Cross-sectional Ct distributions from qPCR tests can provide an early warning signal for the spread of COVID-19 in communities.

Background: SARS-CoV-2 PCR testing data has been widely used for COVID-19 surveillance. Existing COVID-19 forecasting models mainly rely on case counts obtained from qPCR results, even though the binary PCR results provide a limited picture of the pandemic trajectory. Most forecasting models have failed to accurately predict the COVID-19 waves before they occur. Recently a model utilizing cross-sectional population cycle threshold (Ct-the number of cycles required for the fluorescent signal to cross the background threshold) values obtained from PCR tests (Ct-based model) was developed to overcome the limitations of using only binary PCR results. In this study, we aimed to improve on COVID-19 forecasting models using features derived from the Ct-based model, to detect epidemic waves earlier than case-based trajectories. Methods: PCR data was collected weekly at Northeastern University (NU) between August 2020 and January 2022. Campus and county epidemic trajectories were generated from case counts. A novel forecasting approach was developed by enhancing a recent deep learning model with Ct-based features and applied in Suffolk County and NU campus. For this, cross-sectional Ct values from PCR data were used to generate Ct-based epidemic trajectories, including effective reproductive rate (Rt) and incidence. The improvement in forecasting performance was compared using absolute errors and residual squared errors with respect to actual observed cases at the 7-day and 14-day forecasting horizons. The model was also tested prospectively over the period January 2022 to April 2022. Results: Rt curves estimated from the Ct-based model indicated epidemic waves 12 to 14 days earlier than Rt curves from NU campus and Suffolk County cases, with a correlation of 0.57. Enhancing the forecasting models with Ct-based information significantly decreased absolute error (decrease of 49.4 and 221.5 for the 7 and 14-day forecasting horizons) and residual squared error (40.6 and 217.1 for the 7 and 14-day forecasting horizons) compared to the original model without Ct features. Conclusion: Ct-based epidemic trajectories can herald an earlier signal for impending epidemic waves in the community and forecast transmission peaks. Moreover, COVID-19 forecasting models can be enhanced using these Ct features to improve their forecasting accuracy. In this study, we make the case that public health agencies should publish Ct values along with the binary positive/negative PCR results. Early and accurate forecasting of epidemic waves can inform public health policies and countermeasures which can mitigate spread.

College students' attitude toward menu labeling differs by sex, BMI, weight management status, and athletic type.

Objective Determine students' attitude toward menu labeling before and after menu labeling implementation at university dining facility. Participants: College students aged 18 years and older eating at campus dining facility. Methods: Survey on attitude toward menu labeling, weight management status, and athletic classification (NCAA, recreational, or non-athlete) was completed 30 days pre- and post-menu labeling implementation. Results: Females showed stronger positive attitude toward menu labeling. Students trying to lose or gain weight had stronger positive attitudes toward menu labeling than students maintaining weight, as did overweight students compared to normal weight students. NCAA athletes had lower attitude mean scores toward menu labeling than other athletic classifications. Conclusion: Attitude toward menu labeling varies by students' gender, body mass index (BMI), and weight management focus, with NCAA athletes having the least positive attitude. Focus future research on effective ways to inform students on menu labeling in university dining facilities in order to nutritionally engage young adults.

Conjunctival flap with auricular cartilage grafting: a modified Hughes procedure for large full thickness upper and lower eyelid defect reconstruction.

AIM: To investigate the suitability of a modified Hughes procedure, which consists of conjunctival flap with auricular cartilage grafting in reconstructing large full thickness upper and lower eyelid defect. METHODS: Patients with full thickness eyelid carcinoma involving more than 50% margin length who underwent surgical resection were retrospectively reviewed in the study. The defects were reconstructed using conjunctival flap with auricular cartilage grafting, covered with myocutaneous flap above. Followed-up time ranged from 12 to 24mo. Outcomes were classified as "good", "fair", and "poor" by evaluating the margin appearance, eyelid appearance, and complications. RESULTS: A total of 42 patients were enrolled in the study (26 males, 16 females, mean age, 68.6±7.7y, range: 53 to 82y). The mean defect widths measured 23.2±2.9 mm (range, 17 to 28 mm). The mean posterior lamellar defect height was 5.5±1.3 mm (4 to 8 mm). Thirty-seven patients had a "good" outcome (88.1%), 5 patients had a "fair" outcome (11.9%), and no one had a "poor" outcome. CONCLUSION: Conjunctival flap with auricular cartilage grafting and myocutaneous flap grafting is an effective procedure in reconstructing large full thickness upper and lower eyelid defect. It can not only achieve satisfied reconstruction, but also preserve intact tarsal plate of the opposite eyelid, avoiding retraction or entropion.

