Tag: nevin manimala

Chirurgia (Bucur). 2022 Jun;117(4):437-446. doi: 10.21614/chirurgia.2762.

ABSTRACT

The optimal management of distal pancreatic stump after pancreaticoduodenectomies (PD) remains unclear. The study aims to assess the early outcomes after anastomoses with jejunum vs. stomach of the distal pancreatic stump in a relatively large series of patients with PD. Patients and Methods: All patients with PD performed between Oct 1, 2016, and Oct 1, 2021, were retrospectively assessed: anastomoses with the jejunum (PJ group) vs. with the stomach (PG group). Results: A number of 360 PD: PJ group 293 patients (81.4%) and PG group 67 patients (18.6%). No statistically significant differences were observed between the groups regarding the early outcomes (p values 0.065), except for the clinically relevant delayed gastric emptying higher rates in the PG group (38.8% vs. 25.9%, p = 0.049). In the PG group there were statistically significant higher rates of pylorus-preservation (19.4% vs. 8.2%, p = 0.012), soft pancreas texture (76.1% vs. 34.4%, p 0.001), small Wirsung ducts (4 mm (0-25) vs. 3 mm (1-10), p 0.001) and intermediate and high-risk fistula scores (83.6% vs. 52.6%, p 0.001). Conclusions: No particular anastomotic technique can avoid postoperative complications. In patients with hard pancreas texture and dilated Wirsung duct, a duct-to-mucosa PJ anastomosis should be the first option, while for patients with small Wirsung duct and soft pancreas texture, an invagination PG anastomosis should be preferred.

PMID:36049101 | DOI:10.21614/chirurgia.2762

Chirurgia (Bucur). 2022 Jun;117(4):431-436. doi: 10.21614/chirurgia.2603.

ABSTRACT

Background: Pancreatic adenocarcinoma is still considered as one of the most aggressive cancers with low percentages of respectability, despite recent advances in diagnosis. Assessment of preoperative inflammatory markers can increase the rates of resectability. Methods: Patients with potentially resectable pancreatic adenoinvesticarcinoma in a single pancreatic unit were included. Ninety-six patient during a one year period were eligible for analysis. Results: CRP, d-dimers, and fibrinogen levels were similar between the two groups. On the contrary, there were statistically significant differences regarding the prognostic nutritional index (PNI) and neutrophil-to-lymphocyte ratio (NLR). Conclusions: inflammatory markers can act as an additional tool in predicting resectability in patients with pancreatic adenocarcinoma.

PMID:36049100 | DOI:10.21614/chirurgia.2603

Vet Radiol Ultrasound. 2022 Sep 1. doi: 10.1111/vru.13154. Online ahead of print.

ABSTRACT

The renal cortical thickness (RCT) has been correlated with renal function. Previous studies have also reported that the RCT:Abdominal aorta(Ao) ratio is constant in normal dogs with various physical factors. This multi-center, retrospective, analytical study aimed to determine if there are differences between actual RCT and predicted value of RCT considering physical factors in dogs with acute or chronic renal disease. We also aimed to demonstrate whether the RCT and Ao ratio index would be useful for evaluating renal pathology. A total of 54 dogs with acute or chronic renal disease and 30 normal healthy dogs were included in this study. The RCT was measured at the center of the renal pyramid as the shortest distance perpendicular to the renal capsule from the base of the renal medullary pyramid at three points. The diameter of the Ao was measured just caudal to the branch of the left renal artery in the sagittal plane in systole. The RCT:Ao ratio of chronic kidney disease (CKD) patients was 0.50 ± 0.11 (mean ± standard deviation). The RCT:Ao ratio in normal dogs was 0.67 ± 0.07. The RCT:Ao ratio in patients with acute kidney injury (AKI) was 0.83 ± 0.05. There was a statistically significant difference between normal dogs and dogs with CKD (P < 0.001) and between normal dogs and dogs with AKI (P < 0.001). In conclusion, findings from the current study supported using the RCT:Ao ratio as a non-invasive quantitative method for characterizing kidney pathology in dogs with acute or chronic renal disease.

PMID:36049077 | DOI:10.1111/vru.13154

Surg Infect (Larchmt). 2022 Sep;23(7):625-633. doi: 10.1089/sur.2022.179.

