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1.
Water Sci Technol ; 88(5): 1294-1316, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37771228

RESUMO

In this work, the electrochemical degradation of ciprofloxacin (CIP) was studied in a filter-press-type reactor without division in a batch recirculation manner. For this purpose, two boron-doped diamond (BDD) electrodes (as cathode and anode) were employed. Also, the optimal operating conditions were found by response surface methodology (RSM) following a central composite face-centered design with three factors, namely current intensity (i), initial pH (pH0), and initial concentration ([C]0) with two responses, namely remotion efficiency (η) and operating cost. Optimal operating conditions were i = 3 A, pH0 = 8.49, and [C]0 = 33.26 mg L-1 within an electrolysis time of 5 h, leading to a maximum removal efficiency of 93.49% with a minimum operating cost of $0.013 USD L-1. Also, a TOC analysis shows an 80% of mineralization extent with an energy consumption of 5.11 kWh g-1 TOC. Furthermore, the CIP degradation progress was followed by mass spectrometry (LC/MS) and a degradation pathway is proposed.


Assuntos
Ciprofloxacina , Poluentes Químicos da Água , Ciprofloxacina/química , Poluentes Químicos da Água/química , Oxirredução , Eletrólise/métodos , Diamante/química , Eletrodos
2.
Neuroimage ; 220: 117070, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-32599269

RESUMO

Automated methods that can identify white matter bundles from large tractography datasets have several applications in neuroscience research. In these applications, clustering algorithms have shown to play an important role in the analysis and visualization of white matter structure, generating useful data which can be the basis for further studies. This work proposes FFClust, an efficient fiber clustering method for large tractography datasets containing millions of fibers. Resulting clusters describe the whole set of main white matter fascicles present on an individual brain. The method aims to identify compact and homogeneous clusters, which enables several applications. In individuals, the clusters can be used to study the local connectivity in pathological brains, while at population level, the processing and analysis of reproducible bundles, and other post-processing algorithms can be carried out to study the brain connectivity and create new white matter bundle atlases. The proposed method was evaluated in terms of quality and execution time performance versus the state-of-the-art clustering techniques used in the area. Results show that FFClust is effective in the creation of compact clusters, with a low intra-cluster distance, while keeping a good quality Davies-Bouldin index, which is a metric that quantifies the quality of clustering approaches. Furthermore, it is about 8.6 times faster than the most efficient state-of-the-art method for one million fibers dataset. In addition, we show that FFClust is able to correctly identify atlas bundles connecting different brain regions, as an example of application and the utility of compact clusters.


Assuntos
Imagem de Tensor de Difusão/métodos , Rede Nervosa/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Análise por Conglomerados , Bases de Dados Factuais , Humanos , Processamento de Imagem Assistida por Computador/métodos , Fibras Nervosas Mielinizadas
3.
Fish Shellfish Immunol ; 84: 1083-1089, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30389645

RESUMO

The global aquaculture has shown an impressive growth in the last decades contributing with a major part of total food fish supply. However, it also helps in the spread of diseases that in turn, causes great economic losses. The White Spot Syndrome Virus (WSSV) is one of the major viral pathogen for the shrimp aquaculture industry. Several attempts to eliminate the virus in the shrimp have been addressed without achieving a long-term effectiveness. In this work, we determine the capacity of the commercial non-toxic PVP-coated silver nanoparticles to promote the response of the immune system of WSSV-infected shrimps with or without an excess of iron ions. Our results showed that a single dose of metallic silver in the nanomolar range (111 nmol/shrimp), which is equivalent to 12 ng/mL of silver nanoparticles, produces 20% survival of treated infected shrimps. The same concentration administered in healthy shrimps do not show histological evidence of damage. The observed survival rate could be associated with the increase of almost 2-fold of LGBP expression levels compared with non-treated infected shrimps. LGBP is a key gene of shrimp immunological response and its up-regulation is most probably induced by the recognition of silver nanoparticles coating by specific pathogen-associated molecular pattern recognition proteins (PAMPs) of shrimp. Increased LGBP expression levels was observed even with a 10-fold lower dose of silver nanoparticles (1.2 ng/shrimp, 0.011 nmol of metallic silver/shrimp). The increase in LGBP expression levels was also observed even in the presence of iron ion excess, a condition that favors virus proliferation. Those results showed that a single dose of a slight amount of silver nanoparticles were capable to enhance the response of shrimp immune system without toxic effects in healthy shrimps. This response could be enhanced by administration of other doses and might represent an important alternative for the treatment of a disease that has still no cure, white spot syndrome virus.


