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202.
Johanna Temme Anneke Kramer Kitty J. Jager Katharina Lange Frederick Peters Gerhard-Anton Müller Reinhard Kramar James G. Heaf Patrik Finne Runolfur Palsson Anna V. Reis?ter Andries J. Hoitsma Wendy Metcalfe Maurizio Postorino Oscar Zurriaga Julio P. Santos Pietro Ravani Faical Jarraya Enrico Verrina Friedo W. Dekker Oliver Gross 《Clinical journal of the American Society of Nephrology》2012,7(12):1969-1976
203.
Ramon Vilallonga José Manuel Fort Enric Caubet Oscar Gonzalez Manel Armengol 《Obesity surgery》2013,23(10):1501-1507
The da Vinci Surgical System® has shown its possible indications in obesity surgery. This clinical study aims to elucidate the benefits, potentials, or problems of applying robotic technology for sleeve gastrectomy (SG). Data from 200 patients who underwent SG either performed by laparoscopy or robotic approach were assessed. A review of the data was analyzed with 1-year follow-up. There were 143 female patients. Mean age was 43.6 years. Mean BMI was 48.4 kg/m2. Operative time was longer for the robotic SG group (p?<?0.005). The overall leak rate was 3.5 %. Robotic SG is feasible and may be an initial procedure to undergo more complex procedures. Cost issues and operative times will need to be more clearly estimated in the future. 相似文献
204.
Emmeline Nugent Nicole Shirilla Adnan Hafeez Diarmuid S. O’Riordain Oscar Traynor Anthony M. Harrison Paul Neary 《Surgical endoscopy》2013,27(1):214-221
Background
The use of simulation to train novice surgeons in laparoscopic skills is becoming increasingly popular. To maximize benefit from simulation, training needs to be delivered and assessed in a structured manner. This study aimed to define performance goals, demonstrate construct validity of the training program, and evaluate whether novice surgeons could reach the preset performance goals.Methods
Nine expert laparoscopic surgeons established performance goals for three basic modules of an augmented-reality laparoscopic simulator. The three laparoscopic modules were used by 40 novice surgeons and 40 surgical trainees (postgraduate years [PGYs] 1–4). The performance outcomes were analyzed across the different groups (novice, PGYs 1 and 2, PGYs 3 and 4, expert) to determine construct validity. Then 26 recruited novices trained on the three modules with the aim of reaching the performance goals.Results
The results demonstrated a significant difference in performance between all levels of experience for time (p < 0.001), motion analysis (p < 0.001), and error score (p < 0.001), thus demonstrating construct validity. All 26 novice surgeons significantly improved in performance with repetition for the metrics of time (p < 0.001) and motion analysis (p < 0.001). For two of the modules, the proficiency goals were reached in fewer than 10 trials by 80 % of the study participants.Conclusion
Basic skills in laparoscopic surgery can be learned and improved using proficiency-based simulation training. It is possible for novice surgeons to achieve predefined performance goals in a reasonable time frame. 相似文献205.
Oriana Simonetti Guendalina Lucarini Oscar Cirioni Antonio Zizzi Fiorenza Orlando Mauro Provinciali Roberto Di Primio Andrea Giacometti Annamaria Offidani 《Burns : journal of the International Society for Burn Injuries》2013
Age-related differences in wound healing have been documented but little is known about the wound healing mechanism after burns. Our aim was to compare histological features and immunohistochemical expression of matrix metalloproteinase-9 (MMP-9), collagen IV, K6 and CD44 in the burn wound healing process in aged and young rats. 相似文献
206.
207.
Marta Rosenberg Mario M. Celis Walter Meyer III Lisa Tropez-Arceneaux Serina J. McEntire Helen Fuchs Lisa Richardson Charles Holzer III David N. Herndon Oscar E. Suman 《Burns : journal of the International Society for Burn Injuries》2013
Objective
To examine the effect of a 12-week Wellness and Exercise (W&E) program on the quality of life of pediatric burn survivors with burns of ≥40% total body surface area. We hypothesized this comprehensive regimen would improve physical and psychosocial outcomes.Methods
Children were recruited for participation upon their discharge from the ICU. They were not taking anabolic/cardiovascular agents. Seventeen children participated in the W&E group and 14 children in the Standard of Care (SOC) group. Quality of life was assessed with the Child Health Questionnaire (CHQ) at discharge and 3 months. Children completed the CHQ-CF 87 and caregivers completed the CHQ-PF 28.Results
The mean age of children in the W&E group was 14.07 ± 3.5 years and mean TBSA was 58 ± 11.8%. The mean age of children in the SOC group was 13.9 ± 3.1 years and mean TBSA was 49 ± 7.8%. ANOVA did not reveal statistically significant differences between the groups. Matched paired t-tests revealed that parents with children in the W&E group reported significant improvements with their children's physical functioning, role/social physical functioning, mental health, overall physical and psychosocial functioning after exercise.Conclusions
These results are clinically relevant in that a comprehensive W&E program may be beneficial in promoting physical and psychosocial outcomes. 相似文献208.
