; Morice, P; Salengro, A; Stoeckle, E; Taieb, S; Zeng, Z X; Leblanc, E


    Based on registries, the European experience has been that definition of qualitative indicators in ovarian cancer surgery in France. This endeavour was undertaken by the French Society of Gynaecologic Oncology (SFOG) in partnership with the French National College of Obstetricians and Gynecologists and all concerned learned societies in a multidisciplinary mindset. The quality indicators for the initial management of patients with ovarian cancer were based on the standards of practice determined from scientific evidence or expert consensus. The indicators were divided into structural indicators, including material (equipment), human (number and qualification of staff), and organizational resources, process indicators, and outcome indicators. The enforcement of a quality assurance programme in any country would undoubtedly promote improvement in the quality of care for ovarian cancer patients and would result in a dramatic positive impact on their survival. Such a policy is not only beneficial to the patient, but is also profitable for the healthcare system.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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.

  18. Postoperative abnormal response of C-reactive protein as an indicator for infectious complications after oral oncologic surgery with primary reconstruction. (United States)

    Akashi, Masaya; Furudoi, Shungo; Hashikawa, Kazunobu; Sakakibara, Akiko; Hasegawa, Takumi; Shigeta, Takashi; Minamikawa, Tsutomu; Komori, Takahide


    C-reactive protein (CRP) screening has been reported to be reliable for detection of infectious complications. Postoperative abnormal response of CRP can predict wound infection in colorectal surgery. This study aimed to determine the efficacy of CRP monitoring to detect infectious complications in oral oncologic surgery. One hundred patients who underwent oral cancer resection with primary reconstruction were enrolled. Postoperative kinetics of CRP were classified into a normal or abnormal response. A normal CRP response after surgery was observed in 61 patients and an abnormal response was observed in 39. There were postoperative infectious complications in 21 patients, with surgical site infections in 13 patients (early onset in six and late onset in seven). Non-wound infections were found in nine patients. Sensitivity, specificity, the positive predictive value, and the negative predictive value for abnormal CRP response as a predictor for early infectious complications were 100%, 70.1%, 35.9%, and 100%, respectively. Postoperative serial CRP screening is a useful test as an indicator of infectious complications in oral oncologic surgery. Normal CRP responses can rule out almost all early infectious complications.

  19. [Procalcitonin and C-reactive protein as early indicators of postoperative intra-abdominal infection after surgery for gastrointestinal cancer]. (United States)

    Domínguez-Comesaña, Elías; López-Gómez, Victoria; Estevez-Fernández, Sergio Manuel; Mariño Padín, Esther; Ballinas-Miranda, Julio; Carrera-Dacosta, Ester; Piñon-Cimadevila, Miguel Ángel; Barreiro-Morandeira, Francisco


    to evaluate the association between serum levels of procalcitonin and C-reactive protein, on the first 3 postoperative days, and the appearance of postoperative intra-abdominal infection. Prospective observational study including 67 patients operated on for colo-rectal, gastric and pancreatic cancer. Serum levels of procalcitonin and C-reactive protein were analyzed before surgery and daily until the third postoperative day. Values of procalcitonin (PCT) and C-reactive protein (CRP) were recorded as well as their accuracy for detection of postoperative intra-abdominal infection (PIAI). The incidence of postoperative intra-abdominal infection was 13.4%. CRP serum levels at 72h, PCT serum levels at 24, 48 and 72h and the ratio between serum levels of CRP at 72hours and serum levels of CRP at 48hours (CRP D3/CRP D2) were significantly associated with the appearance of postoperative intra-abdominal infection. The highest sensitivity corresponded to PCT at 72hours (88.9%); the highest specificity and positive predictive value corresponded to the ratio CRP D3/CRP D2 (96.49% and 71.4%, respectively); the highest negative predictive value to procalcitonin at 72h and 24h. Serum levels of PCT are significantly associated with the appearance of postoperative intra-abdominal infection. Sensitivity and predictive positive values are low, but negative predictive value is high, even at 24h after surgery. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  20. 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, 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 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

  2. 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

  3. Conversions from anatomic shoulder replacements to reverse total shoulder arthroplasty: do the indications for initial surgery influence the clinical outcome after revision surgery? (United States)

    Holschen, Malte; Franetzki, Bastian; Witt, Kai-Axel; Liem, Dennis; Steinbeck, Jörn


    The most frequent indications for anatomic shoulder replacement are glenohumeral osteoarthritis and fractures of the humeral head. If anatomic shoulder prostheses fail, reverse total shoulder arthroplasty is often the only remaining treatment option. This study evaluates the influence of indications for primary shoulder arthroplasty on the clinical outcome after conversion to reverse total shoulder arthroplasty. From 2010 to 2012, 44 failed shoulder arthroplasties were converted to reverse total shoulder arthroplasty. Forty-four patients were available for follow-up after a mean of 24 months (14-36 months). Twenty-three of them had received an initial shoulder replacement because of osteoarthritis, while the remaining 21 patients had been treated for a fracture of the humeral head. At follow-up, patients were assessed with X-rays, constant-, and ASES scores. The total number of observed complications was higher in patients revised because of failed fracture arthroplasty (24 vs. 9%). Patients initially treated for osteoarthritis achieved a higher ASES score (71 vs. 59 points; p = 0.048). The normalized constant score was not different between the two observed groups (osteoarthritis 73% vs. fracture 67%: p = 0.45). Complications occurred more often in patients who had initially suffered from a fracture of the humeral head (fracture 23.8% vs. osteoarthritis 8.7%). Scapular notching was more frequent after initial fracture arthroplasty (33 vs. 14%). Indications for initial shoulder replacement have an influence on the clinical outcome after conversion to reverse total shoulder arthroplasty. Patients initially treated for a fracture of the humeral head have a lower subjective outcome and a higher complication rate in comparison with patients initially treated for osteoarthritis. IV (Retrospective study).

  4. Indications for and anticipated difficulty of third molar surgery: a comparison between a dental hospital and a specialist high street practice. (United States)

    Macluskey, M; Slevin, M; Curran, M; Nesbitt, R


    To investigate the indications for and anticipated difficulty of third molar surgery between two different referral settings. A prospective study involving completion of a proforma pre- and post-operatively. A dental teaching hospital and a specialist surgical dentistry practice in 2003. Patients referred for the assessment of their third molars were recruited. Details of the clinical and radiographical assessment for each patient were recorded pre-operatively and the extent of surgery required post-operatively. The main indication for referral for third molar extraction was pericoronitis in both centres. A larger number of patients were assessed and treated in a shorter period of time at the surgical dentist compared with the dental hospital. The surgical dentist was accurate in his assessment of the difficulty of surgery 96% of the time compared with 66% for the dental hospital staff. This study highlights the benefits for patients in being treated by a surgical dentist. As dental students require exposure to surgical dentistry in order to attain a level of competence, a reduction in the number of patients being referred to dental hospitals may impact upon students' ability to both assess and perform surgical procedures. This may mean that undergraduates will be less able to fulfil the recommendations of the General Dental Council. An outreach programme for final year dental students to surgical dentistry practices would benefit all concerned.

  5. 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

  6. Alkenone δD as an ecological indicator: A culture and field study of physiologically-controlled chemical and hydrogen-isotopic variation in C37 alkenones (United States)

    Wolhowe, Matthew D.; Prahl, Fredrick G.; Langer, Gerald; Oviedo, Angela Maria; Ziveri, Patrizia


    A combined culture and field study was conducted in order to (1) more firmly identify the physiological controls on hydrogen isotopic composition of C37 alkenones produced by open-ocean coccolithophores and (2) determine the degree to which these controls are manifested in a natural water column. Nutrient-limitation experiments in culture, combined with previously published data, show that net fractionation between the growth medium and alkenones (αK37) varies with cellular alkenone content and production rate, and, by extension, growth phase. It is hypothesized that the relationship of αK37 with cellular alkenone content and production rate is due to increased use of anabolic NADPH in response to high rates of lipid synthesis. Euphotic zone profiles of δDK37, measured in suspended material from the Gulf of California and Eastern Tropical North Pacific, decreased with depth and light availability, and did not correlate in any expected way with previously-suggested controls on αK37. It is possible that the field data are driven by behavior in light-limited cells that is not represented by the available, nutrient-limited culture data. If true, δDK37 may have utility as an indicator of production depth in settings prone to subsurface production maxima. Relationships between αK37, cell density, and the carbon-isotopic fractionation term εp, however, suggest that αK37 acts an indicator of growth rate, which in this setting is only partially dependent on light, consistent with our interpretation of the culture data. If this latter interpretation proves correct, δDK37 may be a powerful ecological proxy specific to these climatically-important, calcifying, temperature-encoding species.

  7. 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.

  8. 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

  9. 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.

  10. Optimizing the indication for breast-conservative surgery (BCS) in patients with locally-advanced breast cancer. (United States)

    Mazilu, L; Suceveanu, A I; Tomescu, D; Ciufu, N; Baz, R; Suceveanu, A P; Parepa, I R; Tofolean, D E; Voinea, F


    The main benefit of neoadjuvant chemotherapy is a reduction in tumor size, which allows breast-conserving surgery (BCS) in patients who otherwise would have required a mastectomy. Breast magnetic resonance (MRI) has been proposed to evaluate tumor extent after neoadjuvant chemotherapy, to determine which patients have become eligible for BCS. The aim of our study was to determine how the association of breast MRI to routine clinical and radiologic assessment of the tumor at initial presentation, and after chemotherapy, affects the overall surgical decision process. 54 women with stage IIB-IIIB breast cancer were prospectively enrolled in a study investigating the effects of MRI on the surgical decision. Surgical plan was changed from BCS to radical mastectomy in 6 cases (13.04%). As a result of using MRI in evaluating disease extent, 21.73% of valuable data were added by MRI (pectoralis major muscle and skin invasion, multifocal multicentric disease). Due to MRI examination 28 (60.86%) of the patients with operable breast cancer after neoadjuvant chemotherapy, were eligible for BCS. Our study demonstrates that MRI is the most accurate in determination of tumor size and extent, and in establishing eligibility for BCS. Celsius.

  11. 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.

  12. 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)

  13. Development and feasibility of a set of quality indicators relative to the timeliness and organisation of care for new breast cancer patients undergoing surgery

    Directory of Open Access Journals (Sweden)

    Ferrua Marie


    Full Text Available Abstract Background Because breast cancer is a major public health issue, it is particularly important to measure the quality of the care provided to patients. Survival rates are affected by the timeliness of care, and waiting times constitute key quality criteria. The aim of this study was to develop and validate a set of quality indicators (QIs relative to the timeliness and organisation of care in new patients with infiltrating, non-inflammatory and metastasis-free breast cancer undergoing surgery. The ultimate aim was to use these QIs to compare hospitals. Methods The method of QI construction and testing was developed by COMPAQ-HPST. We first derived a set of 8 QIs from consensus guidelines with the aid of experts and professional associations and then tested their metrological properties in a panel of 60 volunteer hospitals. We assessed feasibility using a grid exploring 5 dimensions, discriminatory power using the Gini coefficient as a measure of dispersion, and inter-observer reliability using the Kappa coefficient. Results Overall, 3728 records were included in the analyses. All 8 QIs showed acceptable feasibility (but one QI was subject to misinterpretation, fairly strong agreement between observers (Kappa = 0.66, and wide variations in implementation among hospitals (Gini coefficient  Conclusions Of the 8 QIs, 3 are ready for nationwide implementation (time to surgery, time to postoperative multidisciplinary team meeting (MDTM, conformity of MDTM. Four are suitable for use only in hospitals offering surgery with on-site postoperative treatment (waiting time to first appointment after surgery, patient information, time to first postoperative treatment, and traceability of information relating to prognosis. Currently, in the French healthcare system, a patient receives cancer care from different institutions whose databases cannot as yet be easily merged. Nationwide implementation of QIs covering the entire care pathway will thus

  14. 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.

  15. 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

  16. 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.

  17. An analysis of leading, lagging, and coincident economic indicators in the United States and its relationship to the volume of plastic surgery procedures performed: an update for 2012. (United States)

    Paik, Angie M; Hoppe, Ian C; Pastor, Craig J


    As physician compensation and reimbursement tightens throughout the United States, it is important for physicians to be aware of the influence that the economic environment has on the unique medical field of plastic and reconstructive surgery. This study will attempt to determine a relationship between the volume of different plastic surgical procedures and various economic indicators. Information from the American Society of Plastic Surgeons' annual reports on plastic surgery statistics available on the Internet ( was collected from the years 2000 through 2011. Yearly economic indicators were collected from readily available Web sites. In terms of the total number of plastic surgery procedures performed, there was a significant positive relationship with GDP, GDP per capita, personal income, consumer price index (CPI) (all), and CPI (medical), and a significant negative relationship with the issuance of new home permits. There was a significant positive relationship with total cosmetic procedures and GDP, GDP per capita, personal income, CPI (all), and CPI (medical), and a significant negative relationship with the issuance of new home permits. There was a significant positive relationship between cosmetic surgical procedures and the issuance of new home permits and the average prime rate charged by banks. There was a significant positive relationship with cosmetic minimally invasive procedures and GDP, GDP per capita, personal income, CPI (all), and CPI (medical), and a significant negative relationship with the issuance of new home permits. There was a significant negative relationship between reconstructive procedures and GDP, GDP per capita, personal income, CPI (all), and CPI (medical). Cosmetic minimally invasive procedures involve less downtime, are generally less expensive than surgical options, and are widely available, making it easier for patients to decide on them quickly during good economic times

  18. Surgery for transposition of great arteries: A historical perspective

    Directory of Open Access Journals (Sweden)

    Supreet P Marathe


    Full Text Available The history of surgery for transposition of great arteries (TGA has paralleled the history of cardiac surgery. In fact, it began before the birth of open heart surgery when the palliative Blalock-Hanlon septectomy was first performed in 1948. The atrial switch, which was an attempt to correct the physiology of transposition, had significant shortcomings. The arterial switch sought to address them. This has emerged as an anatomically as well as physiologically appropriate solution. Today we continue to pursue technical refinements as well as try to expand the indications of the arterial switch. This review traces the various milestones in this perpetual journey.

  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. Determining reliable cognitive change after epilepsy surgery: development of reliable change indices and standardized regression-based change norms for the WMS-III and WAIS-III. (United States)

    Martin, Roy; Sawrie, Stephen; Gilliam, Frank; Mackey, Melissa; Faught, Edward; Knowlton, Robert; Kuzniekcy, Ruben


    Reliable change indices (RCIs) and standardized regression-based (SRB) change scores norms were established for the recently revised Wechsler Adult Intelligence Scale-III (WAIS-III) and Wechsler Memory Scale-III (WMS-III) in patients with complex partial seizures. Establishment of such standardized change scores can be useful in determining the effects of epilepsy surgery on cognitive functioning independent of test-retest artifacts including practice effects. Forty-two nonoperated-on adult patients with complex partial seizures (primarily of temporal lobe onset) were administered the WMS-III and WAIS-III on two occasions (mean 7-month interval). All patients were receiving stable antiepileptic drug (AED) treatment at both testings. RCI and SRB change scores were calculated. Confidence interval cutoff scores (90% and 80%) and standardized regression equations were calculated for each of the WAIS-III and WMS-III Primary Indices and individual subtests. Age, gender, education, test-retest interval, preoperative test performance, seizure onset, and seizure duration were predictor variables for the SRB equations. Test-retest reliabilities for the WAIS-III and WMS-III Primary Indices were within acceptable ranges, although considerable individual subtest variability was found. Preoperative performance was the single largest contributor to each of the predictive regression equations. Age, gender, education, seizure onset, and seizure duration contributed modest variance to several of the regression equations. We calculated both RCI and SRB change score indices for the recently revised Wechsler instruments. These formulas help control for test-retest methodologic artifacts and provide a standardized method with which to examine both individual and group level cognitive change after epilepsy surgery.