Assuntos
Nanopartículas Metálicas , Penaeidae/imunologia , Substâncias Protetoras/farmacologia , Prata/farmacologia , Vírus da Síndrome da Mancha Branca 1/fisiologia , Animais , Imunidade Inata , Longevidade , Penaeidae/virologia
4.
Nano Lett ; 18(5): 3199-3202, 2018 05 09.
Artigo em Inglês | MEDLINE | ID: mdl-29668289

RESUMO

This work presents the effect of large strains (up to 20%) on the behavior of magnetic nanowires (Ni80Fe20) deposited on a Kapton substrate. The multicracking phenomenon was followed by in situ tensile tests combined with atomic force microscopy measurements. These measurements show, on the one hand, a delay in crack initiation relative to the nonpatterned thin film and, on the other hand, a saturation of the length of the nanowire fragments. The latter makes it possible to retain the initial magnetic anisotropy measured after deformation by ferromagnetic resonance. In addition, the ferromagnetic resonance line profile (intensity, width) is minimally affected by the numerous cracks, which is explained by the small variation in magnetic anistropy and the low magnetostriction coefficient of Ni80Fe20.

5.
Cir Esp ; 95(8): 465-470, 2017 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-28918963

RESUMO

INTRODUCTION: Laparoscopic cholecystectomy is a common procedure in general surgery, and in complex cases it is important for the surgeon to know all the alternatives with low associated morbidity. Laparoscopic subtotal cholecystectomy should be considered as an option when a critical view of safety cannot be obtained, because it has a low complication rate and gives the advantages of minimally invasive surgery. METHODS: Retrospective study of laparoscopic subtotal cholecystectomies in an eight years period. RESULTS: A total of 1,059 laparoscopic cholecystectomies were performed; 22 were subtotal cholecystectomies, without conversion. Biliary fistula (9%) and intraabdominal collections (4.5%) were the most common complications described. No iatrogenic bile duct injuries or deaths were reported. Our follow-up period was 32months, no recurrences were reported. CONCLUSIONS: Laparoscopic subtotal cholecystectomy is a safe and effective procedure. It should be considered as an option in complex cases.


Assuntos
Colecistectomia Laparoscópica/métodos , Complicações Pós-Operatórias/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
6.
P R Health Sci J ; 33(2): 65-70, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24964640

RESUMO

OBJECTIVE: Colorectal cancer (CRC) is among the most common cancers in Puerto Rico. Few studies have correlated clinical and pathological variables with the overall survival of CRC patients in Puerto Rico. We report the clinical and pathological characteristics of patients who underwent surgical resection at a community hospital in Puerto Rico. METHODS: Demographic and pathological variables of patients who underwent CRC surgery at Hospital del Maestro from 2006 through 2011 were reviewed. Descriptive statistics (mean, range, and frequency) and the Cox proportional hazards model were used to determine the influence of demographic and pathological variables on survival, after adjusting for age. RESULTS: Two hundred and five CRC pathology reports were reviewed. Adenocarcinoma represented the most common pathology (202/205; 98.5%). Females represented 52% of the population (106/202) while males represented 48% (96/202). The median age was 71 years (30-96). The right colon was the most common site of presentation (49.7%; 100/201). Stage III was the most common stage at presentation. The presence of mucin, perineural or lymphatic invasion and tumor size were not related to decreased survival. Being male, having a higher stage at diagnosis, and having a moderately or poorly differentiated tumor were characteristics related to decreased survival. CONCLUSION: This study provides information on clinical and pathological variables and their influence on the overall survival of CRC patients at a community hospital in Puerto Rico. Further research must be performed to identify potential disparities and their influence on the prognosis of this patients.


