Human reliability analysis in maintenance and repair operations of mining trucks: A Bayesian network approach.

Failures in mining machinery can abruptly halt mineral production and operations, emphasizing the indispensable role of humans in maintenance and repair operations. Addressing human errors is crucial for ensuring a safe and reliable system, particularly during maintenance activities where accidents frequently occur. This paper focuses on evaluating Human Reliability (HR) to enhance activity implementation effectiveness. Given the challenge of limited and uncertain data on human errors, this study aims to estimate the probability of human errors using Bayesian networks (BN) under uncertain parameters. Applying this approach to assess HR in the maintenance and repair operations of mining trucks at Golgohar Iron Ore Mine in Iran, the study identifies critical factors influencing error occurrence in a fuzzy environment. The results highlight key factors impacting human error and offer insights into estimating HR with minimal human intervention.

Structure-function relationship of phase-separated liposomes containing diacylglycerol analogues.

The composition and morphology of lipid-based nanoparticles can influence their overall in vivo behavior. Previously, we demonstrated that phase separation in liposomes composed of DSPC and a diacylglycerol lipid analogue (DOaG) drives the in vivo biodistribution towards a specific subset of endothelial cells in zebrafish embryos. In the absence of traditional targeting functionalities (e.g., antibodies, ligands), this selectivity is mediated solely by the unique liposome morphology and composition, characterized by a DOaG-rich lipid droplet within the DSPC-rich phospholipid bilayer. The phase separation is induced due to the geometry of DOaG lipid and its ability to create non-bilayer phases in lipid membranes. To investigate the underlying principles of phase separation and to optimize the liposome colloidal stability, we performed a structure-function relationship study by synthesizing a library of DOaG analogues with varying molecular properties, such as the number, length and sn-position of the acyl chains, as well as the degree of saturation or carbonyl substituents. We assessed the ability of these lipid analogues to assemble into phase-separated liposomes and studied their morphology, colloidal stability, and in vivo biodistribution in zebrafish embryos. We found that analogues containing unsaturated, medium length (C16-C18) fatty acids were required to obtain colloidally stable, phase-separated liposomes with cell-specific biodistribution patterns. Moreover, we observed that using the pure DOaG isomer, with acyl chains at the sn-1,3 positions, leads to more colloidally stable liposomes than when a mixture of sn-1,2 and sn-1,3 isomers is used. Similarly, we observed that incorporating a DOaG analogue with fatty tails shorter than DSPC, as well as PEGylation, endows liposomes with long term stability while retaining cell-selective biodistribution. Diacylglycerols are known to promote fusion, lipid polymorphism, signaling and protein recruitment on lipid membranes. In this study, we showed that diacylglycerol derivatives can induce phase separation in liposomes, unlocking the potential for cell-specific targeting in vivo. We believe that these findings can be the foundation for future use of diacylglycerols in lipid-based nanomedicines and could lead to the development of novel targeted delivery strategies.

Whole-genome scan for selection signature associated with temperature adaptation in Iranian sheep breeds.

The present study aimed to identify the selection signature associated with temperature adaptation in Iranian sheep breeds raised in cold and hot environments. The Illumina HD ovine SNP600K BeadChip genomic arrays were utilized to analyze 114 animals from eight Iranian sheep breeds, namely Ghezel, Afshari, Shall, Sanjabi, Lori-Bakhtiari, Karakul, Kermani, and Balochi. All animals were classified into two groups: cold-weather breeds and hot-weather breeds, based on the environments to which they are adapted and the regions where they have been raised for many years. The unbiased FST (Theta) and hapFLK tests were used to identify the selection signatures. The results revealed five genomic regions on chromosomes 2, 10, 11, 13, and 14 using the FST test, and three genomic regions on chromosomes 10, 14, and 15 using the hapFLK test to be under selection in cold and hot groups. Further exploration of these genomic regions revealed that most of these regions overlapped with genes previously identified to affect cold and heat stress, nervous system function, cell division and gene expression, skin growth and development, embryo and skeletal development, adaptation to hypoxia conditions, and the immune system. These regions overlapped with QTLs that had previously been identified as being associated with various important economic traits, such as body weight, skin color, and horn characteristics. The gene ontology and gene network analyses revealed significant pathways and networks that distinguished Iranian cold and hot climates sheep breeds from each other. We identified positively selected genomic regions in Iranian sheep associated with pathways related to cell division, biological processes, cellular responses to calcium ions, metal ions and inorganic substances. This study represents the initial effort to identify selective sweeps linked to temperature adaptation in Iranian indigenous sheep breeds. It may provide valuable insights into the genomic regions involved in climate adaptation in sheep.