Improved Eyelid Muscle Tension Balance With Refined Frontalis Muscle Flap Suspension in the Treatment of Severe Ptosis.

BACKGROUND: The tension balance of the upper eyelid following ptosis repair is crucial to a successful postoperative outcome. To improve on existing surgical techniques, the authors developed a new refined frontalis muscle flap suspension (FMFS) for severe ptosis repair and explored the balancing effect between the orbicularis muscle and frontalis muscle following surgery. METHODS: Forty-three patients (47 eyes) with a mean age of 6.07 ± 2.55 years old were diagnosed with severe congenital ptosis and underwent refined FMFS with complete orbicularis preservation between January 1, 2010 and December 31, 2017 in the Wenzhou Eye Hospital, Wenzhou, China. The outcomes measured include upper eyelid margin reflex distance (MRD1), degree of lagophthalmos, and cosmetic outcome (lash angle, eyelid contour, and crease). Surgical complications were also recorded. RESULTS: The preoperative mean MRD1 was -1.29 ± 0.88 mm and preoperative levator function was 1.87 ± 0.82 mm (ranged from 0 to 3.0 mm). Following surgery, lagophthalmos was observed in all cases in the first week with a mean palpebral fissure height of 1.68 ± 0.40 mm and diminished over 3 months. The MRD1 improved to +3.04 ± 0.68 mm at 6 months following surgery. All cases showed excellent cosmetic outcomes. There were no significant complications. CONCLUSION: The refined FMFS is a safe and reliable surgery in treating severe ptosis. The eye-closing power of the intact orbicularis muscle is sufficient at countering the lifting power of the frontalis muscle suspension, achieving a balanced blink mechanism and eyelid closure.

A New Preoperative Upright Design for Dermatochalasis Correction.

BACKGROUND: Conventional assessment of the height of upper eyelid skin excision in dermatochalasis correction is performed with patient's eyes closed in supine position. It is not able to consider the effects of gravity on the upper eyelid, thus may lead to asymmetric postoperative appearance. The authors herein report a novel preoperative upright design (PUD) that can accurately determine the amount of skin excision with patients' eyes open in dermatochalasis correction. METHODS: Patients with dermatochalasis underwent PUD during blepharoplasty were enrolled and were followed-up for 9 to 15 months. RESULTS: A total of 116 patients (mean age 55.1 ±â€Š6.1 years, range 46-78 years) successfully underwent the surgery. Using the PUD, the vertical height of skin excision was 8.2 ±â€Š2.4 mm (6-19 mm), the preoperative margin fold distance was -0.5 ±â€Š1.0 mm (-4 - 1 mm), which improved to 2.1 ±â€Š0.6 mm (1-3 mm, P < 0.05) at the last follow-up visit. A total of 107 of 116 patients (92.2%) were judged as "good" (natural double eyelid folds with symmetric margin fold distance), 9 patients (7.8%) were judged as "fair" (natural double eyelid folds with the differences of margin fold distance between fellow eyelids within 2 mm), and no one was judged as "poor" (unsmooth double eyelid folds or the differences of margin fold distance between fellow eyelids is more than 2 mm). CONCLUSION: Preoperative upright design is a simple and effective method to accurately determine the amount of skin excision in blepharoplasty, and help to achieve symmetric double eyelids.

Orbicularis Oculi Muscle Flap Rotation for Correction of Sunken Eyelid in Cosmetic Blepharoplasty.

BACKGROUND: Attempting traditional cosmetic blepharoplasty in a sunken eyelid may cause complications such as multiple folds, irregular or high placement of fold. Additional surgical procedures, such as orbital fat repositioning or free fat grafting, are introduced to correct the sunken appearance. The study sought to introduce a novel orbicularis oculi muscle flap (OOMF) rotation procedure for the correction of the sunken eyelid during blepharoplasty. METHODS: Retrospective chart review was performed on patients who presented with sunken eyelid(s) and underwent cosmetic blepharoplasty. All patients underwent OOMF rotation to fill the sunken area during blepharoplasty. Postoperative follow-up ranged from 12 to 15 months - the esthetic outcome and complication rates were recorded at each visit. RESULTS: The sunken appearances of eyelids were improved, and smooth double eyelid folds were achieved in all 62 patients (62 females, mean age 24.1±5.2 years, range: 19-34 years). The mean sunken depths were measured as 6.5 ± 1.0 mm (range: 5-9 mm) preoperatively, and were improved to 4.2 ± 0.9 mm (range: 3-6 mm) at the last follow-up visit (P<0.05). At the last follow-up visit, patients rated the surgical result as good in 88.7% (satisfied with the appearance improvement, n=55), fair in 11.3% (mild complaints about the surgical outcome, n=7), and poor in 0 of cases (unsatisfied with the surgical outcome, n=0). CONCLUSIONS: In selected patients with sunken eyelid who seek cosmetic blepharoplasty, the OOMF rotation offers a simple and effective way to fill the sunken area and help to form beautiful double eyelids.

