Bone mineral density,bone turnover markers,and incident fractures in de novo kidney transplant recipients

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Inflammatory Response After Laparoscopic Versus Open Resection of Colorectal Liver Metastases: Data From the Oslo-CoMet Trial

Laparoscopic and open liver resection have not been compared in randomized trials. The aim of the current study was to compare the inflammatory response after laparoscopic and open resection of colorectal liver metastases (CLM) in a randomized controlled trial.This was a predefined exploratory substudy within the Oslo CoMet-study. Forty-five patients with CLM were randomized to laparoscopic (n = 23) or open (n = 22) resection. Ethylenediaminetetraacetic acid-plasma samples were collected preoperatively and at defined time points during and after surgery and snap frozen at −80 ^oC. A total of 25 markers were examined using luminex and enzyme-linked immunosorbent assay techniques: high-mobility box group 1(HMGB-1), cell-free DNA (cfDNA), cytokines, and terminal C5b-9 complement complex complement activation.Eight inflammatory markers increased significantly from baseline: HMGB-1, cfDNA, interleukin (IL)-6, C-reactive protein, macrophage inflammatory protein -1β, monocyte chemotactic protein -1, IL-10, and terminal C5b-9 complement complex. Peak levels were reached at the end of or shortly after surgery. Five markers, HMGB-1, cfDNA, IL-6, C-reactive protein, and macrophage inflammatory protein -1β, showed significantly higher levels in the open surgery group compared with the laparoscopic surgery group.Laparoscopic resection of CLM reduced the inflammatory response compared with open resection. The lower level of HMGB-1 is interesting because of the known association with oncogenesis.     

Incidence,Characteristics, and Outcome of COVID-19 in Adults on Kidney Replacement Therapy: A Regionwide Registry Study

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Conventional versus computer-aided interpretation of long-term ECG recordings–aspects of precision and economy

Summary. In a sample of 60 12-h long-term ECG recordings we compared a computer-aided analysis method to a conventional scanning technique for diagnostic precision and time consumption. As regards diagnostic precision no significant difference between the methods could be found. Both were considered efficient in detecting episodes of arrhythmia. Using the computer-aided method a physician spent an average of 16 min on analyzing a recording and writing the diagnostic report. The conventional method required 69 min from an ECG technician and 9 min from a physician for each recording. From these figures we conclude that about 750 12-h recordings/year are required to outweigh the extra annual cost for the computer, if it is used only for long-term ECG analysis. If the computer can also be used for other purposes the system for long-term ECG analysis is profitable with a smaller annual number of recordings.     

Immediate Effects of 2 Different Whole-Body Vibration Frequencies on Muscle Peak Torque and Stiffness

Siu PM, Tam BT, Chow DH, Guo J-Y, Huang Y-P, Zheng Y-P, Wong SH. Immediate effects of 2 different whole-body vibration frequencies on muscle peak torque and stiffness.

Objective

To examine the immediate effects of 2 vibration protocols with different vibration frequencies that yielded the same maximum acceleration (106.75ms⁻²) on muscle peak torque and stiffness of knee extensor and flexor.

Design

Randomized crossover study with repeated measures.

Setting

Laboratory setting.

Participants

Recreationally active male adults (N=10).

Intervention

Participants performed 10 bouts of 60-second static half squats intermitted with a 60-second rest period between bouts on a platform with no vibration (control) and a vibration frequency of 26Hz or 40Hz.

Main Outcome Measures

Concentric and eccentric peak torques of knee extensor and flexor were examined within 5 minutes before and after vibration by isokinetic test. Young's modulus as an index of tissue stiffness was determined at quadriceps and hamstring pre- and postvibration by using an ultrasound indentation method.

Results

The 2-way repeated-measures analysis of variance indicated a significant interaction effect between vibration and vibration frequency for knee extensor concentric peak torque (P=.003). The vibration-induced changes of knee extensor concentric peak torque in vibration frequency of 26Hz (14.5Nm) and 40Hz (12.0Nm) were found to be significantly greater than that in controls (−29.4Nm) (P<.05). The change in eccentric peak torque of knee flexor after vibration tended to be greater in 26Hz of vibration frequency when compared with controls (26Hz of vibration frequency vs controls: 13.9±7.1 vs −11.4±5.3Nm, P=.08). No statistically significant differences were obtained in tissue stiffness in the quadriceps and hamstring with any of the conditions.

Conclusions

Our data suggest that whole-body vibration at a frequency of 26Hz and 40Hz preclude the decline in concentric peak torque of knee extensor observed after 10 bouts of 60 seconds of static half squats. A change in muscle mechanical stiffness property as induced by whole-body vibration is not supported by our data.     

Evaluation of Non-Watertight Dural Reconstruction with Collagen Matrix Onlay Graft in Posterior Fossa Surgery

Objective

Many surgeons advocate for watertight dural reconstruction after posterior fossa surgery given the significant risk of cerebrospinal fluid (CSF) leak. Little evidence exists for posterior fossa dural reconstruction utilizing monolayer collagen matrix onlay graft in a non-watertight fashion. Our objective was to report the results of using collagen matrix in a non-watertight fashion for posterior fossa dural reconstruction.

Methods

We conducted a retrospective review of operations performed by the senior author from 2004–2011 identified collagen matrix (DuraGen) use in 84 posterior fossa operations. Wound complications such as CSF leak, infection, pseudomeningocele, and aseptic meningitis were noted. Fisher''s exact test was performed to assess risk factor association with specific complications.

Results

Incisional CSF leak rate was 8.3% and non-incisional CSF leak rate was 3.6%. Incidence of aseptic meningitis was 7.1% and all cases resolved with steroids alone. Incidence of palpable and symptomatic pseudomeningocele in follow-up was 10.7% and 3.6% respectively. Postoperative infection rate was 4.8%. Previous surgery was associated with pseudomeningocele development (p<0.05).

Conclusion

When primary dural closure after posterior fossa surgery is undesirable or not feasible, non-watertight dural reconstruction with collagen matrix resulted in incisional CSF leak in 8.3%. Incidence of pseudomeningocele, aseptic meningitis, and wound infection were within acceptable range. Data from this study may be used to compare alternative methods of dural reconstruction in posterior fossa surgery.