  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. Applications of Cone-Beam Computed Tomography in Oral and Maxillofacial Surgery: An Overview of Published Indications and Clinical Usage in United States Academic Centers and Oral and Maxillofacial Surgery Practices. (United States)

    Carter, Jeffrey B; Stone, Jeffrey D; Clark, Robert S; Mercer, James E


    The American Association of Oral and Maxillofacial Surgeons appointed a task force to study the indications, safety, and clinical practice patterns of cone-beam computed tomography (CBCT) in oral and maxillofacial surgery (OMS). The charge was to review the published applications of CBCT in OMS, identify the current position of academic thought leaders in the field, and research the adoption and usage of the technology at the clinical practitioner level. This study reviewed the CBCT world literature and summarized published indications for the modality. A nationwide survey of academic thought leaders and practicing oral and maxillofacial surgeons was compiled to determine how the modality is currently being used and adopted by institutions and practices. This report summarizes published applications of CBCT that have been vetted by the academic and practicing OMS community to define current indications. The parameters of patient safety, radiation exposure, accreditation, and legal issues are reviewed. An overview of third-party adoption of CBCT is presented. CBCT is displacing 2-dimensional imaging in the published literature, academia, and private practice. Best practices support reading the entire scan volume with a written report defining results, patient exposure, and field of view. Issues of patient safety, ALARA ("as low as reasonably achievable"), accreditation, and the legal and regulatory environment are reviewed. Third-party patterns for reimbursements vary widely and seem to lack consistency. There is much confusion within the provider community about indications, authorizations, and payment policies. The current medical and dental indications for CBCT in the clinical practice of OMS are reviewed and an industry guideline is proposed. These guidelines offer a clear way of differentiating consensus medical indications and common dental uses for clinicians. This matrix should bring a predictable logic to third-party authorizations, billing, and predictable

  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. Indications and outcomes of the components separation technique in the repair of complex abdominal wall hernias: experience from the cambridge plastic surgery department. (United States)

    Adekunle, Shola; Pantelides, Nicholas M; Hall, Nigel R; Praseedom, Raaj; Malata, Charles M


    The components separation technique (CST) is a widely described abdominal wall reconstructive technique. There have, however, been no UK reports of its use, prompting the present review. Between 2008 and 2012, 13 patients who underwent this procedure by a single plastic surgeon (C.M.M.) were retrospectively evaluated. The indications, operative details, and clinical outcomes were recorded. There were 7 women and 6 men in the series with a mean age of 53 years (range: 30-80). Patients were referred from a variety of specialties, often as a last resort. The commonest indication for CST was herniation following abdominal surgery. All operations except 1 were jointly performed with general surgeons (for bowel resection, stoma reversal, and hernia dissection). The operations lasted a mean of 5 hours (range: 3-8 hours). There were no major intra- and postoperative problems, except in 1 patient who developed intra-abdominal compartment syndrome, secondary to massive hemorrhage. All patients were satisfied with the cosmetic improvement in their abdominal contours. None of the patients have developed a clinical recurrence after a mean follow-up of 16 months (range: 3-38 months). The components separation technique is an effective method of treating large recalcitrant hernias but appears to be underutilized in the United Kingdom. The management of large abdominal wall defects requires a multidisciplinary approach, with input across a variety of specialities. Liaison with plastic surgery teams should be encouraged at an early stage and the CST should be more widely considered when presented with seemingly intractable abdominal wall defects.

  5. 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.

  6. 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 ...

  7. The effect of prolapse surgery on vaginal sensibility. (United States)

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


    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 understand the effects of prolapse surgery on sexual function. To assess the effects of prolapse surgery with or without stress incontinence surgery on vaginal sensibility and to assess the relationship between vaginal wall sensibility and sexual well-being. This study was performed parallel to a randomized controlled trial comparing vaginal and abdominal prolapse surgery with or without incontinence surgery in women with uterine prolapse stage 2 or more. Vaginal wall sensibility was defined as mean sensation threshold to electrical stimulation of the vaginal wall at four standardized places, measured before and 6 months after surgery. Higher sensation thresholds postsurgery relative to presurgery indicate diminished vaginal wall sensibility. Sexual function was assessed at the same time points using a questionnaire. Data on vaginal wall sensibility were obtained from 65 patients. The sensibility of the distal posterior (P = 0.02) and distal anterior (P = 0.10) vaginal wall decreased after vaginal surgery compared to abdominal surgery. Abdominal prolapse surgery with incontinence surgery decreased sensibility of the distal part of the anterior vaginal wall significantly more than abdominal prolapse surgery only (P = 0.01). Before surgery, vaginal wall sensibility was lower in women who reported vaginal dryness or anorgasmia. The presence of genital pain was associated with higher vaginal wall sensibility. Postoperative vaginal wall sensibility was similar in women with and without sexual problems. Vaginal prolapse surgery as well as abdominal prolapse surgery with additional incontinence surgery resulted in decreased vaginal wall sensibility. This pilot study shows no influence of the

  8. Nasal Physiology (United States)

    ... Anatomy Virtual Anatomy Disclosure Statement Printer Friendly Nasal Physiology Jeremiah A. Alt, MD, PhD Noam Cohen, MD, ... control the inflammation. CONCLUSION An understanding of the physiology of the nose is critical to understand nasal ...

  9. Prehabilitation Before Major Surgery


    Johnson Francis


    Prehabilitation is a new term for preoperative rehabilitation before major surgery. Some authors use the short form 'Prehab', though it is not so widely used. Prehabilitation involves measures to improve the physical, physiological, metabolic and psychosocial reserves in preparation for an elective surgery. This involves exercise, nutrition, education and psychosocial interventions.

  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. 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...

  12. Female genital cosmetic surgery. (United States)

    Shaw, Dorothy; Lefebvre, Guylaine; Bouchard, Celine; Shapiro, Jodi; Blake, Jennifer; Allen, Lisa; Cassell, Krista


    To provide Canadian gynaecologists with evidence-based direction for female genital cosmetic surgery in response to increasing requests for, and availability of, vaginal and vulvar surgeries that fall well outside the traditional realm of medically-indicated reconstructions. Published literature was retrieved through searches of PubMed or MEDLINE, CINAHL, and The Cochrane Library in 2011 and 2012 using appropriate controlled vocabulary and key words (female genital cosmetic surgery). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. There were no date or language restrictions. Searches were updated on a regular basis and incorporated in the guideline to May 2012. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Recommendations 1. The obstetrician and gynaecologist should play an important role in helping women to understand their anatomy and to respect individual variations. (III-A) 2. For women who present with requests for vaginal cosmetic procedures, a complete medical, sexual, and gynaecologic history should be obtained and the absence of any major sexual or psychological dysfunction should be ascertained. Any possibility of coercion or exploitation should be ruled out. (III-B) 3. Counselling should be a priority for women requesting female genital cosmetic surgery. Topics should include normal variation and physiological changes over the lifespan, as well as the possibility of unintended consequences of cosmetic surgery to the genital area. The lack of evidence regarding outcomes and the lack of data on the

  13. 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.

  14. Robotic surgery (United States)

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... Robotic surgery is similar to laparoscopic surgery. It can be performed through smaller cuts than open surgery. ...

  15. Cosmetic genital surgery in children and adolescents. (United States)

    Wood, Paul L


    Clinicians are faced with increasing requests for female cosmetic genital surgery and prominent amongst these is labiaplasty. The implications of labiaplasty in adolescence are explored with emphasis on what is known about normal genital appearances, pubertal development, anatomy and physiology and the options for surgical intervention including risks and implications. Faced with what is known to date on female cosmetic genital surgery then such interventions should be avoided in adolescence in the absence of defined medical indications until at least the age of 18 years. Copyright © 2017 Elsevier Ltd. All rights reserved.

  16. 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.

  17. [ 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.

  18. Emergency surgery

    DEFF Research Database (Denmark)

    Stoneham, M; Murray, D; Foss, N


    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...... to rise as the population ages, this review summarises the evidence on which such guidance is based, and provides information about how anaesthetists might participate in audit and research aimed at improving local and national outcomes for these most vulnerable of patients....

  19. 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

  20. 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.

  1. Implementation of an academic half day in a vascular surgery residency program improves trainee and faculty satisfaction with surgical indications conference. (United States)

    Robbins, Riann; Sullivan, Sarah; Smith, Brigitte


    The Accreditation Council for Graduate Medical Education mandates scheduled didactics for residency programs but allows flexibility in implementation. Work-hour restrictions, patient care duties, and operative schedules create barriers to attendance for surgical trainees. We explored vascular surgery trainees and faculty perceptions on trainees operative preparation and participation, and overall fund of knowledge after implementing an academic half day conference (AHD) schedule. The vascular surgery conference at a single academic institution was changed from three 1-hour conferences weekly, to a single protected, 3-hour conference once weekly. Faculty and trainees were surveyed before and 5 months after implementing the new AHD schedule. Overall satisfaction improved after initiating the AHD (4 of 4 trainees, 3 of 4 faculty). All trainees (n = 4) and faculty (n = 4) believed the AHD conference format was worthwhile. Most trainees believed the AHD format improved their Vascular Surgery in Service Training Exam preparation (3 of 4), fund of knowledge (4 of 4), and operative preparation (3 of 4). More trainees than faculty tended to feel that the AHD interfered with operative participation (3 of 4 trainees vs 1 of 4 faculty). Neither group agreed that the conference was optimally scheduled. This single-institution, pilot study suggests a positive association in the attitudes of most vascular surgery trainees and faculty regarding preparation for the Vascular Surgery In-Training Exam and overall fund of knowledge after implementing a protected AHD schedule. Further research is needed to understand the impact of the AHD conference on operative experience and training exam scores. Copyright © 2018 Elsevier Inc. All rights reserved.

  2. 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.

  3. Cosmetic Surgery (United States)

    ... Body Looking and feeling your best Cosmetic surgery Cosmetic surgery Teens might have cosmetic surgery for a number ... about my body? What are the risks of cosmetic surgery? top People who have cosmetic surgery face many ...

  4. The use of pneumoperitoneum during laparoscopic surgery as a model to study pathophysiologic phenomena: the correlation of cardiac functionality with computerized acoustic indices--preliminary data. (United States)

    Bickel, Amitai; Eitan, Arieh; Melnik, Dimitry; Weiss, Atalia; Gavrieli, Noam; Kniaz, David; Intrator, Nathan


    Induction of pneumoperitoneum during laparoscopic surgery leads to diverse cardiovascular changes that can be used as a model to study pathophysiologic phenomena. Application of novel signal processing and figure extraction enabled searching for correlation between various signals and pathophysiologic setting. Our aim was to quantitatively correlate cardiac functionality (as expressed by cardiac output) with the spectral energy of the first heart sound (S1) obtained from the phonocardiogram, during laparoscopic surgery. Patients who were scheduled for elective laparoscopic operations were enrolled in the study. Cardiac output was maximally changed during anesthesia and abdominal insufflation and was obtained from the arterial pressure wave (FloTrac™ sensor and Vigileo™ monitor [Edwards Lifesciences Ltd.]). Heart signals were recorded during surgery from each subject by a computerized digital data acquisition system. The automatic analysis of the heart sounds included segmentation that was based on the energy envelope of the heart sounds together with analysis of the electrocardiogram signal. We analyzed the morphology of the sounds using hierarchial cluster analysis to remove those sounds that were not reliably recorded. The magnitude of the amplitude of heart sounds was obtained by using the Hilbert transform for each heartbeat. Statistical analysis was based on linear regression. Following exclusion of 3 patients (mainly because of technical reasons), we were left with 7 patients who demonstrated statistically significant positive correlation between cardiac index and the amplitude of S1 (regression coefficient between 0.4 and 0.9, Pfunctionality, through sophisticated computerized analysis, using the pneumoperitoneum model for changing the cardiac output.

  5. 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

  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. 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. ...

  8. 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.

  9. Maze Surgery (United States)

    ... Center > Maze Surgery Menu Topics Topics FAQs Maze Surgery Article Info En español Electrical impulses in your ... called an arrhythmia. Why do I need Maze surgery? Maze surgery is also called the Maze procedure. ...

  10. Surgical volume and postoperative mortality rate at a referral hospital in Western Uganda: Measuring the Lancet Commission on Global Surgery indicators in low-resource settings. (United States)

    Anderson, Geoffrey A; Ilcisin, Lenka; Abesiga, Lenard; Mayanja, Ronald; Portal Benetiz, Noralis; Ngonzi, Joseph; Kayima, Peter; Shrime, Mark G


    The Lancet Commission on Global Surgery recommends that every country report its surgical volume and postoperative mortality rate. Little is known, however, about the numbers of operations performed and the associated postoperative mortality rate in low-income countries or how to best collect these data. For one month, every patient who underwent an operation at a referral hospital in western Uganda was observed. These patients and their outcomes were followed until discharge. Prospective data were compared with data obtained from logbooks and patient charts to determine the validity of using retrospective methods for collecting these metrics. Surgical volume at this regional hospital in Uganda is 8,515 operations/y, compared to 4,000 operations/y reported in the only other published data. The postoperative mortality rate at this hospital is 2.4%, similar to other hospitals in low-income countries. Finding patient files in the medical records department was time consuming and yielded only 62% of the files. Furthermore, a comparison of missing versus found charts revealed that the missing charts were significantly different from the found charts. Logbooks, on the other hand, captured 99% of the operations and 94% of the deaths. Our results describe a simple, reproducible, accurate, and inexpensive method for collection of the Lancet Commission on Global Surgery variables using logbooks that already exist in most hospitals in low-income countries. While some have suggested using risk-adjusted postoperative mortality rate as a more equitable variable, our data suggest that only a limited amount of risk adjustment is possible given the limited available data. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Orthognathic Surgery

    DEFF Research Database (Denmark)

    Kjærgaard Larsen, Marie; Thygesen, Torben Henrik


    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......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...... to sex, age, and somatosensory change. High satisfaction and improvement in facial esthetic after OS were seen. Young patients (16-25 years) and men indicated a higher degree of satisfaction than old (>25 years) patients and women. The use of social media seems to be an interesting platform...

  12. Reações iniciais do paciente infanto-juvenil ante a indicação de cirurgia de estrabismo First reactions of the patient when facing strabismus surgery indication

    Directory of Open Access Journals (Sweden)

    Maria Cristina Oliveira Regina


    Full Text Available Objetivo: O presente trabalho pretendeu identificar as principais reações de crianças em face de cirurgia de estrabismo resultantes de sua imediata e recente indicação em consulta médica. Métodos: Pesquisa - Ação. Resultados: Ansiedade e medo foram os mais importantes sentimentos encontrados. Parecem ser sustentados por conceitos parciais formados sobre cirurgia a partir do estágio de desenvolvimento cognitivo e emocional das crianças. Motivação própria ou pessoal para a cirurgia somente mostrou-se reconhecível entre sujeitos mais velhos: a partir de 9 anos de idade. Crianças com menos idade têm seu desejo/motivação para cirurgia, mesclado, ou até mesmo confundido, com os objetivos dos adultos que as rodeiam, especialmente os pais. Conclusões: O significado especial destes dados nos remete à função simbólica. Ela deve ser considerada para o preparo psicológico das crianças para cirurgia, em ambas as direções: no âmbito cognitivo e emocional/afetivo.Purpose: To identify the principal reactions of children facing strabismus surgery information as a result of its immediate and recent indication on medical consultation. Methods: Intervention/Action during Research; interview after surgery indication. Results: Anxiety and fear were the most important feelings encountered. They were sustained by partial concepts formed about surgery due the different levels of cognitive development of the children. The motivation for the surgery itself was only recognized among subjects older than 9 years. Children with less age had their surgery motivation mixed with the adults' purposes, especially parents, around them. Conclusions: The special meaning of this data seems to be that the symbolic function should be considered to psychologically prepare children for the surgery, in both directions: cognitive and emotional representation.