Tumescent Liposuction Combined with Power-Assisted Dermal Curettage Through Small Incisions for Axillary Osmidrosis.

BACKGROUND: Osmidrosis is a troublesome disease characterized by excessive bodily malodor. Invasive surgical treatments have proven effective and permanent in treating this disease. This study sets out to evaluate the effect of tumescent liposuction with power-assisted dermal curettage for the treatment of axillary osmidrosis. METHODS: Twenty-eight patients with axillary osmidrosis (56 axillae) were treated with tumescent liposuction and power-assisted dermal curettage between January 2016 and May 2019. Patients were followed up and evaluated using survey questionnaire at least 3 months after the procedure. RESULTS: Twenty-four (85.7%) patients responded excellent for malodor elimination, 4 (14.3%) patients evaluated it as good and no patients evaluated it as fair or poor. One patient reported mild pigmentation in the axilla after the procedure. No recurrence and no serious side effects were reported. CONCLUSION: Tumescent liposuction with power-assisted dermal curettage is a safe and effective surgical treatment of axillary osmidrosis with high patient satisfaction, rapid recovery time and minimal complications or recurrences. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Food insecurity is associated with disordered eating behaviors in NCAA division 1 male collegiate athletes.

Objective: To assess the relationship of high school and collegiate household food security to current disordered food consumption behaviors in a sample of NCAA Division 1 male, collegiate athletes. Participants: Male athletes, 18 years and older from a Southeastern Conference university in August-September 2016. Methods: Cross-sectional survey including food security disordered eating behavior, and food hoarding questions. Results: Among participants (n = 111), high school food insecurity was significantly correlated with a preoccupation with food, but not binge eating in college. Collegiate food insecurity was significantly correlated with a preoccupation with, and hoarding of, food in college. Conclusions: Among male collegiate athletes, both high school and collegiate food insecurity are associated with preoccupation with food, and collegiate food insecurity is associated with food hoarding. Screening for both high school and collegiate food insecurity and disordered behaviors in athletes is warranted. Future research in a larger sample, including females, across institutions is warranted.

Integrated and Stepwise Epicanthoplasty Combined with Blepharoplasty (ISEB) in an Ethnic Chinese Population.

PURPOSE: To evaluate the efficacy of the integrated and stepwise epicanthoplasty combined with blepharoplasty (ISEB) technique in an ethnic Asian population. METHOD: The medical records of patients who underwent ISEB at the Eye Hospital of Wenzhou Medical University over a period of 36 months were retrospectively reviewed. RESULTS: A total of 104 patients (208 eyelids) were included in this study with ages ranging from 16 to 36 years old (mean 21.2 ± 2.8 years) and follow-up duration ranging from 6 months to 26 months (mean 9.7 ± 4.1 months). All patients achieved cosmetically desirable and natural appearances with adequate lacrimal caruncle exposure and horizontal lengthening of palpebral fissure. At the 6-month follow-up, there was no or minimal visible scarring in the medial canthal region. Postoperative evaluation at least 6 months following surgery showed that 98.1% (102/104) of patients felt that their surgical results were good or excellent. No recurrences of the epicanthal fold or disturbances of lacrimal function occurred throughout the follow-up period. CONCLUSION: The ISEB is a novel surgical technique that is effective in dealing with vector forces during epicanthoplasty in combination with blepharoplasty and has been shown to be a practical and reliable method with good aesthetic outcomes. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Incidence and Risk Factors of New Onset Endotheliitis After Cataract Surgery.

