Intraoperative Patterns of Gastric Microperfusion During Laparoscopic Roux-en-Y Gastric Bypass

Introduction

Visible light spectroscopy (VLS) represents a sensitive, non-invasive method to quantify tissue oxygen levels and detect hypoxemia. The aim of this study was to assess the microperfusion patterns of the gastric pouch during laparoscopic Roux-en-Y gastric bypass (LRYGB) using the VLS technique.

Methods

Twenty patients were enrolled. Tissue oxygenation (StO2%) measurements were performed at three different localizations of the gastric wall, prior and after the creation of the gastric pouch, and after the creation of the gastro-jejunostomy.

Results

Prior to the creation of the gastric pouch, the lowest StO2% levels were observed at the level of the distal esophagus with a median StO2% of 43 (IQR 40.8–49.5). After the creation of the gastric pouch and after the creation of the gastro-jejunostomy, the lowest StO2% levels were recorded at the level of the His angle with median values of 29% (IQR 20–38.5) and 34.5% (IQR 19–39), respectively. The highest mean StO2 reduction was recorded at the level of the His angle after the creation of the gastric pouch, and it was 18.3% (SD ± 18.1%, p < 0.001). A reduction of StO2% was recorded at all localizations after the formation of the gastro-jejunostomy compared to the beginning of the operation, but the mean differences of the StO2% levels were statistically significant only at the resection line of the pouch and at the His angle (p = 0.044 and p < 0.001, respectively).

Conclusion

Gastric pouch demonstrates reduction of StO2% during LRYGB. VLS is a useful technique to assess microperfusion patterns of the stomach during LRYGB.

Graphical abstract

     

The role of peer networks in adolescent pornography use and sexting in Croatia

ABSTRACT

Although communication about sexuality is a significant pathway through which peers influence adolescent sexual development, little research has examined the role of peer networks in the use of sexualized media. We applied a social network approach to assess the role of close peers in adolescent pornography use and sexting in a sample of Croatian high school students. Sexual conversation networks’ characteristics did not correlate with pornography use. In contrast, sexting was associated with the proportion of same gender peers, the proportion of older peers and the proportion of sexually experienced peers in the network – pointing to the role of peer influence. Participants’ gender did not moderate these associations. Specific mechanisms underlying the observed associations and the role of peer selection remain important tasks for future research.     

Estimation of chemical resistance of dental ceramics by neural network.

OBJECTIVES: The purpose of this research was to determine the mass concentrations of ions eluted from dental ceramic after an exposure to hydrochloric acid and, drawing on those results, to develop a feedforward backpropagation neural network (NN). MATERIALS AND METHODS: Four dental ceramics were selected for this study. The experimental measurement was conducted after 1, 2, 3, 6 and 12 months of exposure to hydrochloric acid. The results of the 1, 2, 6 and 12 months of immersion were used for training a 13-13-5 model of NN. For evaluating NN efficiency, the regression analysis of input variables obtained by the experiment and output variables provided by the trained network was used. RESULTS: The measured data from the 3-month acid exposure and data obtained by the neural network estimation were compared. High correlation coefficient (R) and low normalized root mean square error (NRMSE) between the measured and estimated output values were observed. CONCLUSIONS: It could be concluded that the artificial neural network has a great potential as an additional method in investigating the properties of dental materials.     

Treating patients with HIV and Hepatitis B and C infections: Croatian dental students' knowledge, attitudes, and risk perceptions

Dentists and dental students can be exposed to the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) during routine work. The aims of this study were to assess a group of dental students' knowledge about HIV, HBV, and HCV infections; assess their attitudes and risk perceptions about the treatment of patients with HIV, HBV, and HCV; and identify factors associated with their knowledge and willingness to treat these patients. An anonymous survey was administered to 534 predoctoral students at the School of Dental Medicine, University of Zagreb, Croatia. The response rate was 71.9 percent. Students' knowledge increased with each year of study. Senior students (in their third, fourth, and fifth years) had more professional attitudes and were significantly more positive about dentists' professional obligation to treat patients who are HIV-positive than were junior students (in their first and second years; p=0.0002). Senior students also expressed significantly more willingness to treat intravenous drug users and patients with hepatitis (p=0.016 and p=0.033, respectively). Female students were significantly more convinced than male students that routine dental treatment carried a significant risk of HIV and hepatitis infection (p=0.025). These students' knowledge negatively correlated with the lack of willingness to treat intravenous drug users and patients with hepatitis, and they expressed their willingness to receive further theoretical and practical education on this topic.