The effect of celastrol in combination with 5-fluorouracil on proliferation and apoptosis of gastric cancer cell lines.

Background: Despite the availability of chemotherapy drugs such as 5-fluorouracil (5-FU), the treatment of some cancers such as gastric cancer remains challenging due to drug resistance and side effects. This study aimed to investigate the effect of celastrol in combination with the chemotherapy drug 5-FU on proliferation and induction of apoptosis in human gastric cancer cell lines (AGS and EPG85-257). Materials and Methods: In this in vitro study, AGS and EPG85-257 cells were treated with different concentrations of celastrol, 5-FU, and their combination. Cell proliferation was assessed using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. The synergistic effect of 5-FU and celastrol was studied using Compusyn software. The DNA content at different phases of the cell cycle and apoptosis rate was measured using flow cytometry. Results: Co-treatment with low concentrations (10% inhibitory concentration (IC10)) of celastrol and 5-FU significantly reduced IC50 (p < 0.05) so that 48 h after treatment, IC50 was calculated at 3.77 and 6.9 µM for celastrol, 20.7 and 11.6 µM for 5-FU, and 5.03 and 4.57 µM for their combination for AGS and EPG85-257 cells, respectively. The mean percentage of apoptosis for AGS cells treated with celastrol, 5-FU, and their combination was obtained 23.9, 41.2, and 61.9, and for EPG85-257 cells 5.65, 46.9, and 55.7, respectively. In addition, the 5-FU and celastrol-5-FU combination induced cell cycle arrest in the synthesis phase. Conclusions: Although celastrol could decrease the concentration of 5-fluorouracil that sufficed to suppress gastric cancer cells, additional studies are required to arrive at conclusive evidence on the anticancer effects of celastrol.

An in vitro antiviral evaluation of punicalagin toward influenza A virus.

Objective: Influenza complications are mild to serious, and can cause death in some cases. A great deal of attention has been paid in recent years to the development and use of new antiviral compounds to overcome drug resistance in certain strains of the influenza virus and treat the clinical implications. This study aimed to investigate the antiviral effect of punicalagin and its associated mechanism against influenza A (H1N1) virus in vitro. Materials and Methods: the ant-influenza activity of punicalagin was studied in Madin-Darby Canine Kidney (MDCK) cells using influenza virus A/Puerto Rico/8/34 (H1N1) (PR8) using Hemagglutinin assay (HA) and 50% tissue culture infective dose (TCID50). Then, the inhibition of haemagglutination, virucidal activity, inhibitory effect at different times, replication of viral RNA and expression of viral genes were investigated. Results: Punicalagin could inhibit influenza virus infection with 50% inhibitory concentration (IC50) of 3.98 µg/ml and selectivity index (SI) value of 6.1. Punicalagin decreased virus titers with an inhibitory effect on virus hemagglutination (p<0.05). Punicalagin also inhibited viral adsorption. The results of virus RNA replication and viral mRNA (NS1 and HA) expression after treatment with punicalagin showed significant suppression of viral mRNA expression but no effect on replication of viral RNA. Conclusion: The results of the present study indicated that punicalagin was effective against influenza infection most probably via inhibition of haemagglutination activity and virus binding.

Evaluation of Trans-Anal Endorectal Pull-Through Outcomes in Hirschsprung's Disease in Different Age Groups: A Comprehensive Systematic Review.

