Use of a tourniquet with and without adrenaline reduces blood loss during liposuction for lymphoedema of the arm

Sixty-two patients with lymphoedema of the arm after mastectomy and with hypertrophy of the adipose tissue were consecutively treated by liposuction in three different ways. The first group was operated on without the use of a tourniquet. In the second group, liposuction extended up to the distal edge of the tourniquet, and then into the proximal upper arm previously covered by the tourniquet using the ‘dry’ technique. Treatment of the third group was identical to that of the second one, but the area covered by the tourniquet was treated by the tumescent technique. Eighteen patients who did not have lymphoedema either treated or not treated with adrenaline served as a reference group to see how blood transfusions varied with various volumes of aspirate. Using a tourniquet significantly reduced blood loss and the number of transfusions, which was further reduced by tumescence. In the historical reference group, the number of blood transfusions increased as the volume of aspirate increased, and further if no adrenaline was added.     

A nickel–titanium memory-shape device for gastrojejunostomy: comparison of the compression anastomosis clip and a hand-sewn anastomosis

Background

The aim of this study was to evaluate the efficacy of a compression anastomosis clip (CAC) for gastrojejunostomy and comparison of a novel technique with a hand-sewn anastomosis.

Methods

Sixty-six patients underwent gastrojejunostomy with the CAC or hand-sewn anastomosis. The time of bowel function recovery, the duration of nasogastric drainage, the time of initiation of oral feeding, the duration of postoperative hospital stay, the time needed to expel the clip, and the observation of any complications were recorded.

Results

Neither group had anastomotic complications such as leakage or obstruction. Anastomosis time was shorter in the CAC group than in the control group (P < 0.01). The mean time of clip expulsion was 15.1 ± 6.04 d. There was no statistical difference in postoperative results between the two groups. There was a moderate positive correlation between the day of first bowel movement and the day of clip expulsion (r = 0.536) and a strong correlation between the duration of nasogastric drainage and the day of clip expulsion (r = 0.881).

Conclusions

The method of using a CAC appeared to be safe, easy, inexpensive, and less time consuming. It should be taken into consideration that intra-abdominal complications may cause delayed CAC expulsion.     

New dinuclear zinc(ii) complexes with Schiff bases obtained from o-phenylenediamine and their application as fluorescent materials in spin coating deposition

Two Zn(ii) complexes, K1 and K2, obtained from the template reaction of zinc(ii) acetate dihydrate with o-phenylenediamine and 2-hydroxy-5-methylisophthalaldehyde (K1) or 2-hydroxy-5-tert-butyl-1,3-benzenedicarboxaldehyde (K2), respectively, were characterized by X-ray crystallography, spectroscopic (UV-vis, fluorescence and IR), and thermal methods. In the complex [Zn₂(MeO)_1.4(OH)_0.6(L1)]·2H₂O K1, there are two binding sites in the macrocyclic ligand and they are occupied by zinc(ii) cations found in slightly distorted square pyramidal environment. The zinc(ii) cations are connected by slightly asymmetric oxo bridges with a Zn1–O14–Zn1[−x, −y + 1, −z + 1] angle of 104.8(2)°. In the dimer [Zn₂(CH₃COO)₂(L2)]·2EtOH K2, there are two crystallographically independent binding sites both occupied by zinc(ii) cations. There is a significant difference between both complexes, since in K1 only one site is independent and the second is occupied due to the application of symmetry rules, and the geometry of both sites is identical. Thin layers of the obtained Zn(ii) complexes were deposited on Si(111) by the spin coating method and studied by scanning electron microscopy (SEM/EDS), atomic force microscopy (AFM), fluorescence spectroscopy and ellipsometry. In the non-absorbing range, the value of the refractive index exhibits normal dispersion between 1.8 and 2.1 for K1_1–K1_3; and between 2.3 and 2.6 for the K2 series of samples established for long wavelengths (longer than 500 nm). The Zn(ii) complexes and their thin layers exhibited fluorescence between 534–573 nm and 495–572 nm for the compounds and the layers, respectively. The highest quantum yield of fluorescence was achieved for K2 in benzene and in the solid state ϕ = 0.78 and 0.58, respectively. The influence of the solvent polarity on the fluorescence properties of the obtained complexes was studied. Additionally, DFT calculations were performed to explain the structures and electronic spectral properties of the complexes.

