RESUMO
Robotic assisted surgery (RAS) has become increasingly adopted in colorectal cancer surgery. This study aims to compare robotic and laparoscopic approaches to left sided colorectal resections in terms of surgical outcomeswith no formal enhanced recovery programme. All patients undergoing robotic or laparoscopic left sided or rectal (high and low anterior resection) cancer surgery at a single tertiary referral centre over 3 years were included.A total of 184 consecutive patients from July 2017 to December 2020 were included in this study, with 40.2% (n=74/184) undergoing RAS. The median age at time of surgery was 68 years (IQR 60-73 years). RAS had a significantly shorter length of median stay of 3 days, compared to 5 days in the conventional laparoscopic surgery (CLS) group (p<0.001). RAS had a significantly lower rate of conversion to open surgery (0% vs 16.4%, p<0.001). The median operative time was also shorter in RAS (308 minutes), compared to CLS (326 minutes, p=0.019). The overall rate of any complication was 16.8%, with the RAS experiencing a lower complication rate (12.2% vs 20.0%, p=0.041). There was no significant difference in anastomotic leak rates between the two groups (4.0% vs 5.5%, p=0.673), or in terms of complete resection (R0) (robotic 98.6%, laparoscopic 100%, p=0.095). Robotic left sided colorectal surgery delivers equivalent oncological resection compared to laparoscopic approaches, with the added benefits of reduced length of stay and lower rates of conversion to open surgery. This has both clinical and healthcare economic benefits.
Assuntos
Neoplasias Colorretais , Procedimentos Cirúrgicos do Sistema Digestório , Laparoscopia , Procedimentos Cirúrgicos Robóticos , Humanos , Pessoa de Meia-Idade , Idoso , Procedimentos Cirúrgicos Robóticos/métodos , Laparoscopia/efeitos adversos , Reto/cirurgia , Procedimentos Cirúrgicos do Sistema Digestório/efeitos adversos , Neoplasias Colorretais/cirurgia , Resultado do Tratamento , Estudos Retrospectivos , Complicações Pós-Operatórias/etiologiaRESUMO
With the use of an immunofluorescence technique Epstein-Barr viral capsid antigen antibody titers were determined in the sera from 226 Sudanese: 41 with nasopharyngeal carcinoma (NPC), 77 with other head and neck cancers, 21 with malignant lymphomas, 63 with other cancers, 6 with specific granulomas, and 18 normal controls. Of the NPC patients, 87.8% had titers of 320 or greater and 43.9% had titers of 2,560 or more, whereas none had titers of less than 40. Their geometric mean titer (GMT) level was 1,855. However, compared to the NPC patients, the other patients and normal controls showed significantly higher percentages of sera with low titers and lower percentages of sera with high titers and they had a GMT that was 4--16 times lower. The high NPC titers were independent of age, sex, tribe, or locality of patients. The preliminary results indicated the importance of future immunovirologic and immunogenetic field investigations on the natural history of the Epstein-Barr virus and on the genetics of the host.
Assuntos
Anticorpos Antivirais/análise , Herpesvirus Humano 4/imunologia , Neoplasias Nasofaríngeas/imunologia , Adolescente , Adulto , Idoso , Capsídeo/imunologia , Criança , Pré-Escolar , Métodos Epidemiológicos , Feminino , Neoplasias de Cabeça e Pescoço/imunologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Nasofaríngeas/epidemiologia , Neoplasias Nasofaríngeas/etiologia , Neoplasias/imunologia , SudãoRESUMO
Strain tolerance to toxic metabolites remains an important issue in the production of biofuels. Here we examined the impact of overexpressing the heterologous groESL chaperone from Clostridium acetobutylicum to enhance the tolerance of Escherichia coli against several stressors. Strain tolerance was identified using strain maximum specific growth rate (µ) and strain growth after a period of solvent exposure. In comparison with control strain, the groESL overexpressing strain yielded a 27 % increase in growth under 0.8 % (v/v) butanol, a 9 % increase under 1 % (v/v) butanol, and a 64 % increase under 1.75 (g/l) acetate. Moreover, after 10 h, groESL overexpression resulted in increase in relative tolerance of 58 % compared with control strain under 0.8 % (v/v) butanol, 56 % increase under 1 % (v/v) butanol, 42 % increase under 1 % (v/v) isobutanol, 36 % increase under 4 % (v/v) ethanol, 58 % increase under 1.75 (g/l) acetate. These data demonstrate that overexpression of the groESL from C. acetobutylicum in E. coli increased tolerance to several stressors. Solvent tolerant strain of E. coli was developed to be used as a basic strain for biofuel production.
RESUMO
New cases of mucosal leishmaniasis and the first case of espundia-like muco-cutaneous leishmaniasis are reported from the Sudan. Cases previously reported are reviewed and the geographical distribution, clinical features, pathology, immunology and treatment of the disease are described. The majority of cases came from the known kala azar endemic regions of the central Sudan. The disease was seen in adult males, it commonly affected the mouth and nose causing in some cases permanent damage to teeth and nasal septi. In the lesions, the cellular infiltrate was composed mainly of histiocytes, lymphocytes and plasma cells. The number of parasites present was inversely related to the number of lymphocytes but was not related to the number of plasma cells. The level of the increased serum immunoglobulins was not constantly correlated with the number of any particular cell in the infiltrate. Treatment with sodium stibogluconate (Pentostam) was effective in the majority of cases.