BACKGROUND: The timing of trans-anal endorectal pull-through (TAEPT) for Hirschsprung's disease (HD) is controversial. Early endorectal pull-through avoids the occurrence of preoperative enterocolitis. However, delayed pull-through (≥31 days) enables postnatal maturation of the anal canal and sphincter complex. The aim of this study was to identify the best age to perform trans-anal pull-through according to the literature. METHODS: This is a comprehensive systematic review. All articles published from 2010 to 2022 were searched in the Web of Science, Ovid Medline, PubMed, CINAHIL, and Embase databases, using the keywords HD, delayed or early treatment, trans-anal pull-through surgery, age, sex or gender, complications and outcomes. Articles that met the inclusion criteria with good to fair quality according to the Newcastle-Ottawa quality assessment and low bias score in the Cochran collaboration tool were reviewed. RESULTS: Sixteen studies were eligible to be reviewed. The overall results of this study showed that due to more common short-term complications at neonatal period and lower contrast enema diagnostic accuracy in determining the transition zone, it seems to be reasonable decision to postpone surgery until the child is several months old. There was also no difference in terms of complications and outcomes of trans-anal pull-through surgery between females and males. CONCLUSION: It is not recommended to delay surgery too much for ages over 1 year. Ages between 3 and 12 months can be a good time for interventional treatment for HD.

A simplified homogeneous approach for non-linear analysis of masonry infill panels under in-plane loads.

This paper aims to create a unified model that effectively combines continuous 2-dimensional elements and discrete components to capture the nonlinear characteristics and failure mechanisms of solid and perforated masonry infill panels. Given that masonry infill behavior is primarily influenced by shear deformations, an equivalent model is developed by using multiple small square panels arranged diagonally and interconnected by two-component springs, encompassing axial and shear behavior at their intersections. For the sake of simplicity, the divided panels are assumed to behave elastically, with plasticity concentrated only in the axial component of the connector springs. Plastic behavior in the boundary elements was considered to involve both flexural and shear plastic hinges to provide an accurate estimation of the entire infill panel's behavior. To validate this approach, the simplified model is benchmarked against eight experimental masonry infill panels surrounded by steel or reinforced concrete frames and with or without openings. The results including global behavior and crack pattern were compared with available numerical predictions based on finite element method from the literature in addition to experimental outcomes. Ultimately, this comparison demonstrated that the homogeneous model could effectively predict the non-linear lateral behavior of the panels and accurately forecast crack patterns. Additionally, the use of unidirectional non-linear springs and the appropriate arrangement of elastic panels significantly reduced both pre-processing and analysis time.

The effect of significant weight loss after bariatric surgery on echocardiographic indices: an observational study focusing on left ventricular deformation by 2D speckle echocardiography and right ventricular size.

BACKGROUND: Obesity is a known risk factor for atherosclerosis and cardiac disease. HYPOTHESIS: This study evaluated the effect of significant weight loss following bariatric surgery on myocardial deformation indices and right ventricular size (RV). This was a prospective cohort study. Morbid obese patients scheduled for bariatric surgery from July 2017 to February 2018 at Firoozgar Hospital were included in our study and referred for transthoracic echocardiography at Rajaie Cardiovascular Medical and Research Center. RESULTS: Thirty-four patients entered the study. The absolute value of global longitudinal strain (GLS) at baseline, 3, and 6 months after surgery was 17.42 ± 2.94%, 18.24 ± 3.09%, and 19.52 ± 2.78%, respectively, with a statistically significant difference from baseline to after six months (P value < 0.001). The absolute value of global circumferential strain (GCS) at baseline, 3, and 6 months after surgery was 20.14 ± 4.22%, 23.32 ± 4.66%, and 24.53 ± 4.52%, respectively, with statistically significant changes (P value < 0.001) from baseline to three months and from baseline to six months and no significant difference from three months to six months. A significant decrease was reported in mechanical dispersion of circumferential strain (38.05 ± 23.81-23.37 ± 20.86 ms, P value = 0.006) 6 months after surgery. Right ventricular size three- and six-month post-surgery showed a significant decrease relative to baseline echocardiography. CONCLUSIONS: Bariatric surgery could enhance cardiac function, as proven by 2D speckle echocardiography. Changes in RV size may be related to weight loss and should be considered when assessing patients who have undergone bariatric surgery.

Effect of Intra-ovarian Injection of Mesenchymal Stem Cells or its Conditioned Media on Repeated OPU-IVEP Outcomes in Jersey Heifers and Its Relationship with Follicular Fluid Inflammatory Markers.