  13. [Cosmetic surgery among Norwegian women]. (United States)

    von Soest, Tilmann; Kvalem, Ingela Lundin; Roald, Helge Einar; Skolleborg, Knut Chr


    There are few data on the frequency of cosmetic surgery among Norwegian women. A random sample of 2000 Norwegian women aged 22 to 55 received a questionnaire on cosmetic surgery, demographic data, self-esteem, and to what extent people around them accepted cosmetic surgery. The response rate was 46% (907 women). Of these, 7.7% indicated that they had undergone cosmetic surgery, while 22.6% wished to do so. Other people's degree of acceptance predicted both the wish to undergo cosmetic surgery and already conducted surgery. Low self-esteem was correlated with a wish to undergo surgery, though women who had done surgery had no lower self-esteem than non-patients. Although the response rate was relatively low, this study gives the first reliable data on the frequency of cosmetic surgery in Norway. The results indicate that other people's degree of acceptance of cosmetic surgery is a predictor of such surgery being chosen.

  14. 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 Bente...

  15. 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

  16. Do current indications for surgery of primary gastric lymphoma exist? ¿Existen indicaciones actuales para la cirugía en el linfoma gástrico?

    Directory of Open Access Journals (Sweden)

    J. C. Rodríguez-Sanjuán


    Full Text Available Objective: to analyze the results of our series in order to assess whether surgical excision is still a valid therapeutic option in case the patient needs surgery. Secondarily, to analyze Helicobacter pylori infection rate. Patients and method: a retrospective study of 69 consecutive patients having stage IE-IIE primary gastric lymphoma; of these, 65 were treated by gastrectomy between 1974 and 1999. Mean age: 62.6 years (28-85. New staining of paraffin-embedded samples from the surgical specimen were carried out (hematoxiline-eosine, Giemsa, immunohistochemistry and reviewed. The histological classification was performed according to Isaacson's criteria. The statistical analysis was done by Chi-squared and Fisher's exact tests, as well as Kaplan-Meier and Log-Rank tests. Results: mortality was 9.2%. There were non-fatal complications in 10.8%. Helicobacter pylori was identified in 62.7%. Seven patients (11.9% suffered a relapse. The 5-year survival probability was 87%. The statistical analysis did not show any influences of Ann Arbor stage, gastric wall invasion, Helicobacter pylori infection, histological type, or margin resection involvement on survival. Conclusions: surgical excision provides a high rate of complete remissions and excellent long-term survival with acceptable mortality. Therefore it appears to be a valid treatment in case of emergency surgery, incidental finding, or lack of histological diagnosis.Objetivo: analizar los resultados de nuestra serie a fin de establecer si la extirpación quirúrgica continúa siendo una opción terapéutica válida para las situaciones en las que pudiera precisarse cirugía. Como objetivo secundario, analizar la prevalencia de infección por Helicobacter pylori. Pacientes y método: estudio retrospectivo de 69 pacientes consecutivos diagnosticados de linfoma gástrico primario, en estadio I E y II E de Ann Arbor, 65 de los cuales fueron tratados mediante gastrectomía entre 1974 y 1999. Edad

  17. 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.

  18. [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.

  19. 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

  20. 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

  1. 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

  2. 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 ...

  3. 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.

  4. The role of the general dentist in the management of obstructive sleep apnea, application of oral appliance therapy, and the indication for surgery. (United States)

    Kelly, Shaunda E; Waite, Peter D


    The general dentist can play an important role in the recognition and initial diagnosis of patients with obstructive sleep apnea syndrome. Obstructive sleep apnea is defined as the repetitive airway obstruction during sleep due to the collapse of the pharyngeal airway potentially causing cessation of breathing. Although many Americans suffer from symptoms of sleep apnea syndrome, most remain undiagnosed until significant problems occur, such as cardiopulmonary and neurologic dysfunction. In recent years, sleep apnea has become a significant public health concern. Both medical and dental practitioners have become increasingly aware of sleep apnea. Early detection of this condition by the dental practitioner can lead to the prevention of comorbid diseases and improved quality of life for many patients. This article will provide a greater understanding of the pathophysiology, diagnosis, indications, risks, and benefits of treatments available so that dental practitioners can make better treatment recommendations.

  5. 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 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 study indicated that lying time, drinking frequency, RR, RT, plasma HSP70, and PBMC HSP70 gene expression may act as ideal biological markers for assessing the impact of CS on adaptive capabilities in bucks.

  6. [Andreas Vesalius and surgery]. (United States)

    Van Hee, R


    By publishing De Humani Corporis Fabrica Libri Septem in 1543, Andries van Wesel (1514-1564) gave surgical science an immense impulse. The revolutionary renovation in the knowledge of man's anatomical structure changed slowly and progressively into topographical and physiological understanding of surgical diseases. At the same time, this made better aimed and more secure operations possible. Apart from the importance of this anatomical publication, Andreas Vesalius also won his spurs as a surgeon. He taught surgery in Padua for many years. He was appointed court physician and surgeon at the Habsburg Court of Charles V and Philip II. He personally performed lots of operations known at the time as major ones. He not only quickly adopted the surgical innovations of his fellow-surgeon Ambroise Paré, but he even performed operations that had been forgotten during several centuries, among which thoracocentesis for pleural empyema. His clinical perspicacity in discovering the indication for some operations was staggering and was appreciated by all great monarchs of Europe in the 16th century. In his several consilia, numerous pieces of advice were given for the treatment of surgical patients. The surgical practice which Vesalius had in Brussels for many years, consequently became most successful. Many publications by Vesalius about surgery and blood-letting are well-known. His Chirurgia magna in septem Libros digesta still remains controversial; these books were published by Prospero Borgarruccio (1560) in 1568 by the Venetian editor Valgrisi. This book gives an excellent survey of surgical pathology as it was taught and treated in the 16th century. The scientific method that Vesalius used, not only in his anatomical studies but also in his surgical practice, deserves not only our full appraisal but should still be studied in our own time.

  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. [Crohn's disease surgery]. (United States)

    Kala, Zdeněk; Marek, Filip; Válek, Vlastimil A; Bartušek, Daniel


    Surgery of Crohns disease is an important part of the general treatment algorithm. The role of surgery is changing with the development of conservative procedures. The recent years have seen the return to early treatment of patients with Crohns disease. Given the character of the disease and its intestinal symptoms, a specific approach to these patients is necessary, especially regarding the correct choice of surgery. The paper focuses on the luminal damage of the small and large intestine including complications of the disease. We describe the individual indications for a surgical solution, including the choice of anastomosis or multiple / repeated surgeries.

  9. 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

  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. 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…

  12. Swimming physiology. (United States)

    Holmér, I


    Swimming takes place in a medium, that presents different gravitational and resistive forces, respiratory conditions and thermal stress compared to air. The energy cost of propulsion in swimming is high, but a considerable reduction occurs at a given velocity as result of regular swim training. In medley swimmers the energy cost is lowest for front crawl, followed by backstroke, butterfly and breast-stroke. Cardiac output is probably not limiting for performance since swimmers easily achieve higher values during running. Maximal heart rate, however, is lowered by approx. 10 beats/min during swimming compared to running. Most likely active muscle mass is smaller and rate of power production lesser in swimming. Local factors, such as peripheral circulation, capillary density, perfusion pressure and metabolic capacity of active muscles, are important determinants of the power production capacity and emphasize the role of swim specific training movements. Improved swimming technique and efficiency are likely to explain much of the continuous progress in performance. Rational principles based on improved understanding of the biomechanics and physiology of swimming should be guidelines for swimmers and coaches in their efforts to explore the limits of human performance.

  13. Dental Implant Surgery (United States)

    ... 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, ...

  14. 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, ...

  15. Corrective Jaw Surgery

    Medline Plus

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

  16. Recent advances in the modification of taste and food preferences following bariatric surgery. (United States)

    Primeaux, Stefany D; de Silva, Taniya; Tzeng, Tony H; Chiang, Monica C; Hsia, Daniel S


    There is a large body of evidence indicating that bariatric surgery provides durable weight loss and health benefits to patients who are obese and have comorbidities such as type 2 diabetes (T2D). However, there are still many questions related to mechanisms of metabolic improvement, predictors of success/failure, and long term consequences, which need to be answered. More recently, there has been a particular interest in the modulation of taste and food preferences that occurs after bariatric surgery and how this affects weight loss in different individuals. Animal models as well as human studies have shed some light on the role of taste in changing food preferences and how these changes may affect weight loss after surgery. The goal of this review is to discuss the physiological and behavioral consequences of bariatric surgery as a treatment for obesity and T2D, with particular emphasis on recent studies describing bariatric surgery-induced modifications in taste perception and food preferences.

  17. Hemorrhoid surgery (United States)

    ... surgery. Hemorrhoid surgery may involve: Putting a small rubber band around a hemorrhoid to shrink it by blocking blood flow. Stapling a hemorrhoid to block blood flow, causing it to shrink. Using a ...

  18. Bariatric Surgery and Hypertension. (United States)

    Owen, Jonathan G; Yazdi, Farshid; Reisin, Efrain


    Obesity continues to increase in prevalence worldwide. Hypertension has long been associated with obesity, and weight loss continues to be a first-line therapy in the treatment of hypertension. Lifestyle modification and pharmacologic therapy, however, often meet with treatment failure. Bariatric surgery continues to be the most successful approach to sustained weight loss. This review focuses on the underlying physiologic mechanisms of obesity-hypertension, and the impact of bariatric surgery on the treatment of hypertension. Current available literature on the physiologic mechanisms of obesity-hypertension, and the major trials, meta-analyses and systematic reviews of the impact of bariatric surgery procedures on hypertension are reviewed. Evidence suggests significant improvement in obesity-hypertension in patients who undergo surgical weight-reduction procedures. Malabsorptive techniques such as the Roux-en-Y gastric bypass or surgical resection techniques such as laparoscopic sleeve gastrectomy appear to offer superior results in regards to hypertension control over restrictive techniques such as Gastric Banding. Though long-term control of hypertension following surgery remains a concern, available follow-up post-operative data of up to 10 years suggests a sustained, if lessened, effect on hypertension control over time. © American Journal of Hypertension, Ltd 2017. All rights reserved. For Permissions, please email:

  19. [Human physiology: kidney]. (United States)

    Natochin, Iu V


    The content of human physiology as an independent part of current physiology is discussed. Substantiated is the point that subjects of human physiology are not only special sections of physiology where functions are inherent only in human (physiology of intellectual activity, speech, labor, sport), but also in peculiarities of functions, specificity of regulation of each of physiological systems. By the example of physiology of kidney and water-salt balance there are shown borders of norm, peculiarities of regulation in human, new chapters of renal physiology which have appeared in connection with achievements of molecular physiology.

  20. Plastic Surgery (United States)

    ... idea for teens? As with everything, there are right and wrong reasons to have surgery. Cosmetic surgery is unlikely to change your life. Most board-certified plastic surgeons spend a lot of time ... the right reasons. Many plastic surgery procedures are just that — ...

  1. 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.

  2. 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

  3. Physiologic effects of bowel preparation

    DEFF Research Database (Denmark)

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


    , plasma and extracellular volume, balance function, and biochemical parameters were measured. RESULTS: Bowel preparation led to a significant decrease in exercise capacity (median, 9 percent) and weight (median, 1.2 kg). Plasma osmolality was significantly increased from 287 to 290 mmol kg(-1), as well......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...... healthy volunteers (median age, 63 years) underwent bowel preparation with bisacodyl and sodium phosphate. Fluid and food intake were standardized according to weight, providing adequate calorie and oral fluid intake. Before and after bowel preparation, weight, exercise capacity, orthostatic tolerance...

  4. 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.

  5. Minimally Invasive Abdominal Surgery


    Richardson, William S.; Carter, Kristine M.; Fuhrman, George M.; Bolton, John S.; Bowen, John C.


    In the last decade, laparoscopy has been the most innovative surgical movement in general surgery. Minimally invasive surgery performed through a few small incisions, laparoscopy is the standard of care for the treatment of gallbladder disease and the gold standard for the treatment of reflux disease. The indications for a laparoscopic approach to abdominal disease continue to increase, and many diseases may be treated with laparoscopic techniques. At Ochsner, laparoscopic techniques have dem...

  6. Surgery for Acute Pancreatitis


    Navadgi, Suresh; Pandanaboyana, Sanjay; Windsor, John A.


    Surgery for acute pancreatitis has undergone significant changes over the last 3 decades. A better understanding of the pathophysiology has contributed to this, but the greatest driver for change has been the rise of less invasive interventions in the fields of laparoscopy, endoscopy and radiology. Surgery has a very limited role in the diagnosis of acute pancreatitis. The most common indication for intervention in acute pancreatitis is for the treatment of complications and most notably the ...

  7. Controlled hypotension for spinal surgery


    Dutton, Richard P.


    Controlled, deliberate hypotension during anesthesia for major spinal surgery reduces intraoperative blood loss and transfusion requirement. Hypotension may be achieved with increased doses of volatile anesthetic agents or by continuous infusion of vasodilating drugs. Safe application of this technique requires knowledge of the physiology of hemorrhagic shock and close intraoperative monitoring to avoid vasoconstriction and end-organ ischemia.

  8. 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…

  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


    African Journals Online (AJOL)

    3 Department of Paediatric Surgery, Sophia's Children Hospital/Erasmus Medical Centre, Rotterdam, The Netherlands. 4 Department of Paediatric Surgery, Emma's Children Hospital/Academic Medical Centre, Amsterdam, The Netherlands. 5 Department of Radiology, Red Cross War Memorial Children's Hospital, ...


    African Journals Online (AJOL)

    Gastroschisis in a developing country: poor resuscitation is a more significant predictor of mortality than postnatal transfer time. PAEDIATRIC SURGERY. P Stevens,1 E Muller,1 P Becker2. 1 Department of Paediatric Surgery, Steve Biko Academic Hospital, University of Pretoria. 2 South African Medical Research Council.

  12. Economic and psychological burden of scheduled surgery ...

    African Journals Online (AJOL)

    Background: Cancellation of scheduled surgery creates a financial burden for hospitals, caregivers and patients. Cancellation ... management. High cancellation rates may indicate that rare health resources are being used ineffectively, thereby increasing costs. There are many reasons for surgery cancellation including.

  13. Physiological Information Database (PID) (United States)

    EPA has developed a physiological information database (created using Microsoft ACCESS) intended to be used in PBPK modeling. The database contains physiological parameter values for humans from early childhood through senescence as well as similar data for laboratory animal spec...

  14. Rodding Surgery (United States)

    ... usually undertaken as a scheduled elective procedure. An optimal age for a first rodding surgery has not ... which may prevent or postpone the need for replacement. The smallest diameter expanding rods are still too ...

  15. Lung surgery (United States)

    ... the pulmonary artery ( pulmonary embolism ) Treat complications of tuberculosis Video-assisted thoracoscopic surgery can be used to ... Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed ...

  16. Bariatric Surgery (United States)

    ... action of certain hormones, such as ghrelin —“the hunger hormone.” People have these types of surgery if ... organizations to further patient education on hormone related issues. Network Sponsors The Hormone Health Network is supported ...