Assuntos
Leishmaniose Mucocutânea/epidemiologia , Adulto , Antimônio/uso terapêutico , Gluconatos/uso terapêutico , Humanos , Injeções Intravenosas , Leishmaniose Mucocutânea/tratamento farmacológico , Leishmaniose Mucocutânea/patologia , Masculino , SudãoRESUMO
The susceptibility to antibiotics of 144 strains of Ureaplasma urealyticum and 34 strains of Mycoplasma hominis isolated in Dakar, Senegal, was determinated by MIC determination in a medium. Doxycyclin and minocyclin are active on more than 90% of the strains of U. urealyticum, and more than 80% of M. hominis strains. Over 93% of U. urealyticum strains are susceptible to all the macrolids and apparented tested (erythromycin, pristinamycin, josamycin), but the activity of lincomycin, pristinamycin and josamycin on M. hominis was found only for 70% of the strains. Fluoroquinolones, once adequately studied, could turn out to be a useful alternative in therapeutics.
Assuntos
Antibacterianos/farmacologia , Genitália Feminina/microbiologia , Testes de Sensibilidade Microbiana , Mycoplasma/efeitos dos fármacos , Feminino , Humanos , Macrolídeos , Mycoplasma/isolamento & purificação , Senegal , TetraciclinasRESUMO
The mycoflora on the hair in 25 samples of each of goats and sheep collected from Libya was analyzed using two isolation methods at 25â. Seventy species and 3 varieties belonging to 31 genera were collected from the two substrates. The hairs of sheep were polluted with fungi than goat, contained high total counts and number of genera and species. Two species of true dermatophytes were isolated namely Trichophyton rubrum and T. terrestre. Several keratiophilic species were isolated of which Chrysosporium indicum, C. keratinophilum and C. tropicum were the most prevalent. The commonest saprophytes in order of frequency were members of the genera Aspergillus, Penicillium, Emericella, Alternaria and Cochliobolus.
RESUMO
PIP: In July 1996, Egypt's Minister of Health reversed a 1994 ruling of his predecessor that allowed public hospitals to perform female genital mutilation (FGM). 1994 also saw the establishment of a Task Force Against Female Genital Mutilation, which launched a national campaign to reverse this ruling. This campaign included taking the previous Health Minister to court and legally challenging a religious leader who stated that Muslim women should be mutilated. Activists also countered official statistics placing the prevalence of FGM at 50%. A 1995 National Health Survey of 14,000 ever-married women 14-59 years old revealed that 97% had undergone the procedure. These findings were supported by a validation study of 1400 women which showed that 94% were affected. Activists are hopeful because contradictory medical and religious messages are being resolved in favor of banning the procedure, and the media has begun to report deaths from FGM. Challenges remain, however, including a suit filed in court by a group of professors of obstetrics and gynecology who claim that prohibiting the procedure in a clinical setting will result in clandestine operations that endanger women's health. The Egyptian Medical Syndicate, which endorsed the 1994 ruling, has remained silent about the current decree.^ieng
Assuntos
Circuncisão Feminina , Atitude Frente a Saúde , Egito , Feminino , Humanos , Direitos da MulherRESUMO
50 plants indigenous to the Sudan and of common use in Sudanese folk-medicine, were screened for their molluscicidal activity, using two local snail vectors, BULINUS TRUNCATUS and BIOMPHALARIA PFEIFFERI. At different concentrations 31 (62%) of these plant samples were found to be lethal to either one or both of the snail species. 28 (56%) proved to be lethal to BIOMPHALARIA PFEIFFERI, 22 (44%) gave 100% mortality to BULINUS TRUNCATUS; while 19 (38%) killed both snail hosts (Table I). The seven most active molluscicidal plants were phytochemically screened for their active constituents; four of them showed the presence of saponins.
RESUMO
Three hundred and seventy-four cases of nasopharyngeal carcinoma (NPC) recorded in the Sudan Cancer Registry (SCR) and 512 cases seen at the Radiation and Isotope Centre, Khartoum (RICK) were analysed. NPC formed 5.8% of all cancer cases in the SCR and 7.2% at the RICK; this is the highest frequency so far reported outside the Chinese. The male/female ratio was 3:1; NPC was the commonest tumour in males at the RICK (12.1%) and second commonest in the SCR (9.2%). It tended to occur in younger patients (youngest, 3 yr), with 14 and 12.1% of cases in children 14 yr or under in the SCR and RICK respectively; it is the commonest childhood malignancy in the Sudan. The ethnic and geographical distribution of the cases showed that racial susceptibility played a significant role in the aetiology of NPC in the Sudan whereas environmental factors could be excluded; however, Epstein-Barr virus might be an exciting factor.