Tin fluorescent materials were obtained using a spin coating method.     

Hepatic,Renal and Inflammatory Biomarkers are Positively Associated with Blood Pressure Changes in Healthy Pregnant Women: A Prospective Cohort

This article evaluates the association of hepatic, renal, and inflammatory biomarkers with changes in systolic (SBP) and diastolic (DBP) blood pressure (BP) during healthy pregnancies.A prospective cohort study with 225 healthy pregnant women was conducted in Rio de Janeiro, Brazil. SBP and DBP were evaluated throughout pregnancy (5th–13th, 20th–26th, and 30th–36th gestational weeks) and were the outcomes. The following biomarkers were measured at the first trimester and analyzed according to tertiles of the sample distribution and were considered the main independent predictors: alkaline phosphatase (ALP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), uric acid (UA), creatinine (Cr), and C-reactive protein (CRP) concentrations. The statistical analysis included 3 stages of modeling with the longitudinal linear mixed-effects procedures: Model 1 was adjusted for gestational age and quadratic gestational age; Model 2 included interactions between the biomarkers and gestational age; and Model 3 was adjusted for self-reported skin color, education, parity, early-pregnancy body mass index (BMI) (under/normal <25; overweight/obese ≥25 kg/m²), smoking habit, and leisure-time physical activity. Additional models were performed for CRP and UA with the inclusion of interaction terms between the biomarkers and BMI.Women classified in the third tertile of the ALP (≥61.1 U/L; β_SBP = 3.474; 95% confidence interval [CI]: 0.955–5.992; β_DBP = 3.291; 95% CI: 1.098–5.485), ALT (≥14.3 U/L; β_SBP = 2.232; 95% CI: 0.221–4.242; β_DBP = 2.355; 95% CI: 0.721–3.989), and Cr values (≥48.6 μmol/L; β_DBP = 1.927; 95% CI: 0.347–3.508) presented higher BP levels during pregnancy compared to those in the first and second tertiles. Women in the highest tertile of the ALP concentration distribution presented a lower rate of change in SBP and DBP during pregnancy (interaction term with gestational age β_SBP = −0.004; 95% CI: −0.007 to −0.001; P = 0.02; β_DBP = −0.003; 95% CI: −0.006 to −0.001; P = 0.01). Higher UA concentrations were associated with higher SBP levels only in overweight/obese women (β = 3.878; 95% CI: 0.687–7.068), whereas higher CRP concentrations (≥2.6 mg/L) were associated with higher DBP in under/normal weight women (β =2.252; 95% CI: 0.267–4.236).ALP, ALT, and Cr concentrations were positively associated with BP levels, whereas ALP was associated with a lower rate of change in BP. The associations of UA and CRP with BP differ according to the early-pregnancy BMI.     

Birth weight and adult bone mass: a systematic literature review

Summary  

This systematic literature review comprised 16 studies. The association of birth weight with bone parameters was much more evident for bone mineral content (BMC) rather than bone mineral density (BMD). This is an important finding since a reduction in BMC is strongly associated with an increased risk of fractures.     

Changing HCV genotypes distribution in Poland--relation to source and time of infection.

BACKGROUND: Understanding the distribution of HCV genotypes has implications for prognosis and therapy of hepatitis C. OBJECTIVES: To describe the distribution of HCV genotypes in Poland in relation to route of transmission and year of infection. STUDY DESIGN: Patients with chronic liver disease were evaluated at the Department of Infectious Diseases, Bialystok (Poland). HCV genotype was determined by means of 5'UTR sequencing and comparison with known sequences of particular genotypes. RESULTS: The genotypes mostly frequently detected were genotype 1 (57.5%); genotype 3 (31.3%); and genotype 4 (8.4%). Genotype 1 constituted the majority of HCV infections caused by blood transfusion (68.8%) and only 34.8% of HCV infections in the intravenous drug use (IVDU) group (p<0.05). In contrast genotype 3 constituted the majority of HCV infections in the IVDU group (56.5%). We observed a significant increase in the proportion of genotype 3 infections detected after 2000--from 19.1% to 38.9%. CONCLUSIONS: The relative proportion of genotype 1b in Poland has decreased and that of genotype 3a has increased, especially among IVDU.