  17. Epilepsy Surgery (United States)

    ... and the portion of your brain that's involved: Memory problems. The temporal lobe handles memory and language functions, so surgery on this part ... computerized tomography (SPECT). The scan image varies in color depending on the amount of blood flow in ...

  18. After Surgery (United States)

    After any operation, you'll have some side effects. There is usually some pain with surgery. There ... anesthesia, or accidental injury. Some people have a greater risk of complications because of other medical conditions. ...

  19. Brain surgery (United States)

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... Barnett J, Mohanty A, Desai SK, Patterson JT. Neurosurgery. In: Townsend CM Jr, Beauchamp RD, Evers BM, ...

  20. Surgery-first accelerated orthognathic surgery: orthodontic guidelines and setup for model surgery. (United States)

    Liou, Eric J W; Chen, Po-Hsung; Wang, Yu-Chih; Yu, Chung-Chih; Huang, C S; Chen, Yu-Ray


    The surgery-first approach indicates that the orthognathic surgery precedes the orthodontic treatment, whereas the orthodontics-first approach indicates that the orthodontic treatment precedes the orthognathic surgery. The conventional approach is an orthodontics-first approach. The purposes of this article are to introduce the concept of the surgery-first approach and to report the guidelines for orthodontic management and model surgery without presurgical orthodontic decompensation. The surgery-first approach treats facial esthetics first and then occlusion, whereas the conventional approach treats occlusion first and then facial esthetics. The surgery-first approach uses osteotomy to solve both skeletal problems and dental compensation, and a "transitional" occlusion is set up postoperatively. Orthodontics in the surgery-first approach is a postoperatively adjunctive treatment to transfigure the transitional occlusion into the solid final occlusion. The advantages of the surgery-first approach are that 1) the patient's chief complaint, dental function, and facial esthetics are achieved and improved in the beginning of the treatment; 2) the entire treatment period is shortened to 1 to 1.5 years or fewer depending on the complexity of orthodontic treatment; and 3) the phenomenon of postoperatively accelerated orthodontic tooth movement reduces the difficulty and treatment time of orthodontic management in the surgery-first approach. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. 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

  2. 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.

  3. Bariatric surgery (United States)

    Karmali, Shahzeer; Stoklossa, Carlene Johnson; Sharma, Arya; Stadnyk, Janet; Christiansen, Sandra; Cottreau, Danielle; Birch, Daniel W.


    Abstract OBJECTIVE To review the management of bariatric surgical patients. QUALITY OF EVIDENCE MEDLINE, EMBASE, and Cochrane Library databases were searched, as well as PubMed US National Library, from January 1950 to December 2009. Evidence was levels I, II, and III. MAIN MESSAGE Bariatric surgery should be considered for obese patients at high risk of morbidity and mortality who have not achieved adequate weight loss with lifestyle and medical management and who are suffering from the complications of obesity. Bariatric surgery can result in substantial weight loss, resolution of comorbid conditions, and improved quality of life. The patient’s weight-loss history; his or her personal accountability, responsibility, and comprehension; and the acceptable level of risk must be taken into account. Complications include technical failure, bleeding, abdominal pain, nausea or vomiting, excess loose skin, bowel obstruction, ulcers, and anastomotic stricture. Lifelong monitoring by a multidisciplinary team is essential. CONCLUSION Limited long-term success of behavioural and pharmacologic therapies in severe obesity has led to renewed interest in bariatric surgery. Success with bariatric surgery is more likely when multidisciplinary care providers, in conjunction with primary care providers, assess, treat, monitor, and evaluate patients before and after surgery. Family physicians will play a critical role in counseling patients about bariatric surgery and will need to develop skills in managing these patients in the long-term. PMID:20841586

  4. Corrective Jaw Surgery

    Medline Plus

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

  5. Is There an Indication for Digital Subtraction Angiography in the Assessment of Irradiation-Induced Vascular Damage before Free Flap Surgery by the Means of the Internal Mammary Vessels?

    NARCIS (Netherlands)

    Klein, Steven; Hoving, Saske; Werker, Paul; Russell, Nicola

    Secondary breast reconstruction is increasingly performed after postmastectomy radiotherapy. Damage to blood vessel walls is one of the adverse effects of irradiation therapy, which may jeopardize reconstructive free flap surgery. It would be of great importance to be informed about the quality of

  6. 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 ...

  7. 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 ...

  8. 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.

  9. Physiologic time: A hypothesis (United States)

    West, Damien; West, Bruce J.


    The scaling of respiratory metabolism with body size in animals is considered by many to be a fundamental law of nature. One apparent consequence of this law is the scaling of physiologic time with body size, implying that physiologic time is separate and distinct from clock time. Physiologic time is manifest in allometry relations for lifespans, cardiac cycles, blood volume circulation, respiratory cycle, along with a number of other physiologic phenomena. Herein we present a theory of physiologic time that explains the allometry relation between time and total body mass averages as entailed by the hypothesis that the fluctuations in the total body mass are described by a scaling probability density.

  10. 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.

  11. Robotic Surgery in Gynecologic Oncology (United States)

    DeBernardo, Robert; Starks, David; Barker, Nichole; Armstrong, Amy; Kunos, Charles A.


    Robotic surgery for the management of gynecologic cancers allows for minimally invasive surgical removal of cancer-bearing organs and tissues using sophisticated surgeon-manipulated, robotic surgical instrumentation. Early on, gynecologic oncologists recognized that minimally invasive surgery was associated with less surgical morbidity and that it shortened postoperative recovery. Now, robotic surgery represents an effective alternative to conventional laparotomy. Since its widespread adoption, minimally invasive surgery has become an option not only for the morbidly obese but for women with gynecologic malignancy where conventional laparotomy has been associated with significant morbidity. As such, this paper considers indications for robotic surgery, reflects on outcomes from initial robotic surgical outcomes data, reviews cost efficacy and implications in surgical training, and discusses new roles for robotic surgery in gynecologic cancer management. PMID:22190946

  12. Sexual and psychological functioning in women after pelvic surgery for gynaecological cancer

    NARCIS (Netherlands)

    Aerts, L.; Enzlin, P.; Verhaeghe, J.; Vergote, I.; Amant, F.


    Pelvic surgery for gynecological cancer can affect sexuality through a number of anatomical, physiological and psychological mechanisms. We aimed to examine the prevalence Of Sexual dysfunction and psychological functioning in women who underwent pelvic surgery for gynecological cancer. Fifty women

  13. 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

  14. Surgery in Amphibians. (United States)

    Chai, Norin


    Amphibian surgery has been especially described in research. Since the last decade, interest for captive amphibians has increased, so have the indications for surgical intervention. Clinicians should not hesitate to advocate such manipulations. Amphibian surgeries have no overwhelming obstacles. These patients heal well and tolerate blood loss more than higher vertebrates. Most procedures described in reptiles (mostly lizards) can be undertaken in most amphibians if equipment can be matched to the patients' size. In general, the most difficult aspect would be the provision of adequate anesthesia. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Bariatric surgery

    Directory of Open Access Journals (Sweden)

    Alojz Pleskovič


    Full Text Available Background: In almost six decades different surgical techniques have been developed to treat patients with morbid obesity. Various surgical techniques are generally divided with respect to their effect into restrictive, malabsorbtive and humoral and a combination of these. Surgically modified human metabolism ameliorates metabolic diseases, particularly diabetes, even in nonobese patients. The understanding of metabolic effects changed the traditional paradigm of bariatric surgery from simple weight-loss procedure to metabolic surgery affecting whole-body metabolism. Proper surgical technique for individual patient is the most important factor influencing long- term results, comorbidities and quality of life. Recommendations for patient selection, surgical methods and pre- and postoperative patient management are to be respected. Metabolic surgery principles and current concepts are presented.

  16. 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.

  17. Robotic surgery in gynecology. (United States)

    Alkatout, Ibrahim; Mettler, Liselotte; Maass, Nicolai; Ackermann, Johannes


    Robotic surgery is the most dynamic development in the sector of minimally invasive operations currently. It should not be viewed as an alternative to laparoscopy, but as the next step in a process of technological evolution. The advancement of robotic surgery, in terms of the introduction of the Da Vinci Xi, permits the variable use of optical devices in all four trocars. Due to the new geometry of the "patient cart," an operation can be performed in all spatial directions without re-docking. Longer instruments and the markedly narrower mechanical elements of the "patient cart" provide greater flexibility as well as access similar to those of traditional laparoscopy. Currently, robotic surgery is used for a variety of indications in the treatment of benign gynecological diseases as well as malignant ones. Interdisciplinary cooperation and cooperation over large geographical distances have been rendered possible by telemedicine, and will ensure comprehensive patient care in the future by highly specialized surgery teams. In addition, the second operation console and the operation simulator constitute a new dimension in advanced surgical training. The disadvantages of robotic surgery remain the high costs of acquisition and maintenance as well as the laborious training of medical personnel before they are confident with using the technology.

  18. Endocrine Function after Bariatric Surgery. (United States)

    Kim, Ki-Suk; Sandoval, Darleen A


    Obesity increases the risks of metabolic disorders including type 2 diabetes mellitus (T2DM). Bariatric surgery is the most successful therapeutic option that causes sustained weight loss and improvements in obesity comorbidities. Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) are two of the most frequently performed bariatric surgeries. Despite their different anatomical rearrangement, they have remarkably similar success in both weight loss and T2DM remission. Interestingly, they also both cause a wide range of endocrine changes. Many of these endocrine changes are reflected specifically within the intestine and are implicated as mechanisms for the metabolic success of surgery. However, while most of the work shows that these hormonal changes are associated with the metabolic changes after surgery, causation has been difficult to ascertain. Here, we review the endocrine changes after RYGB and VSG and explore their mechanistic role in the success of bariatric surgery. Further, we explore important changes in gastrointestinal function and the role of these changes in the increase in postprandial endocrine responses after bariatric surgery. © 2017 American Physiological Society. Compr Physiol 7:783-798, 2017. Copyright © 2017 John Wiley & Sons, Inc.

  19. 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)

  20. 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)

  1. Cosmetic surgery.


    Harris, D. L.


    The psychotherapeutic nature of cosmetic surgery is emphasised by outlining the range of symptoms from which patients suffer and by explaining the sequence of psychological reactions which cause them. The principles which govern the selection of patients are defined. A brief account of each of the main cosmetic operations is given together with notes on their limitations and risks.


    African Journals Online (AJOL)

    surgery or subcutaneous mastectomy utilizing a periareolar or circumareolar ... old. Informed consent was obtained. The height of the patients was measured from heel to vertex with a standard height measuring device. The chest circumference was ... The procedure was followed with liposuction 3-6 months later if required.


    African Journals Online (AJOL)

    Summary: The multidisciplinary management of Breast Cancer (BC) has evolved over the past 50 years: the patient is offered a choice of .... Choice of procedure. – For women with early BC, there is essentially a choice between 2 procedures: mastectomy or breast conserving surgery with radiation (BCT). The standard.


    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 ...


    African Journals Online (AJOL)

    We plan to protocolise earlier surgery and blood conservation strategies intraoperatively in addition to a restrictive strategy in ..... Marshall JC. Review Transfusion trigger: when to transfuse? Crit Care. 2004;8(Suppl 2):S31-3. 11. Hofmann A, Farmer S, Towler SC. Strategies to preempt and reduce the use of blood products: ...

  6. Cosmetic Surgery (United States)

    ... Medical Tourism (Copyright © American Society of Plastic Surgeons) — People considering ... in exotic vacation spots. This publication talks about "medical tourism" and whether it's safe. ...


    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)

    after pancreaticoduodenectomy for pancreatic ductal adenocarcinoma. J Surg Oncol. 2016;113(2):188-193. http:// 2. Wente MN, Veit JA, Bassi C, et al. Postpancreatectomy hemorrhage (PPH): An international study group of pancreatic surgery (ISGPS) definition. Surg. 2007;142(1):20-25. http://.

  9. Metabolic Surgery

    DEFF Research Database (Denmark)

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


    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...


    African Journals Online (AJOL)

    deaths due to other trauma types (gunshot wounds, road traffic fatalities and assault) ... the axillary artery was ligated during surgery. Type of ... Left axillary artery. Ischaemic left upper limb. 3. Fifth intercostal space on the left. Bilateral pneumothorax and haemothorax still present at autopsy. (intercostal drain only inserted on ...

  11. 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...

  12. 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 ...

  13. [Guidelines for clinical practice for bariatric surgery]. (United States)

    Ciangura, Cécile; Nocca, David; Lindecker, Valérie


    Bariatric surgery is intended for subjects with BMI ≥ 40 kg/m(2) or ≥ 35 kg/m(2) with comorbidities. In any case, the indication can only be envisaged in patients who have had access to specialized medical care, and agree with a prolonged medical follow-up. After 60 years old, physiological age and comorbidities need to be highly considered. In genetic obesity and craniopharyngioma, surgery is exceptional. Main contraindications consist in severe disorders in feeding behaviour, non-stabilized psychiatric disorders, alcoholism, drug addiction, inability to participate in prolonged medical follow-up. Surgical process includes many important stages: preparation and information by a multidisciplinary team (identify contraindication, give optimal information, look for and treat comorbidities [as sleep apneoas syndrome, diabetes, cardiopulmonary disease], assess nutritional and psychological status and feeding behaviour); the decision of intervention during a concerted analysis by a multidisciplinary team; follow-up (for life) led to screen for nutritional deficiencies and surgical complications, to reinforce diet and physical activity counselling, to adapt to new situations (as pregnancy), and advise psychological care if necessary. Copyright © 2010. Published by Elsevier Masson SAS.

  14. Cancer Surgery in the Elderly

    Directory of Open Access Journals (Sweden)

    Gopal C. Kowdley


    Full Text Available The proportions both of elderly patients in the world and of elderly patients with cancer are both increasing. In the evaluation of these patients, physiologic age, and not chronologic age, should be carefully considered in the decision-making process prior to both cancer screening and cancer treatment in an effort to avoid ageism. Many tools exist to help the practitioner determine the physiologic age of the patient, which allows for more appropriate and more individualized risk stratification, both in the pre- and postoperative periods as patients are evaluated for surgical treatments and monitored for surgical complications, respectively. During and after operations in the oncogeriatric populations, physiologic changes occuring that accompany aging include impaired stress response, increased senescence, and decreased immunity, all three of which impact the risk/benefit ratio associated with cancer surgery in the elderly.

  15. Oncoplastic surgery: pushing the limits of breast-conserving surgery. (United States)

    Clough, Krishna B; Benyahi, Djazia; Nos, Claude; Charles, Caroline; Sarfati, Isabelle


    In recent decades, the surgical management of breast cancer has steadily and considerably improved. Mutilating procedures have given way to more individualized surgical approaches aiming to preserve the breast as much as possible. For large tumors, preoperative chemotherapy is a major tool, but emerging oncoplastic surgery techniques are also a new approach in the armamentarium of breast cancer surgery, as a third option between conventional breast-conserving surgery and mastectomy. As this new treatment modality allows wider margin excision, it reduces the need for re-excision procedures and possibly increases breast conservation rates by extending the indications of breast-conserving surgery. This review will provide an overview of current practices and clinical data available to date on oncoplastic surgery. © 2015 Wiley Periodicals, Inc.

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


    seven sites were the F7 , F8, T3, T4, Fz, Pz, and O2 (see Appendix B). The right and left mastoids were used as the reference and ground for the EEG...route (county vs. city) manipulation, there was less power in the hard (city) condition than in the easy (country) condition in the delta band at F7 ...5) = 7.58, pɘ.05, and in the theta band at F7 F(1, 5) = 6.81, pɘ.05. When the artifact free data was analyzed for the route (county vs. city

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

    African Journals Online (AJOL)

    The stress treatment induced by withholding irrigation after emergence and giving two supplementary irrigations, one after 60 days post-sowing and the other after 90 days post-sowing and non stress (well-watered). Combined analysis of variance over two seasons showed highly significant differences among wheat ...