Purpose: The purpose of this study was to report the characteristics of new-onset endotheliitis after cataract surgery and to identify contributing risk factors. Methods: In this single-center study, we retrospectively reviewed the clinical records of all patients who underwent uneventful cataract surgery in the Eye Hospital of Wenzhou Medical University between January 2015 and December 2016. Postoperative endotheliitis cases were identified by screening of keywords and individually verified by a cornea specialist. Endotheliitis rates and 95% confidence intervals (CI) were calculated. Cox proportional hazard regression analysis was used to investigate the association between endotheliitis and associated factors. Results: A total of 20,743 cataract surgeries were performed. Fifty-nine eyes developed endotheliitis after cataract surgery, with an incidence of 0.28%. The mean interval between surgery and first record of endotheliitis was 24.51 ± 9.50 days (range, 5 to 45 days); 45 (76.27%) cases of endotheliitis developed within 30 days. The multiadjusted hazard ratio (HR) associated with increased risk of endotheliitis was 16.1 (95% CI, 3.9 to 66.9; P < 0.001) for patients 76 years of age or older and 10.2 (95% CI, 2.4 to 43.2; P = 0.002) for those 66 to 75 years of age compared with those 65 years of age or younger. Endotheliitis was also associated with history of diabetes mellitus (HR, 1.9; 95% CI, 1.1 to 3.2; P = 0.026). Conclusions: This study found the incidence of endotheliitis after cataract surgery to be 0.28%. Diabetes mellitus and old age are major risk factors for developing endotheliitis.

Utilisation of a Novel Test to Measure Severity and Treatment Efficacy of Posterior Blepharitis.

Background. This study evaluated the effectiveness of managing posterior blepharitis (PB) using a novel Posterior Blepharitis Management Protocol (PBMP). Design. Prospective, consecutive case series with 100% followup to one month. Participants. 27 patients (54 eyes) with PB from an Ophthalmology practice in Sydney, Australia. Methods. Each patient's PB was assessed by grading the nature and expressibility of the central lower lid tarsal gland secretions on Compression Of The Eyelid (COTE). Patients were then instructed in detail to undertake daily PB management sessions at home using our modified PBMP. Main Outcome Measures. On a subjective scale, patients compared their symptoms at one month with baseline. COTE scores were reevaluated to assess the objective effectiveness of each individual's PBMP. COTE scoring was described as grades 1 (clear oil), 2 (pus, liquid), 3 (toothpaste-like secretions), and 4 (complete tarsal gland obstruction). Results. Patients reported a mean 77.8% ± 13.5% subjective improvement in symptoms. There was a trend towards improvement in COTE grading at one month compared with baseline: grades 1 (0 to 7.4%), 2a (22.2 to 16.6%), 2b (7.4 to 3.7%), 3 (18.5 to 27.7%), and 4 (51.8 to 44%). Conclusions. PBMP provided a rapid, inexpensive, simple, effective, and safe method of treating PB.

Intraocular pressure-lowering medications and long-term outcomes of selective laser trabeculoplasty.

BACKGROUND: To investigate the effects of current intraocular pressure-lowering medications on the efficacy of selective laser trabeculoplasty. DESIGN: Retrospective chart review of records from an urban glaucoma clinic in Sydney, Australia. PARTICIPANTS: Patients who received their first selective laser trabeculoplasty between 2002 and 2005 were studied (grouped from 0 to 3 according to the number of pre-selective laser trabeculoplasty medications, and followed for 5 years). Those with previous argon laser therapy, trabeculectomy or angle-closure were excluded. METHODS: Selective laser trabeculoplasty (Ellex) used to deliver 180 or 360 degree of treatment, under the same protocol. MAIN OUTCOME MEASURES: Responders were defined by ≥20% reduction from baseline intraocular pressure. Data were censored when pressure-lowering intervention was required. The mean intraocular pressure, survivor, response rate, number and type of medications were compared. RESULTS: There were 206 patients with ocular hypertension, primary, pseudo-exfoliation, or pigmentary glaucoma who used none (n = 20), one (n = 33), two (n = 61) or three or more (n = 92) pre-selective laser trabeculoplasty topical anti-glaucoma medications. The mean baseline intraocular pressures for each group was 23.7, 22.2, 20.7 and 20.4 mmHg, respectively (P = 0.061). Post-treatment mean intraocular pressure was 17.9, 17.7, 15.5, and 15.7 mmHg; percentage reduction was similar between groups (23.6-25.6%, P = 0.20). Kaplan-Meier survival analysis showed comparable survival rates across groups (P = 0.445). At 60 months, 11.1, 17.1, 30.5 and 11.5% of responders remained in each group. Higher proportions of patients in groups 2 and 3 required further laser or surgery. CONCLUSION: The number of pre-selective laser trabeculoplasty medications did not affect the intraocular pressure-lowering effectiveness of selective laser trabeculoplasty; however, groups on more medications required more pressure-lowering interventions.