Background: Repeated Ovum Pick Up (OPU) could have a detrimental effect on ovarian function, reducing In Vitro Embryo Production (IVEP). The present study examined the therapeutic effect of adipose-derived Mesenchymal Stem Cells (MSCs) or its Conditioned Medium (ConM) on ovarian trauma following repeated OPU. Resolvin E1 (RvE1) and Interleukin-12 (IL-12) were investigated as biomarkers. Methods: Jersey heifers (n=8) experienced 11 OPU sessions including 5 pre-treatment and 6 treatment sessions. Heifers received intra-ovarian administration of MSCs or ConM (right ovary) and Dulbecco's Modified Phosphate Buffer Saline (DMPBS; left ovary) after OPU in sessions 5 and 8 and 2 weeks after session 11. The concentrations of RvE1 and IL-12 in follicular fluid was evaluated on sessions 1, 5, 6, 9, and 4 weeks after session 11. Following each OPU session, the IVEP parameters were recorded. Results: Intra-ovarian administration of MSCs, ConM, and DMPBS did not affect IVEP parameters (p>0.05). The concentration of IL-12 in follicular fluid increased at the last session of pre-treatment (Session 5; p<0.05) and remained elevated throughout the treatment period. There was no correlation between IL-12 and IVEP parameters (p>0.05). However, RvE1 remained relatively high during the pre-treatment and decreased toward the end of treatment period (p<0.05). This in turn was associated with decline in some IVEP parameters (p<0.05). Conclusion: Intra-ovarian administration of MSCs or ConM during repeated OPU did not enhance IVEP outcomes in Bos taurus heifers. The positive association between RvE1 and some of IVEP parameters could nominate RvE1 as a promising biomarker to predict IVEP parameters following repeated OPU.

Protective role of citronellol on antioxidant enzymes and oxidative damage induced by gentamicin in experimental nephrotoxic rats.

BACKGROUND: Gentamicin leads to nephrotoxicity with increasing oxidative stress. In the present research the role of citronellol on oxidative damage induced by gentamicin in nephrotoxic rats was evaluated. METHODS AND RESULTS: Forty-twomale Wistar rats were randomly divided into seven equal groups; healthy control, gentamicin, DMSO, citronellol 50, citronellol 100, citronellol 200 and vitamin E. The animals were anesthetized after 12 days of treatment. Kidney and serum samples were received for biochemical, histological changes, and gene expression assessments. The levels of serum glutathione (GSH), serum and kidney glutathione peroxidase (GPX) and the expression of GPX gene against gentamicin group were increased in citronellol treatment groups. The levels of serum and kidney malondialdehyde (MDA), urine protein, serum creatinine and the gene expression of inflammatory factors including tumor necrosis factor-alpha (TNF-α) and Interleukin 6 (IL-6) against gentamicin group were decreased in these groups. Moreover, recuperation in histological alterations was shown in three groups receiving citronellol compared to the gentamicin group. CONCLUSIONS: Citronellol with its antioxidant and anti-inflammatory properties can decrease kidney damage caused by nephrotoxicity induced by gentamicin.

Identification of a Novel Variant in CC2D1A Gene Linked to Autosomal Recessive Intellectual Disability 3 in an Iranian Family and Investigating the Structure and Pleiotropic Effects of this Gene.

Objectives: Intellectual disability (ID) represents a significant health challenge due to its diverse and intricate nature. A multitude of genes play a role in brain development and function, with defects in these genes potentially leading to ID. Considering that many of these genes have yet to be identified, and those identified have only been found in a small number of patients, no complete description of the phenotype created by these genes is available. CC2D1A is one of the genes whose loss-of-function mutation leads to a rare form of non-syndromic ID-3(OMIM*610055), and four pathogenic variants have been reported in this gene so far. Materials & Methods: n the current study, two affected females were included with an initial diagnosis of ID who were from an Iranian family with consanguineous marriage. Whole-exome sequencing was used to identify the probable genetic defects. The Genotypic and phenotypic characteristics of the patients were compared with a mutation in the CC2D1A gene, and then the structure of the gene and its reported variants were investigated. Results: The patients carried a novel homozygous splicing variant (NM_017721, c.1641+1G>A) in intron 14, which is pathogenic according to the ACMG guideline. Loss-of-function mutations in CC2D1A have severe phenotypic consequences such as ID, autism spectrum disorder (ASD), and seizures. However, missense mutations lead to ASD with or without ID, and in some patients, they cause ciliopathy. Conclusion: This study reports the fifth novel, probably pathogenic variant in the CC2D1A gene. Comparing the clinical and molecular genetic features of the patients with loss-of-function mutation helped to describe the phenotype caused by this gene more precisely. Investigating the CC2D1A gene's mutations and structure revealed that it performs multiple functions. The DM14 domain appears more pivotal in triggering severe clinical symptoms, including ID, than the C2 domain.

