Phase I metabolic profiling of the synthetic cannabinoids THJ-018 and THJ-2201 in human urine in comparison to human liver microsome and cytochrome P450 isoenzyme incubation

International Journal of Legal Medicine - Despite the increasing relevance of synthetic cannabinoids as one of the most important classes within “New Psychoactive Substances”, there is...     

Negative association between quantities of body fat and physical fitness of university football players

Sport Sciences for Health - The aim of the present study was to assess, analyze and correlate tests of physical abilities (acceleration and maximum speed in 30 m, Balsom agility test and...     

Percutaneous Axillary Artery Access in Complex Endovascular Aortic Repair

PurposeThis study was designed to assess the feasibility and safety of percutaneous axillary access in complex endovascular aortic repair (EVAR) with use of a percutaneous closure device.Materials and MethodsAll patients undergoing percutaneous axillary artery access between 2012 and 2017 were included. Left percutaneous axillary access was the sole antegrade aortic approach used. Patient and intervention characteristics were documented. Mortality, procedural success, technical success, peri- and postoperative complications, and repeat interventions were examined. A total of 25 percutaneous axillary access procedures were performed in 23 patients. The mean age of the treated patients was 72.2 years, and 71% were male. Percutaneous axillary access was obtained for a variety of indications (chimney EVAR, thoracoabdominal aortic aneurysm repair, thoracic EVAR, and type B dissections). Vascular access sheath sizes ranged from 6 F to 12 F.ResultsThe procedural success rate was 96%. Technical success of vascular closure was 100%. The perioperative access complication rate was 8%: 1 dissection of the axillary artery and 1 stenosis occurred. No hematoma, hemorrhage, or neuropathies were seen. One access-related repeat intervention had to be performed. The 30-d mortality rate was 4%.ConclusionsDirect puncture and percutaneous closure of the axillary artery for complex aortic procedures is safe and feasible.     

Efficacy of safinamide as add-on therapy after subthalamic nucleus deep brain stimulation in Parkinson disease

Neurological Sciences - Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective surgical treatment for advanced Parkinson’s disease (PD). However, some patients still experience...     

Clinical outcomes of latissimus dorsi tendon transfer and superior capsular reconstruction for irreparable rotator cuff tears: a systematic review

European Journal of Orthopaedic Surgery & Traumatology - Functionally irreparable rotator cuff tears (FIRCTs) present an ongoing challenge to the orthopedic surgeon. The aim of this systematic...     

Right Colectomy for Cancer: A Matched Comparison of Three Different Surgical Approaches

Purpose. The standard approach to right colon cancer resection is still a matter of debate and includes laparoscopy, open midline incision, or open transverse incision. We aimed this study to compare the short- and long-term results of laparoscopic right-colectomy with those provided by the open approaches. Methods. Of the 176 patients who underwent right-colectomy at our Department for nonmetastatic colon cancer, 40 patients treated by laparoscopy, 40 treated by transverse incisions, and 40 treated by midline incisions were selected and matched using the propensity score method. Short-term results included: operating time, morbidity rate, number of lymph-nodes harvested (LNH), patients’ recovery features, and costs. Long-term results included: disease-specific survivals and the rate of incisional hernias. The sub-groups were compared using t-test and Chi-square tests, whereas the Kaplan-Meier method was used to assess survivals. Results. Laparoscopies were the longer procedures, providing similar morbidity rates and LNH in comparison with the open approaches. Laparoscopy provided a faster return to oral intake and a shorter use of analgesics comparing with the midline approach; however, it showed only a minor consumption of analgesics in comparison with transverse laparotomy. There were no differences in the hospital stay and the long-term results were comparable between sub-groups. Costs analysis documented minor but not significant surgical expenses for the transverse approach. Conclusions. Laparoscopy was documented safe, with similar morbidity rates and long-term results comparing with open surgery. Laparoscopy provided better functional short-term results comparing with the midline approach, but only small differences with respect to the transverse incision approach.     

Electromagnetic organ tracking allows for real-time compensation of tissue shift in image-guided laparoscopic rectal surgery: results of a phantom study

Background

Laparoscopic resection is a minimally invasive treatment option for rectal cancer but requires highly experienced surgeons. Computer-aided technologies could help to improve safety and efficiency by visualizing risk structures during the procedure. The prerequisite for such an image guidance system is reliable intraoperative information on iatrogenic tissue shift. This could be achieved by intraoperative imaging, which is rarely available. Thus, the aim of the present study was to develop and validate a method for real-time deformation compensation using preoperative imaging and intraoperative electromagnetic tracking (EMT) of the rectum.

Methods

Three models were compared and evaluated for the compensation of tissue deformation. For model A, no compensation was performed. Model B moved the corresponding points rigidly to the motion of the EMT sensor. Model C used five nested linear regressions with increasing level of complexity to compute the deformation (C1–C5). For evaluation, 14 targets and an EMT organ sensor were fit into a silicone-molded rectum of the OpenHELP phantom. Following a computed tomography, the image guidance was initiated and the rectum was deformed in the same way as during surgery in a total of 14 experimental runs. The target registration error (TRE) was measured for all targets in different positions of the rectum.

Results

The mean TRE without correction (model A) was 32.8 ± 20.8 mm, with only 19.6 % of the measurements below 10 mm (80.4 % above 10 mm). With correction, the mean TRE could be reduced using the rigid correction (model B) to 6.8 ± 4.8 mm with 78.7 % of the measurements being <10 mm. Using the most complex linear regression correction (model C5), the error could be reduced to 2.9 ± 1.4 mm with 99.8 % being below 10 mm.

Conclusion

In laparoscopic rectal surgery, the combination of electromagnetic organ tracking and preoperative imaging is a promising approach to compensating for intraoperative tissue shift in real-time.