Comparison of computer-integrated patient-controlled epidural analgesia with no initial basal infusion versus moderate basal infusion for labor and delivery: A randomized controlled trial.

BACKGROUND AND AIMS: Computer-integrated patient-controlled epidural analgesia (CIPCEA) is a novel epidural drug delivery system. It automatically adjusts the basal infusion based on the individual's need for analgesia as labor progresses. MATERIALS AND METHODS: This study compared the time-weighted local anesthetic (LA) consumption by comparing parturients using CIPCEA with no initial basal infusion (CIPCEA0) with CIPCEA with initial moderate basal infusion of 5 ml/H (CIPCEA5). We recruited 76 subjects after ethics approval. The computer integration of CIPCEA titrate the basal infusion to 5, 10, 15, or 20 ml/H if the parturient required respectively, one, two, three, or four patient demands in the previous hour. The basal infusion reduced by 5 ml/H if there was no demand in the previous hour. The sample size was calculated to show equivalence in LA consumption. RESULTS: The time-weighted LA consumption between both groups were similar with CIPCEA0 group (mean [standard deviation (SD)] 8.9 [3.5] mg/H) compared to the CIPCEA5 group (mean [SD] 9.9 [3.5] mg/H), P = 0.080. Both groups had a similar incidence of breakthrough pain, duration of the second stage, mode of delivery, and patient satisfaction. However, more subjects in the CIPCEA0 group required patient self-bolus. There were no differences in fetal outcomes. DISCUSSION: Both CIPCEA regimens had similar time-weighted LA consumption and initial moderate basal infusion with CIPCEA may not be required.

Non-traumatic subperiosteal orbital hemorrhage secondary to barotrauma.

PURPOSE: To report a case of non-traumatic subperiosteal hemorrhage (NTSOH) secondary to barotrauma. MATERIAL AND METHODS: Observational case report. RESULTS: A 42-year-old female presented with right proptosis with bilateral petechial lid hemorrhages, chemosis and diplopia following scuba diving. This occurred in the context of a tight facemask resulting in 'mask squeeze', and performance of Valsalva maneuver to equalize ear pressure. Clinically, there were no signs of optic nerve involvement. Computed tomography (CT) demonstrated signs consistent with right subperiosteal hematoma adjacent to the orbital roof with inferolateral displacement of the superior rectus. Patient recovered well after being admitted for intravenous dexamethasone without surgical intervention. CONCLUSION: NTSOH from barotrauma can result from 'mask squeeze' under a tight-fitting mask and exacerbated by use of Valsalva maneuvers. This may be prevented with frequent pressure equalization during diving.

Orbital gastrointestinal stromal tumor metastasis.

PURPOSE: To report an uncommon case of orbital gastrointestinal stromal tumor (GIST) metastasis. MATERIAL AND METHODS: Observational case report. RESULTS: A 65-year-old woman with metastatic GIST involving the left orbit with a history of two separate GIST nodules involving the stomach 6 years earlier. Computed tomography (CT) scan demonstrated a well-circumscribed enhancing lesion confined to the anterior orbit. Histopathology analysis of the tumor showed predominantly spindle cells with focal epithelioid forms. It also stained positive for c-KIT (CD117) on immunochemistry, confirming the diagnosis. Additional medical treatment was not required, and the patient was followed up regularly for disease recurrence. CONCLUSION: GISTs typically occur as sporadic solitary tumors. In malignant cases, it usually metastasizes to the liver or other intraabdominal sites. Orbital involvement is extremely rare. This is the first case of metastatic GIST involving the anterior orbit with histopathological and immunochemical confirmation.

A randomised trial of the analgesic efficacy of ultrasound-guided transversus abdominis plane block after caesarean delivery under general anaesthesia.