  18. Thalamic pain: anatomical and physiological indices of prediction. (United States)

    Vartiainen, Nuutti; Perchet, Caroline; Magnin, Michel; Creac'h, Christelle; Convers, Philippe; Nighoghossian, Norbert; Mauguière, François; Peyron, Roland; Garcia-Larrea, Luis


    Thalamic pain is a severe and treatment-resistant type of central pain that may develop after thalamic stroke. Lesions within the ventrocaudal regions of the thalamus carry the highest risk to develop pain, but its emergence in individual patients remains impossible to predict. Because damage to the spino-thalamo-cortical system is a crucial factor in the development of central pain, in this study we combined detailed anatomical atlas-based mapping of thalamic lesions and assessment of spinothalamic integrity using quantitative sensory analysis and laser-evoked potentials in 42 thalamic stroke patients, of whom 31 had developed thalamic pain. More than 97% of lesions involved an area between 2 and 7 mm above the anterior-posterior commissural plane. Although most thalamic lesions affected several nuclei, patients with central pain showed maximal lesion convergence on the anterior pulvinar nucleus (a major spinothalamic target) while the convergence area lay within the ventral posterior lateral nucleus in pain-free patients. Both involvement of the anterior pulvinar nucleus and spinothalamic dysfunction (nociceptive thresholds, laser-evoked potentials) were significantly associated with the development of thalamic pain, whereas involvement of ventral posterior lateral nucleus and lemniscal dysfunction (position sense, graphaesthesia, pallaesthesia, stereognosis, standard somatosensory potentials) were similarly distributed in patients with or without pain. A logistic regression model combining spinothalamic dysfunction and anterior pulvinar nucleus involvement as regressors had 93% sensitivity and 87% positive predictive value for thalamic pain. Lesion of spinothalamic afferents to the posterior thalamus appears therefore determinant to the development of central pain after thalamic stroke. Sorting out of patients at different risks of developing thalamic pain may be achievable at the individual level by combining lesion localization and functional investigation of the spinothalamic system. As the methods proposed here do not need complex manipulations, they can be added to routine patients' work up, and the results replicated by other investigators in the field. © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email:

  19. 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.

  20. 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…

  1. 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...

  2. Geographical Indications


    Anechitoae Constantin; Grigoru? Lavinia-Maria


    “The denomination of origin” may be the name of a region, a specific place or country used to describe an agricultural or food product. "The geographical indication" may be the name of a region, a specific place or a country, used to describe an agricultural or food product. The indication of provenance and the denomination of origin serve to identify the source and origin of goods or services.

  3. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the extent of ... and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the extent of ...

  4. 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 ...

  5. Tennis elbow surgery - discharge (United States)

    Lateral epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... Soon after surgery, severe pain will decrease, but you may have mild soreness for 3 to 6 months.

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

  7. Malabsorption as a Therapeutic Approach in Bariatric Surgery (United States)

    Billeter, Adrian T.; Fischer, Lars; Wekerle, Anna-Laura; Senft, Jonas; Müller-Stich, Beat


    Summary Background The increasing prevalence of obese patients will lead to a more frequent use of bariatric procedures in the future. Compared to conservative medical therapy, bariatric procedures achieve greater weight loss and superior control of comorbidities, resulting in improved overall mortality. Methods A search for current literature regarding mechanisms, indications, and outcomes of bariatric surgery was performed. Results In order to care for patients after bariatric surgery properly, it is important to understand its mechanisms of action and effects on gastrointestinal physiology. Recent investigations indicate that the beneficial effects of bariatric procedures are much more complex than simply limiting food intake or an associated malabsorption. Changes in gastrointestinal hormone secretion, energy expenditure, intestinal bacterial colonization, bile acid metabolism, and epigenetic modifications resulting in altered gene expression are likely responsible for the majority of the beneficial effects of bariatric surgery. Malabsorptive bariatric procedures divert the flow of bile and pancreatic enzymes from food and therefore limit the digestion and absorption of nutrients, resulting in reduced calorie intake and subsequent weight loss. Essential micronutrients such as vitamins and trace elements are also absorbed to a lesser extent, potentially leading to severe side effects. Conclusion To prevent malnutrition, dietary supplementation and regular control of micronutrient levels are mandatory for patients undergoing malabsorptive bariatric procedures, in whom the fat-soluble vitamins A and D are commonly deficient. PMID:26288594

  8. Balloon sinuplasty: a new concept in the endoscopic nasal surgery

    Directory of Open Access Journals (Sweden)

    Nogueira Júnior, João Flávio


    Full Text Available Introduction: Sinus diseases affect millions of people annually. Clinical treatment is effective in most patients, but in case of failure of this therapy the functional endoscopic surgery is currently the treatment choice for surgical treatment. The objective of the functional endoscopic surgery is to increase the aeration and drainage of the involved paranasal sinuses, which allows for the adequate functioning of the nasal mucosa mucociliary clearance. However, this method still has some limitations, mainly because it removes the nasal mucosa and bone tissue, and it may lead to physiologic alterations of the nasosinusal mucosa and cicatricial fibrosis. Many of these patients could be benefited from less invasive methods, with larger nasal mucosa preservation. Since 2006, an even less invasive procedure was remarked in our specialty: the balloon dilatation of the paranasal sinus ostia. Objective: The objective of this article is to define the concept of sinuplasty, its action mechanism, and present the necessary material for the procedures performance; to describe the techniques with the equipment in a nasosinusal endoscopic surgery simulator model and review the current literature about the indications, complications, results, and follow-up of patients submitted to this procedure. Balloon sinuplasty is safe and appears to be effective in the improvement of the quality of life of patients not responsive to conventional clinical therapy. New applications and indications for this equipment should be described and researched.

  9. Oncoplastic breast surgery: comprehensive review. (United States)

    Bertozzi, N; Pesce, M; Santi, P L; Raposio, E


    Breast cancer is the most common female cancer in Western populations, affecting 12.5% of women, with 1.38 million patients per year. Breast-conserving surgery followed by postoperative radiotherapy replaced the radical and modified-radical procedures of Halsted and Patey as the standard of care for early-stage breast cancer once the overall and disease-free survival rates of breast-conserving surgery were demonstrated to be equivalent to those of mastectomy. However, excision of >20% of breast tissue, low or centrally located cancer, and large-sized breasts with various grades of breast ptosis, result a in unacceptable cosmetic outcomes. Oncoplastic breast surgery evolved from the breast-conserving surgery by broadening its general indication to achieve wider excision margins without compromising on the cosmetic outcomes. Thus, oncoplastic breast surgery can be defined as a tumor-specific immediate breast reconstruction method that applies aesthetically derived breast reduction techniques to the field of breast cancer surgery and allows for higher volume excision with no aesthetic compromise. However, contralateral breast symmetrization should be regarded as an intrinsic component of the oncoplastic surgery. The main procedures involved are volume-displacement or volume-replacement techniques, which depend on breast size and cancer size/location. Volume-displacement or reshaping procedures apply the plastic surgery principles to transpose a dermo-glandular flap of breast tissue into the defect site, while volume-replacement techniques use autologous tissues to replace the volume loss that follows tumor resection. Furthermore, these procedures are more complex and time-consuming than those involved in breast-conserving surgery. Based on current literature, the authors analyze the different techniques and indications of the oncoplastic breast surgery, determining its complication rate, in order to help both surgeons and their patients in the decision-making stage of

  10. 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

  11. Anthropometric indices

    DEFF Research Database (Denmark)

    Oguoma, V. M.; Nwose, E. U.; Skinner, T. C.


    BACKGROUND: The current anthropometric indices used for diagnosis of cardio-metabolic syndrome (CMS) in sub-Saharan Africa are those widely validated in the western world. We hereby aim to compare the sensitivity and specificity of these tools in identifying risk factors for CMS. METHOD: The study...

  12. 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.

  13. 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...

  14. 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...... 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...... to describing the stages of development from embryogenesis to senescence and the many physiological and environmental factors that regulate them. The result provides students with an improved understanding of the integration of hormones and other signaling agents in developmental regulation...

  15. 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...

  16. 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.

  17. 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

  18. 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

  19. 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.

  20. Positioning patients for spine surgery: Avoiding uncommon position-related complications (United States)

    Kamel, Ihab; Barnette, Rodger


    Positioning patients for spine surgery is pivotal for optimal operating conditions and operative-site exposure. During spine surgery, patients are placed in positions that are not physiologic and may lead to complications. Perioperative peripheral nerve injury (PPNI) and postoperative visual loss (POVL) are rare complications related to patient positioning during spine surgery that result in significant patient disability and functional loss. PPNI is usually due to stretch or compression of the peripheral nerve. PPNI may present as a brachial plexus injury or as an isolated injury of single nerve, most commonly the ulnar nerve. Understanding the etiology, mechanism and pattern of injury with each type of nerve injury is important for the prevention of PPNI. Intraoperative neuromonitoring has been used to detect peripheral nerve conduction abnormalities indicating peripheral nerve stress under general anesthesia and to guide modification of the upper extremity position to prevent PPNI. POVL usually results in permanent visual loss. Most cases are associated with prolonged spine procedures in the prone position under general anesthesia. The most common causes of POVL after spine surgery are ischemic optic neuropathy and central retinal artery occlusion. Posterior ischemic optic neuropathy is the most common cause of POVL after spine surgery. It is important for spine surgeons to be aware of POVL and to participate in safe, collaborative perioperative care of spine patients. Proper education of perioperative staff, combined with clear communication and collaboration while positioning patients in the operating room is the best and safest approach. The prevention of uncommon complications of spine surgery depends primarily on identifying high-risk patients, proper positioning and optimal intraoperative management of physiological parameters. Modification of risk factors extrinsic to the patient may help reduce the incidence of PPNI and POVL. PMID:25232519

  1. Measuring corruption indicators and indices


    MALITO, Debora Valentina


    This Working Paper is a background paper delivered to frame the workshop ‘Global Governance by Indicators: Measuring corruption and corruption indicators’ convened by the Global Governance Programme of the European University Institute in Florence on 17 and 18 October 2013. Successively it was developed further in EUI RSCAS WP 2014/37 - The development of more sophisticated corruption measures has been stimulated by consistent and compelling demands for mor...


    Directory of Open Access Journals (Sweden)

    M. Lankarani


    Full Text Available Postsurgical hypothyroidism and its incidence has not been fully investigated. In this study, the incidence of hypothyroidism and its possible risk factors at Shariati Hospital was assessed. One hundred and two patients with benign thyroid diseases, who had undergone thyroidectomy, were investigated with regards to thyroid function profile during period of one year after the operation every three months with post-operative sample as the baseline. Hypothyroidism was developed in 36 patients (35.2% on average 5 ± 3.2 months after surgery. Factors such as increased age, operation type, histopathologic type, underlying disease, lymphocytic infiltration and use of levothyroxine before surgery were associated with the increased incidence of hypothyroidism. It seems that use of indicators such as Graves' disease and lymphocytic infiltration in pathologic specimens should be helpful in projecting the potential occurrence of hypothyroidism in patients undergoing thyroidectomy.

  3. 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...... and many patients said that they joined the RCT in order to bypass waiting lists. Patients who chose to cross-over described training as time consuming, boring and as unable to provide sufficient results within a reasonable timeframe. Some said their injured knees had given-way; others experienced new knee...... a variety of views and beliefs about those treatments, and trial participation happens in the absence of equipoise. Furthermore, opting for surgical reconstruction does not necessarily provide patients with satisfactory outcomes. Definition of successful outcome may require an individualised approach...

  4. 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

  5. Systematic review on reoperative bariatric surgery: American Society for Metabolic and Bariatric Surgery Revision Task Force. (United States)

    Brethauer, Stacy A; Kothari, Shanu; Sudan, Ranjan; Williams, Brandon; English, Wayne J; Brengman, Matthew; Kurian, Marina; Hutter, Matthew; Stegemann, Lloyd; Kallies, Kara; Nguyen, Ninh T; Ponce, Jaime; Morton, John M


    Reoperative bariatric surgery has become a common practice in many bariatric surgery programs. There is currently little evidence-based guidance regarding specific indications and outcomes for reoperative bariatric surgery. A task force was convened to review the current evidence regarding reoperative bariatric surgery. The aim of the review was to identify procedure-specific indications and outcomes for reoperative procedures. Literature search was conducted to identify studies reporting indications for and outcomes after reoperative bariatric surgery. Specifically, operations to treat complications, failed weight loss, and weight regain were evaluated. Abstract and manuscript reviews were completed by the task force members to identify, grade, and categorize relevant studies. A total of 819 articles were identified in the initial search. After review for inclusion criteria and data quality, 175 articles were included in the systematic review and analysis. The majority of published studies are single center retrospective reviews. The evidence supporting reoperative surgery for acute and chronic complications is described. The evidence regarding reoperative surgery for failed weight loss and weight regain generally demonstrates improved weight loss and co-morbidity reduction after reintervention. Procedure-specific outcomes are described. Complication rates are generally reported to be higher after reoperative surgery compared to primary surgery. The indications and outcomes for reoperative bariatric surgery are procedure-specific but the current evidence does support additional treatment for persistent obesity, co-morbid disease, and complications. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

  6. 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.

  7. Heart failure - surgeries and devices (United States)

    CHF - surgery; Congestive heart failure - surgery; Cardiomyopathy - surgery; HF - surgery; Intra-aortic balloon pumps - heart failure; IABP - heart failure; Catheter based assist devices - heart failure

  8. 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.

  9. [The history of plastic surgery in Israel]. (United States)

    Wiser, Itay; Scheflan, Michael; Heller, Lior


    The medical institutions in the country have advanced together with the development of the state of Israel. Plastic surgery, which has progressed significantly during the 20th century, has also grown rapidly in the new state. The arrival of Jewish plastic surgeons from all over the world with the knowledge and experience gained in their countries of origin, as well as the need for reconstructive surgical treatment for many combat injured soldiers, also contributed to the development of plastic surgery. This review tells the story of plastic surgery in Israel, since its foundation until nowadays. This article reviews the work of the founders of plastic surgery in Israel, indicating significant milestones in its development, and clinical and scientific contribution to the international plastic surgery profession. Moreover, the article describes the current condition of the field of plastic surgery in Israel and presents the trends and the future challenges facing the next generation of plastic surgery in Israel.

  10. 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

  11. Antibiotic prophylaxis in genitourinary surgery. (United States)

    Childs, S J; Wood, P D; Kosola, J W


    Antibiotic prophylaxis in surgery, particularly genitourinary surgery, has been controversial for years. At best, the results have been more testimonial than scientific because of the failure to observe proper experimental design. A survey of the literature indicates that antibiotic prophylaxis in genitourinary surgery probably has little influence on postoperative fever; it appears to favorably affect the incidence of postoperative bacteriuria and bacteremia in the short term without encouraging nosocomial or resistant infections. The regimen for prophylaxis must be perioperative and continued for no longer than 24 hours postoperatively. Given that antibiotic prophylaxis in elective genitourinary surgery has merit, a comparison between cefazolin and cefotaxime was undertaken. Of 160 evaluable cases, a total of 23 patients had positive cultures within the first nine days; only two occurred within the first five days. When cefazolin and cefotaxime were administered in the same dosage regimen, the infection rate for cefazolin was 19% compared with 10% for cefotaxime.

  12. 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 ...

  13. 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.