Assuntos
Adenocarcinoma/patologia , Neoplasias Colorretais/patologia , Adenocarcinoma/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/cirurgia , Feminino , Hospitais Comunitários , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Mucinas/metabolismo , Estadiamento de Neoplasias , Prognóstico , Modelos de Riscos Proporcionais , Porto Rico , Fatores de Risco , Fatores Sexuais , Taxa de Sobrevida
7.
Cir Esp (Engl Ed) ; 102(4): 188-193, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38224772

RESUMO

INTRODUCTION: The robotic transabdominal preperitoneal approach (rTAPP) is a relatively recent technique for the treatment of inguinal hernia. To achieve optimal results, the 10 golden rules described must be followed. Surgeons in training often review videos to familiarize themselves with new techniques, YouTube being one of the most used platforms. The objective of this study is to carry out an evaluation of the 10 most viewed videos on YouTube of inguinal hernia repair by transabdominal preperitoneal approach (rTAPP) to determine if the 10 golden rules are met. METHODS: Identify and evaluate the 10 videos with the highest number of views related to rTAPP. Three experienced Surgeons evaluated compliance with the 10 golden rules using a Likert scale. Data were analyzed in Excel (Microsoft) and plotted with Tableau (Tableau Inc). The consistency between evaluators was determined using Cronbach's alpha, considering a value >0.7 acceptable. RESULTS: The average overall evaluation was 3.63 with a range of 2.6 to 4.9. The scores related to compliance with the rules 1, 2, 9, 10 were satisfactory; on the other hand, rules 3, 4, 5, 7 and 8 were weak, particularly rule number 7. Internal consistency was observed between raters with a Cronbach's alpha of 0.98. CONCLUSIONS: The lack of compliance with the 10 golden rules in most of the videos demonstrates that the use of videos (YouTube) is not an adequate resource for learning robot-assisted inguinal hernia cure.


Assuntos
Hérnia Inguinal , Laparoscopia , Procedimentos Cirúrgicos Robóticos , Mídias Sociais , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Hérnia Inguinal/cirurgia , Laparoscopia/métodos , Herniorrafia/métodos , Telas Cirúrgicas
8.
J Robot Surg ; 17(2): 405-411, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35732918

RESUMO

Robotic surgery provides significant advantages in terms of an optimal three-dimensional and magnified view of the surgical field, superior maneuverability of surgical instruments, removal of surgeon's tremor and excellent ergonomics. Nonetheless, the adoption of this technology in thoracic surgery has been slower than in other specialties such as urology, gynecology or digestive surgery. In this article we describe our institution's experience in robotic-assisted thoracic surgery (RATS) in the span from 2012 to 2020. During this time the average annual growth of the program has been 55%. Among the most frequently procedures performed were lobectomies, wedge resection and segmentectomies. Surgical time and length of stay decreased as the number of procedures performed increased, relative to the learning curve. Additional important elements considered relevant to the success of the program are the resources available, leadership, motivation of the surgical team, adequate and stepwise training, as well as the collection of data for periodic analysis of results. All those initiatives have led to a relevant improvement of financial variables reflecting a cost reduction.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Cirurgia Torácica , Procedimentos Cirúrgicos Torácicos , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Pneumonectomia/métodos
9.
J Robot Surg ; 17(4): 1531-1534, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-36881343

RESUMO

Robotic-assisted surgery has been shown to offer significant benefits for both patients and surgeons. However, the high cost of the equipment remains a major barrier to its widespread adoption in the medical field. To ensure cost-effectiveness of these procedures, it is important to implement strategies that can help reduce the costs involved. One potential strategy to reduce costs is to compare the performance of different generators used in these procedures. In this study, we compared the performance of two generators: the E100 (Intuitive Surgical, Inc.) and the ERBE VIO dV 2.0 (Elektromedizin GmbH). The analysis focused on several key metrics, including the number of times the generators were activated, the average time per seal, total sealing time, and console time. The financial impact of transitioning to the E100 was also evaluated based on annual volume. We analyzed a total of 1457 sleeve gastrectomies, with 746 performed using the ERBE generator and 711 performed using the E100. There were no significant differences in preoperative BMI or bleeding complication rates between the two groups. The average activation of the generator per case was similar in both groups. However, the sealing time was 42.3% lower, and the average console time was 8 min shorter in cases where the E100 was used. Based on our financial analysis, transitioning to the E100 generator would result in cost savings of approximately $33-$34 K per year. This suggests that introducing the new generator is a successful strategy for reducing costs associated with robotic-assisted procedures.