ABSTRACT

Background: We performed a meta-analysis to confirm the efficacy of short-term compared with long-term administration of antimicrobial prophylaxis in gastric cancer surgery. Methods: Randomized controlled trials of the efficacy of short-term versus long-term administration of antimicrobial prophylaxis in gastric cancer surgery were searched using the MEDLINE, EMBASE, and the Cochrane Controlled Trials Register databases. The data were evaluated and statistically analyzed using RevMan version 5.3.0. Five studies including 2,053 participants who received short-term versus long-term administration of antimicrobial prophylaxis in gastric cancer surgery were considered. Results: There was no significant difference in the surgical site infection (SSI) rate between the short-term group and the long-term group (8.1% vs. 9.2%; odds ratio [OR], 0.87; 95% confidence interval [CI], 0.64-1.09; p = 0.39). Hierarchical analysis also showed no significant differences in incisional-site incisions, organ/space incisions, or leakage. Multivariable analysis showed no significant differences in gender, age (>65 years), body mass index (>25 kg/m²), D2, operation time (>3 hours), pathologic stage 3, blood loss, combined resection, diabetes mellitus, total gastrectomy, or blood transfusion between the two groups. Conclusions: Short-term administration of antimicrobial prophylaxis did not increase the incidence of SSIs after gastrectomy.

PMID:36049075 | DOI:10.1089/sur.2022.179

J Vet Med Educ. 2022 Sep 1:e20210016. doi: 10.3138/jvme-2021-0016. Online ahead of print.

ABSTRACT

Traditional lectures, where students listen passively, often do not reflect the complexity of real-life decision-making situations. Furthermore, modern students are using online devices for daily activities, and this has a challenging side effect for educators, as many people these days can only maintain their focus if topics are discussed in concise and engaging ways. For these reasons, there is growing interest in the use of games for educational purposes. The aim of this study was to introduce a board game based on the Clue game for final-year veterinary students during their practical activity in large animal medicine. This type of learning process was compared with a classical case-based discussion and evaluated via a survey delivered to the students to both test their acquired knowledge and obtain their evaluation of the activity. A total of 49 students were enrolled in this study. While the board game was evaluated significatively better than the traditional class, no statistically significant differences were observed for the answers given to questions assessing their veterinary skills. The proposed game requires few resources other than a case-based visual materials and analyses from clinical patients, a board, two dice, and some imagination to create cases at the appropriate level for students’ knowledge. We conclude that this board game-based activity represents innovative techniques to teach clinical approaches in an interactive way with the same utility as a traditional class but is more enjoyable for the students.

PMID:36049070 | DOI:10.3138/jvme-2021-0016

J Vet Med Educ. 2022 Sep 1:e20220054. doi: 10.3138/jvme-2022-0054. Online ahead of print.

ABSTRACT

Canine orchiectomy (COE) is one of the most commonly performed procedures in small animal veterinary surgery. The aim of this study was to assess veterinary students’ confidence in performing this surgery in relation to their previous surgical experience of the procedure. The hypothesis was that confidence to perform canine orchiectomies among recent veterinary graduates increased when having participated in the procedure as part of practical surgical training. A cross-sectional survey was conducted and included 65 fifth-year veterinary graduate students at the Swedish University of Agriculture in Uppsala, Sweden. The survey investigated how differences in experience of COE affected students’ confidence to perform the procedure. Of the responding students, 24.6% had performed the procedure, 47.7% had observed the procedure live, and 27.7% had not seen nor performed the procedure. They were asked how confident they were to perform the procedure both with and without assistance. Data were compared using a non-parametric test (Mann-Whitney U test). The results showed a statistically significant increase in confidence to perform COEs in the group that had previously performed or observed COE compared with the group that had neither performed nor observed the procedure. In conclusion, veterinary students’ participation in COEs significantly contributed to their clinical confidence to perform the procedure.

PMID:36049062 | DOI:10.3138/jvme-2022-0054

J Appl Physiol (1985). 2022 Sep 1. doi: 10.1152/japplphysiol.00399.2022. Online ahead of print.

ABSTRACT

Tracheomalacia is an airway condition in which the trachea excessively collapses during breathing. Neonates diagnosed with tracheomalacia require more energy to breathe, and the effect of tracheomalacia can be quantified by assessing flow-resistive work of breathing (WOB) in the trachea using computational fluid dynamics (CFD) modeling of the airway. However, CFD simulations are computationally expensive; the ability to instead predict WOB based on more straightforward measures would provide a clinically useful estimate of tracheal disease severity. The objective of this study is to quantify the WOB in the trachea using CFD and identify simple airway and/or clinical parameters that directly relate to WOB. This study included 30 neonatal intensive care unit subjects (15 with tracheomalacia, 15 without tracheomalacia). All subjects were imaged using ultrashort echo time (UTE) MRI. CFD simulations were performed using patient-specific data obtained from MRI (airway anatomy, dynamic motion, and airflow rates) to calculate the WOB in the trachea. Several airway and clinical measurements were obtained and compared with the tracheal resistive WOB. The maximum percent change in the tracheal cross-sectional area (ρ=0.560, p=0.001), average glottis cross-sectional area (ρ=-0.488, p=0.006), minute ventilation (ρ=0.613, p<0.001), and lung tidal volume (ρ=0.599, p<0.001) had significant correlations with WOB. A multivariable regression model with three independent variables (minute ventilation, average glottis cross-sectional area, and minimum of the eccentricity index of the trachea) can be used to estimate WOB more accurately (R²=0.726). This statistical model may allow clinicians to estimate tracheal resistive WOB based on airway images and clinical data.