A Contemporary Review on the Critical Role of Nonsteroidal Anti-inflammatory Agents in Colorectal Cancer Therapy.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are widely recognized as effective pain relievers and function by inhibiting the cyclooxygenase enzyme (COXs). Moreover, they have been found to participate in various cellular processes through different signaling pathways, such as WNT, MAPK, NF-κB, and PI3K/AKT/mTOR. This makes them potential candidates for chemoprevention of several malignancies, particularly colorectal cancer (CRC). However, the use of NSAIDs in cancer prevention and treatment is a complex issue due to their adverse effects and gastrointestinal toxicity. Therefore, it is crucial to explore combination therapies that can minimize side effects while maximizing synergistic effects with other agents and to evaluate the success rate of such approaches in both pre-clinical and clinical studies. In this review, we aim to provide an overview of the effects of NSAIDs in the prevention and treatment of CRC. We will focus on elucidating the possible mechanisms of action of these drugs, the signaling pathways involved in CRC, and the potential synergistic effects when combined with other therapeutic agents.

Maternal psychological stress during pregnancy and newborn telomere length: a systematic review and meta-analysis.

INTRODUCTION: Telomeres protect the ends of chromosomes, and shorter leukocyte telomeres are associated with major group diseases. Maternal psychological stress may be related to the shortening of telomeres in infants. This systematic review and meta-analysis set out to consolidate the varying effect sizes found in studies of maternal psychological stress and telomere length (TL) in newborns and identify moderators of the relationship between stress during pregnancy and newborn TL. METHODS: Our systematic review was registered in Prospero. Six databases (PubMed, Scopus, Embase, PsycINFO, Web of Science, and CINAHL Complete) were searched for records in English from inception to February 10, 2023. Observational studies were included that measured the relationship of psychological stress of the mother during pregnancy on the TL of the newborn. The Newcastle-Ottawa quality assessment scale was used to assess the quality of the included studies. A random-effect model was selected. Statistical analysis performed by Stata software version 17. RESULTS: Eight studies were included for qualitative and four for quantitative analysis. There was an inverse statistically significant relationship between maternal stress and newborn TL; A one score increase in maternal psychological stress resulted in a 0.04 decrease in the TL of the newborn (B = -0.04, 95% CI = [-0.08, 0.00], p = 0.05). Selectivity analysis showed that the pooled effect size was sensitive to one study; After removing this study, the pooled effect size remained significant (B = -0.06, 95% CI = [-0. 10, -0.02], p < 0.001). CONCLUSION: Physiological and environmental factors can significantly affect the TL of newborns. Our results support a significant impact of maternal psychological stress on the TL of a newborn. This association demonstrates the significance of stress in influencing the telomere length, which can be a contributing factor in the infant's future. Therefore, recognizing this association is crucial for understanding and addressing potential health risks and necessitates the need for additional future studies to validate our findings.