  14. Primary and Revision Amputation Surgery in a Tertiary Institution in ...

    African Journals Online (AJOL)

    We set out to study the cases undergoing amputation surgery with special interest of determining the prevalence rate of revision amputation surgery; its indication ... The commonest indication found for amputation surgery was trauma while it was ascending gangrene for revision amputation. Among those who had revision ...

  15. Nutritional consequences of bariatric surgery. (United States)

    Xanthakos, Stavra A; Inge, Thomas H


    Bariatric surgery is being increasingly used to help treat morbidly obese adults and adolescents. As a greater percentage of this population faces a lifetime of living with surgically altered gastrointestinal anatomy and physiology, increased awareness of the nutritional consequences is critical for all health care practitioners, as many of these patients may be lost to follow-up and can present with significant nutritional complications years after surgery. Nutritional deficiencies can occur after bariatric surgery, although to a lesser degree after restrictive procedures. Risk may increase over time, perhaps due to poor compliance with supplementation, continued inadequate intake and/or ongoing malabsorption. Adolescent patients may be at greater risk due to poor compliance and longer life span. Nutritional monitoring and supplementation among bariatric programs has been widely variable and few prospective studies of outcomes exist. Bariatric surgery can carry significant risk of nutritional complications. Compliance with dietary recommendations should be monitored and encouraged, with annual screening for selected deficiencies. Prospective longitudinal research is needed to identify the true prevalence and significance of nutritional deficiency in these patients and to determine optimum dietary recommendations.

  16. 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.

  17. 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 ...

  18. 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 ...

  19. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Other 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 ...

  20. Hip Replacement Surgery (United States)

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

  1. 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. ...

  2. Laser surgery - skin (United States)

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  3. Coronary Artery Bypass Surgery (United States)

    ... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

  4. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Surgery Dental Implant Surgery Facial Cosmetic Surgery Head, Neck and Oral Pathology Obstructive Sleep Apnea TMJ and Facial Pain Treatment of Facial Injury Wisdom Teeth Management Procedures ...

  5. Pediatric heart surgery (United States)

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... Ginther RM, Forbess JM. Pediatric cardiopulmonary bypass. In: ... Care . 5th ed. Philadelphia, PA: Elsevier; 2017:chap 37. LeRoy S, ...

  6. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Do Who We Are News Videos Contact Find a Surgeon What We Do Anesthesia Anesthesia Oral and ... Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries ...

  7. What Is Refractive Surgery? (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Glaucoma Education Center Pediatric Ophthalmology Education Center Oculofacial Plastic ... Center Laser Surgery Education Center Redmond Ethics Center ...

  8. LASIK - Laser Eye Surgery (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Glaucoma Education Center Pediatric Ophthalmology Education Center Oculofacial Plastic ... Center Laser Surgery Education Center Redmond Ethics Center ...

  9. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... surgery, orthognathic surgery is performed to correct functional problems. Jaw Surgery can have a dramatic effect on ... without straining Chronic mouth breathing Sleep apnea (breathing problems when sleeping, including snoring) Your dentist, orthodontist and ...

  10. Impact of nesting material on mouse body temperature and physiology. (United States)

    Gaskill, Brianna N; Gordon, Christopher J; Pajor, Edmond A; Lucas, Jeffrey R; Davis, Jerry K; Garner, Joseph P


    In laboratories, mice are housed at 20-24 °C, which is below their lower critical temperature (≈30 °C). Thus, mice are potentially cold stressed, which can alter metabolism, immune function, and reproduction. These physiological changes reflect impaired wellbeing, and affect scientific outcomes. We hypothesized that nesting material would allow mice to alleviate cold stress by controlling their thermal microenvironment, thus insulating them, reducing heat loss and thermogenic processes. Naïve C57BL/6, CD-1, and BALB/c mice (24 male and 24 female/strain in groups of 3) were housed in standard cages at 20 °C either with or without 8 g nesting material for 4 weeks. Core body temperature was followed using intraperitoneal radio telemetry. The thermal properties of the nests were assessed using a thermal imaging camera, and related to nest quality. Higher scoring nests were negatively correlated with the mean radiated temperature and were thus more insulating. No effects of nesting material on body temperature were found. CD-1 mice with nesting material had higher end body weights than controls. No effect was seen in the other two strains. Mice with the telemetry implant had larger spleens than controls, possibly indicating an immune response to the implant or low level infection from the surgery. BALB/c mice express less mRNA for the UCP1 protein than mice without nesting material. This indicates that BALB/c's with nesting material do not utilize their brown fat to create heat as readily as controls. Nests can alleviate thermal discomfort by decreasing the amount of radiated heat and reduce the need for non-shivering thermogenesis. However, different strains appear to use different behavioral (through different primary modes of behavioral thermoregulation) and physiological strategies (utilizing thermogenesis to different degrees) to maintain a constant body temperature under cool standard laboratory ambient temperatures. Copyright © 2013 Elsevier Inc. All

  11. 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 ...

  12. 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.

  13. 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.

  14. Physiology of Sleep. (United States)

    Carley, David W; Farabi, Sarah S


    IN BRIEF Far from a simple absence of wakefulness, sleep is an active, regulated, and metabolically distinct state, essential for health and well-being. In this article, the authors review the fundamental anatomy and physiology of sleep and its regulation, with an eye toward interactions between sleep and metabolism.

  15. Physiology of Breastfeeding (United States)

    This powerpoint presentation summaries physiology of lactation and the impact of a variety of clinical practices on lactation from delivery through weaning. Factors that inhibit lactogenesis stage II are explained, including retained placenta, excess blood loss during delivery, and hypoplastic brea...

  16. 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.

  17. 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.

  18. Human exercise physiology

    DEFF Research Database (Denmark)

    Volianitis, Stefanos; Secher, Niels H.


    The functional anatomy of the respiratory and cardiovascular systems and the neuro-anatomy and neuro-physiology of the systems that are implicated in the co-ordination of cardiac output with ventilation are reviewed in fish, including air-breathing fish, amphibians and reptiles. Recent data...


    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.

  20. 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

  1. 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.

  2. [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.

  3. Surgery and transfusion

    Directory of Open Access Journals (Sweden)

    C.O. Ramos-Peñafiel


    Full Text Available Even though blood transfusion saves thousands of lives worldwide, it causes complications in some patients, and must therefore be correctly administered. As there is no universally accepted consensus on blood transfusion in surgical patients, we have reviewed the latest studies and gathered the best available evidence on blood management strategies. In this study, we discuss indicators for transfusion of erythrocytes and other blood products, haemostatic agents for cardiothoracic and orthopaedic interventions where it is imperative to regulate blood loss, and alternatives in specific situations such as Jehovah's Witnesses patients. Finally, we put forward an algorithm for the preoperative management of surgery patients with low haemoglobin levels.


    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

  5. The Physiology of Glucagon


    Taborsky, Gerald J


    This short review outlines the physiology of glucagon in vivo, with an emphasis on its neural control, the author’s area of interest. Glucagon is secreted from alpha cells, which are a minority of the pancreatic islet. Anatomically, they are down stream from the majority islet beta cells. Beta-cell secretory products restrain glucagon secretion. Activation of the autonomic nerves, which innervate the islet, increases glucagon secretion.

  6. 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.

  7. Robotic mitral valve surgery. (United States)

    Kypson, Alan P; Nifong, L Wiley; Chitwood, W Randolph


    placement of an atrial retractor, as well as needle, tissue, and suture retrieval. With the development of specialized retractors and a delivery/retrieval port, a truly endoscopic approach will be consistently reproducible. New navigation systems and image guided surgery portend an improving future for robotic cardiac surgery. Recently, we have combined robotically guided microwave catheters for ablation of atrial fibrillation with robotic mitral valve repairs (Fig. 8). Thus, we are beginning to achieve the ideal operation, with a native valve repair and a return to normal sinus rhythm. Robotic cardiac surgery is an evolutionary process, and even the greatest skeptics must concede that progress has been made toward endoscopic cardiac valve operations. Surgical scientists must continue to critically evaluate this technology in this new era of cardiac surgery. Despite enthusiasm, caution cannot be overemphasized. Surgeons must be careful because indices of operative safety, speed of recovery, level of discomfort, procedural cost, and long-term operative quality have yet to be defined. Traditional valve operations still enjoy long-term success with ever-decreasing morbidity and mortality, and remain our measure for comparison. Surgeons must remember that we are seeking the most durable operation with the least human trauma and quickest return to normalcy, all done at the lowest cost with the least risks. Although we have moved more asymptotically to these goals, surgeons alone must map the path for the final ascent.

  8. [Cataract surgery in children]. (United States)

    Pavlović, S


    Cataract extraction in children has improved and became more popular over the past few decades but, due to particular features of children's eyes, still remains controversial--especially regarding the intraocular lens implantation. In contrast to adults, indications for cataract surgery in children are much more difficult to determine. Since subjective visual acuity cannot be obtained, greater reliance must be placed on the morphology and location of the lens opacity, and the behavior of the child. Forced preferential looking and visual evoked potentials can be helpful, but they should not be the only criteria. In management of pediatric cataract, correction of postoperative aphakia is still an incompletely resolved problem. Conventionally, optical correction is achieved by spectacles or contact lenses. The power of both spectacles and contact lenses can be readily adjusted to compensate for ocular growth. The success of both depends significantly on parental compliance and the child's acceptance. Hutchinson reported that 44% children with aphakia stopped wearing glasses or contact lenses 2 months after surgery. Contact lens wearing can also result in a number of corneal complications, including infectious keratitis, corneal vascularization and hypoxic corneal ulceration. IOL implantation is theoretically superior to glasses and contact lenses since it provides almost immediate optical correction which is much more reliable because it does not depend on parental or child's compliance. Still, there are many controversies about IOL implantation in infants and young children like IOL-size, material, IOL power calculation, prevention and management of secondary cataract, as well as long term safety of IOLs in children's eyes. Although short-term anatomic results after cataract extraction and primary IOL implantation in children are excellent and stable, long-term follow-up is necessary to answer questions about the long-term safety of implants in children's eyes. A

  9. 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.

  10. 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.

  11. 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

  12. Gastric Bypass Surgery (United States)

    ... gastrointestinal system Death (rare) Longer term risks and complications of weight-loss surgery vary depending on the type of surgery. They ... room, where medical staff monitors you for any complications. Your hospital stay may ... of bariatric surgery Each type of bariatric surgery has pros and ...

  13. Facial Cosmetic Surgery (United States)

    ... 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 ...

  14. 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 ...

  15. Corrective Jaw Surgery (United States)

    ... 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 ...

  16. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... It can also invite bacteria that lead to gum disease. Click here to find out more. Who We Are Find a Surgeon News Videos Contact Anesthesia Cleft Lip/Palate and Craniofacial Surgery Corrective Jaw Surgery Dental Implant Surgery Extractions and Other Oral Surgeries Facial Cosmetic ...

  17. Corrective Jaw Surgery

    Medline Plus

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

  18. Bariatric Surgery Procedures (United States)

    ... Procedures Who is a Candidate for Bariatric Surgery? Childhood and Adolescent Obesity Find a Provider Benefits of Bariatric Surgery Life ... Bariatric Surgery FAQs Bariatric Surgery Procedures BMI Calculator Childhood and Adolescent Obesity 100 SW 75th Street, Suite 201, Gainesville, FL, ...

  19. 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 ... out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft lip may ...

  20. Kinanthropometric and physiological characteristics of national and ...

    African Journals Online (AJOL)

    The MHR and VO2max differences could be attributed to numerous factors including genetics, superior training methods or kayaking technique. The strength data indicates the need for individualized strength training programmes to help restore dynamic joint stability. The study presents kinanthropometric and physiological ...

  1. Evaluation of physiological changes in coffee seedlings ...

    African Journals Online (AJOL)

    This indicates that intercropping coffee with plantain will improve its physiological growth than when grown as sole crop. The land equivalent ratio was recorded for coffee/plantain intercrop in all the locations. Consequently, coffee/plantain intercrop is recommended for coffee farmers in the first three years after transplanting ...


    African Journals Online (AJOL)

    The objective of this study was to evaluate the effects of the interaction between chicken genotypes (Naked-neck, Na, from Ethiopia; New Hampshire, NH; Lohmann White, LW; and F1 crosses of Na males with females of NH [Na´NH] and LW [Na´LW]) and ambient temperatures (normal and high) on physiological indicators ...

  3. Nursing diagnoses and interventions for a child after cardiac surgery in an intensive care unit. (United States)

    Cavalcante, Agueda Maria Ruiz Zimmer; Brunori, Evelise Helena Fadini Reis; Lopes, Camila Takáo; Silva, Andréa Braz Vendramini; Herdman, T Heather


    To describe the nursing clinical judgment as a basis for ND identification and development of a NIC treatment plan for a child after cardiac surgery under intensive care. A case study with data retrospectively collected from charts. Three nurses identified NANDA-I diagnoses and NIC interventions. A 6-month-old child submitted to cardiac surgery, requiring extracorporeal membrane oxygenation in the postoperative period. Four main nursing diagnoses were identified, towards which ten interventions were directed. The proposal of interventions to respond to the priority human responses of the child was optimized by the use of standard terminologies. Every nursing diagnosis was supported by diagnostic indicators; every intervention was scientifically supported. There must be an expectation that nurses address not only physiological responses, but also those within psychosocial domains.

  4. Limited-Access Heart Surgery (United States)

    ... Surgery Menu Topics Topics FAQs Limited-Access Heart Surgery Article Info En español Thousands of heart surgeries ... with cardiovascular disease. What is minimally invasive heart surgery? In minimally invasive heart surgery, surgeons take steps ...

  5. Direct surgery for brainstem lesions

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, Noboru [Gifu Univ. (Japan). School of Medicine


    Direct surgery for intrinsic lesions of the brainstem has been considered a hazardous procedure. During the past 10 years, 32 cases of symptomatic lesions involving the brainstem were operated on. Magnetic resonance (MR) imaging is of greatest value in the diagnosis and for surgical indications. Almost all cases were treated by radical extirpation. Namely, 9 cavernous angiomas and 2 hemangioblastomas resulted in radical extirpation. The preoperative neurological deficits improved after surgery. Also, 2 ependymomas, 4 medulloblastomas, 4 plexus papillomas, and 1 epidermoid were successfully extirpated, and the surgical treatment for them allowed favorable outcome. Therefore, those brainstem lesions were considered to be more favorable indications for direct surgery. On the other hand, 4 astrocytomas and 6 glioblastomas were either subtotally or partially resected, in which a small incision in the fourth ventricle floor and the surface of the brainstem was made when the lesion was intramedullary. Consequently, there were neither mortality in surgery nor aggravation of the focal neurological symptoms. High-grade glioma in 6 cases was removed as much as possible, but almost all of the cases nevertheless expired due to prompt recurrence under 2 years after onset of symptoms and surgery. (author)

  6. Lateral canthal surgery. (United States)

    Chong, Kelvin Kam-Lung; Goldberg, Robert A


    The lateral canthus is a delicate and complicated three-dimensional structure with function relevant to the health of the ocular surface. Dysfunction of the lateral canthus, due to aging changes or iatrogenic trauma, results in ocular morbidity ranging from chronic irritation to tearing to recalcitrant keratopathy. From an aesthetic standpoint, symmetric, normally positioned lateral canthi are cornerstones of youthful periorbital appearance, disruption of which leads to cosmetically significant deformity or asymmetry. Reconstruction of the lateral canthus is important in the rehabilitation of the aging eyelid and an unfortunate necessity after failed lateral canthal surgery. The common methods for improving or maintaining position, tone, and shape of the lower eyelid and lateral canthus use tightening or shortening the lower eyelid horizontally, keeping the canthal angle in an appropriate vertical level, and hugging the ocular surface. Many techniques have been described for the reconstruction of the lateral canthus in functional conditions or for aesthetic purposes. These methods have met with varying success. In this article, we begin with a discussion of the anatomy and physiology of the lateral canthus, followed by clinical examples of lateral canthal abnormalities and underlying pathophysiologies. A review of surgical options for the lateral canthus is presented with concluding remarks on postoperative complications.

