Pre-operative factors associated with short- and long-term outcomes in the patient with inguinal hernia: What does the current evidence say?

Hernia repair is one of the most frequent interventions in surgery worldwide. The approach to abdominal wall and inguinal hernias remains a challenge due to emerging evidence on aspects such as timely diagnosis, use of innovative techniques or post-surgical care. However, pre-operative preparation is also a factor that substantially affects the absolute success rate of this type of condition. Time management between diagnosis and intervention, control of diseases that increase intra-abdominal pressure, weight and nutritional status, are some of the many elements to be considered in this type of patients before surgery. Considering that this condition carries high health care costs, especially in case of recurrence, has a risk of complications and affects the individual's functional capacity, the objective of this review is to synthesize evidence on the role of these factors on the short- and long-term outcome of inguinal hernia management, and to make suggestions on the general approach to this type of patients.

CFD study of the water production in mature heavy oil fields with horizontal wells.

Excessive water production in mature heavy oil fields causes incremental costs, energy consumption, and inefficiency. Understanding multiphase flows near the wellbore is an alternative to improve production efficiency. Therefore, this study conducts a series of numerical experiments based on the full set of the Navier-Stokes equations in 3D to simulate multiphase flows in porous media for heavy oil production horizontal wells. The solution given by this advanced mathematical formulation led to the description of the movement of the fluids near the wellbore with unprecedented detail. A sensitivity analysis was conducted on different rock and fluid properties such as permeability and oil viscosity, assuming homogeneous porous media. The influence of these parameters on the prediction of the breakthrough time, aquifer movement, and the severity of water production was noticed. Finally, the numerical model was verified against field data using two approaches. The first one was conducting a history match assuming homogeneous rock properties. In contrast, the second one used heterogeneous rock properties measured from well logging, achieving a lower deviation than field data, about 20%. The homogeneous numerical experiments showed that the breakthrough occurs at the heel with a subsequent crestation along the horizontal well. Moreover, at adverse mobility ratios, excessive water production tends to happen in water connings at the heel with an inflow area less than 1% of the total inflow area of the completion liner. Different aquifer movement dynamics were found for the heterogeneous case, like the breakthrough through multiple locations along the horizontal well. Finally, critical hydraulic data in the well, such as the pressure and velocity profiles, were obtained, which could be used to improve production efficiency. The numerical model presented in this study is proposed as an alternative to conducting subsurface modeling and well designs.

Experimental and computational advances on the study of Viscous Fingering: An umbrella review.

During the production of heavy oil reservoirs, the movement of the fluids, namely oil and water, significantly affects the production rates. This movement is influenced by the mobility ratio and directly affects variables such as The Water-Oil-Ratio (WOR), production costs, and recovery factor (RF). Moreover, Viscous Fingering, a phenomenon that describes the fluid movement through porous media, has been identified as the root cause of high-water production rates. Studying and comprehending this phenomenon is necessary to understand Oil & Gas companies' challenges nowadays to produce heavy oil. For example, this phenomenon has a direct impact on the assets managed by Enhanced Oil Recovery Techniques (EOR) that involves the injection of fluids such as polymer, water, and CO2 flooding, SAGD, VAPEX, CSP and ECSP, among others. Due to its importance, this paper review and highlights the main computational and experimental studies for over more than 30 years (from the late 1980s) about Viscous Fingering, especially in the oil industry. Also, the need for further studies involving the newest experimental and computational technologies and new novel methodologies for the comprehension of Viscous Fingering is discussed. This review aims to give an overview of the technological developments in the study of Viscous Fingering, not only to understand it but also to illustrate how scientists have been developing new technologies to overcome the consequences caused by this phenomenon.

Carbonic anhydrase IX and hypoxia-inducible factor 1 attenuate cardiac dysfunction after myocardial infarction.

Myocardial infarction (MI) is one of the leading causes of death worldwide. Prognosis and mortality rate are directly related to infarct size and post-infarction pathological heart remodeling, which can lead to heart failure. Hypoxic MI-affected areas increase the expression of hypoxia-inducible factor (HIF-1), inducing infarct size reduction and improving cardiac function. Hypoxia translocates HIF-1 to the nucleus, activating carbonic anhydrase IX (CAIX) transcription. CAIX regulates myocardial intracellular pH, critical for heart performance. Our objective was to investigate CAIX participation and relation with sodium bicarbonate transporters 1 (NBC1) and HIF-1 in cardiac remodeling after MI. We analyzed this pathway in an "in vivo" rat coronary artery ligation model and isolated cardiomyocytes maintained under hypoxia. Immunohistochemical studies revealed an increase in HIF-1 levels after 2 h of infarction. Similar results were observed in 2-h infarcted cardiac tissue (immunoblotting) and in hypoxic cardiomyocytes with a nuclear distribution (confocal microscopy). Immunohistochemical studies showed an increase CAIX in the infarcted area at 2 h, mainly distributed throughout the cell and localized in the plasma membrane at 24 h. Similar results were observed in 2 h in infarcted cardiac tissue (immunoblotting) and in hypoxic cardiomyocytes (confocal microscopy). NBC1 expression increased in cardiac tissue after 2 h of infarction (immunoblotting). CAIX and NBC1 interaction increases in cardiac tissue subjected to MI for 2h when CAIX is present (immunoprecipitation). These results suggest that CAIX interacts with NBC1 in our infarct model as a mechanism to prevent acidic damage in hypoxic tissue, making it a promising therapeutic target.