Assuntos
Laparoscopia , Obesidade Mórbida , Procedimentos Cirúrgicos Robóticos , Cirurgiões , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Estudos Retrospectivos , Gastrectomia/métodos , Laparoscopia/métodos
10.
Obes Surg ; 33(9): 2742-2748, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37440110

RESUMO

INTRODUCTION: Totally robotic-assisted biliopancreatic diversion with duodenal switch (BPD/DS) learning curve has been described to be longer at approximately 50 cases, at which point operative time and complications rate decrease and tend to stabilize. This study aimed to form an analysis of the impact of the learning curve on the safety outcomes of the totally robotic-assisted BPD/DS. METHODS: A retrospective review of patients who underwent primary totally robotic-assisted BPD/DS by one of our certified bariatric and metabolic surgeon member of our institution was performed. The patients were classified into two groups, the learning stage group (first 50 cases) and the mastery stage group. Differences in operative time in minutes and postoperative outcomes were analyzed. RESULTS: Two hundred seventy-six patients were included. The operative time and the postoperative length of stay were significantly higher in the learning stage group (173.8 ± 35.8 min vs. 139.2 ± 30.2 min, p= 0.0001; 3.4 ± 1.4 days vs. 2.6 ± 0.9 days, p= 0.0002). The overall leakage rate was significantly higher in the learning stage group (8% vs. 0.4%, p= 0.0001). The global rate of complications for the learning stage group was 14%, and for the mastery stage group was 6.6% (p= 0.08). CONCLUSIONS: After the first 50 cases, the operative time, the length of stay, and the overall rate of complications decreased, being especially significant the decrease in the duodeno-ileal anastomosis leakage rate after reaching the learning curve.


Assuntos
Desvio Biliopancreático , Laparoscopia , Obesidade Mórbida , Procedimentos Cirúrgicos Robóticos , Humanos , Desvio Biliopancreático/efeitos adversos , Obesidade Mórbida/cirurgia , Curva de Aprendizado , Duodeno/cirurgia , Estudos Retrospectivos , Anastomose Cirúrgica
11.
J Robot Surg ; 17(1): 163-167, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35429331

RESUMO

The incorporation of new technologies in the surgical field, such as the robotic da Vinci System, has made it possible to offer a series of advantages to the patient and the surgeon, with important benefits for both. However, cost continues to be a limiting factor to the adoption of this technology. The development of strategies to maximize the measures that can lead to reduced expenses is a key factor to improve cost-benefit ratio. According to some studies, more than 50% of the costs of a surgical procedure are related to materials and medical supplies, which is why any measure aimed at optimizing their use is pertinent. Our institution, the Orlando Regional Medical Center (ORMC), created a working group whose main purpose is to optimize the Robotic OR process. Their first step was to optimize the surgical trays, and this was carried out in four stages: observation, modification, trial period, and cost analysis. The specialties involved in this initiative were Bariatric and Thoracic Surgeries. Once the optimization process ended, the number of laparoscopic/thoracoscopy instruments in the trays decreased by 63 and 87% for bariatric and thoracic surgery, respectively; and the number of conventional surgery instruments was also reduced by 47 and 64%, for the same specialties, respectively. The financial analysis concluded that implementing this measure will lead to an estimated six-figure savings per year.


Assuntos
Procedimentos Cirúrgicos Robóticos , Cirurgia Torácica , Procedimentos Cirúrgicos Torácicos , Humanos , Procedimentos Cirúrgicos Robóticos/métodos , Instrumentos Cirúrgicos , Redução de Custos
12.
J Robot Surg ; 17(3): 923-931, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36371756

RESUMO

Metabolic and bariatric surgery is an effective treatment for the management of obesity and related comorbidities. Although the duodenal switch has demonstrated superior results in terms of resolution of obesity-related comorbidities and weight loss, it is one of the less performed procedures. The use of robotic surgical platforms offers many advantages in obese patients and is particularly useful in technically demanding procedures such as duodenal switch. Observational, retrospective and analytical study of cases corresponding to robot-assisted duodenal switch performed between 2016 and 2021. We describe our technique using the system DaVinci Xi. Operative and perioperative variables, postoperative complications, and readmission rate were determined. A total of 661 patients underwent duodenal switch which correspond to the 20.7% of the total bariatric procedures performed in this period. A clear decrease in surgical time and length of stay was observed as the number of cases progressively increased. The complication rate during the first 30 days was 9.1%. Among these, only 1.9% corresponded to major complications, being strictures the most frequent (0.9%), followed by leaks (0.45%). Readmission rate in this period was 6.1%. Between 30 and 90 days postoperatively, the complication rate was 0.91%. Robotic-assisted duodenal switch is a safe surgery with a low complication rate. This procedure is highly effective in terms of durable weight loss in obese and super-obese patients. Robotic DaVinci Xi system allows surgeons to achieve a high level of proficiency and master technique resulting in reduction of surgical time and length of stay.


