Facial-Aging Mobile Apps for Smoking Prevention in Secondary Schools in Brazil: Appearance-Focused Interventional Study.

BACKGROUND: Most smokers start smoking during their early adolescence, often with the idea that smoking is glamorous. Interventions that harness the broad availability of mobile phones as well as adolescents' interest in their appearance may be a novel way to improve school-based prevention. A recent study conducted in Germany showed promising results. However, the transfer to other cultural contexts, effects on different genders, and implementability remains unknown. OBJECTIVE: In this observational study, we aimed to test the perception and implementability of facial-aging apps to prevent smoking in secondary schools in Brazil in accordance with the theory of planned behavior and with respect to different genders. METHODS: We used a free facial-aging mobile phone app ("Smokerface") in three Brazilian secondary schools via a novel method called mirroring. The students' altered three-dimensional selfies on mobile phones or tablets and images were "mirrored" via a projector in front of their whole grade. Using an anonymous questionnaire, we then measured on a 5-point Likert scale the perceptions of the intervention among 306 Brazilian secondary school students of both genders in the seventh grade (average age 12.97 years). A second questionnaire captured perceptions of medical students who conducted the intervention and its conduction per protocol. RESULTS: The majority of students perceived the intervention as fun (304/306, 99.3%), claimed the intervention motivated them not to smoke (289/306, 94.4%), and stated that they learned new benefits of not smoking (300/306, 98.0%). Only a minority of students disagreed or fully disagreed that they learned new benefits of nonsmoking (4/306, 1.3%) or that they themselves were motivated not to smoke (5/306, 1.6%). All of the protocol was delivered by volunteer medical students. CONCLUSIONS: Our data indicate the potential for facial-aging interventions to reduce smoking prevalence in Brazilian secondary schools in accordance with the theory of planned behavior. Volunteer medical students enjoyed the intervention and are capable of complete implementation per protocol.

OPEN, LAPAROSCOPIC, AND ROBOTIC-ASSISTED HEPATECTOMY IN RESECTION OF LIVER TUMORS: A NON-SYSTEMATIC REVIEW.

INTRODUCTION: Several factors have made hepatectomy an increasingly safe surgery and new drugs allowed surgical treatment for patients who initially were not candidates for resection. Lesions often require resection, which can be performed by open, laparoscopic, or robotic assisted hepatectomy. AIM: Compare the surgical techniques in open, laparoscopic, and robotic assisted hepatectomy for resection of liver tumors. METHODS: Literature review based on scientific papers published on Lilacs/Pubmed/Scielo in the last 17 years regarding the indications of these techniques for liver tumor resections and on papers comparing such techniques. RESULTS: The comparative study shows the benefits of laparoscopic surgery over open surgery, such as smaller incisions, less postoperative pain, shorter recovery time, smaller immune and metabolic response, and quicker restoration of oral ingestion as well as lower morbidity rates. However, the need for a specialized surgical team and the reduction in handling area still remain as disadvantages in the laparoscopic technique. It is yet not clear whether robotic assistance presents considerable benefits over the laparoscopic technique considering that high acquisition and maintenance costs are limiting factors. CONCLUSION: Despite all challenges, laparoscopic hepatectomy presents many benefits over open surgery. The robotic assisted technique is still in evolution as many centers in the world perform hepatic resections with the platforms but only after a thorough patient selection. Thus, laparoscopy stands as the best option, unless there is some contraindication to the procedure.

Open, laparoscopic, and robotic-assisted hepatectomy in resection of liver tumors: a non-systematic review / Hepatectomia aberta, videolaparoscópica e assistida por robótica em ressecção de tumores hepáticos: uma revisão não sistemática

ABSTRACT Introduction: Several factors have made hepatectomy an increasingly safe surgery and new drugs allowed surgical treatment for patients who initially were not candidates for resection. Lesions often require resection, which can be performed by open, laparoscopic, or robotic assisted hepatectomy. Aim: Compare the surgical techniques in open, laparoscopic, and robotic assisted hepatectomy for resection of liver tumors. Methods: Literature review based on scientific papers published on Lilacs/Pubmed/Scielo in the last 17 years regarding the indications of these techniques for liver tumor resections and on papers comparing such techniques. Results: The comparative study shows the benefits of laparoscopic surgery over open surgery, such as smaller incisions, less postoperative pain, shorter recovery time, smaller immune and metabolic response, and quicker restoration of oral ingestion as well as lower morbidity rates. However, the need for a specialized surgical team and the reduction in handling area still remain as disadvantages in the laparoscopic technique. It is yet not clear whether robotic assistance presents considerable benefits over the laparoscopic technique considering that high acquisition and maintenance costs are limiting factors. Conclusion: Despite all challenges, laparoscopic hepatectomy presents many benefits over open surgery. The robotic assisted technique is still in evolution as many centers in the world perform hepatic resections with the platforms but only after a thorough patient selection. Thus, laparoscopy stands as the best option, unless there is some contraindication to the procedure.

RESUMO Introdução: Nas últimas décadas, inúmeros fatores transformaram as hepatectomias em operações mais seguras. A quimioterapia, juntamente com novas drogas para o tratamento de metástases propiciaram melhores respostas, o que possibilitou a indicação cirúrgica em pacientes que inicialmente não eram candidatos a ela. Lesões hepáticas muitas vezes requerem ressecção, que pode ser realizada tanto por laparotomia, por videolaparoscopia ou assistida por plataforma robótica. Objetivo: Comparar as técnicas cirúrgicas para ressecção de tumores hepáticos. Métodos: Trata-se de revisão com base em artigos científicos publicados nos últimos anos, sobre as indicações dessas técnicas e em artigos que comparam-nas. A pesquisa foi realizada nas bases de dados Lilacs/Pubmed/Scielo. Resultados: O estudo evidenciou vantagens da videolaparoscopia sobre a laparotomia, tais como menores incisões, redução na dor pós-operatória, menor tempo de recuperação dos doentes, dentre outras. No entanto, a necessidade de equipe especializada e a restrição na manipulação da área, consistem, ainda, em desvantagens consideráveis da técnica laparoscópica. Atualmente, ainda não está claro se o auxílio robótico demonstra vantagem substancial sobre a técnica laparoscópica, sendo o alto custo de aquisição e manutenção importante fator limitante. Conclusão: Apesar dos obstáculos e desafios, a hepatectomia laparoscópica demonstra vantagens sobre a laparotômica. A técnica assistida por robótica ainda está em evolução, sendo poucos os centros no mundo que a realizam nas ressecções hepáticas. Dessa forma, indica-se a laparoscopia, a menos que haja alguma contraindicação para sua realização.