Colorectal procedures with the novel Hugo™ RAS system: training process and case series report from a non-robotic surgical team.

BACKGROUND: The landscape of robotic surgery is evolving with the emergence of new platforms. However, reports on their applicability in different surgical fields are still limited and come from teams with robotics experience. This study aims to describe the training process for colorectal surgery with the Hugo™ RAS system of a robotics-inexperienced surgical team and present the initial patient series. METHODS: The training process is depicted, and data from the first 10 consecutive patients operated on for colorectal conditions with the Hugo™ RAS system by a surgical team with no prior experience in robotic surgery were prospectively recorded and analysed. RESULTS: The team received intensive training in robotic surgery and specifically in the Hugo™ RAS system previously to the first case. Between May 2023 and December 2023, 10 patients underwent colorectal procedures: 5 right colectomies, 3 sigmoid resections, 1 high rectal resection and 1 ventral mesh rectopexy. The first case was proctored by an expert. Median docking time was 14 min and median total operative time was 185 min. The only technical difficulty during the procedures was occasional clashing of robotic arms. None had to be converted, and no intraoperative or postoperative morbidity was recorded. Hospital stays ranged from 2 to 4 days. A median of 21 lymph nodes were yielded in the operations for malignant conditions. CONCLUSIONS: Common colorectal procedures can be safely performed using the Hugo™ RAS platform. Prior experience in robotic surgery is not a necessary requirement, but following a structured training program is essential.

Efectos beneficiosos de las antocianinas para la salud / Efeitos benéficos das antocianinas para a saúde / Beneficial effects of anthocyanins for health

Las antocianinas son polifenoles pertenecientes al grupo de los flavonoides que actúan como pigmentos en las flores, hojas o frutos de las plantas en las que se encuentran. Desde un punto de vista nutricional, las antocianinas son los flavonoides más abundantes en la dieta con interesantes propiedades antioxidantes. Además, la industria alimentaria y farmacéutica ha utilizado antocianinas como aditivos alimentarios o excipientes debido a sus propiedades colorantes. Sin embargo, más allá de sus efectos antioxidantes, las antocianinas también pueden actuar como agentes terapéuticos debido a sus propiedades neuroprotectoras, antidiabéticas y cardioprotectoras. A pesar del gran número de estudios in vitro y en animales en relación con la neuroprotección, la actividad antioxidante o los efectos sobre el sistema cardiovascular, el número de ensayos clínicos continúa siendo limitado. Se han realizado muy pocos estudios en humanos en áreas como SNC, cardioprotección o diabetes. Sin embargo, considerando los resultados alcanzados en los ensayos en humanos junto con las intervenciones en relación con el estrés oxidativo, así como los datos que muestran los efectos en los experimentos preclínicos, podemos sugerir que las antocianinas presentan un papel importante en la prevención y podrían contribuir al tratamiento de diversas patologías en las que el estrés oxidativo se encuentra como elemento subyacente. (AU)

As antocianinas são polifenóis pertencentes ao grupo dos flavonóides que atuam como pigmentos nas flores, folhas ou frutos das plantas em que se encontram. Do ponto de vista nutricional, são os flavonóides mais abundantes na dieta com interessantes propriedades antioxidantes. Além disso, a indústria alimentícia e farmacêutica tem utilizado antocianinas como aditivos ou excipientes alimentares devido às suas propriedades corantes. No entanto, além de seus efeitos antioxidantes, as antocianinas também podem atuar como agentes terapêuticos devido às suas propriedades neuroprotetoras, antidiabéticas e cardioprotetoras. Há evidências crescentes sugerindo o papel desses compostos em diferentes áreas. Apesar do grande número de estudos in vitro e em animais sobre neuroproteção, atividade antioxidante ou efeitos no sistema cardiovascular, o número de ensaios clínicos permanece limitado. Muito poucos estudos humanos foram realizados em áreas como SNC, cardioproteção ou diabetes. No entanto, considerando os resultados alcançados em testes em humanos juntamente com as intervenções em relação ao estresse oxidativo, bem como os dados que mostram os efeitos em experimentos pré-clínicos, podemos sugerir que as antocianinas têm um papel importante na prevenção e podem ter um papel importante na tratamento de diversas patologias em que se encontra o stress oxidativo como elemento subjacente. (AU)