Assuntos
Laparoscopia , Obesidade Mórbida , Procedimentos Cirúrgicos Robóticos , Robótica , Humanos , Laparoscopia/métodos , Obesidade/complicações , Obesidade/cirurgia , Obesidade Mórbida/complicações , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/etiologia , Estudos Retrospectivos , Procedimentos Cirúrgicos Robóticos/métodos , Resultado do Tratamento , Redução de Peso
13.
J Robot Surg ; 17(5): 2059-2064, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37191820

RESUMO

Operating room (OR) turnover time (TOT) is the time it takes to prepare an OR for the next surgery after the previous one has been completed. Reducing OR TOT can improve the efficiency of the OR, reduce costs, and improve surgeons' and patients' satisfaction. The objective of this study is to evaluate the effectiveness of an operating room (OR) turnover time (TOT) reduction initiative using the Lean Six Sigma methodology (DMAIC) in the bariatric and thoracic service lines. Performance improvement strategies consist of simplifying steps (surgical tray optimization) and concurrent steps (parallel task execution). We compared 2-month pre-implementation vs. post-implementation. A paired t-test was used to assess whether the difference in the measurements was statistically significant. The study found that TOT was reduced by 15.6% from an average of 35.6 ± 8.1 to minutes 30.09 ± 9.7 min (p < 0.05). Specifically, in the bariatric service line, TOT was reduced by 17.15% and in the thoracic service line, TOT was reduced by 9.6%. No adverse events related to the initiative were reported. The results of this study indicate that the TOT reduction initiative was effective in reducing TOT. The efficient use of operating rooms is crucial in hospital management, as it not only impacts finances but also affects the satisfaction of surgical teams and patients. This study shows the effectiveness of Lean Six Sigma methodology in reducing TOT and improving the efficiency in the OR.


Assuntos
Eficiência Organizacional , Procedimentos Cirúrgicos Robóticos , Humanos , Gestão da Qualidade Total , Procedimentos Cirúrgicos Robóticos/métodos , Eficiência , Custos e Análise de Custo , Melhoria de Qualidade
14.
J Endourol ; 37(2): 185-190, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-36150030

RESUMO

Objective: The aim of this study is to report our experience in minimally invasive management of rectovesical fistulae (RVFs). Materials and Methods: Between 2004 and 2021, 24 patients who underwent minimally invasive RVF repair by a single surgeon at 3 international institutions were retrospectively reviewed. Baseline demographic characteristics and perioperative and postoperative variables were collected. Complications were reported using the modified Clavien-Dindo Classification System and the European Association of Urology Complication Guidelines Panel Assessment and Recommendations. Fistula repair was defined as confirmation of fistula closure by imaging and complete resolution of fistula-related symptoms at the 12-month follow-up. Continuous variables are reported as medians and quartiles, whereas categorical variables are reported as frequencies and percentages. Results: Twenty-four patients with RVFs were treated: 22 males (91.7%) and 2 females with a median age of 66 (64.2-68) years. Twenty cases (83.3%) occurred postsurgery, three cases (12.5%) after surgery with combined radiotherapy, and one case (4.1%) after a combination of energy treatments. A robotic approach was performed in 19 patients (79%) and laparoscopic approach in 5 patients (21%). Ninety-six percent of patients had previous fecal diversions. No intraoperative complications were recorded. The median operative time was 180 (140-282) minutes, estimated blood loss was 50 (40-125) mL, and length of hospital stay was 2 (2-3) days. There were two Grade II complications and one Grade IIIb complication. All patients met criteria for repair. Conclusions: Minimally invasive management of RVFs is feasible. More studies are needed to assess the role of this approach among all RVF management options.