A novelty in laparoscopic total colectomy with natural orifice specimen extraction using a plastic cover / Uma novidade na colectomia total laparoscópica com extração de espécime em orifício natural usando uma cobertura plastic

Abstract Introduction: Minimally invasive colectomy has been performed for some years for many patients worldwide without much complications compared to the open approach. In this study we explained our experience regarding a modification in laparoscopic total colectomy and removing the specimen with Natural Orifice Specimen Extraction (NOSE) through rectum using a plastic cover for the first time. Methods and material: This was an experimental study on a new technique of total colectomy with a small modification. Total colectomy was performed based on 7 port laparoscopic approach. Rectum was sparred. Colon was then taken out through the anal canal using a plastic cover. Results: Thirteen patients underwent laparoscopic total colectomy by removal of the specimen through rectum. Mean age of patients was 42.23 ± 8.15 years. Mean duration of operation was 130 ± 32.4 min. All patients had an uneventful postoperative hospitalization. Discussion: Laparoscopic total colectomy has been proven to have superior benefits than the open approach. In NOSE technique, colon is removed from the anal canal without any complication or consuming much time. This technique might have less pain and removes the complications associated with an incision on the skin to remove the specimen. Also, due to low price of a usual plastic cover, it can be used instead of other techniques to remove the specimen through the rectum.

Resumo Introdução: A colectomia minimamente invasiva vem sendo realizada há alguns anos em muitos pacientes no mundo inteiro, apresentando menos intercorrências do que a abordagem aberta. Neste estudo, os autores relatam sua experiência com uma modificação da colectomia total laparoscópica e extração de espécime em orifício natural (NOSE) pelo reto, usando uma cobertura plástica pela primeira vez. Métodos e materiais: Este foi um estudo experimental sobre uma nova técnica de colectomia total com uma pequena modificação. A colectomia total foi realizada com base na abordagem laparoscópica de sete portas. O reto foi poupado. O cólon foi então retirado pelo canal anal usando uma cobertura plástica. Resultados: Treze pacientes foram submetidos a colectomia total laparoscópica por remoção do espécime pelo reto. A idade média dos pacientes foi de 42,23 ± 8,15 anos. A duração média da operação foi de 130 ± 32,4 minutos. Para todos os pacientes, a internação pós-operatória transcorreu sem intercorrências. Discussão: Foi comprovado que a colectomia total laparoscópica apresenta benefícios superiores à abordagem aberta. Na técnica NOSE, o cólon é removido mais rapidamente do canal anal, sem nenhuma intercorrência. Essa técnica pode causar menos dor e remove as complicações associadas a uma incisão na pele para remover o espécime. Além disso, devido ao baixo preço de uma cobertura plástica comum, ela pode ser usada no lugar de outras técnicas para remover o espécime pelo reto.

Evaluating the effect of gentamicin-clindamycin lavage on post-operational pain and infection through laparoscopic colectomy surgery / Avaliação do efeito da lavagem com gentamicina-clindamicina sobre a dor e a infecção após colectomia laparoscópica

Abstract Introduction Peritoneal antibiotic or normal saline lavage is seen to be beneficial in order to reduce the pain or infection risk through laparoscopic surgeries. It can also be applied for laparoscopic colectomy surgeries. In this study, we have compared the effects of antibiotic solution lavage (gentamycin-clindamycin) with normal saline lavage in patients undergoing laparoscopic colectomy surgery. Method In this double-blind Randomized Controlled Trial (RCT), 40 patients undergoing laparoscopic colectomy surgery were divided into antibiotic and normal saline lavage groups (20 patients in each group). Post-operational pain, need for painkiller, white blood cells count, C-reactive protein level, duration of hospitalization and wound infection were compared in 30 days between the groups. Results Antibiotic lavage group had significantly less pain than the normal saline group (p < 0.05) through 3, 6, 12 and 24 h after surgery. C-reactive protein level, white blood cells count, painkiller use, and hospitalization duration were significantly lower in antibiotic group. However, there was no difference regarding wound or intra-abdominal infection between the both groups. Conclusion Using gentamicin-clindamycin peritonea lavage helps patients undergoing laparoscopic colectomy surgery in pain reduction, need for painkillers and hospitalization duration.