  7. 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.

  8. 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

  9. Physiological function of ABCG1. (United States)

    Ito, Toshimitsu


    Since ATP-binding cassette transporter A1 (ABCA1) was discovered as the cause of Tangier disease and familial high-density lipoprotein (HDL) deficiency, many investigators have been interested in the relationship between ABC transporters and the mechanism underlying abnormal lipid metabolism. ABCG1 is an ABC half transporter that facilitates efflux excess cholesterol from macrophages. To elucidate the potential physiological role of ABCG1, we have initiated a series of studies overexpressing ABCG1, using an adenovirus vector (rABCG1-Adv) in C57BL mice. Overexpression of ABCG1 in the liver of mice using recombinant ABCG1 vectors results in decreased plasma HDL levels and increased biliary cholesterol excretion, and indicates that ABCG1 can modulate plasma lipoprotein levels in vivo. ABCG1 and the other ABC transporters might play an important role in cholesterol homeostasis, especially in the liver.

  10. 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

  11. 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.

  12. Less extensive surgery compared to extensive surgery

    DEFF Research Database (Denmark)

    Lauszus, Finn F; Petersen, Astrid Christine; Neumann, Gudrun


    in postmenopausal women was associated with surgery including hysterectomy and bilateral oophorectomy (pcarcinoma was found 138 times (95% CI: 48, 275) more prevalent than the expected rate. CONCLUSION......: 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...

  13. The use of rat and mouse models in bariatric surgery experiments

    Directory of Open Access Journals (Sweden)

    Thomas Alexander Lutz


    Full Text Available Animal models have been proven to be a crucial tool for investigating the physiological mechanisms underlying bariatric surgery in general and individual techniques in particular. By using a translational approach most of these studies have been performed in rodents and have helped to understand how bariatric surgery may or may not work. However, data from studies using animal models should always be critically evaluated for their transferability to the human physiology. It is therefore the aim of this review to summarize both advantages and limitations of data generated by animal based experiments designed to investigate and understand the physiological mechanisms at the root of bariatric surgery.

  14. Anaesthetic complications in plastic surgery. (United States)

    Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T


    Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients' experience and surgical outcome.

  15. Anaesthetic complications in plastic surgery

    Directory of Open Access Journals (Sweden)

    Soumya Sankar Nath


    Full Text Available Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist′s concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients′ experience and surgical outcome.

  16. Psychosocial factors predicting the motivation to undergo cosmetic surgery. (United States)

    von Soest, Tilmann; Kvalem, Ingela L; Skolleborg, Knut Chr; Roald, Helge E


    The present study investigates psychological factors expected to predict the motivation to undergo cosmetic surgery. It is hypothesized that body image, self-esteem, teasing history, acceptance of cosmetic surgery in the individual's environment, and self-monitoring relate to motivation to have cosmetic surgery. Questionnaire data were obtained from 907 participants who responded to a survey distributed to a representative sample of Norwegian women aged 22 to 55 years. A second sample of 195 female prospective cosmetic surgery patients was recruited from a plastic surgery clinic. Measures of the hypothesized predictor variables were obtained from both samples. Surgery motivation was operationalized in two different ways. First, the women in the first sample were asked to indicate whether they wished to undergo cosmetic surgery, such that women who wished to have surgery could be compared with those who did not. Second, prospective patients were compared with women from the first sample who indicated that they did not wish to have cosmetic surgery. Analyses revealed all predictor variables but self-esteem to be related to either the wish or the decision to undergo surgery, or to both. Social acceptance of cosmetic surgery and body image were the strongest predictors of cosmetic surgery motivation. The study gives new insights into psychological factors predicting cosmetic surgery motivation. Furthermore, the influence of social factors on cosmetic surgery motivation is emphasized, and it is suggested that these factors be included in future research designs.

  17. 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.

  18. Sexuality in Aesthetic Breast Surgery. (United States)

    Guimarães, Paulo Afonso Monteiro Pacheco; Resende, Vanessa Contato Lopes; Sabino Neto, Miguel; Seito, Caroline Lumy; de Brito, Maria José Azevedo; Abla, Luiz Eduardo Felipe; Veiga, Daniela Francescato; Ferreira, Lydia Masako


    The breasts are important for a woman's psychological well-being, which may be negatively affected by distortions of breast size and shape. Improvements in self-esteem and sexuality are important psychological factors associated with motivation for cosmetic surgery. Mammaplasty is among the most sought-after and performed cosmetic procedures. The aim of this study was to evaluate the impact of aesthetic breast surgery on a woman's sexuality. This study was conducted in a plastic surgery clinic of a hospital university in Brazil, between 2009 and 2012. Forty-six patients with hypomastia and 30 patients with breast hypertrophy, who expressed the desire for aesthetic breast surgery, were selected for the study. The patients were assessed preoperatively and 6 months postoperatively using the sexual quotient-Female version scale (QS-F). The QS-F is a validated Brazilian questionnaire to assess sexual function. It contains ten items covering five domains of female sexual function: desire and interest, foreplay, excitement and harmony, comfort, and orgasm and satisfaction. Higher QS-F scores indicate better sexual functioning. There was a significant increase in the mean total QS-F score after surgery in both groups (p surgery was observed in both groups, which is consistent with the literature. Aesthetic breast surgery has a positive impact on the sexuality of patients. 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

  19. 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.

  20. Physiological demands of rugby union matches and practice sessions

    African Journals Online (AJOL)

    Research studies indicate that, by determining the physiological load placed on athletes during competitions, it can aid in the development of strength and conditioning programmes, according to the specific demands placed on athletes. Physiological data, specifically on rugby union players, are limited, thus stressing the ...

  1. Surgical site infection in posterior spine surgery | Ojo | Nigerian ...

    African Journals Online (AJOL)

    Background: Surgical site infections (SSIs) in spine surgery remain a significant cause of morbidity and prolonged hospitalization. Factors affecting SSI includes patient's comorbidities, duration of surgery, type and indication for surgery among others. We intend to document our experience in our center and highlight ...

  2. O papel do ecocardiograma como método isolado na indicação cirúrgica de pacientes portadores de cardiopatia congênita The role of echocardiography as an isolated method for indicating surgery in patients with congenital heart disease

    Directory of Open Access Journals (Sweden)

    Lilian Maria Lopes


    Full Text Available OBJETIVO: Determinar a acurácia diagnóstica do ecocardiograma, analisando prospectivamente, o valor do método na indicação cirúrgica sem cateterismo em portadores de cardiopatia congênita, através da comparação do diagnóstico ecocardiográfico com os achados intra-operatórios e/ou do estudo invasivo. MÉTODOS: De fevereiro/2000 a janeiro/2001, foram acompanhados 493 pacientes cardiopatas congênitos com indicação cirúrgica, submetidos a ecocardiograma com mapeamento de fluxo em cores para decisão terapêutica. Os resultados foram comparados aos achados cirúrgicos e/ou de cateterismo quando realizado para complementação diagnóstica. RESULTADOS: Dos pacientes estudados, 94,3% (465 casos foram submetidos à correção da cardiopatia congênita apenas com o ecocardiograma e sem cateterismo diagnóstico. O estudo invasivo foi realizado para complementação diagnóstica em 28 (5,6% casos, o tratamento cirúrgico realizado em mais de 95% dos casos e o cateterismo terapêutico em 3,6%. Os achados do ecocardiograma se confirmaram em 464 (94,1% dos casos, demonstrando uma alta acurácia do método. Ocorreram 8 (1,6% casos de falso positivos e 39 (7,9% casos de falso negativos. Segundo os cirurgiões, nenhum dos erros diagnósticos levaram a complicações ou afetaram os resultados cirúrgicos adversamente. CONCLUSÃO: O ecocardiograma se mostrou método sensível e seguro para indicação cirúrgica, dispensando, muitas vezes, a realização de estudo invasivo, ficando este, restrito aos casos de complementação diagnóstica ou terapêutica.OBJECTIVE: To determine the diagnostic accuracy of echocardiography for indicating surgery without catheterization in patients with congenital heart disease through a prospective analysis and comparison of the echocardiographic diagnosis with the intraoperative findings, or invasive study, or both. METHODS: From February 2000 to January 2001, 493 patients with congenital heart diseases indicated

  3. 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.

  4. 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.

  5. Changing trends in bariatric surgery. (United States)

    Lo Menzo, E; Szomstein, S; Rosenthal, R J


    Bariatric surgery is considered the only long-lasting treatment for morbid obesity. Techniques and procedures have changed dramatically. We report on some of the major changes in the field. We reviewed some of the major changes in trends in bariatric surgery based on some landmark paper published in the literature. We identified three major phases in the evolution of bariatric surgery. The pioneer phase was mostly characterized by discovery of weight loss procedures serendipitously from procedures done for other purposes. The second phase can be identified with the advent of laparoscopic techniques. This is considered the phase of greatest expansion of bariatric surgery. The metabolic phase derives from the improved understanding of the mechanisms of actions of the bariatric operations at the hormonal and molecular level. Bariatric surgery has changed significantly over the years. The safety of the laparoscopic approach, along with the better understanding of the metabolic changes obtained postoperatively, has led to a more individualized approach and also an attempt to expand the indications for these procedures. © The Finnish Surgical Society 2014.

  6. The Physiology of Microbial Symbionts in Fungus-Farming Termites

    DEFF Research Database (Denmark)

    Rodrigues da Costa, Rafael

    with their symbionts are main decomposer of organic matter in Africa, and this is reflect of a metabolic complementarity to decompose plant biomass in the genome of the three organisms involved in this symbiosis. Many of the physiological aspects of this symbiosis remain obscure, and here I focus on physiology...... termites where this is either absent or minimal, and this indicates evolutionary adaptations to dietary intakes displayed by different termite species. In addition to these two physiological aspects of this tripartite symbiosis, we questioned the physiological mechanisms displayed by Termitomyces...

  7. Hirudotherapy /Leech therapy: Applications and Indications in Surgery

    Directory of Open Access Journals (Sweden)

    Swaid Abdullah


    More recently, HT has found new applications in cancer therapy, hypersensitivity conditions, like asthma, male/female sterility and diabetes. Taking into consideration all the facts, HT efforts should be made in optimizing the success of medicinal leech therapy in clinical and private practice. [Arch Clin Exp Surg 2012; 1(3.000: 172-180

  8. 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.

  9. Aesthetic surgery indications at the National Orthopaedic Hospital ...

    African Journals Online (AJOL)

    ... two cranioplasties, and one lip augmentation, one abdominoplasty and one rhinoplasty. Forty nine were carried out by consultants and nineteen by senior residents; seventeen of those procedures being scar revision. Specialized instruments such as lasers and cannulae for liposuction or liposculpture were not available.

  10. Fast-track surgery in India. (United States)

    Nanavati, Aditya J; Nagral, Sanjay; Prabhakar, Subramaniam


    Fast-track surgery or 'enhanced recovery after surgery' or 'multimodal rehabilitation after surgery' is a form of protocol-based perioperative care programme. It is an amalgamation of evidence-based practices that have been proven to improve patient outcome independently and exert a synergistic effect when applied together. The philosophy is to treat the patient's pathology with minimal disturbance to the physiology. Several surgical subspecialties have now adopted such protocols with good results. The role of fast-track surgery in colorectal procedures has been well demonstrated. Its application to other major abdominal surgical procedures is not as well defined but there are encouraging results in the few studies conducted. There has been resistance to several aspects of this programme among gastrointestinal and general surgeons. There is little data from India in the available literature on the application of fast-tracking in gastrointestinal surgery. In a country such as India the existing healthcare structure stands to gain the most by widespread adoption of fast-track methods. Early discharge, early ambulation, earlier return to work and increased hospital efficiency are some of the benefits. The cost gains derived from this programme stand to benefit the patient, doctor and government as well. The practice and implementation of fast-track surgery involves a multidisciplinary team approach. It requires policy formation at an institutional level and interdepartmental coordination. More research is required in areas like implementation of such protocols across India to derive the maximum benefit from them. Copyright 2014, NMJI.

  11. Surgery for Stress Urinary Incontinence (United States)

    ... Surgery for Stress Urinary Incontinence Page Navigation ▼ ACOG Pregnancy Book Surgery for Stress Urinary Incontinence Patient Education FAQs Surgery for Stress Urinary Incontinence Patient Education ...

  12. Linking toxicant molecular and physiological mode of action in Caenorhabditis elegans.

    NARCIS (Netherlands)

    Swain, S.; Wren, J.; Sturzenbaum, S.R.; Kille, P.; Morgan, A.J.; Jager, T.; Jonker, M.J.; Hankard, P.K.; Scendsen, C.; Owen, J.; Hedley, B.A.; Blaxter, M.; Spurgeon, D.


    Background: Physiologically based modelling using DEBtox (dynamic energy budget in toxicology) and transcriptional profiling were used in Caenorhabditis elegans to identify how physiological modes of action, as indicated by effects on system level resource allocation were associated with changes in

  13. Linking toxicant physiological mode of action with induced gene expression changes in Caenorhabditis elegans

    NARCIS (Netherlands)

    Swain, S.; Wren, J.F.; Stürzenbaum, S.R.; Kille, P.; Morgan, A.J.; Jager, T.; Jonker, M.J.; Hankard, P.K.; Svendsen, C.; Owen, J.; Hedley, B.A.; Blaxter, M.; Spurgeon, D.J.


    Background: Physiologically based modelling using DEBtox (dynamic energy budget in toxicology) and transcriptional profiling were used in Caenorhabditis elegans to identify how physiological modes of action, as indicated by effects on system level resource allocation were associated with changes in

  14. The physiological homeostasis of human populations in variable environments. (United States)

    Goudkova, Lioudmila K


    A close evolutionary relationship of physiology and ecology of organisms determines the dynamic dependence of the population physiological status in man on ecological factors. For the explanation of the stability and variability of population physiological status the concept of physiological homeostasis was applied. The investigation of physiological status in several populations of Middle Asia, Kazakhstan, North-East Asia and Khakassia has shown that reversible changes in the environment may temporarily destabilize the equilibrium in the "population-environment" system and prolonged stresses may cause a state of disadaptation. For estimation of population physiological homeostasis dependent on the environment, generalized dispersion, correlation and factor analyses are very informative. They not only mark the violation of population homeostasis, but also indicate changes in the environment.

  15. 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)

  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. Weight Loss Surgery (United States)

    Weight loss surgery helps people with extreme obesity to lose weight. It may be an option if you ... caused by obesity. There are different types of weight loss surgery. They often limit the amount of food ...

  18. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... administer local anesthesia, all forms of sedation and general anesthesia. Click here to find out more. Cleft Lip/Palate and Craniofacial Surgery Cleft Lip/Palate and Craniofacial Surgery A cleft ...

  19. 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. Extractions and ... more. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  20. Preparing for Surgery (United States)

    ... FAQs Preparing for Surgery Page Navigation ▼ ACOG Pregnancy Book Preparing for Surgery Patient Education FAQs Preparing for ... the person who is in charge of giving anesthesia and checking its effects. What can I do ...

  1. Laparoscopic Spine Surgery (United States)

    ... Global Affairs and Humanitarian Efforts Log In Laparoscopic Spine Surgery Patient Information from SAGES Download PDF Find a SAGES Surgeon Laparoscopic Spine Surgery Your spine surgeon has determined that you ...