Assuntos
Laparoscopia , Fístula Retal , Robótica , Masculino , Feminino , Humanos , Idoso , Estudos Retrospectivos , Laparoscopia/métodos , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Fístula Retal/cirurgia , Fístula Retal/etiologia
15.
JSLS ; 16(1): 10-5, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22906323

RESUMO

BACKGROUND: Training models in laparoscopic surgery allow the surgical team to practice procedures in a safe environment. We have proposed the use of a 4-task, low-cost inert model to practice critical steps of laparoscopic common bile duct exploration. METHODS: The performance of 3 groups with different levels of expertise in laparoscopic surgery, novices (A), intermediates (B), and experts (C), was evaluated using a low-cost inert model in the following tasks: (1) intraoperative cholangiography catheter insertion, (2) transcystic exploration, (3) T-tube placement, and (4) choledochoscope management. Kruskal-Wallis and Mann-Whitney tests were used to identify differences among the groups. RESULTS: A total of 14 individuals were evaluated: 5 novices (A), 5 intermediates (B), and 4 experts (C). The results involving intraoperative cholangiography catheter insertion were similar among the 3 groups. As for the other tasks, the expert had better results than the other 2, in which no significant differences occurred. The proposed model is able to discriminate among individuals with different levels of expertise, indicating that the abilities that the model evaluates are relevant in the surgeon's performance in CBD exploration. CONCLUSIONS: Construct validity for tasks 2 and 3 was demonstrated. However, task 1 was no capable of distinguishing between groups, and task 4 was not statistically validated.


Assuntos
Ducto Colédoco/cirurgia , Cirurgia Geral/educação , Laparoscopia/educação , Ensino/métodos , Coledocolitíase/cirurgia , Humanos , Materiais de Ensino
16.
J Food Biochem ; 46(2): e14056, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34981528

RESUMO

Hot water treatment (HWT) of tomato (Solanum lycopersicum L.) fruit reduces the symptoms of chilling injury (CI). The aim of this study was to identify metabolites associated with HWT-induced CI tolerance in tomato fruit cv. Imperial. Mature green tomatoes with HWT (42°C/5 min) and control were stored under chilling conditions (5°C/20 days) and then ripened (21°C/7 days). Methanol extracts from pericarp were analyzed for total phenolics (TP), antioxidant activity (AoxA), and metabolic profiling by UPLC-DAD-MS and GC-MS. After cold storage and ripening, HWT fruit showed less CI, higher TP, and AoxA than control. It also showed an increased accumulation of phenolics, sugars, and some alkaloids that may be mediated by azelaic acid, glutamine, and tryptophan. The levels of N-feruloyl putrescine, esculeoside AII, and hydroxy-α-tomatine II were reduced. The better metabolic performance of HWT fruit under cold storage was associated with a higher accumulation of several metabolites (e.g., antioxidants and osmolytes) in ripening fruit. PRACTICAL APPLICATION: The identification of metabolites associated with the reduction of chilling injury (CI) symptoms in HWT tomato fruit extends the understanding of the mechanisms involved in CI tolerance. This information provides targets that could be used to develop strategies for preventing CI (e.g., genetic improvement of tomato, direct application of key metabolites). The application of such strategies will increase the economic value and decrease postharvest losses.


Assuntos
Solanum lycopersicum , Antioxidantes/metabolismo , Frutas/metabolismo , Fenóis/metabolismo
17.
Urology ; 169: 102-109, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36002087

RESUMO

OBJECTIVE: To report our experience and outcomes in minimally invasive management of rectourethral fistula (RUF). METHODS: From 2004 to 2021, 15 patients who underwent minimally invasive RUF repair by a single surgeon at 2 international institutions were retrospectively reviewed. Baseline demographic characteristics, perioperative, and postoperative data were collected. Complications were reported using the modified Clavien-Dindo Classification System and the European Association of Urology Complication Panel Assesment and Recommendations. Success was defined as complete resolution of fistula-related symptoms at 12-month follow-up along with confirmation of fistula closure by imaging or cystoscopy. Categorical variables were presented as frequencies and percentages whereas continuous variables were reported as median and quartiles. RESULTS: Fifteen male patients with a median age of 71 (64-79.2) years were treated. Four cases (26.6%) occurred postsurgery, 8 cases (53.3%) occurred after energy treatments, and 3 cases (20%) after surgery combined with an energy treatment modality. A robotic and laparoscopic approach was performed in 9 (60%) and 6 (40%) patients, respectively. No intraoperative complications were reported. Median operative time was 264 (217.5-341) minutes, estimated blood loss was 175 (137.5-200) mL, and the length of hospital stay was 4 days. Nine postoperative complications were reported. All patients were followed-up for 12 months with no recurrence reported. All patients reached our criteria for successful RUF repair. CONCLUSIONS: Minimally invasive surgery could represent an efficient way to manage RUF in selected patients. More studies and treatment standardization are needed to assess the role of minimally invasive surgery in the management of RUF.


