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1.
Cureus ; 16(1): e52904, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38406010

RESUMEN

Colorectal cancer is the third most commonly diagnosed cancer in the world and second in cancer-related mortality. It is most prevalent in the developed world and is often associated with lifestyle factors along with age and genetics. The inclusion criteria comprised high-level evidence, such as randomized clinical trials, meta-analyses, and systematic reviews, conducted between 2012 and 2023, that directly compared the two approaches. The review reveals mixed outcomes between robotic right colectomy (RRC) and laparoscopic right colectomy (LRC). The robotic approach was associated with longer operative duration and higher costs but with decreased blood loss and quicker recovery compared to laparoscopy. On the other hand, no major differences were observed regarding lymph node retrieval, duration of hospitalization, and surgical complications. Regarding future directions, it is evident that the focus needs to shift beyond the operative parameters and to patient-centered outcomes, which are underreported. Also, more randomized clinical trials are required, focusing on safety, efficacy, and long-term quality of life. Costs-benefit analyses are required to weigh the benefits of robotic surgery against the implementation and practice costs. Additionally, improvements in surgeons' training may be necessary to reduce the operative duration and potentially decrease operational costs. Finally, standardization of research protocols may be necessary to reduce biases.

2.
Cureus ; 15(12): e49780, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-38161532

RESUMEN

Robotic gastrectomy has been gaining ground in the past 20 years. This study aims to (a) provide an updated and all-encompassing comprehensive review including post-operative outcomes, rate of complications, surgical efficiency and costs, pathology, overall survival, mortality and recurrence, and disease-free survival of robotic versus laparoscopic gastrectomy, (b) report research gaps, and (c) identify ongoing or forthcoming clinical trials that could potentially shed light on underreported findings within the existing literature. Regarding the methodology, PubMed and Google Scholar were searched for randomized controlled trials, systematic reviews, and meta-analyses published between January 2012 and October 2023. ClinicalTrials.gov was searched for related clinical trials currently underway or recruiting. Robotic gastrectomy, when compared to laparoscopic gastrectomy, for the treatment of gastric cancer, performs equally well or shows superiority in terms of the length of hospitalization, overall complications rates, rate of conversion to open surgery, surgical complications, anastomotic leakage, pancreatic complications, blood loss, mortality rates, time to first flatus, time to oral intake, distal and proximal resection margins, recurrence rate, reoperation rates, and overall survival. However, it is associated with higher costs and longer operative time. Parameters such as duodenal stump leakage, anastomosis stenosis, intestinal obstruction, ileus, delayed gastric emptying, wound complications, acute pancreatitis, pancreatic fistula, direct costs, time to initiation of adjuvant chemotherapy, postoperative morbidity, recurrence, and disease-free survival are currently underreported in the literature and necessitate for further research. Lastly, four clinical trials are currently underway or recruiting that could possibly bridge the research gap.

3.
Artículo en Inglés | MEDLINE | ID: mdl-35582462

RESUMEN

This paper describes an innovative remote surface sterilization approach applicable to the new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The process is based on the application of a liquid film on the surface or object under sterilization (OUS). A beacon signal is used to self-steer the transmitted power from the designed retrodirective antenna array (RDA) towards the OUS using circularly polarized fields; then, the sterilization is completed by raising and maintaining the required temperature for a certain time. Results suggest that the process takes 5 minutes or less for an angular coverage range over 60 degrees whilst abiding by the relevant safety protocols. This paper also models the power incident onto the OUS, providing consistent results with full-wave simulations. A practical RDA system is developed using a 2 × 1 microstrip patch array operating at 2.5 GHz and tested through the positioning of a representative target surface. Measurements, developed by sampling the power transmitted by the heterodyne RDA, are reported for various distances and angles, operating in the near-field of the system. To further validate the methodology, an additional experiment investigating virus deactivation through microwave heating was also developed. Measurements have been performed with an open cavity microwave oven on the Coronavirus (strain 229E) and egg white protein in a cuvette. This demonstrates that the temperature increases of aqueous films up to 70 [Formula: see text]C by remote microwave-induced heat can denature proteins and deactivate viruses. Possible applications of the method include sterilization of ambulances, medical equipment, and internet of things (IoT) devices.

4.
Curr Nutr Rep ; 10(4): 435-467, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-34665439

RESUMEN

PURPOSE OF THE REVIEW: Colorectal cancer is the second most common cause of cancer death in the world. The aim of this review is to provide an update on recent epidemiological studies, the molecular mechanisms involved, and ongoing clinical trials investigating the relationship between red meat consumption and colorectal cancer. RECENT FINDINGS: Evidence in the literature proposes an association between red meat consumption and development of colorectal cancer, and there is some insight with regard to the mechanisms involved. Twenty studies of the IARC report (1990-2015) showed that red meat is positively associated with colorectal cancer whereas 14 studies either supported no positive association or no statistically significant association between red meat consumption and risk for CRC. More recent epidemiological studies conducted from 2016 and onwards provided further evidence that adherence to diets low in red and/or processed meat reduces the risk of colorectal cancer. Evidence from recent studies supports that quantity, doneness, and preparation of red meat play a role in colorectal carcinogenesis. Red meat's degradation products allow for the creation of a pro-inflammatory colonic microenvironment, and the gut microbiome plays a role in colorectal carcinogenesis. Heme, hydrogen sulfide, lipid peroxidation, nitroso compounds, and the bacterium Fusobacterium Nucleatum (as well as possibly other bacteria such as Akkermansia muciniphila, Eubacterium cylindroides, Eubacterium eligens 1 and 2, and Eubacterium rectale 1 and 2) also partake in the process of colorectal carcinogenesis. Several clinical trials are underway investigating the effects of different diets and red meat substitution products on colorectal cancer incidence as well as the underlying molecular mechanisms involved in the process.


Asunto(s)
Neoplasias Colorrectales , Productos de la Carne , Carne Roja , Neoplasias Colorrectales/epidemiología , Humanos , Carne , Productos de la Carne/análisis , Epidemiología Molecular , Carne Roja/análisis , Microambiente Tumoral
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