  2. Heart valve surgery (United States)

    ... techniques are used: Percutaneous surgery (through the skin) Robot-assisted surgery If your surgeon can repair your ... M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health ...

  3. Corrective Jaw Surgery

    Medline Plus

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

  4. 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 ...

  5. 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 ...

  6. 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 ...

  7. 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. Facial Cosmetic Surgery Facial Cosmetic Surgery Extensive education and training in surgical procedures involving skin, muscle, ...

  8. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Lip/Palate and Craniofacial Surgery A cleft lip may require one or more surgeries depending on the ... are not uncommon. Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, ...

  9. Corrective Jaw Surgery

    Medline Plus

    Full Text Available ... Facial Injury / Trauma Surgery Facial trauma injuries include fractures of the upper and lower jaws and the ... Facial Injury / Trauma Surgery Facial trauma injuries include fractures of the upper and lower jaws and the ...

  10. Abdominal wall surgery (United States)

    Cosmetic surgery of the abdomen; Tummy tuck; Abdominoplasty ... Most of the time, this surgery is an elective or cosmetic procedure because it is an operation you choose to have. It is not usually needed for health reasons. Cosmetic abdomen repair ...

  11. 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. ...

  12. 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, ...

  13. Refractive corneal surgery - discharge (United States)

    ... after surgery, it should be OK to use artificial tears. Check with your provider. DO NOT wear contact lenses on the eye that had surgery, even if you have blurry vision. DO NOT use any makeup, creams, or lotions ...

  14. 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 ...

  15. Early Assessment of Delirium in Elderly Patients after Hip Surgery


    Lee, Hyo Jin; Hwang, Deuk Soo; Wang, Seong Keun; Chee, Ik Seung; Baeg, Sengmi; Kim, Jeong Lan


    Objective This study is intended to identify predictive factors of delirium, including risk factors and prodromal symptoms. Methods This study included sixty-five patients aged 65 years or older who had undergone hip surgery. Baseline assessments included age; gender; admission type (acute/elective); reason for surgery (fracture/replacement); C-reactive protein (CRP); Acute Physiology, Age, Chronic Health Evaluation (APACHE III); and the Mini-Mental State Examination (MMSE). The Korean versio...

  16. 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

  17. Mortality Caused by Surgery for Degenerative Lumbar Spine. (United States)

    Salmenkivi, Jyrki; Sund, Reijo; Paavola, Mika; Ruuth, Iiris; Malmivaara, Antti


    Register study. The purpose of this study was to assess the safety of lumbar spine surgery for degenerative disorders and to assess the predictive factors for mortality and causes of death. Growing numbers and relative indications of spine surgery emphasize the importance of patient safety. We assessed the incidence of mortality related to surgery, overall case fatality and factors predicting mortality in elective spinal surgery. A national database was utilized to assess patient characteristics, surgical procedures, and outcomes of degenerative spinal surgery in Finland. Patients were classified into four diagnostic categories: disc herniation, spinal stenosis, degenerative disc disease, and spondylolysis and spondylolisthesis. The mortality related to surgery and overall mortality in each diagnostic group was analyzed at 7 days, 30 days, 90 days, and 1 year after surgery. We categorized the deaths into medical errors, sequelae of surgery, surgery probably a contributing factor, and deaths not associated with surgery. Age, sex, comorbid conditions, and hospital characteristics were considered as potential risk factors for mortality. Out of 408 deaths (0.67% of total of 61,166 patients) deaths that occurred during the 1-year follow up, 49 deaths (12% of deaths, 0.08% of patients) were classified as having an association with surgery: two deaths by medical errors, 28 deaths by complications after surgery and 19 deaths related to the surgery. The surgery-related 1-year mortality was 0.08%. Age >75 years, male sex, diabetes, and hypertension showed an association with increased risk of death related to surgery. Mortality caused by elective spinal surgery is rare. Cardiovascular incidents are the most common reasons for deaths occurring soon after surgery. Consideration of expected gains and risks of surgery, prevention of unintended errors during surgery and recognition and treatment of complications once they occur are recommended. 3.

  18. 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

  19. Micronutrient and physiologic parameters before and 6 months after RYGB. (United States)

    Gobato, Renata Cristina; Seixas Chaves, Daniela Fojo; Chaim, Elinton Adami


    Bariatric surgery is considered an effective method for sustained weight loss, but may cause various nutritional complications. The aim of this study was to evaluate the nutritional status of minerals and vitamins, food consumption, and to monitor physiologic parameters in patients with obesity before and 6 months after Roux-en-Y gastric bypass surgery (RYGB). Thirty-six patients who had undergone RYGB were prospectively evaluated before and 6 months after surgery. At each phase their weight, height, body mass index (BMI), Electro Sensor Complex (ES Complex) data, food consumption, and total protein serum levels, albumin, prealbumin, parathyroid hormone (PTH), zinc (Zn), B12 vitamin (VitB12), iron (Fe), ferritin, copper (Cu), ionic calcium (CaI), magnesium (Mg), and folic acid were assessed. The mean weight loss from baseline to 6 months after surgery was 35.34±4.82%. Markers of autonomic nervous system balance (Pmicronutrients measured, 34 patients demonstrated some kind of deficiency. There was a high percentage of Zn deficiency in both pre- (55.55%) and postoperative (61.11%) patients, and 33.33% of the patients were deficient in prealbumin postoperatively. The protein intake after 6 months of surgery was below the recommended intake (deficiencies for Mg (Pprevalence of hypozincemia at 6 months post-RYGB. Furthermore, protein supplements were needed to maintain an adequate protein intake up to 6 months postsurgery. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.


    African Journals Online (AJOL)

    Dr. S.A. Adewuyi

    of radical surgical procedures, surgery remains the only potential curative treatment for many cancer patients ... catheter, 'Toilet' procedure, e.g. simple mastectomy or amputation of a limb, for fungating tumours. Debulking .... that tumour is irradiated prior to surgery and post- operative implies after surgery. 10. Pre-operative.

  1. Cavus Foot Surgery (United States)

    ... Toes All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A cavus or high-arched foot may have ... related problems. What are the goals of cavus foot surgery? The main goal of surgery is to ...

  2. 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 ...

  3. 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 ...

  4. 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.

  5. 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

  6. Indicadores fisiológicos da interação entre deficit hídrico e acidez do solo em cana-de-açúcar Physiological indicators of the interaction between water deficit and soil acidity in sugarcane

    Directory of Open Access Journals (Sweden)

    Samira Domingues Carlin


    Full Text Available O objetivo deste trabalho foi avaliar os indicadores fisiológicos da interação entre deficit hídrico e acidez do solo em plantas jovens de cana-de-açúcar. As plantas foram submetidas a três tratamentos de disponibilidade hídrica, medidos em percentagem de capacidade de campo (CC - sem estresse (70% CC, estresse moderado (55% CC e estresse severo (40% CC; e três tratamentos de acidez no solo, medidos em termos de saturação por bases (V - baixa acidez (V = 55%, média acidez (V = 33% e alta acidez (V = 23%. O experimento foi realizado em casa de vegetação a 29,7±4,3ºC e 75±10% UR. O delineamento experimental utilizado foi o de blocos ao acaso, em esquema fatorial 3x3, com quatro repetições. Após 60 dias, foram determinados os teores de solutos compatíveis - trealose, glicina betaína e prolina - na folha diagnóstico e o crescimento inicial da parte aérea. Os solutos compatíveis trealose, glicina betaína e prolina são indicadores do efeito da interação dos estresses hídrico e ácido no solo. O acúmulo dos solutos compatíveis nos tecidos foliares das plantas não é capaz de impedir a redução na produção de matéria seca da cana-de-açúcar, resultante do agravamento nas condições de disponibilidade hídrica e de acidez no solo.The aim of this work was to assess the physiological indicators of the interaction between water deficit and soil acidity, in sugarcane. The plants were submitted to three treatments of water availability - no stress (70% of field capacity, FC, moderate stress (55% FC, and extreme stress (40% FC; and three acidity treatments - no acidity [base saturation (V = 55%], average acidity (V = 33%, and high acidity (V = 23%. The experiment was carried out in greenhouse, with 29.7±4.3ºC and 75±10% RH. The experimental design was in randomized blocks, in 3x3 factorial arrangement, with four replicates. After 60 days, the contents of compatible solutes - trehalose, glycine betaine and proline - in

  7. History of Argentine surgery, abaut general surgery residents


    A. Jankilevich


    This work, as its title indicates, is targeted to young general surgery residents, who have been kind enough to open their journal for this collaboration. A gesture that I appreciate and I’ll try to give back narrating some facts of the first century of our independence. The story starts a few decades before 1810, especially with the institution of the Viceroyalty of Rio de la Plata, and ends at 1880, when indigenous peoples are submited, traditional estate, the gaucho gerrillas and ...

  8. 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.

  9. Overview of bariatric surgery for the physician. (United States)

    Hng, Keng Ngee; Ang, Yeng S


    The worldwide pandemic of obesity carries alarming health and socioeconomic implications. Bariatric surgery is currently the only effective treatment for severe obesity. It is safe, with mortality comparable to that of cholecystectomy, and effective in producing substantial and sustainable weight loss, along with high rates of resolution of associated comorbidities, including type 2 diabetes. For this reason, indications for bariatric surgery are being widened. In addition to volume restriction and malabsorption, bariatric surgery brings about neurohormonal changes that affect satiety and glucose homeostasis. Increased understanding of these mechanisms will help realise therapeutic benefits by pharmacological means. Bariatric surgery improves long-term mortality but can cause long-term nutritional deficiencies. The safety of pregnancy after bariatric surgery is still being elucidated.

  10. 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).

  11. 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...

  12. The Use of Rat and Mouse Models in Bariatric Surgery Experiments


    Lutz, Thomas A.; Bueter, Marco


    Animal models have been proven to be a crucial tool for investigating the physiological mechanisms underlying bariatric surgery in general and individual techniques in particular. By using a translational approach, most of these studies have been performed in rodents and have helped to understand how bariatric surgery may or may not work. However, data from studies using animal models should always be critically evaluated for their transferability to the human physiology. It is, therefore, th...

  13. 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.

  14. 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.

  15. Physiology in Modelica

    Directory of Open Access Journals (Sweden)

    Marek Mateják


    Full Text Available Modelica is an object-oriented language, in which models can be created and graphically represented by connecting instances of classes from libraries. These connections are not only assignments of values; they can also represent acausal equality. Even more, they can model Kirchhoff’s laws of circuits. In Modelica it is possible to develop library classes which are an analogy of electrical circuit components. The result of our work in this field is Physiolibrary ( – a free, open-source Modelica library for human physiology. By graphical joining instances of Physiolibrary classes, user can create models of cardiovascular circulation, thermoregulation, metabolic processes, nutrient distribution, gas transport, electrolyte regulation, water distribution, hormonal regulation and pharmacological regulation. After simple setting of the parameters, the models are ready to simulate. After simulation, the user can examine variables as their values change over time. Representing the model as a diagram has also great educational advantages, because students are able to better understand physical principles when they see them modeled graphically.

  16. Outcome of Anesthesia and Open Heart Surgery in Pregnant Patients

    Directory of Open Access Journals (Sweden)

    Golamali Mollasadeghi


    Full Text Available Background: Cardiovascular disease is an important non-obstetric cause of maternal and fetal /neonatal morbidity and mortality during pregnancy. For a pregnant woman with cardiac disease, the potential inability of the maternal cardiovascular system to contend with normal pregnancy-induced physiologic changes may produce deleterious effects on both mother and fetus. To determine the most frequent surgical indications of maternal and fetal mortality, we studied 15 cases of severe cardiac disease in pregnant women who required cardiac surgical procedures. Methods: In this descriptive study, fifteen pregnant women who underwent cardiac surgery were studied. Maternal age ranged from 27 to 36 years, and gestational age varied from 4 to 22 weeks. Most of the patients were in New York Heart Association Classes II and III. Opioid- based anesthesia with fentanyl citrate (50µ/kg or sufentanil (5µ/kg plus low dose of thiopental were used for the induction of anesthesia. During non-pulsatile cardio-pulmonary bypass, core temperature was between 28-36 °C, average CBP time was 61.2±22 min, average aortic cross-clamp time was 34.13±14 min, and mean pump pressure was maintained between 65-80 mmHg. Results: Ten patients had severe mitral valve disease (66.6%, three had aortic valve disease (20%, one had subvalvular aortic stenosis (6.7%, and the remaining one had left atrial myxoma (6.7%. There were five fetal deaths (33.3% and one maternal death (6.7%. Conclusion: It seems that open heart surgery in the first trimester is very hazardous for the fetus and may lead to fetal death. If possible, surgery should be carried out in the second trimester of pregnancy. The recommendations are simply guidelines because research data and clinical experience in this area are limited.

  17. Photoacoustic monitoring of clot formation during surgery and tumor surgery (United States)

    Juratli, Mazen A.; Galanzha, Ekaterina I.; Sarimollaoglu, Mustafa; Nedosekin, Dmitry A.; Suen, James Y.; Zharov, Vladimir P.


    When a blood vessel is injured, the normal physiological response of the body is to form a clot (thrombus) to prevent blood loss. Alternatively, even without injury to the blood vessel, the pathological condition called thromboembolism may lead to the formation of circulating blood clots (CBCs), also called emboli, which can clog blood vessels throughout the body. Veins of the extremities (venous thromboembolism), lungs (pulmonary embolism ), brain (embolic stroke), heart (myocardial infarction), kidneys, and gastrointestinal tract are often affected. Emboli are also common complications of infection, inflammation, cancer, surgery, radiation and coronary artery bypass grafts. Despite the clear medical significance of CBCs, however, little progress has been made in the development of methods for real-time detection and identification of CBCs. To overcome these limitations, we developed a new modification of in vivo photoacoustic (PA) flow cytometry (PAFC) for real-time detection of white, red, and mixed clots through a transient decrease, increase or fluctuation of PA signal amplitude, respectively. In this work, using PAFC and mouse models, we present for the first time direct evidence that some medical procedures, such as conventional or cancer surgery may initiate the formation of CBCs. In conclusion, the PA diagnostic platform can be used in real-time to define risk factors for cardiovascular diseases, assist in the prognosis and potential prevention of stroke by using a well-timed therapy or as a clot count as a marker of therapy efficacy.

  18. Metabolic methanol: molecular pathways and physiological roles. (United States)

    Dorokhov, Yuri L; Shindyapina, Anastasia V; Sheshukova, Ekaterina V; Komarova, Tatiana V


    Methanol has been historically considered an exogenous product that leads only to pathological changes in the human body when consumed. However, in normal, healthy individuals, methanol and its short-lived oxidized product, formaldehyde, are naturally occurring compounds whose functions and origins have received limited attention. There are several sources of human physiological methanol. Fruits, vegetables, and alcoholic beverages are likely the main sources of exogenous methanol in the healthy human body. Metabolic methanol may occur as a result of fermentation by gut bacteria and metabolic processes involving S-adenosyl methionine. Regardless of its source, low levels of methanol in the body are maintained by physiological and metabolic clearance mechanisms. Although human blood contains small amounts of methanol and formaldehyde, the content of these molecules increases sharply after receiving even methanol-free ethanol, indicating an endogenous source of the metabolic methanol present at low levels in the blood regulated by a cluster of genes. Recent studies of the pathogenesis of neurological disorders indicate metabolic formaldehyde as a putative causative agent. The detection of increased formaldehyde content in the blood of both neurological patients and the elderly indicates the important role of genetic and biochemical mechanisms of maintaining low levels of methanol and formaldehyde. Copyright © 2015 the American Physiological Society.

  19. 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

  20. 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.