Assuntos
Fístula Retal , Doenças Uretrais , Fístula Urinária , Idoso , Humanos , Masculino , Complicações Pós-Operatórias/epidemiologia , Fístula Retal/cirurgia , Estudos Retrospectivos , Doenças Uretrais/cirurgia , Fístula Urinária/cirurgia , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Pessoa de Meia-Idade
18.
JSLS ; 14(2): 246-50, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20932377

RESUMO

OBJECTIVES: To compare the effectiveness of laparoscopic common bile duct exploration in patients with failed endoscopic retrograde cholangiopancreatography (ERCP). METHODS: This is a descriptive, comparative study. Patients with an indication of common bile duct exploration between February 2005 and October 2008 were included. We studied 2 groups: Group A: patients with failed ERCP who underwent LCBDE plus LC. Group B: patients with common bile duct stones managed with the 1-step approach (LCBDE + LC) with no prior ERCP. RESULTS: Twenty-five patients were included. Group A: 9 patients, group B: 16 patients. Success rate, operative time, and hospital stay were as follows: group A 66% vs group B 87.5%; group A 187 minutes vs 106 minutes; group A 4.5 days vs 2.3 days; respectively. CONCLUSION: Patients with failed ERCP should be considered as high-complex cases in which the laparoscopic procedure success rate decreases, and the conversion rate increases considerably.


Assuntos
Colangiopancreatografia Retrógrada Endoscópica , Colecistectomia Laparoscópica , Colecistolitíase/cirurgia , Coledocolitíase/cirurgia , Ducto Colédoco/cirurgia , Adulto , Idoso , Feminino , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
19.
JSLS ; 14(1): 41-7, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20529526

RESUMO

BACKGROUND: Training and experience of the surgical team are fundamental for the safety and success of complex surgical procedures, such as laparoscopic common bile duct exploration. METHODS: We describe an inert, simple, very low-cost, and readily available training model. Created using a "black box" and basic medical and surgical material, it allows training in the fundamental steps necessary for laparoscopic biliary tract surgery, namely, (1) intraoperative cholangiography, (2) transcystic exploration, and (3) laparoscopic choledochotomy, and t-tube insertion. RESULTS: The proposed model has allowed for the development of the skills necessary for partaking in said procedures, contributing to its development and diminishing surgery time as the trainee advances down the learning curve. Further studies are directed towards objectively determining the impact of the model on skill acquisition. CONCLUSION: The described model is simple and readily available allowing for accurate reproduction of the main steps and maneuvers that take place during laparoscopic common bile duct exploration, with the purpose of reducing failure and complications.


Assuntos
Competência Clínica , Ducto Colédoco/cirurgia , Cirurgia Geral/educação , Colangiografia , Endoscopia/educação , Humanos , Laparoscopia , Ensino/métodos , Materiais de Ensino
20.
J Sch Psychol ; 77: 52-66, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31837728

RESUMO

Universal screening is a proactive method for identifying student risk, yet remains under-utilized in school systems. Instead, many schools rely on teacher reports and referrals without accounting for different informant perspectives. In the current study, multi-informant universal screening in evaluated using a trifactor model. The study utilized the Social, Academic, and Emotional Behavior Risk Screener (SAEBRS), specifically the teacher (SAEBRS-TRS) and student (mySAEBRS) self-report forms, with items indicating risk for social, academic, and emotional behavior. Data from a national sample of over 24,000 K-12 teacher-student dyads were used to examine the extent and variance of discrepant reports between students and teachers of common, perspective, and item factors. Results demonstrated that informant perspective factors were a strong predictor for student and teacher emotional behavior item ratings. Whereas age had a positive effect on younger student reports of risk on the behavior items compared to older student reports, teachers showed the opposite effect. The teacherperspective of social and emotional behaviors of students was predicted by gender. Implications and directions for future research are further discussed.


Assuntos
Transtornos Mentais/diagnóstico , Serviços de Saúde Escolar , Professores Escolares , Autorrelato , Estudantes/psicologia , Sucesso Acadêmico , Criança , Emoções , Feminino , Humanos , Masculino , Programas de Rastreamento , Transtornos Mentais/psicologia , Psicometria , Medição de Risco , Comportamento Social , Estudantes/estatística & dados numéricos
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