CONTEXT: Previous studies examining the efficacy of transversus abdominis plane block after caesarean section have mostly been in parturients under spinal anaesthesia. OBJECTIVES: We postulated that the advantage of performing transversus abdominis plane block after caesarean section might be even more obvious after general anaesthesia, resulting in reduced 24-h consumption of morphine. DESIGN, SETTING, PATIENTS AND INTERVENTIONS: In this single centre, randomised double-blind controlled trial, 40 women who underwent caesarean delivery under general anaesthesia were allocated randomly to receive a transversus abdominis plane block or no block. In those who received the block, 20 ml of levobupivacaine 2.5 mg ml was deposited bilaterally into the transversus abdominis plane under ultrasound guidance using a Sonosite Titan (SonoSite, Bothell, Washington, USA) 7-13 MHz linear transducer at the end of surgery when the patient was still anaesthetised. MAIN OUTCOME MEASURES: We recorded patient-controlled intravenous morphine use for 24 h, pain scores at rest and activity, sedation, nausea and vomiting, use of antiemetic medication and overall maternal satisfaction. The primary outcome was 24-h morphine consumption. RESULTS: Patients who received the transversus abdominis plane block used significantly less morphine in 24 h than those in the control group [12.3 (2.6) vs. 31.4 mg (3.1), P<0.001) and had higher satisfaction scores [16 (80%) vs. 5 (25%), P = 0.012). There were no differences between groups in the visual analogue pain scores, sedation level, nausea and vomiting or the use of antiemetic medication. CONCLUSION: Ultrasound-guided transversus abdominis plane block reduced morphine consumption following caesarean section under general anaesthesia, with increased maternal satisfaction.

Management of portal venous complications after liver transplantation.

The postoperative vascular complications following liver transplantation, specifically portal venous complications, have been well documented. These complications, which include portal venous stenosis and thrombosis, can be potentially devastating and lead to graft failure. The interventional techniques in managing these complications are relatively new and have been developed only in the past 15 to 20 years. Additionally with the increasing numbers of split liver and living related transplants that are being performed, so has the incidence of portal venous complications increased. This article is a review of the current interventional techniques used in managing portal venous complications in the posttransplant patient. The topics covered include portal vein angioplasty, stenting, and thrombolysis with a description of the variety of techniques used to perform these procedures. The review also covers management of portal hypertension by creating a transjugular intrahepatic portosystemic shunt (TIPS).

Past and present course of cardioprotection against ischemia-reperfusion injury.

Despite tremendous advances in cardiovascular research and clinical therapy, ischemic heart disease remains the leading cause of serious morbidity and mortality in western society and is growing in developing countries. For the past 5 decades, many scientists have studied the pathophysiology of myocardial ischemia-reperfusion (I/R) injury leading to infarction. With the exception of reperfusion therapy, attempts to salvage the myocardium during an acute myocardial infarction showed disappointing results in directly decreasing infarct size. Nevertheless, the phenomena of ischemic preconditioning and ischemic postconditioning show a consistent and robust cardioprotective effect in every used experimental animal model. As a result, many studies have focused on the intracellular protective signaling pathways that are involved in preconditioning and postconditioning. More recently, it has been suggested that components of the reperfusion injury salvage kinases pathway, protein kinase B, and the extracellular signal-regulated kinases can induce cardioprotection against I/R injury when they are activated during the postischemic reperfusion period. In addition, inhibition of mitochondrial permeability transition during postischemic reperfusion also shows a strong cardioprotective effect against I/R injury. The present mini-review highlights a short summary of the historical and present course of research into cardioprotection against myocardial I/R injury.

Robot-assisted versus open radical prostatectomy: a comparison of one surgeon's outcomes.

OBJECTIVES: To compare internally one surgeon's standard open radical prostatectomy (RP) and robot-assisted laparoscopic RP (RLP) results. RLP, like standard laparoscopic RP, ultimately needs to produce similar or improved results compared with standard RP techniques. Little information comparing RLP with standard RP exists. METHODS: As an internal control, we selected the last 60 standard RPs performed by one surgeon (T.A.) before initiating RLPs. For the RLP group, we selected cases 46 to 105 (n = 60) after the learning curve had adequately matured. We compared the clinical characteristics, perioperative results, and early clinical outcomes. RESULTS: The study and control groups had similar clinical characteristics (age, body size, preoperative prostate-specific antigen level, clinical stage, and Gleason score). No statistically significant differences were found between groups for prostate size, pT stage, Gleason score, or margin status (16.7% versus 20%; P = nonsignificant). The RLP group had a statistically significant advantage for estimated blood loss (103 versus 418 mL), postoperative hemoglobin change (1.6 versus 3.3 mg/dL), and hospital stay (1.02 versus 2.2 days). Complete continence (0 pads) at 3 months of follow-up and the rate of postoperative complications were similar for the RLP and RP groups (76% versus 75% and 6.7% versus 10%, respectively). CONCLUSIONS: We present the results of RLP and RP performed by one surgeon. With only a 100-case experience, RLP had oncologic and urinary outcomes that were at least equal to those after RP. RLP offers the benefits of minimally invasive surgery and does not compromise clinical or pathologic outcomes.