Resumo Introdução A lavagem peritoneal com antibiótico ou com soro fisiológico normal é benéfica para reduzir o risco de dor ou de infecção durante cirurgias laparoscópicas, além de poder ser aplicada também em colectomias laparoscópicas. Neste estudo, comparamos os efeitos da lavagem com solução antibiótica (gentamicina-clindamicina) e da lavagem com solução salina normal em pacientes submetidos à colectomia laparoscópica. Método Neste Ensaio Clínico Randomizado (ECR), controlado e duplo-cego, 40 pacientes submetidos à colectomia laparoscópica foram divididos em dois grupos (20 pacientes em cada grupo) para receberem antibiótico ou solução salina normal. Dor pós-operatória, necessidade de analgésico, contagem de leucócitos, nível de proteína C-reativa, tempo de internação e infecção da ferida foram comparados entre os grupos em 30 dias. Resultados De forma significativa, o Grupo Antibiótico apresentou menos dor que o Grupo Salina Normal (p < 0,05) em 3, 6, 12 e 24 horas após a cirurgia. O nível de proteína C-reativa, a contagem de leucócitos, o uso de analgésicos e o tempo de internação foram significativamente menores no Grupo Antibiótico. Porém, não houve diferença em relação à infecção da ferida ou intra-abdominal entre os dois grupos. Conclusão O uso da lavagem peritoneal com gentamicina-clindamicina ajuda a reduzir a dor, a necessidade de analgésicos e o tempo de internação de pacientes submetidos à colectomia laparoscópica.

Anal position index; can it predict pelvic organ disorders in adults? / O índice de posição anal pode prever doenças de órgãos pélvicos em adultos?

ABSTRACT Introduction: Anal position index is calculated with a simple formula, which is used to determine the exact position of anus in perineum. This index is currently used only in neonates and infants. Anteriorly displacement of anus is a common cause of chronic constipation. Here we assessed the association between anal position index with patients' characteristics, chronic constipation, rectum prolapse uterine prolapse, and number of delivery. Material and methods: This was a cross-sectional study performed in 2018 on 63 adult admitted to colorectal surgery clinic. Anus-forchuette, coccyx-forchuette and coccyx-scrotum and anal-scrotum were measure by a simple meter tape. Statistical Package for the Social Sciences (SPSS for Windows, ver. 18) was used for data analysis. Independent Student's t-test, correlation coefficient and ANOVA were used. Results: Sixty-three patients within age range of 22-75 years old were recruited. 48 were male (76.2%) and 15 females (23.8%). Twenty-nine (46%) had chronic constipation. The mean ± SD of the index with confidence interval of 95% was 0.5325 ± 0.11861 in males and 0.4510 ± 0.16803 in females. Also the mean of the index was 0.4616 ± 0.14007 in patients with chronic constipation and 0.5570 ± 0.11559 in patients without constipation. Discussion: Anal position index can be a prognostic factor to predict chronic constipation and pelvic floor anatomy disturbance in adults as well as pediatrics.

RESUMO Introdução: O índice de posição anal é calculado com uma fórmula simples, usada para determinar a posição exata do ânus no períneo. Atualmente, esse índice é usado apenas em neonatos e bebês. O deslocamento anterior do ânus é uma causa comum de constipação crônica. No presente estudo, avaliou-se a associação entre o índice de posição anal e as características dos pacientes, constipação crônica, prolapso uterino, prolapso do reto e número de partos. Material e Métodos: Este estudo transversal, realizado em 2018, incluiu 63 adultos admitidos na clínica de cirurgia colorretal. As distâncias ânus-frênulo dos lábios, cóccix-frênulo, cóccix-escroto e ânus-escroto foram medidas com uma fita métrica simples. O SPSS for Windows (v. 18) foi usado para análise dos dados. O teste t de Student para variáveis independentes, o coeficiente de correlação e o teste ANOVA foram usados. Resultados: Sessenta e três pacientes com idade entre 22 a 75 anos foram recrutados; 48 eram do sexo masculino (76,2%) e 15 do sexo feminino (23,8%). Destes, 29 (46%) apresentavam constipação crônica. A média ± DP do índice, com intervalo de confiança de 95%, foi de 0,5325 ± 0,11861 no sexo masculino e 0,4510 ± 0,16803 no sexo feminino. Além disso, a média do índice foi de 0,4616 ± 0,14007 em pacientes com constipação crônica e 0,5570 ± 0,11559 em pacientes sem constipação. Discussão: O índice de posição anal pode ser um fator prognóstico para predizer constipação crônica e alterações da anatomia do assoalho pélvico em pacientes adultos e pediátricos.