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Ramon O. Minjares-Granillo Bertha A. Dimas Jean-Paul J. LeFave Eric M. Haas 《American journal of surgery》2019,217(4):670-676
Background
Despite numerous benefits, only a small fraction of laparoscopic left-sided colectomy is accomplished without the need for an abdominal incision to retrieve the specimen and prepare for anastomosis. We report our early experience with a robotic approach using Natural orifice IntraCorporeal anastomosis with Extraction of specimen (NICE) to help overcome the technical limitations and challenges of this approach.Methods
Twenty consecutive patients presented for elective sigmoid or rectosigmoid resection for benign and malignant disease and underwent the NICE procedure. Safety, feasibility and post-operative outcomes were analyzed.Results
Intracorporeal anastomosis was accomplished in all patients. One patient required an abdominal incision to extract a bulky tumor. Mean operative time was 222?min (146–344). Mean time to first flatus and length of stay was 23 and 49?h, respectively. All but 4 patients were discharged home on post-operative day 2. One patient was readmitted with a pelvic fluid collection.Conclusion
Robotic left-sided colorectal resection with NICE procedure is a safe and feasible minimally invasive approach and may facilitate greater adoption rates of this technique. 相似文献2.
Marta Benet Ramon Escuriet Manuela Alcaraz-Quevedo Sandra Ezquerra Margarida Pla 《Gaceta sanitaria / S.E.S.P.A.S》2019,33(5):472-479
ObjectiveWe analyse how reproductive health strategies have been incorporated into the everyday activities of the services and the resulting transformation of professional and user practices.MethodCartographic research taking a multi-sited ethnographic approach that seeks to reveal the processes of transformation. Data generation techniques featuring participant observation and situated interviews. Discourse analysis of the text corpus using three analytical axes based on three main lines of action promoted by the strategies.ResultsWe identified transformations in: 1) demedicalisation: an increase in midwives’ know-how and autonomy, changes in episiotomy practice and the facilitation of bonding practices; 2) warmth of care: incorporation of women's needs and expectations and improvements in the comfortableness of birth settings, especially in assistance at physiological birth; and 3) participation: actions that foster shared decision-making and the involvement of the persons accompanying women in labour.ConclusionsAbove all, transformation is visible in the incorporation of new attitudes, sensibilities and practices that have developed around the old structures, especially during physiological childbirth. The more technological areas have been less permeable to change. Risk management in decision-making and addressing diversity are identified as areas where transformation is less evident. 相似文献
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Jos M. Martín Encarnacion Montesinos Pilar Cordero Victor Gonzalez Dolores Ramon 《Pediatric dermatology》2019,36(2):265-267
Trichotillomania is a form of traction alopecia resulting from repetitive and compulsive hair pulling and plucking. Trichotillomania and patchy alopecia areata may have similar clinical and dermoscopic features in some cases. On trichoscopic examination, the presence of black dots, coiled or hook hair, shafts of varying lengths with fraying or split ends (trichoptilosis), and an absence of exclamation mark hairs and yellow dots are suggestive of trichotillomania. 相似文献
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Núria Pedrola Laura Devis Marta Llauradó Irene Campoy Elena Martinez-Garcia Marta Garcia Laura Muinelo-Romay Lorena Alonso-Alconada Miguel Abal Francesc Alameda Gemma Mancebo Ramon Carreras Josep Castellví Sílvia Cabrera Antonio Gil-Moreno Xavier Matias-Guiu Juan L. Iovanna Eva Colas Jaume Reventós Anna Ruiz 《Clinical & experimental metastasis》2015,32(5):467-478
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Feasibility and efficacy of outpatient therapy with intermediate dose cytarabine,fludarabine and idarubicin for patients with acute myeloid leukaemia aged 70 or older 下载免费PDF全文
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Cristina Martínez González Amador Prieto González Lucía García Alfonso Luis Fernández Fernández Ariel Moreda Bernardo Ramon Fernández Álvarez Valeria Rolle-Sóñora Alberto Ruano Raviña Pere Casan Clarà 《Archivos de bronconeumología》2019,55(9):459-464
IntroductionSilicosis is a chronic progressive disease caused by inhalation of crystalline silica. Most cases develop in underground mine workers and in subjects involved in the extraction of natural stone (slate and granite). In view of the progressive emergence of new cases of silicosis in artificial quartz conglomerate workers, we performed a study to analyze the characteristics of silicosis produced by this new agent in Spain.MethodsThe study consisted of a series of 96 cases of silicosis diagnosed according to international criteria during the period 2010-2017. We analyzed clinical, radiological, pathological and functional characteristics.ResultsMean age of participants was 45 years; 55% had simple silicosis and 45% had complicated silicosis. Ten patients were diagnosed with accelerated silicosis, with a mean age of 33 years. Mean time of exposure to conglomerates was 15 years, and 77% had not used appropriate protection measures. Half of the patients were asymptomatic and presented different classic forms on chest X-ray and chest high-resolution computed tomography, along with ground-glass images. No lung function changes were recorded.ConclusionsSilicosis in artificial quartz conglomerate workers occurs in a young, actively employed population, a considerable percentage of whom present an accelerated form. They have few symptoms and no functional limitations. Protection measures are scarce. It is important to characterize these features to provide early diagnosis and implement the necessary preventive measures. 相似文献
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