Cameraless peritoneal entry in abdominal laparoscopy.

BACKGROUND AND OBJECTIVES: Despite significant advances in laparoscopic instrumentation and techniques, injury to intraabdominal structures remains a potentially serious complication of peritoneal access. Consensus on the best method to obtain peritoneal access is lacking. A safe technique that does not rely on direct visualization of the abdominal layers could shorten the learning curve for surgeons and potentially be adopted by other physicians for a variety of nonsurgical indications for peritoneal entry. METHODS: A prospective series of 99 consecutive patients who underwent upper-abdominal laparoscopic surgery performed by a single surgeon between January 2009 and June 2010 was reviewed. The method used to obtain peritoneal access was the fluid-based peritoneal entry indication technique (C-PET) with the EndoTIP trocar. RESULTS: Successful abdominal entry using C-PET was achieved in 90 (90.9%) of the patients; no trocar-related injuries or other injuries associated with peritoneal access occurred. The mean time from incision to confirmed peritoneal access was 21.4 s (range, 12 to 65). Of the 9 cases in which C-PET did not successfully gain entry, 6 occurred during the first 20 surgeries and only 3 in the final 79. CONCLUSIONS: C-PET is simple, safe, timely, and effective for gaining peritoneal access during laparoscopic abdominal surgeries. In this series, C-PET produced no complications and proved effective across a wide variety of patients, including the obese and those who had had previous surgery. Furthermore, C-PET does not require visual recognition of anatomic layers and potentially could easily be taught to nonsurgeon physicians who perform peritoneal access.

Comparing self-reported physical activity and sedentary time to objective fitness measures in a military cohort.

OBJECTIVES: Regular vigorous physical activity (PA) and high levels of physical fitness (PF) confer health benefits. Conversely, sedentary time is a risk factor for chronic illness, independent of PA. We evaluated associations between self-reported PA, sedentary time, and objective PF measures in military Service members. DESIGN: Cross-sectional study including 10,105 Air Force Millennium Cohort participants with a valid physical fitness assessment (PFA). METHODS: Linear regression assessed associations between self-report PA, screen time, and usual activity and abdominal circumference (AC) and VO2 max; logistic regression was used for PFA failure. We stratified by age and sex. RESULTS: Men who self-reported high versus low levels of PA had greater AC (19-29 years: ß=0.23in., 95% CI 0.07, 0.39; 30-39 years: ß=0.45in., 95% CI 0.17, 0.72). High versus low self-reported PA was also associated with greater VO2Max (ß=:0.81-1.41mL/kg/min). Self-reported strength training for ≥2days/week was associated with greater VO2Max in 19-29year old men (ß=0.84mL/kg/min, 95% CI 0.09, 0.60) and 30-39year old women (ß=0.74mL/kg/min, 95% CI 0.02, 1.46). For younger men and women,<2h of screen time/day was associated with greater VO2Max (Males 19-29years: ß=0.23mL/kg/min, 95% CI 0.44, 1.26; Females 19-29years: ß=0.83mL/kg/min, 95% CI 0.25, 1.42). PA was not associated with PFA failure, while screen time was (Males OR: 0.32-0.65, 95% CI 0.17-0.92, p<0.001-0.016). CONCLUSIONS: Self-reported PA and screen time were associated with some objective PF measures, including VO2Max and AC. However, screen time alone was associated with PFA failure.

Interaction of water with three granular biopesticide formulations.

Two obstacles for biopesticide commercialization, long shelf life and reliable efficacy, are both affected by moisture availability. Three biopesticide delivery systems, TRE-G, PEC-G, and PESTA, were analyzed by dynamic vapor sorption analysis. The objective was to investigate the moisture sorption profile of each system in air at 25 degrees C and a relative humidity (RH) ranging from 0 to 90%. The formulations sorbed up to 12.7% moisture. In rehydrating from 0.00 to 90% RH, TRE-G and PEC-G were >or=63% and >or=58% faster than Pesta, respectively. In losing moisture from 90 to 0.00% RH, Pesta was 3.4 and 2.3 times slower than TRE-G and PEC-G, respectively. The GAB model was inadequate for describing moisture sorption, but the Young and Nelson model showed good correlation (r > 0.990) for all three formulations. Moisture distribution for all formulations was obtained. The implications of the findings as they relate to shelf life and dew period requirements of biopesticides are discussed.

The use of organic vapor sorption to determine low levels of amorphous content in processed pharmaceutical powders.

Organic dynamic vapor sorption (organic-DVS) was used to characterize amorphous content in known amorphous-crystalline mixtures of lactose and salbutamol sulfate. N-octane was chosen as an apolar probe and measurements were carried out by exposing mixtures of each sample to partial pressures 0-90% p/p(0). A linear relationship between amorphous content and n-octane partial pressure was observed for both lactose and salbutamol sulfate with R(2) values of 0.992 and 0.999, respectively. In addition, the influence of sequential mechanical processing in a ball mill on the amorphous content in crystalline lactose was investigated. Cumulative milling times resulted in an exponential increase in amorphous content (using the linear relationship obtained for lactose), with a maximum amorphous content of 14% being induced after 60 min milling. In comparison, analysis of the 60 min mill time samples after exposure to 85% relative humidity suggested 0.00% amorphous content.