Young Hwii Ko Rafael F. Coelho Ananthakrishnan Sivaraman Oscar Schatloff Sanket Chauhan Haidar M. Abdul-Muhsin Rair Jose Valero Carrion Kenneth J. Palmer Jun Cheon Vipul R. Patel 《European urology》2013
Background
Although the retrograde approach to nerve sparing (NS) aimed at maximizing NS during robot-assisted radical prostatectomy (RARP) has been described, its significant benefits compared to the antegrade approach have not yet been investigated.Objective
To evaluate the impact of NS approaches on perioperative, pathologic, and functional outcomes.Design, setting, and participants
Five hundred one potent (Sexual Health Inventory for Men [SHIM] score >21) men underwent bilateral full NS and were followed up for a minimum of 1 yr. After propensity score matching, 344 patients were selected and were then categorized into two groups.Surgical procedure
RARP with antegrade NS (n = 172) or RARP with retrograde NS (n = 172).Outcome measurements and statistical analysis
Functional outcomes were assessed using validated questionnaires. Multivariable logistic regression models were applied.Results and limitations
Positive margin rates were similar (11.1% vs 6.9%; p = 0.192), and no correlation with the NS approach was found on regression analysis. At 3, 6, and 9 mo, the potency rate was significantly higher in the retrograde approach (65% vs 80.8% and 72.1% vs 90.1% and 85.3% vs 92.9%, respectively). The multivariable model indicated that the NS approach was an independent predictor for potency recovery at 3, 6, and 9 mo, along with age, gland size, and hyperlipidemia. After adjusting for these predictors, the hazard ratio (HR) for the retrograde relative to the antegrade approach was 2.462 (95% confidence interval [CI], 1.482–4.089; p = 0.001) at 3, 4.024 (95% CI, 2.171–7.457; p < 0.001) at 6, and 2.145 (95% CI, 1.019–4.514; p = 0.044) at 9 mo. Regarding continence, the recovery rates at each time point and the mean time to regaining it were similar, and the method of NS had no effect on multivariable analysis. The absence of randomization is a major limitation of this study.Conclusions
In patients with normal erectile function who underwent bilateral full NS, a retrograde NS approach facilitated early recovery of potency compared to that with an antegrade NS approach without compromising cancer control. 相似文献209.
Andrezza Sanches Garofalo Maria Aparecida Dalboni Oscar Fernando Pavão dos Santos 《Renal failure》2013,35(2):121-131
Purpose. Radiocontrast agents (RAs) cause renal tubular damage by hemodynamic imbalance, which could cause hypoxic stimulus and direct cytotoxicity. However, reactive oxygen species (ROS) could be an important factor in RAs' direct cytotoxicity. This study investigated the involvement of ROS in deleterious effects produced by RAs on normoxic and hypoxic renal tubular cells. Materials and Methods. LLC-PK1 and MDCK were exposed to diatrizoate and ioxaglate in normoxic and hypoxic conditions. Apoptotic and necrotic cell death were assessed by acridine orange/ethidium bromide and annexin V methods. Hydrogen peroxide, superoxide anion, and malondialdehyde levels were analyzed by, respectively, 2′,7′-dichlorofluorescein, luminal, and thiobarbituric acid. Antioxidant agents were used to prevent cellular RAs damage. Results. Diatrizoate and ioxaglate decreased cellular viability in both cells, and this effect was enhanced by hypoxic conditions. Diatrizoate induced more injury than ioxaglate to both cell lines. LLC-PK1 underwent necrosis, while MDCK cells underwent apoptosis when exposed to diatrizoate. These results could not be attributed to an increase in osmolality. RAs did not increase hydrogen peroxide, superoxide anion or malondialdehyde levels in both cells. Additionally, N-acetyl-L-cysteine (NAC), ascorbic acid, α-tocopherol, glutathione, β-carotene, allopurinol, cimetidine, and citric acid did not protect cells against RAs damage. Surprising, NAC increased the cellular damage induced by ioxaglate in the both cell lines. Conclusion. The present study shows that RAs induce damage in cultured tubular cells, especially in hypoxic conditions. ROS were not involved in the observed RAs' cytotoxicity, and NAC increased ioxaglate-induced tubular damage. 相似文献
210.