PMID:36049059 | DOI:10.1152/japplphysiol.00399.2022

IEEE Trans Vis Comput Graph. 2022 Sep 1;PP. doi: 10.1109/TVCG.2022.3203003. Online ahead of print.

ABSTRACT

While user’s perception and performance are predominantly examined independently in virtual reality, the Action-Specific Perception (ASP) theory postulates that the performance of an individual on a task modulates this individual’s spatial and time perception pertinent to the task’s components and procedures. This paper examines the association between performance and perception and the potential effects that tactile feedback modalities could generate. This paper reports a user study (N=24), in which participants performed a standardized Fitts’s law target acquisition task by using three feedback modalities: visual, visuo-electrotactile, and visuo-vibrotactile. The users completed 3 Target Sizes × 2 Distances × 3 feedback modalities = 18 trials. The size perception, distance perception, and (movement) time perception were assessed at the end of each trial. Performance-wise, the results showed that electrotactile feedback facilitates a significantly better accuracy compared to vibrotactile and visual feedback, while vibrotactile provided the worst accuracy. Electrotactile and visual feedback enabled a comparable reaction time, while the vibrotactile offered a substantially slower reaction time than visual feedback. Although amongst feedback types the pattern of differences in perceptual aspects were comparable to performance differences, none of them was statistically significant. However, performance indeed modulated perception. Significant action-specific effects on spatial and time perception were detected. Changes in accuracy modulate both size perception and time perception, while changes in movement speed modulate distance perception. Also, the index of difficulty was found to modulate all three perceptual aspects. However, individual differences appear to affect the magnitude of action-specific effects. These outcomes highlighted the importance of haptic feedback on performance, and importantly the significance of action-specific effects on spatial and time perception in VR, which should be considered in future VR studies.

PMID:36048989 | DOI:10.1109/TVCG.2022.3203003

Int J Dent Hyg. 2022 Sep 1. doi: 10.1111/idh.12619. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluated the relationship between serum vitamin D levels and periodontal healing outcomes in patients with mild or moderate periodontitis.

METHODS: Serum vitamin D levels and periodontal pockets and gingival bleeding were evaluated in 51 patients before and six months after non-surgical periodontal treatment. A t-test and chi-square test were used to analyze the data (p ≤ 0.05).

RESULTS: The mean reduction of periodontal pocket depth was statistically significant higher in patients with vitamin D ≥ 30 ng/mL compared to those with < 30 ng/mL (CI= -0.23 – 0.42, p= 0.05), but not clinically significant. Vitamin D level was not associated with the percentage of sites gingival bleeding on probing at the final evaluation (OR= 0.58, 95% CI= 0.17-1.99, p= 0.39).

CONCLUSION: Lower serum vitamin D level was associated with a slightly reduced periodontal healing after non-surgical periodontal therapy, which should be further investigated in a larger population.

PMID:36048921 | DOI:10.1111/idh.12619

Rev Med Inst Mex Seguro Soc. 2022 Aug 31;60(5):563-568.

ABSTRACT

BACKGROUND: Communication in the health field is essential, since it depends on it that the physician has complete and accurate information to carry out the fulfillment of his functions. The relationship with the medical staff leads the patient to feel listened to and cared for, in order to understand their state of health.

OBJECTIVE: To know the perception of patients about the communicative competence of family physicians during the consult at the Family Medicine Unit No. 27.

MATERIAL AND METHODS: Descriptive and cross-sectional study that identifies patients who attended Family Medicine Unit No. 27 in Tijuana in September 2021. The Communication Assessment Tool was applied to participants to measure the perception of communicative competence of doctors. The responses obtained were collected and analyzed with descriptive statistics.

RESULTS: 200 patients who met selection criteria were studied, made up of patients on morning and afternoon shifts equally. 54.6% of the studied population considers the communicative competence of family doctors to be excellent.

CONCLUSIONS: The communicative competence in the family physicians of the studied unit had a better result than others studies of several countries; however, it has areas of opportunity to optimize this competence, since medical knowledge must include the area of communication and interpersonal relationships.

PMID:36048909