How Do Induced Affective States Bias Emotional Contagion to Faces? A Three-Dimensional Model.

Affective states can propagate in a group of people and influence their ability to judge others' affective states. In the present paper, we present a simple mathematical model to describe this process in a three-dimensional affective space. We obtained data from 67 participants randomly assigned to two experimental groups. Participants watched either an upsetting or uplifting video previously calibrated for this goal. Immediately, participants reported their baseline subjective affect in three dimensions: (1) positivity, (2) negativity, and (3) arousal. In a second phase, participants rated the affect they subjectively judged from 10 target angry faces and ten target happy faces in the same three-dimensional scales. These judgments were used as an index of participant's affective state after observing the faces. Participants' affective responses were subsequently mapped onto a simple three-dimensional model of emotional contagion, in which the shortest distance between the baseline self-reported affect and the target judgment was calculated. The results display a double dissociation: negatively induced participants show more emotional contagion to angry than happy faces, while positively induced participants show more emotional contagion to happy than angry faces. In sum, emotional contagion exerted by the videos selectively affected judgments of the affective state of others' faces. We discuss the directionality of emotional contagion to faces, considering whether negative emotions are more easily propagated than positive ones. Additionally, we comment on the lack of significant correlations between our model and standardized tests of empathy and emotional contagion.

Cardiac hypertrophy reduction in SHR by specific silencing of myocardial Na(+)/H(+) exchanger.

We examined the effect of specific and local silencing of sodium/hydrogen exchanger isoform 1 (NHE1) with a small hairpin RNA delivered by lentivirus (L-shNHE1) in the cardiac left ventricle (LV) wall of spontaneously hypertensive rats, to reduce cardiac hypertrophy. Thirty days after the lentivirus was injected, NHE1 protein expression was reduced 53.3 ± 3% in the LV of the L-shNHE1 compared with the control group injected with L-shSCR (NHE1 scrambled sequence), without affecting its expression in other organs, such as liver and lung. Hypertrophic parameters as LV weight-to-body weight and LV weight-to-tibia length ratio were significantly reduced in animals injected with L-shNHE1 (2.32 ± 0.5 and 19.30 ± 0.42 mg/mm, respectively) compared with L-shSCR-injected rats (2.68 ± 0.06 and 21.53 ± 0.64 mg/mm, respectively). Histochemical analysis demonstrated a reduction of cardiomyocytes cross-sectional area in animals treated with L-shNHE1 compared with L-shSCR (309,81 ± 20,86 vs. 424,52 ± 21 µm(2), P < 0.05). Echocardiography at the beginning and at the end of the treatment showed that shNHE1 expression for 30 days induced 9% reduction of LV mass. Also, animals treated with L-shNHE1 exhibited a reduced LV wall thickness without changing LV diastolic dimension and arterial pressure, indicating an increased parietal stress. In addition, midwall shortening was not modified, despite the increased wall tension, suggesting an improvement of cardiac function. Chronic shNHE1 expression in the heart emerges as a possible methodology to reduce pathological cardiac hypertrophy, avoiding potentially undesired effects caused from a body-wide inhibition of NHE1.

Conductas de prescripción de antibióticos presuntivos en pacientes con trauma penetrante abdominal y torácico en un centro especializado / Conducts of prescription of antibiotic presuntivos in patients with abdominal penetrating trauma and torácico in a center specialized

Objetivo: Evaluar las conductas de prescripción de antibióticos presuntivos en pacientes que sufren trauma torácico y abdominal en un centro especializado.Métodos: Estudio prospectivo tipo cohortePoblación: Pacientes mayores de 12 años que fueron atendidos por el servicio de cirugía general de la institución.Medición y variables: Los pacientes fueron seguidos por los investigadores diariamente durante su hospitalización y hasta 30 días después del alta, ya fuera por revisión clínica o por contacto telefónico, registrando en un formulario prediseñado las siguientes variables: fecha y hora de ingreso, edad, sexo, tiempo entre el trauma y la cirugía, mecanismo y localización anatómica del trauma, clasificación de ASA (American Society of Anestesia), presencia de shock al ingreso, hallazgos intraoperatorios, uso de antibiótico, tipo de antibiótico, dosis, intervalo de administración y duración de la terapia antibiótica, tiempo entre el trauma y la administración del antibiótico, momento de la administración del antibiótico con respecto a la cirugía, tiempo quirúrgico, uso de antibiótico intraoperatorio, complicaciones infecciosas y tiempo entre el trauma y la aparición de la complicación. La observación fue independiente del tratamiento de los pacientes, el cual era responsabilidad del cirujano tratante.Conclusiones: A pesar de la existencia de recomendaciones sobre el uso de antibióticos presuntivos en trauma basadas en la evidencia, la adherencia de los cirujanos a dichas recomendaciones es pobre. La variabilidad en el tipo de antibiótico, la dosis y la frecuencia de administración puede elevar los costos y la frecuencia de resistencia antibiótica. Es necesario establecer protocolos institucionales sobre el uso de estos medicamentos...