Anthocyanins are polyphenols belonging to flavonoid group which act as pigments in plant flowers, fruits and leaves. From a nutritional point of view, anthocyanins arethe most common flavonoids in diet, showing interesting antioxidant properties. In addition, the food and pharma industry has used anthocyanins as food additives or excipients due to its coloring properties. However, beyond its antioxidant effects, anthocyanins may also act as therapeutic agents due to neuroprotective, antidiabetic and cardioprotective properties. Beside the great number of in vitro and animal studies related to neuroprotection, antioxidant activity or the effects on cardiovascular system, the number of clinicaltrials is still very limited. Very few human studies have been conducted in the CNS, cardioprotection or in the area of diabetes. However, considering all the results achieved in human trials together with interventions in relation to oxidative stress, as well as the data showing the effects in preclinical experiments, we can suggest that anthocyanins may play an important role in prevention and could also contribute to the treatment of various pathologies in which oxidative stress is found as an underlying element. (AU)

The role of anthocyanins as antidiabetic agents: from molecular mechanisms to in vivo and human studies.

Diabetes mellitus is a chronic metabolic disease characterized by high blood glucose concentration. Nowadays, type 2 diabetes or insulin resistant diabetes is the most common diabetes, mainly due to unhealthy lifestyle. Healthy habits like appropriate nutritional approaches or the consumption of certain natural products or food supplements have been suggested as non-pharmacological strategies for the treatment and prevention of type 2 diabetes. Some of the main bioactive compounds from plant foods are polyphenols, important mainly for their antioxidant capacity in oxidative stress conditions and ageing. Anthocyanins are polyphenols of the flavonoid group, which act as pigments in plants, especially in fruits such as berries. A search of in vitro, in vivo and human studies in relation with antidiabetic properties of anthocyanins has been performed in different electronic databases. Results of this review demonstrate that these compounds have the ability to inhibit different enzymes as well as to influence gene expression and metabolic pathways of glucose, such as AMPK, being able to modulate diabetes and other associated disorders, as hyperlipidaemia, overweight, obesity and cardiovascular diseases. Additionally, human interventional studies have shown that high doses of anthocyanins have potential in the prevention or treatment of type 2 diabetes; nevertheless, anthocyanins used in these studies should be standardized and quantified in order to make general conclusions about its use and to claim benefits for the human population.

Detection of Executive Performance Profiles Using the ENFEN Battery in Children Diagnosed With Attention-Deficit Hyperactivity Disorder.

Attention-deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children and adolescents. People who have this disorder are characterized by presenting difficulties in the processes of sustained attention, being very active, and having poor control of their impulses. Despite the high prevalence of this disorder and the existence of various tests used for its diagnosis, few data are available regarding the usefulness and diagnostic validity of these tools. Given the difficulties that these subjects present in executive functions, the aim of this study was to evaluate whether the Neuropsychological Assessment of Executive Functions battery for Children (ENFEN, for its acronym in Spanish, Portellano et al., 2009) allows to establish specific profiles of executive performance for people with attention-deficit hyperactivity disorder (ADHD). The sample was made up of 197 participants of both sexes, aged between 6 and 12 years age (134 with a clinical diagnosis and 63 without pathology). A nonexperimental design was followed, using a comparative descriptive study method. The results indicated that the scales of phonological fluency, color path, rings, and interference are the most associated with the diagnosis of ADHD, providing data on inhibition, mental flexibility, sustained and selective attention, planning, verbal fluency, and working memory, among others. The practical implication of these results is in line with providing support in the clinical diagnosis that is carried out in children's mental health units. In addition, the ENFEN tool can be valued as a suitable psychometric instrument in the psychoeducational field, helping professionals in a school environment to be more aware of the areas of cognitive development in which a student diagnosed with ADHD will have more difficulties and, in doing so, providing more adjusted and effective psychopedagogical measures when it comes to supporting students in their adaptation to the school environment.